Academic journal article Journal of Cognitive Psychotherapy

Creation of Meaning in Incest Survivors

Academic journal article Journal of Cognitive Psychotherapy

Creation of Meaning in Incest Survivors

Article excerpt

This paper describes an integrated constructivist treatment for addressing creation of meaning issues in incest survivors. The treatment involves the reaccessing and reprocessing of emotional schemata. It is compared to a cognitive restructuring treatment which considers issues of meaning as faulty beliefs which must be corrected by logical analysis and replacement. A preliminary treatment study found a significant increase in meaning resolution in incest survivors who were offered the integrated treatment approach. No changes were found on self-esteem.

Among the clinical sequalae of trauma, including the trauma of childhood sexual abuse, is the shattering of the victim's perception of living in an orderly, meaningful world (Horowitz, 1986; van der Kolk, 1987; Janoff & Bulman, 1987; Courtois, 1988). A study of a non-clinical sample of 77 adult female incest survivors found that 80% reported that they were still searching for meaning, or a way to "make sense" of their incest experience many years after its occurrence. Fewer than 10% reported that they were not presently searching for meaning (Silver, Boon & Stones, 1983). The ability to find meaning in one's victimization appears to facilitate effective coping (Silver, Boon, & Stones, 1983; Horowitz, 1986). Women who were able to make some sense of their incest experience reported less psychological distress, better social adjustment, and higher levels of self esteem than those who were were still searching (Silver, Boon, & Stones, 1983).

Creation of meaning issues in trauma survivors usually have been included as part of a general treatment plan directed at overall improvement (e.g. Horowitz, 1986). One specific approach related to meaning issues is the treatment of distorted beliefs with interventions drawn from cognitive therapy. Jehu, Klassen, & Gazan (1986) found clinically and statistically significant improvement in the beliefs and mood states of 11 childhood sexual abuse survivors who were treated with cognitive restructuring.

The premise of cognitive restructuring is that beliefs are prior to and influence feelings and lead to particular behavior (Beck, 1976). The application of this premise to issues of meaning in incest survivors leads to the analysis that women have formed distorted or unrealistic beliefs as a result of their trauma experience. By becoming aware of these beliefs and correcting them by a logical and realistic appraisal, feelings and behavior will change (Jehu, Klassen, & Gazan, 1986).

An alternative view of the relationship between beliefs, feelings, and behavior is that they are essentially fused and not necessarily sequential in occurrence (Leventhal, 1979). This perspective does not consider emotion as an epiphenomenon or "noise in the system" to be eliminated so that correct or rational beliefs can effectively guide behavior. Instead, emotion is considered to be an intuitive appraisal of experience and thus an important source of adaptive information (Arnold, 1960). The element of appraisal points to the constructivist flavor of this view of emotion (Kelly, 1955).

Greenberg & Safran (1987) have extended this view and proposed treating emotion as a series of information processing tasks. Emotion is not a "feeling" that simply appears on the scene, but a complex phenomenon that must be acknowledged, accessed, and the meaning of it created. Other emotional tasks include expressing, modifying and taking responsibility for emotion.

The application of this approach to emotion to meaning issues in survivors of trauma is that they have experienced certain emotions at the time of the assaults) and that these emotions contain appraisals or construals of the meaning of the experience. These construals are usually highly intuitive, preconscious, and often out of the awareness of the individual. An integrated, constructivist treatment, based on these premises and an information processing approach, considers unresolved meaning issues to require a reprocessing of emotional experience. …

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