Academic journal article Journal of Marital and Family Therapy

Emotionally Focused Therapy for Couples and Childhood Sexual Abuse Survivors

Academic journal article Journal of Marital and Family Therapy

Emotionally Focused Therapy for Couples and Childhood Sexual Abuse Survivors

Article excerpt

This study explored Emotionally Focused Therapy (EFT) for couples with childhood sexual abuse survivors (CSA) and their partners. Half of the couples in this study reported clinically significant increases in mean relationship satisfaction and clinically significant decreases in trauma symptoms, and thematic analyses identified numerous areas where trauma survivors were challenged in fully engaging in the therapy process. In particular, trauma symptoms such as affect dysregulation and hypervigilance were identified to play a role in the challenges that survivors experienced in fully engaging in the EFT process. Results of these thematic analyses yielded clinical recommendations for working with CSA survivors and their partners in EFT for traumatized couples. Recommendations for future study were articulated.

It is arguably one of the great miracles of our species that in the face of violation and terror, those who have been abused continue to seek out and long for connection with others. Researchers in psychology are only beginning to explore these miraculous connections and emphasize the need to assist those who have been violated to create and maintain these healing bonds.

The trauma literature has opined that trauma survivors should primarily focus on individual treatment with couple therapy only being offered at the completion of the individual work. This has left trauma survivors and their partners with nowhere to turn when their relationships are in distress. Therapists have also missed the opportunity to engage partners as allies in the healing process and to strengthen these important relationships.

There is, however, a growing awareness of the interpersonal context and impact of trauma. With this awareness has come a developing understanding of the importance of integrating systems of support into the trauma treatment process. In this vein, this study explored the use of Emotionally Focused Therapy (EFT) for couples dealing with childhood sexual abuse (CSA). In particular, the goals were to examine the ways in which EFT would aid couples in alleviating their relationship distress and help survivors deal with the aftereffects of their traumatic experience. This study is the first systematic, if exploratory, evaluation of any clinical couples' therapy for CSA survivors and their partners.

PSYCHOLOGIC SEQUELAE OF CSA

In a meta-analytic review, Neuman, Houskamp, Pollock, and Briere (1996) found a significant association between CSA and anxiety, anger, depression, revictimization, self-mutilation, sexual problems, substance abuse, suicidality, impairment of self-concept, interpersonal problems, obsessions and compulsions, dissociation, posttraumatic stress responses, and somatization. More recently, Paolucci, Genuis, and Violato (2001) conducted a meta-analysis and found significant associations between CSA and the following outcomes: posttraumatic stress disorder (PTSD), depression, suicide, sexual promiscuity, the victim-perpetrator cycle, and academic performance.

In a longitudinal study, Kendler et al. (2000) confirmed the findings of other cross-sectional studies that CSA twins had a significantly higher likelihood of developing lifetime psychopathology. Nelson et al. (2002) found that twins with a CSA history evidenced significantly increased levels of depression, suicide attempts, conduct disorders, substance dependence, rape, and divorce. Authors have also suggested that CSA acts as a general stress factor that amplifies the impact of later stressful life events (Horwitz, Widom, McLaughlin, & Raskin White, 2001).

Spataro and Müllen (2004) assessed the impact of CSA on survivors over 20 years. Survivors evidenced a three times greater risk of developing anxiety disorders and acute stress disorder than controls, and were diagnosed with five times higher rates of personality disorders than controls.

However, even in light of significant interpersonal violation, CSA survivors display a remarkable longing for relationships with others and for stable attachment relationships (Alien, Huntoon, Fultz, & Stein, 2001). …

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