For years, when I was reading the research on childhood sexual abuse and PTSD, the research cannot define it is the “abuse” or “lack of care/concern from the caregiver” causing PTSD. That is, we don’t know whether it is the “abuse” itself causing PTSD, or it is because the adult didn’t provide the protection that caused PTSD.
Now, it is very clear why you can’t identify which one. Abuse itself caused the arousal but the lack of protection and/or comfort from the adults, both contributed to the memory unprocessed. If the child told the adults and the adults neglected it, it certainly created another chain of memories that were not processed. Abuse itself certainly caused the physical arousal, cognitive and emotional reaction. However, without the adult to assist the child to comprehend or to calm down from the arousal, especially, if the the adults know about the abuse and not doing anything about it, the caregiver is tied into the memory chain in the abuse.
For years, I insisted that I will meet with my clients at the same time and same day on the weekly basis for the first 12 weeks, at least. If for whatever reasons they cannot commit to the same time and same day during the week, we still have to meet on the weekly basis in the first three months.
It is very hard for me to remember how this principle coming from. My guess is that I adopted this principle from two books I read about working families with childhood sexual abuse victims (see the footnote) earlier in my career. Then, it worked! I have been able to retain my clients as well as to see the tremendous progress in my clients in the first 3 months.
Another important ingredients of my clients’ progress is called “empathy.” As I progressed to become more experienced therapist, I found my ability to be empathetic has increased tremendously. Majority of the time, when I was able to catch what clients are really trying to tell me as if I can see their images in their heads, the responses from them were astonishing.
“Oh My God, how do you know? That is exactly how I feel!”
“I felt much better to hear yo say that!”
After taking the EMDR and understand “unprocessed thoughts,” this makes sense now. Week after week, the same time and the same place, the clients brain are conditioned to receive the stimulation to process the “unprocessed thoughts.” After we talked about those thoughts, especially the traumatic events and I can be that empathetic about their physical arousals, emotions, and thoughts as if I was at the same place to experience with them, they received the comfort that were not provided to them at the time. The physical arousal calmed down and unprocessed thoughts and emotions have a place to go. Of course they are going to feel better.
(to be continued)