Not Trauma Alone

How is an individual to lead a comfortable, productive existence when he or she was never taught the skills necessary for effective living? Adult survivors of child abuse often face this dilemma. Instead of being nurtured as children and taught life-skills by their caregivers, child abuse survivors were subjected to a daily regimen of coercive control, contempt, rejection and emotional unresponsiveness. It is not surprising, therefore, that many survivors encounter difficulty adjusting from this type of damaging childhood atmosphere to one in which they have autonomy. This book addresses the particular problems associated with treating adult survivors of child abuse. Until now, psychotherapy for child abuse survivors often centered on the trauma of their abuse experiences. However, survivors frequently reveal a history suggesting it was not abuse trauma alone that created their difficulties, but growing up essentially alone - without the consistent emotional support and guidance needed for development of effective functioning. This book presents an alternative to trauma-focused treatment that, though effective for treatment of other forms of trauma, can induce deteriorated rather than improved functioning in survivors of prolonged childhood maltreatment. The contextual therapy presented in Not Trauma Alone delineates a psychotherapeutic approach that emphasizes helping survivors develop the capacities for effective functioning that were never transmitted to them during their formative years. Detailed descriptions of the methods and interventions comprising contextual therapy are included in this critical book for all mental health professionals, clinicians, academics, and students in the field.

Steven Gold

Forward. Preface. Part I: Abuse in Context: The Conceptual Framework. Abuse: The Trauma Model. Family: Beyond the Trauma Model. Alone: Growing Up in an Ineffective Family. Unprepared: The Legacy of an Ineffective Family Background. Impact: Intersecting Varieties of Abuse and Deficient Family Context. Society: Beyond Family Context. Part II: Treatment in Context: Foundations of the Therapeutic Model. Collaboration: Forming a Therapeutic Alliance. Conceptualization: Constructing Order from Chaos. Planning: Prioritizing Treatment Goals. Part III: Skills-Based Intervention: Implementation of the Therapeutic Model. Security: Managing and Modulating Distress. Focus: Fostering Experiential Presence and Continuity. Reasoning: Learning to Exercise Critical Thinking and Judgment. Coping: Breaking and Replacing Maladaptive Patterns. Liberation: Resolving the Trauma of Abuse. Transformation: The Miracle of Living Well. Part IV: Conclusion. Epilogue: The Inextricable Tie. References.