May 23, 2003
Counseling People Who Were Sexually Abused: An Approach Based on Morita and Naikan Therapies
by Judy LeClair
In ten years of working with women who have experienced sexual abuse, I have used many different methods. Yet, since my introduction to Japanese Psychology (specifically Morita and Naikan therapy) my approach and the clients' results have changed dramatically.
Sexual abuse happens to many women, children and men daily. Estimates are that as many as one in three people will be sexually assaulted at some time in their lives. Other literature indicates that one in two is a more realistic estimate for women. This appals me as it does most people. I applaud the work of those who have spent years exposing this tragic phenomenon, those who continue to work to change the criminal justice system and those who are painstakingly educating all of us about treating each other in a respectful way. However, I think that statistics of the nature cited above can be misleading since they could lead one to believe that a non-consensual touch of a sexual nature, forced anal rape at knife-point and anything in between these two extremes can be classified under the same category. Clearly, what we call sexual abuse or sexual assault is not just one thing, as statistics may imply. So we should not assume that victims of such varied offenses can be lumped into one category for evaluation or treatment.
Conventional wisdom suggests that sexual abuse is the root of most of its victims' subsequent behavior. Such a theory is vague and can leave the impression that all sexual abuse is traumatizing to all who experience it and that all people who have been sexually abused consider it the central problem in their lives.
It can also suggest to someone who has been sexually abused that unless she undergoes long-term treatment in which she will be required to talk about the details of her abuse, presumably to understand the supposed causes of her behavior, she may be unable to lead a satisfying life.
Life experience teaches us that feelings fade over time unless they are restimulated (Reynolds, 1984). I have had clients come to my office shaking with fear because they expect me to have them recount the details of their abuse experience(s). One client said that the evening before her assessment interview she thought about committing suicide rather than have to tell the details of her childhood sexual abuse. It took me a while to assure her that this would never be required of her, nor did I think it was necessary.
Surprisingly, this may not satisfy those seeking conventional therapy. Last year after I had conducted a 12 week group for "sexual abuse/incest survivors" I asked the participants for some feedback. One women said that she learned much and had a lot of fun, but she added that she would not return because she hadn't experienced enough pain to have done any real "healing".
The Language of "Healing"
In the previous paragraph I used the terms sexual abuse survivors and healing in quotes. I rarely use these terms anymore but they are part of the dominant language in the therapeutic field.
I do not call my clients sexual abuse survivors simply because sexual abuse or incest is something that happens to people. It is not who they are. My clients, like all of us, are people who have experienced many things in their lives and have survived them all.
Healing is a buzzword used in many contexts these days. It suggests sickness or damage which needs to be fixed. It also has medical connotations. I do not see my clients as sick, damaged or in need of being fixed. I see them as people who need new information, skills, and some experience of success in certain areas of their lives. In many areas of their lives they're doing fine.
In my experience, people who have been sexually abused as children and people who have not share many of the same characteristics. Most of those who have been sexually abused seek counseling for help with parenting, relationships, sexual problems, loneliness, fears, anxiety, nightmares, substance abuse, and problems with extended family. Yet many of these same issues surface at one time or another for those who have no history of sexual abuse.
I have discovered in applying Morita-based principles (i.e. Accept your feelings, Know your purpose, Do what needs to be done) that while sexual abuse and memories of sexual abuse can be very painful, they do not necessarily have to continue to plague one's life indefinitely. When women stop trying to control their thoughts and feelings about their abuse they often experience great relief from their suffering.
"I was so shy and too scared to try anything. Once I started doing one small new thing a day I discovered that I could do two new things or three. Now when I experience that narrow, closed-in feeling, I start doing small new things and sometimes even after the first one that feeling goes away. Sometimes it takes a few days of doing new things. It depends on how long I let myself wallow in the narrow, closed-in feelings."
Early in my work, I thought it was necessary to have the client talk about the details of the abuse and to get the client in touch with her feelings about it. It was assumed that to cope as a child she had to dissociate from her feelings or "bury" them. What I found was clients were all too much in touch with certain thoughts and feelings about the past and out of touch with many other elements of their past and present. Attention was often focused on how no one cared for them in the past and into the present. They ignored the efforts of a caring aunt, a grandfather who took them to ball games, or a teacher who payed special attention to them. They take for granted a husband who drives them to their appointment, watches the kids in the waiting room and takes the family for ice cream on the way home. These experiences provide realistic context and balance to those parts of their lives that were, or are, miserable. Many clients lived their day to day lives as if it were the most miserable part of their past. Using Naikan-like assignments with clients, many now recognize that life is not all tragic, even in homes where a lot of abuse may have taken place.
"You know he was very mean in many ways, but doing Naikan (reflection) helped me remember how he used to take us all on picnics and make Sunday lunches after church. Once he bought me a present on his birthday. Looking back, I know there wasn't enough money for a present for him and one for me. He still does many kind and helpful things for me."
This of course is not intended to excuse anyone for abuses they may have visited upon their children. What it does for the client is to give her some realistic way of seeing her past. We tend to see things in black and white terms, as either all bad or all good, and we tend to focus much of our available attention on the bad at times. This is skewed and is not a true picture of our lives. Morita and Naikan therapies focus on seeing reality -- not just the pleasant or unpleasant parts of reality. Unlike many popular forms of therapy, it is not concerned with establishing who is/was right or wrong, but simply with opening up more balanced and realistic perspectives.
Many of the current methods of treating the thoughts and feelings of those sexually abused as children actually increase attention to the thoughts and feelings. The client is encouraged to express her emotions, to lay the blame at the feet of the abuser, to mourn the loss of her childhood, to confront those who did not protect her, etc. Many clients have been thrown into crisis by such unhealthy shifts of attention.
People are generally interested in working with issues that effect their present life. Often when clients do speak of their past painful experiences, feelings associated with those experiences are stimulated. Speaking about past painful experiences may help some people, but focusing on them for an extended period of time can prolong suffering and distort the past.
Working With What's Controllable
One of the great gifts Morita Therapy offers my clients is the knowledge that one cannot control one's thoughts and feelings by an act of will. Clients are relieved to know that they are not responsible for feeling hatred, anger, love, or fear. They did not create the feelings and neither are they responsible for them. Most are also relieved to know they are not responsible for their thoughts and that thoughts do not have any deep and significant hidden meaning. For example, we may get frustrated with our child who has been misbehaving all day long and the thought of hitting the child or worse comes to mind. We are not responsible for the content of that thought. It does not mean we are a bad parent or a potential child abuser as long -- as we don't act on it.
"Because I had feelings of revulsion when my child would come for a hug, I thought that I was a rotten parent. I realized that I could not control those feelings and tried hugging him despite my feelings and focused my attention on what he felt like in my arms, on my breathing, on the smell of his hair, slowly over time, those feelings of revulsion began to lessen. Now they do come back from time to time. That's when I have to take it slow and pay very close attention to what else is going on besides the feelings of revulsion. It was as if those feelings were the only thing that was happening in the world. Now it's like when they are there, there are also lots of other things there as well and I have a choice about what I focus on."
Since one cannot control the thoughts, feelings or the actions of others, we are not responsible for them. Yet some people believe we are responsible for the feelings, thoughts and behaviors of others and waste countless years of their lives trying to control what others think, feel and do. Since these tasks are impossible, responses can range from mild annoyance to frustration to feelings of absolute powerlessness. Actions based on these feelings can make our lives and the lives of those around us quite miserable, adding suffering to suffering. It is surprising to many people that all we control in our lives is our own behavior.
"I used to get so frustrated with myself for feeling scared all the time. I'd try so hard not to be scared. I'd pretend I was not scared, I'd call myself a wimp, but of course I would still feel scared. I spent so much time feeling scared and trying not to I didn't do much of anything else. In fact feeling scared of new people, of new places, of men was a great excuse not to put myself in many situations. Now I realize that I can't control feeling scared I can only control what I do when I feel scared."
Once an individual begins applying the principles of Morita Therapy and experiences the fruits of controlling the controllable, there is little time to waste ruminating about the past or the unpleasant parts of our present situation. As one of my clients so aptly put it:
"Once I stopped nagging my husband about what he was doing wrong and started doing my very best in the relationship, he changed. Magic!"
It's not exactly magic, but controlling the controllable, our behavior, often effects the behavior of others in unpredictable ways.
For anyone who has opened a newspaper, turned on the television or radio or who has watched films in the past few years, there is ample information about sexual abuse, those who abuse, those who have been abused, the effects of sexual abuse on its victims and the "healing process".
People who have been sexually abused see media coverage of "their" experience, and it can be prescriptive. By the time the person reaches my office, her self-image as a "survivor" has been heavily influenced by the media and what has been read in self-help and therapeutic literature.
In the early stages of each therapy group, I ask participants to describe a typical "incest survivor". Usually they say things like:
can't parent angry can't have intimate relationships drinks too much takes drugs frigid oversexed frightened of men hates men psycho afraid of people has panic attacks too sensitive abnormal
This is how some participants see themselves. Qualities which might be considered valuable or positive are ignored. This negative self-concept and the narrow range of expectations that go along with it, coupled with what we are told is necessary to "heal" after sexual abuse, can be a recipe for great suffering and a long, painful and protracted recovery period (another expectation of many clients). Conventional approaches which create a survivor identity segregate such individuals from the rest of society and keep them handcuffed to their past. We should ask "who benefits from such methods?"
Everyone has thoughts, memories, dreams and feelings about the past from time to time. However, when we are living more constructively, life begins to open beyond the past. Morita's principles help us to accept our feelings, know our purpose and do what needs to be done in the present moment. Naikan teaches us to focus more on what we received as children and are now receiving as adults.
Applying Morita and Naikan therapies, much of the pain and anguish experienced by those in mainstream, feeling-centered therapies is unnecessary and some enjoyable constructive work can be done. That is not to say that this work is never difficult. Past memories and feelings still surface. Accepting this and working mainly with the client's present behavior she begins to see herself as an active participant in her life and not as a victim of past circumstances. Her feelings about herself and the world change as a function of her life changing. This is empowerment.
Judy LeClair has ten years clinical experience treating those who were sexually abused as children. She has worked in half-way houses, women's shelters, in and out-patient psychiatric services, crisis centers, rural community mental health programs and in private practice. She holds a Master of Social Work Degree and is Certified by the Ontario College of Professional Social Workers. Judy was certified CL Instructor by the ToDo Institute in Vermont and also received her Neuro Linguistic Programming practitioners' certificate in the summer of l993. She is presently employed as a therapist in rural Ontario.Posted on May 23, 2003 4:51 PM