Psychotherapy for Trauma: Addressing Childhood Sexual Abuse's Impact - Report Example

Introduction

Generally, psychotherapy, also known as talk therapy, refers to a way of helping people with various emotional difficulties and mental illnesses control or eliminate troubling symptoms to improve their functioning and enhance their well-being (Fall et al., 2017). The impact of trauma, such as that arising from childhood sexual abuse and rape, is among the problems addressed using psychotherapy (Schnurr, 2017). Childhood sexual abuse refers to any sexual contact between an adult, or an older person, and a child (Baytunca et al., 2017). It can involve touching or overt sexual contact (Shevlin et al., 2018). Statistics show that between 8% and 12% of children and adolescents are sexually abused in the United States (Hanson & Wallis, 2018).

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Moreover, since the data largely relies on reported cases, it is thought that the statistics are underestimates. Studies have linked childhood sexual abuse and rape to several acute and long-term physical and psychological problems such as posttraumatic stress disorder (PTSD), depression, sexual revictimization later in life, as well as substance abuse (Batool & Abtahi, 2017). Therefore, treatment is critical for victims of childhood sexual abuse experiencing such mental health problems (Sawrikar & Katz, 2017). Different types of psychotherapy, with varying levels of effectiveness, exist. At times, psychotherapy is also used in combination with other therapies and medications (Kamenov et al., 2017). Eye Movement Desensitization and Reprocessing (EMDR) therapy and sensorimotor psychotherapy are some of the common trauma treatments for childhood sexual abuse and rape. This paper seeks to discuss these treatments and compare them in terms of theory and application.

EMDR

This therapy uses interactive psychotherapy techniques to relieve psychological stress (Shapiro, 2018). It is mostly used in the treatment of PTSD, one of the long-term effects of childhood sexual abuse and rape. It is also used to treat anxiety, depression, eating disorders, panic attacks, and addictions (Wilson et al., 2018). Using this therapy, the victim relives the traumatic experiences as the therapist directs their eye movements (Shapiro et al., 2017). It has been shown that recalling distressing events while one’s attention is diverted makes it less upsetting emotionally (Novo et al., 2018). EMDR, therefore, is effective since it exposes the victim to their thoughts and memories without eliciting a strong psychological response (Balbo et al., 2019). When done over time, the technique helps reduce the impact of the victim’s memories. Generally, EMDR is divided into eight phases, and hence one needs to attend multiple sessions (Shapiro & Eye Movement Desensitization, 2016).

The first three phases mainly involve preparation for the therapy. The therapist reviews the history of the victim, identifies potential traumatic memories, and decides on the treatment technique to use (Shapiro & Eye Movement Desensitization, 2016). Besides, the therapist settles on the associated components to be used in stimulating specific memories. The victim is also taught different stress management techniques like mindfulness and deep breathing to help them cope with the therapy (Tounsi et al., 2017). Treatment is done from the fourth to the seventh phase. During the sessions, the victim is asked to focus on the negative thought, image, or memory. At the same time, the therapist asks the victim to perform certain eye movements. Bilateral stimulation can also involve taps and other movements (Amano & Toichi, 2016).

Following the bilateral stimulation, the victim is asked to let their mind go blank and then identify the spontaneous feelings and thoughts they get. After identifying these thoughts, the therapist asks the client to refocus on the traumatic memory. In instances where the victim becomes distressed, they are brought back to the present before focusing on another traumatic memory (Shapiro & Eye Movement Desensitization, 2016). Over the course of the session, the distress associated with the traumatic memories, thoughts, or events fade away (Landin-Romero et al., 2018). In the final phase, both the victim and the therapist evaluate the progress.

Effectiveness of EMDR

Different studies have confirmed that EMDR is effective in the treatment of PTSD (Karadag et al., 2020). Increasingly, research is showing that the effectiveness of the treatment, especially regarding PTSD, improves with an increase in the frequency of treatment (Bongaerts et al., 2017). Besides, no records of worsening of symptoms resulting from the treatment have been made. As such, an intensive treatment program using EMDR is a safe and effective option to address PTSD in survivors of childhood sexual abuse (de Jongh et al., 2019). Moreover, studies have shown that the rate of dropouts is lower in EMDR as compared to other psychotherapy treatments (Bongaerts et al., 2017). EMDR has also been found to be effective, for both children and adults, in rape crisis centers (Edmond et al., 2016). Other than PTSD, EMDR has also been shown to help reduce other trauma-related symptoms in children (Beer, 2018). Since the treatment involves the client in their own healing, often with minimal interference from the therapist, the survivors get empowered (Siegel, 2018). However, regardless of its effectiveness, the rate of usage of the intervention is low, particularly due to uncertainty and lack of familiarity among therapists (Edmond et al., 2016). Therefore, there is a need for more training in this area (Madere et al., 2020).

Sensorimotor Psychotherapy

In some instances, words are not sufficient to heal a victim of childhood sexual abuse, and hence a somatic approach is taken. While the former utilizes the client’s words to treat them, the latter utilizes the bodily experiences of the client to enhance their awareness and mental health (Mahajan, 2018). Sensorimotor psychotherapy can be defined as a body-based talk intervention that combines neuroscience, somatic therapies, cognitive applications, and attachment theory to transform one’s memories into resources and strengths (Murphy, 2017). This intervention uses the connection between one’s psychological concerns and their bodily dissociations (Scheffers et al., 2017). It helps a victim somatically examine the effect that past traumatic experiences are having on them (Stigne et al., 2020).

This therapy is anchored on the belief that traumatic experiences get trapped in the victim’s body (Fisher, 2019). In some instances, the victims are entirely unaware of the unresolved trauma. Such unconscious issues may not be revealed using conventional talk therapy. The therapy makes the victim re-experience the traumatic memories in a safe environment. They are also allowed to carry out any unfulfilled actions to give a feeling of closure and completion. Though the progression of the therapy largely depends on the needs of the client and the training of the therapist, it generally consists of three steps.

The first step involves the creation of a safe place. A safer setting helps the client focus on their impulses, movements, and sensations better. It also helps identify the response of the body to specific thoughts, memories, and emotions (May-Benson & Teasdale, 2019). Where the client is ready to speak, the therapist asks them to talk about the traumatic experience. This second step helps connect the incident to any bodily or emotional responses seen during the session. Finally, the therapist helps the client complete any action or movement that was left uncompleted in the past. Resultantly, the client gets a feeling of triumph that helps them overcome traumatic memories and fears (Mulloy, 2019).

Effectiveness of Sensorimotor Psychotherapy

This therapy has been shown to help victims of childhood sexual abuse develop greater control over trauma-related triggers. It also increases their awareness of the different ways in which trauma affects their minds and bodies. Moreover, they learn to distinguish between the past and present and also pay greater attention to somatic experiences and personal thoughts without being overrun by the past traumatic event. Past studies have revealed that sensorimotor psychotherapy helps improve PTSD symptoms, depression, as well as the overall health of victims of childhood sexual abuse (Gene-Cos et al., 2016).

Comparison

As seen in the discussion above, both interventions have been proven to be effective in the treatment of trauma arising from childhood sexual abuse. However, the two treatments are based on different theoretical foundations. Their application is also different. EMDR is basically a talk-therapy that makes the victim relive their traumatic experience using words. The ultimate goal of the therapy is to help the victim identify the traumatic experiences and hence learn to overcome them. In contrast, sensorimotor psychotherapy uses a somatic approach to help the victim relive the traumatic experiences. It helps them unearth any unconscious trauma and complete any action that was truncated during the traumatic event. Ultimately, the victims gain greater control over trauma-triggers. In EMDR, the therapist uses eye movements as well as other bilateral stimulation such as taps and movements to emotionally divert the patient from the traumatic memories and experiences running through their mind. This move is meant to prevent a strong psychological response. Sensorimotor psychotherapy, on its sides, depends on the creation of a safe place to help the client relive their traumatic experiences and focus on them better.

Conclusion

As shown in the discussion, childhood sexual abuse remains a major issue in society. The vice has several long-term effects on the physical and psychological well-being of the victim. To enhance the quality of their lives, treatment is needed. EMDR and sensorimotor psychotherapy are among the treatments available for childhood sexual abuse victims. Past studies have confirmed the effectiveness of both interventions. However, there exist differences in their theoretical foundations and applications. For instance, while EMDR takes a talk-based technique, sensorimotor psychotherapy utilizes a somatic approach. Besides, while EMDR depends on eye movements and other bilateral stimulations, sensorimotor psychotherapy relies on the creation of a safe space. Owing to their effectiveness, these treatments should be incorporated into the care of victims of childhood sexual abuse.

Reference List

Amano, T. & Toichi, M., 2016. The role of alternating bilateral stimulation in establishing positive cognition in EMDR therapy: A multi-channel near-infrared spectroscopy study. PloS one, 11(10), p. e0162735.

Balbo, M., Cavallo, F. & Fernandez, I., 2019. Integrating EMDR in psychotherapy. Journal of Psychotherapy Integration, 29(1), p. 23.

Batool, S. S. & Abtahi, A., 2017. Psychosocial impact of childhood sexual abuse: Perspective of victims. Journal of Arts and Social Sciences, 4(2), pp. 36-48.

Baytunca, M. B. et al., 2017. Childhood sexual abuse and supportive factors. Pediatrics international, 59(1), pp. 10-15.