Traumatic experience affects everything

One client, who I will call "Matias", was involved in a car accident abroad which caused the deaths of all four members of a family. He hated going to sleep, for he had terrible nightmares, replaying the accident night after night, each time being awoken by his own screams. His body was constantly tense and any reminder of the accident would cause him to "switch off" as though he was no longer occupying his body but looking down upon it from above. He felt helpless and unable to move forward, spending his days watching horror movies and playing computer games. On meeting Matias I was struck by how powerless he seemed; he behaved as though all his choices had been taken from him. In psychotherapy, it proved important that I helped him to see that he could take charge of his life again. I recognised his strengths and encouraged him to examine his options and make his own decisions. He felt safe to talk things through with me. Eventually he felt sturdy enough to experiment with finding a way of talking about the accident which enabled him to make sense of it and store it in his memory such that there was no longer a need for him to replay it each night. Finally, he could also remain present and grounded when reminded of the experience. 

Even though an abuser's behaviour can be intolerable, it is often too difficult to leave or to ask for help. This was the case for one client, who I shall refer to as "Martha", who grew very attached to her abusive boyfriend. His alcohol-fuelled, violent assaults left her in hospital with serious injuries on numerous occasions. Each time, she would leave him, then he would plead for her to return and promise to treat her well, then she would go back to him, only to experience yet another episode of horrific abuse. It took Martha a long time to trust me: it seemed as though she expected that I would also abuse her. She disclosed that this was not her first abusive relationship: she had survived multiple types of abuse from her first husband and had also been sexually abused by two of her brothers when she was a child. Childhood abuse often seems to set up the survivor for a repeating pattern of abuse in adulthood. Martha had to learn about the legacy of her brothers' behaviour, how it had stunted the growth of self-esteem and how she had been drawn to others who would treat her badly. It was a huge turning point in therapy when Martha decided to make a promise to herself that she would not return to her boyfriend. She kept her promise. Hers was a difficult journey, but with gentle encouragement from me and in the safety of my consulting room, she learned how she could have a different type of relationship and seek a partner who would treat her with loving kindness.