Child abuse is identified by the American Psychiatric Association as a formative trauma event for children. Left untreated, the negative impact and effect of these experiences can often wreak havoc when these children reach adulthood. Some abused children are more resilient than others and seem to manage. But no adult or teen who suffered from repeated child abuse, be it physical or emotional, escapes unharmed. For some, the emotional fallout can damage their lives. As adults, these individuals are left with many maladaptive behaviors. Some resort to drugs and/or alcohol, while others fail to make and sustain mature relationships. Other forms of potential fallout include severely damaged self-esteem, anxiety and/or depression, including suicidal thoughts or gestures, disassociation from feelings (not feeling anything) and chronic insecurity in trusting people. In my private work as a psychotherapist, I often help adults who have suffered from child abuse while growing up. Josh, a 29-year-old father of two young children, came to therapy after his wife threatened to leave him as a result of his physical reactions to his four-year-old son. On several occasions when the child had aroused Josh's anger, he had grabbed the child and shaken him, pushed him down or squeezed his body harshly. It was clear that Josh was very upset about his own behavior towards his son, and also worried that his wife would end their marriage if he didn't get help. Josh truly wanted my help to change his behavior. Fortunately, he had not completely crossed the line with his son – the youngster was more frightened of his father than physically hurt – and the behavior was still infrequent. But when this behavior happened, Josh was totally disconnected from himself and his reactions towards his child. He felt like something overtook him, and he was unable to understand where this reaction was coming from. I helped Josh understand that all parents get angry and frustrated with their children, but his anger clearly had serious and very real risk. From our discussions, I saw that Josh was experiencing a growing sense of losing control, and that he lacked the ability to identify his anger and prevent himself from reacting too harshly with his son. During my exploration of Josh's childhood, I learned that he was the oldest of three children. His mother had an explosive personality problem – it in fact sounded psychotic – and almost on a daily basis would scream, yell and hit him and his siblings. Josh's father was passive, and never interfered when his wife went on a rampage. He sounded like he was also afraid of her. Josh had developed what the child abuse literature calls “traumatic bonding.” This involves modeling both inappropriate parental behavior and maladaptive attachment dynamics. For example, when children are under the control of a violent and aggressive parent, such as Josh's mother, and the other parent is ineffectual at protecting the child, the natural need for parental attachment becomes confused. The child in this situation, out of both the need for love and the fear of repercussion from the abusing parent, may bond and even identify with this parent. This explains in part why the reaction to normal stressors in interactions with his son triggered in Josh a knee-jerk reaction to be overly physical towards his son. In therapy, Josh was taught to change his perceptions of what the meaning of his son's behavior was, and not to exaggerate and distort what the normal behavior of a four-year-old is supposed to be. He was taught relaxation techniques, and encouraged to exercise frequently to pump up the good chemicals in his brain that would help him to feel less vulnerable to parental stress. In addition, and perhaps most significantly, Josh was given insight about the dynamics at play in his personality that made him so vulnerable to repeat some of the behaviors that he was exposed to as a child. Couple sessions were very useful in keeping the flow of communication open and helping Josh's wife to support his therapy and growth. It takes courage to face the emotional demons that haunt and affect an adult who underwent child abuse during his or her childhood. It takes time and a very trustful therapeutic relationship, but the journey is worth the effort. People like Josh can be helped to feel more in control of their anger, work out emotional pain and enjoy their role as parents. The writer is a marital, child and adult psychotherapist with offices in Jerusalem and Ra'anana; he also provides online videoconferencing psychotherapy. drmikegropper@gmail.com
