Childhood Abuse Discussion Essay Paper

Childhood Abuse Discussion Essay Paper

Instructions/Descriptions

Childhood Abuse Discussion Essay Paper

Background Miriam often spoke in a flat voice, seemingly disconnected from her feelings and even from any sense of the meaningfulness of her sentences. She had survived terrifying and degrading childhood abuse, and now, some 35 years after leaving home, she had the haunted, pinched look of someone who expected the abuse to begin again at any moment. She could not even say that she wanted therapy for herself because she claimed not to want or need people in her life. She thought that being in therapy could help her to develop her skills as a consultant more fully. Miriam was quite wary of therapy, but she had attended a lecture given by the therapist and had felt a slight glimmer of hope that this particular therapist might actually be able to understand her.

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Miriam’s experiential world was characterized by extreme isolation. She was ashamed of her isolation, but it made her feel safe. When she moved about in the world of people, she felt terrified, often enraged, and deeply ashamed. She was unrelentingly self-critical. She believed she was a toxic presence, unwillingly destructive of others. She was unable to acknowledge wants or needs of her own because such an acknowledgment made her vulnerable and (in her words) a “target” for humiliation and annihilation. Finally, she was plagued by a sense of unreality. She never knew whether what she thought or perceived was “real” or imagined. She knew nothing of what she felt, believed that she had no feelings, and did not even know what a feeling was.

At times, these convictions were so strong that she fantasized she was an alien. Miriam’s fundamental conflicts revolved around the polarity of isolation versus confluence. Although she was at most times too ashamed of her desires to even recognize them, when her wish to be connected to others became figural, she was overcome with dread. She recognized that she wanted to just “melt” into the other person, and she could not bear even a hint of distance, for the distance signaled rejection, which she believed would be unbearable to her. She was rigidly entrenched in her isolated world. A consequence of her rigidity was that she was unable to flow back and forth in a rhythm of contact and withdrawal.

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The only way she could regulate the states of tension and anxiety that emerged as she dared to move toward contact with the therapist and others was to suddenly shrink back in shame, retreat into isolation, or become dissociated, which happened quite often. Then she would feel stuck, too ashamed and defeated to dare to venture forward again. She was unable to balance and calibrate the experience of desiring contact while at the same time being afraid of contact. The following sequence occurred about four years into therapy. Miriam was much better at this point in being able to identify with and express feeling, but navigating a contact boundary with another person was still daunting.

She had begun this session with a deep sense of pleasure because she finally felt a sense of continuity with the therapist, and she reported that for the first time in her life she was also connected to some memories. The air of celebration gave way to desperation and panic later as therapist and patient struggled together with her wishes and fears for a closer connection to the therapist. In a conversation that had been repeated at various times, Miriam’s desperation grew as she wanted the therapist to “just reach past” her fear, to touch the tiny, disheveled, and lonely “cave girl” who hid inside. Miriam felt abandoned by the therapist’s “patience” (Miriam’s word).

P: You’re so damn patient!

T: . . . and this is a bad thing? [Said tentatively.]

P: Right now it is. Because you need . . .

P: [Pause.] Something that indicates something. [Sounding frightened and exasperated, and confused.]

T: What does my patience indicate to you right now?

P: That I am just going to be left scrambling forever!

T: It sounds like I am watching from too far away—rather than going through this with you—does that sound right?

P: Sounds right . . .

T: So you need something from me that indicates we will get through this together, that I won’t just let you drown. [Said softly and seriously.]

A few minutes later, the exploration of her need for contact and her fear had continued, with Miriam even admitting to a wish to be touched physically, which was a big admission for her to make. Once again, Miriam started to panic. She was panicked with fear of what may happen now that she has exposed her wish to be touched. She feared the vulnerability of allowing the touch, and she was also panicky about being rejected or cruelly abandoned. The therapist had been emphasizing that Miriam’s wish for contact is but one side of the conflict, and that the other side, her fear, needed to be respected as well. The patient was experiencing the therapist’s caution as an abandonment, whereas the therapist was concerned that “just reaching past” the patient’s fear would reenact a boundary violation and would trigger greater dissociation.

T: . . .so, we need to honor both your fear and your wish. [Miriam looks frightened, on the verge of dissociating.] . . . now you are moving into a panic—speak to me . . .

P: [Agonized whisper.] It’s too much.

T: [Softly.] Yeah, too much . . . what’s that . . . “it’s too much”?

P: Somehow if you touch me I will disappear. And I don’t want to—I want to—I want to use touch to connect, not to disappear!

T: Right, OK, so the fear side of you is saying that the risk in touching is that you’ll disappear. Now we have to take that fear into account. And I have a suggestion— that I will move and we sit so that our fingertips can be just an inch or so from each other—and see how that feels to you. Do you want to try? [Therapist moves as patient nods assent. Miriam is still contorted with fear and desperation.] Okay, now, I am going to touch one of your fingers—keep breathing— how is that?

P: [Crying] How touch-phobic I am! I shift between “it feels nice” and “it feels horrid!”

T: That is why we have to take this slowly. . . . Do you understand t h a t . . . if we didn’t take it slowly you would have to disappear—the horror would make you have to disappear [all spoken slowly and carefully and quietly] . . . do you understand t h a t . . . so it’s worth going slowly . . . your fingers feel to me . . . full of feeling?

P: Yes . . . as if all my life is in my fingers . . . not disappeared here, warm . . . The patient attended a weeklong workshop the next week, after which she reported, with a sense of awe, that she had stayed “in her body” for the whole week, even when being touched.

After this session, the patient reported that she felt a greater sense of continuity, and as we continued to build on it (even the notion of being able to “build” is new and exciting), she felt less brittle, more open, more “in touch.” As more time has passed, and we continued to work together several times per week, long-standing concerns about feeling alien and about being severely dissociated and fragmented began to be resolved. The patient felt increasingly human, able to engage more freely in intimate participation with others.

S U M M A R Y

Gestalt therapy is a system of psychotherapy that is philosophically and historically linked to Gestalt psychology, field theory, existentialism, and phenomenology. Fritz Peris and his wife, Laura Peris, and their collaborator, Paul Goodman, initially developed and described the basic principles of Gestalt therapy. Gestalt therapists focus on contact, conscious awareness, and experimentation. There is a consistent emphasis on the present moment and on the validity and reality of the patient’s phenomenological awareness.

Most of the change that occurs in Gestalt therapy results from an I-Thou dialogue between therapist and patient, and Gestalt therapists are encouraged to be self-disclosing and candid, about both their personal history and their feelings in therapy. The techniques of Gestalt therapy include focusing exercises, enactment, creative expression, mental experiments, guided fantasy, imagery, and body awareness.

However, these techniques themselves are relatively insignificant and are only the tools traditionally employed by Gestalt therapists. Any mechanism consistent with the theory of Gestalt therapy can and will be used in therapy. Therapeutic practice is in turmoil in a time when the limitations associated with managed care have encroached on clinical practice. At a time of humanistic growth in theorizing, clinical practice seems to be narrowing, with more focus on particular symptoms and an emphasis on people as products who can be fixed by following the instructions in a procedure manual. The wonderful array of Gestalt-originated techniques for which Gestalt therapy is famous can be easily misused for just such a purpose.

We caution the reader not to confuse the use of technique for symptom removal, however imaginative, with Gestalt therapy. The fundamental precepts of Gestalt therapy, including the paradoxical theory of change, are thoroughly geared toward the development of human freedom, not human conformity; in that sense, Gestalt therapy rejects the view of persons implied in the managed care ethos. Gestalt practice, when true to its principles, is a protest against the reductionism of mere symptom removal and adjustment; it is a protest for a client’s right to develop fully enough to be able to make conscious and informed choices that shape her or his life. Because Gestalt therapy is so flexible, creative, and direct, it is very adaptable to both short- and long-term therapies. The direct contact, focus, and experimentation can sometimes result in important insight. This adaptability is an asset in dealing with managed care and related issues of funding mental-health treatment.

The Assignment

For  this assignment, you will draft a formal, academic essay in MLA format  that details an argument about your selected topic. You will use the  outline from the previous assignment as a guide, but you can make  modifications to your thesis and argument as necessary.

Here are the basic requirements for your essay:

(1) Your essay must be 4-5 pages in MLA format with an additional Works Cited page.

(2) You  must use at least 4 sources in this essay, two of which MUST be  academic journal articles. The other two may be journal articles or  other credible, academic sources.

(3) Your  essay must be organized with a formal structure, developed with  concrete evidence and analysis, documented in appropriate, ethical MLA  style, and written with a formal, clear style.

Please use the following guidelines to help develop a successful essay:

(1)  Your essay should begin with an introduction that introduces the topic  and ends with a strong thesis. Your thesis should state your argument  and its major reasons in a clear, concise manner. Think of it as a  mini-map of your paper for a reader.

(2)  Then, you should include a background paragraph that offers your reader  more information about the topic and its current debate (or relevant  history). Make sure your reader is clear about the exigence of the  argument; in other words, why does this argument matter NOW?

(3)  After, you should include two to four paragraphs that identify your two  to four major reasons. Each paragraph should have a clear topic  sentence that links back to the thesis, and you should support each body  paragraph with sufficient, credible evidence and analysis.

(4)  Before you conclude, please add a Refutation of Opposing Arguments,  where you will present the opposing side or potential obstacles and  offer a refutation in order to convince your reader and eliminate bias.

(5) Finally, compose a conclusion paragraph that ties all of your paper’s points together and argues an overall significance.

(6)  Each body paragraph should include concrete evidence from research. You  should integrate your research smoothly and ethically. Use identifying  tags to introduce your sources and show your reader an outside idea.  Always analyze the significance of the research before you move on to  the next point! Example: In Jason Ree’s article, he notes that, “QUOTE”  (32). This reveals that…

(7)  Your tone and style needs to be academic and polished. This helps add  credibility to your voice. Reading aloud will help the most with this!  Avoid first and second person in this style of writing.

Assignment Requirements

Your  paper should reach a minimum of four pages, 1000 – 1200 words, not  including the Works Cited page. You must submit this draft by the due  date listed for this assignment.

Formatting Requirements

MLA format

Childhood Abuse Discussion Essay Paper

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