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Sexual Abuse

© By Albert Pesso, 1988

(This lecture was given for the Studiedag (Study Day) on Sexual Abuse held at the Vrije Universiteit (Free University) in Amsterdam, May 31, 1988)

Over the years I have seen many adults who have had histories of sexual abuse, some of it incestuous - with parents or siblings - some of it with relatives, and some of it with neighbors or strangers.

Abuse victims, whether it be sexual, physical or psychological abuse, share one thing in common. They all carry a wound that makes them extremely vulnerable. Though some of them may learn to cover this vulnerability with a facade of toughness and prickliness, underneath it they share a terror of their own softness.

They tend to become sensitive people with a deep capacity for feeling. They also tend to be very alert to what other people are feeling, especially about them.

In my way of trying to understand and explain the forces that the psyche is composed of I use the term power to describe the penetrating quality of force and aggression, and vulnerability to describe the polar opposite drawing force of openness and receptivity. I associate mass or matter with power and space with vulnerability.

All of us are born with the polarities of power and vulnerability and our task in life is to integrate those forces and to keep them balanced. It is our ego that holds all this together. The ego is like an encircling membrane that contains and moderates those forces. If the ego is damaged, those forces tend to become unruly and chaotic.

Abuse is a major cause of severe damage to the ego. It is as if the force of abuse produces a rip or a tear in that ego membrane and then it doesn't function so well. Sexual abuse, especially with women, sometimes can include a literal, unwanted, tearing open of their bodies. This insult to their physical as well as psychological integrity has profound consequences.

All the ego functions are affected and reduced, resulting in feelings of loss of control, diminishment of speech and use of words, diminishment of consciousness, of identity, of meaning, and finally, diminishment of the capacity for discrimination in the differences between inner and outer, fantasy and reality.

Abuse victims tend to be more closed than other people, unwilling to let anything of any kind near or into them. Their vulnerability becomes not only unprotected and exposed by the abuse but dangerously exaggerated and reinforced because of it. The vulnerability of some victims, no longer under the control of the ego, appears unbounded and without dimension. That may explain why some abuse victims act out and become promiscuous. In others the unbounded vulnerability is not acted upon at all. In fact, their vulnerability and openness may be so frightening to them that they don't dare to feel even the slightest quantity of it. In some the openness of the person and their ego is so great that they experience psychosis.

Some abuse victims who don't act on the vulnerability in a direct way may express it by being spacey. You remember space is a metaphor for the openness of vulnerability.

I am thinking now of one recent client who had a long history of incestuous relations with her father. She had learned to be out of her body as a way of coping with the impossible sensations that the sexual contact with her father produced in her. That way, she could say to herself, that no matter what he did to her body, it was not being done to her because she wasn't really there anymore. This dissociation added to her appearance of being far away, mysterious, not of this earth. She was also interested and deeply absorbed in things metaphysical. But when she spoke of those matters it was never quite clear what exactly she was talking about. That, I saw as part of her spacey quality.

Her voice was very quiet, almost inaudible. Ordinarily, I think of the voice as an expression of power. In her case it was practically the reverse. Her voice was so soft it was as if she was drawing in the words with her breath rather than speaking them out.

The same quality was true of her gaze. When most people look into someone's eyes as they do in conversation, you get the impression that they are looking into that other's person's mind or thoughts. That supports the notion that some part of sight is like a penetrating force. Of course seeing is also taking in sight and is therefore an expression of openness. Ordinarily this quality is balanced in people. But her gaze rarely gave that penetrating impression. Only the reverse was true. Her eyes were quite open, even enlarged and had that quality that would make people think they could fall into them.

Her personality and behavior gave out that kind of too vulnerable message that could often produce its opposite in contact with others. It is common that when someone is very powerful, some part of the local environment tends to become less powerful and more vulnerable. Also when someone is very vulnerable others become less vulnerable and more powerful. I think of the polar forces of power and vulnerability as tending to pull out or elicit the opposite effect on people. That might explain why some vulnerable people seem almost literally to attract attack.

As a therapist I have learned to note my own subtle, not quite unconscious reactions of subliminal aggressiveness and sexual awareness toward this client. Having seen many super vulnerable clients I have come to expect those feelings and have some knowledge about how to use those reactions as a way to further the therapeutic work. Therapists have to be on their guard not to fall into the trap of reflexive opposite reactions. It is almost an expression of some abuse victims' power that they can make some people do and say terrible things to them. That is not their conscious intention, they hate being hurt, they want that pattern stopped, but other unconscious forces are also operating which we should be careful not to reinforce in the therapy.

Because of their increased feelings of defenselessness and helplessness, some clients work hard at finding the strength and force that would hold off future abuse. They strive to be strong and able to protect themselves. This helps balance their psyche and is important work. However, in order for them to finally feel comfortable with their feelings, they must also learn to master the feelings of vulnerability, not only by developing the opposite forces but by corralling it, that is by feeling the receptivity and then experiencing its limits - which leads to having good ego boundaries around the openness. But to do that they must first feel the full strength of their super vulnerability again, and for those clients that is not a very attractive prospect.

Those are some of the typical elements I expect to find when I work with an abuse client. Not all clients have all these elements, but all have some suggestion of them and at one time or another demonstrate one part or another. I will now list eight important topics that we attend to in dealing with abuse clients in Pesso System Psychomotor Therapy.

I. Need For Control

II. Need For Protection

III. Guilt and Shame

IV. Eroticism and Receptivity

V. Hatred and Murder

VI. Sadness and Loss

VII. Love and Tenderness

VIII.Antidote Relationship

Before going further, I would like to bring in an important point. and that is that a therapist has to deal not only with the concepts and ideas of power and vulnerability. but ultimately with the physical and active body expression of those forces felt in the body during the therapy. Power and vulnerability are not just thoughts and feelings, they are the stuff that moves and activates our lives.

But here is a caveat, a warning that should be included with the above statements. Since it was unwanted touch and action that contributed to the sexual abuse in the first place, those clients are naturally aversive to touch and action. Much time must be spent just to help them feel safe with the therapist or the group itself. Only then should the therapist help them become reaccustomed to safe touch and action in a group. I emphasize group because my experience indicates that it takes many people to do the limiting and contacting necessary to contain all the power that eventually is available to the client. Then those elements must be used with caution and great discretion. Too rapid application of those potentially therapeutic elements could frighten clients and reinforce their belief that their bodies are still not very safe places.

NEED FOR CONTROL

So reestablishment of control is the first requirement in working with abuse clients. They have lost control of their bodies and their choices and the therapy must begin with the explicit redeclaration and resumption of their rights to maintain integrity of their bodies and choices. Also their right and ability to be in control of the events that will happen in the therapy has to be acknowledged and developed. I will not go into detail now about specific exercises which attend to these topics. The workshops this afternoon will include two of them.

Before I describe some of the ways to work with power and vulnerability in a structure using touch and action, I would like to briefly tell those of you who were not here yesterday what a structure is. A structure is the name for the therapeutic session in Pesso System Psychomotor Therapy. It is a controlled, role-played reconstruction of an event like abuse, where we help the client to work out all the feelings in action and interaction, that they may not have been able to feel when it actually happened. Included in a structure is the alternative possibility with what we call ideal figures, like ideal mother and ideal father, who, if they had been there at that time would have treated them totally differently and with more respect and without abuse, etc.

Now I would like to describe some of the work with the abovementioned client. I will not go into what had to be attended to in the pre-structural work or the preparatory work she had done in many years of therapy with other therapists. To further my goal of demonstrating some of the essential issues to look for in the work with abuse using structures I will combine elements from several different structures, and treat it as if it was one single structure. I will make comment on these elements as I go along.

During the session the client began to remember the contacts with her father. She started to feel sick and felt that she would throw up. I understood that reaction as having too much feeling in her body, more than she could handle. She was one of those people who learned how to leave her body and now we could see why, because if she felt what was in there it would be too much. Whenever there is such an overload, I know that the route out is to have the person use the energy in their body very strongly and then to have that action that comes out of the body be in contact with supporting or containing figures who provide countershaping pressure and resistance to the action as a way to help them to handle it. Without those outside people to contact them when they have those feelings, they might feel as if their egos would explode from the force of the feelings inside and that they then might go crazy. The physical contact and pressure from the outside contacting people is experienced like a healing seal or cover over the hole in their fragile egos.

So I suggested she select some people to role-play just such contact, containing figures so she could process that energy. The contact figures, who were females, gently put their arms around her as she sat on the floor with her arms around her knees and then I suggested that she tighten the muscles around the areas of tension in her body. She began to tremble. The contact figures held her more securely and she began to cry, saying she was very frightened. I understood that she was frightened not only because she was remembering how helpless she felt when her father abused her but she might also be frightened of the feelings that it brought up in her that she did not understand. It was fear of the inside as well as of the outside. There are steps to work with that but for now I will only tell you that the contact figures are usually asked to say, or are needed to say things like, "We can help you handle how scared you are." This gives license to the feelings, giving them a name and making them handleable as the containing figures are there as an outer surface to hold them together.

The feeling of fear is extremely high in abuse clients. Not only is fear intense for them, but that distress is compounded or increased by the fact that the fear has been held so long inside without being fully expressed. That is, the full amount of feeling, force and expression is kept from reaching consciousness and bodily expression. But the fear remains as a symptom in the body and does not go away until it is finally processed in an interaction, and using yesterday's term, properly ego-wrapped.

One of the body symptoms associated with fear is an achiness in the shoulders. When I ask clients reporting that symptom to move in the way the achiness seems to make them want to move, they usually raise their shoulders. The look of that movement gives the impression of someone trying to pull their head into their body in an attempt to shrink and hide inside themselves.

Slight downward pressure on the shoulders by the contact figures assists the client in fully accessing the fear. The expression of this level of fear frequently includes a peculiarly high pitched sound, one you might hear from a terrified person or animal. When the fear is fully processed in the safe haven created by the contact figures this tension disappears and the body becomes more relaxed. If the fear is allowed to build up without the counter pressure contact with outside figures it is likely that the client will immediately feel nauseous and close to vomiting. Such moments of vomiting are a reflexive, unconscious attempt to get the unpleasant overcharged feelings out of the body.

THE NEED FOR PROTECTION

I have learned that with this depth of fear there is a great need to have protection. I proposed to the client that she choose ideal figures who would have protected her at that time. She agreed. That gave her sufficient safety to fully feel the fear. She cried and screamed in those high shrieking sounds and shivered as the feelings ran through her body which was trembling all over.

The absence of protection is a major element in abuse clients. Frequently the abuser is a family member who should have been the one giving protection rather than being the threat. When it is the parent who has been the abuser the child feels totally undefended and unprotected by the opposite parent who they feel should have known what was happening and stopped it. This kind of protective experience is supplied in structures by ideal parents who standardly say things like, "If I had been back there then I would have known what was going on and I would have stopped it from happening."

The client, in the arms of the protective figures, felt free to touch even deeper levels of fear and terror. Suddenly, she clasped her neck which had cramped with pain. That is a common reaction when people feel very vulnerable. At those moments some part of the body, frequently the neck, becomes very hard, as a kind of alternative to their own softness that has made them feel so defenseless. I asked her to exaggerate the tension in her neck and in doing so her head pressed backward. That action needed to be contacted with and one of the containing figures, with her approval, placed her hands around the base of her head and the client, using the force created by the contracted muscles, pushed her head backwards into her hands.

This kind of intervention is provided to meet the counterforce which the client calls up in the attempt to balance the too vulnerable feelings. It is important that when this hard reaction to their soft feelings surfaces that it is not met with limits. Limits are that special intervention which stop an action from being completed. In this case limits are not required, but a more subtle amount of resistance is offered, with just the right amount of force applied. This allows the client to continue to move their body in whatever direction they wish it to go but they have to work harder to make it happen. This intervention demonstrates to the client that their strength and force is effective. The words that the accommodators might be asked to say in connection with it are, "You're strong, you can have an effect on me." Or other words that would give a similar message of validating the client's attempts at increasing the amount of power they have available in their bodies. This validation of that kind of strength has the paradoxical effect of giving the client the license and safety to go deeper into their vulnerable feelings.

From that interaction, the client, with great force, pushed her hips forward and with the contact figures giving counterpressure on her hip bones, the client's thighs and pelvis shook violently.

GUILT AND SHAME

She said something like "That is so sexual", sat back on her heels and began to pound on her thighs. Quickly the containing figures restrained her from hitting her legs and in a flash she began to aim her fists toward her face which it appeared she would like to smash. She seemed to be in a fit of self hate, guilt and shame for having sexual feelings in her body and would destroy those parts of herself that had those feelings. The limiting figures with her agreement, I must say that nothing is allowed to happen without the client's agreement, say to her, "We will not let you hurt yourself." Then when they are clearly ready for her attempts the client feels free to release all the pent up self hate and disgust she has about her feelings. They struggle greatly but it is always a relief to find that no matter how hard they try they will be limited from doing damage to themselves.

A lot of things are combined in the above description. Things can move pretty quickly when people follow their impulses and it is important that the therapist has a kind of inventory or list in his or her mind so that the major possibilities can be anticipated. Let me cover in more detail some of what was involved in that sequence. As expected, when the counter phobic strength was validated, the vulnerability presented itself, this time in the form of sexual excitement and receptivity.

EROTICISM AND RECEPTIVITY

First let me say that one of the most unexpected and surprising findings in our work has been that abuse of any kind, physical, psychological or sexual, produces a reflexive erotic element. The person under attack not only responds with defensive reactions, but may also experience reflexive bodily impulses, not immediately available to consciousness, that imply a readiness to receive penetration. It is as if some archaic portion of the psyche is highly responsive to, and appreciative of aggression - and is prepared to welcome it. This part of vulnerability includes a kind of chaotic excitement and willingness that would appear ready to take in and absorb everything and anything. Of course in sexual abuse this element is even further heightened. Not that she wants or consciously feels any sexual excitement, but the sexual organs are involved and some unconscious part of her reacts to this stimulation. This only adds to her distress. For she has not asked or wanted to be stimulated. She has been denied her rights to have mastery over her own feelings and body.

The guilt that she feels at such moments is enormous. She blames herself for her own predicament. The fact that she just found herself feeling sexual seems proof to her that it was her fault that the abuse occurred. She would kill the offending parts of herself, "If thine eye offend thee pluck it out." She would pluck out her sexual feelings in her guilty thighs and smash the sexual feelings out of her head.

HATRED AND MURDER

But when this self hate and guilt is limited it can quickly turn to hatred and murder directed toward the person who made all those unwanted feelings happen. That too must be expressed. But in a form where it is clear that there would not be the allowance of literal murder.

When those feeling of self-hate shift to become hatred of the person who brought those feelings out in her, the client chose to have a negative father enrolled so that she could vent her fury at him. The negative father role-player accommodates as if struck when she directs her blows at him. It was satisfying to the client to see her negative father in pain. She wanted to punish him for what he had done to her.

"I'll really kill him now." she said. If she had not been limited she might become frightened that nothing would stop her from carrying out her murderous intentions. At such moments the containing figures can say, "It's all right to be so angry at him, but we won't let you literally kill him. We can handle your anger and we can help you handle it." Their firm limiting action was concrete proof of that. This allowed her to fully express all the hatred and rage she felt for him. She lunged toward him and punched in his direction and kicked toward him venting all the suppressed hostility.

SADNESS AND LOSS

But she didn't stay with anger for long. Shortly, she was remembering how much she loved her father, how he had been the adored daddy for her in her childhood and now she could not bear to think of him being hurt. That brought her to great sadness and loss, for she remembered how hurt and confused she was the day he first approached her sexually. It was like the end of her world.

Paradoxically, during the process of expressing this sadness and grief, right in the middle of her crying and all the shaking and convulsive feelings that came with it, she noted that her thighs were trembling and that there was another tension in her belly and lower back.

When I asked her to exaggerate the tension and to see what movement came of it, it made her legs shake in a way that they oscillated between opening and closing.

Here the combination of vulnerability, openness and eroticism was most present. I don't yet know the explanation for this phenomenon that the openness is expressed as open legs but I have seen it so regularly that it became clear to me that it has sexual meaning. But the very same reaction occurs with males who have been physically abused, and they have no genitals that would be exposed by open legs. At such moments the impulse to open the legs is directly connected in my mind with the boundless openness of space and vulnerability I spoke of earlier. Here is where it is to be met and where it is corralled and brought within bounds with the help of limiting figures. In a way their success in keeping the legs from splitting apart is equivalent to the creation of a boundary around the spaciness or openness of the personality. It is also a way of illustrating and reinforcing the ego's new grip on the chaotic vulnerability, as the ego, figuratively represented by the limiting figures succeeds in putting the omnipotent vulnerability back under its control.

Before carrying out the appropriate intervention to limit this erotic receptive feeling I explained some of the theoretical notions about it to her. This was helpful to her and permitted her greater freedom to move under the force of those impulses.

The limiting figures, and it is important that in this case they be female and not male, otherwise it might feel like she was submitting to male strength, wrapped their arms around her knees so that no matter how hard she might try to open her legs she would not be able to do so.

It is a paradoxical thing. Here is a person who has been abused and who wants more than anything to close herself up to keep from being abused, and she finds that a part of herself that she is not in conscious control of intends to move in a way that is quite the opposite. Now that external figures are doing the closing, she can attend totally to the impulse to open her legs and that releases an enormous amount of energy. There is a great struggle, and not only does she fight to separate them, but her hips thrust forward repeatedly and when she makes the sounds that the effort brings, it surprises her. She says, "Those are the sounds that he made when he was doing it." Now the emotions connected to that event are entirely conscious and she can find some of the same feelings in herself. Although it at first makes her ashamed, she finds that she can continue to make the movement and the sounds and is relieved that she can own those sexual feelings in herself but still while she is kept from separating her legs. If the sexual contact a client had included some conscious sexual excitement and a wish to have incestuous relations, the ideal limiting figures could say something like this, "It is OK that you might want to have sex with your father but we wont let you literally do it." There is relief when limiting figures succeed in getting that omnipotent feeling of receptive sexuality and vulnerability under control. After the limits she feels that her body is more her own and she relaxes in a way she has not been able to do before.

EXPRESSION OF LOVE AND TENDERNESS

Now she takes some time to feel where she is and she remarks that the room looks different, lighter and her body feels softer and less tense. She looks over to where the negative father was and begins to remember her real father again and how she used to adore him. Feelings of love well up in her and she begins to cry now. This is a soft feeling and she begins to stroke the floor in front of her as she talks about how wonderful she used to think he was.

She asked a group member to role play the loved aspect of her real father. This figure is entirely separate from the negative figure. It represents that part of her real father that she loved, but now in a form that was separate from the negative father. This kind of polarization allows the tender feelings to be expressed toward the loved aspect without ambivalence. If she should begin to be angry again, those feelings would be directed toward the negative father.

Now the feeling in her body is neither sexual, furious or guilty. She is feeling tender with the unexpressed love she had felt for him and had to bury after the incest began.

The male group member role playing the loved aspect is asked to sit closer. She is still being held by the contact figures are around her. As she looks at him her body begins to tremble again and they do their encircling function to help her to contain her vulnerability as she feels the love for him. This is reassuring for without it those feelings might get out of control, in a way it is omnipotent tenderness. Their holding can include their saying, "We can help you handle how much you love him." For her love feelings are also somewhat out of ego control.

As she reaches her hand to touch him she becomes frightened by the force of her feelings and other containing figures are enrolled to hold onto her wrists as she reaches toward her father's face and hair. They exert a little counter pressure, giving just enough resistance so that the effort is not stopped completely. That is why they are called resistance figures, not to represent her resistance, but to give her enough external resistance so that she does not get paralyzed by her own ambivalence about touching him. Those resistance figures make it just possible for the tender feelings to be expressed without getting out of control.

Together they enable her to feel all that she feels without the ego bursting. It is very tender to see that moment, for then some of the old child feelings toward her father can be expressed toward that part of her father she still loves.

HEALING ANTIDOTE

I haven't said anything about ideal parents yet, but in many structures they may be there throughout offering regular antidoting contact and statements. By antidoting I mean the process of giving the kinds of interaction that are opposite to the toxic ones given by the original parents.

I'll jump ahead now and describe how she used the ideal parents in her structure. She chooses two group members, male and female to represent the ideal father and ideal mother. They are instructed to sit side by side, entirely opposite to the original situation where the parents were not close at all.She said something about still not believing that they liked each other or had sex together and I asked her if would be OK if I provided her with what I have found is a kind of classic image of parental intimacy. I described it to her and when she agreed I instructed the ideal parents to embrace each other and look into each other's eyes. This made her face light up. She said she had never seen her real parents so close and that it was wonderful to imagine her ideal parents being so intimate. The ideal father would say, "I would never be sexual with you I would only be sexual with your mother" It was a great relief for her. It made her feel free, like a child and now she felt she could have a mother again

She began to cry and climbed into her ideal mother's lap like a little child, experiencing what she hadn't felt in a long time, being loved and protected by a mother who was only a mother and not a competitor for the father.

Here we come to the end of this condensed composite structure.

Through it I have tried to show how we attend to those important needs and deeply suppressed emotions that are waiting for expression in victims of sexual abuse. Her nuclear forces of power and vulnerability are no longer either totally suppressed nor near meltdown. She has expressed the emotions in her body in a way that she can feel more control over them. They have been seen, touched, named and given boundaries, therefore ego-wrapped. She is more of one piece. The integrity of her body and the feelings in it have been recognized in a respectful setting and given a place. I hope you have found these ideas interesting and useful.

Thank you.

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