Healing Childhood Sexual Abuse: A Narrative Approach

by Charley Lang, MFT
Posted on: November 30th, 2013

Jake, a gay-identified 26 year-old man enters my office for our first session and sits down on the sofa with a deep sigh.  “I’m finally ready to do it”, he says.

“Do what?” I ask.

“Tell you everything.  All the gory details about what my uncles did to me, about the sexual abuse that started when I was ten”, he replies.

“Woah!” I say, holding up my hands for emphasis.  “Let’s take this one small step at a time.  First of all, I’m curious where this idea of needing to tell me all the gory details comes from.”

“Well that’s what you’re supposed to do, isn’t it?  It’s what I’ve always heard the experts say on TV, even read about in books.  The only way to get through childhood trauma is to finally have the balls to tell someone everything that happened.  In all its creepy living color.”

“I’m certainly aware of those messages that come from the culture”, I say, “and I’m not saying I’m not willing to go there.  But I’m suspicious of a one-size-fits-all approach to something as personal and as devastating as childhood sexual abuse.  In fact, I think it’d be irresponsible of me to just dive in there without having a pretty clear idea of your hopes for what might be on the other side of that process.”

Jake looks at me for a long moment.  “Well I never really thought about my hopes”, he says.  “All I know is I’ve always been terrified of doing this thing that everyone says I have to do.”

‘Well I for one am inclined to respect your experience of feeling terrified” I say.  “The fact is, you’re sitting here, you survived the trauma.  I’m frankly more interested in your knowledge of how you managed to do that, especially in the face of such powerful imperatives from the culture.”

This line of inquiry is quite intentional in an affirmative, strength-based context of therapy.  Most clients come to see us with the idea of talking about their problem stories.  This is a given.  Before going there, however, my first question always points in the direction of the possible future, a question like “What’s your hope for what our conversations will be able to provide?”  By so doing, the client is informed of my interest in both the narratives of future possibility along with the problem narratives from the past.  I need to know my clients’ ideas about the space they’re interested in occupying instead, a space beyond the one that’s currently rendering them stuck by the problem story.

“What are my hopes?” Jake quietly asks himself.

Through our ensuing conversation, Jake expresses relief at the possibility of not having to, as he says, “re-live the nightmare of my childhood.”  He shares with me a vivid dream he’s had on many occasions since that time.  In this dream, Jake is standing in what feels like an underground bunker, surrounded by a half dozen doors, all closed.  One of the doors has “a kind of a glow” to it, and Jake knows it leads to the world above, a vibrant place, free from the isolation of this frightening underground.  But in the dream, he is somehow restricted from approaching the door and opening it.  Instead, he is compelled to endure the dampness of this darkened space, immovable and alone.

“That’s a pretty potent dream”, I say.  “What’s your take on it?”

“It’s how I always felt after the abuse”, he replies.

I share with Jake my own ideas about childhood sexual abuse, that it’s not always about sex or even sexuality, but often more about power.  The abuse of power by the abuser.  Jake and I talk about the powers that abusers use to take advantage of young children, the powers that his uncles used over him: coercion, physical strength, threats, secrecy.

“Would it be ok if I asked you some questions about the abuse?  Not what happened or how it happened, but rather, what effects it had on you and your life afterwards.”

“Sure”, Jake says.

He describes having been an outgoing kid before the age of ten, but afterwards, things took a dramatic turn. He stopped playing sports, started cutting school and seeking comfort from the bottles in the family liquor cabinet.  Shame about his “dirtiness” and fear of retaliation if he “ever shared this secret with anyone” created a powerful relationship between Jake and isolation.  Shame convinced him that he was “damaged goods” and not worthy of relationship with others.  As a teenager, he found further escape from these pressures in a variety of recreational drugs and prescription medications.  Throughout our conversations, Jake identifies shame as “a heavy blanket that was thrown over me by my uncles and what they did.”

“Do you think the shame you describe belongs more with abused kids or with the abusers?”

“With my uncles for sure”, Jake replies.  “I didn’t deserve this shit.”

“Right on”, I say.  “Based on my experience with other survivors of sexual abuse as children, I strongly suspect that shame also lies to you, perhaps convincing you that you’re not worthy of relationship, and that drugs, alcohol and isolation are your only options.”

“That’s certainly what it’s felt like.”

“Is it okay with you that shame is having these effects on your life?” I ask, inviting Jake to take a stand relative to these forces in his life.  In this evaluative process, the problem is further unmasked and externalized, and space is opened for us to begin exploring alternative experiences of Jake in the world, separate from shame, unworthiness and isolation.

“No it’s not okay!” Jake declares.

“Why not?” I ask.

“Because I deserve a decent life, like everyone else”, he says.

“Great. So are you game to join me in challenging this experience of unworthiness in your life?” I ask.

Jake sits up and leans toward me.  “Sure”, he says.

“Let me ask you another question then”, I say.  “What has shame tried to steal from you that you used to like about yourself?”

“I’d have to go back a long ways for that one”, Jake responds.

“That’s okay.  Take your time.”

Slowly, Jake begins to tell me how much fun he used to have as a little kid at the arcade, “challenging my friends at video games, especially Space Invaders, Sword Quest and Super Mario Brothers.  I’ll never forget the day I outscored every other player on the pinball machine and was declared “Master of the Universe!”  He loved going with his buddies after school to get Italian ices at the deli, and even mowing the neighbors lawns was fun because it gave him the money to save up for his first Gameboy, and to take a camping trip in the mountains with his Indian Scout troupe.

“So here’s what I’m wondering now”, I say, leaning forward in my chair.  “Despite everything that shame has stolen from your life, and I get that its a lot…I’m very curious about any small, small way that you’ve managed to hold on to some shred of this ‘fun’ in the recent past.”

“There’s nothing”, he says, almost automatically.

“Take a moment, Jake, and think about it.  I’m not asking for anything big here.  I’m looking for some small, even tiny thing that has given you the slightest pang of pleasure in recent days.”

Jake sits back on the sofa and takes a deep breath.  After a long moment, his eyes meet mine again.  “Well, this may sound ridiculous, but when I heard the new R.E.M. song in the coffee shop this morning, I remember catching myself humming along and tapping my foot.  I realized I hadn’t done that in a really long time.”

A seemingly small exception perhaps, but in my mind, a potential piece of gold.  Exceptions are the incremental building blocks to the alternative stories of possibility that we seek to co-author with our clients.  A powerful assumption in the work is that small change leads to larger changes.  As a result of this process, Jake and I begin to tease out his long-standing appreciation for music and the fun he has always associated with it, an appreciation that shame has not managed to eradicate from his life.  This line of inquiry begins to open space, ever so slightly, between an identity description enforced by shame, and Jake’s own preferred sense of self in the world.  It is within this space that we start to explore alternative descriptions of who Jake is, and perhaps more importantly, who he is interested in becoming.

“When you are able to stand apart from shame’s definitions of you, what alternative possibilities arise?”

Along with additional notions of fun, Jake says he is keen on experiencing a different kind of sexual interaction, one in which he values intimacy, caring, connection and “a supportive sexual partnership with a man… something I’ve never known before.”  He agrees that any potential connection with this goal, in even the smallest of ways, represents a crack in the opening of that glowing door from his recurring dream in childhood.

“In what ways have you already begun to think about engaging this possibility of partnership?” I ask.

Jake explains that in his explorations online, he found the website of a social action volunteer group for gay men.  This is acknowledged as an important first step in the direction of possible new connections for Jake, and subsequent steps continue to be considered.  The collaborative construction of what I call “fieldwork” is an important aspect of the work here.  Fieldwork involves the identification of specific, measurable and doable actions for the client to consider engaging between our sessions together.  Since problems are viewed as external to people, having their roots in systemic discourses in the culture, it’s important for clients to integrate their strength-based ideas of possibility in their day-to-day actions out there in the world.  This is a way to grow the exceptions that challenge the dominance of problem narratives in clients’ lives.  What we pay attention to, tends to grow.  If we’re looking for unworthiness, we’re likely to find it.  If we’re vigilant for signs of meaningful and caring connections, we’re likely to find these experiences as well.  Eventually, through incremental pieces of fieldwork, Jake makes contact with the volunteer group and attends his first event, planting trees at a local high school with twenty other gay men and joining them for lunch afterwards.

“Who from your past wouldn’t be surprised that you were able to take this important step in the direction of self-care?”  I ask at our subsequent meeting.  Jake ponders this question for a long moment and then tells me about Mr. Hernandez, his history teacher in 5th and 6th grades.  He remembers other kids whispering that Hernandez was gay because he wasn’t married, but Jake also remembers his teacher’s passion and energy for life, especially about history.  On class museum trips, Hernandez always made eye contact with all of the students, drawing Jake in to the richness of the stories from the past and the excitement that they had to offer.  Jake shares the story of presenting his class report on the explorer Cortez, and how Hernandez invited the class to join him in applauding Jake’s efforts after his presentation.  The teasing out of stories such as this are essential in the development of Jake’s ongoing narrative of possibility, for they not only serve to historicize a connection to his current goals, they also require a re-visioning of the dominant unworthiness narrative from his past.  As Jake comes to realize and appreciate the achievements he’s capable of and the qualities he’s been able to engage in service of these achievements, he begins to redefine and revalue himself.  As he looks back from his new, preferred perspective, Jake begins to understand his history as one of courage and determination in the face of extremely oppressive circumstances.

Throughout our meetings together, I am also willing to hold pieces of Jake’s abuse experiences that are important for him to share.  The distinction here is crucial.  Jake came in believing he had to “tell all the gory details” in order to heal.  This idea was identified as a cultural construct that did not, upon further inquiry, fit Jake’s own preferences for healing.  These conversations include deep emotional expressions of anguish, fear, sadness and rage, often accompanied by the flow of tears and extreme physical discomfort.  Throughout all of these encounters, we hold the pain together.  With Jake positioned as the expert of his own experience, we are able to honor a pace that is defined by him, free from top/down, prescriptive advice giving on the part of the therapist.

As our discussions proceed, Jake and I continue to draw out various narratives of resistance to the shame-dominated story that has run his life for so long.  He nurtures a new appreciation for his value as a person committed to the experiences of caring and connection, and in the process, comes to know a new definition of what power can look like.  “This is the power I want to have in my life”, he says.  “The power to connect.  The power to care.  The power to get control over drugs and alcohol.  The power to feel something a little bit scary sometimes, and do it anyway…”

Our work continues in this vein for nine months.  Eventually, Jake reaches a point of deciding that he is fortified enough to consider taking a break, always knowing that my door remains open to him for any periodic tune-ups that might want to be engaged.  Throughout our transitioning process, I’m reminded of an element in the work that continues to inspire me, something known as double-listening.  Double-listening is the process of deconstructing dominant frameworks of meaning that are responsible for lives of distress, while co-authoring preferred narratives that engage relief from these oppressions.  As we help grow the latter along with our clients, the former automatically diminishes.  And in so doing, we become collaborative agents of generative change.

I still remember with emotion the words that Jake spoke the last time I saw him, firmly established on his own path…sometimes wavering, other times transcendent…of connection and self-care.

“Thank you”, he said, taking my hand in his, closing this chapter of our work together.  “Thank you for not making me tell you everything.”






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Charley Lang, MFT, is director of the B.A. Psychology Program at Antioch University L.A. and co-founder of Narrative Counseling Center, providing strength-based consultation services to individuals, couples, families, and interns in the greater Los Angeles area (narrativecounselingcenter.com).