Survivor-led relational psychotherapy and embodied trauma: A qualitative inquiry

Background: Childhood sexual abuse has complex and multifarious consequences for one's physical and mental health, including injuries and psychological illnesses such as depression (Psychological Bulletin, 99, 1986, 66; The SAVI Report. Sexual abuse and violence in Ireland. A national study of Irish experiences, beliefs and attitudes concerning sexual violence, 2002; Journal of Paediatric Health Care, 24, 2010, 358). In contrast to traditional psychotherapeutic approaches that focus on the treatment of disorders, humanistic integrative frameworks address the relational and neurobiological roots, and cumulative impact, of trauma (Rape: How women, the community and the health sector respond, 2007; The body remembers: The psychophysiology of trauma and trauma treatment, 2000). Quantitative research investigating the efficacy of these various therapies is gaining momentum (Campbell Systematic Reviews, 9, 2013, 3; Clinical Psychology Review, 34, 2014, 645; Journal of Nervous and Mental Disease, 203, 2015, 443), yet qualitative evidence on individuals' experiences, and analyses of a humanistic approach, are lacking. Aim: This study sought to address these gaps by examining the role of Rape Crisis Centre (RCC) specialist psychotherapy in addressing the psychophysiological impact of child sexual abuse in Ireland. Method: Semi-structured, in-depth interviews were conducted with a purposive sample of 11 adult survivors of childhood sexual abuse accessing RCC therapy and 12 RCC psychotherapists. Interview questions focused on their experiences and perspectives of RCC therapy and recovery. Interview data were analysed using qualitative thematic analysis. Findings: The analysis showed that working with embodied trauma is integral to the recovery process, while providing salient insights into the complexity of the empowerment approach in trauma work. Recovery is survivor-led, but it is the individual's somatic experience that guides the process, monitored by the psychotherapist. Conclusions: This study makes an important contribution to trauma treatment research by detailing the lived experience of the recovery process. The findings enhance our understanding of the dynamics involved in processing the biological, psychological and social components of sexual abuse trauma. They also underscore the importance of a non-directive relational approach. Implications for practice are discussed.