Briere Child Abuse Trauma

Child Abuse TraumaJohn Marsden

Reference

Briere, J. (1993) Child Abuse Trauma, London, Sage

Briere’s Seven Categories

Briere grouped the symptoms of child abuse trauma into seven categories:

Post-traumatic Stress Cognitive Distortions Altered Emotionality Dissociation Impaired Self-reference Disturbed Relatedness Avoidance

Post-traumatic Stress

Post Traumatic Stress Disorder (PTSD) can result from childhood abuse where there is the threat of death or intense fear (acute or chronic)

Symptoms:

Intrusive thoughts and/or nightmares Flashbacks Exaggerated startle response Avoidance Anger Depression Co-morbidity (alcohol/drug dependency)

Genesis of PTSD

Abuse that is violent may be experienced as life threatening

Chronic abuse may also lead to PTSD Both acute and chronic abuse may

be accompanied by intense fear Powerlessness and isolation are risk

factors for PTSD. Perpetrators seek to isolate and

control their victims.

Cognitive Distortions

Guilt Low-self-esteem Self-blame Impaired self-efficacy Abuse dichotomy – “bad people

suffer, I am suffering therefore I must be bad”

Genesis of Cognitive Distortions

Tactics of abusers include confusing the victim, undermining his or her self-confidence and decision making.

Tactics also include shifting responsibility onto the victim

Control of the victim and transgression of personal boundaries impacts on victim’s self-efficacy.

Abuse may impair school performance and overall cognitive development

Altered Emotionality

Anxiety Depression Suicidal thoughts Self-harming behaviour

Genesis of Altered Affect

Behaviour of the abuser and the sense/reality of being trapped results in “learned helplessness” or depression.

Fearfulness and hyper-vigilance results from living in an abusive situation and results in anxiety disorders.

Dissociation

Disengagement – spacing out Detachment - numbing – of feelings Observation – watching self rather

than participating Amnesia Dissociative Identity Disorder

Genesis of Dissociation

Threatening situations which cannot be escaped must be endured. In order the endure what is intolerable individuals learn to dissociate, those who do not dissociate tend to develop PTSD.

In extreme cases the individual “splits” into different personalities.

Impaired Self-reference

Sense of self as impaired leading to boundary issues, identity problems and feelings of personal emptiness.

Genesis of Impaired Self-reference

One development task is the creation of “personal integrity” or boundaries between Self and Other. Perpetrators of abuse blur and abuse those boundaries. The victim experiences their personal integrity transient and dependent on others.

In borderline personality disorder the individual struggles to contain his or her emotions, has a chaotic lifestyle and unstable relationships.

Disturbed Relatedness

Inability to differentiate the needs of the self from the needs of others (co-dependency)

Attachment issues, such as a fear of intimate and/or sexual relationships

Inability to trust Inability to enjoy intimacy, including

sexual intimacy

Genesis of Impaired Relationships

Abuse damages the victim’s trust in others

Victims may avoid close relationships

Sexual abusers “condition” sexual behaviour in victims by establishing a “token economy” of rewards and threats.

Sexualised behaviour in childhood may lead to promiscuity in later life.

Avoidance

Avoidance of conflict Avoidance of sex and sexuality Avoidance of time and place Avoidance of triggers and

associations (e.g. films and TV)

The active maintenance of low self-esteem

Genesis of Avoidance

Children avoid contact with the abuser and/or the abuse environment.

Children avoid triggers and associations that remind them of the abusive experience

Avoidance becomes an approach to managing threatening situations and negative emotions.

Risk Factors for Sexual Abuse Trauma

Age at onset of abuse Intrusiveness of the abuse Relationship with the abuser Use of Violence (level of violence) Female abuser Reaction of others on disclosure

Conclusion

Child abuse trauma has the potential to negatively shape a victim’s personality, his or her development, relationships and ways of being in the world .