Monday, November 16, 2009

What is therapy exactly and how could it help an adult molested as a child?

A guest post by TikunOlam

Yesterday we heard a tragic report of a young man who committed suicide as a newly wed. He was unable to become sexually intimate with his wife due to reactions to traumatic sexual abuse that he had suffered when he was younger. The word “therapy” got tossed around a lot as the cure for the post traumatic symptoms of this young man. But I think that unless you have had some experience in therapy or training as a therapist, what goes on in the therapy sessions is often mysterious or misunderstood. There are many types of therapies out there. Today’s most scientifically studied (for many reasons I won’t go into) are various versions of Cognitive Behavior Therapy.

So lets say that a young man, let’s call him Jacob, decided to go into therapy because he was beginning to have nightmares, feelings of depression and anxiety as his wedding got closer. He knew it was because of his history of molestation. He had never sought treatment before and decided he should before becoming sexually intimate with his wife.

Cognitive Behavior Therapy works like this:

It is understood that all people have a set of schemas. Our schemas are own personal narratives about what we believe about ourselves and the world around us. Our schemas influence our feelings and our feelings influence our behavior and then back around again. It is a self perpetuating cycle. Therapists, together with their patients, look to define problematic cognitive schemas, which result in maladaptive feelings and behaviors.

For example, in Jacob’s situation, possible schemas could include, for instance:

1. I should have stopped him from molesting me
2. I am defective
3. I am unworthy of love
4. I do not deserve a wife and family
5. Sex is bad, shameful and frightening
6. If I can’t perform as a man, I don’t deserve to live

Possible feelings that go along with those schemas could include, for instance:

1. Shame
2. Guilt
3. Anger
4. Fear
5. Sadness

Possible behaviors that could be associated with those thoughts and feeling may include:

1. Avoiding sexual intimacy
2. Difficulties trusting others
3. Hiding the truth from others
4. Use of drugs to escape
5. Suicide attempts
6. Suicide

Once identified, the maladaptive thoughts, that are by definition irrational, are challenged. And, for example, if you no longer believe that sex is shameful, you begin to think and feel differently about sex. And with some confidence, in time, you may decide to change your behaviors by taking steps toward sexual intimacy with someone you trust.

This, of course is Cognitive Behavioral Therapy 101 as can fit into a blog post of course. It is in no way a manual for psychotherapy and only very broadly defines Cognitive Behavioral psychotherapy.

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