Introduc tion to Counselling Survivors of Interpersonal Trauma by the same author Counselling Survivors of Domestic Abuse ISBN 978 84310 606 Counselling Adult Survivors of Child Sexual Abuse 3rd edition ISBN 978 84310 335 The Seduction of Children Empowering Parents and Teachers to Protect Children from Child Sexual Abuse ISBN 978 84310 248 of related interest Supporting Women after Domestic Violence Loss, Trauma and Recovery Hilary Abrahams ISBN 978 84310 431 Safeguarding Children Living with Trauma and Family Violence Evidence-Based Assessment, Analysis and Planning Interventions Arnon Bentovim, Antony Cox, Liza Bingley Miller and Stephen Pizzey Foreword by Brigid Daniel ISBN 978 84310 938 Working with Adult Abuse A Training Manual for People Working With Vulnerable Adults Jacki Pritchard ISBN 978 84310 509 Making an Impact – Children and Domestic Violence A Reader 2nd Edition Marianne Hester, Chris Pearson and Nicola Harwin With Hilary Abrahams ISBN 978 84310 157 Introduc tion to Counselling Survivors of Interpersonal Trauma Christiane Sanderson Jessica Kingsley Publishers London and Philadelphia First published in 2010 by Jessica Kingsley Publishers 116 Pentonville Road London N1 9JB, UK and 400 Market Street, Suite 400 Philadelphia, PA 19106, US www.jkp.com Copyright © Christiane Sanderson 2010 All rights reserved No part of this publication may be reproduced in any material form (including photocopying or storing it in any medium by electronic means and whether or not transiently or incidentally to some other use of this publication) without the written permission of the copyright owner except in accordance with the provisions of the Copyright, Designs and Patents Act 1988 or under the terms of a licence issued by the Copyright Licensing Agency Ltd, Saffron House, 6–10 Kirby Street, London EC1N 8TS Applications for the copyright owner’s written permission to reproduce any part of this publication should be addressed to the publisher Warning: The doing of an unauthorised act in relation to a copyright work may result in both a civil claim for damages and criminal prosecution Library of Congress Cataloging in Publication Data Sanderson, Christiane Introduction to counselling survivors of interpersonal trauma / Christiane Sanderson p cm Includes bibliographical references and index ISBN 978-1-84310-962-4 (alk paper) Psychic trauma Treatment Sexual abuse victims Victims of violent crimes Interpersonal relations Psychological aspects Terror Post-traumatic stress disorder I Title RC552.T7S26 2010 616.85’210651 dc22 2009020881 British Library Cataloguing in Publication Data A CIP catalogue record for this book is available from the British Library ISBN 978 84310 962 ISBN pdf eBook 978 85700 213 Printed and bound in Great Britain by Athenaeum Press, Gateshead, Tyne and Wear For James and Max and In Memory of Didi Daftari 1962–2009 “Therapy is not about relieving suffering, it’s about repairing one’s relationship to reality” (Anonymous, 1994) Acknowledgments There are many people that I wish to thank, most importantly all those survivors who have shared their stories and lives with me over many years Their resilience and courage is a true inspiration I would also like to thank Paul Glyn for his enduring support There have been many colleagues and friends who have supported me throughout this writing process and a special thanks goes to Mary Trevillion and Paul Gilbert from Family Matters UK, Kylee Trevillion, Debbie Dallnock and Patricia Hynes at the NSPCC, Linda Dominguez, Lucy Kralj from the Helen Bamber Foundation, Andrew Smith, Mark Donnaruma, Didi Daftari, and Kathy Warriner As always I would like to thank Jessica Kingsley for her patience and faith in me, along with all the staff at Jessica Kingsley Publishers especially Lisa Clark and Louise Massara for her expert direction Finally this book would not have been written without the presence of Michael, James and Max – I thank you for your patience, support and love of life Contents Introduction Part I 11 The Nature of Interpersonal Trauma and Clinical Practice Chapter 1 What is Interpersonal Trauma? 19 Chapter The Dynamics of Interpersonal Trauma 26 Chapter The Impact and Long-term Effects of Interpersonal Trauma 38 Chapter Creating a Secure Base: Fundamental Principles of Safe Trauma Therapy 56 Chapter Working with Survivors of Interpersonal Trauma 77 Part II Spectrum of Interpersonal Abuse Chapter Child Abuse as Interpersonal Trauma 101 Chapter Child Sexual Abuse as Interpersonal Trauma 117 Chapter Rape as Interpersonal Trauma 134 Chapter Sexual Exploitation: Child and Adult Prostitution, Human Trafficking and Sexual Slavery 154 Chapter 10 Domestic Abuse as Interpersonal Trauma 180 Chapter 11 Elder Abuse as Interpersonal Trauma 199 Chapter 12 Institutional Abuse as Interpersonal Trauma 224 Chapter 13 Professional Abuse as Interpersonal Trauma 247 Part III Professional Issues Chapter 14 Professional Challenges and Impact of Counselling Survivors of Interpersonal Trauma 275 Resources 288 Bibliography 295 subject Index 312 Author index 318 List of Figures, Tables and Boxes Figure 3.1 Continuum of dissociation (adapted from Allen, 2001) Box 6.1 Core clinical symptoms of child abuse Box 6.2 Core therapeutic goals Table 7.1 Spectrum of child sexual abuse activities Box 7.1 Core clinical symptoms of child sexual abuse Box 7.2 Core therapeutic goals Box 8.1 Spectrum of rape contexts Box 8.2 Common reactions to rape Common fears associated with rape Box 8.3 Figure 8.1 Rape trauma syndrome (adapted from Burgess and Holmstrom, 1974) Figure 8.2 Four symptom categories in rape-related post-traumatic stress disorder (adapted from National Centre for Victims of Crime, 1992) Box 8.4 Core clinical symptoms of rape Box 8.5 Core therapeutic goals when working with rape Figure 9.1 The spectrum of sexual exploitation Box 9.1 Links between sexual exploitation and other crimes Figure 9.2 Risk factors in sexual exploitation and child prostitution 43 111 112 118 127 129 137 142 143 145 146 147 149 155 156 157 Figure 9.3 Entry into child prostitution Box 9.2 Core clinical symptoms associated with sexual exploitation Box 9.3 Core therapeutic goals Figure 10.1 Spectrum of domestic abuse (Sanderson, 2008) Figure 10.2 The abuse cycle (adapted from Walker, 1979) Figure 10.3 Abuser dynamics and cognitive processes that support cycle of abuse Box 10.1 Core clinical symptoms of domestic abuse Core therapeutic goals Box 10.2 Box 10.3 Safety planning (Sanderson, 2008) Box 10.4 List of items to pack (Sanderson, 2008) Figure 10.4 Spectrum of losses associated with domestic abuse (Sanderson, 2008) Figure 11.1 Spectrum of elder abuse Figure 11.2 Factors identified that predispose to elder abuse (AEA, 2004) Box 11.1 Indicators and impact of physical abuse Box 11.2 Indicators and impact of psychological abuse Box 11.3 Indicators and impact of financial abuse Box 11.4 Indicators and impact of sexual abuse Box 11.5 Indicators and impact of neglect Box 11.6 Core symptoms and long-term effects of elder abuse Core therapeutic goals Box 11.7 Table 12.1 Three levels of institutional abuse (adapted from Gil, 1982) Figure 12.1 Spectrum of abuse in children’s institutions Box 12.1 Impact and long-term effects of institutional abuse Box 12.2 Core therapeutic goals Figure 13.1 Spectrum of interpersonal abuse by professionals Therapist–patient sex syndrome (adapted from Pope, 1989) Box 13.1 Box 13.2 Core symptoms associated with survivors of professional abuse Box 13.3 Core therapeutic goals Box 14.1 Core professional issues in working with survivors of interpersonal trauma Box 14.2 Impact of working with survivors of interpersonal trauma Table 14.1 Impact on personal functioning Table 14.2 Impact on professional functioning Figure 14.1 Self-care when working with survivors of interpersonal trauma 159 172 174 182 186 187 189 190 191 192 193 200 205 209 210 211 212 214 215 218 225 227 235 238 248 258 259 263 277 279 282 283 285 c o u n s e 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118–21 affect regulation 23, 24, 44–5, 79–81, 110 and impulse control 45 therapy considerations 67, 79–81 aggressive behaviours 35, 45–6, 109, 130 alcohol use 39, 46 and human trafficking 163 and rape 141 therapeutic interventions 84–5 to groom children 121 alexithymia 47 ambivalence 88 American Psychiatric Association (APA) 19, 40, 43–4, 48, 108 anger responses 45–6 anorexia nervosa 46 antisocial personality disorder 39, 126 arousal disturbances 12, 23, 39, 40–2, 80 see also sexual arousal attachment disturbances 23, 125, 205–6 and relational styles 51–2 attention disorders 40 “authentic self ” 49–50 connecting with during therapy 69, 71 autonomy 72 “Baby Peter” 101, 105 Barnado’s 160–1, 165 BASK model of dissociation 43 behavioural changes 45–6 belief distortions 30–1, 47, 49–50 body dysmorphic syndrome 39, 46, 126 borderline personality disorder 110, 126 boundaries within therapy 62–3 violations by professionals 250–1 breathing techniques 82 British Crime Survey 139, 183–4 bulimia nervosa 46 burnout 130, 281–4 case vignettes 14 charm techniques 27 child abuse categories and types 101–2 children at risk 104–5 core symptoms 111 dynamics 105–6 impact 106–10 information sources for survivors 292–3 intergenerational 52 long-term effects 110–12 perpetrators 105 prevalence 102–3 resources and information 288 therapeutic aims and goals 112–13 312 therapeutic challenges 113–15 child abuse images 164–5 child prostitution 157–61 Child Protection Plans 104 child sexual abuse 117–33 categories and spectrum of activities 118 children at risk 122–3 core symptoms 127 definitions 117–19 dynamics 119 grooming process 120–1 impact 124–6 long-term effects 126–7 perpetrators 123–4 prevalence 121–2 therapeutic goals 129 therapeutic interventions 128–32 therapy challenges 130 see also child prostitution ChildLine 122–3 children’s homes see institutional abuse classification of trauma disorders 20–1, 22 Climbié, Victoria 101 closeness 67 Coalition for the Removal of Pimping (CROP) 165 cognitive behavioural therapy, for rape 148 cognitive impacts 47 Community Safety Unit 191 compartmentalisation 29–30, 44 complex trauma conditions 22, 42 Complex Trauma Task Force 108 confidentiality 62 S u bj e c t I n d e x contracts for therapeutic encounters 62 control needs 20 during therapy sessions 64–5, 66–7 controlled exposure 67 conversion disorder 46 coping mechanisms see survivor coping mechanisms counselling principles 56–76 aims and goals 58–9 management of sessions 64–5 therapeutic settings 61–2 counselling sessions counsellor stances 70 design of settings 61–2 management principles 64–5 pacing 64–5 processes and phases 66–8 timing 64 see also therapeutic process; therapeutic relationship counselling and abuse see professional abuse counsellor(s) boundary violations 248, 250–1 core professional issues 277 defensive coping mechanisms 279 personal qualities 69–70 power relations 249–50 role during therapy 68–9 self-awareness 130, 276–8 stance during therapy 70 stress and burnout 130, 281–6 use of self 81 counter-transferential reactions (CTR) 74–5, 93, 249, 280 CPTDS (complex post-traumatic stress disorder) 22, 42 CTR see counter-transferential reactions (CTR) cues 65 for dissociation reactions 81 cultural norms 184 cultural sensitivity 276 cutting see self-harming behaviours cyberstalking 182 cycles of abuse 52, 184, 185–7, 206 defence mechanisms 88–90 dehumanisation processes 28–9, 53, 55, 78, 89 dementia, influence of early attachment patterns 205–6 dependency and elder abuse 206–7 depression 127 developmental trauma disorder 22–3, 42–3 diagnostic criteria 19–20 discharging of emotions 80 disclosure issues by counsellor 63 “colluding’ with abuser 32 “disorders of extreme stress not otherwise specified” (DESNOS) 22, 42 dissociation 29–30, 43–4, 48, 105–6 compartmentalisation 105–6 concealment of self 49 during therapy sessions 81 models 43 distortions and lies, by abuser 33–4, 120–1, 131–2 distraction techniques 80 distress tolerance techniques 80 domestic abuse 180–97 categories and spectrum 182 core symptoms 189 definitions 181–2 impact 188 incidence and prevalence 183 information sources 289–92 long-term effects 189 obstacles to leaving 187–8 safety and contingency planning 191–3 spectrum of losses 193 therapeutic challenges 194–5 therapeutic goals 190 working with survivors 189–94 Domestic Stockholm Syndrome 185 double bind 88 “double think” 47 drug use addictions and selfmedication 39, 46 and human trafficking 163 and prostitution 158–9 313 and rape 141 therapeutic interventions 84–5 to groom children 121 DSM-IV Field Trial 108 DSM-IV-TR (2000) 20, 24 dynamics of abuse 26–37, 77 internalised 73 dynamics of therapeutic relationship 70–3, 77–8 counter-transference 74–5 transference 74 eating disorders 39, 46 elder abuse 199–223 categories and spectrum 200–1 definitions 201–2 impact 208–14 incidence and prevalence 202–3 influence of early attachment patterns 205–6 long-term effects 214–16 nature and dynamics 204–8 neglect indicators 213–14 physical signs 209 psychological signs 210 resources and information 288–9 signs of financial abuse 210–11 therapeutic challenges 219–20 therapeutic goals 218 therapeutic work 216–20 embodied counter-transference 75, 81 emotional regulation see affect regulation empathy, excessive 89 employment bullying see professional abuse ending therapy sessions 68 enticement and entrapment 26–8 erotic transference 130 explicit memory 48 “false body” 50 “false self ” 49–50, 127 father–daughter sexual abuse 164 fear responses 110 c o u n s e l l i n g s u r v i v o r s o f i n t e r p e r s o n a l t r a u m a financial abuse, elders 210–11 flashbacks 48 coping mechanisms 82 flight or fight response, denied 33–4 foot stamping 82 forced marriages 164 freeze response 33–4 Fritzel, Josef 164 gang cultures 139 Garrido, Phillip 164 gastrointestinal disorders 109 grieving and trauma 67, 94–5 “grooming” 26–8, 118–19, 120–1 grounding techniques 81, 82–4 growth following trauma see post-traumatic growth Haut de la Garrene (Jersey) 229–30 hippocampus 40 honour killings 182, 184 hostile acts 130 human sexual trafficking 162–3 information and support 293–4 humour 89 hyperarousal 23 hypervigilence 23, 40, 44, 45, 109 hypochondria 46 hypovigilence 40, 109 ICD–10 Classification of Mental and Behavioural Disorders 22, 25 imagery techniques 80 impulse control 45 information sources 288–95 for children 288 for domestic abuse victims 289–91 for elderly people 288–9 for lesbian and gay people 289 for survivors of child abuse 292–3 institutional abuse 224–46 categories and spectrum 225–7 definitions 228 impact and long-term effects 233–7 incidence and prevalence 228 perpetrators 229–30 risk factors 228–9 therapeutic challenges 240–3 working with survivors 237–40 intergenerational transmission of violence 52, 184, 185–7, 206 internalised abuser dynamics 73 interpersonal trauma concept defined 12 different types 28 dynamics and processes 26–37 forms and classification 20–1 language and terminology 13–14 legitimising and naming 32 long-term impacts 38–53 paradoxes and contradictory beliefs 30–1, 49 professional issues and challenges 276–81 secrecy and enforced silence 32–3 within attachment relationships 23–4 see also child abuse; child sexual abuse intimacy avoidance 35–6 during therapy 67 fears 51 irritability 40, 45 Islington Council Children’s Homes 229 Ismail, Aliyah 160 Jersey, institutional abuse 229–30 Kampusch, Natascha 164 language and terminology of abuse 13–14 “learned voicelessness” 47, 89 legitimising abuse 32 length of sessions 64 lesbian and gay abuse, information sources 289 letter writing 80 lies and distortions, by abuser 33–4, 120–1, 131–2 locus of control 49 during therapy sessions 64–5, 66–7 loneliness 52 loss and trauma 67, 94–5 “love bombing” 27, 163, 256 “malignant contagion” 90–1 masturbation 118–19 memory disturbances 48 see also flashbacks mental health problems 39 mentalisation difficulties 47–8, 92 mentalising techniques 80–1 metaphors 78 “mind blindness” 81 mind reading 50, 92 music and self-soothing 82 narcissistic personality disorder 39, 126–7 narratives on trauma 85–7 National Center on Elder Abuse 201 National Center for Victims of Crime 146 National Centre for Social Research 202 National Child Traumatic Stress Network 108 NAYPIC (National Association of Young People in Care) 228 negative self-beliefs 47 neglect definitions 103 elders 200, 201, 213–14 neurobiological disruptions 39–40, 109–10 nightmares 48 non-verbal body language, during therapy sessions 65 pace of therapy sessions 64–5 paedophile networks 232 pain disturbances 46, 109 distraction techniques 84 Palermo Protocol (UN 2000) 162 S u bj e c t I n d e x paradoxes and contradictory beliefs 30–1, 49 parenting capacity 52 Paying the Price (Home Office 2004) 158 perception distortions 27–8, 31–2, 40 perfume and self-soothing 82 perpetrators see abusers pets and self-soothing 84 photographs, sexually explicit material 118 see also child abuse images physical abuse see child abuse; domestic violence; elder abuse physical contact, during therapy 63 physical health problems 46–7, 109, 127 pleasing others 50 poetry 83 POPAN see WITNESS post-traumatic growth 95–6 post-traumatic stress disorder (PTSD) 39, 40–2 post-traumatic stress (PTS) 12, 40 power dynamics 77–8 in professional relationships 249–50 Priklopil, Wolgang 164 prisoners 139 professional abuse 247–71 boundary violations 250–1 categories and spectrum 248–9 definitions 251–2 impact and long-term effects 257–60 nature and dynamics 254–7 perpetrators 254 power abuses 249–50 prevalence 252–3 risk factors 253 symptoms 259 therapeutic challenges 264–8 working with survivors 260–8 professional issues and challenges 276–81 projections and distortions 29 projective identification 48–9 prompts 65 prostitution 157–62, 293 adult 161–2 child 157–61 psychiatric disorders 39 psychoeducation 78–9 rape 134–53 categories and types 136–8 common fears 143–4 common responses 142–3 core symptoms 147 costs 138 definitions 135–6 gender issues 139–40 impact 142–6 incidence and prevalence 132 information sources 292 long-term effects 146–7 nature and dynamics 140–2 perpetrators 140 purpose and motivations 140–2 risk factors 139 therapeutic challenges 150–2 therapeutic goals 149 working with survivors 148–50 Rape Crisis England and Wales 135, 138 rape-related post-traumatic stress disorder (RR-PTSD) 146 reality distortions 27–8, 47, 92 and falsifications 31–2 rejection fears 51–2 relational self functioning levels 50–2 and self-worth 29, 51–2 therapeutic interventions 91–3 resignation and despair 88 resilience assessments 60 revictimisation 52 risk taking by counsellors 69 by survivors 47 safe trauma therapy 56–76 fundamental principles 57–8 aims and therapy goals 58–9 management of sessions 64–5 therapeutic settings 61–2 315 Safeguarding Children and Young People from Sexual Exploitation (DfCSF) 156 scent 82 schizophrenia 39, 126 seating arrangements 61–2 secondary traumatic stress (STS) 281, 281–6 prevention 284–5 secrecy about abuse 32–3, 110, 128 security fears 73 seductive behaviours 130 self emergence during therapy 71 false vs authentic 49–50, 127 self-agency 24, 28–9, 47, 72, 78 self-awareness, and compartmentalisation 29–30, 44 self-blame 34, 49, 128–9 self-care 285–6 self-harming behaviours 39, 44, 45 during therapy 73 and risk taking 47 therapeutic interventions 84–5 self-identity 28–9 irreconcilable paradoxes 30–1 projections and distortions 29 self-sabotaging behaviours 50 self-soothing 44 grounding techniques 82–4 self-structures changes during therapy 71 false vs authentic 49–50, 127 therapeutic interventions 90–1 self-talk 82 self-worth 29, 48–50, 51–2 sensory techniques, for grounding 82–3 sessions see therapy sessions settings for therapy 61–2 sexual abuse definitions 103 of elders 200, 201, 212–13 legacies 53, 55 professionals 251–2 c o u n s e l l i n g s u r v i v o r s o f i n t e r p e r s o n a l t r a u m a sexual abuse cont therapeutic interventions 93–4 see also child sexual abuse; sexual exploitation sexual acts, spectrum of activities 118 sexual arousal 31, 53, 55, 128–9 and rape 141–2 vs sexual desire 94 sexual assault 135 sexual assault by penetration 135 sexual attraction, therapist–client 254–5 sexual exploitation 154–79 categories and spectrum 155–6 child abuse images 164–5 core symptoms 172 human sexual trafficking 162–3 impact 169–70 information and support 293–4 links with other crimes 156 long-term effects 170–2 nature and dynamics 168–9 perpetrators 167–8 prevalence 165–6 by professionals 252–3 prostitution 157–62 risk factors 166–7 sexual slavery 164 working with survivors 173–5 sexual inhibition 47 Sexual Offences Act 2003 135–6, 162 sexual slavery 164 sexual trafficking see human sexual trafficking sexuality 47, 53 shame feelings 34–5, 46, 49, 128 during therapy sessions 67 and rape 141–2 and sexuality 53 silences during therapy 65, 88–9 somatic counter-transference 75, 81 somatoform disorders 46, 109, 127 “soul murderer” (Shengold) 125 Stockholm Syndrome 185 stomach problems 109 stress response systems 33–4, 40 impairment consequences 44–5 stress responses (counsellors) 130, 281–4 STS see secondary traumatic stress (STS) submission behaviours 88 substance dependency conditions 39, 46, 127 therapeutic interventions 84–5 suicidal ideation 84–5, 131–2 therapeutic interventions 84–5 survival instincts, denied 33–4, 39 Survivors Trust 122 sympathetic nervous system disruptions 33–4, 39–40 therapeutic process 66–8 disclosure of trauma narrative 85–7 grounding and protective measures 81, 82–5 learning to challenge past legacies 87–90 therapeutic relationship 70–3 barriers 73 boundary violations 250–1 collapse 93 power dynamics 249–50 sexual exploitation 252–3 and uncertainty 69, 280–1 work challenges 278–81 working on the relational self 92–4 therapist–patient sex syndrome 257–8 therapists core professional issues 277 defensive coping mechanisms 279 personal qualities 69–70 power relations 249–50 professional boundary violations 248, 250–1 role during therapy 68–9 self-awareness 130, 276–8 stance during therapy 70 stress and burnout 130, 281–6 use of self 81 therapy principles 56–76 aims and goals 58–9 management of sessions 64–5 therapeutic settings 61–2 therapy sessions counsellor stances 70 design of settings 61–2 management principles 64–5 pacing 64–5 processes and phases 66–8 timing 64 see also therapeutic process; therapeutic relationship touch, during therapy 63 transference 74, 93, 130, 249 erotic 130 trauma classification and definitions 19–20 complex conditions 22, 42 developmental disorders 22–3, 42–3 forms and spectrum 20–1 and loss 67 see also child abuse; “interpersonal trauma” trauma narratives 85–7 trauma therapy see safe trauma therapy traumatic bonding 33–4, 51–2, 105–6, 185–6, 256 trust betrayals 28, 50–1 trust within therapeutic process 62–3, 66–7 abuse of trust by professionals 260–71 working with self-structures 90–1 truth, difficulties with 69 uncertainty, dealing with during therapy 69, 280–1 United Nations, Palermo Protocol (UN 2000) 162 “victimisation” 13–14 victims “colluding” with abuser 32 paradoxes and contradictory beliefs 30–1, 49 S u bj e c t I n d e x traumatic bonding with abuser 33–4, 51–2, 105–6, 185–6, 256 see also survivor coping mechanisms visual flashbacks 47 voice, pace and tone 65 withdrawal behaviour 88–9 WITNESS 252–3, 264 Women’s Aid 191 Women’s Aid Federation 181–2, 184 work-based abuse see professional abuse Working Together to Safeguard Children (DoH 2006) 103, 117–18 317 Author Index AEA (Action on Elder Abuse) 200–7, 211–12 Ainsworth, M.D.S 72 Alexander, P.C 51 Allen, J 136, 138–9 Allen, J.G 20–1, 24, 34, 39, 46–7, 60, 67, 148, 186 American Psychiatric Association (APA) 19, 40, 43–4, 48, 108 Amiel, A 204 Amstadter, A 146, 148 Anderson, C.L 51 Arensman, E 234, 237 Aronson, E 282 Bales, K 167 Barnado’s 160–1, 165 Barrett, D 161 Barter, C 226, 228–30 Bateman, A.W 47 Bennet, G 202 Bevan, S 138, 139 Blackman, J 47 Blatt, E 228–9 Blizzard, R.A 70 Biggs, S 200 BMA 201 Boseley, S 104–5 Bowlby, J 11, 51, 72, 232 Brandon, M 101, 103–5 Braun, M.D 43 Brett, E.A 41 Briere, J 39 British Crime Survey 139, 183–4 British Medical Association 182, 184 Brodie, I 161 Broken Rainbow 183 Bromberg, P 13, 14, 57, 75 Brown, D 48 Brown, R 62 Brown, S 229 Buber, M 28, 52 Buie, O.H 74, 278 Burgess, A.W 145 Calder, M.C 52 Cantor, C 40–1 Casement, P 284 Chefetz, A.A 75 ChildLine 122–3 Clarkson, P 70–1, 249 Coe, J 252–4, 256–7 Cohen, C 205–6 Cohen, D 137, 139 Cohen, J.A 148 Coleman, K 183–4 Colson, Elizabeth 174–5 Community Safety Unit 191 Coxell, A.W 140 Crittenden, P.M 231, 233 Dale, P 48 Danieli, Y 284–5 de Zulueta, F 58, 286 Dean, P 158 Deblinger, E 148 Department for Children, Schools and Families 122, 165 Department of Health 103, 117–18, 207 Diehl, M 206 Dobie, D.J 46 Dutton, D.G 34, 51, 184–6, 207 Eastman, M 206 Engel, G.L 39 Fairbairn, W.R.D 30 Fairweather, E 229 Farmer, E 226 Field, N 75 318 Figley, C.R 281 Finkelhor, D 207 Fisler, R.E 110 Foa, E.B 20, 41, 148 Fonagy, P 24, 29, 47, 51, 67, 80–1 Frayne, S.M 46 Freyd, P 21 Friedman, M.J 70 Garrett, T.I 253 Gil, E 225 Gilbert, R 104, 122 Glendinning, F 201 Glenny, M 163 Goffman, E 230 Goldberg, H 47 Grand, S 29, 31, 33, 53, 89, 90, 242 The Guardian 124 Hammersley, P 126 Harold, G.T 52 Harper, Z 165 Harwin, N 52 Heard, D 71 Heath, I 204 Herman, J.L 22, 25, 30, 42, 51, 58, 66–7, 281 Hester, M 52 Holmes, E.A 48 Holmstrom, L.L 143 Home Office 135, 157–8, 165–6, 181 House of Commons Health Committee 202 Howarth, E.L 52 Janoff-Bulman, R 47 Jansson, K 183–4 Kahn, M 57–8, 70 Kaisa, P 183–4 A u t h o r I n d e x Kalsched, D 79, 107, 238 Kell, P 140 Kelly, A 137 Kelly, L 138, 161 Kershaw, C 138 Kilpatrick, D 146, 148 King, M.B 140 Kingston, P 200 Kinnell, H 161 Kleber, R.J 281 Kluft, R.P 43 Kreiter, S.R 139 Krystal, J.H 31, 47 Kübler-Ross, E 95 Lake, B 71 Lambert, M.J 70 Langer, L.L 33, 89 LeDoux, J.E 47 Lenihan, T 158 Lindsay, M 226 Lindy, J.D 70, 74 Linehan, M 39, 80, 148 Liotti, G 51 Loftus, E.F 48 McCann, I.L 47, 281 McDougall, J 30 McFarlane, A.C 30 Magai, C 205–6 Main, M 72 Maltsberger, J.T 74, 278 Mannarino, A.P 148 Mattley, C 194 Melrose, M 161 Mezey, G.C 140 Miller, D.T 89 Mollica, R.F 67 Mollon, P 29, 49, 86, 125 Mullen, P.A 126 Nachmani, G 52 Nair, P.M 167 National Center on Elder Abuse 201 National Center for Victims of Crime 146 National Centre for Social Research 202 National Child Traumatic Stress Network 108 NAYPIC (National Association of Young People in Care) 228 Nietzsche, F 281 Nijenhuis, E.R.S 71–2 Ochberg, F.M 51 Ogg, J 202 O’Keefe, M 203–4 O’Neil, T 226 Orbach, S 50, 234 O’Riordan, M 234, 237 Orwell, G 30 Painter, S.L 34, 51, 185–6 Parkes, C.M 95 Pearlman, L.A 47, 281 Pearson, C 52 Perren, S 205 Phillipson, C 200 Piaget, J 110 Pillemer, K 207 Pines, M 282 Pollock, S 226 Pope, K 253–4, 257–8 Porter, C.A 89 Pryke, J 184 Rape Crisis England and Wales 135, 138 Read, J 39, 126 Regan, L 161 Resick, P.A 148 Resnick, H 146, 148 Roe, C.M 48 Rosenthal, J 228–9 Rothbaum, B.O 20, 148 Rothschild, B 21, 25, 71 Ruggiero, K 146 Russell, J 257 Saakvitne, K.W 281 Salter, A.C 70, 122 Samuels, A 75 Sanderson, C 0, 19, 26, 41, 45–6, 48–9, 51, 53, 66, 75, 84–6, 91–5, 119, 120, 122–7, 139, 165, 182–7, 190, 192–3, 195, 208, 219, 277, 279–81, 284–5 Sapolsky, R.M 47 Scarf, M 39, 47, 89 Scheflin, A.A 48 Schmale, A.H 39 Schmid, R 205 Schnicke, M.K 148 Schoener, G.P 249, 252, 265 319 Schwartz, M.F 48 Scott, S 165 Shapiro, F 148 Shaw, R 75 Shengold, L 29, 91, 105, 125–6 Simon, R 256–7 Sinason, V 286 Skuse, D 124 Spiazzola, J 39 Spinhoven, P 71 Steele, K.S 72 Stobart, K 62 Streeck-Fischer, A 45, 58, 110 Survivors Trust 122 Sutton, J 44, 85 Target, M 24 Teicher, M.H 108–9 Terr, L.C 21, 25, 48 Thomas, G 70, 225 Thomas, M 184 van der Hart 72 van der Kolk, B.A 22–3, 25, 30, 43–5, 47–8, 57–8, 106, 108, 110, 112, 285 Vanderlinden, J 71 Walby, S 136, 138–9 Walker, E.A 46 Walker, L.E 185–6 Wastell, C 281 Weisaeth, L 30 Whittaker, T 207 Williams, L.M 48 Williamson, E 184 Wilson, J.P 70, 74 Winnicott, D.W 49–50, 71, 107 Wolfe, D.A 234 Women’s Aid Federation 181–2, 184 Worden, J.W 95 World Health Organization 22, 25 Woskett, V 63 Wyre, R 123 Yalom, I 58, 68, 70–1, 73 Yassen, J 281, 284 Zimmerman, C 168–71 Zinbarg, R 20 ... professional challenges and the impact of counselling survivors of interpersonal trauma, especially the need for thorough knowledge of the nature and impact of interpersonal trauma, awareness of. .. nature of interpersonal trauma and illustrate how to work with survivors of such trauma Chapter aims to define interpersonal trauma, and investigate how it relates and differs from single event trauma. .. rise to complex post-traumatic stress (PTS) symptoms, counsellors will need to direct specific therapeutic attention and focus to such trauma To undo the pervasive effects of interpersonal trauma,