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j135v01n01 02
j135v01n01 02
To cite this article: Laurie Anne Pearlman PhD (1997) Trauma and the Self, Journal of
Emotional Abuse, 1:1, 7-25, DOI: 10.1300/J135v01n01_02
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Trauma and the Self:
A Theoretical and Clinical Perspective
Laurie Anne Pearlman
Survivors of childhood abuse and neglect, their loved ones and thera-
pists are aware of the difficulty many survivors have engaging in trusting,
framework then provides guidelines for healing. This article describes the
impact of trauma on the self within the framework of constructivist self
development theory (CSDT; McCann & Pearlman, 1990; Pearlman &
Saakvitne, 1995a, 1995b). The goal of this article is to review and expand
upon CSDT’s descriptions of the effects of early emotional abuse on the
self in order to provide guidelines for clinicians as well as more detailed
groundwork for future research on trauma and the self.
Self Capacities
Self capacities are inner abilities that allow an individual to maintain a
consistent, cohesive sense of self. These abilities or self capacities develop
through early relationships with caregivers and regulate one’s inner states,
contributing to inner balance. CSDT describes three self capacities: the
ability to maintain an inner sense of connection with others; the ability to
experience, tolerate, and integrate strong affect; and the ability to maintain
a sense of self as viable, benign, and positive. The first self capacity
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(connection) makes the other two (affect regulation and self-worth) pos-
sible through the internalization of loving others in the context of a secure
attachment relationship (Bowlby, 1988) or holding environment (Winni-
cott, 1965). Self psychologists have eloquently described the early devel-
opment of the self (Kohut, 1977; Mahler et al., 1975; White & Weiner,
1986). As these theorists describe, the emergence, differentiation, and
development of the self is facilitated by sensitive caregivers who respond
to the child’s needs, mirror inner states and behaviors, and protect and
encourage the child’s individuation which provides an emotionally secure
base from which the child grows (Bowlby, 1988). The self capacities
cannot develop properly in an abusive or neglectful home. Researchers
using Bowlby’s work as a foundation have found a range of attachment
relationships from secure to disorganized; Bowlby’s attachment theory
and Ainsworth’s security theory are integral to the conceptualization pre-
sented here (see Bretherton, 1992, for a comprehensive review of these
theories).
Connection
The healthy development from childhood into adulthood of the capacity
to maintain an inner sense of connection with benign others runs along a
continuum from the use of others to gratify needs, to the use of others as
judges of one’s self-worth, to the internalization of others who are experi-
enced as separate and as stable sources of internal support. Repeated abuse
and chronic neglect by parents, siblings, or other presumed caretakers
interfere with the internalization of loving others; the caretakers who
should be attending to the child’s safety and well-being are not, and so
they cannot be taken into the child’s inner world as a protective presence
(Bowlby, 1988; Davies & Frawley, 1994). Children learn a powerful les-
10 JOURNAL OF EMOTIONAL ABUSE
son: that they are helpless to protect themselves and that others will not
protect or assist them. The inadequate development of this self capacity
interferes with the development of the other two: affect regulation and self
worth are fundamentallybased in the internalization of loving others.
Affect Regulation
Under ideal conditions, this self capacity‘develops from undifferentiated
affect states through an ability to distinguish pleasurable from painful states,
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others by their secret shame, yet unable to understand why they feel so
bad, so angry, so different.
These difficulties cam be compounded by dissociation, a natural
response for some to severe or early abuse (Putnam, 1989). When it
persists into adulthood, dissociation can become an automatic response to
the earliest stirrings of any feelings, thus standing in for (and in the way
of) affect. This process prevents the individual from learning what the
experience of feelings is like, what the natural course of each feeling state
is for that child.
Seu- Worth
The developmental continuum of this self capacity begins with the self
being experienced as alive when active; when inactive or in a negative
feeling state, the experience may be one of nonexistence. With increasing
development, the self is experienced as existing or worthy when the indi-
vidual receives recognition from others. In later development, the individ-
uals assume their own psychological self-regulating functions and can
differentiate between a bad or wrong act and their fundamental self-worth.
Perpetrators may reinforce the child’s isolation by conveying that the
adult’s abusive behavior is in some way reserved for this child because of
the child’s special status, that the child’s continuing compliance with the
abuser’s needs and demands are making the adult’s life better or worth-
while, or that the child’s compliance is protecting other family members
from harm. The natural desire every child has to feel special becomes
tainted, again leading to confusion, self-abnegation, shame, and self-loath-
ing. Identification with the abuser’s projections onto the victim or internal-
ization of the self as described by the abuser’s words and behaviors also
result in confusion and profound self-loathing.
ships) that might evoke feelings, craving nurturance (although this may
not be within the survivor’s awareness, or may be experienced as loath-
some, disgusting, and dangerous), questioning one’s right to exist, experi-
encing oneself as toxic, and having difficulty meeting one’s own needs.
Dissociation, substance abuse, and self-destructive behaviors may be
attempts to compensate for missing self capacities. While self-destructive
behaviors may represent traumatic reenactments and a form of behavioral
memory, they arise from undeveloped self capacities (Deiter & Pearlman,
in press). As self-loathing, shame, self-fragmentation, or other threatening
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Aflect Regulation
Childhood experiences of physical, sexual, or emotional maltreatment
suffise children’s relationships with themselves with negative affect. Mal-
treated children may negate themselves, demonstrated most clearly in
some individuals with dissociative identity disorder (American Psychiatric
Association, 1994), within whom one state denies the existence of others.
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respond like a deer, caught in the headlights, paralyzed and destined for
retraumatization.
Self capacities allow people to experience ambivalence, to hold contra-
dictory thoughts or feelings simultaneously. Without this ability, the world
must be made black or white, right or wrong. Relationships thus become
potential minefields: “If you don’t agree with me, you must hate me.”
The frustration that arises in everyday life may be vented outward
rather than held, examined, and processed. Anger may be expressed
through violence. Abused children may harm younger children or pets
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or alienated from others. They may struggle to accept or feel good about
themselves, or even to feel entitled to exist. These feelings may shape an
individual into a driven achiever who is never gratified or a person who
cannot bear to try anything new because of fear of failure. In research on
cognitive schemas, Black and Pearlman (in press) found that beliefs about
self-esteem mediated the relationship between beliefs about self (in the
areas of trust and intimacy) and beliefs about others (also related to trust
and intimacy). This finding implies that feelings of self-worth are central
to one’s relationship with one’s inner world and with other people.
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Intervention Strutegy
authenticity: not the self-disclosure of the therapist’s personal life, but the
thoughtful use of the genuine feelings and thoughts of the therapist as a
participant in the healing process. Through the development of such a
relationship, clients over time are seen, acknowledged, and known. They
internalize the therapist’s caring, concern, and respect. They begin to
recognize that connection with the therapist is possible, and even helpful,
and use it to sustain them even when the therapist is not physically present.
The stage is then set for a different kind of relationship with oneself, which
in turn can lead to a different kind of relationship with others (Black &
Pearlman, in press).
How does it work? Therapist and client start by negotiating a frame for
the therapy. By inviting the client to speak needs and preferences (perhaps
about frequency of meetings, form of address, etc.) and feelings about the
therapist’s proposed frame (perhaps about fees, length of sessions, etc.),
the therapist conveys to the client that they are partners, that the client is
not a victim of yet another authoritarian relationship. The therapist invites
the client at the earliest moments of the treatment to begin to notice
feelings and needs, to tolerate conflict, to negotiate, and to remain aware
of ambivalence, processes from which the survivor may have withdrawn
in the forgotten past. By naming interpersonal processes, therapist and
client are breaking old rules of silence and secrecy. By inviting the client
to notice what s h e feels, the therapist helps the client begin to develop an
awareness of feelings, give them names, tolerate and voice them. Sessions
with survivors are often concluded with the question, “What will you be
needing in the hours and days ahead?” Initially, many clients find the
question inscrutable. Over time, they approach it creatively, playfully, and
gratefully.
A therapeutic relationship that is based in authenticity is one that con-
veys hope for a different kind of reality than childhood abuse and neglect
survivors may have known. It is a relationship that is more complex in that
it can include both caring and conflict. Conflicts inevitably arise related to
the frame of the therapy (the client requesting a reduced fee, longer ses-
sions, a hug), to the therapist’s errors or empathic failures (being late for
Laurie Anne Pearlman 17
Specific Interventions
ment may be sarcasm. What is it for this individual? What are the histori-
cal roots of these responses? If the individual once had, but has subse-
quently lost, an internalized benevolent other, how did the loss come
about? This information has important implications for the transference
that will unfold over time, and the client’s ability to internalize the thera-
pist as a caring other. What transferences emerge? What interpersonal
dynamics unfold between client and therapist in sessions? Can the client
imagine the therapist thinking of him or her positively?
How does the individual self-soothe, or respond to the therapist’s sooth-
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it that way” or “I don’t think children are responsible for adults’ actions,
but I understand you feel responsible”).
Clients who are working on experiencing self as benign may benefit
from reviewing self-statements about their own self-worth. The therapist
will help clients not personalize and overgeneralizewhat others say to and
about them. The therapist may encourage the client to speculate about
possibilities in others’ words beyond criticism of the client.
With people who are working on experiencing themselves as worthy or
positive, the work will focus on helping them value themselves. Identify-
ing talents and strengths can be enormously healing. The process of self-
examination is useful, as well as the task of considering valuing oneself.
The therapist must be careful not to engage the clients’ habitual devalua-
tion of themselves (T: “YOUmanage your daughter so well”; C: “No I
don’t’’). A less direct approach may be easier for the client to tolerate (T
“Your daughter seems to feel loved and cared for by you”). This is also a
building block in the therapeutic relationship; clients experience the thera-
pist as someone who encourages them to find the positive within them-
selves rather than as another critic.
clients may expect that, as a result of therapy, they will no longer feel
upset, hurt, angry, or disappointed. They need to learn that painful feelings
are a natural part of human experience. The individual may choose to
remain disconnected from others in order to try to minimize disappoint-
ment and betrayal. But once they bring their dissociation under control and
stop numbing feelings, such separation will likely invite feelings of loneli-
ness and yearning. The goal of this aspect of the work is not to erase
feelings but for survivors to become acquainted with the whole range of
human feelings and to know and understand their own.
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rewards to survivors who are reclaiming their lives and to the therapists
who have the honor of accompanying them on the journey.
NOTES
1. Dissociation, the separation of mental contents, is one of the common
sequelae of childhood sexual abuse (Neumann, 1994; Polusny & Follette, 1995;
Pumam, 1989).
2. Research is currently underway to operationalize and measure the self
capacities (Pearlman & Deiter, 1996). Readers may obtain copies of the Inner
Experience Questionnaire by sending a self-addressed stamped envelope to the
author with a request for the scale.
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SUBMITTED:0 I/ 13/96
REVISION SUBMITTED: 07/22/96
REVISION SUBMITTED: 10/10/96
ACCEPTED: 12/23/96