Using Intersubjectivity to Help Abused Children

Helping Abused Kids Rewrite Their Own Stories

Dan Hughes

CaseStudy-smSadly, children who’ve suffered abuse and neglect at the hands of their parents are often convinced that their mistreatment was justified. As a result, they typically grow up with a pervasive sense of shame, struggling with emotional regulation, cognitive and reflective functioning, and the inability to experience positive emotions. It isn’t surprising, then, that these children are often unlikely to be cooperative participants in therapy or easily engaged with new parents and teachers.

Therapists must therefore work to discover the children under the symptoms—those who lived before the abuse, who survived in the face of it, and who can begin to emerge after being accepted and embraced by those who’ve come to love them. To have a positive impact on these children, caretakers and therapists must offer them a different felt experience of who they are. As Daniel Stern, Colwyn Trevarthen, and other child psychologists have shown us over the past 30 years, the most powerful means of achieving this is through congruently communicating, both verbally and nonverbally, how they see these children and mirroring the children’s emotional experiences. That process is called intersubjectivity, and it’s the primary way that children develop a stable representation of self. For example, parents who communicate anger and indifference raise children who experience themselves as bad and unlovable. If those children are to change their primary experience of themselves, they need parents—and possibly therapists—who express the experience of joy that they’ve brought into the world, love for their previously unseen selves, and admiration for their perseverance.

Jake was 9 years old when he first came to see me. He’d had a rough start in life, full of physical, emotional, and verbal abuse, mostly from his father, while his mother looked the other way so that she wouldn’t be abused also. At age 4, he was put in foster care and moved twice until, at age 8, he was adopted by Peter and Stephanie. After a few months of relative calm, he began to exhibit the behaviors that had been common in his three previous foster homes. He argued a great deal, seldom acknowledged being in the wrong, and never expressed any kind of sadness, fear, or regret. His hair-trigger temper often resulted in long bouts of screaming and swearing. Although he had some interests, he didn’t seem to enjoy engaging in many activities. In fact, Peter reported that if they spent the day together building something or swimming, at the end of the day Jake would complain that he hadn’t had any fun and would seem preoccupied with the one incident that didn’t go his way.

When children come into therapy with me, I seek to discover how they formulate their own life stories, knowing that much of what I’m likely to hear about them initially comes from others, especially their parents. My goal as a therapist is to help children begin to more actively become the authors of their own stories, increasingly aware of their own possibilities, hopes, and dreams. To do that, I try to help them reexperience their lives as I communicate my support and my emotional responses to the events we discuss, including my sadness and compassion for the hard parts of their stories, my joy and excitement for their courage and perseverance, and my interest in their strengths and vulnerabilities.

Find the full Case Study, "Rewriting the Story: Entering the World of the Abused Child," in the January/February 2014 issue of Psychotherapy Networker magazine.

Topic: Children/Adolescents

Tags: case study | child abuse | child psychologist | child psychologists | child therapy | children in therapy | Dan Hughes | foster care | intersubjectivity | neglect

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