![]() ![]() I thought maybe he could help me get published somewhere. A.-I was really into writing poetry, and I would sometimes stay after school to show him what I had written. A.-Junior year…I was 16 when it happened, I guess. I thought he wanted to help my writing, but no. Like, even my high school English teacher. So…yeah, if you want a man to like you, give him sex. A.-Well, I guess, if I’m being honest, all men want sex. So, I’m just trying to reconcile these ideas and better understand what your feelings are on this issue. You’ve told me that you wanted to have sex with him and that you’d planned not to. I’m trying to understand what your feelings are. B.-I’m sorry if my words or tone suggested judgment. ![]() A.-You think I only slept with him so that he’d like me.ĭr. B.-Would you have enjoyed the date more if you didn’t have sex? A date is always better with sex for them and, so, if we have sex, he’s going to like the date more.ĭr. But, then, he was just a great guy, and guys always want to have sex. A.-Well, I know I said last week I wasn’t going to on the first date, but I wanted to. A.-It felt good, I wanted him to… Also, we had sex.ĭr. We went to the boardwalk, played games, and he put his arm around me and kissed me. A-It went well! He was handsome and charming. B-Last week, we talked about your date that you had planned for this past weekend. She initiated therapy with the goal of improving her comfort in and ability to maintain an intimate relationship.ĭr. ![]() A is a 28-year-old woman who has survived multiple instances of sexual abuse and sexual assault from men of authority in her life. 7 Without these elements, a patient might feel retraumatized and unsafe.Ĭomposite case vignette 1. In order to do this, the therapist must create a safe space for talking with the patient by being empathic and nonjudgmental, attending to the patient’s physical comfort, and demonstrating understanding. “Follow the red thread” is a phrasing used to encourage the therapist to focus on the feelings and emotions occurring in the therapy session rather than be pulled into discussing superficial issues. When treating a patient who has been sexually abused or assaulted, these distinctive features of psychodynamic psychotherapy remain the focus of the treatment. In this article, we review these psychotherapeutic treatment methods in regard to managing this patient population and provide additional treatment suggestions to assist therapists in achieving optimal outcomes among survivors of sexual assault and abuse. 3 The treatment of survivors of sexual assault gains benefits from several general and specialized types of psychotherapy including psychodynamic psychotherapy, trauma-focused cognitive–behavioral therapy (TF-CBT), and eye movement desensitization and reprocessing therapy (EMDR). 2 The United States Centers for Disease Control and Prevention (CDC) estimates that sexual violence affects one in three women and one in four men over the course of their lifetimes. 1 In the past, rape survivors were thought to need only counseling-that is, direct, problem-focused treatment-rather than broader, more in-depth treatment such as psychotherapy and, if the survivor did undergo psychotherapy, the major focus was on preexisting psychopathology. ![]() 1 In their 1974 American Journal of Psychiatry article, Burgess and Holmstrom reported that there was little information on the physical and psychological effects of rape or how to manage the treatment of a survivor of sexual assault in the psychiatric literature. It was not until relatively recently that the treatment of survivors of sexual assault came to be under the purview of psychotherapeutic treatment. The intersection of sexual assault and psychotherapy is complicated. ![]()
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