The link between childhood sexual abuse (CSA) and psychiatric disorders in adulthood is well documented. Because much CSA is enshrouded in secrecy, group work is often recommended as a method of treatment. While studies show good outcomes in short-term groups, there are fewer studies of long-term analytic groups for survivors of CSA. This study compares outcomes in long and short-term groups and explores the findings through analysis of the process of one long-term group.
The impact on individuals of severe and early trauma is looked at from an integrative perspective that seeks to combine the growing body of evidence and literature from psychoanalysis and from an attachment perspective, which emphasizes the centrality of the relationship in which the trauma occurs. As much sexual abuse happens without the opportunity for communication, it is suggested that what is most traumatic about the trauma is its lack of shareability. This is exactly what group psychotherapy can promote. Through cohesiveness the group can create a secure base through which to explore the world of inner objects and interpersonal relationships and, specifically, the traumatic responses of the self. The majority of groups in non‐forensic settings are for women only and short‐term specifically in order to prevent the tendency of the women to get stuck in an identity of being victims. The author discusses the literature that addresses differences in the way in which men and women respond to childhood sexual abuse. As the group functions as a microcosm of society, it is suggested that mixed groups enable cultural stereotypes, or the social, to enter the group room where it can be shared and illuminated, and as further demonstrated through clinical material, the presence of the ‘other’ facilitates an interplay between the male/female/abuser/victim poles leading to an opportunity to work with more perverse attachments and identifications.
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