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What I Wish I Knew Beginning Therapy for Childhood Sexual and Emotional Abuse

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Editor's Note

If you’ve experienced sexual abuse or emotional abuse, the following post could be potentially triggering. You can contact The National Sexual Assault Telephone Hotline at 1-800-656-4673, or the Crisis Text Line by texting “START” to 741741.

After three years in therapy for childhood sexual and emotional abuse, there are several things I have learned that I wish I had known going into this process. While each person’s process and trauma may be different, here are a few things that might be helpful if you are looking to begin the process of healing from abuse. Please note: I am not a medical professional, but I feel as though I’ve gained a lot of insight over these last three years that could be beneficial from a patient’s perspective.

• What is PTSD?

1. Find a therapist you can connect to.

I cannot stress this point enough. There are many qualified therapists out there. All of them will do an initial phone call and consultation. Your gut will tell you pretty quickly if you connect with a therapist or not. A couple of considerations are:

Sex of the therapist and specific modalities within which they are trained. As a child sexual abuse survivor, I knew I did not want a male therapist. This was a must for me. I also wanted someone with a doctorate, who I knew had the clinical hours needed to work with trauma patients. Specialty training in eye movement desensitization and reprocessing (EMDR), somatic therapies or emotional freedom therapy (EFT) can also be valuable. In my case, I started working with a therapist who works within a psychodynamic approach, which has been particularly helpful to me in terms of helping me heal my attachment wounds and doing inner child work, but she doesn’t do EMDR and she suggested I add that to my therapy to help moderate my post-traumatic stress disorder (PTSD) symptoms. So I had to go find a second therapist who specialized in EMDR.

The first one I started with just didn’t sit well with me. I tried really hard but I was uncomfortable. So, I listened to my gut and found another therapist whom I immediately clicked with. I now work with both my primary therapist and EMDR therapist. They complete each other and are a great balance for me in my needs.

2. Don’t hold back or sugarcoat.

There is nothing a well-trained therapist cannot handle. Not being completely truthful about your life, abuse history self-harm history, addiction history or anything else you may be ashamed of cannot enable your therapist to help you in an effective way. It may take a while to build up the trust needed to fully share your truth, particularly with regard to sexual assault or abuse, but take the time you need to get there.

Once you truly feel safe and connected, there is nothing more cathartic and healing than being able to share your “yuck” with someone who is going to listen with empathy and without judgment.

3. Do your homework.

Therapy is a two-person job. Well, actually, it often involves many people including partners, friends and family, but ultimately, healing and progress can only be made if you are invested in doing the work. I’m not gonna lie: it’s hard work. The hardest work you will ever do. Some days, you won’t have energy for anything else, but it’s totally worth it.

Every baby step you make toward healing is a monumental achievement. Homework is assigned to you and designed for you to help you push yourself and challenge your ingrained beliefs and coping strategies. They can help you shift your perspectives on how you see yourself and those around you and they can help you learn healthier coping strategies.

4. Boundaries.

As hard as these can be, boundaries have to exist between you and your therapist. They may be one of the most important people in your life, but as much as they care about you, they have other patients and their own lives and needs. Establish boundaries early and ask what kind of communication they will allow between sessions. Each therapist is different so make sure you are clear. I’m the queen of pushing my therapists’ boundaries because I was so afraid to trust, but once I started being more observant of their boundaries, my self-soothing strategies started to improve.

Keep in mind, some therapists won’t engage at all between appointments. Some will allow email, some text and almost all have an emergency phone line for crises. Have these tools at your fingertips and know when you reach out they may not reply immediately. After all, they may be busy with other things. That doesn’t mean they don’t care or are abandoning you.

5. Don’t resist “attaching to,” “needing” or “connecting” with your therapist and don’t be afraid to challenge them.

Therapy is the only place we can receive the skills we needed to learn as children but we didn’t get. It’s normal and even expected for anyone with trauma to attach to their therapist. In many ways, the therapist is the closest thing to a parent you can have as an adult.

Similarly, don’t be ashamed if you begin developing romantic feelings. This is called transference and it happens all the time. Talk to your therapist openly about how you are feeling. They have the skills to help you reframe your feelings and to help you learn from them. And, if something your therapist says or does upsets you or angers you, tell them! They are human. Mistakes happen. It doesn’t mean they don’t care. The safety of the therapist’s office is a great place to practice working through disagreements, feelings of anger and conflict. They won’t be hurt or offended. They will use it as an opportunity for you to learn and if they did make an error they will apologize, which can be a powerful step toward becoming your own biggest advocate.

6. Finally, don’t put a time frame on healing.

You cannot compare your trauma or healing journey to that of anyone else. We all heal at the pace necessary for our own safety. Give it time and be gentle on yourself. Healing isn’t linear; it’s a spiral. Well, sometimes it feels like a squiggly mess, but the reality is that it takes as long as it takes. You will keep coming back to things you have yet to resolve and that’s OK. Your therapist is used to repeating themselves as often as needed for things to start feeling true, and they won’t give up on you because you aren’t a “good patient” or healing “fast enough.” 

Now you are ready to jump in and start your healing journey. It’s scary, exciting, exhilarating and often maddening. You will experience many highs and lows, but I promise it’ll be worth it. I still have a long ways to go on my own journey, but not a day goes by that I’m not grateful for it, even through all the bad days, anxiety-filled days, insomnia, nightmares and loss of friends and family. All of these have been a part of the process and have enabled me to not only rediscover the me I was always meant to be, but also to find my tribe, my family, those who love me in spite of my history and not because I’m putting on some kind of seemingly perfect mask that doesn’t exist. That’s worth ever penny on the planet.

Photo by Jake Noren on Unsplash

Originally published: February 8, 2019
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