Not Trauma Alone
Therapy for Child Abuse Survivors in Family and Social Context
By Steven Gold
Routledge – 2000 – 334 pages
Series: Series in Trauma and Loss
How is an individual to lead a comfortable, productive existence when he or she was never taught the skills necessary for effective living? Adult survivors of child abuse often face this dilemma. Instead of being nurtured as children and taught life-skills by their caregivers, child abuse survivors were subjected to a daily regimen of coercive control, contempt, rejection and emotional unresponsiveness. It is not surprising, therefore, that many survivors encounter difficulty adjusting from this type of damaging childhood atmosphere to one in which they have autonomy. This book addresses the particular problems associated with treating adult survivors of child abuse. Until now, psychotherapy for child abuse survivors often centered on the trauma of their abuse experiences. However, survivors frequently reveal a history suggesting it was not abuse trauma alone that created their difficulties, but growing up essentially alone - without the consistent emotional support and guidance needed for development of effective functioning. This book presents an alternative to trauma-focused treatment that, though effective for treatment of other forms of trauma, can induce deteriorated rather than improved functioning in survivors of prolonged childhood maltreatment. The contextual therapy presented in Not Trauma Alone delineates a psychotherapeutic approach that emphasizes helping survivors develop the capacities for effective functioning that were never transmitted to them during their formative years. Detailed descriptions of the methods and interventions comprising contextual therapy are included in this critical book for all mental health professionals, clinicians, academics, and students in the field.
"…this book is a thought-provoking alternative way of approaching a difficult treatment population. It will lead many readers to question the "accepted wisdom" of their preferred approaches to PCA survivors, and it offers concrete treatment strategies that many will wish to try for themselves." -- Journal of Trauma & Dissociation
"Gold's sensitivity to the traumatized patient is everywhere in evidence throughout this volume… This represents a bold step forward. I wholeheartedly recommend this book as a worthwhile addition, not only to the trauma literature, but to our understanding of the human condition." -- American Journal of Psychotherapy
"Dr. Gold has contributed a much-needed resource to assist clinicians in working with individuals reporting prolonged childhood abuse. This book represents a significant shift in treatment of child abuse survivors in that Gold purports that direct confrontation of the traumatic incidents may be one aspect of treatment for survivors, but should not be the primary focus for most survivors. The book is written so as to make it easy to put principles and guidelines into practice." -- Trauma, Violence & Abuse
"Not Trauma Alone brings forward in a practical and insightful manner the perception that traumatic resolution can occur outside of the abuse-focused therapy that many of us have been trained in… Dr. Gold has masterfully provided many learners and clinicians an additional approach to treatment that is likely, in my opinion, to impact on not only how treatment happens, but also its very definition. HIGHLY RECOMMENDED!" -- National Council on Sexual Addiction and Compulsivity News
"Steven Gold offers therapeutic efforts and treatment techniques that serve to support client-therapist connection and renewed accountability to wellness, using a present-day focus that cultivates adaptive living skills…This is an essential and rewarding read that promises to enrich the texture of treatment for both clinicians treating adult survivors of child abuse as well as by traumatologists struggling to help any number of people throughout the world." -- Sidran Institute
"This book is about post-modern psychotherapy for people abused as children; a systems sensitive, transgenerational, goal-oriented, respectful approach to helping people of all ages confront, manage, and draw strength from overcoming a legacy of maltreatment. From the first moment I understood Professor Gold's thesis, I knew that this gentle and wise approach had great promise for a wide group of traumatized people." -- Charles R. Figley
"Steven Gold is a skilled clinical researcher with a special affinity, understanding, and empathy for the plight of adult survivors of pervasive and prolonged abuse. Not Trauma Alone is an important book and a brave clinical contribution due to its shift away from a strict abuse-trauma orientation to one that is more trauma-responsive and more encompassing." -- Christine Courtois
Forward. Preface. Part I: Abuse in Context: The Conceptual Framework. Abuse: The Trauma Model. Family: Beyond the Trauma Model. Alone: Growing Up in an Ineffective Family. Unprepared: The Legacy of an Ineffective Family Background. Impact: Intersecting Varieties of Abuse and Deficient Family Context. Society: Beyond Family Context. Part II: Treatment in Context: Foundations of the Therapeutic Model. Collaboration: Forming a Therapeutic Alliance. Conceptualization: Constructing Order from Chaos. Planning: Prioritizing Treatment Goals. Part III: Skills-Based Intervention: Implementation of the Therapeutic Model. Security: Managing and Modulating Distress. Focus: Fostering Experiential Presence and Continuity. Reasoning: Learning to Exercise Critical Thinking and Judgment. Coping: Breaking and Replacing Maladaptive Patterns. Liberation: Resolving the Trauma of Abuse. Transformation: The Miracle of Living Well. Part IV: Conclusion. Epilogue: The Inextricable Tie. References.