Therapy as Search and Rescue for the Abused Inner Child

Over the course of my career in nursing homes, I have spoken with a disturbingly large number of persons from their 30’s to 90’s, occasionally men, yet predominantly women, who have survived horrible sexual, physical, and mental abuse in childhood.

When they were children, they did not approach a responsible adult to say, “Could you please help me with the bad feelings I have because the adults who should have loved me were awful to me.”

Obviously, no child thinks or acts that way. So what do they think?

“I’m bad.” “I’m no good.” “It’s all my fault.”

“If I was better that would never have happened.”

“I’ve screwed up all my life.”

“No one will ever love me.”

“I deserve to be punished.”

“I’m really just not worth anything.”

These people were innocent children who were treated monstrously; there was nothing wrong or bad about them. Yet they are now entwined in cords of unforgotten cruelty, surrounded by shadows of shame, their faces shrouded in feelings of disgrace and humiliation.

People who have been violated in such primal ways do not easily trust others, or readily expose their wounds, or explicitly seek help for the lasting agony of primary betrayal.

Like Bob Dylan, they leave “Blood on the Tracks” of their travels through a difficult life. The blood stains appear as problems with relationships, moods, psychiatric symptoms, SUD, and self-harming actions.

In my view, psychotherapy can be likened to crime-solving detective work, as both involve an archeology of sin. The present days shards we find on the surface of their complaints point to a history of sinful and criminal actions that broke into pieces the wholeness and integrity of a client’s sense of self.

Present day symptoms are fragments of meaning, pieces of stories out of context; their understanding lies in the past and below the surface. Our work is to excavate with gentle brush strokes at the fragments of the story available to us. Following the steps of Hercule Poirot or Miss Jane Marple, the therapist needs to inquiringly pursue clues that lead backward to the original harms wrongly inflicted upon the innocent.

One of the many tools we use as psychotherapists is cognitive-behavioral therapy. We teach clients to notice patterns of automatic negative thoughts, to reassess the rationality of those thoughts, and to practice replacing them with affirming and encouraging self-talk.

Those techniques are aimed at the adult before us now, yet the one suffering most deeply can sometimes be the innocent and abused child who remains dynamically present in their symptoms.

I find CBT to be helpful with some clients, such as with OCD, for example. Yet the standard CBT approach might not work as efficiently with a client serially raped or tortured or otherwise tormented as a child, because of their hardened defenses.

Some clients may not be able to comfortably tolerate conversation about his or her personal strengths (“I hear you saying those words, Tom, but I just can’t believe them”), or (“no matter how many times I think something good about me, it’s like it’s about someone else”).

There may be degrees of dissociation, and deeply ingrained attitudes of rejection of self. In such cases, I have found it productive to turn the focus from the adult survivor to the child victim, because the adult hardened by sustained suffering can be softened by a new sense of concern for herself before the abuse began.

Now, not every person who has been victimized by severe abuse in childhood has the ego-strength, or intellectual capacity, or the architecture of social contacts and daily structure to allow themselves to safely enter into direct therapeutic discussion of the long past events and the history of underground growth of anguish into present-day symptoms.

It is sufficient if the person can simply acknowledge the fact of past abuse, without verbalizing all the details of their torment, and if they grasp the imaginal concept of a little boy or girl inside of them who needs their help to find greater relief and freedom.

If I suggest that the person practice positive self-talk aimed at their adult self, it might be like taking a photo from the rim of the volcano without entering the fire below.

Clients readily acknowledge in therapy that they were an innocent child at the time of the unjust and criminal abuse. I point out that their derogatory remarks about self are heard most keenly by the little ears of that child inside of them.

I explain that no one in the world better understands what that child experienced, or what that child needs now, and that nobody anywhere is better equipped to comfort and reassure that child, and help her learn to feel safe.

When the client comes to clearly grasp that their self-attacking thoughts are attacks against that scared child in their heart, they can attain a new degree of gentleness, a new attitude of responsibility for drawing that little one closer and easing her fear and pain.

Some clients have gotten a photo of themselves as a child, and looking at the picture deepens their commitment to protect rather than insult that little one. Some hug a pillow or a stuffed animal to comfort the inner child.

This approach has an empowering effect on clients, and helps them move from helplessness to a caring duty to self, with concrete ways of easing their own distress.

One client, Rachel, said that this approach “makes a huge difference!”

“I feel different because I finally have someone in my corner showing me how to work out my problem with my mother, and without you I would still be in that paralyzed state.”

“I feel better because I know I can get to the point where I’m not thinking that it’s all my fault.”

“This helps me have a more tender thought about myself as a girl that didn’t minimize what happened, and it has also helped me have more tender thoughts about my mother, and see her differently, when I think about what might have happened when she was a girl,” Rachel said.

Many clients I see for therapy suffered grave psychic wounds in childhood due to rape or violent assaults. We are sometimes challenged as therapists to find new ways of working with clients that might lead to genuine progress in healing catastrophic injuries. We sometimes explore in dimmed light for new possibilities. I have had some success with some clients through shifting the attention to the concept of a still present inner child, and guiding the adult client to take direct intellectual, attitudinal, and emotional actions to find and rescue that frightened inner child.