In my practice at Midwest Counselling, of the many long-lasting impacts child sexual abuse (C.S.A.) and one of the most prominent is the difficulty for adult survivors of C.S.A. to maintain healthy fulfilling couple relationships. The merits of focusing on the role the partner has in this recovery is becoming more and more apparent (The Australian and New Zealand Journal of Family Therapy, 2012) as too is the value of using a multidisciplinary approach (Ibid). For many therapists the focus of the therapy is the healing process for the traumatised individual rather than looking at the potential healing opportunities provided by a safe and trusting couple relationship. Furthermore, in many situations it is a couple who have presented with relationship, intimacy or sexual issues stemming from CSA and are looking for help from within dynamic of the relationship; and so the work of treating CSA needs to take place within a couples counselling paradigm.
Ignoring the impact of CSA on adult relationship or focusing only on the survivor of CSA or ignoring the role the other partner can play may limit the healing opportunities within the therapeutic relations and can level the client feeling let down or dissatisfied particularly if you are working within the confines of couples counselling. Similarly it is a well-established consensus within the psychotherapeutic and counselling communities that treatment of complex trauma, especially with regard to CSA that survivors of sexual abuse require safe and healing relationships from which recovery can most ably begin. (Courtois, Ford & Cloitre, 2009)
While this notion had generally been accepted to apply to the therapeutic relationship, it is important not to overlook the restorative opportunities and potential offered from with the confines of existing couple relations; especially when the clients have expressed a desire to work on and improve the sexual contact, intimacy or other aspects of their relations. If, as we can all agree, healing takes place in moments of secure attachment (Solomon, 2003) then the opportunity provided for healing within the current couple relationship is a vital and dynamic opportunity that ought not to be overlooked.
As per the attachment theory the security of the existing couple relationship (as well as the security of the therapeutic relationship) can allow the therapist to encourage the client to explore the trauma and its impact from a safe place.
In using this approach is it also important to recognise the frequency with which one finds that if one partner bring to the relationship a history of CSA, then the other partner will bring problems of equal measure, often, though not necessarily always, sexual abuse. Therefore it may very well be the case that as a therapist you may find yourself treating not one, but two separate victims of traumatic childhood or early life experiences.