The Psychological Aftermath of the Traumatic Event for the Primary Survivor

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The traumatic event for the primary survivor, Joy Newsome, was abduction and being forced into captivity for seven years, where she lived in one small ten by ten shed. The trauma, was prolonged, multiple, and repeated where she was confined and left to her own devices daily and sexually abused and thus humiliated nightly by her abductor who she named “Old Nick”. During the second year of captivity she bore a son, called Jack, who lived with her in the tool shed for five years, until they escaped. The shed was secured by a code that only the captor new, and they were dependent on him for all their needs such as food, plumbing, electricity, basic clothes etc, which meant that there was a relationship of coercive control over most aspects of their lives for seven long years. The mother did not let Jack, the son, see their abductor, “Old NIck” and he did not seem particularly interested in his son any way. The mother insisted that Jack slept in a closet, when the abductor was in the shed, but there were slats so her so could see and hear the conversations and much of their relationship nightly. The abductor, within the relationship demanded gratitude and respect from Joy, and she, for the good of her son and herself appeared to act out this role for many years.

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The culmination of captivity was Joy and her son’s escape, where she places her son and herself in potential danger. She reaches a breaking point in her seen years of captivity where she becomes increasingly fearful for her and son’s future. She tutors her son to play dead, so the abductor will take him out the room and instructs him to escape when he is not looking. Her last hours in captivity she has to endure the torture of not knowing the fate of her own or destiny and crucially that of her most beloved child, that has been her only source of comfort and hope. This last resort, of placing her child in danger, in order to gain their freedom, was the culmination of the traumatic event for Joy, where she appears to break her moral principles, of protecting her son at all costs, in order to secure their freedom.

Who were the other traumatized victims?

The other significant traumatized victim was Joy’s son Jack. Even though they were in the same vicinity and suffered from a similar situation, Jack’s trauma will most probably be different since he was born in captivity, and to an extent protected my his mother. The immediate friends and family would also be traumatized victims, it was prolonged for seven years, and they would have had to deal with the issue of not knowing what had happened to the victim, and then hearing the events once Joy and her son are integrated back into the community and family unit. The community where her family lives and where the abduction took place will also be affected, especially as they hear the story in the media. We must not forget the vicarious trauma of the emergency responders and health care professionals that will support Joy in the future.

Identification and discussion of three key issues relative to the events. What were the effects? Explain how these symptoms manifested in the person's life.

Insufficient affect regulation skills

In he own words Herman explains, (1997, p86) “People in captivity become adept practitioners in the arts of altered consciousness. Through the practice of dissociation, voluntary taught suppression, minimization, and sometimes outright denial, they learn to alter an unbearable reality.” In other words, Joy has spent considerable time learning the art of controlling her symptoms by restricting and suppressing her thoughts that could trigger post traumatic intrusion. We see examples of this when she communicates her learned mantra to her son, which is, “if you don’t mind, it doesn’t matter” and how she says to herself her philosophy of dealing with the situation in that she is going to go through life, post captivity, as if nothing happened.

Joy seems to be suffering from affect Dysregulation in that she has difficulties in her capacity to tolerate painful internal states (Briere, 2015, p175) Many scholars believe that affect Dysregulation is typical of extreme trauma exposure (Briere, 2015) and this results in distress avoidance symptoms. Joy is textbook case of affect Dysregulation in that the consequences of her distress avoidance, resulted in the symptoms of the abuse of painkillers and suicidality. Joy was literally ,although understandable, trying to numb her pain, but by using painkillers as a means for excessive avoidance of trauma triggers. Using the method of substance abuse to block out her pain, in the long run, will interfere with her recovery process of exposure, activation and processing (Briere, 2015, p250). Joy also suffers from mood swings, sudden emotional distress, a tendency to act out, and dissociative responses during her initial time in her mother's home and these are all hallmarks of affect dysregulation.

Intrusive negative self-perceptions and sudden feelings of helplessness

Joys time in captivity has produced profound alteration in her self identity and this has resulted in issues of trying to piece together her new identity, now that she is seven years older, and back in her family home. Post captivity, Joy has developed an intrusive negative sense of self as an inadequate mother. These feeling of inadequacy were triggered when she was recently questioned by the media about her captivity. She has developed feeling of unacceptability and has started to see herself as betraying her own son and this in turn has given rise to self loathing and shame. These negative self perceptions, when questioned, caused Joy emotional overload which has lead to her recent attempted suicide.

Rupture in continuity between the present and the past

Seven years of Joy have been on hold during her time in captivity. This is also relevant to all of Joy’s immediate circle of loved ones as there have been changed family dynamics during this time. She is at present attempting to build a new life with her family. Her room is exactly how she left it as a fourteen year old girl. There have been major changes in her identity since she was fourteen and is finding it hard to come to terms to the new person, especially as her present schema is to pretend that the past seven years never happened. She now is a mother and has become an adult, also her parent are now divorced and she has a new step father living in her house. The family unit has changed, in that she has now a five year old son and a step father to integrate into the new family unit. Her biological is finding it hard to come to process Joy’s son Jack, who is simultaneously the abdoctors son, and refuses to talk to him or acknowledge his existence. All the members of the family unit living in the her mother's house are supportive of the situation, but are also finding hard to adjust to the new reality. At present, the trauma of the captivity is not successfully being integrated into the Joy and her families ongoing identity and life story as Joy is practicing double think.

Therapeutic considerations: Client General Treatment Approach and Rational

While Joy was in captivity she used structure and routine as a survival mechanism for her and her son. She is also a very intelligent young woman who responds well to cognitive reasoning, and also used this as a survival mechanism in captivity. My overall plan is to use a cognitive therapeutic approach and suggest her implementing routines, her past survival mechanisms, as tools to help her for the present and future.

Pre briefing, and Psychoeducation

Understandably Joy’s time in captivity has made her more vulnerable, fearful of other people, she has developed a need to be fully in control, and and is distrustful of forming relationships. With this in mind, a general approach is to work in partnership with Joy and to explain the underlying reason for the counseling approach every step of the way. Both pre-briefing and psychoeducation will be crucial for therapeutic relationship and any kind of recovery. This approach could help by normalizing the counseling process, validating what Joy is currently experiencing in the present, and help predict the possible post traumatic outcomes for the future.

I will use Psychoeducation to help us identify potentially triggering stimuli in the future so that Joy may avert activation that will cause intense distress. I will provide Joy with information regarding self care. I will counsel Joy using psychoeducation, the problems that can occur with excessive behavioral avoidance, including secluding herself away, and the excessive use of drugs, which was her previous approach before the attempted suicide. I will explain how the excessive avoidance of trauma triggers and memories, although completely understandable in logic, often interferes with recovery by halting the process of exposure activation and processing, which is the main technique for trauma recovery (Briere, 2015, p250). I will explain in detail the underlying reasons for my statement by showing her the research statistics and information from expert practitioners in the field.

It is also necessary to explain the value of therapeutic exposure and the method that I am to use so she will hopefully feel in control. Since her schema pre suicide attempt has been to control her symptoms by using intentional avoidance strategies, learning that the therapeutic approach for gradual exposure will most probably sound counterintuitive (Briere, 2015, p175) The explanation of the procedure is crucial for our client-counselor relationship. It is crucial that we work together in making sure that these memories do not become too upsetting, in that she should only talk about how much she feels comfortable at the same time knowing that when she involves herself in this process, most likely, an improvement will occur. By using both psychoeducation and pre-briefing, and continually sharing the process along the way, I am hopeful that a strong client-therapist alliance will naturally form. Sharing the process, will hopefully mean that

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