Ken* is a trauma survivor of early abuse and neglect at the hands of his parents and siblings. This includes bearing witness to a rape at age four and himself being raped at age five. Always appearing well-dressed, he is a charismatic, university-educated professional, with a supportive wife and smart kids. Such attributes collectively make Ken’s tormented internal life very well-camouflaged. During this morning’s therapy session, he is bending over in his chair delicately cradling his head, occasionally breaking the silence with heavy sighs. Then wearily lifting up with a pleading look asks:
“Can you summarize the reason why a child needs guilt?”
Why is it so tough for intelligent patients, like Ken to let go of guilt? After all, now as adults they are free to attend to their long overdue needs. Ken has a gravitational pull towards irrational guilt. This problematic issue has been repeatedly re-framed with full responsibility for the abuse correctly reallocated. Yet patients with Ken’s background are not automatically psychologically or emotionally free. One could argue that people often confuse feelings of shame with feelings of guilt (see “Shame Matters” in MindCafe Issue #20), or that because people like Ken are often parentified that guilt plays a role (Jurkovic, 1997). But guilt has a gripping power among trauma survivors that runs deeper.
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A person feels guilt when they believe they have disobeyed, infringed or contravened a social or moral belief system they, or the group they belong to, have subscribed to (Lee, Scragg, & Turner, 2001). Freyd’s (1996) work helps us to appreciate how, for survival, Ken had to believe he disobeyed, infringed or contravened the immoral social belief system of his family of origin. Many traumatised individuals become used to not remembering earlier maltreatment. In pursuit of more pressing emotional, psychological and physical survival needs (whether real or symbolic) from their attachment figure, such as food, love and shelter, they have to forget. That is, as a boy Ken found it necessary to forget or remain unaware of who ultimately was responsible for his safety and developmental needs. Ken’s need for some level of control in an out-of-control social environment generated this illusion of irrational guilt or an unwarranted sense of responsibility. In this context, guilt can be viewed as an artificial way of exercising control over that which Ken, as a child, had no control. Ken’s legitimate request for a summary of the reasons “why a child needs guilt” is a critical question about early survival. It is a call for mental clarity. This demands psycho-education. I replied to Ken’s question as follows:
Children need to feel secure and that somebody — including themselves — is in control. Often an abused and neglected child uses ‘fake guilt’ to do this. Guilt thus becomes an illusion of control. It is a very important illusion. The maltreated child needs and so uses this illusion to psycho-emotionally control frightening, terrible things happening to them or others, directly or indirectly. Within this artificially dreamt-up fake control, there lies a clear purpose. It gives to the abused child something that was in very short supply which is a (artificial) sense of comfort and security. This instinctive need for comfort and security fed a very necessary, albeit illusory, belief system which was self-protective. In such a sad, unfortunate and much distorted context the abused child “needs” guilt because it serves a special function. But the utility of this much needed yet irrational guilt is limited. If such a person manages to successfully grow up while distancing from their abusive parent, they are at risk of being burdened by irrational guilt unless they receive appropriate mental clarity. None of what happens to a traumatised child warrants their guilt. But until somebody summarizes “the reason why a child needs guilt” they will remain painfully confused because for the traumatised, guilt as an illusion of control works only as provisional support.
Tangney and colleagues (1996) note that the focus of guilt is on the one expected to repair damage they were responsible for or to receive some kind of punishment. Since no adult in Ken’s early life was capable of taking responsibility or punished for their criminal acts, artificial self-blame became one way Ken felt any sense of control and autonomy while growing up in a chaotic atmosphere. In other words, as a coping strategy Ken had to create and then believe in an illusion of guilt (i.e., control) — this being a normal reaction to abnormal circumstances associated with early trauma (Courtoise, 2010; Freyd, 1996). This suggests taking advantage of what one knows about a patient’s early abnormal history and feeding back just how their “guilt” is a direct outcome of interpersonal trauma. In Ken’s case, I fed back to Ken as follows:
Young, dependent, naïve and innocent, at an unconscious level, there was a need to self-blame even when: (1) he did nothing wrong; (2) what happened was beyond his control due to his age, developmental needs, his rights as a minor; and (3) he was not there at the time when bad things happened, such as his mother’s physical deformity, his parents’ alcoholism, undiagnosed and untreated mental illness, the witnessing of domestic violence, his father raping his sibling. Adding to this list, I remind Ken he already was a victim, at age five, when his older sibling raped him. I wrap up this coverage with the question “who indeed is guilty?”
On some level, Ken logically understands he is not guilty. But consistent with survivors of early abuse and neglect, Ken is used to blaming himself rather than responsible parties. As Courtois (2010) notes: “Before being able to reattribute responsibility, the client may need to have the abuse repeatedly reframed by the therapist, who must also continually notice and interrupt any ongoing negative self-perceptions” (p.390). In order to interrupt Ken’s ongoing negative ideas regarding “guilt” three reframed messages became necessary:
1. No child needs guilt. As a child, he did not “need” guilt but protection, etc., (e.g., see Brazelton & Greenspan, 2000; Wallace, et al., 2011, Table 1, pp.8–10 for a conceptualisation of children’s wellbeing needs). Guilt was a necessary outcome for survival when those surrounding him during childhood did not want to, or were incapable of, taking responsibility.
2. He committed no crime. Guilt is when somebody committed a specific or implied offense or crime. He was never to be blamed for the criminal acts and culpability of those who were meant to care for and nurture his development, or who were much older than him at the time of their criminal acts, abuse or neglect.
3. Adult responsibility ultimately rests with adult caregivers not children. Somehow, irresponsible individuals made him feel guilty in order to induce him to do something for them, fulfil their needs rather than his own, or fill a gap in what should have been their responsibility. He conformed to their demands because he absolutely needed to for his very survival.
For clinicians, recognition of the power of guilt in relation to trauma and neuroscience is critical. For instance, uninformed practitioners aiming to unite guilt-ridden, traumatised individuals, like Ken, with their seriously mentally-ill parents are very likely causing harm (Misrachi, 2012). This is because doing so may induce in such people “separation guilt” (Friedman, 1985; Weiss, 1993) characterized by the belief that one is harming one’s parents by virtue of separating or being different from what is expected (Weiss, 1993). This is similar to survivor guilt because, as with other trauma groups such as survivors of childhood sexual abuse (Easton, Coohey, O’leary, Zhang, & Hua, 2011), incest (Courtois, 2010) or the Holocaust (Durst, 2003; Kestenberg & Kahn, 1998; Solkoff, 1981), survivor guilt can keep individuals suffering the impact of trauma that was repetitive and prolonged in a problematic situation. It also prevents guilt-ridden, traumatised individuals from achieving their potential (Bloom, 2002). For patients like Ken, the added danger is when a pervasive sense of (fake) guilt gets rusted on. It is as if his abusive parents’ needs never stopped being his responsibility or obligation. The added risk in this context is when guilt fast becomes misunderstood for feelings of closeness or love (Misrachi, 2012).
The experience of shame occurs in most people’s lives, which in turn influences their actions and behaviors (Dearing …
Dealing with the gripping power of guilt in traumatised patients is critical. The cumulative exposure to multiple traumatic stressors, usually of an interpersonal nature and in a range of situations and roles with intermittent escalations, resulted from actions by Ken’s primary caregivers on whom Ken depended while growing up. Embedded in abuse histories, interpersonal trauma often entails abandonment or harm by primary caregivers (including older siblings) thus embroiling guilt. This is clinically significant as it contributes towards persistent, long-term challenges to health, impacting on various chronic physical diseases which can then lead to early death (Felitti & Anda, 2010; Felitti, Anda, Nordenberg, Williamson, Spitz, & Edwards, 1998; Scott-Storey, 2011).
* Ken is not his real name
Suzette Misrachi, Master of AdvSW (Research), MBSW (Acc — Medicare). International presenter, consultant and professional supervisor specialising in trauma and grief of Competent and Non-Disordered Children of Parents with a Severe Mental Illness (CAN-ACOPSMI): http://goo.gl/W47Mr
This article was originally published in Mind Cafe, September, 2016, Issue 24.
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