Survivor To Thriver

SURVIVOR
TO
THRIVER
———— õ ————
Manual and Workbook for

Adult survivors of child Abuse
Who want to move-on with life
Survivor to Thriver, Page 1

1995 THE MORRIS CENTER, Revised 7/99, www.ascasupport.org
THE MORRIS CENTER
for healing from child abuse
1537 Franklin Street #307

San Francisco • CA • 94109
phone: 415 • 928 • 4576

e-mail: [email protected]
website: www.ascasupport.org
 1995
THE NORMA J. MORRIS CENTER
for healing from child abuse
All rights reserved, including the right of reproduction

In whole or in part in any form.
Revised
10/95, 7/96, 7/99
———— õ ————
The information and program contained herein are

not intended to be psychotherapy or to substitute
for consultation with a licensed health or mental
health professional. Application of the
contents is at the reader's sole discretion.

TABLE OF CONTENTS
About THE MORRIS CENTER . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
Chapter One: The ASCA StepWork Program

Introduction ..................................... 7
StepWork, ASCA-Style ............................... 8
Responsible Recovery, Responsible Therapy . . . . . . . . . . . . . . . 11
Chapter Two: Safety First!

Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17
Safety Checklist . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19
Suicide/Harmful Behavior Checklist ............ ... 20
Creating Your Plan For Safety First! ..................... 21
Awareness_Assessment_Action . . . . . . . . . . . . . . . . . . . . . 21
Building Your Support System ..................... 24
Identifying Your Support Network ......... 24
ASCA Colleagues . . . . . . . . . . . . . . . . . . . . . . . . . . 25
Resolving Abusive Relationships First . . . . . . . . . . . . . . . 25
Personal Relationships Checklist . . . . . . . . . . . . . . . 26
Stabilizing Your Life .......................... 27
Crisis "Hot Spots" Checklist ............... 28
Self-Soothing Activities . . . . . . . . . . . . . . . . . . . . . . . . . . 31
Living Safety First! _ A Final Note ..................... 33
Chapter Three: Assessing Child Abuse

Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35
What Is Child Abuse? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36
Physical Abuse . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36
Sexual Abuse. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39
Emotional Abuse . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 42
What Are The Adult Repercussions of Child Abuse? . . . . . . . . . . 47
Relationship Problems . . . . . . . . . . . . . . . . . . . . . . . . . . 48
Low Self-Esteem . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49
Self-Sabotage . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 51
Sexual Problems . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 53
Symptoms of Trauma . . . . . . . . . . . . . . . . . . . . . . . . . . 55
Physical Ailments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 57
Social Alientation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 59
Handling Feelings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 60
Conclusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 63

TABLE OF CONTENTS
Chapter Four: Stage One  Remembering

Stage One: Remembering . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 65
Step One . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 66
Step Two . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 69
Step Three . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 72
Step Four . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 75
Step Five . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 77
Step Six . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 79
Step Seven . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 82
Chapter Five: Stage Two  Mourning

Stage Two: Mourning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 85
Step Eight . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 86
Step Nine . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 88
Step Ten . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 90
Step Eleven . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 92
Step Twelve . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 94
Step Thirteen . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 97
Step Fourteen . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 99
Chapter Six: Stage Three  Healing

Stage Three: Healing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 101
Step Fifteen . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 102
Step Sixteen . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 103
Step Seventeen . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 105
Step Eighteen . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 107
Step Nineteen . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 110
Step Twenty . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 111
Step Twenty-One . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 114
ASCA Stages & Steps . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 115

ABOUT THE MORRIS CENTER
A non-profit 501(c)(3) public benefit corporation, THE MORRIS CENTER

was founded in 1991 (as the Adult Survivors of Incest Foundation) to provide
individual and group sliding scale psychotherapy and low-cost educational and
self-help programs for adult survivors of sexual abuse. In November 1993 the
name of the organization was changed to The Norma J. Morris Center for healing
from child abuse. This changed reflected the fact that its programs had expanded
to serve survivors of physical and emotional, as well as sexual, abuse, and to honor
the organization's co-founder and principal benefactor, Norma Morris.
In 1994, perceiving an increased need for cost-effective, easily replicable

programs, THE MORRIS CENTER shifted its primary focus to our ASCA support
program and discontinued its psychotherapy program. ASCA began to take shape
in January, 1993, when George J. Bilotta, Ph.D., THE MORRIS CENTER's Executive
Director, asked J. Patrick Gannon, Ph.D., to develop his ideas for a "second
generation" self-help group for adult survivors of child abuse. This edition of the
Survivor to Thriver manual is an updated and expanded edition of Dr. Gannon's
book: Soul Survivors: A New Beginning for Adults Abused as Children along with
additional material from our unpublished manual The ASCA Workbook.
In February, 1993, the ASCA Leadership Council, composed of volunteers

interested in developing the new program, started to create the Stage One meeting
format, program guidelines and Co-Secretary responsibilities. The first ASCA
meeting was held in May 1993, in San Francisco. ASCA has continued to evolve
and has become a powerful and effective support program for adult survivors of
child abuse.
In September 1999, THE MORRIS CENTER began to promote the ASCA

program nationally through the World Wide Web. It is our desire and hope that
through this efficient and cost effective avenue, ASCA will become available to
survivors of child abuse throughout the country.

Chapter One
ASCA StepWork Program
INTRODUCTION
Welcome to our Survivor to Thriver manual! The Norma J. Morris Center

for Healing from Child Abuse (or THE MORRIS CENTER), in collaboration with J.
Patrick Gannon, Ph.D., THE MORRIS CENTER's former Clinical Consultant, has
created this manual as part of its program of services for adult survivors of
physical, sexual and emotional child abuse. Virtually since ASCA began in 1993,
participants have asked for a workbook or manual to be used as part of their
recovery process. In his 1989 book SOUL SURVIVORS: A New Beginning for
Adults Abused as Children, Dr. Gannon outlined a three-stage alternative recovery
model that was the blueprint for ASCA, but that book is no longer in print.
Consequently, THE MORRIS CENTER has taken portions of Dr. Gannon's earlier
writings, revised and updated them to reflect the ASCA program as it operates
today and added significant explanatory material. The result is before you.
This manual is designed to complement your ASCA meeting participation.

Use it individually, but as a supplement to regular ASCA meeting attendance. Of
course, you are welcome to bring your manual to meetings with you, but you will
not find any exercises or sections that are specifically keyed to meeting
participation. You will first find a chapter entitled Safety First!, designed to help
you evaluate your present level of safety and stability and establish a firm footing
on which to begin your recovery journey. This is followed by a lengthy chapter on
the types of child abuse and some of the ways the consequences of child abuse can
affect your adult life. Chapters Three, Four and Five correspond to Stages One,
Two and Three of the ASCA program, respectively. Each chapter contains a
section on each of the seven steps that make up that particular stage. Each section
includes a discussion of the step and its role in recovery and some exercises,
survival tips and resource material to help you work through the issues. It is our

hope that you will use the questions, exercises and suggestions included with each
of the steps as a framework for your ASCA participation. Using the contents of
the manual in this way will bring an immediacy and concreteness to your ASCA
shares, one that will help both you and your fellow survivors to achieve some
clarity about the particular step and what role it plays in your recovery.
There are good reasons for encouraging you to use this manual in
conjunction with attending meetings or participating in our online meeting at
www.ascasupport.org. One of the benefits of attending ASCA meetings is
experiencing the sense of community that develops between survivors who are
discovering that they are not alone in their abuse experiences and recovery efforts.
The carefully structured ASCA meeting formats make it easier to share
experiences and to start to trust others both key parts of breaking out of the
isolation that characterizes most survivors' lives. The skills that you practice and
observe in ASCA meetings often, if not always, will prove valuable in your
interactions in the larger world. While there is much to be gained from using the
manual individually, your recovery will be more balanced and, we believe, more
rewarding if you also take advantage of the group experience afforded by ASCA
meetings. For these reasons we encourage you to use this manual as an adjunct to
attending ASCA meetings and individual or group psychotherapy (if you have
these).
ASCA is a support program with an individual and group component. It is

not professional psychotherapy, nor is it intended to take the place of individual or
group therapy. Unlike some other self-help programs, though, ASCA does not
hold an anti-therapy or anti-professional stance. In fact, THE MORRIS CENTER
believes that ASCA works most effectively in conjunction with individual or group
therapy, and we encourage survivors to combine professional consultation and
ASCA if at all possible. The last section of this chapter talks a little more about
the role of therapy, finding a good therapist and the recovery process in general.
ASCA-STYLE
What is ASCA?
As you probably know if you are attending ASCA meetings, ASCA is a

support program with several unique features. First, it is psychologically-based
and was created expressly to address the particular needs of adult survivors of
child abuse. To our knowledge, it is the only program that provides a

psychological framework for the complex process of healing from child abuse and
moving on with life. ASCA combines elements drawn from the recovery
movement (programs such as Alcoholics Anonymous) with a theoretical approach
that emphasizes recognizing and resolving past pain, identifying maladaptive
coping behaviors and developing new skills that foster self-esteem and healthy
relationships.
Second, ASCA meetings, which follow carefully scripted meeting formats,

are run by lay facilitators, themselves survivors, who have received training to help
them handle the problems that may arise in meetings and to provide a safe,
structured environment for fellow survivors. Third, ASCA meetings are open to
survivors of all types of child abuse: physical, sexual and emotional. And fourth,
ASCA is the fruit of a collaborative effort between THE MORRIS CENTER,
survivors, volunteers, professionals, community agencies and the community at
large. As such, it benefits from a broad range of experience and skills.
The purpose of ASCA meetings is to allow survivors to share their abuse

and recovery experiences; to receive support and affirmation for their recovery
efforts; to try out new, more adaptive behaviors and, in so doing, to better
understand themselves and their recovery process. As survivors come to terms
with their abuse histories and develop healthier behaviors and relationship
patterns, they are able to test out some of those new patterns. The increased
confidence, mastery and sense of responsibility that survivors build as a result of
participating in ASCA meetings are skills that transfer to the larger world.
ASCA and 12-Step Programs
As mentioned above, ASCA is a recovery program based on psychological

concepts of recovery. While many ideas represented in 12-Step programs may be
valuable for survivors of child abuse, some are not. In particular, many survivors
have difficulty with the idea of "surrendering to a higher power." The challenge
for many survivors is to find the power to change within oneself, not in an outside
source. This is related to the fact that, for most survivors, the source of power and
control was always located outside of themselves, in their parent or other abuser.
To find the power to change from within is to break old, persistent patterns.
Some survivors also have problems with some 12-Step programs' recurring
themes of forgiveness, blame and misplaced responsibility. 12-Step programs start
with the belief that the individual has committed wrongs, is responsible for those
wrongs and must make amends to others for those wrongs. These beliefs are not
particularly applicable to survivors of child abuse. Adult survivors were abused as

children. As children, they had no control or choice over the abuse, and it was not
their fault that the abuse occurred. The abuse was the doing of another person (or
persons), and many adult survivors do not feel that they should make amends for
behavior that was not their responsibility and over which they had no control. It is
for these reasons, among others, that THE MORRIS CENTER believes that ASCA's
psychological approach is more suitable for recovery from child abuse.
However, this does not mean that ASCA is opposed to 12-Step programs.
One of ASCA's principles is a policy of "addition, not competition," with respect
to 12-Step programs, and we do not compete with 12-Step programs for your
participation. We believe that 12-Step groups are extremely useful and
appropriate for persons facing addictions and attempting to live clean and sober
lives. ASCA is deeply grateful to Alcoholics Anonymous and other 12-Step
programs as the godparents of the recovery movement. Without them, there would
be no ASCA  but we view ourselves as a separate program for a separate
problem.
How Does ASCA StepWork Work?
StepWork is a process whereby you concentrate on one particular step at a

time in a given recovery program. It is really an organizing tool to focus your
work on one issue at a time so that you do not become overwhelmed by the
number and enormity of the tasks that comprise a recovery journey. The idea is to
explore in a focused manner the issues presented by a particular step, without
confusing these issues with other issues related to other steps.
ASCA's 21 Steps are a statement of the tasks and issues that most adult
survivors face during their recovery from child abuse. Think of them as signposts
or landmarks along the road of recovery. Unlike some self-help programs, ASCA
does not require that participants work the steps  although you may choose to do
so  or that the steps be worked in a linear order. Survivors often spiral through
several steps simultaneously and may return to earlier steps after they have
reached closure on later ones, or as new material surfaces in their recovery
process. Your concept of StepWork may be to emphasize a particular step in your
shares in ASCA meetings, or in your individual or group therapy sessions.
The steps of Stage One are concerned with the memories of your childhood
abuse. You must acknowledge what happened in the past before you can move
forward in recovery. This becomes the foundation upon which you build your
recovery. Stage Two focuses on examining your adult behavior, connecting your
present strengths and weaknesses to the abuse you suffered and the coping

mechanisms you adopted, and allowing the child within you to grieve the aspects
of childhood that never existed for you. Stage Three involves consolidating your
new, healthier feelings and behaviors, your feelings about the abuse and your adult
goals into a new sense of self and then going out and "practicing" this new self in
the world.
Remember that not all of the 21 Steps are going to have equal relevance to
your life and your abuse history. Depending on your personal experience, some
steps will have a more profound significance for you, and these are the steps
where you might want to concentrate your focus. You might work on one issue at
a particular time because it is the issue that is most relevant to your life at this
time. You might work on several steps simultaneously, and you might even feel
that some steps have no relevance to your particular experience. You are the
ultimate judge of which steps to work and when to work them.
RESPONSIBLE RECOVERY,
RESPONSIBLE THERAPY
False Memories, Real Memories
Child abuse, recovered and repressed memories and "false memory

syndrome" are very sensitive topics and are currently highly controversial subjects
in our society. Research into the process of memory encoding, storage and
retrieval is still in its infancy, but there is substantial evidence that indicates that
memories are not stored intact. Instead, different elements of what is considered
"a memory" may be stored in different parts of the brain and then "reassembled."
This fragmentation of memory storage may be even more pronounced if the
event(s) was traumatic and occurred very early in life. One of the reasons posited
for this is that the portion of the brain responsible for coalescing memory
fragments into a single whole does not develop until sometime between the ages of
2 and 4 years. This, together with the passage of time, means that there can be
distortion and fragmentation of the details of a given memory.
However, abuse survivors usually remember at the very least that their
abuse occurred, even if they do not remember exact details of their abuse or
confuse the details with other material. In fact, most studies estimate that at least

50% of persons enter therapy with all or part of their abuse memories intact. The
remaining group may have been so traumatized by their abuse that they have
literally blocked the memories until such time as it is safe for them to remember.
This protective process, called repression, is a standard concept in most
psychotherapeutic disciplines, and is not unique to the area of child abuse and
recovered memories. It is the psyche's means of protecting the individual from
excessive trauma  whatever the nature  until such time as the person is ready
to address the memories.
THE MORRIS CENTER believes that the vast majority of survivors who come
forth to deal with their abuse histories were in fact abused to some extent and may
well have repressed some or all of their memories of the abuse, only to have them
surface later due to some kind of external trigger or their own readiness to deal
with the issues. However, this does not mean that there are not valid cases in
which memories have been fabricated, suggested or even "implanted" and are
therefore not legitimate. Actions of unethical therapists can cause this, but so can
exaggerated media reports, sensational "talk show" banter, and individual
imagination. We believe that some, if not all, of the persons who have recovered
memories and then recanted their stories are telling the truth. We also believe that
the number of these "false memory" cases is minuscule and statisticallly irrelevant
when compared to the actual incidence of child abuse and the number of persons
who enter therapy with at least some of their memories intact. Nevertheless, we
encourage you to be careful with this aspect of your recovery. Only you can be
the true judge as to whether you were abused as a child. There may be
corroborating evidence  a doctor's report, a friend or neighbor who "knew" but
didn't say anything  but in the end, you must be truthful with yourself about
what happened to you.
The Role of Professional Therapy
As mentioned earlier, ASCA is not anti-therapy or anti-professionals. In

fact, ASCA is designed to work in conjunction with individual or group
psychotherapy. We believe that professional help can be of tremendous value to
survivors attempting to overcome the negative effects of their abuse. Some people
try to do this on their own or by attending support and self-help groups only, but
recovery usually proceeds more quickly and more safely if you are working with a
skilled professional. If you are debating whether to seek professional help, a key
question to ask yourself is, "Am I able to face the abuse on my own and resolve it
to the extent that my symptoms and problems in adult living go away?" If the
answer is "No," then you may want to consider professional help.

For many survivors, a professional individual or group therapy relationship
is the cornerstone of their recovery, without which other changes would be hard to
come by. In a relationship with an ethical and clinically appropriate professional,
the client experiences safety, respect for boundaries, sensitivity to needs and
validation of both the abuse that occurred and the role of recovery in creating a
happy and meaningful life.
If you are unable or unwilling to enter therapy, though, do not despair!

You can still use this manual and other ASCA material found on our web site
www.ascasupport.org to help you in your recovery journey. If you are in this
position, you will want to take special care in selecting and building your support
network, as these people  friends, supportive family members, clergy members,
teachers, and others  will serve some of the functions of a therapist for you.
You will want to pay special attention to the section in Chapter Two, "Building
Your Support System," for help with this task. And, of course, ASCA meetings
will probably assume a greater role in your recovery if you are unable to be in
therapy.
Choosing a Therapist
As in any profession, there are therapists who demonstrate greater and

lesser amounts of responsibility in their practices. Neither ASCA NOR THE
MORRIS CENTER is in the business of evaluating individual practitioners.
However, we encourage ASCA participants who are interested in individual and/or
group professional therapy to select their therapist(s) carefully. Do be an informed
consumer. Do ask questions about the therapist's training, experience and
licensure. If you feel comfortable doing so, ask about the therapist's theoretical
orientation and what kinds of techniques or practices s/he uses in therapy. To the
extent possible, trust your senses.
The current debate about child abuse, memories and recovery often
mentions "repressed memory therapy." As a point of clarification, there is no such
identified discipline. There are various therapeutic techniques  some more
reputable than others  that therapists may use in working with clients.
Therapists may use these same techniques with clients who have no abuse issues
as with clients who either know or suspect that they may have been abused. The
real key to competent therapy lies not in techniques but in the expertise and ethical
stance of the therapist.
Once you have entered into a therapeutic relationship with a professional, if

you feel yourself being pushed too fast or encouraged too much, or you are

uncomfortable with suggested therapeutic methods, try to discuss your concerns
with your therapist. If the therapist's suggestions don't feel right or aren't
compatible with your memories, feelings or beliefs about your abuse, then try to
discuss this as well. You should be comfortable with the pace of your therapy and
be able to discuss your progress openly with your therapist. An ethical therapist
will never force you to engage in an activity or recovery technique about which
you are truly uncomfortable. Ultimately, you are the authority on your own
experiences. Although your therapist is a professional and may possess knowledge
and skills that you do not, you bear the responsibility of being an active
participant in your recovery.
This isn't to say that therapy won't, at times, be painful and difficult,
especially when working on deep-seated issues around child abuse. But there is a
difference between your natural resistance to looking at and dealing with painful
memories, and the discomfort that arises when you feel that something is being
suggested to you that is instinctively wrong or uncomfortable. If this happens, and
if you and your therapist cannot come to a mutually agreeable solution, then
perhaps it's time to consider changing therapists.
What About Confronting My Abusers?
This is a very difficult question, and one that only you can answer for
yourself. Step 18 of ASCA reads: "I have resolved the abuse with my offenders to
the extent that is acceptable to me." For some survivors, this means an internal
coming to terms with the abuse and the abuser(s) but does not involve direct
confrontation. For others, it means direct confrontation, either face-to-face or by
letter or phone. For still others it may mean writing articles, stories, newspaper
op-ed pieces or by speaking out in public gatherings. And for still others it may
mean pursuing legal action to gain restitution for the abuse suffered. Every
survivor is different in his/her need to confront the abuser(s). Neither ASCA nor
THE MORRIS CENTER has a policy or position on confrontation. Instead, we
believe that each survivor must make this choice individually. We do, however,
encourage survivors to think carefully about their options and the consequences of
their choices.
Confrontation of any sort, and especially legal action, can be very

disruptive to life in general and the recovery process in particular. The legal
system is inherently adversarial in nature. The objective, evidence-based
standards of proof required for either a civil judgment or a criminal conviction are
not easily met by testimony relating to memory, memory retrieval or
psychotherapeutic techniques and interpretations. Perhaps most importantly,

though, suing your abuser brings all of the old feelings of hurt, shame, guilt,
antagonism, anger and sadness that accompanied the abuse to the forefront of your
conscience. You are likely in effect to relive your abuse experiences in court. For
these reasons we encourage survivors to think about, and get information on, the
possible consequences of various courses of action and to weigh whether they are
sufficiently grounded in their recovery to withstand the pressures and stress that
almost always accompany a decision to pursue legal action.
____________________________________

Chapter Two
Safety First!
INTRODUCTION
We have included this chapter at the beginning of this manual because

feeling safe in your recovery should ALWAYS come first. Whether you are
working on Step One or Step Twenty-one, you need a framework of physical and
emotional safety in order to progress in your recovery, because child abuse  at
its core  is about being and feeling unsafe. People can change only from a
position of safety. If you don't feel safe, then you won't progress in your recovery.
You want a strong foundation upon which to build your new self, and safety is the
core of that foundation.
Safety is something that you want to incorporate seamlessly into your daily
life, something you approach with the same dedication as you would a spiritual or
moral practice. Safety is something that you must consider no matter where you
are  at home, with friends and lovers, at work or play and especially at ASCA
meetings. Recovery entails facing horrible memories, painful feelings, powerful
bodily sensations and potentially self-destructive impulses and behaviors. To
withstand these reactions, you need to feel safe and strong as much of the time as
possible.
There are several steps involved in evaluating your current level of safety
before you proceed with creating a plan for your recovery. The remainder of this
section will focus on helping you assess your strengths and weaker points so that
you can move through the ASCA program from as strong a place as possible.
Assessing and Facing Risks

Facing your abuse and your reactions to it brings with it risk: risk that you
will feel overwhelmed, out of control, unable to make the right decision in any
number of situations. You can't grow without taking risks, but you won't recover
if you take risks that you are not prepared for. So, as part of approaching recovery
from a position of safety and strength, you need to learn to distinguish between
healthy and harmful risks.
Think of safety as an inverted U curve, with the left end of the inverted U
representing total safety but no risk and the right end of the U representing no
safety and total risk.
The optimum growth point is to the right of the middle of the curve 
where high safety is combined with low risk. You always want to be conservative
in balancing safety and risk because you want to avoid setbacks that may occur
when the level of risk outweighs the level of safety you feel you need.
Considering that many survivors have histories of self-sabotage or of being re-
victimized as adults, SAFETY FIRST! means learning to take fewer risks while
you create more safety for yourself.
Besides helping you to avoid setbacks, the idea of SAFETY FIRST! is to

maximize your chances of success when you do decide to take appropriate risks,
so that you begin to build success and mastery into your life. By mastering
challenges that contain some risks, you will begin to develop confidence in
yourself, which in turn will enhance your self-esteem. In other words, you want to
be s t r e t c h e d by your recovery but never broken.
Timing is Everything
Recovery occurs in small, steady steps taken one after another. Each step
you take needs to be reviewed, evaluated and experienced so that you can derive
maximum benefit from your hard work. Try not to get ahead of yourself. Many
survivors feel impatient with the pace of their recovery, especially if they have
spent years feeling stuck. You may want to jump ahead and go for the "big
success" out of a sense of wanting to finally put the past to rest. But remember,
when you jump ahead before you are really ready, you sacrifice safety and risk a
setback that can leave you feeling dispirited and hopeless. Try to reassure yourself
that your abuse occurred over a long period of time  important formative years
 and so full recovery is also likely to take time.

It is very important that YOU set the structure and pace of your recovery.
Many survivors anxious to proceed with and "finish" their recovery often find
themselves exploring recovery techniques that threaten them or make them feel re-
victimized and violated. Often these survivors had some sense that they were not
yet ready to explore their abuse issues at that particular level, but failed to trust
their intuition cautioning them to move slowly. Although it is difficult to resist a
path that promises to lead to healing and recovery, we strongly encourage you to
trust your own inner sense about your readiness. If you are not sure yourself
whether you are ready to explore your abuse issues using particular techniques or
at a different pace, see if you can get some help from a trusted friend or therapist.
Ultimately, though, you must be the judge of whether you are ready for a certain
recovery experience.
If you have a therapist, she or he may suggest certain techniques to help

you in your recovery. If you have established a consistent level of trust with your
therapist, you should be able to tell him or her that you do not feel ready to try a
particular technique, or that you feel the therapy is moving too fast (or too slowly).
An ethical therapist will never force you to do anything about which you are
unsure, and will respect your sense of appropriate timing.
Assessing Your Current Safety Level
Before you move on to the next section of this chapter  Creating Your
Plan for SAFETY FIRST!  we suggest that you take some time with the
following two self-assessment scales: the Safety Checklist and the
Suicide/Harmful Behavior Checklist. These will help you determine your current
level of safety. After each checklist and the scoring information, there are some
recommendations which are designed to help you determine whether you are ready
to progress with a recovery program.
Safety Checklist
Check "Yes" or "No" to answer each question:
1. Do you have impulses to harm yourself? Y:___ N:___
2. Do you find yourself in unsafe situations? Y:___ N:___
3. Do you easily feel overwhelmed by feelings, thoughts,

memories or bodily sensations? Y:___ N:___

4. Do you currently feel threatened by someone close to you? Y:___ N:___
5. Have you ever attempted suicide? Y:___ N:___
6. Have you ever "lost time" or lost sense of being yourself? Y:___ N:___
7. Do you use alcohol or drugs to excess? Y:___ N:___
8. Is there a firearm or other potentially dangerous

weapon at your residence? Y:___ N:___
9. Have you been victimized by someone within

the last three years? Y:___ N:___
10. Is someone close to you involved in illegal activities? Y:___ N:___
SCORING: If you checked "YES" to more than three questions, your

current risk level is HIGH.
RECOMMENDATIONS: Let this checklist tell you what you must do to

lower your risk level and create more safety in your life. Some of the situations,
such as that posed in question eight, concerning firearms or dangerous weapons,
can be resolved easily: remove the firearm or weapon from your residence. With
other situations, such as past victimization (question nine), there is little you can
do except to make every effort to prevent a recurrence. In most of the other
questions, the issues are somewhat complicated but not unsolvable. You can (and
should) seek professional help if you lose sense of time or of your self or have
impulses to harm yourself. If you are being threatened or abused by someone
close to you, you need to take steps to protect yourself and to make the threats or
abuse stop  even if this means ending the relationship. If you are unsure as to
how to address any of these questions, then you may need help to figure out how
to create SAFETY FIRST!
Suicide/Harmful Behavior Checklist
Check "Yes" or "No" to answer each question:
1. Do you feel chronically depressed? Y:___ N:___
2. Do you have recurring thoughts of killing Y:___ N:___

yourself?
3. Do you have a specific plan to kill yourself? Y:___ N:___
4. Have you acquired the means to kill yourself,

such as a supply of pills or a gun? Y:___ N:___
5. Do you intend to carry out this plan to kill yourself

within a specified time frame? Y:___ N:___
6. Do you have thoughts of actually killing or harming others? Y:___ N:___
7. If yes, have you made specific plans or arrangements

for this to occur? Y:___ N:___
SCORING: If you answered "YES" to ANY of the above questions, your

suicide/harmful behavior risk level is HIGH.
RECOMMENDATIONS: Get professional help IMMEDIATELY. If you

do not have access to names of private therapists, you should call your county
mental health services. ASCA Co-Secretaries may have a list of selected resources
for their meeting's particular area, and you can ask for some names and telephone
numbers. You need to first lower your suicide/harmful behavior risk before
attempting to initiate or continue recovery from your child abuse. The two are
probably connected, but it is very important that you concentrate first on
stabilizing yourself before delving deeper into your abuse issues. Discuss your
answers to these questions with your therapist, so that he or she can make your
personal safety and the safety of others the primary focus in your therapy until you
have stabilized yourself and feel you are ready to commence or continue recovery
efforts.
You should know that your therapist has certain legal and ethical
obligations to warn potential victims and, in some cases, to notify the police if s/he
reasonably believes that you are suicidal or homicidal, or likely to harm another
person. Although this may mean breaking the confidential relationship between
the two of you, your therapist is mandated by law to do this and cannot be
sanctioned for doing so. This is discussed in greater detail in Chapter Five, in
connection with Step Fourteen.

CREATING YOUR PLAN FOR SAFETY FIRST!
Awareness  Assessment  Action
Your SAFETY FIRST! plan starts with three parts  Awareness,

Assessment and Action. Ensuring your safety first requires that you be Aware of
situations that present danger or risk - both to yourself (in terms of the degree of
risk you can tolerate) and to others (in the event that you have thoughts of killing
or harming another person), and that you take appropriate steps to protect both
yourself and others. Once you have identified dangers and risks and recognize the
signals that your body and mind send out in response to these stimuli, you need to
Assess why these signals are being triggered. What in your current environment is
bringing these responses to the foreground? After connecting the cause (the
triggering event, sign or behavior) with the effect (the signal or response), you will
need to take Action in a way that restores a sense of safety both for you and for
others around you.
Having this structure in mind and readily accessible as you live your daily
life is essential to understanding and interrupting the destructive patterns of the
past and replacing them with more healthy patterns. Remember that breaking the
old habits based on unconscious scripts linked to your abuse means overcoming
the tendency to do the same old (familiar) thing. At first it takes more energy to
change, but it gets easier with practice and success.
Awareness
Write down as many physical, emotional or intuitive signs as you can that
tell you that your safety might be in question. (For example, your heart beats
faster or you sense a clutching sensation in the throat.)
1. ____________________________________________________________
2. ____________________________________________________________
3. ____________________________________________________________
4. ____________________________________________________________
5. ____________________________________________________________

If you need more space, use additional sheets of paper and keep them with
your manual.
Assessment
Write down what you think might typically trigger these reactions to certain
situations. For example, triggers can be either internal (for example, unconscious
memories, dreams or fears) or external (for example, interactions with certain
people or particular types of activities or experiences). Remember that
EVERYONE has difficulty with certain kinds of situations, though the nature of
the situations varies with each individual. If you can, you should try to focus on
the types of situations that you perceive to be related to your abuse or abusers.
1. ____________________________________________________________
2. ____________________________________________________________
3. ____________________________________________________________
4. ____________________________________________________________
5. ____________________________________________________________
If you need more space, use additional sheets of paper and keep them with
your manual.
Action
Write down all of the actions you can think of to help you restabilize
yourself after feeling unsafe. Some of these actions will be obvious and practical,
such as simply leaving the environment that is causing the danger. Other actions
must be tailored to your unique needs, based on the type of abuse you suffered.
Try to develop a range of options that will serve you in a variety of situations.
1. ____________________________________________________________
2. ____________________________________________________________
3. ____________________________________________________________

4. ____________________________________________________________
5. ____________________________________________________________
Building Your Support System
Many survivors feel that they have few people they can talk to or get
support from regarding their recovery. It is important not to try to recover in a
vacuum. You do need help from like-minded and empathetic survivors and trained
professionals. The ASCA program encourages combined use of professional
therapy and self-help for optimum recovery; we do not share the anti-professional
stance of some self-help programs. Learning to trust others and to turn to them for
support is a crucial step in recovery. Doing so challenges one of the basic notions
that arises from a history of abuse: namely, that people are dangerous.
Identifying Your Support Network
In the space below, list everyone you can think of whom you can call for
support during times of need.
1. ____________________________________________________________
2. ____________________________________________________________
3. ____________________________________________________________
4. ____________________________________________________________
5. ____________________________________________________________
6. ____________________________________________________________
7. ____________________________________________________________
8. ____________________________________________________________
9. ____________________________________________________________
10. ____________________________________________________________

Now take a thoughtful look at your list. Is it adequate for your everyday
needs? Can you identify those people you could call for a routine check-in or cup
of coffee and those you could rely on in an emergency situation? If you came up
with only one or two names in all, then perhaps you need to expand your support
system. If the only person you wrote down is your therapist, then consider getting
more involved with ASCA or other survivor-oriented activities. Co-workers and
fellow students may prove to be valuable allies in your recovery; just remember
that, by their nature, work and school settings place more restraints on the type of
contact you can have with others. If you have a particular interest, such as a sports
activity, you may find kindred souls who can be of help in times of need. And
finally, if you attend different ASCA meetings, use the weekly phone list from
each meeting to expand your support network.
ASCA Colleagues
Use the space below to write down the names and telephone numbers of
ASCA participants whom you would feel comfortable calling for support.
1. ____________________________________________________________
2. ____________________________________________________________
3. ____________________________________________________________
4. ____________________________________________________________
5. ____________________________________________________________
Resolving Abusive Relationships First
Many adult survivors find themselves in relationships that in some way

parallel or resemble their childhood abuse scenarios. In some cases, these
relationships are actually abusive  if not physically or sexually, then
emotionally. Spousal or partner abuse is another behavior linked to childhood
abuse. The psychological or emotional impact of spousal abuse on the survivor
can be every bit as devastating as the physical harm because it reinforces and
reinstates the sense of fear, threat and personal devaluation that the childhood
abuse originally created. Many survivors are inclined to deny the abusive nature
of their adult relationships, much as they once denied their childhood abuse.

If you have never acknowledged or resolved your childhood abuse, you
stand a surprisingly high chance of unconsciously repeating it  fully or partially
 with a partner, spouse or friend. Research tells us that abuse survivors are
subject to as much as five times the risk of future victimization as are persons who
were not abused. In addition to creating problems in your current relationships,
and even presenting the threat of physical harm, this denial can seriously
undermine your recovery.
Part of your SAFETY FIRST! plan is to assess whether your current

personal relationships are abusive. If you determine that your personal
relationships are abusive, then you will need to resolve them before initiating your
recovery. This issue can be very complicated because, in some cases, your
expectations for relationships (which are shaped in part by your childhood abuse),
can affect your perceptions of how people treat you. In other words, what you
expect to happen to you in your relationships can play as important a part in your
perceptions as what actually happens to you in your relationships. Depending on
the specifics of your situation and personality, you may need help in distinguishing
what is really happening to you now and what is a perception based on your
childhood experiences and memories.
Whatever the case, your interactions with others need to support your
overall recovery goals, not to destroy your current efforts or reinforce past
childhood abuse patterns. Remember that the whole idea behind SAFETY FIRST!
is to be able to work on your recovery from a position of strength that results from
having eliminated the fears associated with the abuse. Since recovery is a most
challenging task, you need all the help and support you can get, and this includes
making sure that your personal relationships do not replicate old abuse patterns.
Following is a Personal Relationships Checklist. Use it to assess the degree

of support and safety provided by your personal relationships. You can also use
the checklist for work relationships, although these tend not to have as much
impact on your sense of safety, in part because of the more structured and
(usually) restricted nature of the workplace.
Personal Relationships Checklist
Check "Yes" or "No" to each question that applies:
1. Does your partner or spouse ever hit you? Y:___ N:___

2. Does your partner ever force you to have sex? Y:___ N:___
3. Does your partner verbally abuse or disrespect you

by calling you names, belittling you or threatening you? Y:___ N:___
4. Does your partner try to restrict whom you spend time with
or limit other choices in your life? Y:___ N:___
5. Does your partner consistently assign unfounded malicious

intent to your actions and opinions? Y:___ N:___
6. Do you find yourself afraid of disagreeing with

or opposing your partner? Y:___ N:___
7. Does this relationship make you feel the way

you did as a child? Y:___ N:___
8. Do you feel dominated or controlled by your partner? Y:___ N:___
SCORING: If you answered "YES" to any of the above questions, you

will need to determine whether your childhood abuse history is shaping your
perceptions of your current relationship(s) or whether the relationship is, in fact,
abusive in some way.
RECOMMENDATIONS: If you are being hit, forced to have sex, or

criticized or verbally abused, you must take steps to stop this very real and
potentially dangerous pattern. If you are being dominated in one or more
destructive ways, you should seek professional help to figure out how to rectify or
leave the relationship or insist that your partner get help to eliminate the abusive
behavior. In more subtle instances, where you are unclear as to whether your
perceptions of abuse are based on the past or on the present, you may also need
professional help to understand fully the interpersonal dynamics that are being
played out in your relationship(s). Again, your ASCA meeting Co-Secretaries
might have local resource lists to help you find the assistance you need.
Stabilizing Your Life
Before recovery, many survivors live lives characterized by constant crisis.

Job disappointments, relocations, failed relationships and financial setbacks are
among the hallmarks that may result from unresolved childhood abuse issues. Of

course, these things can be caused by other life stresses and problems as well. The
reasons for this are complex, but for many survivors it comes down to an inability
to build regularity, predictability and consistency into one's life because of the
ongoing internal chaos associated with a history of abuse. Many survivors find
themselves functioning in "crisis mode," responding with stopgap measures that do
nothing to resolve the underlying issues. As a result, each new crisis consumes
precious energy and attention, and the task of resolving the underlying issues is
ignored. Living life in "crisis mode" is truly exhausting and dispiriting. After
years, it can lead to discouragement, helplessness and hopelessness.
Trying to initiate and proceed with recovery when your daily life is so
unstable is a setup for failure. Recovery really is possible, but unlikely to occur
until the various crises raging in your life have been settled. So, a key component
of your SAFETY FIRST! plan will be to identify and start to stabilize the problem
areas in your life before embarking on your recovery. It is not necessary to fully
resolve these problems  that will come as you work through recovery  but
successful recovery depends on your taking steps to bring some order to your life.
In so doing, you will reduce the frequency of crises and thereby increase the
amount of time and energy you can devote to your recovery. The following
checklist will help you identify and rank the issues that may be diverting energy
from your recovery efforts.
Crisis "Hot Spots" Checklist
Check "Yes" or "No" for each area of your life and then rate the level of the
problem on a scale from one (not a problem) to ten (very much a problem) for any
YES answers:
LEVEL
1. Relationships Y:___ N:___ _____
2. Finances Y:___ N:___ _____
3. Parenting Y:___ N:___ _____
4. Job Y:___ N:___ _____
5. Housing Y:___ N:___ _____
6. Psychological or Emotional State Y:___ N:___ _____

7. Family Relations Y:___ N:___ _____
8. Addictions Y:___ N:___ _____
9. Health Problems Y:___ N:___ _____
10. Legal Problems Y:___ N:___ _____
SCORING: Count the number of YES answers and then rank them from
highest (most problematic) to lowest (least problematic) score.
RECOMMENDATIONS: Your long-term goal is to stabilize as many of

your problem areas as you can, but you should start with the three highest-ranking
problems on the checklist, or those you believe cause the greatest instability in
your life. Focus on each one of these three key problem areas and try to determine
how you might stabilize each over the long term. It may take some time and
thought to come up with truly valuable ideas but, unless you start this process, you
are likely to delay your recovery and continue to operate in "crisis mode."
Priority "Hot Spots" in My Life
Hot Spot #1 ______________________________________________________
Things I Can Try: _______________________________________________
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
Hot Spot #2: _____________________________________________________
Things I Can Try: _______________________________________________

__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
Hot Spot #3: _____________________________________________________
Things I Can Try: _______________________________________________
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
If you find that you have high scores in more than three problem areas, try
to identify the "top three" and focus your efforts on these areas first. If you try to
tackle them all at once, it is easy to get overwhelmed by the volume and scope of
the problem areas. If you can isolate three key areas and focus on how to go about
resolving them, you will gain a sense of accomplishment and mastery that will
help you to identify the next group of "hot spots," and so on until you have been
able to address all of the issues that are of concern to you.
If you can't do these exercises or find that you can't implement them in your
life, then you need some help to focus your efforts. Think about seeing a therapist
or talking to someone who you believe has resolved the issue(s) in her/his own
life. Try to grasp what it is that holds you back from making the necessary
changes to stabilize your life.

Self-Soothing Activities
One of the most important skills for survivors to learn is how to soothe
themselves emotionally. Most survivors never learn to self-soothe in childhood
because parents who abuse are also often poor at soothing themselves and,
consequently, at teaching their children to self-soothe. However, it is essential to
your recovery that you develop some capacity for self-soothing early on in your
recovery journey. You will need this skill as you proceed through the various
stages of recovery.
Soothing is what good parents do when their children are upset. It often
involves soothing touch that is warm and comforting. It can involve words that are
reassuring, empathic and hopeful. It may involve activities that are physically,
intellectually or sensorially nourishing, such as taking a walk, reading a favorite
book or sharing a special meal. It can also involve daily practices that are
spiritually uplifting and inspiring, such as meditation. When you can perform this
type of caring for yourself  whatever your chosen activities may be  then you
have learned to self-soothe.
You probably have you own list of self-soothing strategies. Some may be
healthier than others. You will need to evaluate how you soothe yourself, so you
can retain the healthy practices and try to eliminate or control the less healthy
ones. Then you will need to add some new strategies that can provide extra
comfort during your most emotionally challenging times in recovery.
The Ways I Soothe Myself Today
1. _____________________________________________________________
2. _____________________________________________________________
3. _____________________________________________________________
4. _____________________________________________________________
5. _____________________________________________________________
6. _____________________________________________________________
7. _____________________________________________________________

8. _____________________________________________________________
9. _____________________________________________________________
10. _____________________________________________________________
New Ways I Might Soothe Myself
1. Exercise
2. Practice meditation, guided imagery or deep relaxation
3. Write in my journal
4. Do a spiritual practice
5. Take a warm bath
6. _____________________________________________________________
7. _____________________________________________________________
8. _____________________________________________________________
9. _____________________________________________________________
10. _____________________________________________________________
11. _____________________________________________________________
12. _____________________________________________________________
13. _____________________________________________________________
14. _____________________________________________________________
15. _____________________________________________________________

LIVING SAFETY FIRST!  A FINAL NOTE
The goal of this chapter is to encourage you to develop a daily practice of

living SAFETY FIRST! In any situation, with any people, facing all kinds of
choices or decisions, you always want to start with your SAFETY FIRST! plan,
both to evaluate potential dangers and to identify useful and appropriate coping
mechanisms for the situation. The more you can incorporate your SAFETY
FIRST! plan into your life, the more you will eliminate the kinds of setbacks that
plague so many survivors (and that probably plagued you as well). You can then
focus your energy on creative recovery efforts and reduce self-sabotaging
behavior. In so doing, you will begin to experience the stability that is so essential
for healthy functioning.
You can also carry elements of your SAFETY FIRST! plan into your
involvement with ASCA. Should you ever feel overwhelmed or triggered by what
you hear in a meeting, you will have a range of options at your disposal. Instead
of listening to what is being said, you can direct your focus to your personal
reaction and determine why you are having that particular reaction. If your
feelings are overwhelming, you can always leave the meeting. You can raise your
hand and ask the Co-Secretaries to ask for volunteers to go outside and sit or talk
with you. You can decide not to attend meetings on days you feel especially
vulnerable. You can discuss your reactions to meetings or shares with other ASCA
participants or even the Co-Secretaries. And, of course, you can discuss your
reactions with members of your support network to determine if it is still helpful
for you to attend ASCA meetings. Any or all of these strategies might be part of
your SAFETY FIRST! plan, along with many other options you have identified for
yourself.
Whatever your SAFETY FIRST! plan, it is important that you adopt it as

part of your daily life. The more you do this, the more you will internalize a sense
of safety that non-survivors take for granted. From this foundation of SAFETY
FIRST!, your recovery can proceed, bringing with it the development of a new self
capable of creating the kind of life that you long for.

Chapter Three
Assessing Child Abuse
INTRODUCTION
The next step in your recovery journey is learning some general definitions
and statistics about the three types of child abuse. It is important to know this in
order to compare your own experience with what is generally known about child
abuse. A critical part of recovering from child abuse is learning to distinguish
what really happened to you and whether it constituted child abuse. In this next
section, we will be facing the reality of child abuse frankly. The purpose of this
review is not to deny the past but to illuminate it; not to indict your
parents/abusers, but to hold them responsible; and finally, not to blame yourself,
but to develop a new understanding of your experience. Your ability to
understand the complexity of factors involved in your abuse will serve you well in
making the past less overwhelming and threatening.
Reading this may be painful for you, and you may not want to proceed until
you feel prepared to experience whatever feelings may surface. You may want to
read this chapter in sections, allowing yourself plenty of time to digest each one
before moving on. You can read it with a friend and discuss your reactions with
members of your support network ASCA or therapist. Remember that you are an
adult now, but the feelings that come up may be those of a child.
The section on child abuse is followed by a general discussion of some of

the ways in which child abuse can impact survivors' adult lives. You probably will
recognize many of the behavioral patterns described in this section, since you are
already involved in the recovery process. Meant to highlight some of the key
problem areas, the discussion is far from comprehensive, and you should
remember that persons who were not abused may have the same behaviors and

problems. In other words, difficulties in adult living can be caused by a number of
environmental and social factors, only one of which is child abuse.
WHAT IS CHILD ABUSE?
Child abuse is generally defined as any act of omission or commission that

endangers or impairs a child's physical or emotional health and development, and
is usually broken into three subcategories: physical, sexual and emotional.
Physical Abuse
Physical abuse is defined as any physical act committed against a child,

which results in a non-accidental injury. Examples of physical abuse include
severe hitting, slapping, biting, cutting, pushing, poking, burning, twisting,
shaking, choking, punching, pinching, squeezing, whipping, kicking, pulling of the
hair, legs or arms and dunking in water.
Bodily signs that may indicate physical abuse include bruises, burns, bites,
marks, welts, skin punctures, cuts, abrasions, bleeding, broken bones, spiral
fractures, tearing of the skin, internal hemorrhaging, and loss of hair. Most, if not
all, of these physical signs may also be the result of other natural causes not
related to child abuse. It is extremely important that you keep this in mind, both
while assessing what happened to you and in any instance in which you observe
such bodily signs on another person  child or adult.
Behavioral signs that may indicate physical abuse include extreme

vigilance, fearfulness, scanning the environment for perceived threats, flinching in
a self-protective way, either avoidance or unusually quick attachment to people,
hostile or aggressive behavior, self-destructive behavior (such as walking in front
of cars or falling out of windows), and other-directed destructive behavior such as
setting fires and maiming or killing animals. While we believe that persons
exhibiting any of these behavioral signs is likely to have some history of abuse, we
again caution you not to assume automatically that child abuse is the cause of such
behaviors.

The assault, abandonment and killing of children has been going on since
the dawn of civilization, and has only recently become a punishable crime in most,
if not all, states. What was once referred to in previous centuries as "soul murder"
became defined in 1962 as "battered child syndrome;" now, in recognition that
there are other types of child abuse, it is referred to as physical abuse. In 1985, the
American Humane Society reported that 22% of all reported cases of abuse
involved physical abuse, making it second only to neglect. Physical abuse occurs
in all ethnic, occupational and socioeconomic groups, although it may be more
pronounced in families living in poverty. Economic hardship, racism and
unemployment are stress factors that may prompt family violence. Physical abuse
also occurs outside the home in schools, daycare centers, after-school recreation
programs and in community youth groups and organizations.
Between the ages of 2 and 12, boys are more frequently physically abused
than girls because boys are more likely at this age to present behavior or discipline
problems. At this age boys generally have higher activity levels than girls. This
can irritate parents or caretakers and lead to abusive corporal punishment. In
adolescence, girls become more of a target for physical violence than boys because
they are physically more vulnerable. Social roles encourage girls to adopt a more
passive approach to the world; as a result, they often find themselves in jeopardy
of being dominated by others.
Physical neglect tends to precede actual physical abuse because most

children hate being ignored or neglected and will escalate their attention-seeking
behavior to engage, as well as enrage, their parents. Parents or other adults who
physically abuse were usually treated in a similar manner as children; thus do
abused children often become abusers themselves. The chances of abuse increase
if the children remind their parents/abusers of someone whom they do not like or
about whom they have unresolved or ambivalent feelings. Children with special
needs or disabilities are at greater risk of being abused because they demand more
from their parents.
Physical abuse often begins under the guise of punishment and ends as
punishment gone awry. What starts out as corporal punishment intended to be
purposeful and restrained can often become excessive. It is often an expression of
the parents'/abusers' own personal conflicts. In some cases, physical abuse takes
the form of extreme punishing behavior that the parent imposes on the child for
seemingly arbitrary reasons. Corporal punishment that is sudden, arbitrary or not
explained as a consequence of some particular behavior on the part of the child is
generally considered abuse. Hitting a child in sensitive areas of the body such as
the face, stomach or genitals is severe punishment and is reportable as child abuse.

Punishment that is meted out to prevent some future behavior before that
behavior has actually been initiated by the child  for example, burning a child's
hand as a way of teaching him/her not to touch the stove  is generally
considered abusive. Physically disciplining young children before they are able to
understand the connection between the behavior and the punishment is generally
considered abusive. Any requirement or demand that calls for the child to do
something that he or she cannot physically or developmentally accomplish, such as
toilet training prior to the age of one or taking responsibility for the care of
younger siblings, is generally considered abusive.
Journal Questions
1. Did your parents punish you by hitting you with a hand or some implement
until you were bruised or injured?
2. Were you slapped in the face and left with a black eye, bloody nose or
bruised cheek?
3. Were you ever punched, kicked or thrown against the wall?
4. Were you forced to assume a physically uncomfortable position such as

squatting or kneeling for extended periods of time?
5. Were you ever locked in a closet or basement for several hours?

Sexual Abuse
Sexual abuse is defined as any sexual act directed at a child involving

sexual contact, assault or exploitation. Sexual abuse is divided into two categories:
contact and non-contact. Acts of contact child sexual abuse include fondling,
rape, incest, sodomy, lewd or lascivious acts, oral copulation, intercourse and
penetration of a genital or anal opening by a foreign object. Examples of non-
contact sexual abuse include exhibitionism, presentation of pornographic pictures,
telling of sexual stories, allowing the child to witness adult sexual relations,
treating the child in a sexually provocative way or promoting prostitution in
minors.
Physical signs that may suggest sexual abuse of children include sexually
transmitted diseases; genital discharge or infection; physical injury or irritation of
the oral, anal or genital areas; pain when urinating or defecating; difficulty walking
or sitting due to genital or anal pain; and stomachaches, headaches or other
psychosomatic symptoms. Again, most, if not all, of these symptoms can result
from other, non-abuse related causes or conditions. Please keep this in mind as
you evaluate your own history.
Behavioral signs that may result from sexual abuse include age-
inappropriate sexual behavior with peers or toys; excessive curiosity about sexual
matters; overly advanced understanding of sexual behavior (especially in younger
children); compulsive masturbation, prostitution or promiscuity; and incontinence
(in the case of anal intercourse). Once again, these symptoms may be the result of
other occurrences, and you should be wary of jumping to any conclusions.
Concern about and awareness of sexual abuse have grown dramatically in

recent years as numerous public surveys have reported its pervasiveness. It is
currently estimated that up to one third of all women and up to one seventh of all
men over the age of 21 have been sexually abused as children. Sexual abuse may
be the final skeleton in the family closet, one that has been obscured for years or
even generations behind a veil of secrecy and denial. Thanks to the emergence of
the adult survivor movement, men and women who have suffered from childhood
sexual abuse for years as children are now breaking their silence about their secret.
Sometimes abused children think that if they couldn't stop the abuse, then
they were at least partially responsible for it. Trends in state laws challenge this
kind of thinking. For example, in California, if the child victim is under the age of
14, any sexual contact with an adult is presumed to be sexual abuse, even if the
child has purportedly consented. In the case of child victims over the age of 14
who may have consented to the sexual contact, the issue is determined by looking

at a number of factors including the age of the adult, the nature of the relationship,
and the emotional maturity of the child. Some teenagers under the age of 18 may
not have sufficient psychological maturity to consent to a relationship with
someone much older, while others may be deemed to have consented. The
determination will vary in each situation.
There are many factors that place children at risk for sexual abuse,
especially in an era of high divorce rates and blended families. Children are most
likely to be sexually abused between the ages of 8-12. Girls are more at risk for
sexual abuse than boys (statistics show one out of every three girls compared to
one out of every seven boys). Girls who are abused are more likely to live in a
blended family or with a single mother who is employed outside the home. When
a natural father is the abuser, the girl's mother is often absent or uninvolved for
some reason. She may be disabled, ill, working outside of the home or alcoholic.
Factors such as these may result in less than adequate care-giving and a lack of
parental authority. The parents' marital relationship may be in discord, and the
parents may be avoiding dealing with each other. Ever so gradually, the father
may begin to place the girl in the role of wife.
Sexual abuse also happens to boys, although not to the extent reported for
girls. Boys are more likely to be abused by adult males, teenage siblings and other
older boys known to the victim. Some male victims might later point to this sexual
abuse as the cause of confusion about their sexual identity. When the molester is
female, boys are confused about how to interpret the experience. Is it sexual abuse
or sexual opportunity? Because boys are socialized to want sex, cultural norms
often cloud their perceptions of the experience. Because boys are supposed to be
"tough" and able to defend themselves, they may be disinclined to speak up about
having been taken advantage of. In many cases, it may be a more convenient
psychologically for them to interpret their abuse as a "conquest" rather than a
victimization. But the conflicts do not go away just because the abuse is cast in a
positive light.
Incest between mother and son is every bit as harmful as father-daughter

incest. Mother-son incest is usually the outgrowth of a long-established seductive
relationship that may then evolve into overt sexual relations when the boy reaches
puberty and begins experiencing his own sexual awakening. This is an important
dynamic that touches on issues of emotional abuse as well. Although some
children may feel responsible, the responsibility always rests with the parent to set
appropriate standards of behavior. In cases of mother-son incest, the mother is
almost always incapacitated as a parent due to addictions, severe emotional
problems or her own unresolved childhood sexual abuse.

There are many factors that can influence the degree of impact of sexual
abuse on a child. A child who has been abused by more than one offender is likely
to be more traumatized because the repetition of the abuse reinforces the child's
attitude that s/he is somehow responsible. The type of sexual contact can also be
significant. Intercourse can have more serious consequences than fondling or
exposure to pornography. When aggression or violence is used to force sex, the
impact is even more negative because the child feels fear and greater loss of
control, as compared to more seductive molestation in which persuasion and
manipulation are employed.
When children participate to some degree in the sexual contact or are

unable (as is usually the case) to find a way to prevent the abuse from happening,
the guilt and shame over their involvement often causes severe consequences. If
there were some pleasurable sensations from the contact (common when the abuse
involves fondling), children often interpret their feelings as evidence of their
culpability and responsibility. Children do not usually understand that the
responsibility for preventing sexual expression of affection lies with the parent or
adult.
In cases where the sexual abuse occurs outside of the home, the reaction of
the family is paramount in shaping the degree of impact on the child. When the
family is supportive, gets immediate help for the child and avoids any blaming or
stigmatization, the long-term effects can be lessened. However, when the family
does not understand, blames the child for the sexual abuse or is unable to accept
that the child was victimized, the impact can be truly devastating because the
family's reaction confirms the child's worst fears: that s/he did something wrong or
did not do enough to prevent the sexual abuse. In these cases, the family members
become co-conspirators in the abuse because, in failing to give the child what s/he
needs during a time of tragedy, they may do far more damage to the child than did
the abuser. It is no surprise that children will feel stigmatized by the sexual abuse
if their families treat them with disdain and disgust.
Sexual abuse outside the family may have actually increased during the last
twenty years because more children are being cared for in daycare centers, after-
school programs and juvenile institutions. There has been a rash of stories of
sexual molestation in daycare centers across the country, although proving guilt in
these cases has often been unsuccessful. There are even three "pro-pedophilia"
organizations operating in North America, all dedicated to finding and maintaining
sexual relationships with young girls and boys.
With the explosion of the adult film industry, there is evidence that child
pornography rings are proliferating. It is estimated that upwards of half a million

children are involved in these activities. Teenage runaways, many of whom end
up on the streets hustling for food money, are likely targets for sexual abuse and
exploitation. Unfortunately, the effects of child sexual abuse will not be fully felt
until today's child victims grow up to become tomorrow's adult survivors.
Journal Questions
6. Did your parent or another adult purposely expose his/her body to you?
7. Did anyone have sexual contact with you when you were a child that left
you confused or feeling ashamed?
8. Were you ever shown sexual pictures or films or were you ever
photographed undressed or provocatively posed?
9. Were you exposed to your parents' sexual relations?
10. Did your parents say sexual things about you; make lewd comments about
your body; or call you a slut, whore, or hustler?
Emotional Abuse
Emotional abuse is defined as a pattern of psychologically destructive

interactions with a child that is characterized by five types of behaviors: rejecting,

isolating, terrorizing, ignoring and corrupting. Emotional abuse involves the use
of "words as weapons." The scars left may be more psychological than physical,
which makes emotional abuse harder to identify. Physical signs of emotional
abuse may include malnourishment, small physical stature, poor grooming and
inappropriate attire for the season or circumstances. Behavioral signs that may
suggest emotional abuse include constant approval-seeking; self-criticism; letting
oneself be taken advantage of; excessive timidity or quiet aggression;
indecisiveness; fear of rejection from others; and verbally hostile, provocative or
abusive behavior. Because these signs can result from other social and
environmental causes, we again encourage you to take care in assessing your own
personal experiences.
Because much emotional abuse consists of words, and because the use and
meaning of words are highly subjective, it is harder to quantify and clarify
examples of emotional abuse. What is heard as abusive language by one child
may be the norm for another, although it still may be abusive, even if it is not so
classified by the community. Similarly, much emotional abuse consists of acts of
omission, rather than commission, and so there may not be a sign or symptom to
point to as evidence. For these and other reasons it is difficult to generate accurate
statistics on the occurrence of emotional abuse.
Emotional abuse, more than physical or sexual abuse, must be measured in

terms of severity. It is deemed mild when the acts are isolated incidents; moderate
when the pattern is more established and generalized; and severe when acts are
frequent, absolute and categorical. All parents are emotionally abusive to their
children at certain times. Parents are not perfect, and they too are subject to
stresses and strains of daily living that may cause them to lash out at others. It is
especially important to determine whether there is an established pattern of verbal
abuse or mental cruelty in order to label the behavior emotional abuse. Emotional
abuse is the least understood, and perhaps the most controversial of the three types
of abuse because of the confusion about how to define and describe it. It was
psychologist James Garbarino who defined emotional abuse in terms of the five
behavioral clusters described below.
Rejecting: Rejecting involves the adult's refusal to acknowledge the child's

worth and the legitimacy of the child's needs. Children experience rejection and
abandonment when parents act in ways that minimize the child's importance or
value. During infancy, this may involve not returning the infant's smiles or
misinterpreting crying as manipulation. In later years, it may include refusing to
hug the child, placing the child away from the family, "scapegoating" the child for
family problems and subjecting the child to verbal humiliation and excessive
criticism. The child begins to think, "If my parents don't think I matter, then I

must not be very worthwhile. If I'm not very worthwhile, maybe they will abandon
me."
Terrorizing: Terrorizing includes verbally assaulting, bullying or

frightening the child, thereby creating a climate of fear that the child generalizes to
the world at large. Terrorizing usually involves threatening the child with some
kind of extreme punishment or dire outcome, one that is clearly beyond the child's
ability to respond or protect him/herself. The end result is that the child
experiences profound fear and is left to her/his own psychological imaginings.
Examples of terrorizing vary according to the child's age. During infancy, the
parent may deliberately violate the child's tolerance for change or intense stimuli
by teasing, scaring or engaging in unpredictable behavior. As the child grows
older, the terrorizing may take the form of verbal intimidation: forcing the child to
make unreasonable decisions (such as choosing between competing parents),
constant raging at the child or threatening to expose or humiliate the child in
public. In families that practice strict religions (fundamentalist and other sects),
children can be terrorized by parents who "put the fear of God" in them or threaten
them with the devil's wrath, should they not behave.
Ignoring: Ignoring entails depriving the child of essential stimulation and

responsiveness, thereby stifling emotional growth and intellectual development.
Ignoring refers to the condition in which, due to excessive preoccupation with
their own issues, the parents are emotionally unavailable to the child. In contrast
to rejecting, which is actively abusive, ignoring is passive and neglectful. Ignoring
behaviors include not responding to the child's talk, not recognizing the child's
developing abilities, leaving the child without appropriate adult supervision, not
protecting the child from physical or emotional assault by siblings or friends, not
showing interest in the child's school progress and focusing on other relationships
(such as a new lover) to the point that the child feels displaced. Emotional neglect
may be the most common type of abuse, but it may also be the least reported.
Isolating: Isolating involves the adults' cutting the child off from normal
social experiences, thereby preventing the child from forming friendships and
reinforcing the child's belief that s/he is alone in the world. Isolating the child
from normal opportunities for social relations is another form of emotional abuse
because it impedes the social development of the child. Included here are efforts
by the parents to put the child at odds with friends, presenting "outsiders" as the
object of suspicion, reinforcing the child's concerns about peer acceptance and
thwarting the child's attempts to be industrious and self-sufficient. Specific
behaviors that tend to result in isolation are preventing children from seeing family
or friends, preventing receipt of appropriate medical care, punishing the child's
social overtures, rewarding the child for avoiding social situations, prohibiting the

child from inviting other children home, withdrawing the child from school and
preventing the child from joining clubs or dating. Because children tend to
become more socially active as they get older, it is far easier to seclude a young
child than an older one.
Families that are members of strict or closed religious groups may be

especially prone to isolation and have been known to keep their children out of
school because the "outside world" so conflicts with their personal beliefs and
values. However, there are certain religions which de-emphasize, and even
prohibit, certain contacts with the "outside world," especially those involving
doctors and medical procedures. In these contexts the isolating behavior does not
necessarily constitute abuse. If you grew up in this kind of atmosphere, there may
be an explanation for why your family engaged in isolating behaviors.
Isolation is also common in families where father-daughter incest exists. In

these cases the father wants to keep the child at home to preserve his access to her
and to limit the possibility that she will tell someone about the incest. Many
times incest comes to light only after several years when the girl, now a teenager,
tells somebody in her peer group what has been going on at home.
Corrupting: Corrupting involves encouraging the child to engage in

antisocial behavior that reinforces deviant social attitudes. Most frequently the
corruption has to do with suggesting inappropriate ways of handling aggression,
sexuality or substance abuse. By encouraging antisocial values and behaviors and
discouraging the learning of positive social attitudes and skills, the parents hinder
the child's social development. Sometimes a child evolves an identity that puts
him/her at odds with the conventions and standards of society. Some examples of
corrupting behavior include reinforcing the child for sexual behavior; condoning
drug use; rewarding aggressive behavior; exposing the child to pornography; and
involving the child in criminal activities such as prostitution, drug dealing or
insurance fraud. Another example is parents who force their racist or exclusionary
attitudes on their children and encourage them to act on these beliefs in ways that
cause problems for them with peers, at school and even with the law.
Journal Questions
11. Did your parents frequently rant and rave about what a horrible, stupid or
ugly child you were?

12. Did they involve you in some illegal activity?
13. Did your parents prevent you from having friends?
14. Did they refuse to take you to the doctor when you were sick (absent
religious constraints)?
15. Would they frequently ignore you by refusing to speak or listen to you?
16. Were you left alone for extended periods of time before the age of ten?
17. Did your parents make you stay home from school to take care of brother(s)
or sister(s)?
18. Would they threaten to leave you or kill you if you did not do what they
said?
19. Did they often make disparaging comments about men or women and
predict that you would grow up to be just as bad?

20. Would your parents sabotage your efforts to succeed at school, sports, work
or relationships with friends?
After reading this section, you have some guidelines as to what constitutes
physical, sexual and emotional abuse. Now you can use this knowledge as a
standard to determine what actually happened to you. If you have some memories
that you determine were abusive, write them down in your journal. See if you can
add the fine details to give a more complete rendering of the experience. Jot down
all thoughts, feelings, associations and images that are evoked by this memory. If
you have no or few memories from the past, you may still need more time to
remember. Or, you may not have been abused. If you weren't in fact abused, you
don't want to get caught up in the feeling that you must have been. If this is the
case, consider yourself fortunate!
WHAT ARE THE ADULT REPERCUSSIONS

OF CHILD ABUSE?
If survivors of child abuse share many common experiences as children, it

should be no surprise that they also share many of the long-term effects of child
abuse. These problems often have a pervasive impact on all areas of a survivor's
life. Following is a discussion of some of the most frequently cited problems
experienced by adult survivors, and some journal questions to help you in
determining whether each issue is problematic for you. Not everyone shares all
the different types of symptoms, nor do all survivors experience the same degree
of intensity of the problems. You will have to determine which of the following
problems are primary and which are secondary in your life. Recognize what
seems to apply to you, make note of it, and leave the rest. Use the journal
questions as a framework, and remember that the fact that you experience any (or
all) of these problems does not prove that you were abused as a child or that the
abuse you suffered is the cause of your current problems. These self-perceptions
and problems can stem from a variety of other sources, both internal and external.
Relationship Problems

Adult survivors often have a difficult time initiating, maintaining and
enjoying relationships. Any kind of relationship, ranging from collegial
relationships at work, to personal friendships, to parent-child relationships, to
intimate, romantic relationships, may be problematic. Relationships for survivors
may reflect the all-or-nothing syndrome: either too few or too many relationships
that seem to come and go like people through a revolving door. In some
relationships, the survivor may assume a particular role and proceed to play out a
replication of the past abuse. Given that child abuse most often occurs in the
context of family relationships, the possibility of your repeating old patterns in
personal adult relationships should not be underestimated.
Relationships can be difficult because they call upon personal

characteristics and emotional capabilities that are often new to adult survivors,
such as trust, assertiveness, intimacy, self-confidence, good communication skills,
the ability to give and receive affection, self-awareness and empathy for others,
and acceptance of one's own feelings and needs. Many adult survivors find their
personal relationships characterized by fighting, feeling misunderstood, projecting
blame on each other, and feeling overwhelmed by powerful moods. Frequently,
adult survivors anticipate rejection or non-acceptance and protect themselves by
withdrawing or by becoming overly aggressive. These behaviors, and others, are
probably ones you adopted as a child to help defend yourself against the abuse, but
they may not be productive or healthy in adult relationships.
After years of not feeling their feelings or expressing them to others, many
survivors feel limited in their daily dialogue with a loved one. Making changes in
your relationships begins with developing awareness about which modes of
communication work and which don't. Discuss with your partner when and how
best to talk to each other.
Journal Questions
21. Do you find it hard to maintain close, trusting relationships?
22. Do you have a habit of choosing relationships that don't work?

23. Do you notice choosing friends or lovers because of their similarity or
dissimilarity to your abuser?
24. Do you find it difficult to give and receive affection?
25. Do you see a pattern of clinging to or distancing yourself from people?
26. Do you find yourself testing others' commitment to you?
27. Do you expect to be left or rejected by your relationships?
28. Do you get anxious or scared when someone gets too close?
29. Do you often feel used or taken advantage of?
30. Do you often fight with little hope of resolving differences?
Low Self-Esteem
If there is one quality most survivors share, it is low self-esteem. Chronic

feelings of being bad or unworthy are intricately connected to all the other "self"
words that are used to describe the adult survivor: self-effacing, self-deprecating,
self-conscious, self-blaming, and so on. Low self-esteem causes survivors to

become their own worst enemies by turning against themselves in a damaging
reenactment of their own abuse.
There are many abuse-related factors that contribute to low self-esteem.

The way your parents/abusers treated you, the message they conveyed about your
personal value and worth, the amount of power they granted you and the degree of
control you had over your own life are a few examples. Of course, there is also a
host of non-abuse-related factors that can lead to low self-esteem. Concerns about
your physical appearance (especially during adolescence), your progress in school,
your social standing among your peers and your family's financial or social
position may all contribute to feelings of low self-esteem.
While self-esteem stays relatively constant over the years, it is still a

learned behavior and, as such, can be changed by rethinking and reworking old
attitudes and perceptions. The first step in reversing low self-esteem is
recognizing how you feel about yourself. Then you must learn to see how your
shame, sense of unworthiness and anger turned inward pervade your life and cause
you to make bad decisions. Building self-esteem is a major task for adult
survivors and is specifically addressed in Step Sixteen.
Journal Questions
31. Do you feel bad, unworthy, ashamed or dirty?
32. Do you feel unable to stand up for yourself?
33. Do you feel stigmatized or tainted by your childhood?
34. Are you endlessly critical of yourself?
35. Do you wish you were someone else?

36. Is it difficult to ever feel good about yourself?
37. Is it hard to feel entitled to success or good fortune?
38. Do you believe that others are more right than you?
39. Do you compare yourself to images of perfection?
40. Are other people's needs more important than yours?
Self-Sabotage
Where low self-esteem is the primary feeling of the adult survivor, self-
sabotage is the corresponding behavior pattern in the external world. Self-
sabotage is any kind of conscious or unconscious behavior that undermines your
successful functioning in the world. Self-sabotage may range from buying a
"lemon" of a used car to losing one's checkbook to becoming involved with an
alcoholic partner to engaging in life-threatening activities. You may allow
yourself to be exploited by a boss or engage in physically harmful or potentially
dangerous activities such as cutting yourself or engaging in unsafe sex. Typically,
one's pattern of self-sabotage is closely related to one's personal issues and family
history. Survivors who grew up in addictive families may self-sabotage by driving
while drunk or getting caught with illegal drugs. Survivors from violent families
may tend to get themselves beaten or injured. Survivors from wealthy families
often find themselves losing money, getting swindled or making bad investments.
Studies have shown that survivors of child sexual abuse are more likely to be
assaulted as adults.

Self-sabotage is linked to the survivor's instinct to become re-victimized in
a way that continues or replicates the past abuse. Sometimes the self-sabotage is
not directed against the survivor, but rather against someone the survivor loves.
For example, the adult survivor of family-perpetrated sexual abuse who is now a
mother may be surprised to find that her daughter is being molested by her
husband or a friend of the family. In this case, the self-sabotaging behavior is the
mother's inability or failure to see what is happening and to protect her child.
Reversing self-sabotage begins with building awareness of everything you

do in your daily existence that sacrifices your happiness, satisfaction and
productivity. This will be discussed in more detail in Step Nine.
Journal Questions
41. Have you ever thought about or attempted suicide?
42. Do you engage in life-threatening behavior?
43. Do you ever put yourself in dangerous situations?
44. Do you ever purposely harm your body?
45. Do you ever feel that you are your own worst enemy?
46. Do you have frequent accidents involving bodily injury?
47. Do you pick the wrong kind of people as friends or lovers?

48. Do you undermine yourself at work?
49. Do you often lose things such as money, credit cards and other valuables?
50. Do you make decisions without thinking them out?
Sexual Problems
A variety of sexual problems are associated with childhood sexual abuse,

although there is also evidence to suggest that physical and emotional abuse can
affect the survivor's sex life as well. Survivors of sexual abuse often mistrust their
partners, experience anxiety over the demands of intimacy and feel uncomfortable
with their bodies.
During young adulthood, many survivors of sexual abuse tend either to

avoid sex entirely or to engage in compulsive sexual activity. Either choice
creates problems for adult survivors, particularly if they are still in denial about
what happened to them as children. Where there is a history of sexual abuse, adult
sexual activity and identification are colored by past associations, memories and
conflicts. These may impair the development of a healthy sexual identity and
lifestyle.
Survivors with sexual problems stemming from childhood abuse often

consent to sex when they really don't feel like being intimate, and then experience
the encounter as another episode of abuse. It is not uncommon for survivors to
have flashbacks during sexual contact, in which a memory of the past abuse is
triggered by a familiar touch, smell or position. If the sexual abuse included the
use of violence or force, survivors may mix up sexual and aggressive urges. A
history of sexual abuse can add confusion about a survivor's sexual preference.
How can you deal with sexual problems? You can start by confiding in a
trusted friend or lover about your sexual feelings, reactions and associations.
Sharing your personal reactions with a loved one can provide understanding and

support. If you have specific symptoms or flashbacks, you may want to avoid
sexual contact until you can resolve your feelings. If you are in therapy, you can
discuss these issues with your therapist, although some sexual problems require
the services of specialists. This is discussed in more detail in Step Eight.
Journal Questions
51. Do you ever have flashbacks of your abuse while having sex?
52. Do you ever experience numbness, cold or pain during sex?
53. Do you avoid sex completely or engage in promiscuous sex?
54. Do you frequently have problems with erections or orgasms?
55. Is it hard to say no to sex, or do you use it to avoid intimacy?
56. Is your sexual arousal dependent on violent or abusive fantasies left over
from the past?
57. Do you often feel dirty during or after sex?
58. Have you ever been sexually abusive toward another person?
59. Do you need to control sex in order for it to feel safe?

60. Do you have difficulty separating your adult sexual activities from images
of your childhood abuse?
Symptoms of Trauma
Psychic trauma is a psychological condition caused by overwhelming stress

that cannot be controlled by normal coping mechanisms. It can result from a
number of situations in addition to child abuse, including war or battlefront
experience, natural disasters, being held hostage and being in the middle of a
bombing, hijacking or shootout. Perhaps the most common symptom of such
traumatic exposure is panic attacks involving hyperventilation and severe anxiety.
These can be triggered by anything your senses associate with your past abuse.
Insomnia, sleepwalking, nightmares and night terrors (a more extreme type of
nightmare occurring during non-dreaming sleep cycles) are other signs of
unresolved trauma of some sort.
Many adult survivors don't show signs of psychic trauma until years after
the abuse ends. When they do show signs, survivors often report feelings of
extreme anxiety, panic, general fearfulness and disorientation. In the most
extreme cases, survivors may evidence dissociation (splitting of mind and body),
numbing of the body and intrusive, repetitive thoughts and flashbacks to the abuse
episode(s). The appearance of these symptoms lets you know that your psyche is
still trying to resolve conflicts associated with your past abuse. There is growing
evidence that survivors of extreme and prolonged child abuse are susceptible to
developing multiple personalities as a means of self-protection and that child abuse
may be the major cause of multiple personality disorders.
When any signs of trauma are noticed, the best suggestion is to get
immediate help. Turn to members of your support network, trusted family and
friends and your therapist, if you have one. If you experience any of the more
severe trauma symptoms such as dissociation, we strongly encourage you to seek
professional help. If you feel totally unable to function, you may need medication
or hospitalization to control the anxiety. The goal during this time is to make sure
you are safe and protected and to minimize the possibility of your hurting yourself.

Journal Questions
61. Do you have frequent panic attacks?
62. Do you have trouble sleeping or experience terrifying nightmares or

sleepwalking?
63. Do you have sudden flashbacks of images or thoughts that are connected to
the abuse?
64. Do you sometimes feel like you are somebody else?
65. Do you have partial amnesia or blackouts?
66. Do you fantasize a lot or feel disconnected from your body?
67. Do you have overwhelming anxiety that seems connected to a particular

situation or stage of your life?
68. Do you have trouble concentrating or remembering?
69. Do you have periods of overwhelming grief or terror?
70. Do you often feel agitated and ill at ease?

Physical Ailments
Adult survivors of physical and sexual abuse frequently complain of a host

of illnesses and psychosomatic problems during their adult lives. The most
common generalized effects include stomach problems, difficulty in breathing,
muscular tension and pain, migraine headaches, incontinence and heightened
susceptibility to illness and infection. In addition, skin disorders, back pain ulcers
and asthma are common ailments that are stress-related and may signify
unresolved childhood abuse issues. In cases of sexual abuse, the breasts, buttocks,
anus and genitals may be the site of discomfort, chronic pain and otherwise
unsubstantiated sensations. If the survivor was forced to have oral sex, s/he may
experience episodes of nausea, vomiting and choking that are unrelated to a
physical or systemic cause. Incontinence has been found in survivors who have
been sodomized. Again, we remind you that any or all of these problems may be
caused by non-abuse-related factors or conditions as well.
In particular, sexual abuse has been linked with gastrointestinal functioning,

while leftover feelings of anger may be related to migraine headaches. Some
research indicates that eating disorders such as anorexia and bulimia are more
frequently found in women who have survived prolonged sexual abuse. The
bingeing and purging behavior that characterizes eating disorders offers survivors a
sense of control over their bodies when they lack such control over their feelings.
Phobias, such as claustrophobia, although not technically physical symptoms, may
be directly related to the circumstances of the abuse, as in the case of a child being
locked in a closet for hours on end. Sudden weight gain and obesity can also be
related to childhood abuse, and are sometimes related to the survivor's need to feel
more insulated from his/her body or to present a safer, non-sexual appearance to
the world.
Depending on one's childhood experience and type of personality, illness

can have different meanings for the survivor. Being sick can offer an opportunity
to be taken care of either by yourself or someone else. For some survivors, the
best care they ever received from their parents may have been when they were
sick. Being sick may be one of the few instances in which survivors will care for
themselves. In many cases, however, illness may be the body's message that all is
not well emotionally. When strong feelings are repressed, the unexpressed
psychic energy can cross the mind/body threshold and establish its presence in the
form of bodily symptoms and illness.
Journal Questions

71. Do you have a history of stomachaches or headaches?
72. Do you have any eating disorders such as anorexia or bulimia?
73. Do you have any loss of bodily functioning that cannot be accounted for by
medical reasons?
74. Do you have any psychosomatic ailments such as skin disorders, asthma or
lower back pain that are not due to physical or systemic causes?
75. Do you have a susceptibility to infectious illnesses?
76. Do you have many health-related absences from work?
77. Do you have constant worries about your health?
78. Do you have significant fluctuations in your weight?
79. Do you have frequent fatigue and body aches?
80. Do you have negative attitudes about your body?
Social Alienation

Because of their abuse experiences, most adult survivors feel stigmatized
and experience people as dangerous and not to be trusted. Attending parties or
other social gatherings can evoke anxiety, insecurities and concerns over not being
"good enough." Fear of rejection is also a common concern for survivors. And,
because they were usually harmed by adults whom they trusted, survivors tend to
carry their fear of being harmed by others into the present.
Many survivors end up living in isolation because it feels safer and less
threatening to them. The role of the recluse, employed during childhood to avoid
the abuse, becomes in adult life a means of protecting oneself against hurt.
Sometimes the threat is real; other times it is imagined. When survivors do
venture out into the world and attempt to establish contact with others, they may
be tremendously sensitive about how they are treated. Survivors may experience
joking or teasing  intended as lighthearted banter appropriate to the social
situation  as critical or hostile and at their expense.
Much of survivors' difficulties in social situations have to do with never

having learned how to communicate. Others may have ignored or invalidated
survivors' childhood opinions and perceptions, and left them wondering how to
relate to people. If you expect rejection, criticism and humiliation, it is hard to
learn to speak with conviction, listen with interest and telegraph your receptivity to
others via body language and non-verbal cues.
Journal Questions
81. Do you often feel uncomfortable in groups of people?
82. Do you feel tongue-tied, nervous or self-conscious?
83. Do you try to avoid social situations?
84. Do you feel that others may not accept you?
85. Do you feel different than, in the sense of "worse than," other people?

86. Do you often feel misunderstood, blamed or ignored by other people?
87. Do you either avoid conflict or attract it seemingly endlessly?
88. Do you assume a typical role that is not really you in social situations?
89. Do you lack trust in your judgment of social expectations?
90. Do you feel that your experience of life is somehow not right or not as good
as others?
Handling Feelings
All adults carry feelings that are rooted in their childhood developmental
experiences. Adult survivors, however, may have particularly powerful feelings
that are left over from their abuse. These feelings can be triggered by
circumstances that are somehow reminiscent of the abuse and, in the context of
being a survivor, may have particular importance. Anxiety is the result of not
having known what to expect or how to act in social or family situations. Fear
and anger are both natural responses to the threat or act of assault. Sadness
results from recognizing that your parents or another trusted adult could abuse
you. Shame and guilt tell you that you still hold yourself responsible for what
happened.
Rage is the built-up reservoir of the anger that could never be safely
expressed within your family. Frustration is the feeling you are left with when
nothing seems to go your way. Confusion is a sign that you don't know why

something has happened or what you can do about it. Alienation from others is
the result of too many disappointments. Helplessness, hopelessness and
powerlessness are the feelings that tell you that you are resigned to life as it is and
may have temporarily given up on it ever being better. Your feelings always tell
you something important about yourself, even if sometimes the message is
frightening, troubling or saddening.
Survivors often use a number of mechanisms to numb themselves when the

feelings get too strong. Some may adopt a "workaholic" lifestyle in order to avoid
the feelings. Others may try to "stuff" the feelings by compulsive eating or to
anesthetize them by drinking or using drugs. Certain feelings such as anger and
rage may be so strong that they dominate a survivor's internal life and overshadow
the other feelings that may also be there.
Learning to regulate the intensity of these feelings will be an important part

of your recovery. For the time being, develop the habit of asking yourself what
you are feeling at different times of the day. Run through a laundry list of
common feelings and notice if and when you are feeling something in particular.
Make a note of the feeling and try to identify what may have triggered it.
Journal Questions
91. Do you have strong feelings of anxiety, fear, depression and anger that
threaten to overwhelm you?
92. Do you need to withdraw periodically from the world in order to regain
control of yourself?
93. Do you have difficulty recognizing and expressing your feelings?
94. Do you tend to have an "all or nothing" experience of feelings?
95. Do powerful feelings trigger the desire to eat, drink, take drugs or engage in
other compulsive activities?

96. Do strong feelings leave you feeling disconnected, numb or afraid that you
are going crazy?
97. Have you learned to disconnect yourself from your feelings by refusing to
pay attention to them?
98. Have you ever lost control of your anger and abused someone else?
99. Do you often feel confused by what you feel?
100. Are you inclined to feel a certain feeling more often than others,
particularly anger or depression?

CONCLUSION
Reading the information in this chapter may have stirred up many feelings
in you. Recognizing that child abuse may continue to impact you past your
childhood is a necessary step in your recovery. The tendency to sabotage yourself
in various aspects of your life does not mean that you are a bad person; it means
that you are a wounded person. Identifying the wounds and acknowledging the
difficulties that grow out of them is an essential part of healing. Facing the anger
that you have turned against yourself (and possibly against others) represents a
cleansing of these wounds. As with the treatment of any wound  physical or
psychic  the process will cause some pain. This may lead you to question
whether the process of recovery is really good for you. Because you have become
so used to pain in all of its myriad forms for so many years, you may wonder
whether recovery can have positive effects.
When these doubts begin to surface, remember that you have survived the
torment as a child, and that this is the worst part of the abuse. As an adult, you
have new capabilities, new choices and a great deal more control over your life.
Be open to new understandings of what you experienced. Allow yourself to draw
inspiration from the positive elements in your life: your friends who support your
recovery, empathetic family members, your children (if you have them), your
spouse or lover who accepts you as a special person or your therapist, who is
committed to helping you find your true self. There are many people like you who
came back from total despair and confusion about their lives and recovered from
their abuse. Others, such as your ASCA co-participants, are on the journey with
you as well. We all can find our inner strengths and use them to turn our lives
around.

Chapter Four
Stage One: Remembering
As explained in Chapter One, the 21 Steps of recovery that you are about to
embark on are designed to be adapted to your particular situation and needs. In
Stage One recovery, your main task will be to acknowledge one of the reasons
your life may be unsatisfying or even harmful to you  your childhood abuse 
and then begin to regain some self-control and stability by identifying the trauma
symptoms that may be left over from your past. Out of this new awareness of the
long-term impact of the abuse is born a commitment to recovery. The steps in
Stage One will help you begin to heal the wounds inside and thus pave the way for
changes to be made later on in Stage Two and Stage Three.
As you begin to reclaim your childhood, you will also need to identify and
then moderate the self-destructive behaviors and maladaptive patterns that may
currently plague your adult life. If your life consists of one calamity after
another, as is often the case with adult survivors, it will be very hard to work the
steps. Therefore you must establish some level of calm before you begin to face
your abuse.
Stage One, like Stages Two and Three, can take anywhere from one to three
years to complete, depending on how severely you were abused as a child, how
much of your abuse history you remember and the extent of the emotional
wounding incurred. Sometimes the first stage takes the longest and the remaining
two stages take less time because you can use the skills and insight developed
while resolving the challenging early steps to work through the later steps.
Remember that recovery is an individual process, the pace of which only you can
determine. It is essential that you not race through the steps. Find a rhythm that
feels right to you. You want your healing and the changes that grow out of it to
last a lifetime and to provide a stable foundation for your new sense of self.
How do you know when you are finished with one step and ready to move
on to the next? Listen to the voice of your newly developing self  that fair,
honest and objective sense inside you  that is growing stronger day by day.
Listen to this voice and cultivate its developing wisdom. This voice will signal

when you have resolved the task or issue presented by each step. The step is
accomplished if you can demonstrate the task in action with another person 
your therapist, partner or ASCA members  and thus begin to integrate it into
your new self. If you move forward to another step prematurely, simply admit it
to yourself and return to the earlier step until you resolve it. Remember, too, that
the 21 Steps are flexible and that you do not have to work them in a linear
progression. You don't have to be perfect in recovery. Pursue your recovery your
way, at your speed, but try to keep to the new standards and values that you are
creating for yourself.
_______________________________________
STEP ONE
I am in a breakthrough crisis,
having gained some sense of my abuse.
For many survivors, this first step represents the first sign that their past has
caught up with them. Survivors at this point often experience a "breakthrough
crisis": something happens to release a flood of old memories, feelings and even
physical sensations of the abuse. Although this crisis does not necessarily
destabilize all survivors, for many it can be the most harrowing time in recovery,
and it often provides the impetus to finally face the past.
For those of you who experienced less severe abuse, the breakthrough crisis
may manifest itself not as a new crisis, but rather as a low-grade, perpetual state of
disorganization in which everything that can go wrong does go wrong. This
reinforces your anxiety, depression and shame  all your worst feelings about
yourself. Survivors of extreme and prolonged physical and/or sexual abuse in
which terror or violence typically occurred often experience a more dramatic
breakthrough crisis. This is usually triggered by some event: seeing a movie,
engaging in a relationship that unexpectedly turns abusive or having a sexual
experience that somehow parallels the childhood sexual abuse. This leaves you
feeling like the scared little child again, lacking any sort of adult control over your
life. You may even think you are going crazy and may come up with all sorts of
possible explanations for what is going on.

As a child, you developed formidable psychological defenses to protect
yourself against this massive assault, and you probably continued to rely on these
rigid defenses well into adulthood, until they no longer worked for you. This is
where you may be now. In a breakthrough crisis, your psyche realigns itself in
order to bring the past into harmony with the present. Like an earthquake, this
realignment results in the release of powerful feelings and energy, and can create
periods of disorganization, helplessness and incredible fear. If you are a survivor
of truly severe abuse, you may have mini-breakthrough crises as each new set of
abuse memories surfaces, although these smaller crises are usually not as
tumultuous as the first.
The breakthrough crisis is actually quite normal, although it certainly does

not feel normal to you. Crises are scary. You have been used to screening out all
stimuli that might trigger your out-of-control feelings, only to feel that now you
have lost control over your mind. Although it is frightening to do so, it is best in
the long run to let these feelings out. Rest assured that this is a temporary
experience which will gradually subside as you express feelings and develop a
more flexible type of control over your life.
Although the breakthrough crisis is normal, you should take special

precautions during this time to preserve your safety and to promote healthy
integration of these memories and feelings. Anyone is vulnerable in a crisis, and
there have been reports of survivors attempting suicide or engaging in other self-
destructive behaviors in response to the crisis. Remember that the Chinese
definition of crisis translates to "danger and opportunity." Your task during the
breakthrough crisis is to minimize the danger to yourself by reaching out for help
while riding the tidal wave of feelings safely into shore.
Self-Help
1. Give yourself permission to get whatever help you need to face this crisis.
Reaching out to a therapist, support group and family and friends means that you
do not have to be alone anymore. Your ASCA support network and ASCA
meetings can be invaluable at this time.
2. Write some positive affirmations about the breakthrough crisis in your journal.
For example, "I survived the abuse, I can survive this also," or "Out of crisis, there
can be opportunity." Even if you don't feel that positive right now, try to write
down whatever sentiments come to you about managing this crisis in a positive
manner. Do whatever is necessary to give yourself the hope and strength you
desperately need.

3. Learn and practice this simple 7-part relaxation technique: 1) sit comfortably
and close your eyes; 2) imagine lying down at an ocean beach; 3) listen to the
waves build, crest and wash over the sand; 4) feel your breathing; 5) focus on your
breathing by inhaling, holding your breath for 3 seconds and releasing; 6) repeat
the cycle of breathing and focusing on your breathing until the tension gradually
washes away from your body and you feel relaxed from head to toes; 7) continue
the cycle, all the while attaining ever-deeper levels of relaxation.
4. During the time you work this step, relieve yourself of unnecessary pressures
on yourself. If the disruption to your life is extreme, and if you can afford to do
so, you may want to give yourself a sabbatical from work, school or normal
domestic duties while you struggle with the breakthrough memories. Of course,
you may actually prefer to work during this crisis as a way of coping. Judge for
yourself how much time you will need for taking care of yourself during this
period and adjust your schedule to the extent possible.
5. Don't make any big decisions during this time. It may be hard to think clearly
right now, and you don't want to complicate your predicament by acting
impulsively. If you are suicidal or fear you might harm yourself or another, reach
out to friends and empathetic family for help. If you are in therapy, call your
therapist and schedule an emergency appointment. If your therapist is not
available, call a suicide or crisis hotline. One day in the future when your life is
better, you will be glad you did.
Professional Help
1. The breakthrough crisis can be a remarkably productive time in therapy

because the memories and feelings are so accessible. However, you will also need
help to express and manage the feelings without stifling them. Ask your therapist
for help in devising a structure to help you modulate your experience of the
feelings so that you can deal with them piece by piece.
2. During this time it may help to see your therapist more frequently than once a
week, if this is possible. Discuss with your therapist whether this would be
advisable. The advent of managed care and diminishing third party reimbursement
(insurance) for therapy has made this more difficult, but many therapists are
willing to make arrangements with their clients. Also, check to see that you have
your therapist's emergency phone number so you can reach him/her during evening
and weekend hours. You and your therapist may want to develop a crisis

management plan, including actions that you can take to help calm yourself and a
gauge for determining if you need emergency help.
3. If you feel that you cannot cope with what is surfacing, tell your therapist and
explore ways to slow this powerful process down. Remember that you have a
right to move at your own pace, so be sure to let your therapist know if it feels too
overwhelming to continue focusing on the memories. If you need to, refer to the
section on "Responsible Recovery, Responsible Therapy" in Chapter One. You
may need to put some distance between yourself and the memories until you can
regain sufficient control to feel safe again. In some cases, taking medication or
entering the hospital for a brief stay may be helpful. Not everyone will need this,
but some survivors who are recovering traumatic memories may benefit from this
kind of support.
_______________________________________
STEP TWO
I have determined that I was physically,
sexually or emotionally abused as a child.
Step Two asks you to determine and then acknowledge to yourself that you
were abused as a child and that the effects of the abuse may be causing some of
your difficulties as an adult. Many of you who are in the process of recalling
memories of your past may not yet have objective evidence of the abuse, and you
may never find outside validation or corroboration of what happened. Instead,
your evidence may be more intuitive. Even in the absence of "hard evidence,"
these intuitive feelings are significant and should not be dismissed. Many abuse
survivors were either too traumatized or psychologically incapable of organizing
memories into words and images that can be recollected years later. If this is
where you are in your recovery now, continue to work this step to clarify the kind
of abuse you suffered. If you need to, refer to the section on "False Memories,
Real Memories," in Chapter One.
An important sub-goal in this step is learning to accept your feelings about

the abuse, whatever they may be at this time. These feelings may not make
complete sense to you, but they are there for a reason. In the same way that the

pain from a bruise tells you of a physical injury, the feelings associated with your
abuse signal an internal emotional bruise. Instead of ignoring the feelings, you
should try to figure out what those feelings are telling you. As a survivor, you
probably had your feelings invalidated by your parents or abusers, so not
recognizing your feelings as valid now may be an old pattern you want to break.
Give yourself the benefit of the doubt when it comes to verifying your feelings.
You will need time and help to sort out what happened, free of the denial and
distortion of the past.
At this point, the connection between your abuse and your current problems
as an adult may be very tenuous. It will take more work on the subsequent steps in
Stage One before you can firmly establish this link. In the meantime, keep an
open mind as you explore the reality of your abuse and let the meanings emerge
with the new information and understanding that you develop.
Self-Help
1. Write down the date that you first acknowledged the abuse to yourself. This
date will signify the beginning of your recovery. Remember it well, as you will
want to honor this date in subsequent years when you are enjoying the fruits of
your labor.
2. Over the course of a week or two, look over any old family albums and
photographs or home movies you may have. Just leave them around the house so
that you can look at them and think about them at your leisure. If you have no
photographic records of the past, try some visualization exercises, such as
imagining taking a walk though your childhood home, your relatives' houses or
your old school.
3. If you enjoy art, draw a picture of your parents and family members. Draw a
picture of yourself as a child. Include as much detail as you can recall. If the
words to describe the abuse episodes are still escaping you, try drawing pictures of
whatever memory fragments you have of the abuse. More details of the visual
images will probably come to you as you continue to sketch out what happened,
and eventually the descriptive words will follow.
4. You might consider writing your autobiography, starting with your earliest
memory and working forward to the present. If you can, make a trip back to your
hometown to research your autobiography. Interview the people who knew you as
a child and ask them about their memories and perceptions of you back then. Just

let the impressions, memories and feelings wash over you. Write them down in
your journal for future reference.
5. Start recording your dreams and nightmares in your journal. A week or so

later, reread them and write down any impressions, specific feelings or images
that come to you. Don't worry if everything seems disconnected. As you add the
feeling and image details to the picture of your childhood, the whole picture will
start to take shape.
6. In ASCA meetings, share your acknowledgement about being abused as a child

and your feelings about this realization.
Professional Help
1. Talk with your therapist about the fears and apprehensions connected to
remembering the abuse. What are you afraid might happen if you remember it all?
What reason might there be for wanting to keep some or all of these memories at
bay?
2. Talk to your therapist about what, if anything, you need in order to fully
reclaim these memories: more time, specific assurances or information from your
therapist, or modifications to the structure of your sessions that might help you
feel safer and more in control. Whatever it might be, you have the right to tailor
your therapy to your individual needs.
3. If you have not been able to remember the specific episodes of abuse after a
year or so of therapy, ask your therapist about other techniques to help you reclaim
the memories fully. There are a number of techniques that can be used to aid
memory retrieval. Some are more effective than others, and some are more
effective with certain people and at certain times. All require that your therapist
be trained in their use and competent in practicing them. Remember, there may be
good reasons for your still not remembering all of your abuse clearly, and both you
and your therapist will want to respect this.
_______________________________________

STEP THREE
I have made a commitment to recovery from my childhood abuse.
All survivors who have recovered from child abuse can point to a moment
in time when the desire to change and the hope of a better life overcame the wall
of denial and resistance. After acknowledging that you were abused and that the
effects of the abuse may be undermining your life as an adult, you next need to do
something about it. This is a critical step for many survivors because moving from
thinking about the abuse to actually doing something about it for example,
committing to a recovery program  is a large leap indeed. It is a point at which
many survivors flounder.
Because this "step" is more like a "leap," it may mean more to you than
many of the other steps once you finally achieve it. Taking this giant step signifies
that you are no longer a passive victim of the past. You are now truly a survivor in
the sense that you are motivated to overcome the effects of your abuse and are
initiating change in the present in the hope of creating a better future for yourself,
becoming a thriver. You are building on your acknowledgement of the abuse and
recognizing that, while you have been deeply hurt by it, you have not been
defeated or destroyed.
What does it mean to make a commitment to recovery? Basically, it means

acting: reaching out for help by joining a support group like ASCA and, if
possible, entering therapy with an experienced professional who will work with
you from now until you have reached Step Twenty-one. If you are still not ready
to make this commitment, you can bridge Steps One and Two in a way that may
help you eventually to join ASCA or start therapy. Consider disclosing your
struggle to a spouse, trusted friend or clergy member. Disclosing your abuse to
someone else can be extremely powerful because it shatters the silence and
secrecy of the past, and may well shatter your expectation of a negative response.
But be sure to choose very carefully the person whom you tell. You want this
action to help you and encourage you to move forward, not to set you back.
Throughout this manual we have stressed both professional therapy and

self-help as important tools for your recovery. Because you are attending ASCA
(and perhaps other self-help meetings), you are obviously aware of the benefits of
self-help, but it doesn't hurt to summarize them briefly. Self-help support groups
offer understanding, support, information and acceptance for participants in
recovery. Most cost nothing to join and meet at various times and locations. Most
accept anyone who has an interest in the topic of the meeting or who expresses a

desire or willingness to change. Self-help groups can provide resources and
information for participants needing additional help. By use of a sponsor system
or, as in ASCA, a phone list, self-help support groups offer support during difficult
times and welcome relief from the isolation, stigmatization and shame that most
survivors face.
Perhaps most importantly, self-help groups offer a sense of belonging and

"family" that probably was not available to you as you were growing up. If your
family is still in denial about the abuse or unwilling to change defensive attitudes,
then self-help groups can become a sort of surrogate family for you. As we have
said before, it is very difficult to do this work alone, and ASCA and other self-help
groups can help provide you with the community and support you need to continue
working through your recovery.
Some survivors have gone through the motions of making a commitment to

recovery without necessarily putting their hearts into it. You, too, may have
attended self-help and other support groups or started therapy without really
intending to face the reality of your childhood abuse or the feelings associated
with it. During the initial stages of recovery, you may discover that you are
avoiding some crucial aspect of yourself or your problem. This will likely only
hinder your progress. Don't wait for someone else to point it out. Start acting in
your own best interests to help your identified helpers help you.
Self-Help
1. Write in your journal about the circumstances or insights that caused you to
make a commitment to recovery at this time.
2. Who, if anyone, has inspired you to get help?
3. Describe the part of you that is motivated to get help and to make changes.
4. How do the voices of your internal "naysayers"  those parts of you opposed
to making such a commitment  justify not going forward with recovery? What
are the reasons and how do you counter them?

5. Write an affirmation in your journal about your commitment to recover from
child abuse. It can be a poem, a letter to yourself, a statement of your goals or an
unsent letter to your parents/abusers. This can become a personal manifesto to
which you can return for strength, inspiration and encouragement during the most
difficult times of recovery.
6. If you have not already done so, make a commitment to attend ASCA meetings,
or participate in the ASCA online meeting at www.ascasupport.org and any other
self-help meetings you feel you may need. Use some of your share time in ASCA
meetings to talk about your commitment to your recovery process. You might
address what strengthens your commitment, as well as what periodically erodes
your commitment to recovery.
Professional Help
1. If you have not already done so, and provided that this is an option for you,
make a commitment to find a competent and caring therapist, someone who will
support you as you go through the ups and downs of recovery. Refer to the
section on "Choosing a Therapist," in Chapter One, if you need help in going
about this task.
2. Once you are in therapy, share with your therapist your thoughts on what you
want to accomplish and what you have accomplished to date. Remember that your
therapist will likely be intuitive but not a mind reader. If you share your
recollections of the abuse as soon as you feel comfortable, you and your therapist
can devise a plan for healing that both acknowledges your past work and focuses
on your present needs.
_______________________________________

STEP FOUR
I shall re-experience each set of memories
of the abuse as they surface in my mind.
This step represents the major task of the first stage of recovery and may
require the most time to accomplish. Often, survivors of extreme and prolonged
abuse will need to return to this step again and again as new recollections of the
same or additional episodes of abuse surface. This step essentially involves going
through the memories of your abuse and expressing them at ASCA meetings, to
trusted friends, supporters or your therapist in as much detail as you can remember
and to the extent appropriate for your listener(s). If at all possible, we encourage
you to find a therapist before beginning work on this step. If this is not possible,
this is the time to strengthen your support network and continue your participation
in ASCA meetings.
"Re-experiencing the abuse" comprises many things. First, you will need to
allow yourself to re-experience the various feelings, express them as they arise and
eventually be able to label them so they do not confuse and overwhelm you.
Second, you need to try to describe any sensory impressions connected to the
abuse: visual images, sounds, smells, tastes and tactile sensations. Third, you will
need to recall your thoughts about the abuse, both during and after each episode.
Try to notice if you have any body memories of the abuse while you are re-
experiencing it. Body memories include aches, pains, numbing or other physical
sensations that appear suddenly in key locations of your body such as your arms
(suggesting you were hurt while trying to ward off blows), genital areas (which
may have been physically injured during episodes of sexual abuse) and face and
mouth (which may have been injured when you were slapped, gagged or forced to
orally copulate your abuser). These body sensations mean something. By
allowing yourself to re-experience them, you will help to discharge them and thus
allow them to gradually fade away.
Finally, try to remember what behaviors you engaged in during and after
the abuse. Did you try to run away and hide, roll up into a ball to protect yourself
or fight back and scream? Or were you immobilized and unable to move while the
abuse occurred? What about later? Did you run out of the house, crawl under the
bed, hide in a closet or wash off in the bathroom?
This step likely will be very difficult to achieve because it means returning
in your mind to the scene of the crime. But this time you can have all of the
control you need. The experience will not be as painful or scary as when you

were a child. Remember that you are dealing with memories, not present reality.
Move slowly, step by step, memory by memory so that you can manage the
feelings and share your reactions with your therapist and trusted members of your
support system.
Self-Help
1. Record in your journal each episode of abuse that you recount in ASCA
meetings or in your therapy. Describe your story in your own words or in the way
you have heard other survivors share their stories. Just be sure that the
experiences you recount are yours and not someone else's. Draw pictures to
accompany the words and to create a fuller image of the surroundings. Include as
much detail and emotional expression as you feel comfortable with. Writing and
drawing in story form is helpful in organizing and integrating the past experience
for you in a different manner, one that takes into account your adult perspective
and knowledge. Try to sort out exactly what happened and your reactions then as
well as now. Your goal is to develop a more complete understanding of the abuse
episodes, one that incorporates the roles played by your parents, your abusers,
your family and the forces over which you had no control.
2. You really need to take good care of yourself while working this step because
re-experiencing your memories can be very exhausting. Try to incorporate
exercise, plenty of sleep, stress management techniques, meditation, maybe even
some high-dose vitamin therapy in your daily routine. All of these things can help
your body and spirit stay healthy and vigorous while you work through your
memories.
3. If you tire of writing, try tape recording your memories and listening to them a
few weeks later. You may choose or not to add new segments at the end of the
tape. Listening again to these tapes several months later may be especially eye-
opening because it may both confirm your progress in remembering and trigger
new memories.
4. What about that group you were going to join? By Step Four, a support group
may prove to be an invaluable source of support and encouragement for your
efforts. Recovery is usually faster and safer if you don't do it alone. You need
people more than you might think.

Professional Help
1. In your work with your therapist, explore your reactions to talking about the
abuse. How do you find yourself expecting your therapist to react? How do you
feel after disclosing especially personal segments of your story? Do you feel less
ashamed of what happened now that you have shared it with someone else? Are
you able to talk more easily with other people about your abuse and your work in
recovery?
2. Remember again that you have the right to control the pace of your therapy. At
times, you and your therapist may disagree on the best pace for your particular
stage of recovery. At times, you may want to go faster, while s/he thinks you
should slow down. Other times, s/he may want to push you to deal with something
if s/he thinks it would benefit you. Ultimately, you must take an active role in
setting the pace of your recovery, settling on one that is comfortable but not
stagnant.
_______________________________________
STEP FIVE
I accept that I was powerless over my abusers' actions
which holds THEM responsible.
By now you know that survivors grow up believing the classic myth of
child abuse: that they, not their parents or abusers, were somehow responsible for
the abuse. The "justifications" for this myth are as varied as your imagination is
fertile. "I let him do it to me." "I should have been able to protect myself." "I
liked certain aspects of the abuse  the attention, the gifts, the pleasurable
sensations, the sense of being special." The child's often distorted perceptions of
who was responsible are enhanced by the parents'/abusers' indictments. "I'm
beating you because you are a bad boy." "I am showing you how much I love
you." "I wouldn't be calling you stupid if you showed me you have more than half
a brain in that head of yours." "You have the devil inside you and I'm going to
beat it out of you." These words are truly toxic because they do more than simply
(and unjustly) place the blame for the abuse on your shoulders. They eat away at

your positive sense of self, and the lingering messages continue to do so in your
adult life.
You can challenge those words of your parents/abusers that continue to

echo in your mind by coming to understand your dysfunctional family and
recognizing the real reasons why you were abused. This is an essential step in
recovery because, without seeing that your parents/abusers were at fault, you will
have difficulty in facing the remaining tasks of recovery: directing your anger
away from yourself and towards them, uncovering your shame and understanding
how the abuse affects your life today. Most importantly, you need to understand
that you were the child and that you had neither the power nor the authority to
make your parents/abusers do anything to you. The abuse was their responsibility
because, quite simply, they had the greater power and they did it to you. Nothing
you could have done would have changed this, because families and society are set
up to give power and authority to parents (and adults in general). Children have
little or no power over their abuse, or much of anything else.
Besides recognizing the reality of who was responsible for the abuse, think
about the following realities as well. As a child, you were not psychologically
equipped to believe that what your parents/abusers were doing was wrong, much
less speak out about it. Because you were dependent on them for so much, you
couldn't risk alienating them by speaking the truth  even if your child mind was
precocious enough to make sense of the complex web of issues that comprises
child abuse. Few, if any, children can do this effectively because their intellectual
capacities are not sufficiently developed to do so. You desperately wanted to love
them and be loved by them. It would have been foolish for you to incur their
wrath and dash whatever hope of love, caring and nurturing you harbored inside.
Think back to what it would have meant for you, the child, to accept that the
people who were supposed to love you were actually hurting you. It's not
surprising that few children can face this horrible reality, because to do so would
cause them to become emotional orphans in the process, and little could be worse
than that.
Self-Help
1. Write in your journal the words you recall your parents/abusers using to place
the burden of responsibility for the abuse on you. What was the tone in their
voices, the look in their eyes when they said those words? What reasons did you
adopt to hold yourself responsible for the abuse?

2. Imagine what you would say to your parents/abusers today about who was
responsible. As you speak to them, what feelings do you notice within yourself?
3. Sharing your story in ASCA meetings can work to expose myths about child
abuse and can bring you much-needed validation for eventually seeing things the
way they really were. ASCA meetings are particularly effective in challenging
these myths because most of the participants share the oppression born of this
misplaced sense of responsibility.
Professional Help
1. What is your therapist's response to the question of responsibility for the abuse?
How do you feel about this response? Is it helpful or not? Tell him/her what you
feel and discuss what you need from him/her in this regard.
2. Some therapists encourage their clients to use the "empty chair" technique to
talk back to their parents/abusers. After years of keeping your feelings and
thoughts to yourself, this can be extremely empowering. However, this technique
can also stir up old feelings of being disobedient and fears of being abused again.
If the latter is your experience, explore what your resistance is to addressing your
parents/abusers in this safe, controlled way.
_______________________________________
STEP SIX
I can respect my shame and anger as a consequence of my abuse,
but shall try not to turn it against myself or others.
Anger is a natural reaction to child abuse. Yet survivors have a hard time
managing anger. They veer between lashing out or over-controlling it, not
knowing when it is appropriate and when it isn't, not knowing how to express
themselves forcefully without overdoing it. You were no doubt angry as a child,
but probably were not able to express the anger safely in your family. You may
still be afraid of your anger because it may have been intricately connected to
many of the bad things that hurt you. But bottling up your anger will also block

your recovery because, without ventilation, the anger may turn into aggressive
behavior.
Where did that anger from the past go? Most survivors turn the anger
against themselves. This pattern could possibly be a major reason for your
difficulties as an adult. Fighting, criticizing or withdrawing from your friends,
lover, spouse or child(ren) are also likely patterns for you, especially if your
family was ever violent. If you are a parent, you need to recognize how your
anger may be triggered by your child(ren)'s inadvertently pushing the wrong
buttons at the wrong time. As was true with your parents, it is your responsibility
to control your behavior and your anger with respect to your child(ren).
Many survivors do not express their anger overtly. In addition to turning

the anger inwards into anxiety, self-loathing and depression, many survivors
develop habits that serve to cover over their anger and dull its impact. Compulsive
eating, drinking, sexual activity and a host of other behaviors serve to blunt the
anger as well as the pain, shame and isolation that arise from abuse. This kind of
behavior  often called self-medicating in the case of alcohol or drug use 
masks the underlying feelings and promotes a blustery, but often hollow, public
image.
If you have to express your anger to better manage it, the best strategy is to
externalize it  that is, to get rid of it by discharging it outward. But do it safely,
with maximum control, and direct it where it belongs: at your abusers. Of course,
it is not always possible to do this, nor is it always advisable. Refer to the
discussion in Chapter One about whether to confront your abusers, and talk to the
members of your support network about any plans. These people can help you
with ways to access this pent-up anger and turn it away from yourself and towards
the proper target in a safe manner. Practicing how to express your anger and
learning how to turn it on and turn it off will not only be therapeutic, but will also
give you the skills to use your anger in appropriate ways in the real world.
Self-Help
1. If you have not already done so, make a list of techniques you can use to help
you identify and manage your anger. For example, become aware of the body
signals that tell you that you are starting to feel angry. Try to figure out what is
making you feel this way. Is it something in the present or is it a replay of an old
tape from your childhood? If you find yourself getting angry, take a "time out"
and give yourself a chance to calm down. Call a friend or a hotline for help in
figuring out what is triggering your anger.

2. There are many ways that you can safely express your anger on your own
without hurting yourself or anyone else. One of the best ways is to engage in
active sports where you can bash a ball: tennis, racquetball, baseball. Virtually
any kind of physical activity such as aerobics or dancing will reduce your feelings
of anger. You can write about the anger in your journal, exercise, go for a walk,
scrub the floors  whatever will dissipate the anger in a safe manner. Other more
direct expressions of anger are hitting pillows, screaming in your house or car
(though not when driving) and learning martial arts or self-defense skills. Other
more intellectual avenues include getting involved in public speaking and political
marches and activities.
3. Write drafts of letters to your abusers expressing your anger with them. You
can get a lot of the anger sorted out by writing long letters that detail every
imaginable angle of your anger. Whether you send the letters or not is up to you.
Sending these types of letters is considered a confrontation, so you will want to
give this issue serious consideration.
Professional Help
1. Use your therapy sessions to explore using some techniques for expressing
anger at your parents/abusers. Besides the "empty chair," psychodrama and other
Gestalt therapy techniques that use role-playing and reenactment of family
situations are especially powerful for survivors who want to practice expressing
their anger toward their parents/abusers.
2. The major work of therapy during this stage is to develop a flexible control
over your anger. Anger in itself isn't bad, but the expression of it can be harmful
to you and to others around you, and so you need to learn to differentiate
situations and responses to those situations. Identify situations where you lose
control of your anger as well as situations where you need to use your anger more
constructively to stand up for yourself. Work out new routines to handle your
anger and then practice these routines in your therapy sessions before trying them
out in your everyday life.
_______________________________________

STEP SEVEN
I can sense my inner child whose efforts
to survive now can be appreciated.
This step involves turning inward, away from the violence and pain of your
abuse, to reach inside to your inner child and begin learning how to nurture and
develop this vulnerable part of yourself. This is both a grieving and healing step,
because what you give now to this child will be restorative and fulfilling and will
form the foundation upon which you can build other changes as you work the later
steps. This is also a step that will help you recognize and acknowledge your
childhood efforts to survive the abuse.
By now, you know pretty much what happened to you, who did what and
how you felt about it. It is now time to continue the work you began in Step Five
by forgiving yourself for any of the millions of reasons that you may have used to
blame yourself for the abuse. Working this step means further identifying and
challenging these inaccurate and outdated notions and modifying your perceptions,
based on your new understanding of your childhood experience. Along the way
you need to appreciate and validate yourself for having survived the abuse. As
you accept what happened to you and who really was responsible, you will
inevitably become more and more accepting of yourself and the child within you.
As you develop self-acceptance, you may notice that your relationships

begin to improve. Accepting yourself may make it easier for others to accept you.
If you haven't yet had this experience, you will be pleasantly surprised. Allow
yourself to share these new feelings about yourself with people you care for and
trust. Look for acceptance and understanding, and if you don't get it, ask for it.
Let this vulnerable part of you explore being dependent and intimate with someone
and see if you can feel trust starting to build. If you feel afraid, try to figure out
why and share your thoughts with this person.
Self-Help
1. Pick one photograph of yourself as a child that you especially like, frame it and
put it where you can see it often. If you don't have a picture and cannot get one
from family or relatives, try drawing a picture of yourself as a child. Don't worry
about its being a "good picture." It may be better to let your inner child draw a
child's drawing. If it fits, put it on your refrigerator.

2. If you have children, this is a good time to renew your relationship with them
and to plan some activities that allow you to be a child along with them. If you
don't have children, or if you have some extra time, consider volunteering at a
daycare center or school and let yourself enjoy childhood from your new vantage
point. Use your time with children to let your inner child come out and express
itself through the activities of a healthy childhood  drawing, telling and listening
to stories, playing games and singing songs. Enjoy this inner child and reclaim it
as an important part of who you are today.
3. At ASCA meetings, share how you are trying to nurture your inner child.
Professional Help
1. Many survivors describe a particular feeling or sensation in their bodies that,

over time, comes to represent their wounded inner child. Explore that feeling with
your therapist and see if you can't bring this part of you into sharper focus. What
does this wounded child feel like to you? What does s/he want or need from you
today? Are there any metaphors  images that capture the bodily sensations 
that could explain what this child is experiencing? Many survivors report feeling
"empty" inside or "cut off" below the neck or a "hole" in the stomach. Exploring
the inner child through your own personal metaphor may help you and your
therapist figure out how to heal the wounds.

Chapter Five
Stage Two: Mourning
In Stage Two recovery, the focus shifts from the details of your past abuse
to the impact of the abuse on your adult life. This stage represents the intermediate
point in your recovery, in which healing and change occur in tandem, each
reinforcing and complementing the other. As in the fourth step of Alcoholics
Anonymous, the cornerstone of Stage Two is taking an honest inventory of your
current life problems and then dedicating yourself to changing the behaviors that
are making your life unsatisfactory. For adult survivors, this means going beyond
awareness of your self-sabotage and taking direct action to deal with it.
Stage Two also requires you to delve deeper into your psyche to face your
shame, a core feeling experienced by many adults from dysfunctional families.
Ultimately, you must challenge the shame and turn it around into self-acceptance,
which will then become the source that nourishes your new self. This will enable
you to accept and express your grief over the disappointments in your childhood
and mourn the loss of your dream of an ideal family. By letting go of childhood
hopes for the parents who failed you and feeding your budding self-acceptance,
you give birth to a new sense of entitlement. You will be free to be your own
person and to choose how to live your new life. By altering distorted perceptions
and beliefs and learning how to control your aggressive behavior, you will foster
changes in your personality that will end forever the possibility of your continuing
the cycle of abuse with the next generation.
Rarely does recovery proceed in a neat, step-like progression, especially

during this middle stage. There will be times when you stray from the focus on
your abuse and head off in new directions that seem either too pressing to ignore
or likely to yield valuable insights. As you develop confidence in your ability to
assert your opinions and even disagree with your therapist, family and friends, you
may find yourself examining your relationship with them. This is a desirable and
healthy development because it indicates that you are learning to express your
newfound sense of autonomy.
_______________________________________

STEP EIGHT
I have made an inventory of the problem areas in my adult life.
The initial step of Stage Two recovery involves taking a full and honest
inventory of the problem areas in your life, because you first have to identify what
you want to change before you can begin to change it. By now, you should be
fairly clear as to how the abuse has affected your adult life. If you are still unclear
about this, review the checklists and exercises in Chapter Two. You may also
have identified additional problems that you did not recognize earlier. If so, add
them to your inventory. This inventory is more than just an accounting of your
problems. It will serve as the blueprint for the changes that you need to make to
create the "new you."
Self-Help
1. Go back and review the journal entries that you have made to date and make a
list of the concerns and problems you have identified. Which of these problem
areas are the most disruptive to your life? Which need to be resolved or eased
before you will be able to resolve the other ones? Are there any that need to be
dealt with so you will not lose something important, such as a personal
relationship, a job or even your life? For example, if you can't afford the cost of
therapy and have lost your health insurance benefits because of unemployment or
underemployment, the lack of a job may be the biggest barrier to your moving
forward in recovery. If you are depressed and immobilized in your life and are
contemplating suicide, then getting help to manage your feelings is a high priority
for you. If you feel that you might strike out at your child, thereby risking legal
charges of abuse as well as renewed feelings of self-hatred, then you should focus
on parenting issues. If you did not already do so in Chapter Two, rank each of
these problem areas in descending order of priority and use this ranking to help
you select those areas in which you need to focus your energies.
2. In ASCA meetings, talk about this process of making an inventory. What

feelings arose in the process? What were some of the difficulties, surprises and
successes in creating this inventory of your adult life?

Professional Help
1. Review your inventory of problem areas with your therapist and discuss how to
best address these life issues as you continue to heal your inner wounds. This will
give you a sense of control over your recovery and will help you learn to speak up
for what you want and negotiate an agreement about the direction of your therapy.
While your therapist may have reasons for wanting you to address certain things
first, it is your decision that counts the most.
2. Some of the problems you will likely identify, such as physical ailments, sexual
problems, severe mood disorders, parenting problems and work-related concerns,
are common among survivors and may require the services of specialists. In
general, this is the time for you to develop a more detailed treatment strategy for
the various symptoms of the abuse that do not readily remit through your weekly
therapy sessions. This is in keeping with a holistic approach to recovery, one that
seeks to take the best of each therapeutic modality and apply it strategically as part
of a comprehensive treatment plan.
3. For example, if you have body memories that manifest themselves as muscular
aches and pains, soreness in certain areas of your body or decreased joint
flexibility, consider seeing an acupuncturist, who may be able to provide either
topical or systemic relief for these symptoms. Acupuncture treatments can also
trigger the release of specific feelings, especially fear and anxiety, that may then
become localized in the specific areas of the body that were directly affected by
the abuse. However, unless your acupuncturist is also a trained psychotherapist,
you will need to continue to work with your therapist to identify and resolve the
underlying feelings.
Sexual problems can be addressed directly using specific behavioral

techniques. However, these may be outside your therapist's area of expertise, and
you may need to seek a referral to a specialist. Severe mood disorders, especially
in survivors whose parents were similarly afflicted, may have a physiological base
and may not be a delayed reaction to the abuse. If this is the case, therapy may be
more effective if augmented by some of the newer psychotropic medications. You
will need a referral to a psychiatrist for a medication evaluation and ongoing
monitoring. Likewise, parenting problems may require either a consultation with
your pediatrician or a referral to a child or family therapist.
_______________________________________

STEP NINE
I have identified the parts of myself connected to self-sabotage.
This step involves identifying and sorting out all the various aspects of
yourself so that you can understand which parts are helpful and which are
responsible for self-sabotaging acts in your life. Self-sabotage is probably a
source of some of the problems you identified in your inventory in Step Eight. By
now, you probably know where the self-sabotage comes from and how it affected
you as a child. Now, as an adult, you need to look at the part of you that controls
this behavior and how it expresses itself in your everyday life.
As you identify the parts of you responsible for the self-sabotage, you will
probably discover adult versions of the childhood roles you played. Many of the
most common roles that adult survivors used as children are still employed but
bear different labels: "co-dependent" for "caretaker," "masochist" for "scapegoat,"
"offender" for "bully," "leader" for "hero," and "eccentric" for "recluse." Although
certain aspects of these roles may help you in your daily functioning, they will
create problems for you if you let them dominate your interactions. For example,
caretaking is an essential part of parenting, but dominating or overcontrolling your
child is a common characteristic of co-dependent mothers. Try to identify what
roles you adopt as an adult  the positive ones as well as the problematic ones.
Learning to strengthen the healthy aspects of yourself while controlling the less
helpful ones will be a major task in Stage Two and Stage Three recovery.
Self-Help
1. Write about your various adult roles or parts in your journal and explore how
they operate in your life. Describe in as much detail as you can when these roles
emerge, what behaviors are connected to them and what feelings about yourself
and others they engender. Who seems to trigger the emergence of the roles in you:
spouse or lover, child(ren), peers, superiors at work, family, members of the
opposite sex or people of the same sex as your abuser? Do you "own" these parts
for yourself or project them onto others?
2. Ask the trusted people in your life how they see you. Don't react to anything
they say immediately. Instead, reflect on their comments for a day or two and see
how others' observations compare to the various roles you have identified for
yourself.

3. Share in ASCA meetings regarding your progress in identifying the various
roles you play, and the aspects of yourself that are self-sabotaging. Also share
how you are gaining mastery over these areas.
4. If you haven't done so already, try to record your dreams in your journal so that
you can see how the different parts of you interact on an unconscious level.
Record each dream in story form, with a beginning, a middle and an end. Tell the
story in the first person, and develop the details and imagery as you write. Many
people think that, because they don't remember their dreams, they don't dream.
This is inaccurate. Everyone dreams, although denial and repression may make
your dreams unavailable to your conscious awareness. Practicing remembering
your dreams will help you actually remember them. Develop a routine of leaving
your journal next to your bed and, when you first wake up, ask yourself what
dreams you had and record them.
Professional Help
1. Working with your therapist, try to give expression to all of the different roles
you play. You cannot learn how to strengthen or reduce the parts without first
giving each of them a voice and perhaps even a name. As you experience and
express each part or role, try to relate it to specific memories, images and
dialogues from your past. What were the conflicts in these situations? What
about each part made you feel good? Which of your roles comes out most
frequently with your therapist? Does it help you to get what you want from your
therapist? If not, talk with your therapist about what role(s) might be more
effective in getting you what you want and need.
2. This is a crucial time in your therapy because it can be tricky to enhance the
healthy parts of your personality and at the same time increase your control of the
maladaptive parts. Your therapist is well qualified to help you strengthen those
parts that promise change and hope.
3. In this section we have been talking about parts or roles that are similar to
character traits or tendencies. While distinct, they form part of the coherent and
unified personality that is you. If you are aware of having antagonistic or
aggressive sub-personalities or multiple personalities that are more autonomous
than this, you will need strong guidance from your therapist to decide how best to
reduce their impact on and intrusion into your life. A discussion of true multiple
personalities and ways of working with persons who exhibit them is beyond the
scope of this manual. Briefly stated, however, the predominant therapeutic
approach today is to ask you to speak to the various sub-personalities within

yourself and negotiate a sort of truce that will reduce the power of these
persecutory parts and help you to regain full control over your primary personality.
_______________________________________
STEP TEN
I can control my anger and find healthy outlets for my aggression.
Step Ten is similar to Step Six in that anger and aggressive or abusive
behavior are intricately connected. This step focuses on mastering control over
your abusive behavior and establishing safe and acceptable methods for
discharging your aggression. Anger may be a natural emotional response to your
childhood abuse, but aggression and abusive behavior directed at others repeats
old patterns. You need to manage these emotions carefully to avoid hurting
yourself or someone else. Becoming an abuser would obviously set back your
recovery because, in so doing, you would undermine the compassion you are
developing for the child victim you were and the adult survivor you are.
Remember that feelings of anger don't have to be expressed as aggressive or
abusive behavior.
Aggression is both learned and a product of physiological factors, mostly

hormonal. For this reason, many survivors, especially men, get stuck at this step
because their aggression has such a firm hold over them. Social roles permit males
to behave more aggressively than females, and male survivors are therefore more
likely to engage in abusive behavior as adults than are women. Boys learn to
respond aggressively to conflict situations very early in life. This is then
reinforced by athletic competition, military training and an increasingly violent
popular culture. Boys may be more likely to identify with their fathers because
they are the same sex. If the father is an abuser, then this identification may also
carry over to boys in a family. In actuality, testosterone, the male hormone, may
be the biggest cause of aggressive male behavior. If this is so, what can you do?
The answer is simple: You can't change the hormones in your body, but you can
learn some techniques and strategies for controlling aggressive behavior.

Self Help
1. Regardless of what happened to you as a child, you are always responsible for
your actions as an adult, just as your parents/abusers were responsible for what
they did to you years ago. Some survivors harbor fantasies about getting revenge
or punishing their abuser(s) for what occurred. It is one thing to have these
thoughts, and quite another to think about acting on them. If you entertain
fantasies such as these, you are entering dangerous territory, and we suggest that
you seek professional help immediately. Actions taken on such thoughts could
constitute criminal acts and subject you to severe penalties, including jail.
2. You have good reason to be so angry, but you need to be able to separate your
right to have these feelings from your right to act on them. As is stated in the
ASCA meeting guidelines, "We draw a line between thinking or feeling angry and
actually doing something abusive through words or actions." If you can learn to
express your feelings with people you trust, as opposed to acting out feelings
against them, you can dissipate this built-up aggression without becoming another
abuser. For men who are inclined to aggression and violence, this may be one of
the most important steps of recovery  and the most difficult to achieve.
3. Make a list of the situations where you lose control of your behavior and
become aggressive. Can you identify the determining factor in losing control?
What feelings tend most to trigger the abusiveness? What do you hope to
accomplish by reacting aggressively? Does it work? How do you think the person
at whom you are directing your aggression feels? Do you feel optimistic about
being able to control this part of you or do you feel hopeless? Are there any
external factors such as alcohol or drug use that might be related to losing control?
What are your healthiest options for controlling your frustrations and coping with
stress? Once you have identified them, see if you can't find ways to apply them in
the typical situations where you lose control.
4. If you are having a very difficult time learning how to control abusive and
aggressive behavior, think about joining a focus group or taking a class in parent
effectiveness training or non-violent behavior alternatives. You might be able to
find an anger management or other similar educational course that emphasizes
expressing anger constructively rather than destructively. Local community mental
health services and community colleges may have programs. Check with your
Employee Assistance Program at work and your HMO/health insurance carrier for
possible community listings.
5. Learning how to short-circuit your aggression will mean hard work and
tailoring behavioral strategies to fit your individual needs. Once you have

acquired the necessary behaviors, you will need to practice them so that they
become instinctive responses and part of your behavioral repertoire.
Professional Help
1. What kind of aggressive/hostile feelings are activated in your therapy

sessions? What seems to trigger them? Have you discussed this process with your
therapist? This is a legitimate topic for your therapy and your therapist should be
able to help you with it without withdrawing needed support from you.
2. One last word: Your therapist is legally required to warn potential victims and,
in some cases, to notify law enforcement officials if s/he reasonably believes that
you are likely to harm yourself or another person. In such a case, your therapist is
permitted to break the confidential relationship between the two of you in the
interests of protecting both you and your intended victim. For this reason, as well
as his/her interest in your continued growth and well-being, your therapist is not
able to support or condone violent actions under any circumstances.
_______________________________________
STEP ELEVEN
I can identify faulty beliefs and distorted perceptions in myself and others.
This step is focused on changing the faulty thinking, attitudes and beliefs
about yourself and your past that continue to shape your view of the world. Given
that the thoughts and attitudes born of your abuse will never really favor you, it is
essential that you learn to challenge the internal tapes that are likely still playing in
your head.
Because their childhood experience has often been extreme, many survivors
become victims of their own misconceptions. A few examples of this tendency are
1) splitting everything into good and bad, or "thinking in black and white;" 2)
discrediting the positive aspects of yourself or your efforts: "If it isn't perfect, then
it's nothing;" 3) magical thinking, or attributing some outcomes to factors that are
not relevant: "I was born under the wrong stars, so nothing will ever change," or

"I got lucky once doing this, so all I need to do is repeat myself;" 4) basing
conclusions on initial impressions or circumstantial evidence rather than balanced
objectivity: "I don't know why I did it; I thought this guy had it in for me;" 5)
personalization: assuming responsibility for something caused by other people or
factors; 6) magnification and minimization: either making something catastro-
phically important or excessively diminishing its importance. There may be other
types of distortions that you still fall prey to, perhaps more out of habit than
anything else.
First, familiarize yourself with the patterns that you use and practice
identifying them when they occur. Then, using your newly-developed self-
awareness, stop yourself so that you can short-circuit the patterns before they can
do damage to you. Lastly, devise techniques to help you internalize corrected
attitudes about yourself.
Self-Help
1. Read back over your journal and see what distortions in thinking, perceptions
and attitudes you have had about yourself. Notice the obvious patterns. Are there
any common themes in these distortions as regards behaviors and feelings?
2. The most basic skill for you to learn is the ability to stand back and view events
and situations from a broader perspective, so as to become more objective in your
perceptions, beliefs and judgments. This skill is essential because this analytical
ability is called into play in virtually all aspects of your life. It can make the
difference between repeating old habits and choosing new ways of looking at
things.
3. Whenever you uncover some distortion in your thinking, attitudes or beliefs, try
to determine the reality of the situation and then use this as a standard against
which to evaluate your thought processes. Don't assume you know something
when you really don't. You may have to make a particular effort or engage in some
specific activity in order to access the information you need. By learning to
identify what is objectively true, you can determine the validity of your previously
held beliefs and then substitute a less distorted version.
4. ASCA meetings might be good environments in which to talk about the

negative internal tapes that still play in your head. You might also share some of
your success in identifying and changing faulty beliefs and distorted perceptions.

Professional Help
1. What kind of distortions has your therapist pointed out to you in the past?
Share your ideas about this and discuss with your therapist which ones still present
problems for you.
2. Use your therapy sessions to help you refine your thinking and decision-making
style. You can do this by discussing specific situations that are currently giving
you problems. With the help of your therapist, delve into these situations and see
what kind of perceptions, attitudes and beliefs they may reveal. Considering that
feelings may significantly disrupt this process, you may need to work very slowly
and deliberately and to practice regularly if you are to identify and minimize your
patterns of distortion.
_______________________________________
STEP TWELVE
I am facing my shame and developing self-compassion.
Shame is a general term that encompasses all of survivors' negative feelings

about themselves. It is also the psychological source of self-sabotage. Unlike guilt,
which is the result of feeling bad about what you do in the external world, shame
reflects feelings of failure inside, as a person. Shame is experienced as self-blame.
You perceive yourself as flawed, inferior, contemptible, no good. Considering how
little you probably received as a child, shame, like anger, is a normal feeling. The
problem is that you may have too much of it. Shame is the part of you that you
can't face because it is so intolerable. In the words of John Bradshaw, "toxic
shame" is an "emotion that gets internalized as a state of being."
Adult survivors begin to internalize shame when they identify with parents
who abuse them, abandon them and fail to validate them as people. The shame
becomes part of a package of self-blame, bad feelings, self-destructive thoughts
and self-sabotaging behaviors. During the childhood years this bundle of negative
feelings evolves into a major part of the survivor's sense of self. As you go
through life, this negative part gets reinforced by other people, external events and

even yourself, if you tend to defend against the feelings triggered by the abuse by
"turning against (your)self."
The second part of this step involves developing acceptance and self-
compassion for who you are, what you have overcome and the efforts you are now
making to live a healthier life. It is important that you remember that you
developed this self-blaming behavior as the result of being told  directly or
indirectly  that you were somehow bad. In a very real sense, you are not
responsible for the initial seeds of self-blame, although you may have aggravated
your situation by internalizing your abusers' blame and turning it against yourself.
In addition to accepting these self-defeating tendencies, you need to develop
compassion for yourself. You certainly weren't responsible for the abuse that
occurred to you. You probably couldn't help but turn the blame inwards. You are
now making earnest efforts to recover and heal. For all these reasons you need to
be kind to yourself, to recognize that you are a valuable person and to start to turn
some of your self-loathing into compassion and acceptance.
Considering that shame is probably deeply imbedded in your sense of self,

it will take a lot of courageous work to uncover it, examine it and begin to
transform it into self-acceptance. But it can be done. By working with your
support network and sharing your feelings with other people whom you trust, you
can begin to internalize a different, more accepting message about yourself. To
continue self-blaming is to do to yourself as an adult what was done to you as a
child. You must sever this legacy by changing what you say to yourself, how you
treat yourself and how you let others treat you.
Self-Help
1. Read any of several available books and articles on shame and its debilitating
effects.
2. Learn to identify the feeling of shame as it occurs in your daily life and write in
your journal about situations that trigger shame.
3. Reach out to others for help in learning to act differently in situations that
trigger shame. By assertively affirming your strengths and admitting your
weaknesses, you will counteract internal shame and arrest the shaming process in
your everyday life. You will also begin to accept yourself, good parts and not-so-
good ones, as a valuable person.

4. Recall the people in your childhood who had something good to say about you.
What words did they use to describe your best qualities? How did you feel when
you were around them? Revive these important people from your past by writing
about them in your journal and exploring what their support meant to you, then
and now.
5. Those of you who are religious or spiritual can turn to your Higher Power to
cleanse yourself of the shame and unworthiness that you feel so deeply. Religion
and spiritual practice can be tremendous sources of inner sustenance and can
provide an ideal vision to replace the negative role models and scenarios of the
past.
6. Share your struggle with working this step at ASCA meetings.
Professional Help
1. In order to resolve shame, you need to have an ongoing reparative relationship

with another person who will help you challenge your internal voice of shame and
replace it with a healthier dialogue. Your therapist is an important ally in helping
you to transform the shame into self-acceptance. Talk about your shame with
him/her and share how you experience shame in your life, including in your
therapy sessions.
2. With your therapist's help, identify the ways in which you keep yourself from
feeling your shame by adopting a role or "false self" that you portray to others.
Share this "false self" with your therapist and try to understand what the role gives
you that you feel you lack inside.
_______________________________________
STEP THIRTEEN
I accept that I have the right to be who I want to be
and live the way I want to live.
This step marks the separation of your new self from your parents and
family and permits you to make conscious choices about your life, free of guilt and
the lack of entitlement that characterized your past. Ultimately, survivors must
accept and protect their right to self-determination: to be the persons they want to
be, to live the life they want to live and to be treated the way they want to be
treated. Working through the abuse and coming to feel entitled to define your own
life means that your true identity as a person is beginning to emerge. When you
complete this step, you will have acknowledged and affirmed your right to make
choices that reflect your personal preferences: your values, how you spend your
time and money, and with whom you share your life  and your body.
Once you have made the voice of the "new you" heard, you will need to
protect it, as a parent should protect a vulnerable child. This is an apt analogy
because the wounded child that you reclaimed in Step Seven is now growing up
and feeling strong enough to venture out into the real world. If someone tries to
invalidate you or expects you to behave in old passive, aggressive or maladaptive
ways, you can protect that newly-emerging self by asserting your new identity.
Many people  not just survivors  have difficulty distinguishing between

assertiveness and aggressiveness. Assertiveness is a skill and a tool that can help
you in your daily life. On the other hand, aggressiveness rarely gets you what you
want, and is at base an abusive way of acting towards others. While this manual
doesn't have space to present a full discussion of the differences between the two,
the following may help you to differentiate between them. If you are interested in
learning more, there are numerous books and courses on assertiveness training that
you may want to investigate.
It is perhaps easiest to think of assertiveness and aggressiveness as being

points on a continuum or scale. The left-hand end of the scale would be victim-like
behavior, and the right-hand end would be overt aggression or even perpetrator-
like behavior. In other terms, the left-hand end is a passive, powerless point, and
the right-hand end is a very active, powerful, even violent one. Assertiveness lies
somewhere around the middle of the scale. Think of it as a fortifying, anchoring
style of behavior in which you make your point or position known in a strong but
respectful manner. The term "assertiveness" is usually applied to verbal, rather
than physical, behavior, and has been called "neutralized anger." On the other
hand, aggressiveness, which generally takes the form of actions rather than words,

is usually violent, intimidating, abusive behavior. It usually succeeds in
threatening others, and may get you your desired goal, but it is not a particularly
healthy or respectful way of treating others.
Self-Help
1. If assertiveness is a problem for you, now is the time to do something about it

because you have a lot at stake  the beginning of the "new you." People who
are unaware of your progress in recovery will expect you to be the same old
person and may treat you accordingly. Therefore, you need to learn some new
skills that will help support the "new you." Consider reading a book on
assertiveness training or taking a brief class to learn some strategies that will
enable you to put these new behaviors into practice. You may be surprised at how
quickly you reap rewards. When you start behaving from a position of equality and
strength, people often notice and begin to respond in kind. This encouragement
will, in turn, reinforce your efforts to behave in an assertive manner.
2. Have a friend take a photograph of you to document the emerging "new you."
Arrange the pose so that the camera is shooting slightly up to you, from an angle
that captures your best features. As the picture is being taken, try to communicate
your new sense of yourself to the camera. Take several shots and experiment with
the feelings you want to convey. Choose the picture that best expresses your
newfound strength and frame it. Put it on your desk or on a wall in your bedroom.
If a picture is worth a thousand words, then this picture will capture the changes
you have made during the first twelve steps of recovery.
Professional Help
1. Take some time in your sessions to discuss the progress you have made to date
in therapy. In what ways do you feel different than when you first started? What
have you accomplished and what remains to be addressed? How is your life better
now than before? What does your therapist say about your efforts to date? Are
there any areas in your therapy or in your relationship with your therapist that
make you uncomfortable or pose problems? Can you discuss them with your
therapist?
2. At this point you may want to consider changing your name. Names have
important and interesting meanings to people. If your name has a negative
significance for you, it can become psychologically burdensome and hamper your
efforts to recover from your abuse. However, not everyone will want or need to

change her/his name to allow the new sense of self to emerge. Discuss what your
name means to you with your therapist and determine how comfortable you are
with it. If you feel your name is a burden, you can consider changing it or finding
a new meaning or association for it so you feel that it represents the "new you."
_______________________________________
STEP FOURTEEN
I am able to grieve my childhood and mourn
the loss of those who failed me.
This is a step that asks you to recognize your losses and helps you resolve
them once and for all. Grieving your childhood losses and mourning the loss of
the "ideal" parents will require a great deal of patience and self-compassion. Be
prepared for this step to take time. You can't be rushed into healing these deepest
wounds from childhood, and the healing won't happen all at once. More likely you
will heal the wounds in layers throughout your recovery, coming back to this step
several times. You may always have a scar, but the scab covering your painful
losses eventually will disappear.
Many survivors tend to avoid this stage after one pass or so, preferring to
avoid its dreadful pain ever again. After working through some of the pain in Stage
One, you may feel much better than before but still have not fully resolved the
grief. You may find that your life has improved but now feel that your growth has
stalled. You can get past this block by sharing the most vulnerable parts of
yourself with others, thereby turning your fear of being hurt into the building of
trust. Ask yourself if you can allow yourself to be comforted by your spouse, lover
or friends. Healthy dependency means letting other people take care of you at
times like this. You need caring, and you need to be able to accept it from others.
Self-Help
1. This step requires a lot of outside support. ASCA meetings can provide you
with generous support, validation and encouragement for your efforts. You need
to be around people who have gone through what you are going through and who

can serve as positive role models. To the grieving survivor, survivors in advanced
recovery, mentors and therapists are very important people because they provide
much-needed sustenance and symbolize the light at the end of the tunnel.
Professional Help
1. Your therapist's job is to help you ventilate your feelings of loss and let go of
the fantasy of getting something that is not available. Expect to receive support,
understanding and compassion during this difficult and painful step. If you cannot
resolve these wounds or give up the hope for the ideal parents, consider doing
some guided visualization exercises with your therapist. In this method, your
therapist uses some type of trance induction technique to fully and deeply relax
you and then creates an imaginary experience that metaphorically captures your
dilemma as a child.
As mentioned in Chapter One and the discussion of Step Two, it is critical

that your therapist be trained in and comfortable with the practice of this and any
other technique(s). If your therapist is not trained or comfortable using techniques
such as this, then discuss the possibility of your attending a workshop that focuses
on healing childhood traumas. Guided visualization and other exercises can aid the
grieving process and help you transform your inner emptiness into an evolving
process that leads to resolution.
2. Sharing your dreams in therapy sessions can open up exciting avenues of

personal exploration. If your therapist is skilled in dream interpretation, you may
want to try this. If you have been recording your dreams (refer to the discussions
in Steps Two and Nine), you can bring your journal to therapy with you and read
your dreams to your therapist. Together you can explore various possible
meanings and interpretations. Dreams can be especially vivid and informative
during the grieving process in that they may illuminate conflicts and resistances
beyond your conscious awareness.

Chapter Six
Stage Three: Healing
Stage Three recovery asks you to build on the progress you have made in
Stages One and Two by incorporating behaviors, skills and attitudes that reflect
your newfound psychological health into your current life. No longer primed to
respond defensively to the world, you are now enlivened and challenged by life's
opportunities: love, work, parenting and play. As a result of integrating positive
changes into your personality and practicing new behaviors in your everyday life,
you will develop a new confidence in yourself. In this stage, you will learn to take
healthy risks that benefit you by paying off in new and positive ways. Stage Three
can be a very exciting time because you will finally experience the fruits of your
labors as you become comfortable with taking control of your life.
In this stage you will revisit the issue of resolving your abuse by deciding
whether to confront your parents/abusers. From this decision and subsequent
contact with your family, if any, you will gain a revised and deeper understanding
of why you were abused. Having this new understanding and making it part of
your life will allow you to let go of the abuse once and for all and proceed with
developing new expressions of your individuality. Mere survival will not be
enough for you  you aspire to thrive. Move through this stage with optimism and
anticipation. You are seven steps away from your new beginning.

STEP FIFTEEN
I am entitled to take the initiative to share in life's riches.
In this step you will address the old feeling that you are not deserving of the
good things in life: success, financial rewards, achievement, even luck. A feeling
of lack of entitlement makes it difficult for survivors to make prosperity part of
their lives or to accept it and acknowledge it when it appears. By prosperity we do
not mean simply financial rewards or material possessions. Prosperity is a state of
mind that encompasses your need, desire and dreams for a life that bestows
emotional and spiritual riches as well as material well-being.
Step Fifteen requires wholesale changes in your thoughts, feelings and

behaviors concerning what constitutes success and achievement and your worthi-
ness to partake in them. By now you know that much of this sense of lack of
entitlement is related to your abuse. Nevertheless, knowing intellectually that you
deserve your "fair share" and feeling it emotionally are quite different, to say
nothing of the experience of enjoying and celebrating your gains, which is the
most fun. Your task will be to practice challenging old attitudes and expectations
by taking healthy risks that offer more than a minimal likelihood of success.
Taking the initiative to partake in life's riches is critical to your continued

growth and well-being. In taking the initiative, you are saying that you know
something, that you have something to offer and that you stand behind your
actions. Taking an active stance such as this may feel awkward and pushy to you.
You may be asked to lead others, a request that may seem like more of the same if
you are one of yesterday's caretakers. For those used to being ignored or
dismissed, being put in a position of authority can be uncomfortable. But to step
away from responsibility, authority and power is to deny yourself and your talents
their full expression and to turn your back on the possibility of financial rewards
and a sense of accomplishment. If you have resolved the previous steps, you are
ready to undertake this newest challenge.
Self-Help
1. How could you take initiative in a way that would benefit your life? Seeking a
job promotion, buying a house, going back to school, joining an organization or a
church or opening a retirement account are a few of the myriad ways that you can
take a step that could benefit you. Remember, the basis for taking such initiative is
feeling entitled to share in success and prosperity. This feeling grows from within,

but eventually you have to put that internal belief into practice by taking action in
the outside world.
2. Take a look at yourself in the mirror. Does your appearance reflect the
entitlement and confidence you feel? In our society, image and appearance are
important, although some people overdo it. And looking good on the outside can
go along with feeling good on the inside. Your self-esteem, long suppressed by the
burden of shame, may also be clamoring to be part of the image you present to the
world. In this last stage of recovery, many survivors begin making cosmetic
changes to their appearance to reflect their new, more positive feelings about
themselves. Altering your wardrobe, getting a more stylish haircut or working
yourself back into shape are all ways to take initiative in altering the way you
present yourself to the world.
Professional Help
1. With your therapist, explore how you can take initiative to make your material
or personal life better. If problems remain in realizing your goals, try to clarify
what is holding you back. You may still be struggling with an inner sense of not
feeling entitled to success. Go back to Steps Nine, Eleven and Twelve and see if
you can't identify the source of your resistance to success.
_______________________________________
STEP SIXTEEN
I am strengthening the healthy parts of myself, adding to my self-esteem.
In Step Sixteen you will continue the process of strengthening the healthy,
adaptive parts of you that you first developed during childhood and later fortified
in the early steps of your recovery. Your task now is to begin to organize and
consolidate these healthy parts into an integrated, positive sense of self. As you
refine this sense of self, you will find that you are more flexible, balanced and
adaptive with respect to your thinking, your emotions and your actions. These are
personal strengths that you can live with on a permanent basis!

While strengthening the healthy parts, you will also need to continue to
resolve any feelings remaining from the past, especially those that make you
susceptible to resuming old destructive behaviors. You probably have noticed that
feelings related to the abuse last a long time. Although you probably have more
resources  internal as well as interpersonal  to deal with these feelings now,
certain situations can still evoke them. By now, self-sabotage should be an
infrequent occurrence, as you are now aware of old patterns and able to stop
yourself before you actually commit the destructive action(s). Likewise, you are
better able to control your aggression, as you have refined new ways of coping
with these feelings and learned to avoid or defuse old triggering situations.
Self-Help
1. In your journal, describe both the healthy parts of yourself that you want to
acknowledge and strengthen over time and the less positive tendencies and
behaviors that still plague your life today. Continue to focus your awareness on
how these parts play themselves out in your life and what you can do to emphasize
the positive ones while diminishing the negative ones.
2. Are there people in real life or characters in novels, magazine profiles or

movies who possess particular personality traits that resemble some emerging part
of you? Write in your journal about the similarities or the qualities that you find
so appealing.
3. Gradually start to take on roles in your life that will allow you to use these
newly developing healthy parts. Consider becoming a Co-Secretary at ASCA
meetings or signing on for a special committee project at work. If you are a parent,
become involved in your child(ren)'s school or extracurricular activities. These
new roles will let you display your developing strengths and start to consolidate all
of your recovery-related changes into an integrated whole  the "new you" you
present to the world.
Professional Help
1. If you continue to experience problems in your intimate relationships, this may

be the time to consider entering couples' therapy. With all of the changes you have
already made, you and your partner may greatly benefit from seeing a couples'
therapist, even for a brief period of time. At this point, many interpersonal
problems are largely habitual and reflexive and can be easily changed with the
help of a good referee. Still, because you are in many ways a different person than

you were when you started recovery, you may need to restructure or redefine
certain aspects of your relationship. Discuss this issue with your therapist and ask
him/her for a referral if necessary. As a rule, it is better for you and your partner to
see someone other than your individual therapist, so that the relationship work
remains separate and there is minimal chance of the therapist's favoring one
partner over the other.
2. If sexual problems persist, you may want to consider seeing a specialist in sex
therapy to resolve old associations and fears that may have become habitual and
that may be affecting your sexual relationship(s). You may also want to read any
of a number of books to give you more information about the methods and goals of
sex therapy. Some survivors give up on their sexuality when they reach this last
stage because there are so many other positives to fill their lives now. However,
you need not limit yourself and your partner in this area. You can reclaim your
sexuality for yourself  and your partner  just as you reclaimed your childhood.
If you need additional information or referrals, speak with your therapist.
3. With your therapist, review thoroughly your behavior in the kinds of situations
that challenge you to draw on the changes you have made. Use the discussion of
these situations to pinpoint where you were successful and where you may have
faltered. Look for new situations in which you can continue to practice those new
behaviors that may not yet have become instinctive or comfortable to you.
_______________________________________
STEP SEVENTEEN
I can make necessary changes in my behavior
and relationships at home and work.
This step challenges you to learn new interpersonal skills to replace old,
maladaptive ways of relating. Like many survivors, you may never have learned
these basic skills that are normally taught in a well-functioning, healthy family.
As a result, your relationships may be suffering. In order to create more fulfilling
relationships at home, you may need to develop some additional skills in the more
personal realms of parenting, sexuality and intimacy. In addition, you may still be

playing catch-up when trying to relate to others in competitive or even cooperative
situations at work. This may result in discomfort, stress, poor work evaluations
and even failure to achieve desired promotions or goals.
Assertiveness, listening, communication, decision-making, negotiation,

conflict resolution and leadership skills are among the many skills that survivors
may need in order to relate more effectively in both personal and work relation-
ships. Because you didn't acquire these skills in your biological family, you will
now have to learn them and then adopt them as your own. With these skills
available to you, you may find each day's tasks a little easier and more likely to
yield positive results. With positive results comes more self-confidence in your
abilities.
Self-Help
1. What professional or interpersonal skills or knowledge do you still need to

realize your life ambitions? How can you go about developing these tools? Does
your company provide training or other programs to help you develop in these
areas? Have you ever thought of returning to school to get the degree that you once
felt was beyond you?
2. There are many books on the market that provide an introduction to the kinds
of skill-building that you may need. Read some of these books to gain background
information on what the next step in educating yourself might be.
3. Check with your local community college or university extension division for
workshops and courses on the topics that you have targeted for yourself.
4. Many work-oriented skills are transferable to your personal life. Make a list of
the professional skills that you feel will also help you in your personal and family
relationships.
5. Consider taking a workshop or class that focuses on the personal/relationship

skills you want to refine. In addition to community colleges and university
extension divisions, many churches, community counseling centers and family
service agencies offer these classes.
Professional Help
1. If you are still unclear about your career interests or goals, consider meeting
with a career counselor, who may use vocational interest and personality tests to

help you narrow down your career and job preferences. As they work through their
recovery, many survivors shift jobs or careers to find a position that better suits
their newly developed personalities.
2. You can always discuss career options and ideas with your therapist. S/he will
be able to help you identify and prioritize your interests and learn how to realize
your objectives. Since values, interests and job preferences are intricately
connected to your identity and personality (and these have been in flux up to now),
it may have taken this long even to recognize your professional interests and
aspirations.
3. Use your therapist to help you identify and refine those professional skills that
can transfer to your personal life and relationships.
_______________________________________
STEP EIGHTEEN
I have resolved the abuse with my offenders
to the extent that is acceptable to me.
This step involves making a decision about resolving the issues left over
from your childhood abuse with those who abused you and/or failed to protect
you: your parents/abusers. The important task in this step is to resolve the abuse
with your family in a way that is acceptable to you. You have the right to choose
how to do this. It is not mandatory to confront your parents, family or abusers,
although many survivors find confrontation valuable. However, you want to
maintain a relationship with your parents/abusers without hiding your recovery
efforts or denying your new identity as a recovered survivor, you probably will
need to do something. And, if there is to be a continuing relationship, your
parents/abusers will need to accept you as you now desire to be accepted: with
respect, consideration and acknowledgement of the burdens you have overcome.
You must remember that, because you are dealing with people who may
never have faced or changed their own abusive behavior, the degree of resolution
will depend on the extent to which they can acknowledge the abuse. For this
reason, there is a wide range of possible resolutions which, ultimately, will

determine whether you can still have some kind of relationship with your parents/
abusers. If you decide to confront them, it is critical that you go into it fully
prepared for whatever responses or consequences follow. If they do not want to
hear your experience or accept the person you are becoming, then you must face
the question of whether ongoing contact will be healthy for you.
This step presents the big issue of whether to forgive your parents/abusers.
In a sense, resolving the abuse means coming to terms with what was done to you
and accepting the feelings you have toward the people that did it. For some people
this means forgiveness, but not necessarily for you. Those who were very
sadistically and severely abused may never be able to forgive their parents/abusers.
Accepting that the abuse occurred and putting it all behind you once and for all
may be the only resolution that makes sense and feels right. Deciding whether to
forgive or accept is your choice and no one else's.
Self-Help
1. Review the section in Chapter One, "What About Confronting My Abusers?"

Although far from a complete discussion, it highlights some of the complicated
issues involved in answering this question.
2. Write some letters to your parents/abusers in your journal and then reread them
a few weeks later. This will help you to develop your sense of what you may
someday want to say to them. These letters are a "working statement" of your
message to your parents/abusers and may evolve over time until such time as you
decide whether to confront them.
3. If you are having difficulty deciding whether to confront, try to answer some of
the following questions in your journal. What past attempts, if any, have you made
to address the abuse, and how did they turn out? What are your reasons and
motivations for confronting your parents/abusers? What do you hope to get out of
it? How do you want your parents/abusers to react to you? How do you imagine
they will react to you? Is there a specific outcome that would make you regret your
decision to confront your parents/abusers?
Professional Help
1. Confronting your parents/abusers is an issue that will require the committed

involvement of your therapist in helping you sort out what you want to do and how
you want to do it. Planning any kind of confrontation about the abuse, be it a

meeting or simple discussion with your parents/abusers, will benefit from a full
and complete airing of feelings, doubts, expectations and hopes. You will need the
outside perspective of your therapist to make the best decision.
2. If you wrote answers to the questions posed in Self-Help item 3 (above) in your
journal, discuss them with your therapist. Together you may be able to reach a
conclusion, based on your writings, doubts, feelings, hopes and expectations.
2. Sometimes it is helpful to invite your parents, family or abusers into your

individual therapy for a session or more to discuss and work out selected conflicts
with the help of your therapist. This would temporarily change the format and
focus of your individual therapy, although you and your therapist would already
have an established alliance. You should be aware, though, that family therapy is
not necessarily advisable or possible, given varying circumstances and attitudes of
the persons involved. Adding your parents, family or abusers to your therapy
sessions would pose an ethical conflict for your therapist, at least initially.
Obviously, any consideration of such a plan must stem from your desire for it and
your belief that it would be productive. Your therapist would also have to agree
that the benefits of such an arrangement would outweigh the possible detriment.
If family therapy is your goal, then you will need to do a lot of preliminary
planning as to what you want to say, what your goals are, and how you will deal
with challenges to your point of view. If more extensive family work is indicated
and/or acceptable, you probably would want to find a separate family therapist
who could be more neutral than your individual therapist. In general, therapy of
this sort is most likely to be successful when your parents/abusers have done some
work on themselves or at least have admitted that they made a mistake.
4. Discuss with your therapist what you think and feel about the issue of forgive-
ness. Explore what feels right to you and your reasons for feeling that way. Be
aware that feelings about forgiveness, like any other symbol of resolution, may
shift over time.
_______________________________________

STEP NINETEEN
I hold my own meaning about the abuse
that releases me from the legacy of the past.
This is the last step that focuses directly on your abuse, but it is
nevertheless critical in this long process of putting the abuse behind you once and
for all. After all your hard work on the previous eighteen steps, your last task is to
arrive at your own philosophical understanding of why the abuse happened to you
and what it means for you today. After growing up thinking that the abuse
occurred because of who you were as a person, you must now replace this with an
explanation that accords with what you now know and who you now are.
In a sense, this step asks you to reflect on how and why things happen the
way they do and what this means for the person who is caught up in events beyond
her/his control. You may ask yourself about the nature of good and evil. Why do
bad things happen to good people  in this case, innocent children? You may call
into question your notions about God or reaffirm your faith in a Higher Power.
Your answers to these questions will be highly individual, as has been the
development of your new self.
You need to organize the thoughts, feelings and information you have
gathered during your recovery into a consistent and unified concept that will stay
with you for the rest of your life, so that, when old doubts arise, you can return to
it to explain to yourself what the abuse really meant. As such, your explanation
will serve to anchor you when you are buffeted by the challenges and opinions that
will inevitably be voiced by some around you.
Self-Help
1. Your understanding of the abuse and its meaning has probably evolved over the
course of your recovery. Still, it is important to crystallize this understanding and
to acknowledge to yourself that you have resolved this difficult issue. Write about
it in your journal to develop your ideas further.
2. Share your understanding and meaning about your abuse at ASCA meetings
and listen to others' explanations and thoughts. You may hear conceptualizations
that capture a feeling you had but were unable to put into words. Continue to
refine your thinking on this topic.

3. Have you had any dreams that might reflect this new level of resolution regard-
ing the abuse? Frequently, at major milestones of recovery, survivors have dreams
that capture the essence of their understanding in a way that words cannot.
Professional Help
1. Your therapist can be an important sounding board on this complicated philoso-

phical issue. Remember, though, that this step is about what you think about the
meaning of the abuse, not what your therapist thinks. This can be one of the most
poignant moments in your therapy as you finally settle on an acceptance of your
past and then share your feelings about it with someone else, free of feelings of
shame or defensiveness.
_______________________________________
STEP TWENTY
I see myself as a thriver in all aspects of life 
love, work, parenting and play.
Your journey on the road to recovery is almost over. You have progressed
from being a survivor of the abuse to becoming a thriver: someone who finds joy
and satisfaction in many aspects of life. By now, you probably have created a new
family or support system for yourself that banishes the isolation and shame you
felt in the past. You can readily give of yourself to others and accept nurturance
and consideration in return. This is the step in which your new self comes together
into a personality that expresses your full essence in the world.
Intimate relationships are now infused with trust, sexual sharing and mutual
self-reliance. You can communicate your needs, allow healthy mutual dependency
and resolve conflicts, free of the concerns and self-doubt of the past. Your new
self-acceptance allows you to be less critical of others, while your new self-
awareness helps you to identify hurtful situations before they cause damage. You
can gauge situations accurately and share your feelings, as appropriate, without
losing control of them.

By now, you are able to avoid exploitative job situations and can identify
and pursue appropriate promotion opportunities. You are no longer mired in office
politics or oppressed by bosses or authority figures. You can develop your career
in a way that fosters your interests and talents and accept the financial and
emotional rewards that follow. If you find yourself facing a dead end in your
career, you can make the necessary changes to keep yourself vital and interested in
your work. Instead of experiencing your work life as a strain, you now feel
challenged and satisfied by your job.
If you have children, your new sense of self has brought you a new identity
as a loving, caring parent. You accept your children as people and raise them to
respect themselves and others. You foster their self-esteem by giving them
appropriate amounts of power and control and protect them from harm by setting
clear and consistent limits. You are able to discipline them by using the positive
elements of your relationship with them to hold them accountable when they fall
short of the values you have set for your family. This is the time to acknowledge
that your family's intergenerational chain of abuse has ended with you. You and
your children are living testimony to this formidable accomplishment. You can
continue to grow together, allowing your relationship to mature into a seasoned,
adult-to-adult friendship that can provide joy and affiliation for the rest of your
lives.
Finally, your new self begins to express itself in one area that may have
always been difficult: play. You probably have neglected this area of expression,
but the newly-confident you may now be ready to explore this exciting domain.
Hobbies, sports, creative arts, traveling and music are just some of the many ways
you can play as an adult. Playing keeps you in touch with your own inner child
and affords you an opportunity to share another experience with your children.
Playing revives us and recharges our emotional batteries. It improves our outlook
on life and rewards us for our hard work. Don't deprive yourself of this important
element of life. Find new ways of playing that fill you up and charge your active
participation in life.
Many survivors wonder how they will know that they have completed their
recovery. That moment is very personal and may or may not be related to an
external event in your life. It occurs at the moment when healing on the inside and
change on the outside merge into a unified sense of self. This moment may be a
"mystical experience," one in which you feel at one with the world. It may be the
moment in which you realize you have attained an achievement that symbolizes
success to you. It will be different things to different people, and you are the best
judge of the moment for yourself.

Self-Help
1. Have a celebration or perform some personal ritual to mark formally the

completion of your recovery. There are endless possibilities for acknowledging
this important rite of passage. You could bring together all of the people who have
supported you during this process and let them know what they have meant to you.
You could take the vacation of your dreams. If you have moved into a new home
that reflects the "new you," you could have a housewarming party. Think of
something that symbolizes what your recovery has meant to you and find a way of
expressing it  one that celebrates this enormous achievement and affirms the
person who did it: YOU!
2. How long has it been since you marked the start of your recovery? Go back and
reread your journal entry marking this long-ago date. What feelings surface as you
reread the words that accompanied your start on the road to recovery? How many
years ago was this? Was the journey worth it? Do you like where you are today,
relative to yesterday? Make note of today's date and acknowledge your reactions to
coming to the end of recovery. What future directions would the "new you" like to
explore now?
3. At this point you may want to reach out into the community to share your new
strengths. If you are attending ASCA meetings, you may want to share your
recovery experiences and encourage others who are still on their journeys. One
way to deepen your sense of resolution and support others in their efforts to heal is
to become a "mentor" or contact for someone just entering recovery. You might
become more involved with ASCA in an organizational capacity. You can
volunteer with a community hotline that reaches out to parents at risk for abusing
their children. You might try your hand at social change by running for the local
school board, thereby exercising a healthy expression of power and authority.
Any of these activities will affirm the changes you have made in recovery and will
give you the chance to share with others what you have accomplished.
4. This is the last self-help step you will need in this recovery program. By Step
Twenty, helping yourself will be almost second nature!
Professional Help
1. By now you are probably thinking about terminating your therapy. You have
gained the perspective to understand your feelings and reactions to life events and
have the capacity to make additional changes as needed. You feel strong, stable
and ready to meet life's challenges. You may well feel that you can be your own

therapist now. Nevertheless, the idea of "going out on your own" may bring up
feelings of self-doubt, insecurity and possibly even loss. Don't worry. This is
normal, even at the lofty height of Step Twenty-one! You have benefitted greatly
from this most unusual professional relationship, and the idea of not having its
support may be difficult to accept. You may have grown very fond of your
therapist, who has become so much more than the person to whom you tell your
problems.
2. Discuss these feelings and thoughts with your therapist. Be aware that you may
have conflicting feelings during this time. Give yourself time to be sure that the
decision to terminate is the right one. Many survivors prefer a gradual reduction in
sessions over an extended period of time, with periodic "check-in" sessions to
reinforce all the positive changes they have introduced into their lives. Old feelings
and reactions often resurface during the major milestones of life, and many
survivors want to return to therapy at these times to further resolve or solidify their
changes. In most cases, this will be possible  check with your therapist.
_______________________________________
STEP TWENTY ONE

I am resolved in the reunion of my new self and eternal soul.
Step Twenty one is the last step of this recovery model, but not everyone
necessarily reaches it. It is the step that we all strive for as we continue through
our lives. If you keep working on your recovery beyond simple survival, you can
reach a state of self-acceptance and satisfaction that represents a unique synchrony
between your soul  your spiritual essence  and the new self born of your hard
work in recovery. Bringing the "new you" into congruence with your soul's
aspirations is the ultimate step because it represents the combined expression of
your conscious, unconscious and spiritual essences.

ASCA Stages and Steps
________________________
STAGE ONE: REMEMBERING

1. I am in a breakthrough crisis, having gained some sense of my abuse.
2. I have determined that I was physically, sexually or emotionally abused as a child.
3. I have made a commitment to recovery from my childhood abuse.
4. I shall re-experience each set of memories as they surface in my mind.
5. I accept that I was powerless over my abusers' actions
which holds THEM responsible.
6. I can respect my shame and anger as a consequence of my abuse,
but shall try not to turn it against myself or others.
7. I can sense my inner child whose efforts to survive now can be appreciated.
STAGE TWO: MOURNING

8. I have made an inventory of the problem areas in my adult life.
9. I have identified the parts of myself connected to self-sabotage.
10. I can control my anger and find healthy outlets for my aggression.
11. I can identify faulty beliefs and distorted perceptions in myself and others.
12. I am facing my shame and developing self-compassion.
13. I accept that I have the right to be who I want to be and
live the way I want to live.
14. I am able to grieve my childhood and mourn the loss of those who failed me.
STAGE THREE: HEALING

15. I am entitled to take the initiative to share in life's riches.
16. I am strengthening the healthy parts of myself, adding to my self-esteem.
17. I can make necessary changes in my behavior and relationships
at home and work.
18. I have resolved the abuse with my offenders to the extent
that is acceptable to me.
19. I hold my own meaning about the abuse that releases me
from the legacy of the past.
20. I see myself as a thriver in all aspects of life - love, work, parenting, and
play.
21. I am resolved in the reunion of my new self and eternal soul.


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SURVIVOR

Manual and Workbook for

Survivor to Thriver, Page 1

1537 Franklin Street #307

phone: 415 • 928 • 4576

All rights reserved, including the right of reproduction

The information and program contained herein are

Survivor to Thriver, Page 2

Chapter One: The ASCA StepWork Program

Chapter Two: Safety First!

Chapter Three: Assessing Child Abuse

Survivor to Thriver, Page 3

Chapter Four: Stage One  Remembering

Chapter Five: Stage Two  Mourning

Chapter Six: Stage Three  Healing

ASCA Stages & Steps . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 115

Survivor to Thriver, Page 4

A non-profit 501(c)(3) public benefit corporation, THE MORRIS CENTER

In 1994, perceiving an increased need for cost-effective, easily replicable

In February, 1993, the ASCA Leadership Council, composed of volunteers

In September 1999, THE MORRIS CENTER began to promote the ASCA

Survivor to Thriver, Page 5

Welcome to our Survivor to Thriver manual! The Norma J. Morris Center

This manual is designed to complement your ASCA meeting participation.

Survivor to Thriver, Page 7

ASCA is a support program with an individual and group component. It is

As you probably know if you are attending ASCA meetings, ASCA is a

Survivor to Thriver, Page 8

Second, ASCA meetings, which follow carefully scripted meeting formats,

The purpose of ASCA meetings is to allow survivors to share their abuse

ASCA and 12-Step Programs

As mentioned above, ASCA is a recovery program based on psychological

Survivor to Thriver, Page 9

How Does ASCA StepWork Work?

StepWork is a process whereby you concentrate on one particular step at a

Survivor to Thriver, Page 10

False Memories, Real Memories

Child abuse, recovered and repressed memories and "false memory

Survivor to Thriver, Page 11

The Role of Professional Therapy

As mentioned earlier, ASCA is not anti-therapy or anti-professionals. In

Survivor to Thriver, Page 12

If you are unable or unwilling to enter therapy, though, do not despair!

As in any profession, there are therapists who demonstrate greater and

Once you have entered into a therapeutic relationship with a professional, if

Survivor to Thriver, Page 13

What About Confronting My Abusers?

Confrontation of any sort, and especially legal action, can be very

Survivor to Thriver, Page 14

Survivor to Thriver, Page 15

We have included this chapter at the beginning of this manual because

Assessing and Facing Risks

Survivor to Thriver, Page 17

Besides helping you to avoid setbacks, the idea of SAFETY FIRST! is to

Survivor to Thriver, Page 18

If you have a therapist, she or he may suggest certain techniques to help

Assessing Your Current Safety Level

Check "Yes" or "No" to answer each question:

1. Do you have impulses to harm yourself? Y:___ N:___

1. Do you have impulses to harm yourself? Y:_ N:_

2. Do you find yourself in unsafe situations? Y:_ N:_

5. Have you ever attempted suicide? Y:_ N:_

7. Do you use alcohol or drugs to excess? Y:_ N:_

10. Is someone close to you involved in illegal activities? Y:_ N:_

1. Do you feel chronically depressed? Y:_ N:_

2. Do you have recurring thoughts of killing Y:_ N:_

3. Do you have a specific plan to kill yourself? Y:_ N:_

6. Do you have thoughts of actually killing or harming others? Y:_ N:_

1. Does your partner or spouse ever hit you? Y:_ N:_

8. Do you feel dominated or controlled by your partner? Y:_ N:_

2. Finances Y:_ N:_ _____

3. Parenting Y:_ N:_ _____

4. Job Y:_ N:_ _____

5. Housing Y:_ N:_ _____

6. Psychological or Emotional State Y:_ N:_ _____

8. Addictions Y:_ N:_ _____

9. Health Problems Y:_ N:_ _____

10. Legal Problems Y:_ N:_ _____