Sexual Trauma and Psychopathology: Clinical Intervention with Adult Survivors

Today most clinicians are well educated about the diagnostic and treatment issues specific to childhood sexual abuse and victimization. However, all too often emphasis is placed on traumatic stress reactions in isolation from other psychological manifestations. Clinical experience teaches us that patients commonly show signs and symptoms of other psychiatric disorders and atypical presentations along with the traumatic reactions, yet very little is written about it. This breakthrough clinical guide for the treatment of survivors of sexual abuse is the first to emphasize severe psychopathology and its relationship to trauma reactions.
Sexual Trauma and Psychopathology is a comprehensive investigation of concomitant psychopathology and sexual victimization, focusing on survivors who manifest serious psychiatric disturbances and sometimes require hospitalization. Drawing on case studies as well as theory, Shapiro and Dominiak, with contributions from Elizabeth Hess, Barbara Orrok, and Kathleen Bollerud, offer professionals a deeper understanding of the effects of victimization in the context of other psychopathologies which serve to maintain persistent symptoms. Diagnostically, the book includes a review of defense mechanisms, the spectrum of dissociative disorders, suicidality, and evaluation and treatment of substance abuse in the context of trauma reactions. The broad range of topics covered - which also include psychopharmacology, inpatient treatment, attachment dynamics, and use of hypnotic techniques - creates for therapists a foundation for addressing the complexity of clinical presentations often seen in the course of psychotherapy.
Not all sexually abused individuals are alike, regardless of the commonalities of traumatization. The challenge for therapists and psychopharmacologists is to find ways to better understand and treat the differences. Reading and using this book will provide professionals with an increased ability to respond more to the clinical needs of the patient as a whole rather than to the stress reaction as a syndrome.