What's Age Got to Do With It?
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Gender Violence: Voices of Older Women
Working with Older Women who are Survivors of Multiple Trauma
Elder Abuse: South Asian Women Speak Up
Does Caregiving Lead to Abuse?
Legal Issues: The Case Against Adult Protection Legislation
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Resources

Working with Older Women 
who are Survivors of Multiple Trauma: 
Treatment Issues

by Catherine Chan
The Women’s Health Centre, St. Joseph’s Health Centre

In this article, I will highlight issues that I have found helpful in my psychotherapy with older women who are survivors of multiple trauma. These issues can be summed up as empowering women through their connections with the therapist, the community, and most of all, themselves. These issues are related to my eclectic approach, and especially to the relational-cultural model developed by Dr. Jean Baker Miller and her associates at the Stone Centre. I will also use brief case examples to illustrate how I have applied the treatment issues in my clinical practice.

Connections with the Therapist
Transference: Traditional psychotherapy, based on Freud’s work, suggests that, to make her work effective, the therapist should be neutral and objective in relation to the client. While this approach works well with some clients, I have found that more of my clients respond well to an empathic approach. This has helped them to develop the self-confidence and trust they need to explore their issues in session, and to work through them with the therapist’s support.

Counter-transference reactions: Traditional psychotherapy also suggests that the therapist should be conscientious about her own reactions to the client and the client’s issues, and to avoid allowing counter-transference reactions to influence the therapeutic process. While the above principle is valid to a certain extent, I have also used counter-transference in an effective manner. For instance, when I share my gut response to a client’s disclosure, I can help her experience a sense of mutuality; that is, I can identify with her experience and feelings.

Two major barriers to healing for abuse survivors are loneliness and isolation.

Connections with the Community
Two major barriers to healing for abuse survivors are loneliness and isolation. I often recommend that clients join a group program here at St. Joseph’s Women’s Health Centre. This can range from a relaxation group that teaches skills for taking breaks from stress, to a partner-abuse group that provides psycho-educational and mutual-support experience for women who want to address their partner-abuse issues. There are also many complementary programs in the community, such as yoga classes, day programs, and shelters.

These types of involvement enable my clients to cultivate a fertile ground for dealing with their abuse by addressing the following issues:

• Zest: New connections change their emotional state and increase their feelings of vitality, aliveness, and energy.
  
  

• Action: This empowers them to act within the immediate relationship and beyond it.
  
  

• Knowledge: This helps them to gain a fuller and more accurate picture of self as well as of their abuser.
  
  

• Worth: They begin to question their batterers’ attempts to make them feel bad about themselves, and to start believing in their self-worth again.
  
  

• Empowerment: This enhances their motivation for seeking further connections.

Connections with Self
I have also found it critical for the women to get in touch with themselves, their feelings, and personal resources. There are three major tasks that I facilitate them to address:

• Recognition: Moving from denial and chaos into recognizing the reality of the abuse and coping with it.
  
  

• Renegotiation: Working with the people that are important to them, and with themselves—a different way of dealing with reality.
  
  

• Regeneration: Figuring out how they have grown from their abusive experiences and their assertive actions. If and when they are ready, I encourage them to see how the experience has deepened their capacity to connect, and to help other people to do the same.

Client A:
It took some time to help her work through her agoraphobia, which hindered her from attending sessions at the Centre. She indicated that she was happy that I took her seriously when she told me about her trauma and her dream of becoming an actress in spite of her concerns that she is older, overweight, and a woman of colour.

Client B:
When she came to the Partner Abuse Support Group for the first time, she said that she was not sure if she would fit in with the younger women in the group, and if she should take up space that should be given to women who need the service more than she does. Now in the second month of her involvement, she recently shared her initial ambivalence about coming to the group with a new participant.

Client C:
She indicated that counseling at the Women’s Health Centre has helped her to work through her guilt related to the abuse, to acknowledge her need to take care of herself, and to do this with support from her adult children.

In summary, I believe that it is crucial for us as service providers to help older women who are survivors of multiple traumas to escape the trap of abuse, create supportive networks around them, and develop close connections for the different parts within themselves.

Women can be empowered through their connections with therapist, community, and self.

The Service at the Women’s Health Centre, St. Joseph’s Health Centre
The Women’s Health Centre serves women who are survivors of trauma through individual counseling support and psychotherapy, and group programs such as relaxation groups, groups for childhood sexual abuse survivors, and groups for survivors of partner abuse. We are committed to principles such as being client-centred, sensitive to diversity issues, and empowering women to deal with the socio-political and environmental forces that affect their lives.

 
Please contact EWA for a complete hard copy:
publications@womanabuseprevention.com
Telephone: 416.968.3422 x21