Running Head: CLINICAL TRAINING AND CAREER DEVELOPMENT RESEARCH

PROJECT
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Clinical Training and Career Development Research Project

Jillian Pratzner
SMF/Sherrell
April 12, 2015

CLINICAL TRAINING AND CAREER DEVELOPMENT RESEARCH PROJECT

Introduction
The research for this paper was initially supposed to be about women and trauma,
however as I sifted through the articles sexual trauma continually came up the most often. I
learned that trauma and women most often translates to sexual trauma and women. Adult
sexual assault is highly prevalent, with approximately 50% of college women reporting having
been victimized since the age of 14 (Abbey, Zawacki, Buck, Clinton, & McAuslan, 2001;
Ullman, Karabatsos, & Koss, 1999), compared with conservative estimates of 25% of women
nationwide (Abbey et al., 2001) (as cited in Blayney, Gilmore, Kaysen, Koo, Nguyen, 2013, p.
337). If a victim was also a survivor of childhood sexual assault then the risk factor goes up.
These are very large numbers that reflect the values of a society where sexual abuse is allowed,
and even glorified. The Survivors & Loved Ones Guide to Healing (2014) states to survivors,
our bodies were used as an object to meet the perpetrators needs to feel powerful and possibly
give the perpetrator pleasure (p. 70). This objectification leads the survivor to internalize the
abuse and objectify or split from the self. Rape is an attack on the core of an individual and may
leave the survivor with anxiety disorder, depression, somatic disorders, sexual dysfunction,
obsessive- compulsive disorders, addictions, loss of self-esteem and many of the symptoms of
posttraumatic stress disorder (PTSD) (Lalumiere, Harries, Quinsey & Rice, 2005 as cited in
Drte 2014, p. 5), and I would also add to that eating disorders. There are many different
therapies that claim to help women trauma survivors, but I am curious as to why body centered
therapy is not one of the primary therapies with this population. Sexual assault is an attack of the
body, and as such is stored in the body. Drte (2014) states,
The body responds viscerally in the present moment to a past event that has slipped
consciousness, essentially, a tear in the fabric of time (Baum, 2013, p. 35). This
repeated neurobiological stress in the brain leads to a hypo- or hyper-aroused nervous

CLINICAL TRAINING AND CAREER DEVELOPMENT RESEARCH PROJECT

system, and over time, the bodys nonverbal stories become habituated and thus part of
inseparable identity. In other words, traumatic memory is embodied, continuously
recreating the past trauma in the present (p.5).
Sexual trauma underlies many psychological disorders in women and affects their relationship to
their body, and as such deserves to be thoroughly investigated and acknowledged. For the
purpose of this paper I wanted to discover who was more susceptible to sexual trauma, what
therapies and help there is out there for survivors and if multicultural factors are taken into
consideration.
Literature Review/Community Based Research
Finding multicultural research on sexual trauma proved to be somewhat difficult. I
discovered one study that compared Asian American college women to White American college
women and how they coped with being victims of sexual assault. It was found that Asian
American college women endorsed more maladaptive beliefs about the sexual assault than White
American college women, which in turn was associated with higher PTSD symptom severity
beliefs that women are responsible for preventing rape and victims cause rapeand
maladaptive cognitions about not being able to trust oneself and the world (Blaney et al. 2013,
p. 341). Basically Asian Americans were more likely to endorse posttraumatic cognitions than
White Americans, and that in turn affected how they viewed the abuse and what coping strategies
they choose. The study indicated, racial differences in PTSD rates may be in part a function of
how individuals create meaning out of these events (Blaney et al. 2013, p. 342). The group of
Asian Americans ended up at an increased risk to more severe symptoms of PTSD. This is one
small study, however a step in the right direction to multicultural trauma informed care. Each
culture views sexual trauma in a unique way, and that will in turn affect what therapies will be
most effective for different groups of people.

CLINICAL TRAINING AND CAREER DEVELOPMENT RESEARCH PROJECT

It is a common belief in the mental health field that having a history of abuse puts people
at risk for being abused further. I wanted to find out what the research said on this account and if
having a partner with a history of trauma further puts a couple at risk for reenactment. Partners
have many different ways of affecting each others behavior and cognitions, and relationships in
general tend to serve as mirrors for our projections. Alexander (2014) found that,
Women with trauma history should happen to be in a relationship with an abusive
partner, their own affect dysregulation may be triggered by that of their equally
traumatized partners, with a variety of potential outcomesrevictimization (as suggested
by their self-reported histories of previous abusive relationships in adulthood), their own
aggressive behaviors (as suggested by their partners reports), increased tolerance of
violence (as suggested by their reports of their partners behavior), or at the very least,
decreased ability to escape the relationship (as suggested by their decreased helpseeking). In any case, women from dual-trauma couples are at serious risk for long-term,
ongoing abuse (p. 229).
Men from dual trauma relationships also reported that they engaged in more psychological and
physical aggression against their partners than the men whos partners did not have a history of
trauma. It was also found in the study that, A history of child emotional abuse, child physical
abuse, child sexual abuse, or exposure to parental violence leads to increased risk for engaging in
and experiencing IPV, regardless of ones gender, (Ber- zenski & Yates, 2010; Cast,
Schweingruber, & Berns, 2006; DiLillo, Giuffre, Tremblay, & Peterson, 2001; DiLillo et al.,
2009; Whitfield, Anda, Dube, & Felitti, 2003 as cited in Alexander 2014, p. 224). As well cited
as that statement is it was contradicted when I conducted an interview with Jackie Ashley, a
therapist who works with women survivors of sexual assault (I will discus the conversation more
in the discussion section). I was also surprised at what little information existed regarding
partnerships and trauma. Trauma is healed through relationship, and it was created in
relationship. I could imagine couples therapy for survivors of trauma as being incredibly useful,

CLINICAL TRAINING AND CAREER DEVELOPMENT RESEARCH PROJECT

however again the research in this area is sparse and the only reference I found to trauma and
relationships was the above cited research article on Dual-trauma couples.
When researching the role of body-based therapy in trauma informed care, I came across
an article by a former Naropa student that cited an incident right after World War II in which the
Red Army raped thousands of German women as they were conquering Germany. What was
most surprising to me was that I went to look up the horrific event in a search engine I found
almost nothing mentioned about it. It is a common war tactic to rape and torture the conquered
women, however is our culture so desensitized or blind to it that we forget to mention it in our
history books and news reports? An estimated number of 180,000 women and girls died during
the mass rape or as a result of the rapes along Germanys Eastern front (von Mu nch, 2009), and
about 200,000 of the raped women committed suicide (Eichhorn & Kuwert, 2011;
Messerschmidt, 2006 as cited in Drte 2014, p. 3). The most common coping method of the
survivors in this instance, and most other sexual traumas too, was to not speak of it. However
this further prolonged the trauma as it was left for the body to deal with on its own. Drte (2014)
states, The body is moved by a sensation but cannot assign meaning to the felt sense due to the
missing words. The silence cuts off the meaning making process and leaves the body with a
confusing truth or a visceral knowing, and the mind with unanswered questions (p. 3). The
silence also further perpetrated the victims shame. The shame moved silently from generation
to generation as a felt sense and thus became part of the new German identity of future
generations (Drte 2014, p. 4). The study of epigenetics have suggested that trauma can lead to
alterations of genetic expression, and can be passed on to following generations through cellular
memory. Drte (2014) also suggests that, the primary attachment figure responds to triggers
from the past in the present parentchild relationship, allowing the dissociated experience to

CLINICAL TRAINING AND CAREER DEVELOPMENT RESEARCH PROJECT

become a shared bodily experience in forms of inexplicable, dysregulated affect (p. 5). In any
case it is clear that trauma can be easily transmitted from parent to child without the child
experiencing the trauma itself. The article states the most common defense to sexual assault is
immobility, When a fight or flight response is not possible due to the overpowering proximity
of the perpetrator, the body becomes paralyzed (Drte 2014, p. 7). However this creates a
movement sequence in the body that is left unresolved. Drte (2014) states, Beneath the
disorganization lies the bodys need to complete the movement sequence that was not possible
during the experienced rape, which are either escaping or physically defending oneself (p. 7).
Body based therapy and especially dance therapy can help victims finish the movement sequence
and find completion and integration through the use of their body. The implications of rape on a
body are many and vast. The body must become more involved in trauma informed care in order
for healing to occur.
For community-based research I interviewed Jackie Ashley (March 31, 2014), who works
with women who are survivors of sexual assault and horses in a somatic based way. I also used
the Survivors & Loved Ones Guide to Healing (2014), published by WINGS as my community
based source of information. Ashley explained that the healing she sees happens when women
learn to trust again through the relationship they have with the horses. She says that the women
she works with often isolate themselves, have a hard time trusting their own innate intuition, and
although highly functioning, have a hard time being in their bodies. Ashley stated that
disconnecting from the body and dissociation are ways the mind copes to allow the women to
survive, and that dissociative disorders are very common in this population. She further
supported the concept of completion of a movement sequence as an important part of working
with trauma survivors on a somatic level, and she provided me with examples she has seen in her

CLINICAL TRAINING AND CAREER DEVELOPMENT RESEARCH PROJECT

practice. One story she told me was particularly impactful: There was a woman she worked with
whom one day was about to be trampled by a horse, however one of the horse trainers pulled her
away just in the nick of time. This helped the woman to know that she was worth saving, and she
claimed that was the day her life turned around. (J. Ashley, personal communication, March 31,
2014). This mirrors another survivors story I have heard; she said that one day she realized she
was worth being saved. It is really interesting to me that both women used the same wording.
It points to the feeling of worthlessness a victim of sexual assault must feel, and how liberating it
is when they find out that they are once again worthy of love.
Discussion and Integration
Trauma work is like peeling an onion, there is always another layer to be discovered and
healed. Sexual trauma is impactful on a generational, somatic, interpersonal, intrapersonal and
institutional level. With it impacting so many areas in the survivors life, it is important for the
therapist to be able to have a variety of interventions and referrals at hand. I myself am a
survivor of trauma, including sexual abuse, and so this subject is very near to my heart. I can
absolutely attest to the fact that healing from abuse takes many years and there is almost always
something new to discover with each passing year. As a survivor who is about to be in practicum
at an agency that works with clients that are victims of childhood sexual trauma, it was important
for me to learn what skills I needed to take with me into my practice. Ashley explained that it
would be very important for me to know my own trauma, to note my body and my reactions with
sensitivity, and to let things the clients say roll off me (J. Ashley, personal communication,
March 31, 2014). I automatically feel body-based empathy when I listen to other survivors
stories, however I think that will make it even more important for me to learn techniques that
will protect me from vicarious trauma.

CLINICAL TRAINING AND CAREER DEVELOPMENT RESEARCH PROJECT

I do think that having a history of trauma in the family and dating partners with their own
trauma history impacts how victims will reenact the trauma in their lives. Ashley believes that
access to mental health care is much more prevalent than it once was and that sexual abuse is
more widely spoken about now, making it much less likely to be passed down generationally (J.
Ashley, personal communication, March 31, 2014). I can agree with that statement in some
ways, but I still very much believe that abuse is a learned pattern and that families and partners
with their own history of abuse will greatly impact the relationship you will have together.
I am also very interested in the correlation of eating disorders and sexual trauma, and it is
an area I plan on researching more. Eating disorders were mentioned in almost all of the research
I found. The Survivors & Loved Ones Guide to Healing (2014) states, many of us may have
eating disorders as a result of the body image distortions we learned, which cause us to disappear
into the nothingness of anorexia or hide behind the safety of excessive weight (p. 70). Eating
disorders provide the victim with a sense of control over their body, control and mastery that was
cruelly stolen from them by the abuse.
The use of the body and trauma came up time and time again in all of the research I
found, as the body is what is being abused and where the abuse is stored. I was curious as to why
interventions and therapies were not more body-centered as a result. There are people who work
with it, and research to support it, but not at the level which I believe is needed. In the Survivors
& Loved Ones Guide to Healing there are sections on bodywork, DMT and somatization; yet
they are small sections and trumped by the amount of cognitive based information. I am left with
the feeling that although it is understood that the body is intrinsically tied to sexual abuse and
trauma, there is a hesitation to bring it to the forefront of this work. It can make survivors
extremely uncomfortable as they have generally been used to disassociating from the body as a

CLINICAL TRAINING AND CAREER DEVELOPMENT RESEARCH PROJECT

way to cope. There is a true need for body-based therapists in this population to begin to heal the
mind/body connection.
I can also see a need to work more with sexual identity and sexual abuse. It is an area on
which I found very little information yet which must be so incredibly important to heal. The
Survivors & Loved Ones Guide to Healing (2014) says, When our first sexual experiences
include abuse, our sexual imprinting is likely to include some unhealthy messages about our
sexuality and our gender expression(p. 279). And Drte (2014) states, The body becomes a
reminder of the experience. As a consequence, the womens relationship to their bodies and thus
gender identity as well as the ability to be in gendered relationships is negatively affected (p. 4).
More information is needed about how sexual identity is impacted by sexual assault and what
types of therapies help most with the recovery work.
Conclusion
The use of body-based therapies in working with sexual assault survivors has huge
potential to become a highly regarded and widely used standard. The body has a deep innate
wisdom of knowing when to unravel memories that are held in its tissues (Drte 2014, p. 8). It
is also through completing movement sequences that trauma can be moved out of the body.
There is also room for trauma informed care to take into account multicultural factors. We know
that different races deal with trauma in different ways, and therefore warrant different types of
treatment. I would love to see future research about how body-based therapies land on survivors
of different ethnic and cultural backgrounds. I also noted that the word he became synonymous
with perpetrator in the research. This does not take into account that many perpetrators are also
female, and that many of the victims are also male. It is unconsciously promoting heterosexism
and I think that researches could use more sensitivity training around sexual and gender

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expression. As trauma is passes down generationally, and is often magnified in personal

relationships, I can see that there is a need for therapies to get more relationally based. I could
see family therapy and couples therapy as becoming more relevant in the field. I realize that the
clients relationship with the therapist, or perhaps an animal, is extremely important. However in
order for the client to integrate what they are learning into their life they need to be able to
practice it with the people in their lives and have plenty of support in starting the conversation.
The field of trauma informed care has a lot of room to grow and body-based therapy has a very
legitimate right to shaping the future of the field.

Alexander, P. C. (2014). Dual-Trauma Couples and Intimate Partner Violence. Psychological

Trauma: Theory, Research, Practice, and Policy, 6 (3), 224-231.
Blayney, J. A., Gilmore, A. K., Kaysen, D. L., Koo, K. H., Nguyen, H. V. (2013). Posttraumatic
Cognitions, Somatization, and PTSD Severity Among Asian American and White
College Women With Sexual Trauma Histories. Psychological Trauma: Research,
Practice and Policy, 6 (4), 337-344.
Drte, S. (2014). Bridging past and present: Embodied Intergenerational Trauma and the
Implications for Dance/Movement Therapy. Body Movement and Dance in
Psychotherapy: An International Journal for Theory, Research and Practice, 1-12.

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Survivors & Loved Ones Guide to Healing (3rd Edition). (2014). Denver, Colorado: WINGS
Foundation, Inc.

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