Craig Hutchison

Vicarious traumatisation in practitioners who work with adult survivors of sexual violence and child sexual abuse: Literature review and directions for future research

Primary objective: The authors sought to summarise and evaluate evidence regarding vicarious traumatisation (VT) in practitioners working with adult survivors of sexual violence and/or child sexual abuse (CSA). Methods and selection criteria: Relevant publications were identified from systematic literature searches of PubMed and PsycINFO. Studies were selected for inclusion if they examined vicarious traumatisation resulting from sexual violence and/or CSA work and were published in English between January 1990 and June 2008. Critical analysis and results: Ten studies met the criteria of the present review. In summary, VT levels in the field of sexual violence/CSA are high with negative effects, but do not appear to exceed those reported by professionals working with non-sexual violence or with sexual offenders. Further investigation is needed into predisposing and mediating factors before clear conclusions can be drawn. Conclusions: Previous research has suffered a number of methodological limitations regarding definitions, sampling, comparison groups, support arrangements and measurement. These factors compromise not only the rigour and generalisability of findings but also our ability to define VT as a useful concept. These limitations are discussed and recommendations made for a future research agenda.

Trusting the process? Anxiety-provoking situations as challenges to the symbolization and processing of experience in person-centered groups

The person-centered approach lacks a coherent theory of groups. Drawing on Rogers’ theories of personality and therapy and his writing on group work, as well as on the works of Gendlin, Warner and others, this paper examines the group facilitator’s task in relation to the members’ symbolization and processing of experience. Groups can present anxiety-provoking situations where members may feel temporarily overwhelmed in the face of feedback and confrontation which challenges their self-concept, resulting in confusion, stress, flooding or shutdown. In these situations their normal capacities for processing may falter and members can experience a degree of “fragile process.” The facilitator’s responsibility, it is suggested, is to actively support the development of a cohesive group climate characterized by the core conditions wherein members will engage with one another in a constructive and facilitative manner, to assist (when needed) in affect regulation, and to help provide an optimal reflective environment in which members can symbolize and process their experiencing optimally.

Unlimited intimacy: reflections on the subculture of barebacking, by Tim Dean

In our current era of HIV and AIDS, barebacking (unprotected anal sex) has become a controversial subject provoking vigorous and heated debate. Numerous theories have been utilised to account for the existence of this ‘problematic’ behaviour, and countless means have been sought to reduce its potentially harmful consequences or to eradicate it entirely. In this new book, Tim Dean argues that psychoanalytic thought has an original contribution to make to our understanding a contribution overlooked in contemporary epidemiology. Rejecting the rationalist perspective, which has dominated discussion to date, Dean instead suggests that barebacking is an overdetermined behaviour that cannot be understood without reference to the fantasies that animate it and he makes the use of psychoanalytic thinking – which has a particular interest in fantasy, fetishism and desire – to offer an interesting and original perspective on unprotected anal sex: a perspective which goes beneath the behaviours to explore the role of unconscious wishes. Helpfully, Dean starts by carefully defining his terms, an important consideration which some other authors have neglected to do. He, therefore, distinguishes ‘barebacking’ from other forms of unprotected anal sex, such as negotiated safety in relationships, and makes clear that he is specifically interested in examining the motivations of men who have unprotected anal sex with casual sexual partners, including ‘bug-chasers’: men who have ‘fetishized’ HIV and who consciously seek infection with the virus. Unusually, Dean is honest about his own sexual practices, which include barebacking with casual partners in sex clubs. This gives his observations some credibility, as he is not willing to objectify, demonise, moralise or define the behaviour as simply pathological. Instead, he makes an attempt to engage with the complex psychological motivations of those who have unprotected anal sex with men whose HIV status is either unknown or believed to be HIV positive. A number of arguments (with varying degrees of plausibility) are put forward to explain the possible attraction of barebacking as a behaviour and as a subculture, including the association of risk-taking with hypermasculinity: by engaging in ‘risky’ behaviours, gay men are believed to be undertaking a physical test of courage, physical prowess and machismo that serves to challenge the spectre of effeminacy or gender inversion. Indeed, some men who have sex with men but who are not self-identified as gay may engage in barebacking precisely because HIV is seen to be a ‘gay disease’ which should not be of concern to them. Dean also suggests that HIV infection may provide gay men with forms of initiation and opportunities for kinship through consanguinity, creating new forms of relatedness which he likens to ‘biosociality’.