Heather B. MacIntosh

“I Was Like Damaged, Used Goods”: Thematic Analysis of Disclosures of Childhood Sexual Abuse to Romantic Partners

ABSTRACT A thematic analysis of the reported experiences of childhood sexual abuse (CSA) survivors in disclosing their CSA history to romantic partners was completed with the goal of learning about the experience of their disclosure and to consider role partners may play in the disclosure experiences of CSA survivors. Transcripts of 19 survivors were analyzed using a standard thematic analysis methodology. Two global themes emerged, reasons for disclosing and impact of response, and these were highly interrelated by shame. A preliminary theory of disclosing to romantic partners was posited.

Dissociative Identity Disorder and the Process of Couple Therapy

Couple therapy in the context of dissociative identity disorder (DID) has been neglected as an area of exploration and development in the couple therapy and trauma literature. What little discussion exists focuses primarily on couple therapy as an adjunct to individual therapy rather than as a primary treatment for couple distress and trauma. Couple therapy researchers have begun to develop adaptations to provide effective support to couples dealing with the impact of childhood trauma in their relationships, but little attention has been paid to the specific and complex needs of DID patients in couple therapy (H. B. MacIntosh & S. Johnson, 2008). This review and case presentation explores the case of “Lisa,” a woman diagnosed with DID, and “Don,” her partner, and illustrates the themes of learning to communicate, handling conflicting needs, responding to child alters, and addressing sexuality and education through their therapy process. It is the hope of the author that this discussion will renew interest in the field of couple therapy in the context of DID, with the eventual goal of developing an empirically testable model of treatment for couples.

Measuring Outcomes in Couple Therapy: A Systematic Review and Critical Discussion

This systematic review examined the measurement of outcomes in couple therapy research over the previous ten years. Eighty-one couple therapy outcome studies were systematically examined. Relative to previous two reviews that included both couple and family interventions, this review focused solely on couple therapy outcome studies and identified that a greater diversity in outcome measurements have begun to emerge in the field. Additionally, couple therapy outcome studies are beginning to explore the impact of couple interventions in the context of problems traditionally associated with individual pathology and individual treatment. Our review reinforced findings and recommendations from previous reviews, including the need for rigorous research design and explication of couple therapy models of intervention. Additionally, we recommend that qualitative analyses of unexpected findings or outcomes that may be interpreted as negative outcomes may assist couple therapy researchers in better understanding these findings.

Emotionally Focused Therapy in the Context of Addictions: A Case Study

Substance addictions represent a serious social problem in North America, negatively impacting family relationships and couple functioning. Research is increasingly considering the potential for couple therapy as a model within this context. Issues presented by an addiction can be exacerbated by other issues present in a couple relationship. Using a case study design, this research study explored a proposed theoretical extension of emotionally focused couple therapy (EFT) in the context of substance addictions. Four couples were recruited, and an analysis of the therapeutic process and their experiences is presented. Comparisons between the normative EFT treatment model and the theoretical extension are made and recommendations are provided for further adaptations to the model. Results from this study indicate the important place of couple therapy in addiction treatment.

Implementation and Evaluation of the Skills Training in Affective and Interpersonal Regulation (STAIR) in a Community Setting in the Context of Childhood Sexual Abuse

Purpose: The objective of this article is to describe the implementation of the Skills Training in Affective and Interpersonal Regulation (STAIR), a manualized, evidence-based cognitive behavioral group treatment for childhood trauma at Cedar Centre, a community-based trauma treatment center, and describe the preliminary evaluation of the effectiveness of the treatment. Method: Pre- and postmeasurements of emotion regulation, interpersonal problems, and traumatic stress symptoms using psychometrically validated instruments were collected. Outcomes were assessed for 85 individuals who experienced childhood sexual abuse and participated in the first cycles of intervention at the center. Results: Results indicated significant reductions in difficulties in emotion regulation, interpersonal problems, and trauma symptoms among participants from pretreatment to posttreatment. Discussion: Overall, there was a positive response to the adoption and integration of the STAIR intervention into the program. Qualitative assessment identified the benefits perceived by both facilitators and group participants.

A Bridge Across Silent Trauma: Enactment, Art, and Emergence in the Treatment of a Traumatized Adolescence

This paper recounts the 4-year treatment of Hannah, a virtually silent, traumatized adolescent. Over the course of 4 years Hannah was in and out of the hospital with severe self-injury and suicide attempts. While Hannah communicated her distress through bloodied scabs and overdoses, her words were few. Eventually, Hannah and her therapist were able to find their way to communicate about her pain and terror through shared art making, which became a bridge across the silence. Hannah’s art and her therapist’s struggle to find ways to be with her, communicate with her, and help her heal through moments of meeting and shared art making are explored.

As time went on, i just forgot about it: thematic analysis of spontaneous disclosures of recovered memories of childhood sexual abuse

Abstract This study was a thematic analysis of transcripts of interviews of child sexual abuse survivors discussing their experiences of recovered memories. This study included 27 English-speaking participants from 3 major Canadian cities: Montreal, Toronto, and Ottawa. Seven participants identified as male and 20 as female. Participants ranged in age from 31 to 69 with a mean age of 47. The educational background of participants ranged from 9th grade to doctoral levels. Out of the sample of 27, 21 participants reported some period of amnesia for their CSA experiences. Three primary global themes emerged in the transcripts of participants describing adult emergent recovered memories: flashbacks, triggers, and denial. Three global themes emerged in the transcripts of participants describing partially discontinuous memories: dreams/nightmares as the “how” of memory recovery, triggers, and active processes of forgetting.

Structure with Engagement: Toward an Integration of Trauma and Relational Psychoanalytic Models in the Treatment of Dissociative Disorders

Trauma model approaches to the treatment of dissociative disorders may provide containment and direction and yet, these same approaches may be constricting and limit exploration. However, relational psychoanalytic approaches may allow for engagement and exploration while potentially failing to provide containment and structure. This article provides an overview of key elements of both models and considers the question of whether it is possible to creatively resolve theoretical and clinical tensions between trauma model and relational psychoanalytic responses to dissociation. A review of the history of the study of dissociation in the field of psychoanalysis and concerns about psychoanalytic practice in the context of dissociation is followed by comparing contrasting conceptualizations of the assumptions of normality, definitions of dissociation, theories of etiology, goals of treatment, and theorized mechanisms of action. The review ends with a discussion of potential possibilities for clinical integration.