Reader’s Question

I have been in therapy for nearly two years dealing with childhood sexual abuse (CSA) issues. My problem is I still do not feel safe enough emotionally to take the therapy to the level I need to take it. My therapist and I talk about my problem of feeling safe in nearly every session now. Is the therapist supposed to help me feel safe? If so, how are they supposed to do that? Am I supposed to be able to learn how to trust on my own? I know why I don’t feel safe, but I have no idea how to overcome this. I am feeling frustrated and my patience is running out. I’m wondering if I should stop therapy. Is it possible for me to overcome the problem of feeling unsafe?

Our Clinical Psychologist’s Reply

Trust and safety issues are of paramount importance in almost any kind of therapy situation, but most especially in situations dealing with the scars of sexual abuse. While duly trained therapists are expected to make every reasonable effort to establish a safe, trusting rapport and environment, they cannot “make” a person feel safe who has been scarred by boundary violations and a betrayal of trust. That leap of faith falls upon the victim only and there are many factors that influence whether or when a survivor might feel safe enough to take that leap.

For a variety of reasons mostly related to the difficulty CSA survivors have trusting and feeling safe, many times CSA therapy is conducted in a group setting. Abuse survivors tend to feel a more natural bond with fellow survivors. They also tend to trust their emotional responses more when they experience the fact that others have similar feelings and responses. There is even some evidence from research suggesting that group-based treatment should be considered the treatment of choice, especially for those whose trust and safety issues are significant.

You indicate you have some awareness of the reasons you don’t feel safe in your present therapy. You should feel free to discuss these with your therapist and to explore alternative venues for carrying your treatment to the level you think it needs to go for you to heal.