BOOK REVIEW: Exploring Resilience in Victims of Childhood Abuse

ISTSS

This thought-provoking and empathic book explores the characteristics and processes of resilience in female survivors of childhood sexual abuse. The book specifies ways to encourage resilience in clients with these types of childhood experiences, which clinicians will find especially helpful. Clinicians working with survivors of childhood sexual abuse will welcome this book as an additional resource.

The book emanates from a qualitative research study of 10 women with a range of traumatic childhood experiences, all including childhood sexual abuse, conducted by Frances Grossman and her colleagues in Boston. The study was followed up by interviews with the participants five to eight years after the initial interviews. The authors provide a frame of understanding about resilience for the participants' stories. And these stories contribute to making With the Phoenix Rising a very engaging and readable book -- a book that reminds clinicians to focus on the strengths and resilience within each person when they conduct trauma-focused psychotherapy.

The authors use a number of lenses in their look at resilience. They convey the importance of examining the context (e.g., racial, economic) in which childhood sexual abuse was experienced. For example, resilience in a participant from an economically disadvantaged background might look different from resilience in a participant from a more privileged background. Participants reflected diversity in terms of race, economics, and sexual orientation -- and the ways in which this diversity intersects with experiences of resilience are noted throughout the book.

A life-span developmental perspective is another lens through which the authors view resilience, as they note some of the ways various coping styles may be more or less resilient at different stages of one's life. The lens of resilience in multiple domains (work, school, relationships) is employed. In keeping with their integrative approach to this topic, the authors explore resilience characteristics (e.g., intelligence, early independence) as well as processes (e.g., coping style, meaning making). They use a transactional framework (looking at how participants' individual strengths and vulnerabilities intersect with particular sources of external support or external demands) in examining resilience in the women whose stories form the backbone of this book.

Section one includes a review of relevant literature, a description of the study and sketches of participants as their stories are integrated with the research literature and clinical experience each step of the way. Through these descriptions, readers are drawn into the women's lives early on. In the second section, resiliency within a variety of contexts (school, work, relationships) is explored. The authors note that resilience varies for the participants in the different context within which they operate. Also, factors that affect resilience in one area may not translate well into resilience in another area. The third section of the book is the one that most fully addresses specific processes for fostering resilience in female survivors of childhood sexual abuse. The authors view psychotherapy, affect management, self-care and meaning making all as domains in which resilience can be strengthened. The last section of the book focuses on the condition of the women at the time of the follow-up interviews.

The emphasis in this book is on discovering, fostering, reflecting and celebrating resilience within each individual who has faced childhood sexual abuse. Thus resilience is viewed as compatible with major difficulties in certain areas of life functioning (e.g., intimacy, work, hospitalizations). This is an interesting perspective to take -- one that expands the concept of resilience as well as taking a potential risk of trivializing the concept. This stance suggests that most if not all survivors can be viewed as resilient in some way at different points of their life trajectory.

With the Phoenix Rising provides an in-depth view of resilience in the lives of these female survivors of childhood sexual abuse. It builds on both the research literature on resilience that has developed over the past decade as well as the books on resilience written about and for survivors that have preceded it (Gina Higgins' Resilient Adults: Overcoming a Cruel Past, Lyn Sanford's Strong at the Broken Places). This is the first book that specifically addresses how clinicians can help survivors of childhood sexual abuse become increasingly resilient in their lives. It deserves a place in the library of each clinician working with adults who have been sexually abused in childhood.

Deborah L. Block, PhD, is clinical instructor at Harvard Medical School and Cambridge Hospital in Cambridge, Mass., and she has a private practice in Needham, Mass.