Book review
| Title:
Surviving Sexual Violence: A Guide to Recovery and Empowerment Editor: Thema Bryant-Davis Publisher: Rowman & Littlefield Publishers, Plymouth PL6 7PY, United Kingdom. ISBN: 978-1-4422-0641-0 Year: 2014 Pages: 372 Price: $ 46.97 |
Mental health professionals, irrespective of their years of experience or practice, would have rarely treated a victim of sexual violence. Traditional clinical textbooks underestimate the emotional trauma faced by the victims of sexual violence by subsuming it under the rubrics of posttraumatic stress, depression and anxiety. However, such conventional labels usually fail to fully represent the complete extent of their suffering. Though there is plenty of clinical literature which emphasizes symptom-based intervention strategies, none of them mentions the global incidence of such cases, different contexts of sexual violence, or evidence based intervention strategies specifically meant for this population. Many people, living in different spheres of life, in any society of any geographical region, would be able to remember at least one incident that could be considered as sexual violence. Sexual violence has physical, psychological, social, and cultural aspects; and all these dimensions has to be considered while planning management strategies for its victims.
Editor of this book, Thema Bryant-Davis, is the director of the Culture and Trauma Research Lab, and Associate Professor of Psychology in Pepperdine University. She works for trauma survivors and educates officials on interpersonal trauma. She has also authored the book “Thriving in the wake of trauma: A multicultural guide”. She is also an Associate Editor of the peer reviewed journal Psychological Trauma.
The book being reviewed here will come handy to all mental health professionals as well as to the caregivers of victims (the book addresses them as “survivors”) of sexual violence who want to expand and update their knowledge to provide better care for the survivors. It aims to help the survivors with lessons in positive self-esteem, purpose of life, relationships, and self-efficacy to move through the path of empowerment and life fulfillment. There is a definite scarcity of literature on recovery strategies for survivors of sexual violence, and the editor claims that this is the first book of its kind which gives an in depth coverage of the multifaceted process of sexual violence recovery. The editor — herself a survivor of sexual violence, an experienced trauma researcher and a licensed clinical psychologist — has succeeded in providing details of studies on various pathways of recovery and empowerment.
The book is divided into two parts: Part one is titled “Overview of specific sexual violations”, and has seven chapters. In this part, the authors discuss relevant definitions, prevalence, dynamics, theoretical models, outcome, etc. They also deliberate about different contexts of sexual violence like human trafficking, sexual assault by strangers and non-intimate associates, marital rape, war and sexual violence in the military, multiple perpetrator sexual assault, and child sexual abuse; with special emphasis on incidence rates in different countries. Major highlights of this section are the authors’ concern for multicultural perspectives in providing data related to global sexual violence, and the diversity of topics they selected for discussion. Even though this section has been enriched with detailed facts and figures of concerned topics, some average readers may find it boring and hard to move on due to a lack of flow in the writing. On the other hand, it is an exceptional source of information for those searching for global data of sexual violence and its theoretical underpinnings.
The second part is titled “Paths of recovery”, and has fourteen chapters which elucidate diverse intervention strategies. Chapters of this section illustrate psychosocial and spiritual strategies to reconstruct oneself back to life. Elaborate details of all traditional ways of psychotherapy like cognitive behavioral therapy, psychodynamic psychotherapy, family systems therapy, psychoeducation, group interventions, and eye movement desensitization reprocessing; and non-traditional approaches like feminist counseling, mind-body practice, integrated narrative therapy, positive psychology, self-defense training, social support, spirituality/religion, and empowerment journaling are presented in different sections. Each such section consists of descriptions of general background and levels of the therapy, and a case example in which the therapy is applied.
Coming to the highlights of some chapters, in the chapter on cognitive behavioral interventions, the author explains a highly developed cognitive restructuring therapy named Cognitive Processing Therapy (CPT). Relieving depression is particularly important in the context of sexual violence, because it can seriously interfere with engagement and recovery. CPT is an intensive 12-session therapy, and it goes beyond traditional CBT by identifying five belief themes that are often badly altered after sexual violence: safety, trust, power/control, esteem, and intimacy. The first seven sessions teach the survivors the causal link between thoughts and feelings, and help them to progressively improve the skills of questioning and challenging their negative beliefs. Work on the five themes begins with a homework assignment to write at least one page on how the sexual violence affected the beliefs on each theme. The client brings the writing to the session and reads it aloud, and the therapist and the client analyze it for distorted, negative, or judgmental thoughts. The client is then asked to rehearse the process of checking, challenging, and changing thoughts; as well as to practice the new, adaptive thoughts. The same chapter describes different exposure-based strategies too.
Chapter on mind - body practices for recovery describes various breathing, meditation, movement, and yoga postures. One breathing technique this chapter highlights is Victory Breath or Ocean Breath — a sort of resistance breathing popularized after publication of the famous study by Dr. Sharon Sageman on spirituality oriented group therapy for seven women with chronic mental illness and histories of sexual abuse.1 In this technique, resistance is created in the airflow by a slight tightening of muscles at the back of the throat, producing a soft sound like the sound of the sea or the inside of a seashell. Sageman arranged a yoga teacher to teach the women this breathing technique for 30 minutes each at three group meetings. They were trained to breathe at about five breaths per minute. Theoretically, combining slow breathing with airway resistance further stimulates the vagus nerves and relaxes the soothing part of the autonomic nervous system. The end result is a state of calm alertness. Sageman observed significant improvements in mood and interactiveness of participants after they practiced this form of breathing. Other breathing techniques like breath awareness, belly breathing and coherent breathing too are explained in the chapter.
The book has dedicated a full chapter to discuss the benefit of self-defense training for sexual assault survivors, based on the findings of a recent literature review that two out of three sexually victimized women will experience sexual revictimization.2 Hence self-defense training is an option that sexual assault survivors may seek out in the hopes of reducing their risk of revictimization by providing them with opportunities to learn, observe, and practice the necessary physical, social, and cognitive skills through the use of role-plays, discussion and simulation exercises.
The editor has to be praised for the lucid presentation of each chapter and the selection of appropriate experts to deal with different aspects of sexual violence and recovery. Each author did justice to the respective chapters with up to date research findings and theoretical perspectives. On the whole, this book will be an asset to those engaged in research or care of survivors of sexual violence.
Acknowledgement: Thanks to Dr. Johnson Alex, HOD Clinical Psychology, for emotional support and encouragement.