Exploring the process of meaning making in healing and growth after childhood sexual assault: A case study approach

Sheryle Vilenica*, Jane Shakespeare-Finch and Patricia Obst

School of Psychology and Counselling,
Queensland University of Technology, Brisbane, Australia
(Received 14 August 2012; final version received 3 September 2012)

Childhood sexual assault (CSA) is one of the most devastating of all
traumatic experiences, with population studies documenting survivors
experiencing higher levels of pathology than survivors of other traumatic
experiences. Yet, recent research has demonstrated that far from being
permanently crippled by their experiences, many adult survivors of CSA
manage to heal and move forward in their lives to experience a rich and
fulfilling existence. In this article, two case studies are presented to provide
a detailed account of how people who have experienced CSA may find a
pathway to healing. Our data demonstrate that meaning making, spiritual
or otherwise, is a pivotal part of acceptance of CSA and ensuing growth.
The case studies amplify the unique journeys of two women along with
underlying similarities in their pathways to healing. Clinical implications
of the research are discussed and specific strategies for encouraging healing
and growth are outlined.

Keywords: child sexual abuse; child sexual assault; post-traumatic growth;
meaning making; healing

Introduction

Sexual assault in childhood is one of the most personally impactful traumas that
an individual can experience (Frans, Rimmo ̈,A ̊ berg, & Fredrikson, 2005; Hapke,
Schumann, Rumpf, John, & Meyer, 2006). After exposure to a traumatic event,
many people experience initial, short-term post-traumatic symptoms that in most

cases abate with time, with only a minority of people going on to develop post-
traumatic stress disorder (PTSD; Bonanno, 2004). For those who experience child

sexual abuse (childhood sexual assault (CSA)) however, the trajectory for post-
traumatic symptoms in general, and PTSD in particular, are significantly different.

Those who experience CSA are not only more likely to develop PTSD at some stage,
compared to survivors of other sorts of trauma, but also more likely to endure
lifelong PTSD symptoms (e.g. Rodrigues, Vande Kemp, & Foy, 1998), a testament
to how powerfully impactful sexual trauma can be.

The negative sequelae following CSA are wide-ranging and highly idiosyncratic.
Oft-reported concerns include major depression (Nelson et al., 2002), sexual
dysfunction (Gold, Lucenko, Elhai, Swingle, & Sellers, 1999), anxiety (Calam,
Horne, Glasgow, & Cox, 1998) and suicidal ideation and attempts (Belik, Stein,

Asmundson, & Sareen, 2009). Perhaps the most devastating of outcomes associated
with CSA is the negative impact on one’s intrapersonal connection and sense of self.
People with a history of CSA report often holding long-standing, negative
core beliefs about themselves, which include perceptions of the self being ‘‘wrong,’’
‘‘damaged’’ or somehow separate relative to others (Isely, Isely, Freiburger, &
McMackin, 2008; Zinzow, Seth, Jackson, Niehaus, & Fitzgerald, 2010). These
negative core beliefs have been reported by both those who have endured repeated
and sustained abuse over many years as well as by those who have experienced one
intrusive contact sexual abuse act (Isely et al., 2008; Molnar, Buka, & Kessler, 2001).
Contributing to the development of negative core beliefs is an inherent dynamic
of CSA, which often involves feelings of complicity and responsibility for the
abuse, as well as deep feelings of shame and guilt on behalf of the child (Coffey,
Leitenberg, Henning, Turner, & Bennett, 1996). All of these factors, compounded
by the occurrence of this particular trauma during the formative years, have the
potential to be profoundly devastating to a child’s developing sense of self.
Current theories of coping after trauma emphasise how traumatic events can be
powerful enough to shake the foundations of belief systems, the fundamental
assumptions people hold that provide a sense of predictability and meaning
in life (Calhoun & Tedeschi, 2006; Janoff-Bulman, 2006). Janoff-Bulman (1989)
conceptualised these fundamental assumptions in three primary areas. These include
beliefs that people are basically good, helpful and kind; world view assumptions such
as ‘‘people get what they deserve’’ (i.e. good things happen to good people, bad
things happen to those who deserve bad things) and, beliefs about the self, based on
the self-perceptions of people as good or worthy individuals (Janoff-Bulman, 1989).
These fundamental assumptions, or core beliefs, are threatened because of the
experience of traumatic events, due to the dissonance between previous experience
and current reality. Healing, then, becomes a process of learning to integrate
new knowledge about the unpredictability of life, malevolence and senselessness
into a transformed understanding and framework of reference regarding oneself
(Calhoun & Tedeschi, 2006; Janoff-Bulman, 2006).

When trauma occurs during childhood and adolescence, the life stages where the
formation of assumptive worlds begin, the impact appears to be less on the shaking
of established foundations and rather on the shaping of emerging foundations.

Based upon these emerging foundations, people create suppositions about them-
selves, others and the world. A child or young person who suffers sexual trauma,

a crime most frequently committed by a known and trusted adult, experiences the
unpredictability and senselessness of life, and the malevolence and disregard of often
important others, during influential and formative stages of life. Many healed and
healing survivors of CSA, both men and women, report that only later in life, at the
point where they acknowledged how deeply the abuse experiences had negatively
affected the way they saw themselves and their world, did the real pain and real
healing begin (Bogar & Hulse-Killacky, 2006; O’Dougherty Wright, Crawford, &
Sebastian, 2007; Woodward & Joseph, 2003).

Finding a new way of seeing one’s self has been reported by men and women as
paramount in healing from CSA. Changing old self-beliefs, accepting and connecting
to the impact of the CSA on their lives and sense of self, changing self-views
(Bogar & Hulse-Killacky, 2006) and developing a kinder intrapersonal relationship
(Woodward & Joseph, 2003) have all been reported as essential components of
wellness and closure in the journey of healing from sexual trauma in childhood.
40 S. Vilenica et al.

Studies that investigate salutary outcomes in those who have experienced CSA
provide a deeper understanding of how healing is achieved after the experience
of such a trauma, rather than the traditional focus on pathological outcomes and
symptom reduction. Further, these studies bring welcome acknowledgement of the
fact that even after suffering such a potentially damaging trauma, the human
capacity for healing, growth and transformation is clearly evident.

The active process of transformation, or reconstruction of inner global views, has
been termed ‘‘meaning making’’ (Joseph & Lindley, 2005; Park & Ali, 2006) and
appears to be an important component of wellness and growth after trauma in
general (see Park, 2010 for review). Meaning making refers to a process of active
cognitive engagement to restore or resolve ruptures or dissonance within one’s global
sense of meaning after the experience of a life shattering event such as trauma
(Park, 2010). In action, meaning making may manifest as a new way of
understanding a particular situation; reforming beliefs one holds of self, the world
and others; or, gaining internal consistency between beliefs and goals (Park & Ali,
2006). The catalyst for meaning making to take place is a facet of reality being
appraised in a way that is incongruent with one’s global meaning (Park, 2010),
a contrast between what is and what was always thought to have been. Meaning
making then is an active process involving deliberate and sustained cognitive
attention, otherwise known as volitional rumination, to restore congruency and
equilibrium within one’s self.

Recently, Cann, Calhoun, and Tedeschi (2010) have shown how the active and
deliberate process of rumination is an important factor in overcoming disruption to
core beliefs after traumatic or highly stressful life events. In addition to confirming
that post-traumatic growth (PTG) can be an outcome of the shattering of
assumptions that accompanies highly stressful life events in adulthood such as
trauma, greater PTG was found in those with higher levels of deliberate rumination.
Further support was found in this study for the role of meaning making in growth
and healing after trauma, particularly if the trauma disrupted deeply held core
beliefs (Cann et al., 2010). Volitional rumination has been previously shown to play
a crucial role in PTG outcomes, the positive changes that people often report
in the wake of struggling to cope with trauma, including positive changes in self, a
strengthening in relationships with others and a change in spirituality or philosophy
in life (Calhoun & Tedeschi, 2006). The importance of volitional rumination to these
PTG outcome domains shows how essential active cognitive engagement and
understanding is to healing and growth after adversity.

Joseph and Linley (2005) have proposed a PTG process model that includes
meaning making as one of the four primary components. The first theoretical
principle is termed the ‘‘completion tendency,’’ which postulates that adjustment
to trauma comes from an innate, human drive to integrate dissonant experiences
into a coherent self-narrative. The second principle is cognitive accommodation,
or changing worldviews to accommodate new information, versus assimilation, or
incorporating new information into existing mental schemas. Both processes are
necessary for wellness, but an emphasis is placed on the need for accommodation
to be present for growth to be possible as this presence signals the emergence
of new worldviews. The third principle concerns the importance of meaning and
asserts that meaning has two components: comprehensibility and significance.
Comprehensibility is being able to make sense of why a particular event or trauma
has happened. However, it is ‘‘meaning as significance’’ – the impact the trauma has
Counselling Psychology Quarterly 41

on one’s world views, philosophies, or the way in which one leads one’s life – that is
of particular importance in growth outcomes. Finally, the fourth principle considers
the difference between eudaimonic versus hedonic well-being. Hedonic well-being, or
subjective well-being, relates to subjective feelings of happiness and life satisfaction.
In contrast, eudaimonic well-being, or psychological well-being (PWB), incorporates
states of greater self-awareness, spiritual connection and closer connections with
others. The model proposes that PTG is more likely to stem from PWB, in that a
person may not necessarily be happier but is sure to be wiser as a result of working
through trauma. The focus on the processes of transformation presented in this
model provides a descriptive account for the currents of change in the growth process
(Joseph & Linley, 2005).

In this article, we provide a process-focused, in-depth analysis of the ways in
which two women experienced the effects and personal impact of serious childhood
sexual abuse, and more importantly, how these women found pathways to healing
from the sexual trauma. We also present the outcomes of their healing journeys on
their sense of self, with particular emphasis on changes to their core beliefs. We hope
the narratives of the healing journeys that these two women undertook will provide
a deeper understanding of how healing occurs after such a devastating trauma,
and will articulate the human ability to change, grow and even flourish through the
process of an active engagement in healing.

Method

Participants
The two women discussed in the case studies we examine in this article are
participants in a larger ongoing research project conducted by the authors,
examining pathways to healing and growth after sexual assault in childhood.
Participation in the study was based on self-selection on three primary conditions.
First, the sexual assault must have involved physical contact. Second, participants
must have deemed their experiences to be traumatic. Last, participants had to
consider themselves to be either healed from the sexual trauma or believed they were
well into their healing journey. The women whose stories are told in this article were
52 (Participant 1) and 44 years of age (Participant 2) at the time of interview.
The following two case studies were chosen for: (a) their representativeness of the
themes reported by the majority of the participants in the broader study; (b) the
clarity with which the women reported their healing journeys and (c) their disparity
in terms of the onset and duration of offences (one experienced on-going abuse from
an early age through to adolescence, while the other experienced two assaults in
adolescence). Both women experienced invasive, contact sexual abuse; both women
were raped. Participant 1 was raped in early childhood by a non-relative and sexually
assaulted for many years by older brothers, as well as suffering further assaults
during adolescence. Participant 2, at age 14, was raped by a man who was known to
her. She experienced a second rape at age 15.

Procedure

Participants in the larger project were recruited via a general public invitation. The
first author was interviewed on a state-wide radio station and women were

encouraged to contact her via email or phone if they fit the research criteria and
wanted to contribute their story to the project. Participation involved a 90-minute
semi-structured phone interview that covered a brief history of the assault, the initial
and later effects of the abuse, what contributed to their healing, as well as any
potential benefits participants felt to have come out of their healing journeys or
their experiences. Prior to the interviews, participants were provided the research
questions, to give them time to reflect on their answers. Each interview was then
transcribed verbatim.

Exploration of the data was conducted using interpretive phenomenological
analysis (IPA), an idiographic approach where each participant’s narrative is
individually analysed before any generalisations are made to other cases
(Langdridge, 2004). The IPA process involves an initial reading over of the
transcripts searching for meaning, garnering reflections and observations from
the text and identifying themes or patterns that emerge. For rigour and validity
of identified themes, the second author also analysed a number of transcripts, a

process that yielded high inter-relater reliability. Identified themes were struc-
tured into various inter-related clusters and from this a master table was

constructed.

Results

Following are the narratives of the women describing how the CSA was experienced;
its impact on their core beliefs of self, others and the world and, the role of
dissociation in managing their distress. Their healing pathways are also discussed,
and the processes of meaning making are explored with a particular focus on
narratives of change processes to their core beliefs.

Global beliefs

Participant 1 describes how seismic the first rape was and the indelible change that
occurred at the core of her being as a result:
I died, meaning the person I was or was developing into was no more. That person
still isn’t here today. That person was shattered the moment of that first abuse. I didn’t
know who or what I was. I became segregated within myself. It was like being, my whole
soul had been splintered into thousands of pieces and I didn’t know how to put it
together again. (Participant 1)

Beliefs about self

Here the women reflect on the self-beliefs they held before the process of their
healing began:
I didn’t have any …real values or beliefs, because it didn’t matter what you
believed in or what values you had, because they could be taken away from
you …There was always in the back of my mind the idea that I wasn’t good
enough, that I was guilty for what had happened to me or what I let happen, so
nothing good should happen to me unless I pay for it. And I felt my life would
always have dramas and I would always be completely overwhelmed by them but
that is what I deserved …I believed I was guilty … because I was raped when
I was 5. (Participant 1)

Counselling Psychology Quarterly 43

And similarly the second participant said:
I couldn’t handle being less than perfect, I just had to be. If I was less than perfect
then I was that hideous slimy creature that I thought I was because I had been raped.
So less than perfect was, I couldn’t stand the thought of being flawed …I was terrified
they would find out I was a real dummy and throw me out of Uni, so I worked really
hard … What I couldn’t articulate at the time was really profound shame. I felt I had
to get away from anyone that knew me…from the person I thought everyone thought
I was, and the person I thought I was too. (Participant 2)
The sexual assault had a profound impact on the way the women came to view
themselves. Beliefs of being unworthy, guilty or hideous stem from deep feelings of
shame and perceived guilt over the assaults, incorrectly internalising the assaults as
something they contributed to and for which they were responsible. Both women
portrayed the powerlessness that comes with CSA in their narratives of control, one
feeling she had no control over herself or her life, the other feeling the need to always
be in control, but both based on a deep belief of being wrong – the epitome of shame.
Beliefs about the world and others
Both women spoke of holding global negative beliefs about others, the world and
their place in the world as a result of the trauma. Here the women describe the
experience of holding such beliefs:
I trusted no one, the moment it happened the first time. I didn’t believe in role models
because of my belief that everyone had something bad happen to them. I believed all the
men were going to abuse me … Sex was nothing to me, and even if I didn’t want it to
happen I still allowed them to, because I had that mental chain around me that had
been put there by the first abuser… being so much stronger and bigger than me.

(Participant 1)
So after those two events I had a really weird idea of what my value was in the world.
I assumed that my value to boys and men was sex, and so I had way, way too many
sexual relationships with people because I thought that is what boys want and they are
going to take it so I might as well give it to them, this is just the way the world works.

(Participant 2)
As was true for the vast majority of women within the larger study, both women
included in this analysis speak of an inability to feel they had the right to say no
to sexual contact in adulthood. Sexual assault violates the most personal of
boundaries – the physical boundary. The violation of a person’s intrinsic right to be
respected, coupled with the intrusion of sexual acts a child is not yet prepared for,
and deep feelings of shame and responsibility for the assault, all converge. With their
internalisation and personalisation, their experience shaped beliefs of having no
rights in relation to others, particularly men.

Avoidance/dissociation from experience

As a way of coping as children, both women used avoidance and dissociation from
their experience. Evidence of this is reflected in the lack of connection to the trauma
the events experienced before they began to acknowledge what had happened to them:
In my 20s it didn’t have an effect on me. Of course it did, but I believed that it was just
something I could tell people ‘‘I was raped when I was a kid,’’ but it was like in the third
person. It was this little girl, but it wasn’t me. (Participant 1)

I hadn’t given much thought to being sexually assaulted, it was just something that
I thought of as in the same way as I had been born …I went to school and I was
sexually assaulted. It was all the same. I remember I was with a boy once and I told him
‘‘Look, someone forced me to do this once and I am not really comfortable with it.’’ and
that was the only time ever that I had said anything about it and that was the closest
I came to talking about it. (Participant 2)
The personal resources of these women were already taxed from the expenditure
of energy and emotional burden that comes with living with negative core beliefs of

self. Without the defence mechanism of dissociation, life could become overwhelm-
ing to the point of unbearable. Staying disconnected from the emotional intensity

of the trauma provided the women a measure of functionality in their daily lives
before they were ready to honestly accept their experiences.

Healing

Turning points
For both women there came a time when avoidance of the depth of their experiences
could no longer be facilitated. Both were confronted with the necessity to accept the
truth of what they had been through. For both, this involved a process of turning
towards their fear; for one, turning inward and facing herself, while the other turned
towards the truth of her experience:
I suppose the biggest influence, I planned a trip around Australia – the first time I was
ever going to be alone in my life. It was pretty terrifying to think of that but I knew
I had to do that. I knew I had to get out of my life as it was and get away from it all to
be able to focus on being able to heal …I loaded my trailer with a box load of self-help
books and headed off … And I never spoke to anyone for nearly six months. I knew
I had to do it to claim back my own sanity. (Participant 1)
I started to get a really intense horrible pain in my vagina … and I started to wonder
‘‘[Does] this have anything to do with that thing?’’ A GP … gave me the referral to a
really nice psychiatrist and … it was like Pandora’s Box. Once this pain had started
it seemed to trigger a series of situations where I couldn’t say it didn’t happen
anymore …It was exactly 10 years (after the first rape) that I acknowledged what had
happened and called it what it was. That was actually when it became really
overwhelming. To call it rape. It was like a pit of horror to take the lid off the box and
actually look inside. It was a really important stage for me to go through but it was
the worst, because it was the rawest. (Participant 2)
The active acknowledgement and emergence of acceptance of the trauma and its
effects began. Being no longer willing or able to continue avoiding themselves
or their experiences, the women in this study connected to themselves and their story
albeit with great emotional difficulty and turmoil. At this stage in their journeys,
the beginnings of their healing, both women describe experiencing intense emotions
of terror and horror at confronting themselves and their fears directly. And yet,
the necessity to turn towards their fear in order for healing to begin was stronger
than the desire for things to remain the same.

Awareness of inner world

During this stage each woman talked about confronting insights or changes that
were occurring in their inner worlds:
Not only had I had the occasions of being raped but it was the 10 years where I lived
thinking those things about myself and cementing those ideas about myself and these
Counselling Psychology Quarterly 45

really weird survival skills, that emotional distance and disconnection, all of the things
you do. (Participant 2)
I learnt that I can be by myself and not be scared of being by myself … Accepting all my
faults and believing that I was a good person and it wasn’t my fault and I wasn’t guilty
of that happening to me … Mostly I did it by myself, reading the books and sitting
with myself, and learning how to meditate and just walking along the beach was one of
the most calming effects on me. (Participant 1)
In the above quote, Participant 2 reflected on how she began to understand the
destructive self-beliefs she held that underpinned her behaviours and reactions.
She also started to recognise how disconnected she truly was from herself and
her experiences. Participant 1 began changing shame-based beliefs by embracing
herself and beginning to accept her inherent goodness.

Counselling

There naturally came a time for both women, many years after their turning points,
when each sought counselling to work on deeper issues stemming from the abuse.
The women spoke of the role of the person of the therapist and how important
positive rapport and trust was within that relationship:

When I decided it was my life and I needed to take stock of it and sort myself out instead
of blaming everyone else and other people and circumstances, that I could change me,
to change my circumstances, then yeah, I started talking and seeing the counsellor.
Finding someone I trusted was a huge thing, because if you don’t trust the person
you are talking to then you won’t bring it out, you just won’t, you will hide stuff.

(Participant 1)
I went to a workshop and the woman who ran the workshop was a counsellor and
I asked her to take me on as a client. I went to see her for about three years, and that
was the process where I felt I did the healing part. She was a humanist counsellor,
but basically she was a gorgeous women and I would go to her house and talk for an
hour. There were no particular strategies or revelations; it was just the slow work of
healing.

(Participant 2)
There was a natural readiness in both women to want to work through the
trauma and its effects that caused them to seek counselling with a trusted
practitioner. Having come as far as they could on their own, the process of
counselling paved the way for the beginnings of their new relationships with
themselves through the re-working of their long-held negative beliefs.

Meaning making: Reconstruction of self

Interestingly, both women reported that it was in the work with their counsellors
where they began to look at their core beliefs, the impact of these on their lives and
then learned how to create new, self-congruent beliefs. The following quotes
highlight the role of meaning making in the cognitive reconstruction of the internal
worlds of these women. Here the women spoke of the ways and means their core
beliefs were re-formed:

Learning how to focus on me and not turn away from myself and what had happened
to me. And learning how to gradually change the way I was thinking, and change my
ideas and values and beliefs, because everything was negative …I started looking at me,

and trying to find the real me, because I had lost that person all those years ago … and
I am still trying!

(Participant 1)
I suppose the healing was going through and looking at my world view and my view
of myself and unpicking it all and putting it back together again was the real nuts and
bolts thing. Looking at all the ripples that being sexually assaulted had caused in my life
and figuring out how to live my life not as a survivor or someone who has been sexually
assaulted. It was the process of becoming a whole person and not a rape survivor.

(Participant 2)
Understanding the way their global views were shaped by their traumatic
experiences was deeply healing for both women. Here the active process of deliberate
rumination comes into play with talk of focusing on, not turning away from, the
truth. Negative beliefs of the self and world begin to change through the process
of first understanding what beliefs were held, knowing how they came to be and then
uncovering why they were untrue. This process opened the way for both women
to begin to see themselves as they truly were: whole.

Self-disclosure

Although the idea of talking about the trauma through re-experiencing the abuse
acts was abhorrent to most women in the larger study, for some like Participant 1,
the need to externalise the abuse, to give voice to the content of their experiences,
was healing:

Pouring out the full details of what had happened to me. I had never voiced it, it had
gone around my head a million times but I had never voiced it, so letting out all
that pent up fearfulness, hatred, betrayal, anger. Everything that was inside of me that
had been locked away from what had happened to me. I explained every detail that
had always been in my mind. I did go through a lot of years thinking the abuse didn’t
happen.

(Participant 1)
The self-disclosure here was a client-led process, with the healing component
being in the externalisation and validation of her experience, in contrast to
‘‘desensitising’’ her to the traumatic memory.

Self-understanding and validation

Participant 2 gives a precise account of how her core beliefs were changed:
It was really about healing and coming up with different ways of being in the world, and
different ways of being. It wasn’t like ‘‘Oh God, this terrible thing has happened to me,’’
it was just a gradual unpicking of all the parts of my life that had been built up around
having been raped and looking at them one by one and seeing if I wanted to keep them.
I got to value the survival skills I put in place but also say goodbye to them as being
unnecessary in a really slow way. And it was hard. I remember sessions where most of
the session was just working through the anger I felt over everything and everyone.
(Participant 2)

Again, the process of repeated, sustained and active rumination is visible. In this
quote, her meaning making – the transformation of her inner world – came through
a deep understanding of how her beliefs had been shaped in the first place,
understanding how they were intended to protect her, and why they were no longer
relevant.

Counselling Psychology Quarterly 47

Transformation of self

Both women reflect here on the transformation of the process of their journey and
the integration and acceptance of the trauma. Both reported fundamental changes
from the beliefs they once held:
Now I just see me. I am not defined by the abuse anymore …The abuse, although
traumatic, was just a part of my life, there is so much more to me. My life is my own,
I want to give, not take, and FEEL being a part of this world. (Participant 1)
It is like a scar that has healed, you can see the scar is still there but there is not a wound
there anymore. It is not a horrible disfiguring scar anymore it is a part of lots of other
things that have happened in my life that have all made me who I am now. It defines me
as much as any part of my life does, not anymore or any less because I have had a lot
of momentous things happen in my life, and being raped was momentous, but so was
travelling and having my children, and getting married, all of those are big life events.
(Participant 2)

These quotes reveal the distinct change from their old self-beliefs. The assaults
have been assimilated into their being. No longer do they find themselves
unacceptable or the trauma overwhelming and defining. Instead, their experiences
have been accepted as part of a larger whole that they embody. Not only has the
abuse been accepted into their narratives of self, the whole self is seen as acceptable.

Post-traumatic growth

Here the women spoke of how their lives were enriched by learning to work through
their suffering, and how their experiences have contributed to the people they are
today:
There is so much that has come good out of, dare I say, being abused. Nobody can say
how different they would be if it didn’t happen. I can’t say what sort of person I would
be if I wasn’t abused, but everything that happened to me has eventually helped
me be the person I am today. It has helped prepare me for other parts of my life.
(Participant 1)
It has made me an optimistic person, knowing that you do get better and that you can
survive really traumatic events. Going through the healing process gives me optimism
when talking to people who are going through hard times that things pass. And being
able to listen to other people who have trauma in their lives and being able to bring my
own experiences to bring compassion into their lives. (Participant 2)
Both women report feeling blessed by the lessons and growth garnered from the
active, sustained and challenging work of reconstructing their internal lives from
their suffering to emerge on a new side with a new level of understanding and being
in the world. The trauma, once an overwhelming burden, had been transformed into
growth.

Discussion

The preceding exploration of the impact of CSA revealed how the experience of
sexual trauma shaped the fundamental, global beliefs of the women reviewed in this
article. Far from holding positive views of benevolence, meaningfulness of the world
and worthiness of self (Janoff-Bulman, 1989), both women reported that the sexual
trauma had a fundamentally negative impact on their emerging global views.
They also articulated how their experiences profoundly shaped how they came to see

themselves and their place in the world, as well as what they believed they could
expect from others. Further, both women held deep feelings of shame and
responsibility for the abuse as a consequence of the internalisation of their
experiences – findings often reported in the CSA literature (Coffey et al., 1996; Isely
et al., 2008; Molnar et al., 2001; Zinzow et al., 2010). Despite the offences occurring
at widely disparate times and differing in duration, the beliefs the women held were
remarkably similar. This finding highlights the critical effect that sexual trauma
exerts on emerging beliefs, regardless of whether the assaults occurred during
childhood or early adolescence. Researchers have previously found that negative
core beliefs can be shaped by the experience of one incident of intrusive contact
sexual abuse in childhood (Isely et al., 2008).

The egocentric nature of childhood makes it easy to understand how deep
feelings of shame and responsibility for abuse becomes internalised, and why the
coping strategies of dissociation and avoidance become highly relied upon to
maintain the integrity of the personality structure. Unable to cognitively separate
themselves from responsibility for a non-consensual act, children or young people
assume accountability, either in part or in full, for the sexual assaults. Despite not
having the knowledge that what has occurred is a ‘‘sexual assault,’’ survivors often
speak of intrinsically knowing the act was itself wrong. Therefore, with immature
reasoning, if the act is wrong, and they were a part of that act, then they must be
wrong. If the experience of shame (‘‘I am wrong’’) and guilt (‘‘I have done wrong’’)
that is inherently a part of CSA was not so abjectly internalised, cognitive
assumptions regarding the self, others and the world may not become so inherently
negative and critical. However, the frequency with which shame, guilt and negative
core beliefs are reported by those who have experienced CSA, shows that sexual
trauma during the formative years can be so powerful and so dissonant with
expected experience that it shapes the very foundations of emerging assumptive
worlds.

Fundamental beliefs are the basic operating system people use to understand
their world and themselves, as well as being the blueprint for how they relate to
others. Therefore, holding beliefs such as ‘‘I am wrong’’ (shame) and ‘‘I do wrong’’
(guilt) will fundamentally colour the interpretation of subsequent experience, due to
the dynamic interplay between internal representational models and behavioural
experience (Carlson, Sroufe, & Egeland, 2004). As childhood experiences are the
foundation for all subsequent personality development, disruptions and distortions
during these stages are sure to have ramifications into adulthood, as was clearly
evidenced in the narratives of the women reviewed here.
The role of meaning making becomes particularly relevant in healing sexual
trauma through the process of learning to see beliefs in a new light. Park and Ali
(2006) speak of the need for research to understand how trauma survivors change
their global beliefs, under what conditions beliefs become modified and what changes
occur to adjustment and well-being as a result of beliefs being changed. This study
shows that for these women who suffered CSA, the modification of beliefs occurred
when they understood what beliefs they held, understood how the beliefs historically
developed and then examined the validity of their beliefs. Through their counselling
experiences, both women began to understand the fundamental beliefs they held,
that formerly were out of their conscious awareness, because they were so entrenched
in their patterns of thought.

Counselling Psychology Quarterly 49

An important part of healing for both women was to understand why they held
the beliefs they did and to connect their beliefs to their internalisation of their trauma
experiences. A large part of this process involved active rumination, turning towards
themselves and the impact of the trauma, and really examining all the ripples that
being sexually assaulted had caused in their lives. This active rumination and the
process of meaning making is what made it possible for these women to come to a
deep understanding and acceptance not only of what had happened to them, but also
the damage caused through the shaping of their beliefs as a result of the sexual
trauma. Actively processing the trauma and its effects stands in contrast to the
intrusive rumination that occurs when one is still trying to manage trauma symptoms
by avoidance and non-acceptance (Cann et al., 2010). Deliberate, active rumination
was a critical component of how these women came to understand their existing
beliefs, which gave them the platform to be able to change them.
To answer other questions posed by Park and Ali (2006), the conditions under
which beliefs were changed for these two women appeared to be when the thought of
facing their fears became less frightening than continuing to live under them.
Both women spent many, many years actively avoiding the depth of their experiences
due to fear. Fear that their beliefs were ‘‘true’’; fear they were only what they believed
they were and what they feared others believed they were; fear they were worth
nothing more than what they received and, fear of actually facing the truth of what
they had experienced. However, for both there came a time when these fears became
less of a threat to their integrity than the possibility of actively facing their fears,
and turning towards the pain and looking deeply at themselves. An important note
(and one echoed in the larger study) is that the conditions under which their beliefs
came to be changed almost exclusively arose via the assistance of another, most often
within a therapeutic relationship. This makes intuitive sense, as a key process of
therapy is to ‘‘hold a mirror’’ for clients to help them see what may not be clear to
them due to habit and familiarity. Working within a trusted therapeutic relationship
that provides acceptance and non-judgement can provide individuals with the safety
required to look deeply at their often conflicted belief structures so that change
can occur.

Finally, the effects that changing their global beliefs had on their adjustment
and well-being was marked, and the women themselves would say ‘‘life altering.’’
What occurred as a result of re-working their beliefs of self, world and others was
a total change in their inner relationship, moving from hostile and negative to
connected and optimistic. Another fundamental change that occurred was how they
saw themselves in relation to the sexual assault. Both women reported a fundamental
change in their view of self; from once feeling defined by the abuse to now knowing
that it is but one part of the larger whole that makes up who they are. They accepted
the abuse as a part of the whole individual, rather than being the dominant or
defining feature of the whole individual. This was the process of becoming ‘‘a whole
person.’’ Further, the change in their connectedness to themselves enabled them to
also connect more deeply with others in their lives, making their inner and outer
worlds more fulfilling.
The outcome and processes of healing and growth that we reported in this article
are highly congruent with Joseph and Linley’s (2005) model of growth, with all four
theoretical principles of their model being covered in the narratives of these women.
The first principle is the completion tendency, which states we all contain an inner
drive towards equilibrium and the need to integrate dissonant experiences and ideas

into a coherent sense of being. This principle is seen strongly in the journeys of these
two women. A time came when both needed for their lives and their beings to be
different. Although their beliefs had been shaped by prior experience, and they had
lived their lives in accordance with those beliefs, there came a time when both women
knew this was not serving them well. Both strived to make difficult changes so
their beliefs and actions became more congruent with their inherent nature.
Liedloff (1977) also speaks of this point in her continuum concept theory that within
each life form is a tendency to evolve that is not random, but driven to further
one’s own interests, directed towards greater stability and therefore greater
diversity, complexity and adaptability. Prior to healing, although both women
were ‘‘functioning,’’ neither would have considered themselves as stable. However,
after healing, the diversity and complexity of their true nature was revealed,
providing both with newfound stability and adaptability within their lives.
The second theoretical principle was also evident; for these women both
assimilation and accommodation were necessary for growth. Accommodation was
indeed highly important, as their old global beliefs needed to change in order to
reflect the truth of their inherent nature. Assimilation was also present when looking
at the changes in the way they saw themselves in relation to their abusive experiences.
As echoed by a large percentage of women within the larger study, the abuse needed
to become assimilated into their story of self and accepted, rather than being
rejected. This acceptance included assimilating the fact that the abuse happened and
that they could have done nothing differently as a child, as well as acceptance of the
damage the sexual assault caused to their being, in particular how it shaped their
fundamental assumptions.

The third principle, the role of meaning in growth, was a fundamental part of the
growth process for both women. Joseph and Linley (2005) mention that ‘‘meaning as
comprehensibility’’ may not be as significant to growth as ‘‘meaning as significance.’’
This was certainly true for these women, as trying to make sense of why the sexual
assault happened was not a point mentioned by either. However, understanding the
impact the trauma had on their global beliefs and the ways they lived their lives was a
crucial component in their healing and growth. Both women reported that a deep
understanding of the workings of their belief systems, and the impact this had on
how they engaged in their lives and with others around them, was an integral part
of healing and growth.

Finally, the outcomes of growth evidenced in these women most surely fell more
precisely in the domain of eudaimonic or PWB. Both women reflected on major
changes that occurred in relation to greater self-awareness as well as deeper
connections with others. Although the women’s narratives reported here touch
briefly on aspects of spirituality, within the larger study this principle is more
strongly represented, but not in a religious capacity. A different way of looking
at spirituality, divergent from a religious perspective, is the understanding of
spirituality as a deep self-connection and connection to earth, spirit, energy or
particularly intuition. The importance of this spiritual connection is reported by
Liedloff (1977), who speaks of the personal significance of being connected to
intuition. When we are ruled by intellect or the mind, our inherent sense of what
is good for us can become distorted, and we lose our ability to distinguish between
intuition and distortion, reality and non-reality. Developing this deep, spiritual
connection not allows one to feel connected to a larger ‘‘whole,’’ but can also be
a powerful ally against over-thinking, getting caught up in the mind or caught up
Counselling Psychology Quarterly 51

in constructed belief systems and reactive thinking. Developing this deep inner
spiritual connection can bring one back into the self and in touch with one’s most
ancient and undiluted information sources – intuition.

Clinical implications

The clinical implications of our study point specifically to the crucial role that beliefs
play in one’s perception of reality, and as a consequence, how people come to see
themselves, others and their world. Far from being static, negative beliefs can be
highly malleable and can be fundamentally changed through awareness; awareness
itself can be curative (Chodron, 1997). The role awareness plays in understanding
fundamental beliefs cannot be understated. In clinical practice, when working with
those who have suffered CSA, awareness needs to be raised concerning the existing
beliefs the individual holds of themselves, others and the world. Becoming aware of
what beliefs are held is the first step to being able to change them. After awareness is
brought to what beliefs exist, the beliefs then need to be placed into context by
linking them to the event or series of events that shaped the beliefs in the first place.
Being able to connect beliefs to a historical root creates the space for clients to see
that their existing beliefs are not chosen but instead have been shaped during a highly
influential and formative stage of their life.
Holding positive core beliefs should be a birthright. The inherent nature of

humans is fundamentally pro-social and self-fulfilling, as opposed to the discon-
nectedness and self-deprecating feelings that so often occur after CSA. Re-working

beliefs needs to incorporate an understanding of why the existing negative core
beliefs are false, as well as an exploration to uncover what the true beliefs of people
actually are – a reflection of their real nature.
Finally, when working with those who have experienced CSA, it is important to
acknowledge that this process takes time. Re-working fundamental beliefs that have
existed for years, and in many cases decades, is not a process that happens quickly or
easily. Both therapist and client need to be mindful of the fact that this process takes
time, effort, patience and above all, compassion, in order for lasting change to occur.
However, as is clearly evidenced here, change, healing and growth after CSA is not
only a possible, but perhaps an inevitable, outcome of re-working belief structures
and one that is vital to establishing a healthier, more authentic way of being.

Notes on contributors
Sheryle Vilenica is a registered psychologist in private practice, primarily working with
individuals who have experienced sexual trauma in childhood. Sheryle’s current research
examines how individuals manage to heal and grow personally after experiences of early-life
sexual trauma. Sheryle is passionate about assisting in changing current societal views on how
child sexual abuse is portrayed and on broadening the methods or treatments used to assist
those affected, incorporating an holistic approach.
Dr Jane Shakespeare-Finch is an Associate Professor in the School of Psychology and
Counselling, at Queensland University of Technology, Brisbane, Australia. Posttraumatic
growth (PTG) is Jane’s primary area of research and she has studied the PTG phenomena in a
wide variety of populations from emergency service personnel, to refugees, and adult survivors
of childhood sexual assault. Passionate about both proactive and reactive promotion of
mental health for trauma survivors, Jane has published approximately 20 books and book
52 S. Vilenica et al.

chapters and dozens of peer-reviewed articles and is a regular presenter at national and
international conferences.
Dr Patricia Obst is a Senior Lecturer in the School of Psychology and Counselling, at
Queensland University of Technology, Brisbane, Australia. Patricia research interests have
focused on the area of applied social psychology in particular social identification, sense of
community and more recently the area of social support. Patricia’s work focuses on the
relationship of theses variable with wellbeing in a diversity of populations. Patricia has over 30
publications in peer reviewed articles and conference papers.

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