Yourself
Helping
Yourself
Heal
A Recovering Woman’s Guide to
Coping With Childhood Abuse Issues
U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES
Substance Abuse and Mental Health Services Administration
Center for Substance Abuse Treatment
www.samhsa.gov
Acknowledgments
This brochure, accompanying the publication Substance
Abuse Treatment for Persons With Child Abuse and
Neglect Issues, #36 in the Treatment Improvement Protocol
(TIP) series, was produced by Johnson, Bassin & Shaw, Inc.,
under Contract No. 270-99-7072 with the Center for
Substance Abuse Treatment (CSAT), Substance Abuse and
Mental Health Services Administration (SAMHSA), U.S.
Department of Health and Human Services (DHHS). Karl D.
White, Ed.D., served as the Government Project Officer.
Disclaimer
The views and opinions in this publication are those of
Consensus Panel members and do not necessarily reflect
the views or policies of CSAT, SAMHSA, or DHHS.
Public Domain Notice
All material appearing in this booklet is in the public domain
and may be reproduced or copied without permission from
SAMHSA. Citation of the source is appreciated. However,
this publication may not be reproduced or distributed for a
fee without specific, written authorization from the Office of
Communications, SAMHSA, DHHS.
Electronic Access and Copies of Publication
This product, the TIP series, and their companion products
are available from SAMHSA’s National Clearinghouse for
Alcohol and Drug Information (NCADI). To receive free
copies of all TIP products, call 800-729-6686 or 800-487-4889
TDD (for the hearing impaired), or visit SAMHSA’s Web site
at www.csat.samhsa.gov.
DHHS Publication No. (SMA) 03-3789
Printed 2003
Introduction
ow that you’re in treatment for substance abuse, you
Nmay begin to have many different feelings. At times,
these feelings may be painful, and you may have a hard time
understanding or coping with them. You may feel:
+ Fearful
+ Helpless
+ Guilty
+ Ashamed
+ Anxious
+ Depressed
+ Angry
+ Bad about yourself
+ As if you can’t connect with family or friends
+ As if you’re crazy
+ Numbness or nothing at all
+ As if you want to die.
Some of these feelings are common for any woman who
starts treatment for substance abuse, but the same feelings
may be stronger for many women who were abused in
childhood. The pain may be so great that a woman may do
anything to cope with her feelings, including using drugs or
alcohol.
Some women in treatment for substance abuse don’t clearly
remember being abused, but they have some of the feelings
mentioned here. Some women may have pushed the memories
of the abuse so far away that they may not be able to
explain why they feel intense anger, fear a particular person,
have nightmares, or always believe something bad is about
to happen. Sometimes, after people stop drinking or using
drugs and are in treatment, memories may surface that
were too painful to remember before or that were blocked
from memory by drugs and alcohol.
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Working through childhood memories or memory lapses can
help you when you’re in substance abuse treatment because
facing past pain can help you focus on your present life.
What Is Childhood Abuse?
buse has many definitions, and sometimes it can be
Ahard to know whether what you went through as a child
was abuse. At the time, the way you were punished or treated
may have seemed normal. Here are some questions to think
about. These questions ask about just a few experiences
that are generally considered abuse. You may have had
other experiences that are not on this list but are still
considered abuse.
Do you remember anyone when you were a child:
+ Using extreme discipline or
punishment on you?
+ Spanking or hitting you so hard
that it left bruises, cuts, or broken
bones?
+ Beating or punching you?
+ Acting in a way that made you feel
uncomfortable or powerless?
+ Calling you names or abusing you
verbally?
+ Among family members or others close to you, criticizing
or making fun of your physical characteristics, such as
your hair, your skin color, your body type, or a disability?
+ Talking to you in a sexual way, watching you undress or
bathe, showing you pornographic pictures or movies, or
photographing you in inappropriate ways?
+ Touching you sexually or making you touch yourself or
someone else sexually?
+ Forcing you to watch others acting in a sexual way?
+ Forcing you to have sex?
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What Symptoms Could You Have If
You Were Abused?
he effects of childhood abuse may be with you as an
Tadult. As well as feeling angry, anxious, ashamed, or
depressed, you may:
+ Have flashbacks of the abuse
+ Have frequent nightmares
+ Be very sensitive to noise or to being touched
+ Always expect something bad to happen
+ Let people abuse or take advantage of you
+ Not remember periods of your life
+ Feel numb.
These feelings may get worse or become more intense
when you’re stressed or in situations that trigger memories
of the abuse, such as when you fight with someone close to
you. If you feel like hurting yourself, or are thinking
about suicide, tell your counselor immediately, or call an
emergency hotline or 911.
How Can You Address Childhood
Abuse Issues While You’re in
Treatment?
or the first month or so of substance abuse treatment,
Fyou’ll be focusing on getting the drugs or alcohol out of
your system, clearing your head, and establishing healthy
patterns of thinking and behaving. You may want to put off
addressing painful past abuse until you are comfortable
being drug and alcohol free, establish a strong relationship
with your counselor, make new friends, and build relationships
with people who do not abuse drugs or alcohol. Then you
may begin to feel safe enough to think about this issue.
However, if the feelings are too overwhelming and painful,
or if you feel that you must address them right away, know
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that you can raise the issue whenever you want or need to.
No matter what stage of recovery you’re in, help is available
for you. And remember: Many other women have worked
through their pain and now lead happy, fulfilling, drug-free lives.
It’s up to you to decide when to discuss abuse with your
counselor, but it is important for you to raise the subject
when you are ready. This may be the first time you’ve ever
told anyone about what happened to you as a child. You
may feel guilty or disloyal talking about a family member or
another person close to you. You may fear how your family
will react to you after you’ve talked about what happened.
All of these feelings and fears are very normal; talk
about them with your counselor.
Sometimes, it’s hard to remember the difference between
what you felt as a child victim and the choices you have as
an adult in counseling. You could not protect yourself
then, but you can now. As an adult, you can talk about
what happened to you and you can begin to heal.
How Can Your Counselor Help?
t’s important that you know that all
IStates require mental health and
substance abuse counselors to report
abuse. If you’re younger than 18, talk to
your counselor about your State’s require-
ments. If you’re an adult, your counselor
generally is not required to report the
childhood abuse. The exception is when
the abuser still has access to children and may harm them.
As you and your counselor or therapist talk about your
experiences, your talks may become more difficult when
painful memories and feelings arise and you look more
closely at the past. Sometimes, these overwhelming feelings
contribute to a drug or alcohol relapse. A counselor or
therapist can help you understand the relationship between
the abuse in your past and your substance abuse. He or she
4
can help you cope with your feelings better so that you
won’t become overwhelmed.
Your substance abuse counselor also can help you find a
counselor or therapist who specializes in working with people
who have been abused as children. Addressing child abuse
issues takes time; you’ll need to develop a relationship with
a therapist who can work with you now and who will continue
to work with you after you’ve finished your treatment for
substance abuse.
In addition to helping you find a skilled therapist, your
substance abuse counselor can help you find self-help
groups, such as Survivors of Incest Anonymous. If you grew
up in a family in which one or more members had addiction
issues, groups like Adult Children of Alcoholics (ACA) or
Co-Dependents Anonymous (CoDA) might also be very
helpful for you (see back cover).
A Final Note
s a woman in recovery from substance abuse, you’ve
Afaced great challenges and survived. It is a tribute to
your strength that you’ve made the courageous choice to
enter a substance abuse treatment program. You deserve
the chance to heal and to live a happy, healthy life.
You will face challenges, but you have the ability to make
things better. You can do this, as many have before you.
Remember: You are not alone. Use the many resources
and support networks available to help you feel safe and to
keep you moving toward your goal. As you stay sober, your
options grow. As you create a trusting relationship with your
counselor or therapist, you begin to heal. And the courage
you find to help yourself heal may one day help another
person who is lost in addiction and pain.
Be patient with yourself. Healing takes time, but it’s worth
it—because you are.
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Place Clinic Sticker Here
Federal Resources
+ SAMHSA’s National Clearinghouse for Alcohol and Drug
Information (NCADI), www.ncadi.samhsa.gov, 800-729-6686,
or 800-487-4889 (TDD)
+ SAMHSA’s Substance Abuse Treatment Facility Locator,
www.findtreatment.samhsa.gov, 800-662-HELP
+ SAMHSA’s National Mental Health Information Center,
www.mentalhealth.samhsa.gov, 800-789-2647
Other Selected Resources
+ Adult Children of Alcoholics, www.adultchildren.org,
310-534-1815
+ Co-Dependents Anonymous (CoDA),
www.codependents.org, 602-277-7991
+ Emotions Anonymous International,
www.emotionsanonymous.org, 651-647-9712
+ National Clearinghouse on Child Abuse and Neglect
Information, www.calib.com/nccanch, 800-394-3366
+ National Mental Health Association, www.nmha.org,
800-969-6642
+ National Mental Health Consumers’ Self-Help
Clearinghouse, www.mhselfhelp.org, 800-553-4539
+ Parents Anonymous, www.parentsanonymous-natl.org,
909-621-6184
+ Posttraumatic Stress Disorder Alliance,
www.ptsdalliance.org, 877-507-PTSD
+ Sidran Institute, www.sidran.org/resourcesurv.html,
410-825-8888
+ Survivors of Incest Anonymous, Inc., www.siawso.org,
410-893-3322
