J o u r n a l of Religion and Health, Vol. 26, No. 1 Spring 1987

The Emotional Impact of Treating Child Abuse LAWRENCE H. H E N N I N G A B S T R A C T : The author agrees with the need for pastoral intervention in child abuse and ne-

glect, but warns t h a t pastors need to be prepared to handle the intense emotional effects t h a t result. The emotional impact of t r e a t i n g child abuse and neglect is examined under the rubric "countertransference." Three sources of countertransference are outlined: identification with the child, identification with the parent, and encountering resistance. Finally, ways to cope with countertransference engendered by t r e a t i n g child abuse and neglect are explored. The need for quality supervision is especially stressed.

Our society has become increasingly sensitized to the pervasive existence of child abuse and neglect. In response to this heightened awareness, persuasive cases have recently been made for pastoral involvement in abusive situations. Garbarino and Hershberger, who view current social science paradigms as unable to face the evil in child abuse fully because of amoral presuppositions, argue that pastors are in a unique position to respond to the evil inherent in child abuse.' They also contend that the church's traditional practice of pastoral care offers excellent opportunities for responding to abusive situations. These opportunities include: 1) access to families through pastoral visitation, 2) the confessional quality of pastoral care, and 3) the movement toward conversion to healthy patterns of relating. 2 Bentley likewise contends that pastors have a unique role in ameliorating child abuse situations2 He states that secular approaches are limited by an objective, deterministic framework. A pastor, on the other hand, can respond uniquely to the client's subjective world, using a religious framework to help the client become "open to the grace of God's actions within. TM In addition to the unique quality of pastoral care, there is another salient reason for pastors to learn how to intervene in abuse and neglect cases: the high probability of encountering child abuse and neglect. Given the base rates of abuse and neglect as well as a pastor's familiarity with parishoners, it is highly unlikely that a pastor will not encounter abuse and neglect in the course of pastoral work. For this reason, pastors ought to know how to respond when an abuse or neglect situation is detected. There are very difficult ethical and legal dilemmas associated with child abuse and neglect intervention (for Lawrence H. Henning, Ph.D., is presently studying at W a r t b u r g Theological S e m i n a r y in Dubuque, Iowa. 37

9 1987 Institute of Religion and Health

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example, possible conflicts between state reporting laws and privileged communication). However, the one response that is clearly off-limits is denial. Even when primary treatment is given by other professionals, pastors should offer ongoing pastoral support. Secular treatment does not lessen the need for traditional pastoral care (for example, prayer and confession/absolution). Ideally, such ongoing pastoral care can be coordinated with other professional treatment in a teamwork approach. The need for pastoral intervention in child abuse and neglect is clear; however, there are high emotional costs for pastors who attempt to treat abuse and neglect. These costs can be generally categorized under the psychotherapeutic rubric of "countertransference." I will first discuss the general phenomenon of countertransference. Second, I will identify three sources of pastoral countertransference in abuse and neglect situations. And third, I will discuss ways to cope effectively with the emotions engendered by treating abuse and neglect.

Countertransference Freud originally used the term "countertransference" to refer to an unconscious process whereby the analyst would project feelings about past figures onto the patient (analysand)2 That definition has broadened considerably, so that today "countertransference" commonly refers to any feeling, positive or negative, that helpers develop toward those they are helping2 It is viewed as inevitable and, if understood and properly handled, can even enhance therapeutic efficacy. However, left unattended, negative countertransference (for example, anger in particular) may impair effectiveness and in some cases may diminish helper empathy. 7 When negative countertransference is prolonged, it can be a primary source of burnout including such symptoms as alienation, depression, apathy, and somatization. + Child abuse intervention can especially engender intense negative affect. This negative countertransference, when sustained, puts pastors working with abuse and neglect at particularly high risk for burnout in its most severe forms.

Sources of countertransference Identification with the child. Powerful feelings toward abusive parents can originate from identifying with abused children. Even as adults, pastors can maintain deep feelings of childhood vulnerability that are easily tapped when seeing children hurt by their parents. It is easy to identify with the defenseless position children appear to have. We have all felt defenseless as children and sometimes still do as adults. The combination of perceiving abused children as helpless victims and the identification with their hurt and vulnerability can create intense anger. Perhaps some of the anger may not be for the abused child only; it m a y extend to include anger for the still vulnerable "child"

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within the pastor. For professional reasons, pastors need to control their anger. However, if this anger remains suppressed for prolonged periods, negative effects may occur. These include displacement of the anger to other areas of one's professional and personal life. In pastors who were victims of child abuse themselves, the countertransference can be greatly intensified. Most adults can relate vulnerability and pain to feelings they had as children. For adults who were abused as children, this identification is naturally much stronger. In the pastor abused as a child, fighting for the rights of abused children may be in part motivated by desires for personal restitution and even revenge. The intensity of this countertransference increases the need to find effective ways to cope with it. Identification with the parents. Pastors may also identify with the abusive or neglectful parents. These parents are often under great stress, feel harassed by the "system," and feel inadequate as parents of children whom they sometimes perceive as against them. These are feelings not unknown to pastors as well. Most adults can identify with being frustrated and with venting frustration on something or someone else other t h a n the true source. Identification with the abusive parents can lead to confronting negative parts of oneself. When feelings similar to those of abusive parents are recognized within oneself, a fear may develop t h a t one may become like the abusive parent and lose control of anger. This countertransference is intensified by the psychic difficulty in differentiating feelings from behavior. Pastors may subconsciously conclude that if they have the same feelings as abusive parents, then they may have the same destructive tendencies. This conclusion is strengthened even more in pastors who are themselves parents. Reaction formation is a mechanism to defend against those parts of ourselves t h a t we find abhorrent. The process involves reacting vehemently against those negative qualities in others t h a t we may recognize unconsciously in ourselves. This vehement reaction allows pastors to draw a sharp (and possibly arbitrary) distinction between themselves and abusive parents and thus to foster denial of unwanted feelings. This reaction formation can significantly decrease the pastor's effectiveness in providing help. Encountering resistance. Abusive or neglectful parents are often highly resistant and even hostile to outside intervention. There are several reasons for this resistance, both psychological and practical. Psychologically, these parents often have poor and fragile self-esteem. Therefore, they perceive blame easily and fight hard to convince others (often actually themselves) t h a t they are adequate parents and worthwhile people. Practically, outside intervention is often perceived, frequently for good reason, as leading to temporary or perm a n e n t separation from their children. This perceived threat has m a n y psychological components including, again, a perceived threat to self-esteem. Encountering resistant and sometimes hostile abusive or neglectful parents can be another source of countertransference. Dealing with this hostility is not pleasant or easy. No matter how much pastors can understand and expect resistance and hostility, it is h u m a n nature to take it personally. Repeated exposure to hostility will engender counterhostility; if this counterhostility is not effectively discharged, it can take a heavy personal toll and diminish empathy.

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Coping with countertransference There are m a n y general strategies pastors can use to cope with countertransference. These strategies include many of the suggestions made in recent years to handle burnout: good nutrition, exercise, relaxation training, and other elements of stress management. However, as useful as these coping techniques are, they are not adequate in themselves to deal with the countertransference created by involvement with child abuse and neglect. They do not deal directly with the sources that underlie the emotions. I contend t h a t what is essential to cope effectively with the emotional impact of child abuse and neglect situations is quality supervision. In suggesting the necessity of supervision, it is important to be clear about what is meant by supervision. Therefore a definition and some general comments are in order. Supervision is defined here as an intentional, personally focused relationship in which one person facilitates the development of pastoral competence in another? This definition describes an activity considerably broader t h a n t h a t which exists between an experienced pastor and a novice (for example, C.P.E. student or intern). That one person facilitates the development of another implies t h a t the supervisor does not necessarily need to be more experienced t h a n the one supervised. More experience may be important in supervising a novice where the focus is often on skill development. But in the case of experienced pastors, supervision can take place as a collaborative effort between professional peers (that is, peer supervision). What is needed in peer supervision is a clear definition of roles. The primary focus will be on the needs of the one supervised, with the supervisor's task being t h a t of facilitator. More will be said below about facilitation as it relates to coping with countertransference. Another important element of the definition is that supervision is seen as "personally focused." This means t h a t supervision focuses on the unique personal and professional needs (behavioral, emotional, spiritual) of the one supervised. Early in one's training, supervision often emphasizes the need to develop behavioral competence--skill b u i l d i n g - - a n d to establish role identity. However, the acquisition of a large and refined skill repertoire does not eliminate the need for supervision. There are always emotional and spiritual issues to be examined in the course of ministry. Thus, the need for supervision exists independently of one's competence or experience. This brings us back to our topic at hand. Few activities raise as intense emotional and spiritual consequences as does dealing with child abuse and neglect. Therefore, few activities so urgently need supervision. However, for supervision to be helpful for the pastor dealing with child abuse and neglect, certain elements need to exist. It is the task of the supervisor and facilitator to insure their presence. These elements are: 1. Listening and acceptance. In good supervision, the pastor experiences permission to express feelings freely and can expect that they will be heard and accepted. As mentioned above, the intensity of countertransference is strengthened when suppressed, as it often is in treating child abuse. It is important t h a t supervision be a time when the emotional "lid" can be removed. Other-

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wise suppression may proceed to frank d e n i a l - - a dangerous possibility. In an accepting supervisory atmosphere pastors can become more aware of their countertransference. In addition, the supervisor's acceptance of negative affect can lead to the pastor's acceptance of these intense feelings as well. 2. R e l e a s e . This element is related to the first. In quality supervision, pastors are encouraged to express the anger they m a y feel toward abusive or neglectful parents. Supervision is a h e a l t h y environment in which to release pent-up emotion. 3. U n d e r s t a n d i n g . Beyond awareness, acceptance, and release, good supervision helps pastors understand their countertransference by exploring its components and possible origins. This may involve, for instance, examining the three sources outlined above as they m i g h t exist for the pastor. 4. U t i l i z a t i o n . Finally, good supervision helps pastors use r a t h e r t h a n suppress their feelings involved in treating abuse and neglect. Countertransference, once expressed, explored, and understood, can be a powerful source of data about the intra- and interpersonal worlds of the abusive parents and their children. Intrapersonally, for instance, countertransference involving identification with the parents and abhorrence at the aggressive potential within oneself can give the pastor clues about the self-hatred the parent m a y be experiencing. Interpersonally, the feelings a person engenders in the pastor are not likely to be unique and therefore may give potent clues about the relationships t h a t person has with others. These clues are, of course, to be treated hypothetically and not to be assumed as fact. Once they have surfaced and been examined in pastoral supervision, it may be appropriate to use these clues as guides in exploration with members of the treated family.

Summary

There are good reasons for pastoral involvement in child abuse and neglect situations. However, these situations include intense emotional effects (countertransference). If left unattended, negative countertransference can contribute to burnout and decreased pastoral effectiveness. Good supervision, however, can contribute to the release, acceptance, understanding, and utilization of countertransference engendered by t r e a t i n g child abuse and neglect.

References

1. Garbarino, J., and Hershberger, J., "The Perspective of Evil in Understanding and Treating Child Abuse,"J. Religion and Health, 1981,20, 208-217. 2. Ibid, 214. 3. Bentley,S., "The Pastoral Challel~ge of an Abusive Situation," J. Religion and Health, 1984, 23, 283-289. 4. Ibid, 289. 5. Freud, S., "The Future Prospects of Psycho-analyticTherapy."In Riviere, ed. and trans., Siground Freud: Collected Papers H. New York, Basic Books, 1959. 6. Giovacchini,P.L., ed., Tactics and Techniques in Psychoanalytic Therapy (Vol. II): Countertransference. New York, Jason Aronson, 1975.

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7. Peabody, S.A., and Gelso, C.J., "Countertransference and Empathy: The Complex Relationship Between Two Divergent Concepts in Counseling," J. Counseling Psychology, 1982, 29, 240-245. 8. Armstrong, K., "An Exploratory Study of the Interrelationships between Worker Characteristics, Organizational Structure, Management Process and Worker Alienation from Clients (How to Avoid Burnout)," Ph.D. dissertation, University of California, 1977. 9. Loganbill, C.; Hardy, E.; and Delworth, U., "Supervision: A Conceptual Model," The Counseling Psychologist, 1982, 10, 3-42.

The emotional impact of treating child abuse.

The author agrees with the need for pastoral intervention in child abuse and neglect, but warns that pastors need to be prepared to handle the intense...
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