This book began with a quotation from Scott Peck’s All-American Boy (1995). In his poignant memoir, Peck shared his personal traumatic account, found a way to renew a future for himself, and did so against enormous familial, cultural, and religious pressure to keep silent, to continue to pretend. In my introductory comments, I stated that this book asks the question: How do you engage the client who pretends, the client who denies and minimizes the effects of her own cruel past?
Of course, my hope is that this book has shed some light on this question, but as also noted in the introduction, my goal is that the reader, now reaching the end, will be both realistic about the challenges of the work and hopeful about the prospect of change.
While working with clients in this population can be complicated, psychotherapy may well afford these individuals with a chance for productive reappraisal if the clinician finds opportunities to address attachment patterns and challenge defensive processes. Intrafamilial trauma often develops in a climate of troubled attachment and acts to further disrupt attachment. Through a psychotherapeutic process that values focusing on these disrupted attachments and their emotional meanings, the therapist provides a holding environment for the safe exploration of issues that until now have been far too threatening to examine.
It is important to recognize that when such clients begin treatment, there is, in fact, a deeply rooted vulnerability, a hidden hurt, and an underlying yearning for love and care (Sable, 2004) as much as there is an overt insistence on self-reliance, defensiveness, and the minimization of traumatic events. While they have spent many years turning their attention away from the consequences of their difficult histories, this strategy is no longer effective.
The challenge in treatment, then, is in helping such clients find a way to tell a story too painful to speak but too compelling to ignore.