Abstract
Although child abuse is a topic, familiar to most of us, the reality is that it is too often missed in the therapy room and mental health services, with devastating effects on the client. On longer, term these clients inadvertently build a therapeutic resume with a variety of therapies, therapists, and therapeutic experiences - with short term relief of symptoms, or no long-term impact on their lives, just to continue seeking out the next therapist. But what are we missing? And why? During this workshop we will explore the different reasons why child abuse is missed during therapy. Child abuse, child complex trauma and dissociation, can too easily conceal itself in words, behaviours, metaphors, or attitudes. Existing diagnoses might reinforce the capacity of concealment from the eyes of the therapist. Mental health systems might struggle with endless waiting lists, impatient potential clients where the complex trauma and dissociation becomes ‘the monkey wrench that jams these systems full of individuals, families and communities who do not respond to “standardised” treatment’ (Salter, 2023:3). The educational systems might struggle with finding space for the groups of children “who do not ‘reform’ or ‘behave’ when punished, and who generally do not do as they are told” (Salter, 2023:3). We will explore whether there is an answer to these realities in our societies. Across the globe, in most educational and clinical settings for children and adults, complex trauma and dissociation which developed due to child abuse is mostly still not referred to or spoken about. Dissociation is not only linked to individuals with complex trauma but is often connected to affect dysregulation and thoughts disconnected from emotions, lack of somatic feelings, somatic complaints, problems with sleeping, etc. (Luoni, Agosti, Crugnola, Rossi & Termine, 2019). Many of these symptoms are typical reasons for referrals to therapists. But through a myriad of symptoms, how do we find the child abuse, the trauma, the masked dissociation? Multiple strategies, therapeutic ‘tools’ and examples of practical cases, will be discussed to illustrate how children and adults who continue to seek help for their pain, anxiety, depression, anger, violence, complex relationships and never ending dreams, nightmares, voices, and fears that there is no help for them, and can indeed be helped effectively. They do not need to continue believing that they are doomed to a life of misery. Their childhood trauma and level of dissociation can be assessed and treated by the very same therapists who have seen them before or are seeing them currently. The conclusion will contain examples of how each individual therapist can make a difference on a small scale and how eventually together multiple individual therapists can achieve an ultimate change in systems and society.

This session was originally presented as a live conference session in April 2023.