Z Seda Sahin and Melissa L McVicker

The impact of sexual abuse may vary, depending on the individual's perception of the experienced abuse. The experienced trauma can influence beliefs about oneself, life experiences, and relationships, often creating abuse-dominated stories laden with generalizations of helplessness or sense of lost agency. The use of narrative therapy in aiding sexual abuse recovery may not only support survivors in exposing the stories around the abusive experience, but encourage the creation of new, personal meanings and preferred stories of strengths, competence, and resilience. In addition, integrating positive psychology with narrative therapy can build on the individual's resources and strengths in overcoming adversity and building on discourses of hopefulness and healing.

SEXUAL ABUSE

The impact of sexual abuse can be influenced by many factors, including the survivor's perception of the abuse and causal attributions around the experience. Experiences of trauma can inform or challenge individuals' beliefs about themselves, their life experiences, and even their relationships. The narratives that are developed around significant life events can include causal explanations and evaluations of losses and changes.1 The perception of the experience of sexual abuse, and the meanings attributed to the experience, may change over time or as a result of other life events and experience of relationships.2 Often the themes or meanings given to specific traumatic experiences need to be narrated for the individual's recovery or resolution, not only to facilitate the expression of these narratives but also to place them in perspective for the individual.1

SURVIVOR NARRATIVES

While sexual abuse experiences may be ignored, minimized, or even denied, feminists and systems theorists have challenged these responses—insisting that the voices of survivors be heard and acknowledged.3,4 However, while the development of the survivor narrative can encourage people to speak out about abusive sexual experiences, it can also lead to survivor blaming and be potentially stigmatizing for the individual who experienced such experiences.4,5,6 As such, victim stories have begun to be replaced by survivor narratives in the last twenty years.4,7 Replacing a story of victimization with one of being a survivor may allow a focus on strength, courage, and resilience of those who had overcome adversity. In addition, survivor narratives portray an individual who has overcome adversity and been transformed in the process.4 This narrative offers survivors a sense of power that may be absent from victim stories and can offer hope of healing and recovery to those that have experienced sexual abuse.4

However, narratives, whether victim or survivor stories, still may connect an individual's identity to the abusive experiences, which may be rejected by the individual or seen as different types of stigmatizing identities.7 In addition, narratives, such as those of transcendence, support a social con-structionist approach, which challenges both the victim and survivor nar-ratives.4 Therefore, for the purpose of this chapter, narrative therapy will be introduced as a tool to encourage the creation of preferred stories of strengths and resilience in sexual abuse recovery.

NARRATIVE THERAPY

Don't we all write stories about life—stories about how we have experiences with other people, places, sounds, and smells? While we live in our own worlds, do we not sometimes forget that there are other realities? We give meaning to the world, and that meaning becomes the reality. So are there multiple realities? Whose reality is the real reality? How much of our reality is shaped by our society, our family, and our relationships?

Imagine two people sitting on a bench, looking at the lake in front of them. Let's say that each of them comes and sits there for a half an hour. Both of them look at the same image but experience something very different. They narrate their experiences in a different way. Here are two excerpts from their minds:

It was boring sitting there. Crickets annoy me, too. The lake was a fake one anyway; just filling spaces with water does not make it real. I do not understand why people have to imitate everything. Why can't people just be satisfied with what they have? I would rather sit on my comfortable couch at home and read my book. It is really sunny today; even this breeze is not helping. In addition, the sun is burning my skin. I should have grabbed the sunscreen before I left. It is becoming more like a habit of forgetting things these days. Why can't I remember anything? God, how am I going to finish all those tasks at work? I can't wait to retire.

Here is the second experience:

Sometimes a half an hour helps me to refresh myself. I sometimes get sucked into the craziness of the world, but it is good to take a break. I love this breeze. It makes me feel like I am part of something, like I am sharing this piece of wind that is coming from the other side of the world. It is really easy to forget to appreciate life these days. I am trying to make it a habit to remind myself to be grateful and recognize the beauty of this world, how everything is connected and how magnificent every piece of life is. I am amazed by how we even see this world. I mean literally, don't you get shocked about the incredible mechanisms that allow us to see the light and transform the light into images in our brains? I thank God every day for that.

Is it not the same image that these two people are looking at? Why do they narrate their experiences so differently?

Narrative therapy argues that our worlds are constructed by how we give meaning to our experience; therefore, there are multiple explanations for any event, experience, or memory. Narrative therapy approach adopts a worldview that an individual has a multistoried life. It is a social constructionist therapeutic model that argues that we cannot have direct knowledge of the world, and we can only know life through experience. White and Epston (1990) state that "persons organize and give meaning to their experience through the storying of experience, and in the performance of these stories they express selected aspects of their lived experience. It then follows that these stories are constitutive—shaping lives and relationships" (p. 12).

Narrative therapists allow the individual to deconstruct his/her problemdominated stories. Problem-saturated story has a focus that does not allow the individual to tell any alternative story.8 During therapy, narrative therapists highlight the life events that were formerly untold and create space through reauthoring.9 Monk et al. explain reauthoring as "developing an alternative story in therapy" (1997, p. 305).

In order to develop alternative stories, problem-saturated stories need to be altered. Problem-saturated/dominated descriptions are narratives that focus on the negative aspects of their life explanations. The dominant story can be reauthored, and an alternative story can be created through externalization and finding unique outcomes. White and Epston (1990) describe this process:

The identification of the unique outcomes can be facilitated by the externalization of the dominant "problem-saturated" description or story of a person's life and relationships. The externalization of the problem-saturated story can be initiated by encouraging the externalization of the problem, and then by the mapping of the problem's influence in the person's life and relationships. This is begun by asking persons about how the problem has been affecting their lives and their relationships. By achieving this separation from the problem-saturated description of life, from this habitual reading of the dominant story, persons are more able to identify unique outcomes. (pg. 16)

By viewing the problems as existing outside them, the individuals are empowered through narrative therapy.10,11 In this therapeutic process both the therapist and the individual contribute and are responsible for the construction of the reality. Externalization distances the individual from the problems and creates space for him or her to reflect on the influence of the problems.9 Through this process, the individuals are encouraged to find unique outcomes, representing the untold stories in their lives. In this new space that has been created by acknowledging these unique outcomes, individuals have more power to come up with alternative solutions and to regain their sense of self-agency. The reauthoring process allows the clients to discover their hidden strengths and use their skills to create a storyline that is more in line with them.

Narrative therapists map the influence of the problem on the individual's life and relationships by asking about the effect of the problem. These are questions that can help the clients discuss the psychological, physical, and behavioral aspects of the influence of the problem on their lives.11 This step is called mapping the influence of the individual with the problem. It includes asking questions related to how the individual has been trying to cope with the problem, amplifying the recognition of strengths, and nurturing the alternative story. During this process, unique outcomes are identified that enable new meanings. Figure 15.1 provides a visual representation of this process.

THE USE OF NARRATIVE THERAPY IN SEXUAL VIOLENCE RECOVERY

From a narrative therapy perspective, knowledge is understood as being socially constructed, with individuals creating a personal narrative about themselves and their interactions with others—describing and understanding their experiences while being influenced by the dominant discourses of

■ Problem-Saturated Story

Deconstraction

Externalization

Separation From the Problem m Alfornatuia

■ Alternative Story

society.12,14 Stories around sexuality and sexual experiences may be particularly sensitive to social influences, as social context and changes in norms may influence the meaning attributed to such concepts and experiences.

In addition, reality is not seen as something that is objective or permanent, but is viewed as being constructed by the exchange and interaction between the contributors. Narrative therapy expands the possibilities of this reality, allowing the creation of new constructions and meanings around abusive experiences.15

DOMINANT STORIES OF ABUSE

The experience of the abuse, specifically if the individual feels responsible for the abusive experience, continues to victimize the survivor by becoming the dominant story for the individual.16 Narratives that may emerge in therapy could include those of silence (a form of denial or coping); ongoing suffering; transformation or survivorhood; or transcendence.4 Characteristic of those who experience sexual abuse, the individual may feel powerless to resolve the problem (or to modify the dominant story), especially as the abusive symptoms and effects continue to take away the individual's sense of control.15 Individuals who identify themselves as victims or as being responsible for the abuse are at risk of developing abuse-dominated nar-ratives.17

Furthermore, abuse-dominated narratives can also involve disqualifying stories, in which a person is unable to recognize experiences or events that reflect talents, accomplishments, positive values, or competence of the individual.12 Disempowering stories may also occur when the individual's sexual abuse experience is denied by others, blamed on the individual who experience the abuse, or defined as not abusive. If one of these beliefs is accepted, the individual may have difficulty trusting one's own experience of the abuse, thus possibly maintaining the strength of the dominant story of being responsible for the abusive experience.17

Narratives that overlook strengths and positive experiences, focusing instead on the negative aspects of a person's life, are problem-dominated narratives.12 These narratives can often surface in therapy with sexual abuse survivors, offering an opening for therapists to address them.

DEVELOPING ALTERNATIVE STORIES

Narrative therapy considers both the therapist and client as contributors, each responsible for the construction of reality. However, a narrative approach emphasizes the client (in this case, the survivor) as the expert on his or her experiences, emphasizing the strengths, resources, and self-perception of the individual.9 The therapist assumes a nonexpert stance (a "not-knowing position"), not intending to solve the survivor's problems or repair the survivor from abuse, but rather supporting the client to modify and explore stories and meanings.15 This not-knowing position encourages the development of the client's sense of competence and empowerment, promoting an atmosphere in which the client is considered the expert on the abusive experiences.12,18

In the process of narrative therapy, the client and the therapist expose the dominant discourses around the experience of abuse—exploring such aspects as what supports the problem or who benefits from the problem.9 The mapping of the problem not only exposes the dominant stories around the abuse, but in this way, creates space for new stories to develop. Furthermore, the therapist and client can map the negative influences of the abuse through relative influence questioning, establishing that the person is not the problem, but rather the person has a relationship with the problem.9 In addition, the therapist and client can map the times when the client, or others, have refused to give in to the effect of the abuse, such as refusing to maintain the secrecy or accept blame for the abuse having occurred.9,14

Through this collaboration, questions are asked to increase the understanding and awareness of the resources and strengths of the client. The conversation generated between the client and therapist can open up opportunities to discuss and identify times when the client has been successful in controlling the effects of the abuse, with the therapist building on the strengths and resources of the client in doing so. In this way, preferred stories, and a preferred way of living, can be facilitated through organizing and examining the client's experiences and successes.10 Narrative therapy can assist the sexual abuse survivor in recognizing the personal power to recognize and create new stories.15 In addition, through the use of narrative techniques, the client and therapist can modify narratives that are ineffective or unhelpful for the client, opening up the abuse-dominated stories.19 Without having to directly challenge the dominant story, a narrative approach guides the individual to focus on indications of alternative stories already occurring. The client is supported in broadening the possibility of new, preferred stories through deconstructing the dominant story of being a victim.15 Through developing different, more functional, narratives around the sexual abuse, individuals can be assisted in making meaning of their experiences, which do not necessarily have to focus on the traumatic events the individual experiences.20

Narrative therapy can encourage the client to explore the possibility of moving on in life in a preferred way, empowering the client to not focus on the abuse as the problem (which cannot be undone) but rather to view the problem as existing outside him- or herself.10,11 Narrative therapy has demonstrated the effectiveness of externalizing conversations in generating individuals' sense of responsibility for behavior.9 Through externalizing the problem (and seeing the self as separated from the problem), the client then has the responsibility for the interactions with it and can see more possible ways to change their situation.14 Importantly, sexual abuse (as the problem) should not be externalized; it is the attitudes, beliefs, and effects of the violence that are externalized, such as the imposition of isolation or secrecy on individuals who were abused.11

Through reauthoring conversations, the individual develops and tells his/her story but also can begin to incorporate some of the neglected, or subjugated, events or experiences not present in the dominant stories—referred to as "exceptions" or "unique outcomes."14 Reauthoring conversations begin with identifying these unique outcomes, which may include experiences in which the client refused to be defined by the abusive experience; made the decision to disclose the abuse; resisted fear in telling about the experience; or acted in a way to protect someone else from harm.12,13 Through identifying a unique outcome, the client is able to realize the control he or she has over the effect of the problem, and in this way, the power to change it.12

CONSIDERATION OF CLIENT VALUES, RESOURCES, AND STRENGTHS

Treatment for sexual abuse survivors often encourages the individual's movement from "victim" to "survivor," supporting a nonobjectified status.15 This process facilitates the sexual abuse survivor regaining control over his or her life and defining the self by a reality that is self-determined— developing self-affirmation and a sense of competence.15,19 In addition, when working with an individual who has experienced trauma, the therapist should be attuned to the client's responses to the traumatic events, as responses are often based on what the individual gives value to in life.12,13 Therapists should not only hear what the individual feels is important to share about the experienced trauma, but also should notice opportunities to recognize responses to trauma, specifically identifying what the client has continued to value despite what he or she has experienced.13 Through the practice of double listening, the therapist can listen to the story of the trauma experience but also attune to indicators of the client's ability to find, and maintain, values in spite of the trauma.13 Furthermore, combined with positive psychology, narrative therapy allows a more preferred, perhaps even optimistic, way of storying the client's past, present, and future experiences.

INTEGRATING POSITIVE PSYCHOLOGY

To help the sexual abuse survivor to realize their abilities, talents, and competencies, the positive psychology approach can be integrated with narrative therapy. The client's skills and knowledge are the resources that can be built on and use while creating the alternative stories.

Positive psychology is the science of positive subjective experience, which studies concepts such as well-being, contentment, hope, optimism, flow, and happiness.21 Positive psychology examines the circumstances that strengthen the performance of individuals, families, and groups, reinforcing the good things in life as well as repairing the worst. It also focuses on what makes life fulfilling as well as on helping the distressed.22 In the last ten years, research about positive psychology interventions started to underscore the efficacy of this field. A meta-analysis of fifty-one positive psychology interventions indicated that these interventions significantly enhance well-being and decrease depressive symptoms.23 Positive psychology relies on empirical research, which distinguishes it from the positive thinking movement.24

Building positive emotions with sexual abuse survivors is a goal that should be pursued in therapy, as desensitization work with the survivors is not enough to build back their strengths. Individuals who have experienced sexual abuse may also have a poor self-image, lower self-esteem, relationship difficulties, and other characteristics that can affect their sense of self and their interactions with others.25,26,27 Helping clients who have experienced sexual abuse to construct positive emotions could support them in communicating differently with themselves and with others.

According to Fredrickson (1998), negative emotions constrict the individual's "thought-action tendencies." This is an adaptive function, con sidered as a response to dangerous circumstances. When faced with risky situations, we need to make decisions quickly to stay alive. This narrowing process for giving automatic responses such as fight, flight, or freeze is not true for the positive emotions. Thus, this researcher suggests a different interpretation of positive emotions' function as broadening the "thought-action" range for the individual.30 By experiencing positive emotions, the individual does not get hooked to the evolutionarily appropriate limited responses. Instead of being limited, he or she actually experiences the expansion of new, different, inventive routes of reactions. Fredrickson (1998) discusses four different positive emotions (joy, interest, contentment, and love) to show how these emotions enable the individual to make creative, novel, and explorative decisions that broaden their "thought-action" possibilities. This process also builds individuals' personal coping skills and reserves.

Fredrickson (1998) also reviewed the research of Isen (1987) and his colleagues (1984) and states that "these and other findings have led Isen to conclude that positive affect leads people to see relatedness and interconnections among thoughts and ideas and to material in a more integrated and flexible fashion.28,29 Expansion of thinking and solving problems also broadens the possibility of taking action and makes the individual more flexible. Positive emotions also build physical, intellectual, and social resources, which increase survival.

Promoting positive feelings enables the individual to develop psychologically and physically.31 This process facilitates growth and broadens the response repertoires, which can be beneficial for the sexual abuse survivors in their recovery. Thus, therapists should underline the importance of cultivating positive emotions to help to cope with life stressors and to improve life satisfaction. Positive emotions not only indicate but also produce well-being.30 The well-being is also accompanied by widening of cognitive and social resource-building abilities.

Positive psychology concentrates on three main areas: the study of positive subjective experiences, the study of positive individual traits, and the study of institutions that allow positive subjective experiences and positive traits.22 The study of character strengths and virtues is an effort to understand positive individual traits. Peterson and Seligman (2004) state that a person's character can be fostered, but psychology needs empirical ways to achieve this. To answer the question of "how can we measure good character among youth?" Peterson and Seligman developed a categorization called VIA (Values in Action) Classification of Strengths. This scientific effort focuses on what people's strengths are and how to categorize them. Interventions related to character strengths and virtues can be a different avenue for therapists to increase individuals' life satisfaction and life meaning. Narrative therapy highlights the importance of strengths and assets of individuals and helps the survivors to construct a more positive perception of themselves.9 Cultivating character strengths might be another avenue to enable sexual abuse survivors to build their alternative stories. Let us describe character strengths and give an example about the application with a sexual abuse survivor.

CHARACTER STRENGTHS

Character strengths began to be classified to help create common vocabulary in positive psychology in regard to defining positive traits. According to Peterson and Seligman (2004), virtues are the characteristics that are valued by moral philosophers, religious thinkers, psychologists, psychiatrists, and other youth development researchers. The researchers identified six virtues: (a) wisdom and knowledge, (b) courage, (c) humanity, (d) justice, (e) temperance, and (f) transcendence. These six categories of virtues seem to be consistent across culture and history.32 Virtues are defined by twenty-four character strengths, which include creativity, curiosity, love of learning, open-mindedness, perspective, bravery, persistence, integrity, zest, kindness, love, social intelligence, citizenship, fairness, leadership, forgiveness, humility, prudence, self-regulation, appreciation of beauty and excellence, gratitude, hope, humor, and spirituality.

According to Park and Peterson (2006),33 character is "a multidimensional construct comprised of a family of positive traits manifest in an individual's thoughts, emotions, and behaviors" (p. 891). Thus, a quantitative measure plays an important role in assessing and helping to enhance character strengths. These character strengths are measured by a free Internet-based questionnaire called the VIA Survey of Character, which was created by Dr. Christopher Peterson, and the VIA Survey for Youth, which is for ages ten through seventeen and was authored by Dr. Nansook Park. VIA Survey has acceptable internal consistency and test-retest reliability and has been taken more than 1.5 million times.34

The next and final section is devoted to representing our integration of narrative therapy and positive psychology with sexual abuse survivors and self-help recommendations used in a case study.

CASE STUDY

Lily was a fifteen-year-old teenager who was brought to therapy by her mother for help getting through the residual effects of trauma. She looked more mature than her age group, had a lot of makeup on, and dressed pro vocatively. Lily's mother, Emma, was a lawyer, and her father worked for the government. She had two younger siblings, Russ (ten) and Jim (seven).

Lily had gone to therapy for a year, but due to her therapist leaving town, she was transferred to me (ZSS). According to her mother, Lily's previous experience in therapy was not very successful; she continued lying and was very distant from her family. Lily was very quiet in the initial session. Her mother did most of the talking and informed me about what Lily has gone through. Lily was sexually abused from ages twelve to fourteen by Lily's father's friend, who was also their neighbor. The abuser was arrested and sentenced to prison. Emma struggled with much guilt and shame at the same time. She disclosed that she was also raped when she was a teenager. After learning about the assault, Emma became overly protective and was not allowing Lily to have a personal life, which frustrated Lily extremely. While Emma was explaining how learning about her daughter being molested affected her, Lily was staring at the floor and had no emotional response to what was being shared in the session.

I saw Lily alone the rest of the initial session and tried to get more information about the assaults. Lily started sharing her "problem-saturated" description of her story in the first session. In the next couple of sessions, through externalization and finding unique outcomes, I tried to alter this problem-dominated story and create an alternative story. To start the ex-ternalization process, I started by asking Lily how this abuse affected her.

Seda: From what I am hearing from you, I understand that you would like to get some help with how to deal with these traumatic events. Can you tell me more about how this abuse had an effect on you?

Lily: I don't trust people now, and I don't care if I have friends or not.

Seda: So the abuse that you have experienced made you not trust people and not worry about if you have close friends or not. How else have these traumas played a role in your life?

Lily: I can get any boy in the school I want. I don't care if they like me or not but when we go to the bathroom, I can make them happy and get attention from them.

Seda: It sounds like the abuse has affected your sexuality and how you relate to the opposite sex. How did these traumas affect other aspects of your life or your relationships?

Lily: It definitely made my mom stricter. She does not let me hang out with friends or stay over at any friends' houses. She checks my cell phone and does not let me go on the Internet. So it really affected how she treats me. It was not this bad before.

Seda: Has your father been affected by your traumas?

Lily: I think it made him feel very guilty. Since it was his friend who made me touch him, I think he feels that all this is his fault.

Here I realized that Lily was having a hard time externalizing the abuse and putting a name to it. She was also having a hard time naming her feelings when I asked about the effects, and it seemed that she was very numb about how these abusive experiences affected her. She was very withdrawn and mistrustful of adults.

Problem-saturated stories have become like her identity, and it was hard for her to see any alternative stories being created. At this point, I decided to ask her to take the character strengths questionnaire online. Previous research shows that integrating character-strengths assessment and recovery work with veterans has been a successful avenue for specifying and promoting the goals of recovery.35 Therefore, we suggest that it would be beneficial for the therapists to integrate the character-strengths work while working with sexual abuse survivors in the narrative therapy approach.

Lily came the following week with the results of the questionnaire. The top five character strengths of the VIA inventory are called the signature strengths. Here is how we started talking about them and integrating them with narrative therapy.

Seda: So how has taking this test been for you? What do you think about the results?

Lily: It was pretty cool. I like taking tests online. It's fun.

Seda: What have you learned from the results? What were your top five strengths? We will call them "the signature strengths," okay?

Lily: Okay. I had love of learning, bravery, curiosity, humor, and kindness as my top five.

Seda: That's great. Do you think that your friends would use similar words to describe you if I asked them to talk about you?

Lily: I guess so, I love reading books, and they always say I am funny, so I guess they would agree.

Seda: Well, for the next five weeks what I would like you to do is to practice using these top five strengths in different ways.

Lily: What do you mean in different ways?

Seda: That is a great question. The reason that you have these signature strengths as your top five is because you use them more than the other strengths. So it doesn't mean that you don't have the strengths that are in the bottom, you just don't use them as your signature strengths. I would like you to try using your signature strengths in different ways than you usually do. To help you to do this I am going to give you a print-out, which is going to give you some ideas as well . . .

Here, the purpose is trying to step away from the problem-saturated story of her life and explore some untold aspects of her. Research has shown that identifying character strengths and using them in new ways had long-term positive effects on happiness.36 Here is the link to the 340 Ways to Use VIA Character Strengths exercise.37

With the help of using character strengths, it was easier to identify unique outcomes and clearer for Lily to see that she had so many strengths, which would assist her with forming her alternative story. I shared with her research about trauma survivors following the national crisis on September 11. We talked about how these individuals demonstrated an increase of gratitude, hope, kindness, leadership, love, spirituality, and teamwork after the attack.38

Adding character-strengths perspective to the existing narrative therapy approach also can reduce negative family interactions. Since both authors are family therapists, we propose to use character-strengths work in the family context. The following is an excerpt from the sixth session with Lily, where I invited her mother, Emma, her father, Greg, and her brothers, Jim and Russ, for a session.

Seda: I bet you are all wondering why I brought all of you guys here. Today I planned a different and fun activity for all of us. It is pretty simple. We will take turns pulling a piece of paper from this bag. Each paper has words written on it, and we are going to read them out loud. There will be explanations of the words, which are actually the strengths that we use in our lives. So, when we read the strength and the explanation, I will ask each one of you who uses this strength the most in the family. I think it will be pretty fun. Shall we start? Okay, why don't you go first, Jim, and pick a piece from the bag.

Jim: "Curiosity: Taking an interest in all ongoing experiences, finding all subjects and topics fascinating, exploring, and discovering."

Seda: So, who do you think uses their curiosity strength most in this family, Jim?

Jim: I guess Russ is very interested in video games. He always wants to find new games and learns them very quickly and teaches me.

Seda: That is a great example, Jim. Thank you very much. Does anyone have any other ideas about who uses their curiosity strength in the family?

Greg: I think Emma is pretty curious about cooking and trying new recipes, which I really like (laughs), and Lily has an interest in mascaras. I think she has tried every one of the brands in the market (laughs).

Seda: Thank you very much, Greg. How about you choose the next strength?

Greg: "Open-mindedness: Thinking things through and examining them from all sides; not jumping to conclusions; being able to change one's mind in light of evidence; weighing all evidence fairly."

Emma: I think most of us do not use this strength much. Everybody here thinks they know it all, and nobody changes their minds no matter how much we argue.

Seda: That is a very good point, Emma. Thank you very much for bringing that up. Actually, we all have all of these strengths, but what makes us different is the amount we use them. I hear that you are saying you do not use your open-mindedness strength as much as the other strengths you have. Is that correct?

Emma: Yeah, we jump to conclusions about what the other thinks and stop listening to them.

Greg: I agree with Emma. I think that is something we need to work on.

Seda: That is a great goal as a family—to focus on the strengths that you do not use as much as the other ones. We can come back to this and decide how you can work on the strengths that you want to cultivate more. How about you choose another one, Lily?

Lily: "Humor: Liking to laugh and tease; bringing smiles to other people; seeing the light side; making (not necessarily telling) jokes." Oh, this is totally dad. He teases us all the time. And I think Russ is picking up on it and sometimes can be pretty funny.

Jim: I know, he told me a joke the other day, and when I told it in school, the boys really liked it a lot.

Seda: I can see that as a family, you use humor a lot and there is a very playful approach to life. After we finish picking from the bag, we can talk about how we can use the strengths that we already use more. In addition, at the end of the session, I am going to give you homework, which will be to use one of your own strengths during the next week.

During the family session, Lily was very engaged, enjoyed herself, and saw that her family was very supportive. Recruiting other family members in the creation of an alternative story by using character strengths has been very successful in our practices.

In another session, Lily shared with me about being anxious and not being able to relax. An intervention that can be used in therapy sessions with sexual abuse survivors is teaching mindfulness meditation to let them to take charge of their breathing. Research shows significant positive changes in the brain and immune system as a result of eight weeks of mindfulness meditation training.39 In this randomized, controlled study, results indicated that "meditation can produce increases in relative left-sided anterior activation that are associated with reductions in anxiety and negative affect and increases in positive affect" (pg. 569). In a three-year follow-up study, scientists showed that mindfulness meditation has constructive long-term effects on individuals, such as improvements in symptoms of anxiety and decreases in depressive symptoms.40

MINDFULNESS MEDITATION EXERCISE

Here is a beginner's mindfulness meditation exercise that we teach our clients; we ask them to continue doing the exercise at home as well. We do this exercise in the session with them to show them how to apply it.

I would like you to sit in a comfortable position and place your hands on your lap. Please close your eyes fully or partially, however you like, and take a couple of deep breaths to relax.

• Now I'd like you to bring your attention to your breathing and just to your breathing. Turn your attention to how your belly and chest are filling with air . . . where the air is traveling.

• I'd like to you to think about how a bottle is filled, starting from bottom to top, and how it gets emptied, from top to bottom. This is how you are going to try breathing.

• Start with the expansion of your belly with every in-breath and then moving to your chest. With every out-breath the contraction starts from your chest and then moves to your belly.

• Now try inhaling and exhaling, paying attention to your breath. It might feel a little different than your typical breathing pattern, which will take some time for you to adjust.

• Pay attention to your breathing. Different thoughts will arise and distract you from paying attention to just your breathing. This is very normal. What I want you to do is just gently bring your attention to your breathing. This is our exercise. Exercise bringing the attention to breathing.

• Your mind might start wandering away; just gently bring your attention back to your breathing.

• I'm going to do this with you for the next ten minutes, breathing in and out. My mind will wander away, and I'll be trying to bring my attention back to my breathing. At the end of ten minutes, I will ask you open your eyes when you are ready.

Lily said that she felt relaxed after doing the meditation, and I advised her to practice this two times each day. In the following sessions, we continued to deconstruct her problem-saturated story by emphasizing her strengths and creating a survivor narrative. Focusing on strengths has allowed her to find unique outcomes more easily and reauthor her alternative story.

CONCLUSION

When individuals experience trauma, a shift to their perception of themselves and the world is likely. It is an extensive therapy process to view oneself as a survivor rather than a victim. A narrative therapy approach allows individuals to rewrite their experiences by enabling them to create a new personal narrative, outside being a "victim of abuse." Integrating character-strengths work allows the individuals to look at what is working in their lives and what they are good at. Using narrative therapy, clients can deconstruct their problem-saturated story through externalization and mapping the influence of the problem. When individuals can separate from the problems, they can explore unique outcomes and reauthor their alternative story. Incorporating character-strengths investigation and cultivation into the narrative therapy process can make the results more efficient and supportive of clients. In conclusion, combining narrative therapy with positive psychology can allow individuals to externalize their problems and internalize their strengths.

RECOMMENDATIONS

As previously mentioned in this chapter, the mindfulness breathing exercise and completion of the strengths inventory can be useful in managing the sexual abuse symptoms and exploring aspects of the self unrelated to the abusive experience. In addition, the integration of the narrative component with the character strengths can be practiced and supported by creating a "strengths scrapbook." Survivors can build a scrapbook album depicting the times and experiences in which they used their strengths, including images, words, and drawings to capture their stories. Through this activity, the survivors can identify their values that have continued despite what they have experienced, as well as acknowledge the positive traits and qualities in themselves over time and in experiences not related to the abuse. The pages then become artifacts of the recovery process, documenting the alternative stories and highlighting the demonstrated strengths of the survivor. In this way, the survivor's journey can be visualized and complemented by the created pages, signifying successes and progress in recovery and hence, further empowering survivors.

REFERENCES

1. Krause, E., DeRosa, R., & Roth, S. (2002). Gender, trauma themes, and PTSD: Narratives of male and female survivors. Gender and PTSD (pp. 349-381). New York: Guilford Press. Retrieved from PsycINFO database.

2. Leahy, T., Pretty, G., & Tenenbaum, G. (2003). Childhood sexual abuse narratives in clinically and nonclinically distressed adult victims. Professional Psychology: Research and Practice, 34, 657-665.

3. Breckenridge, J. (1999). Subjugation and silences: The role of the professions in silencing victims of sexual and domestic violence. In J. Breckenridge & L. Laing

(Eds.), Challenging silences: Innovative responses to sexual and domestic violence (pp. 6-30). St. Leonard's, Australia: Allen & Unwin.

4. Hunter, S.V. (2010). Evolving narratives about childhood sexual abuse: Challenging the dominance of the victim and survivor paradigm. The Australian and New Zealand Journal of Family Therapy, 31, pp. 176-190.

5. Dunn, J. (2005). 'Victims' and 'survivors': Emerging vocabularies of motive for 'battered women who stay.' Sociological Inquiry, 75(1), 1-30. Freedman, J. & Combs, G. (1996). Narrative therapy: The social construction of preferred realities. New York: W.W. Norton & Company.

6. Jenkins, P. (1998). Moral panic: Changing concepts of the child molester in modern America. New Haven, CT: Yale University Press.

7. Phillips, A., & Daniluk, J.C. (2004). Beyond 'Survivor': How childhood sexual abuse informs the identity of adult women at the end of the therapeutic process. Journal of Counseling & Development, 82(2), 177-184.

8. Monk, G., Winslade, J., Crocket, K., & Epston, D. (Eds.). (1997). Narrative therapy in practice: The archeology of hope. San Francisco: Jossey-Bass.

9. Freedman, J., & Combs, G. (1996). Narrative therapy: The social construction of preferred realities. New York: W.W. Norton & Company.

10. McKenzie, A. (2005). Narrative-oriented therapy with children who have experience sexual abuse. Envision: The Manitoba Journal of Child Welfare, 4, 17-29.

11. White, M., & Epston, D. (1990). Narrative means to therapeutic ends. New York: Norton.

12. Brooks, G. (2010). Creating a narrative therapy workbook for children who have experienced extra-familial sexual abuse and their parents. Dissertation Abstracts International, 70, Retrieved from PsycINFO database.

13. White, M. (2006). Working with people who are suffering the consequences of multiple trauma: A narrative perspective. In D. Denborough. (Ed.) Narrative responses to traumatic experiences (pp. 25-85). Adelaide, S. Australia: Dulwich Centre Publications.

14. White, M. (2007). Maps of narrative practice. New York: W.W. Norton & Company Inc.

15. Baird, F. (1996). A narrative context for conversations with adult survivors of childhood sexual abuse. Progress-Family Systems Research and Therapy, 5, 51-71.

16. Reavey, P., & Warner, S. (2001). Curing women: child sexual abuse, therapy, and the construction of femininity. International Journal of Critical Psychology, 3, 49-72.

17. Adams-Westcott, J., & Dobbins, C. (1997). Listening with your "Heart's Ears" and other ways young people can escape the effects of sexual abuse. In C. Smith & D. Nylund (Eds.), Narrative therapies with children and adolescents (pp. 195-220). New York: The Guilford Press.

18. Durrant, M., & White, C. (1990). Ideas for therapy with sexual abuse. Adelaide: Dulwich Centre Publications.

19. Sahin, Z.S., & McVicker, M. (2009). The use of optimism in narrative therapy with sexual abuse victims. Journal of European Psychology Students, 1, 1-6.

20. White, M. (1989). Negative explanation, restraint, and double description: A template for family therapy. In M. White (Ed.), Selected papers (pp. 85-100). Adelaide: Dulwich Centre Publications.

21. Seligman, M.E.P., & Csikszentmihayli, M. (2000). Positive psychology: An introduction. American Psychologist, 55, 5-14. doi:10.1037//0003-066X.55.1.5

22. Seligman, M.E.P. (2002). Authentic happiness. New York: Free Press.

23. Sin, N.L., & Lyubomirsky, S. (2009). Enhancing well-being and alleviating depressive symptoms with positive psychology interventions: A practice friendly meta-analysis. Journal of Clinical Psychology: In Session, 45, 467-487. doi:10.1002/ jclp.20593

24. Peterson, C., & M.E.P. Seligman. (2004). Character strengths and virtues: A classification and handbook. Washington, D.C.: American Psychological Association.

25. Kendall-Tackett, K.A., Williams, L.M., & Finkelhor, D. (1993). Impact of sexual abuse on children: A review and synthesis of recent empirical studies. Psychological Bulletin, 113, 164-180.

26. Swenson, C.C., & Hanson, R.F. (1998). Sexual abuse of children: assessment, research, and treatment. In J.R. Lutzker (Ed.), Handbook of child abuse research and treatment. Issues in clinical child psychology (pp. 475-499). New York: Plenum Press.

27. Zurbriggen, E.L., & Freyd, J.J. (2004). The link between childhood sexual abuse and risky sexual behavior: The role of dissociative tendencies, information-processing effects, and consensual sex decision mechanisms. In L.J. Koenig, L.S. Doll, A. O'Leary, & W. Pequegnat (Eds.) From Child Sexual Abuse to Adult Sexual Risk: Trauma, Revictimization, and Intervention (pp. 135-158). Washington, D.C.: American Psychological Association.

28. Isen, A.M., & Daubman, K.A. (1984). The influence of affect on categorization. Journal of Personality and Social Psychology, 47, 1206-1217.

29. Isen, A.M., Daubman, K.A., & Nowicki, G.P. (1987). Positive affect facilitates creative problem solving. Journal of Personality and Social Psychology, 52, 11221131.

30. Fredrickson, B.L. (1998). What good are positive emotions? Review of General Psychology: Special Issue: New Directions in Research on Emotion, 2, 300-319.

31. Fredrickson, B.L. (2004). The broaden and build theory of positive emotions. Philosophical Transactions of the Royal Society of London, 359, 1367-1377. doi:10.1098/rstb.2004.1512

32. Dahlsgaard, K., Davis, D., Peterson, C., & Seligman, M.E.P. (2003). Do character strengths really matter? A prospective longitudinal study of signature character strengths and adolescent development. Poster presented at the 2003 Biennial Meeting of the Society for Research in Child Development, April 10, Tampa, FL.

33. Park, N., & Peterson, C. (2006). Moral competence and character strengths among adolescents: The development validation of the Values in Action Inventory of Strengths for Youth. Journal of Adolescence, 29, 891-909. doi:10.1016/j .adolescence.2006.04.011

34. VIA Strengths Inventory. (2010). Retrieved September 28, 2010 from http:// www.viacharacter.org/Surveys/SurveyCenter.aspxfgfg

35. Resnick, S.G., & Rosenheck, R.A. (2006). Recovery and positive psychology: Parallel themes and potential synergies. Psychiatric Services, 57, 120-122. doi: 10.1176/appi.ps.57.1.120

36. Seligman, M.E.P., Steen, T.A., Park, N., & Peterson, C. (2005). Positive psychology progress: Empirical validation of interventions. American Psychologist, 60, 410-421. doi:10.1037/0003-066X.60.5.410

37. Rashid, T., & Anjum, A. (2010). 340 ways to use VIA character strengths. Retrieved September 28, 2010 from http://education.ucsb.edu/janeconoley/ed197/ documents/WaystouseSignStrengthsFilms.pdf

38. Peterson, C., & Seligman, M.E.P. (2003). Character strengths before and after September 11. Psychological Science, 14, 381-384. doi: 10.1111/1467-9280.24482

39. Davidson, R.J., Kabat-Zinn, J., Schumacher, J., Rosenkranz, M., Muller, D., San-torelli, S., et al. (2003). Alterations in brain and immune function produced by mindfulness meditation. Psychosomatic Medicine, 65(4), 564-570.

40. Miller, J.J., Fletcher, K., & Kabat-Zinn., J. (1995). Three-year follow-up and clinical implications of a mindfulness meditation-based stress reduction intervention in the treatment of anxiety disorders. General Hospital Psychiatry, 17(3), 192-200.

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