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 Healthcare Training Institute - Quality Education since 1979CE for Psychologist, Social Worker, Counselor, & MFT!! 
  
  
 
 Section
      7 
  
Victimization 
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In the last section, we discussed survivor guilt and other
    self-destructive behaviors arising from it such as:  self-mutilation,
    substance addiction, and eating disorders. 
In this section, we will examine the three levels of victimization
    regarding shattered assumptions, secondary wounding, and victim thinking.  We will present PTSD resulting from sexual abuse and natural
    disasters. 
     
    3 Levels of Victimization  
♦ #1 Shattered Assumptions 
  The first level of victimization is shattered assumptions.   Often,
  such traumatic events as tornadoes, hurricanes, or flash floods upheave conceptions
  that clients once had about themselves and their lives such as invulnerability,
  an image of an orderly world, and a positive self-image.  Most
  clients grow up with the idea that something terrible could
  never happen to them.   
   
  When a crisis does occur, however, this assertion
  is thrown out the window.  When the assumption of an orderly world is
  challenged, clients conclude that life is meaningless and
  incomprehensible or that fate singled them out for punishment.   
   
  Sheryl,
  a PTSD client I was treating, suffered from the loss of her orderly world.  From
  the age of 8 to 11, Sheryl’s uncle had sexually abused her.  When
  she finally told her parents about the abuse at the age of 16, they considered
  the abuse unimportant and her uncle’s wife accused
  Sheryl of lying and trying to break up the family.   
   
  Years later, at 20,
  Sheryl was involved in a traumatic car accident which her aunt attributed as
  her punishment for her lies.  A member of Sheryl’s church also saw
  the accident as Sheryl’s punishment for having orgasms
  during the incest and for not forgiving her abuser.   
   
  Consequently, Sheryl
  suffered from a loss of positive self-image and considered herself a dirty
  and unworthy person who even God hated.  At the end of this section I will
  explain how the Primary Effects technique was beneficial to Sheryl. 
♦ #2 Secondary Wounding 
  The second level of victimization is secondary wounding.   Secondary
  wounding results from the negative effects of other people
  in the client’s life.   Such attitudes that encompass secondary
  wounding are: "You weren’t injured enough to be
  entitled to benefits" or "It happened weeks or
  years ago.  You should be over it by
  now."  These attitudes augment the pain already
  suffered by trauma survivors.   
   
  Recall the story of Sheryl that
  we related earlier on in this section.  Her parent’s apathy towards
  her abuse, her aunt's attacks, and her friend’s belief that she deserved
  the accident are all examples of secondary wounding.   
   
  There
  are three forms of secondary wounding:  
  -- 1. Disbelief, Denial, or Discounting  
  The
  first, disbelief, denial, or discounting, occurs when others belittle the
  effects of the client’s trauma.  After Hurricane Katrina, Ronaldo,
  a concert pianist, was told that three of his fingers were
  to be amputated. He began to cry, but the nurse told him, "Hush
  now, you big crybaby.  Look around you.  Bed number one lost his
  arm and bed two has to have both legs removed.  Count your blessings."  
  -- 2. Blaming the Victim  
  The
  second type of secondary wounding, blaming the victim, is
  much like what happened in Sheryl’s story in which her friend blamed
  her for the accident.  
  -- 3.  Stigmatization  
  The third type of secondary wounding, stigmatization,
  occurs when others judge the client negatively for normal
  reactions to the traumatic event.   
   
  These judgments can take several forms:   
  a. Condescension toward the survivor;  
  b. Misinterpretation of the survivor’s psychological
  distress;  
  c. Implication that the survivor’s symptoms reflect
  his or her desire for financial gain, attention, or unwarranted sympathy; 
  or 
  d. Punishment of the victim rather than the offender.   
♦ Technique:  Primary Effects of Secondary Wounding 
  To help Ronaldo and Sheryl cope with the effects of their secondary wounding,
    I asked them to complete an exercise in their journals that I call "Primary
    Effects of Secondary Wounding."   
     
    I asked both of them
    to answer the following questions concerning the various situations in which
    they encountered secondary wounding: 
  
    - Did it alter your views of your social, vocational, and
      other abilities?
 
    - Did it change your attitudes towards certain types or
      groups of people and/or certain government and social institutions? 
 
    - Were your religious or spiritual views affected?
 
    - Did it affect your family life, friendships, or other
      close relationships?
 
    - Did it alter your ability to participate in groups or
      belong to associations or your attitudes towards the general public?
 
    - Now, review the attitudes you just listed and ask yourself, "Which
      of these attitudes do I wish to retain?  Which of
      them are in my best interest to reconsider?  Which
      ones would I like to discard because they hamper my life
      in the present?"
 
   
 
♦ #3 Victim Thinking                                                                             
  In addition to shattered assumptions and secondary wounding, the third level
    of victimization is victim thinking.  This occurs when
    a client acts and speaks as though they are still a victim when in fact the
    danger has been removed.  States Dr. Barry McCarthy, "The third
    level of victimization involves the person adopting a lifelong label as
    a victim."   
     
    In essence, the traumatic event and its aftermath
    becomes the central theme in the client’s
    life, negating all other experiences.  The feelings
    of hopelessness, helplessness, defilement and betrayal embody victim thinking.    
     
    There
    are four sources of victim thinking:   
  
    - Intolerance of mistakes in others and in self.  During
      traumatic events, even the tiniest of mistakes can result in death or injury.  Those
      suffering from victim thinking begin to adopt this mindset and may soon
      develop into perfectionists.
 
    - Denial of personal difficulties.  Those working
      in such fields as medicine, combat, or rescue work come in contact with
      traumatic events day after day.  Because their occupations demand solid and calm
      thinking, they develop a mindset that any display of emotional weakness renders
      them incompetent for their job.  As a result, they start to downplay
      their fear.
 
    - All-or-nothing thinking.  Clients
      suffering from PTSD that are encased in this mindset begin to see issues
      as good or bad, friends or enemies.  Children, teens,
      and young adults tend to suffer the most from this mindset.  
 
    - Continuation of survival tactics.  Because some clients
      are still stuck in the emotional victim gear, they continue the
      survival tactics they utilized during the trauma in their everyday lives.  For
      instance, if their survival tactic was anger, a PTSD client
      with a victim thinking mindset of continuation of survival tactics will
      use seem easily irritated or angered.
 
   
 
In this section, we discussed the three levels of victimization:  shattered
    assumptions, secondary wounding, and victim thinking. 
In the next section, we will present the effects of triggers
    on PTSD clients and also various types of triggers:  anniversary triggers,
    current stresses, and bodily triggers. 
    Reviewed 2023     
     
    Peer-Reviewed Journal Article References:  
    Assink, M., van der Put, C. E., Meeuwsen, M. W. C. M., de Jong, N. M., Oort, F. J., Stams, G. J. J. M., & Hoeve, M. (2019). Risk factors for child sexual abuse victimization: A meta-analytic review. Psychological Bulletin, 145(5), 459–489.  
     
    Boysen, G. A., & Prieto, L. R. (2018). Trigger warnings in psychology: Psychology teachers’ perspectives and practices. Scholarship of Teaching and Learning in Psychology, 4(1), 16–26. 
     
Callahan, J. L., Maxwell, K., & Janis, B. M. (2019). The role of overgeneral memories in PTSD and implications for treatment. Journal of Psychotherapy Integration, 29(1), 32–41. 
     
Komarovskaya, I., Brown, A. D., Galatzer-Levy, I. R., Madan, A., Henn-Haase, C., Teater, J., Clarke, B. H., Marmar, C. R., & Chemtob, C. M. (2014). Early physical victimization is a risk factor for posttraumatic stress disorder symptoms among Mississippi police and firefighter first responders to Hurricane Katrina. Psychological Trauma: Theory, Research, Practice, and Policy, 6(1), 92–96. 
 
Nguyen-Feng, V. N., Baker, M. R., Merians, A. N., & Frazier, P. A. (2017). Sexual victimization, childhood emotional abuse, and distress: Daily coping and perceived control as mediators. Journal of Counseling Psychology, 64(6), 672–683.  
QUESTION
      7 
  
What are the three levels of victimization? 
To select and enter your answer go to .
     
       
          
         
          
    
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