International Journal of Cultic Studies ■ Vol. 10, 2019 51
Recommendations to Clinicians and
Students
Clients who report complex childhood trauma,
particularly ritual and cultic abuse, often present
information in session that seems chaotic and
emotionally charged. Providing clients with a
rationale for both understanding their problem
and the necessary treatment is essential to
achieving positive outcomes. Informing Sarah of
the purpose behind each intervention, each phase
of treatment, and how it related to the
developmental trauma she experienced seemed
to help her tame the chaos that pervaded her
thoughts, feelings, and behaviors.
Sarah was successful in treatment because she
developed rapport with her counselor and
believed that the therapeutic process could help
her. Our sessions were collaborative, and she
was provided the opportunity to alter each
intervention to meet her needs. My experience
with Sarah renewed my belief in the importance
of honoring a client’s voice. As clinicians, we
honor the client by believing their story, and by
acknowledging that they are the expert of their
lives.
Understanding how clients came to experience
the distress and suffering they present in session
is only half of the battle. Clients must be willing
to reexperience difficult emotions and painful
memories in session. As clinicians, we must
provide a framework for helping these clients to
practice new skills and develop new
perspectives.
References
American Psychiatric Association (APA). (2013). Diagnostic and
statistical manual of mental disorders: DSM-5 (5th ed.). Arlington,
VA: American Psychiatric Association.
Beck, J. (1995). Cognitive therapy: Basics and beyond. New York,
NY: Guilford Press.
Bremness, A., &Polzin, W. (2014). Commentary: Developmental
trauma disorder: A missed opportunity in DSM-V. Journal of the
Canadian Academy of Child and Adolescent Psychiatry, 142–145.
Carlson, E., &Putnam, F. (1993). An update on the Dissociative
Experience Scale. Dissociation, 6(1), 16–27.
Cloitre, M., Stolback, B., Herman, J., van der Kolk, B., Pynoos, R.,
Wang, J., &Petkova, E. (2009). A developmental approach to
complex PTSD: Childhood and adult cumulative trauma as
predictors of symptom complexity. Journal of Traumatic Stress,
22(5),1–10.
Felitti, V., &Anda, R. (2010). The relationship of adverse
childhood experiences to adult medical disease, psychiatric
disorders, and sexual behavior: Implications for healthcare. In R.
Lanius, E. Vermetten, &C. Pain (Eds.), The hidden epidemic: The
impact of early life trauma on health and disease (pp. 77–87). New
York, NY: Cambridge University Press.
Goodwin, J. (1993). Sadistic abuse: Definition, recognition, and
treatment. Dissociation: Progress in the Dissociative Disorders,
6(2/3), 181-187.
Herman, J. L. (2015/1992). Trauma and recovery: The aftermath
of violence—from domestic abuse to political terror. New York,
NY: Basic Books.
Levine, P. (1997). Waking the tiger: Healing trauma. Berkeley,
CA: North Atlantic Books.
McCann, I., &Pearlman, L. (1990). Psychological transformation
and the adult survivor: Theory, therapy, and transformation. New
York, NY: Brunner/Mazel.
Miller, A. (2012). Healing the unimaginable: Treating ritual abuse
and mind control. London, UK: Karnac Books.
Noblitt, P., &Noblitt, R. (2008). Redefining the language of ritual
abuse and the politics that dictate it. In P. Noblitt &R. Noblitt
(Eds.). Ritual abuse in the twenty-first century: Psychological,
forensic, social, and political considerations (pp. 21–30). Bandon,
OR: Robert D. Reed.
Noblitt, J., &Perskin, P. (2000). Cult and ritual abuse: Its history,
anthropology, and recent discovery in contemporary America.
Westport, CT: Praeger.
Saakvitne, K., &Pearlman, L. (1996). Transforming the pain: A
workbook on vicarious traumatization. New York, NY: Norton.
Porges, S. (2004). Neuroception: A subconscious system for
detecting threats and safety. Zero to Three, 19–24.
van der Kolk, B. (1996). Dissociation and the fragmentary nature
of traumatic memories: Overview. British Journal of
Psychotherapy, 352–361.
van der Kolk, B. (2005). Developmental trauma disorder: Toward
a rational diagnosis for children with complex trauma histories.
Psychiatric Annals, 35(5), 374–378.
van der Kolk, B., Pynoos, R., Cicchetti, D., Cloitre, M., D’Andrea,
W., Ford, J., &Teicher, M. (2009). Proposal to include a
Developmental Trauma Disorder diagnosis for children and
adolescents in DSM-V. Available online at
http://www.traumacenter.org/announcements/
dtd_papers_oct_09.pdf
Weathers, F., Litz, B., Keane, T., Palmieri, P., Marx, B., &
Schnurr, P. (2013). PTSD Checklist for DSM-5 (PCL-5). From
U.S. Department of Veterans Affairs, PTSD: National Center for
PTSD. Available online at https://www.ptsd.va.gov/professional/
assessment/adult-sr/ptsd-checklist.asp
About the Author
Cortny Stark, LPCC, LADAC, CRC, a 2013
graduate of New Mexico Highlands University’s
Masters of Community Mental Health
Counseling and Rehabilitation Counseling
program, is currently a doctoral candidate,
graduate assistant, and teaching assistant in the
Recommendations to Clinicians and
Students
Clients who report complex childhood trauma,
particularly ritual and cultic abuse, often present
information in session that seems chaotic and
emotionally charged. Providing clients with a
rationale for both understanding their problem
and the necessary treatment is essential to
achieving positive outcomes. Informing Sarah of
the purpose behind each intervention, each phase
of treatment, and how it related to the
developmental trauma she experienced seemed
to help her tame the chaos that pervaded her
thoughts, feelings, and behaviors.
Sarah was successful in treatment because she
developed rapport with her counselor and
believed that the therapeutic process could help
her. Our sessions were collaborative, and she
was provided the opportunity to alter each
intervention to meet her needs. My experience
with Sarah renewed my belief in the importance
of honoring a client’s voice. As clinicians, we
honor the client by believing their story, and by
acknowledging that they are the expert of their
lives.
Understanding how clients came to experience
the distress and suffering they present in session
is only half of the battle. Clients must be willing
to reexperience difficult emotions and painful
memories in session. As clinicians, we must
provide a framework for helping these clients to
practice new skills and develop new
perspectives.
References
American Psychiatric Association (APA). (2013). Diagnostic and
statistical manual of mental disorders: DSM-5 (5th ed.). Arlington,
VA: American Psychiatric Association.
Beck, J. (1995). Cognitive therapy: Basics and beyond. New York,
NY: Guilford Press.
Bremness, A., &Polzin, W. (2014). Commentary: Developmental
trauma disorder: A missed opportunity in DSM-V. Journal of the
Canadian Academy of Child and Adolescent Psychiatry, 142–145.
Carlson, E., &Putnam, F. (1993). An update on the Dissociative
Experience Scale. Dissociation, 6(1), 16–27.
Cloitre, M., Stolback, B., Herman, J., van der Kolk, B., Pynoos, R.,
Wang, J., &Petkova, E. (2009). A developmental approach to
complex PTSD: Childhood and adult cumulative trauma as
predictors of symptom complexity. Journal of Traumatic Stress,
22(5),1–10.
Felitti, V., &Anda, R. (2010). The relationship of adverse
childhood experiences to adult medical disease, psychiatric
disorders, and sexual behavior: Implications for healthcare. In R.
Lanius, E. Vermetten, &C. Pain (Eds.), The hidden epidemic: The
impact of early life trauma on health and disease (pp. 77–87). New
York, NY: Cambridge University Press.
Goodwin, J. (1993). Sadistic abuse: Definition, recognition, and
treatment. Dissociation: Progress in the Dissociative Disorders,
6(2/3), 181-187.
Herman, J. L. (2015/1992). Trauma and recovery: The aftermath
of violence—from domestic abuse to political terror. New York,
NY: Basic Books.
Levine, P. (1997). Waking the tiger: Healing trauma. Berkeley,
CA: North Atlantic Books.
McCann, I., &Pearlman, L. (1990). Psychological transformation
and the adult survivor: Theory, therapy, and transformation. New
York, NY: Brunner/Mazel.
Miller, A. (2012). Healing the unimaginable: Treating ritual abuse
and mind control. London, UK: Karnac Books.
Noblitt, P., &Noblitt, R. (2008). Redefining the language of ritual
abuse and the politics that dictate it. In P. Noblitt &R. Noblitt
(Eds.). Ritual abuse in the twenty-first century: Psychological,
forensic, social, and political considerations (pp. 21–30). Bandon,
OR: Robert D. Reed.
Noblitt, J., &Perskin, P. (2000). Cult and ritual abuse: Its history,
anthropology, and recent discovery in contemporary America.
Westport, CT: Praeger.
Saakvitne, K., &Pearlman, L. (1996). Transforming the pain: A
workbook on vicarious traumatization. New York, NY: Norton.
Porges, S. (2004). Neuroception: A subconscious system for
detecting threats and safety. Zero to Three, 19–24.
van der Kolk, B. (1996). Dissociation and the fragmentary nature
of traumatic memories: Overview. British Journal of
Psychotherapy, 352–361.
van der Kolk, B. (2005). Developmental trauma disorder: Toward
a rational diagnosis for children with complex trauma histories.
Psychiatric Annals, 35(5), 374–378.
van der Kolk, B., Pynoos, R., Cicchetti, D., Cloitre, M., D’Andrea,
W., Ford, J., &Teicher, M. (2009). Proposal to include a
Developmental Trauma Disorder diagnosis for children and
adolescents in DSM-V. Available online at
http://www.traumacenter.org/announcements/
dtd_papers_oct_09.pdf
Weathers, F., Litz, B., Keane, T., Palmieri, P., Marx, B., &
Schnurr, P. (2013). PTSD Checklist for DSM-5 (PCL-5). From
U.S. Department of Veterans Affairs, PTSD: National Center for
PTSD. Available online at https://www.ptsd.va.gov/professional/
assessment/adult-sr/ptsd-checklist.asp
About the Author
Cortny Stark, LPCC, LADAC, CRC, a 2013
graduate of New Mexico Highlands University’s
Masters of Community Mental Health
Counseling and Rehabilitation Counseling
program, is currently a doctoral candidate,
graduate assistant, and teaching assistant in the
