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Mac McClelland - Irritable Hearts

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Child Sexual Abuse / Paris Goodyear-Brown, Abbe Fath, Lori Myers -- Child Sexual Abuse, Traumatic Experiences, and Their Impact on the Developing Brain / Richard L Gaskill, Bruce D Perry -- The Long-Term Health Effects of Child Sexual Abuse / Kathleen Kendall-Tackett -- Assessment. Navigating the System / Patti Van Eys, Bonnie Beneke -- The Forensic Interview / Linda Cordisco Steele -- Developmentally Sensitive Assessment Methods in Child Sexual Abuse Cases / Sandra Hewitt -- Comprehensive and Therapeutic Assessment of Child Sexual Abuse / Patti Van Eys, Alanna Truss -- Evidence-Based Treatments and other Effective Approaches. Determining Best Practice for Treating Sexually Victimized Children / Benjamin E Saunders -- Trauma-Focused Cognitive-Behavioral Therapy / Monica M Fitzgerald, Judith Cohen -- Eye Movement Desensitization and Reprocessing (EMDR) Psychotherapy With Children Who Have Experienced Sexual Abuse and Trauma / Robbie Adler-Tapia, Carolyn Settle, Francine Shapiro -- Trauma-Focused Integrated Play Therapy (TF-IPT) / Eliana Gil -- Parent-Child Interaction Therapy for Sexually Abused Children / Anthony J Urquiza, Dawn Blacker -- Flexibly Sequential Play Therapy (FSPT) With Sexually Victimized Children / Paris Goodyear-Brown -- Child-Parent Relationship Therapy With Nonoffending Parents of Sexually Abused Children / Sue C Bratton, Peggy L Ceballos, Garry L Landreth, Mary B Costas -- Trauma Informed Art Therapy and Sexual Abuse in Children / Cathy Malchiodi -- Group Therapy With Sexually Abused Children / Liana Lowenstein, Rachel Cook Freeman -- Effectively Incorporating Bibliotherapy Into Treatment for Child Sexual Abuse / Deanne Ginns-Gruenberg, Arye Zacks -- Special Issues. Clinical Considerations When Children Have Problematic Sexual Behavior / Jane F Silovsky, Lisa M Swisher, Jimmy Widdifield, Lorena Burris -- Intervention Application for Self-Injury Following Childhood Sexual Abuse / Keegan R Tangeman, Janine Shelby -- Treatment Considerations With Sexually Traumatized Adolescents / Sharon A McGee, C Curtis Holmes -- Understanding and Treating Adolescents With Illegal Sexual Behavior / Susan R Schmidt, Barbara L Bonner, Mark Chaffin -- Cultural Issues in Child Sexual Abuse Intervention and Prevention / Lisa Aronson Fontes, Carol A Plummer -- Working With Survivors of Child Sexual Abuse / Michele M Many, Joy D Osofsky -- Preventing Childhood Sexual Abuse / Sandy K Wurtele, Maureen C Kenny.;A comprehensive guide to the identification, assessment, and treatment of child sexual abuse The field of child sexual abuse has experienced an explosion of research, literature, and enhanced treatment methods over the last thirty years. Representing the latest refinements of thought in this field, Handbook of Child Sexual Abuse: Identification, Assessment, and Treatment combines the most current research with a wealth of clinical experience. The contributing authors, many of whom are pioneers in their respective specialties, include researchers and clinicians, forensic interviewers and law e.

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For Nico

and for Chris

He was on his knees when he did it, but I wasnt doing what I was supposed to be doing at all. Or rather, I was doing what people are supposed to do, which is cry, but not like that, because Id been crying, for hours already, before he slid off the couch where were we sitting, dropped down in front of me, and proposed. Actually Id been crying, chokingsobbing, reallyon and off for three days straight in our rented room in a winter-abandoned wine village. Or actually, since almost the moment Id arrived in France. Or, in fact, since Id been diagnosed seventeen months earlier, when these kinds of episodes became part of my personality, when it became not at all unusual to break down like this. Just that now, something electric bloomed in my gut and shot through my torso, constricting my throat. So I turned my face away from him and cried some more.

Nico did not say Will you marry me? That is not what the French say. A few months before, he had seen the English version of Jerry Maguire for the first time and learned that Tom Cruise had not asked Rene Zellweger if she wanted to marry him as he had in the dubbed French translation Veux-tu mepouser but if she would . Do Americans really say that? hed demanded. Its so aggressive . So hed inquired after my desire instead.

This is as bad as it gets, he said about my crying. But I still want to make my life with you. He said, Even though you tell me this is what youre really like.

Id been telling him that since shortly after we met, a year and a half ago, while he was peacekeeping and I was reporting a story in Haitiwhere Id experienced something that had shaken me such that Id never managed to properly put myself back together. Where two days later Id escaped an isolated room where a stranger stripped down to his undershirt had backed me into a corner and promised me that my father should be worried. Id told Nico that I had nightmares, flashbacks, that I dissociatedan interruption of normal psychological functioning in which my consciousness was suddenly and completely unable to integrate with reality. But he hadnt really seen what that looked like yet.

You tell me this is what youre really like, he said. And I tell you Im still here.

Empirically speaking, he could be forgiven for thinking that I was good wife material. I had a job, and a savings account. Straight As all through school, masters degree, summa cum laude. Culinarily and sexually outgoing. Tall. Healthy hair. Relentlessly on time. Id kept my shit relatively together during a year and a half of brief reunions with him in Dutch hotel rooms, Belgian B&Bs, a borrowed Parisian apartment, rented Riviera or French Caribbean abodes, in cities on the way to one of my assignments or to which hed been deployed. And the few scenes Id caused could be mistaken for jet lag or disoriented fatigue or even a penchant for high relationship drama instead of what they really were: symptoms of post-traumatic stress disorder.

But then the other morning, Id been stepping into our chalet bathtub when I glimpsed myself in the mirror, and paused.

No , I thought. Oh, no.

Changes in self-perception and hallucinationsthose are some of my other symptoms.

Historically, I was on good terms with mirrors, which generally told me that I was lucky for having been born with the long, athletic shape that happened to be popular at the time. But now, the two big mirrors hanging on the walls to the front and side of the bathtub were saying something else.

All I could see was a boy. A flat, weak, castrated, insubstantial fragment of a boy. The curve of my hips seemed medically wrong. Awful. I shouldnt be showing any of this to Nico , I thought urgently. I shouldnt be letting him see this disgusting thing .

I ducked down into the tub, out of sight of the reflection, and pressed my hands into my face.

You are fucking insane , I told myself. You know its not true. Look again.

I hesitated, remaining crouched, nude.

Look at it again.

I popped my head and chest up.

No. Not better. I could see breasts this time, but they were misshapen, meaningless lumps.

I went about turning the water on and washing myself, careful to keep the mirrors out of my line of vision, but by the time I emerged from the bathroom, I was nearly hyperventilating, partly because I was the grossest thing Id ever seen, but mostly because I couldnt convince myself that it wasnt true, even though I knew for a fact that it wasnt. I couldnt trust myself. Id lost all credibility with, of all people, myself. And Id been in rough shape already; the day before, Id woken up incapable of believing in possibility. Can you make a coffee cake? I asked myself on days when I suspected I wasnt mentally well, and when everything in my being responded, No , though everyone knows my blueberry coffee cake is delicious, I knew I wasnt stable, and shouldnt listen to anything else I said.

After the bath, I turned shameful and cold. When I walked into our bedroom, Nico told me I was gorgeous, and I yelled that he was a liar. Started screaming when he tried to touch me, pulling clothes on spastically, strangled by tears. Hurled myself around the kitchen, fuming that wed let a baguette go stale.

I knew that one thing that would help alleviate the grief and fury suddenly charging through my veins was opening up my mouth and throat and screaming and screaming. But I wasnt going to do that in front of another person. As usual, I considered how effective it would be to do myself harm, open my skin up or shatter a bone, perhaps, get a real crisis on my hands, the kind of crisis people I met the world round were uniformly impressed I took in such stride. But even when I was alone, I acknowledged that that was a line I wasnt supposed to crossdoctors ordersand if I did it in Nicos presence, he might have me committed. Half a liter of Johnnie Walker would have done the trick, too, but I didnt consider that, because I didnt have any, and because it was 9 A.M. , so Nico would be alarmed.

Compared with these, crying was the best option. I let it overtake me and flush out, and after I sobbed for hours, I sat an exhausted Nico down. I know Ive been telling you this the whole time weve been together, I said. But now you can see what I mean. Sometimes I cant experience emotion, when I go into self-defensive shutdown. And when I can, it often looks like this. I told him how unpredictable and nonsensical the PTSD triggers could be, how a month ago on a subway platform Id become engulfed by a rage so strong I couldnt take it standing still, honestly fearing that if I hadnt started running up and down the platform my arms would take hold of my left leg and rip it out of my pelvic bone as the first step of my bodys tearing itself to pieces. Just because I missed a train. Even though the next train was coming in seventeen minutes. I told him how when I was in Congo I interviewed people who swore to me that if I didnt help them they would be murdered, and my translator was shaky and breathless, as any normal person would be, and I wasnt. I told Nico that I had days like this all the time, when I could not stop crying, even if I was only watching TV, much less trying to have an intense romantic relationship. Especially once I had already failed the coffee cake test. Then everything flooded in worse, and it wasnt better until it just was, no matter how hard I tried to make it otherwise.

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