Oplevelsen af dissociation efter seksuelle overgreb i barndommen: En hermeneutisk-fænomenologisk undersøgelse af tegnings bidrag til forståelse af oplevelsen af dissociation hos voksne, som har været udsat for seksuelle overgreb i barndommen

Abstract

Background: When a child is subjected to sexual abuse, they can experience a pro-found betrayal that they are unable to process. A common response to such trauma is dissociation, which can persist into adulthood and have devastating consequences for the individual. Despite this, there is still a lack of studies which explore the experience of dissociation among adults who have suffered sexual abuse during childhood. How-ever, few studies on the subject include drawings as a creative method to explore dis-sociation, because it can be complex and challenging for researchers to understand as well as for participants to explain. Purpose: The purpose of this study was to explore how drawing can contribute to the understanding of the experience of dissociation among adults who have been subjected to sexual abuse during childhood. Approach and method: Participants were recruited through Center for Seksuelt Mis-brugte (CSM) in Aalborg and Aarhus, resulting in the inclusion of five research partic-ipants. Through a hermeneutic-phenomenological standpoint we employed a mixed methods approach using drawing, semi-structured interviews, and field notes. The transcriptions were analysed using Interpretive Phenomenological Analysis (IPA) where we also included the drawings and field notes in the analysis. Findings: Through the IPA four themes emerged; “The experience leading up to and preceding dissociation”, “The experience during dissociation”, “The experience follow-ing dissociation” and “Participation in the study”. In the different themes we found descriptions of the sensations prior to, during and after dissociation, including triggers, dissociation as a continuum, detachment, reexperiencing the past, varying degrees of control, exhaustion, amnesia, identity confusion, dissociation as useful among others. Furthermore, some participants exhibited and experienced dissociative responses dur-ing the study, and some found drawing beneficial, while others found it challenging and unpleasant. Discussion: By comparing our findings with previous research, we identified numer-ous similarities in the descriptions of the experience of dissociation. However, we also found that some aspects of our study design and findings stood out from the existing research on the topic. We furthermore broadened our understanding on some of our findings by including relevant theory. Lastly, we discussed the limitations of the study, including the fact that some of the group members volunteer at CSM and our choice to leave out questions about the participants’ history of sexual abuse. Clinical implications and further research: Our findings can in a clinical setting help emphasize the usefulness of drawing having a visual as well as language enhanc-ing potential to foster the understanding of dissociation for both the client as well as the therapist. Furthermore, we suggest that drawing could contribute to desensitizing, and that the possible function of touch can be useful in working with individuals who ex-perience dissociation. We present that future research could explore the extent to which drawing contributes to the understanding of the experience of dissociation. We also see relevance for further research to explore the development in the experience of dissocia-tion over time, and that future research could expand our findings of dissociation as a chronological process by separately investigating the phases presented in the themes in our study. Conclusion: Through this study we got an understanding of the experience of dissoci-ation among adults who have been subjected to sexual abuse during childhood, and we understand that dissociation involves discomfort and disruption to daily functioning for the majority of the participants. Based on our findings, we understand that the experi-ence of dissociation is highly subjective despite several similarities across the descrip-tions. We also understand the experience of dissociation as a chronological process with different phases that involves a before, during and after. We found that partici-pants used their drawings to explain their experiences, and some found it helpful, but for some the act of drawing was causing discomfort and distress. We found that draw-ing prior to the interview potentially served as a language-enhancing tool and gave a visual product that enabled participants to further elaborate on their experiences and allowed us to ask questions about specific aspects of their experience, thereby contrib-uting to a deeper understanding of the experience of dissociation.

A master thesis from Aalborg University

Oplevelsen af dissociation efter seksuelle overgreb i barndommen: En hermeneutisk-fænomenologisk undersøgelse af tegnings bidrag til forståelse af oplevelsen af dissociation hos voksne, som har været udsat for seksuelle overgreb i barndommen

[The experience of dissociation following childhood sexual abuse: A hermeneutic-phenomenological study of the contribution of drawing to the understanding of the experience of dissociation in adults who have been subjected to sexual abuse in childhood.]