Adult client remembers father french kissing her at a young age, but nothing else? Does french kissing qualify as sexual trauma/abuse?

[NewTherapist1964]

Client says she thinks she was 5 or 6 when her father and her french kissed, she believes more than once. Does not remember it being traumatizing or forced at all. Did not understand it was inappropriate until much much later.

Despite claiming the memory is not traumatic to her, client appears embarassed when discussing it, and also claims that the reason she barely ever sees her father is that she does not want to and experiences intense discomfort and "awkwardness" around him (which she attributes to feeling guilty about how he was treated by her abusive mother growing up, and how she was too scared to ever defend him even though she knew he was being abused by client's mother -- client also reports being forced as an adolescent to demean and belittle father during her mother's rages at him, and to call family members and say bad things about her father, which she hated and did not believe but did to protect herself from her mother's extreme rage)

Client expresses confusion that it "never went further" with her father. And feels that french kissing isn't serious enough to warrant serious attention, but also admits to feeling uncomfortable about it. Has tried to remember more and admits that it would almost be a relief if something else had happened because it would justify her discomfort around him.

Client reports always being closer to mother, despite her mother being unstable and abusive and her father being "always kind." Client also reports that father once claimed his own father raped his sister (client's aunt) as a child. But apparently father later retracted statement.

Does any of this sound typical to you? I have never had a case like this.

Client's main issues and goals revolve around self worth (extremely low at the moment), developing boundaries (nonexistent right now), and distancing from abusive, enmeshed relationship with mother, but also feels very confused about what happened with her father and unsure how to navigate relationship with him in the present. Frankly, I am confused too. How would you handle?

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[NewTherapist1964]

My young adult client reports father french kissing her as a young child, but client denies anything else happening. Is this common? How would you conceptualize/handle? Would you consider this sexual abuse?

Client says she did not even think about or realize this experience was inappropriate until she was in college and mentioned it to a friend and then a therapist. Client also denies that the experience was traumatizing, not understanding it was abnormal.

Despite claiming the memory is not traumatic to her, client appears uncomfortable when discussing it, and also claims that the reason she barely ever sees her father is that she does not want to and experiences intense discomfort and "awkwardness" around him (which she attributes to feeling guilty about how he was treated by her abusive mother growing up, and how she was too scared to ever defend him even though she knew he was being abused by client's mother -- client also reports being forced as an adolescent to demean and belittle father during her mother's rages at him, and to call family members and say bad things about her father, which she hated and did not believe but did to protect herself from her mother's extreme rage)

Client expresses confusion that it "never went further" with her father. And feels that french kissing isn't serious enough to warrant serious attention, but also admits to feeling uncomfortable about it. Has tried to remember more and admits that it would almost be a relief if something else had happened because it would justify her discomfort around him.

Client reports always being closer to mother, despite her mother being unstable and abusive and her father being "always kind." Client also reports that father once claimed his own father raped his sister (client's aunt) as a child. But apparently father later retracted statement.

Does any of this sound typical to you? I have never had a case like this.

Client's main issues and goals revolve around self worth (extremely low at the moment), developing boundaries (nonexistent right now), and distancing from abusive, enmeshed relationship with mother, but also feels very confused about what happened with her father and unsure how to navigate relationship with him in the present. Frankly, I am confused too. How would you handle?

 

[cara susanna]

Imo qualifying as sexual abuse depends on how old she was when it began and her ability to consent, as well as a consideration of the power dynamics. Was she tricked into doing this? Coerced? Did she feel pressure to comply?

In terms of qualifying event for PTSD, generally for events like forced kisses etc I would think about credible fear that the situation would go further (e.g., rape). So for this specifically as you described, I would lean towards no.

Edit: Also, I would try to suss out if the discomfort is stemming from her realizing now that this was not societally condoned, or more the nature of the incident itself.

In terms of treatment, I would explore her beliefs around the incident and how it's changed her views of herself, others, and the world. What matters most is what she makes of it now, and how it's impacting her everyday life. I really like CPT for this sort of thing and have used it in situations where there was incest that was not legally consensual, that the patient didn't really recognize as non-consensual or find upsetting at the time, and now causes negative emotions like shame or guilt as well as impact to relationships. When I offer this I do emphasize to the patient that it may not be the 100% best fit. I should add though I would only offer CPT if it's criterion A, otherwise you would want to do more general CBT.

 

[NewTherapist1964]

Imo qualifying as sexual abuse depends on how old she was when it began and her legal ability to consent to sexual activity, as well as a consideration of the power dynamics. Was she tricked into doing this? Coerced? Did she feel pressure to comply?

In terms of qualifying event for PTSD, I would say no. Generally for events like forced kisses etc I would think about credible fear that the situation would go further (e.g., rape).

Client believes she was probably about 5 or 6 years old. It stopped shortly after that it seems. She never thought about the incidents much and honestly thought it was fairly normal for little girls and dads to kiss with tongue (as normal as play wrestling which they also did frequently at that age) until she went away to college and started rethinking those early memories and offhandedly mentioned it to a friend.

The only thing that gives me pause is her aversion towards being around her father (even talking to him on the phone gives her anxiety) but she agrees with you that she was not traumatized by the french kissing. It is unlikely that anything else happened that she does not remember, right? I of course would never ever suggest that but client herself has occasionally wondered why it didn't go further.

As for the kisses, they were not forced, in client's memory it was "consensual" though client was only 5 or 6 years old with no understanding of the inappropriateness of it.

Client is definitely not interested in reporting event, and claims to love her father and feel sorry for him, and not angry, but is unable to tolerate even talking to him on the phone. Client is confused about if event is serious or not and if she has an obligation to her father to be in his life even though it makes her so anxious.

 

[cara susanna]

If it started at age 5 or 6 I would say it's sexual abuse no matter if she perceived it as such at the time. Her aversion to her father could be due to the incident, her body may be reacting even if she doesn't cognitively view it as traumatic. However, she doesn't have to feel traumatized by it, and it's okay for her to have complex feelings about it. I don't think it's even necessary to really address it in therapy unless it's part of her treatment goals or impacting her everyday life/relationships.

 

[NewTherapist1964]

Imo qualifying as sexual abuse depends on how old she was when it began and her ability to consent, as well as a consideration of the power dynamics. Was she tricked into doing this? Coerced? Did she feel pressure to comply?

In terms of qualifying event for PTSD, generally for events like forced kisses etc I would think about credible fear that the situation would go further (e.g., rape). So for this specifically as you described, I would lean towards no.

Edit: Also, I would try to suss out if the discomfort is stemming from her realizing now that this was not societally condoned, or more the nature of the incident itself.

In terms of treatment, I would explore her beliefs around the incident and how it's changed her views of herself, others, and the world. What matters most is what she makes of it now, and how it's impacting her everyday life. I really like CPT for this sort of thing and have used it in situations where there was incest that was not legally consensual, that the patient didn't really recognize as non-consensual or find upsetting at the time, and now causes negative emotions like shame or guilt as well as impact to relationships. When I offer this I do emphasize to the patient that it may not be the 100% best fit. I should add though I would only offer CPT if it's criterion A, otherwise you would want to do more general CBT.

Thank you so much! So basically since it doesn't qualify as criterion A I should just do general CBT with this patient? The other issue this patient has is continual incest, rape and abuse fantasies and desires to be the victim in these fantasies but I know these can be normal and unrelated to trauma.

Anyway, I just don't know how to validate the client without over-emphasizing something that may be non-important. She has extremely low self esteem in general and seems to feel her experiences are never "bad enough" and feel embarrassed and guilty for feeling hurt and for struggling in life. I worry that by playing off her experience as non-serious I am reinforcing the idea that she herself doesn't matter and her experiences and feelings are insignificant and minor. Is that a valid concern on my part?

 

[AcronymAllergy]

Mod Note: I've merged the threads, as they appear to be discussing the same topic and case.

 

[R. Matey]

If it started at age 5 or 6 I would say it's sexual abuse no matter if she perceived it as such at the time. Her aversion to her father could be due to the incident, her body may be reacting even if she doesn't cognitively view it as traumatic. However, she doesn't have to feel traumatized by it, and it's okay for her to have complex feelings about it. I don't think it's even necessary to really address it in therapy unless it's part of her treatment goals or impacting her everyday life/relationships.

Unequivocally. In states where I've worked, this kind of behavior is a sex crime.

 

[smalltownpsych]

Thank you so much! So basically since it doesn't qualify as criterion A I should just do general CBT with this patient? The other issue this patient has is continual incest, rape and abuse fantasies and desires to be the victim in these fantasies but I know these can be normal and unrelated to trauma.

Anyway, I just don't know how to validate the client without over-emphasizing something that may be non-important. She has extremely low self esteem in general and seems to feel her experiences are never "bad enough" and feel embarrassed and guilty for feeling hurt and for struggling in life. I worry that by playing off her experience as non-serious I am reinforcing the idea that she herself doesn't matter and her experiences and feelings are insignificant and minor. Is that a valid concern on my part?

A parent crossing boundaries like that is often extremely problematic whether the patient is aware of it or not. Typically a remembered incident is just the tip of the iceberg. The continued fantasies and desires point to this as well. Also, like trauma cat has taught me, just because you can’t remember the bad things that happened and articulate them doesn’t mean that they didn’t affect you. I would be surprised if this patient didn’t have NSSI and suicidality, or substance abuse to deal with the dysfunction. I’m thinking DBT and eventually trauma therapy as you and the patient realize that they were in fact traumatized and probably a lot worse than what they remembered I could be wrong and there are times when the pattern doesn’t fit what I have seen 100s of times, but usually not.

 

[Justanothergrad]

yes.