TY - JOUR PY - 2003// TI - Maintaining an Illusion: Abuse, Somatization, and the Elaboration of Meaning JO - Clinical social work journal A1 - Arnd-Caddigan, Margaret SP - 107 EP - 121 VL - 31 IS - 2 N2 - Many clinicians who have treated adult survivors of abuse have known for some time what is now confirmed by the empirical literature: these clients often suffer from a host of physical complaints for which their doctors tell them there is no physical cause. The symptoms as well as the response of the doctors are frequently quite disturbing to the client. Both aspects of the clients' experiences are also very difficult to treat. Relational theory may provide a perspective that will enhance the understanding of somatization in survivors of abuse. The resulting thesis is that somatization may be the result of deficits in meaning, which are in turn due to conflicts between distinct levels of meaning. This theory weds two previously opposed perspectives: the deficit and conflict models of psychopathology. While the hypothesis may be interesting on the level of pure theory, the ultimate aim of the paper is to apply the theory to the treatment of somatic symptoms among adult survivors of abuse, expanding upon existing interventions. First, the clinician must assess for deficits in the levels of meaning, then utilize interventions appropriate to specific levels. To safeguard that no new conflicts arise, the clinician must ensure that the meanings elaborated in treatment support an integration of meaning on all three levels. To this end, he or she must target interpretations to the client's "zone of proximal meaning." These principles are illustrated in a case example. (Abstract Adapted from Source: Clinical Social Work Journal, 2003. Copyright © 2003 by Springer) Adult Female Adult Survivor Adult Treatment Physiological Victimization Effects Victim Treatment Coping Skills Adult Adjustment Victim Adjustment Emotional Adjustment Female Victim Child Abuse Effects Child Abuse Victim Child Female Child Victim Child Sexual Abuse Effects Child Sexual Abuse Victim Childhood Experience Childhood Victimization Long-Term Effects Psychological Victimization Effects Sexual Assault Effects Sexual Assault Victim 02-04

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