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The courage to heal: A guide for women survivors of child sexual abuse (3rd edition)
By Ellen Bass and Laura Davis. Harper Collins Publishers, 1994, 585 pages, $22.50
The courage to heal: A guide for women survivors of child sexual abuse (3rd edition) is an invaluable resource when working with female, adult survivors of childhood sexual abuse. This book takes various therapeutic factors into account such as universality and instillation of hope. These factors are very important in psychotherapy in general, but when it comes to working with survivors of sexual abuse, these factors become absolutely crucial. Bass and Davis’ approach to the book offers hope to readers and assists them in the healing process.
The target population for this book is female survivors of childhood sexual abuse. The language is written in lay terms and is easy to read. Therefore, if the client is of low average intelligence or higher, the use of this book is recommended. The book provides facts about sexual abuse such as behavior patterns of survivors and typical emotional reactions to sexual abuse. Excerpts from survivors are provided throughout the book and it is these excerpts that are the most heartfelt aspects of the book. The facts of sexual abuse are intertwined with survivor experiences and are read with ease. This book would not be recommended for use with clients in the first stages of therapy. The book should be used as a supplement to psychotherapy only after sufficient rapport has been established and the client appears to be ready to address sexual abuse issues. This is recommended because emotionally, some of the contents of the book may be quite difficult to read. Bass and Davis do not take a “sterile” approach to this book in that they are very honest and straightforward regarding sexual abuse. However, The courage to heal should not be used in isolation and the contents of the book should be processed in therapy. Also, it is imperative for clinicians to read the chapters before assigning them to clients. This is recommended due to emotionally-laden content of the material and the clinician must decide whether or not the material is appropriate for the client at that time in therapy.
There are various editions of this book. This particular edition is extensive in that it offers personal stories of survivors at the end of the book. The book is divided into six parts. Each chapter of the book begins with a quote by a survivor. These quotes serve to provide an outline to the chapter as well as a short blurb that could prove to be inspirational to individuals. The first part is titled “Taking Stock.” This consists of recognizing the damage of the abuse as well as recognizing and “honoring” the coping mechanisms that one utilized in order to survive. The second part is “The Healing Process.” This section is one of the more influential and pivotal aspects of the book. It addresses a wide variety of topics such as making the decision to heal, remembering, understanding that it wasn’t your fault, anger, confrontation, and resolution. Clinicians must be advised that many individuals may labor through this section of the book. This is to be expected because the contents of this section are very difficult. For example, the chapter entitled “Understanding That It Wasn’t Your Fault” may be especially difficult because self-blame is very common for survivors of abuse. Also, due to the highly emotional content of this book, clients should not be assigned too much material at one time. It is advisable to assign chapters one at a time and to use this in therapy sessions. The third section (“Changing Patterns”) and the fourth section (“For Supporters of Survivors”) should be used in the latter stages of therapy because it deals with issues that can be important, but are not particularly salient during the acute stages of therapy. Once again, clinical judgment is quite important when deciding what material is appropriate at what time. The fifth section of the book is “Courageous Women.” Like the excerpts provided earlier in the book, these stories contribute to universality and instillation of hope. Finally, the sixth section is “Honoring the truth: A response to the backlash.” This addresses the backlash against sexual abuse that has been seen in recent years in the public eye such as false memories. This particular section is only recommended if these topics appear to be important to the particular client. Also, if these topics are relevant for the client, this would only be used in the latter stages of treatment because it does not deal with the healing process per se. Finally, a resource guide consisting of organizations and other pieces of literature are provided at the very end of the book.
The Courage to Heal has various strengths. Bass and Davis examine very traumatic experiences and offer hope to survivors of these experiences. A second strength is that Bass and Davis use the word “survivor” instead of “victim.” This works to instill hope in readers and helps to enable survivors to actively engage in the healing process. A third strength is the emphasis not only on the facts of sexual abuse, but on real experiences of survivors. This can assist readers in not feeling alone (e.g. universality) and it can also provide hope to survivors because many of the stories in this book reflect courage and determination. A weakness is that this book can be overwhelming. There is a great deal of information in it and if the book is not read in small portions, the potential benefits of the book may be lost. Another weakness is that there are certain portions of the book that are not necessarily required for the healing process (e.g. forgiveness) and this could add to the already confusing nature of this process.
The Courage to Heal is a very useful bibliotherapy tool and is highly recommended. However, as with any form of bibliotherapy, clinical judgment must be used when assigning this book in psychotherapy.