The following are case studies from The Green House. Identifying features like names have been changed.

Meet Kate

Kate disclosed that her step-Grandfather had abused her when she was 10 years old.

She first came to The Green House aged 11, but found acknowledging the abuse she had experienced too triggering. It was too difficult to stay in sessions. Now 14, Kate struggled with self-harm, anger regulation, sleeping, and showering. She returned to The Green House in the hope that now it would help her deal with her difficult feelings.

In early sessions, Kate still found it tough to discuss what happened to her. The words “sexual abuse” had a powerful effect, and made speaking and maintaining eye contact very difficult. Kate preferred to distance herself from those words, and used “that” to refer to what happened to her instead. Her and her therapist discussed avoidance as a symptom of trauma, and how it was a form of self-protection that sometimes made it difficult to manage emotions. Together, they defined which words she felt able to use, and created a goal for their work – to make Kate’s difficult feelings a little bit easier to cope with.

After a little while, Kate’s therapist introduced a creative metaphor to help make discussing the abuse easier.

“Think of the thoughts and feelings you’d like to avoid as like a pond. In our sessions you can ‘dip your toe’ in to the pond, at your own pace.”

Over 18 sessions, Kate and her therapist used the ‘pond’ metaphor to gradually and safely explore Kate’s experiences and feelings. In one session they physically marked out the edges of the ‘pond’ with string and walked around it as they talked. In another, they simply laid out the ‘pond’ and discussed it. In some sessions however, they didn’t go near the ‘pond’ at all. Kate trusted that it was her tool to use whenever she wanted. Kate and her therapist explored other tools alongside the pond metaphor, like creating figures from clay or drawing pictures, to help Kate express what she was feeling.

At the end of her time at The Green House Kate explained that now she had a safe place to put her thoughts and feelings, somewhere outside of herself. She felt able to hear terms related to her experience without becoming overwhelmed or experiencing panic attacks. She was able to shower without needing to be partially clothed. Though she hadn’t liked doing this, it felt like a huge step forward that she had been able to consider doing this and see how it felt.

For many people, choice and control are a very important part of recovery from sexual abuse. Working together with her therapist, Kate helped to create a form of recovery that represented her, and allowed her to communicate the more challenging memories of abuse.

Meet Lucy

Lucy is non-binary and uses both she/her and they/them pronouns.

Lucy is 15 years old, and was referred to The Green House after a disclosure of sexual abuse by their stepfather when they were 7 years old. They struggled with complex ongoing mental health issues, and had received support from CAMHS after an intentional overdose. When Lucy came to The Green House, they were having a hard time. They struggled with self-harm, anxiety and hypervigilance. They were finding relationships difficult and had missed a lot of school.

Initially, Lucy found therapy very challenging, because they struggled with overwhelming anxiety. They didn’t want to communicate verbally, keeping their headphones on and using physical gestures to indicate their feelings. Direct questions about the trauma they had experienced were tricky, and often led to Lucy becoming dysregulated.

At first, Lucy wasn’t even sure if they wanted to continue with therapy. However, Lucy’s therapist helped them to understand that they had control in the therapy room. Together they developed a trusting relationship thanks to a non-directive, low-arousal approach. They focused on regulating and stabilising Lucy’s feelings through music and art, as well as sensory and somatic work. Lucy also explored psychoeducation to understand anxiety responses, and the impact trauma can have on your brain and body.

After working with their therapist for a little while, Lucy could tolerate thinking about the abuse they had experienced. Using helpful tools like drawing, metaphors, and small objects, Lucy was able to explore feelings of anger, hurt, and loss in a safe way that worked for them. With help from the therapist, they even used a fire ritual to process the complex emotions around their relationship with their mother, and the person who harmed them.

Lucy’s therapist also worked with key adults in Lucy’s life, including staff at Lucy’s school. The therapist offered trauma-informed guidance that helped Lucy feel acknowledged and understood. This meant that Lucy’s attendance at school improved. The therapist also worked with the Family Support Team to help Lucy’s family. Lucy’s family learnt how to create space for difficult emotions to emerge and be safely contained, and to respond to Lucy’s emotional needs rather than their behaviour.

Lucy still does not wish to speak directly about the abuse they experienced. However, therapy has made a big difference to Lucy’s recovery. Lucy is now more open and engaged with life. They spend more time with friends, more time at school, and no longer uses self-harm as a coping mechanism. They can even speak the name of the person who harmed them. Lucy now hopes to engage in further therapeutic support in the future and is interested to join our Nature Based Therapy group.