Single Paper or Case Study

Shame and the Reconceptualization of Attunement and Empathy in Work with Survivors of Sadistic Perpetration of Childhood Sexual Abuse

Sunday, March 25
2:10 PM - 2:30 PM
Location: Wilson

In this paper, I discuss shame and the reconceptualization of attunement and empathy in work with survivors of sadistic perpetration of childhood sexual abuse with a focus on understanding survivors’ capacity for attachment. Attunement and empathy are integral to the work with survivors of relational trauma. The extent of cruelty in sadistic abuse involves a high degree of attunement and empathy in perpetrators; thus, for survivors, being seen and understood are at the core of the injury in such abuse. This creates a dilemma in survivors’ attempts at engaging with others and essentially compromises the possibility of attachments, including in treatment. Consequently, treatment necessitates a judicious approach to engagement with survivors.


Shame is inextricably tied to the experience of childhood sexual abuse. The shame from sadistic abuse primarily arises from having been attuned to and empathized with, which are instrumental to how the perpetrator inflicts harm. The coercive nature of sadistic abuse further compounds shame, as the accountability for the abuse is put upon the survivor. In treatment, dynamics of sadistic abuse manifest through enactment and projective identification with varying intensities of shame. The treatment focuses on the skillful use of attunement and empathy to alleviate shame and maintain the attachment.

Learning Objectives:

Grace Tomas-Tolentino

Director
Core Psychotherapy Center, Ltd.
Schaumburg, Illinois

Grace Tomas-Tolentino, PhD, is the founder and director of Core Psychotherapy Center. She works primarily with adult survivors of childhood abuse, sexual assault, intimate partner violence, sex trafficking, and torture. She specializes in the treatment of PTSD, dissociative disorders, somatoform disorders, self-injury, and eating disorders. She offers individual psychotherapy and facilitates groups for adult women survivors of childhood sexual abuse and groups for women and men that focus on the impact of trauma on sexuality and sexual intimacy. She is trained in clinical hypnosis through the American Society of Clinical Hypnosis. She is the current president of the ISSTD Northwest Illinois Component Group.

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Shame and the Reconceptualization of Attunement and Empathy in Work with Survivors of Sadistic Perpetration of Childhood Sexual Abuse



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