title: The problem with pleasure: part II. The research.
abstract: This study explores how adult survivors of chronic abuse and neglect define pleasure, the disruption of pleasure, and the repair of the capacity for pleasure in the context of the therapeutic relationship. Using narrative methodology, I interviewed 15 clinical pairs of patients and their therapists separately. Thematic analysis revealed 8 findings. All patients reported the capacity to experience pleasure throughout life prior to therapy. Subjects defined pleasure as a variety of positive affects that fell into 2 categories: pleasure in activities and interests and pleasure in relationships. All patients reported a history of traumatic disruption of pleasure in childhood. Patients reported a history of internalizing and reenacting their own disruption of pleasure. Narratives of the patients were consistent with the narratives told by the therapists. In many clinical pairs, both parties spoke positively of an important therapeutic event when the therapist stepped out of his or her usual treatment frame. Safety, consistency, reliability, predictability, and compassionate caring were spoken of throughout the sample as elements that created a pleasurable and therapeutically reparative relationship. Patients spoke repeatedly of the importance of "finding a self" to the experience of pleasure. Pleasure enhanced the ability to find a self, and finding a self enhanced patients' capacity for pleasure. This study invites further research to investigate the function of pleasure in the process of therapeutic repair for chronically traumatized populations.
authors.affiliation: Institute for Clinical Social Work, Chicago, IL 60605, USA. jmigdow@icsw.edu
authors.forename: Janet
authors.initials: J
authors.lastname: Migdow
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D054523:Adult Survivors of Child Abuse / Q000523:psychology*; D000368:Aged; D004213:Dissociative Disorders / Q000523:psychology / Q000628:therapy; D004532:Ego; D005260:Female; D006801:Humans; D007389:Internal-External Control; D007406:Interview, Psychological; D008297:Male; D008875:Middle Aged; D009042:Motivation; D033262:Narration; D057181:Pleasure; D011369:Professional-Patient Relations; D011613:Psychotherapy / Q000379:methods; D012106:Research; D055500:Resilience, Psychological; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis / Q000523:psychology* / Q000628:therapy