Couples therapy with childhood sexual abuse survivors (CSA) and their partners: Establishing a context for witnessing

Ron Nasim*, Yochay Nadan

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

15 Scopus citations


This article proposes a clinical practice for therapy with couples in which one partner suffered sexual abuse in childhood. Such couples often encounter unique difficulties with physical contact, intimacy, sexuality, communication, and trust, and their relationship dynamic may be marked by reenactments of past traumatic relational patterns. This clinical practice is founded on the assumption that establishing the witnessing lacking during the traumatic event in childhood can break the traumatic reenactments in adulthood, and spur recovery. The suggested practice may facilitate twofold witnessing: the couple's therapist witnesses the reenactments of the trauma in the couple's relationship; and the survivor's partner witnesses the trauma's effect on the survivor's personal life and relationship. Twofold witnessing can help break the cycle of traumatic reenactment and help the survivor integrate the events of her life into a more coherent, continuous narrative. The partner's presence also facilitates acknowledgement of what happened to the survivor, and helps the survivor elaborate on her stories of resistance, survival, and strength. Finally, each of the partners is able to appear more wholly and fully, and together to tell the preferred stories of their life as a couple, replete with the multiple relational patterns they wish to live, which may contradict the characteristics of the original trauma.

Original languageAmerican English
Pages (from-to)368-377
Number of pages10
JournalFamily Process
Issue number3
StatePublished - Sep 2013
Externally publishedYes


  • Childhood Sexual Abuse (CSA)
  • Couples Therapy
  • Narrative Therapy
  • Relational Psychoanalysis


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