Forensic Considerations in Ritual Trauma Cases (Part 3)

use of adjunctive therapies can be invaluable to the therapeutic process. Art therapy, for example, can be very helpful in the treatment of dissociative disorders, and should be considered in the treatment of adolescents who have been ritually traumatized. In children under the age of three, memories of trauma are expressed more behaviorally than verbally. Consequently, play therapy may be a critical therapeutic tool.

Drs. Catherine Gould and Vickie Graham-Costain, recognized experts in the treatment of ritual child abuse victims, believe that “…play therapy constitutes the most powerful healing modality for ritually abused children from age two to 11 years of age, and sometimes older.” Treatment of ritually abused children necessarily involves the surfacing and working through of dissociated memories. Consequently, Drs. Gould and Graham-Costain propose a three-part model using play therapy:

“First the therapist must treat the post traumatic stress disorder resulting from chronic, massive abuse. Second, the therapist helps the child identify and work with the dissociative, fragmented personality system that results from extreme abuse. Some ritually abused children exhibit fluid multiple personality disorder (MPD), whereas others exhibit less severe forms of dissociative disorder. Third, the therapist assists the child in finding and working through the indoctrinating messages that were received during the traumatic and abusive dissociation-producing experience. Disclosure of the abuse and appropriately structured abreactive play therapy, in which the therapist actively involves him or herself in the child’s therapeutic play, constitutes the primary mechanisms of treatment of ritually abused children.”

Gould and Graham-Costain recommend that play therapy involve access to a wide range of props and toys, including animal and small monster-type figurines, masks, hats, costumes, weapons, miniature coffins and cages, and other items that are typically used to terrorize children. During play therapy, children who have been ritually traumatized will almost invariably select items that have thematic significance to their abuse, e.g., being confined, held under water, “buried,” hung upside down, etc. When security and trust are apparent in the therapeutic relationship, such children repeatedly act out their “trauma dramas” in a variety of ways which include chase and rescue themes, frightening perpetrator figures and monsters, as well as other related scenarios. For example, a child may use a sand tray to reenact scenes related to “burying;” pick up a toy stick or knife to act out the killing of a figure; etc.

It is important to remember that ritually abused children must be allowed to work through and re-associate

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