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Reviewed Publisher: 
Bucharest: Zeta Books. ISBN: 978-973-1997-46-9 (paperback). 978-973-1997-47-6 (ebook).
Reviewed Title: 
The Lived Experience of Violation: How Abused Children Become Unhealthy Adults (2010)
Publication Date: 
December, 2011
Starting Page: 
Page Count: 

Anna Luise Kirkengen, M. D, Ph.D, primary care physician and phenomenological researcher, makes a vital contribution to our understanding of the embodiment, over- time, of childhood experiences of violation. Dr. Kirkengen illuminates the relationship between the meaning of these experiences in survivors' lives and the unique manifestation of symptoms and behavior that are expressed through their lived bodies into adulthood. Dr. Kirkengen cites research that demonstrates the prevalence of reported violence experienced by individuals in childhood and by women throughout their childbearing years, but reminds the reader these statistics represent only "reported" violence and that it is well known that many incidents of violence go unreported.

Kirkengen presents a powerful argument for the need for those who work within the medical, legal, and social systems to transcend the dichotomous mind-body paradigm that has limited their understanding of the embodiment of experiences of violation and prevented them from effectively helping individuals who have experienced violence in childhood. Kirkengen demonstrates how these limitations have, at times, resulted in further injury to survivors who seek support from these systems.

Kirkengen's book synthesizes the multidimensional impacts of experiences of violation that begin in childhood and often continue into adulthood. She draws upon her experience with patients and study participants to provide the reader with a deep understanding of these impacts. Kirkengen includes discussion of recent research on the long-term health impacts of adverse childhood experience, including those that affect the health, development and behavior of survivors' offspring. She also describes patients' histories and the care they received and provides first-hand accounts of patients' lived experiences of violation, as well as their efforts to elicit help from their families, community, and the medical, legal and social systems.

Through compassionate presentation of the history and context of patients' lived body experiences of violation, and the inclusion of their own words, Kirkengen unveils the meaning of their seemingly cryptic symptoms and behavior. In the process of doing so, she sheds light on the inherent limitations of Western medicine's view of what constitutes relevant knowledge regarding patients' health and how these limitations undermine the ability of health care providers to offer effective treatment for survivors of childhood abuse and neglect. The patients' descriptions of their experiences and the meaning of these experiences in their lives allow the reader to understand, as Kirkengen points out, how an assault to the "integrity of a person as a human being," no matter what form it takes, can shape that person's life and health over their lifespan. The patients' voices provide a unique opportunity for the reader to intimately perceive the depth and intensity of these experiences and their embodied expression over time.

Kirkengen and her patients reveal how the impacts of these experiences often remain misunderstood and incomprehensible or invisible to others, even family members, and those in the helping professions and medical, legal and social systems. She helps the reader understand how repeated experiences of being misunderstood or having one's symptoms and behaviors deemed incomprehensible, even deviant, may be perceived by survivors as additional experiences of violation.

Kirkengen explains that the key to understanding the lived body's expression of experiences of violation or "how," not just "that," these experiences have been manifested in the lived body is in the exploration of the meaning these experiences hold in an individual's life. Through this exploration in a safe, supportive environment, symptoms and behavior that had previously confused care providers and eluded diagnostic compartmentalization and effective treatment may now be comprehended and new opportunities for healing may emerge.

Kirkengen's work informs the field of prenatal and perinatal psychology by expanding our understanding of the reverberations of violence during pregnancy, birth, and the postnatal period. The fact that the inscriptions of these childhood experiences shape the health, development, and behavior of adult women and men, and teen boys and girls, as they move intentionally or unintentionally into parenthood, is of crucial importance to our field. Kirkengen provides a comprehensive analysis of a substantial body of quantitative and qualitative research demonstrating the transgenerational impacts of these experiences. This research and Kirkengen's insights, gained from her extensive clinical experience treating survivors of violence, compel us to expand our awareness so that all who work with families at this crucial time may be most effective in providing support for the healing of these wounds for the benefit of both the survivor and their offspring.

Kirkengen's book includes statistics on pregnancy and birth outcomes, and the first hand accounts of the prenatal, birth, and parenting experiences of women who've experienced violation in childhood. She explains how the medical systems and caregivers that provided gynecological and obstetrical care to these women failed to inquire about or understand the embodied expressions of their past experiences. Unrecognized and unattended to, unprocessed and unresolved, Kirkengen reveals how childhood boundary violations impacted women's relationships with their offspring during and after pregnancy, as well as their children's long-term health, behavior and development. These observations are supported by recent knowledge and research in the fields of epigenetics and behavioral perinatology.

Those in the field of prenatal and perinatal psychology may resonate with Dr. Kirkengen's call for an increased awareness and understanding of imprinted experience, although research on the lifelong impact of experiences of violation implicitly imprinted during embryonic and fetal development is not included in this book.

Kirkengen's work convincingly conveys an urgent need for a paradigm shift in those fields that continue to compartmentalize human experience, especially experiences of violation, in ways that render its impacts incomprehensible. The deeply moving and painful experiences of her patients expressed in their own words, will very likely touch your heart and provide you with a new appreciation for the embodiment of violation, its meaning, and its implications for individual survivors, and our world. For survivors of childhood violence, Kirkengen's unique, compassionate, and critically important work may fill a need for recognition, acknowledgement, and a deep appreciation of their experiences of violation, long sought in relationships with family, community, care providers, and systems of support.