Read an Excerpt From "Push Back the Dark"

What is autonomy?

The second milestone is autonomy. Children given freedom to explore within boundaries that protect them develop the ability to set appropriate limits for themselves and to express and meet their needs. Parents are familiar with the difficulties of parenting young children who want to do more than they are allowed to, and who "want their own way." Although a difficult stage of parenting, autonomy is achieved as parents allow exploration, within appropriate limits, and negotiate expression of needs paired with appropriate meeting of needs.

What is initiative?

A third milestone is initiative. In this stage, trust combines with autonomy to give children the power to master new challenges and to set and reach goals. Initiative can be seen when a child is determined to slide down the playground slide alone and happily achieves that success. Emotional regulation begins to occur during the third milestone too. Emotional regulation is the term for the process that happens as children understand their own emotions, obtain emotional "nourishment" from others, and deal with negative emotions such as disappointment and anger.

What is attachment and why is it so important?

The work of John Bowlby on attachment was the beginning of our understanding that children's attachment to a caregiver, usually a mother, is more than just the development of trust in that particular parent. In fact, attachment is crucial for the construction of the pathways by which all interpersonal relationships are formed during childhood into adulthood. Infants are "hard wired" for relationships with caregivers, most notably mothers, and these relationships are the foundation for a system of pathways formed during attachment.

Children met with warmth and loving responses from parents have pathways that encourage interactions with others; those pathways help the child see himself or herself as "good," as someone worthy of interaction, and also to see others as people who can be trusted to return the interaction. A child who says "Hi" brightly to strangers from her seat in the grocery cart is demonstrating this ability. However, when children's needs are not met with consistency, or the child is rejected by the caregiver, those developing pathways cause the child to see himself or herself as "bad" and other children and adults as untrustworthy. The long term outcomes of these negative childhood experiences is adults who desperately want and need intimate human interactions, but who cannot form or maintain them.

Why is shame so central to understanding the adult who experienced childhood sexual abuse?

Shame is experienced on multiple levels. First, children who are abused cannot understand why the abuse is happening; they blame themselves, and this misbelief is often reinforced by an abuser who shifts guilt and blame to the child. Additionally, it is developmentally impossible for the child to conclude that a parent or other trusted adult is bad. It is only possible for children to believe that they are bad and therefore must deserve the treatment they are receiving. Finally, children, and older survivors of childhood sexual abuse cope in ways that bring blame and disapproval onto them; examples are acting out among children, self-mutilation among adolescents, and promiscuity among adolescents and adults. These actions and their accompanying blame and disapproval drive more shame and self-loathing, which in turn drive more destructive behavior.

Since all humans experience shame, making a clear differentiation between shame developed after abuse and normal shame is essential. Normal shame is the painful recognition of a personal failure, what Christians refer to as conviction. Healthy shame leads to conviction of guilt; guilt is the recognition of shortcoming that leads to confession and repentance. The Apostle Paul wrote of that process in this way:

"Even if I caused you sorrow by my letter, I do not regret it. Though I did regret it- I see that my letter hurt you, but only for a little while - yet now I am happy, not because you were made sorry, but because your sorrow led you to repentance. For you became sorrowful as God intended and so were not harmed in any way by us. Godly sorrow brings repentance that leads to salvation and leaves no regret, but worldly sorrow brings death" (2 Cor. 7:8-10 NIV).

Unhealthy shame is the feeling that, at the core, the "self" is and always will be wrong. Unhealthy shame results in enduring, even permanent deep inferiority. People with this pervasive insecurity typically seek validation from others but never find it because as they compare themselves to others, others always appear perfect and the self always appears bad. These shamed adults are often unable to accept criticism and they demonstrate a counterpart need to blame others. This type of shame may prevent children, adolescents, and adults from accepting God's love and salvation fully.