Assessing for symptoms of Family Scapegoating Abuse (FSA)

6 Clinical Signs of Family Scapegoating Abuse (FSA)

Rebecca C. Mandeville, MA
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To recover from something, you need to understand what you’re trying to recover from. In this week’s article, I discuss the clinical consequences of being scapegoated by your family that I have identified via my research on what I named ‘Family Scapegoating Abuse’ (FSA) and in my trauma-informed Coaching and Psychotherapy practices. If you would prefer to access my video discussion on FSA clinical signs, scroll down to the end of this article (I also include video chapters beneath the video).

One of the reasons I published my book on FSA, Rejected, Shamed and Blamed, in advance of publishing my research (which I’m still working on because I have over 10 years of research to get out) is I wanted people to understand the clinical consequences of being scapegoated by your family (this could also be via extended family, in-laws, step families, families you marry into) because there is so little information out there about family scapegoating’s short and long-term clinical effects on adult survivors.

Throughout the course of my book, I talk about the various types of consequences that can occur as a result of being a victim of FSA, both as a child and as an adult child. However, I’d like to now go over the specific clinical consequences that might be recognizable to a clinician, to a therapist – to someone who might be able to offer the sort of help that someone suffering from FSA desperately needs – given that the consequences of being scapegoated by one’s family can be severe.

As I discuss in Rejected, Shamed, and Blamed, family scapegoating can lead to the development of complex trauma symptoms that often the FSA Adult Survivor has no idea they’re suffering from. When I’m working with clients as they begin to identify complex trauma symptoms via the workbook I use right now in my practice, Transforming the Living Legacy of Trauma: A Workbook for Survivors and Therapists by Janina Fisher, PhD, they typically had no idea that certain qualities, aspects, characteristics, and ways of being that they’ve been experiencing for much (or part) of their life were actually trauma responses (or connected to trauma symptoms). Although this can initially be a shocking realization, it eventually can provide a sense of great relief, because symptoms can be treated.

Inquiring about a client’s symptoms in a trauma-informed manner and inviting them to share their experiences with family serve to guide my initial assessment questions, (i.e., what I will ask to draw out more information so that I can better understand a client’s ‘lived experience’, past and present).

Significant Clinical Consequences of FSA

As a trauma-informed therapist and coach specializing in systemic / familial abuse, I consider the following symptoms and experiences to be clinically significant when getting to know a new client who believes they may be in the ‘family scapegoat’ role or are otherwise experiencing psycho-emotional distress within their family-of-origin or extended family system:

  1. The client will have a a dramatically altered relationship to themselves and to others due to having been scapegoated by their family. This is because the entire sense of self may have developed around a core belief that the client is bad, defective, different, or difficult, particularly if the scapegoating began in early childhood when the neural pathways were developing. Naturally, if a child is repeatedly made to feel that there is something wrong with them by their own parent, this will cause them to have a compromised relationship to themselves that will affect their relationships with others.
  2. Poor functioning in the area of what we call Activities of Daily Living, or ADLs. For example, the client may be struggling to get out of bed; struggling to do self-care; struggling to even want to reach out to form relationships. They may be having difficulty at work or may have difficulty working at all. They may find themselves back living at home with their parents, which isn’t going to help their situation, but given that they are having trouble functioning in life, few other options may be available to them.
  3. A client may report to me they’ve had a long history of seeking treatment or seeking out therapists trying to get help. They may have tried working with many different therapists or coaches and nothing seemed to make them feel better. They report to me that they may have gotten a little bit of help or got something out of past therapy work they’ve done but that the core issue or pain that drove them into therapy wasn’t really addressed – and they often still don’t even know what the core issue or pain is. Many people who reach out to me for assistance confess that they fear they are “the client that can’t be helped” and that there is no hope for them and feeling better is just not possible.
  4. The client will tell me a variety of diagnoses they’ve received in the past: Bipolar disorder; Borderline Personality Disorder; Histrionic Personality Disorder; Major Depressive Disorder; Generalized Anxiety Disorder – disorders that are found here in the United States Diagnostic Statistical Manual – but trauma usually won’t have shown up in that person’s diagnostic history. I will therefore see a long string of different diagnoses and the client is confused as to what this all might mean because the treatment that they’ve had may have helped a little, but not a lot.
  5. Complex Trauma Symptoms: How I’ll start noticing symptoms of complex trauma is the client may tell me (or may display through their behaviors in their life and the stories that they come in and share with me about their life) that the world feels like an unsafe, dangerous place. And indeed, that is true for them because their nervous system is constantly being activated. The brain’s amygdala is firing up over and over again due to triggers. The client often does not realize that they are being triggered; the client often doesn’t know the brain’s firing up and going into a state of fight, flight, freezer, or fawn – they just feel that their nervous system is over-activated. They may feel very tense and at the same time nervous and exhausted. They may feel depleted and that they have to take to their bed and their bed’s the only safe place in the world, which is a sign of hypo-arousal. Alternatively, they may be going a mile a minute and have trouble relaxing or being with themselves, which would be a sign of hyper-arousal.
  6. The client may feel at times that nobody cares about them. This isn’t always true, but even if the client reports that they have a good circle of friends and/or a supportive partner, there will be at times painful intra-psychic pockets, like little holes, that they fall into. What is actually happening is that they have been triggered – they are feeling activated – in response to something that happened to them that felt painful or wounded them interpersonally, which is mirroring something from their past related to their family. In many instances they will go deep into the narrative that nobody loves or cares for them, despite plenty of evidence to the contrary. There is seemingly no ability to expand the perspective beyond this contracted point of view, which is understandable, given that what’s happening during such times is the past reality is feeling true today. Obviously, if the client is in contact with family that’s still scapegoating them, that past reality is still true for them in the present and they will find themselves triggered and activated much of the time.

ACCESS VIDEO HERE (Chapters below).

  • 00:00 – Intro
  • 02:12 – Trauma and Family Scapegoating Abuse (FSA)
  • 02:53 – “Was my entire life one big trauma response?!?”
  • 04:53 – How family scapegoating impacts one’s relation to self and others
  • 06:01 – The myth that scapegoating abuse occurs only in private
  • 07:06 – ADLs and over and under-functioning
  • 08:29 – When no type of therapy seems to help
  • 09:06 – A string of different diagnoses.
  • 09:58 – Complex trauma and feeling activated and unsafe
  • 11:26 – Feeling nobody cares
  • 12:47 – About Structural Dissociation (coming next week)

✅ You can purchase my best-selling book on family scapegoating abuse (FSA), ‘Rejected, Shamed, and Blamed’, on Amazon: https://amzn.to/3sEaqcx. Or buy from your favorite online book retailer via this secure Universal Buy Link (UBL): https://books2read.com/intro2fsa.

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About Rebecca C. Mandeville, MA

Rebecca C. Mandeville coined the research-supported terms 'family scapegoating abuse' (FSA) and 'family scapegoat trauma' (FST) and is a recognized thought leader in understanding the consequences of being in the family 'identified patient' or 'scapegoat' role. Her best-selling book, 'Rejected, Shamed, and Blamed', is the first book ever written on FSA. Rebecca is now working on a book of reflections with affirmations to support adult survivors in their FSA recovery. Rebecca serves as a YouTube Health Partner via her channel Beyond Family Scapegoating Abuse and is also active on Instagram and Facebook.

7 comments / Add your comment below

  1. Yep fit the description from 5 years of age. Sadly my male family abuser portrayed to family members that I somehow wanted or deserved the abuse. A ridiculous notion directed at an innocent child. And I’ve learned it was his sexual identity in question not mine.

    Still today my eldest sister promotes this story to anyone who’ll listen. That’s because she offered me as an alternative to save herself from the abuse. In turn becoming the archetypal golden child who glorifies to this day the abuser while mercilessly scapegoating me. Fortunately I’ve managed to cut her out of my life. And this in effect has returned a great deal of much needed energy. As I no longer respond to her desperate reliance on scapegoating me to cover the true story about our childhood.

    1. Thank you for sharing a bit of your story, Jack. I am glad you are finding your energy returning. The truth can indeed be threatening, especially when it comes to dysfunctional and/or narcissistic family systems. But for others, it can be not only healing, but liberating. I hope this is the case for you.

  2. What type of therapy(s) help a client who was unwanted when the client was pre-verbal? Unwanted in the womb, more unwanted if not a male, and overall, just cast aside?

    A psychologist I worked with explained how it’s difficult to resolve trauma when it occurred in a pre-verbal time of our lives, b/c we just had emotions and no words to put to what was happening.

    Qi Gong? Treat symptoms only?

    1. There is a new EMDR protocol for treating Early Trauma (ET): Four Steps of the Early Trauma (ET) Approach to EMDR Therapy at https://attachmentdisorderhealing.com/emdr-sandra-paulsen-developmental-trauma/.

      Somatic-based therapies that are trauma informed can also be helpful. This Masters student did a research study on this issue and also shared their own story of Prenatal and Birth Trauma: https://www.proquest.com/openview/151fd17314b38307eb66da7b99511eba/

  3. I can really relate to the feeling safe when you’re in bed. That explains a lot to me. Why can’t I change. I know it’s gonna take time, we’re talking my whole entire life. How I wish I found out much sooner than later. I’m going to try joining spin classes to help my endorphins.

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