The outcomes of early sexual abuse last well into adulthood, affecting relationships, work, family, and life in general. Individual symptomatology tends to fall into four areas:
1. "Damaged goods": Low self-esteem, depression, self-destructiveness (suicide and self-mutilation), guilt, shame, self-blame, constant search for approval and nurturance.
2. Betrayal: Impaired ability to trust, blurred boundaries and role confusion, rage and grief, difficulty forming relationships.
3. Helplessness: Anxiety, fear, tendency towards re-victimization, panic attacks.
4. Isolation: Sense of being different, stigmatized, lack of supports, poor peer relations.
Adult incest survivors may demonstrate some of the following symptoms:
Fear of the dark, fear of sleeping alone, nightmares, night terrors
Difficulty with swallowing, gagging
Poor body image, poor self-image in general
Wearing excessive clothing
Addictions, compulsive behaviors, obsessions
Self-abuse, skin-carving (also addictive),
Suicidality
Phobias, panic attacks, anxiety disorders, startle response
Difficulties with anger/rage
Splitting/ de-personalization, shutdown under stress
Issues with trust, intimacy, relationships
Issues with boundaries, control, abandonment
Pattern of re-victimization, not able to say "no"
Blocking of memories, especially between age one and 12
Feeling crazy, different, marked
Denial, flashbacks
Sexual issues and extremes
Multiple personalities
Signs of posttraumatic stress disorder
Certain issues appear repeatedly. For example, victims typically blame themselves for the abuse, even if they were two or three years old at the time of the event. Guilt and shame are expressed, along with intense feelings of rage
If the rape or molestation was committed by an individual of the same sex (i.e., a man abusing a boy), questions regarding sexual orientation tend to arise in the patient ("I must be gay; after all, a man raped me!"). Female victims will frequently develop sexually promiscuous lifestyles in an effort to "conquer" the situation and bring it under their control. In other instances individuals will largely withdraw from any social or sexual interactions in order to avoid the feared stimuli, and turn toward extremely isolated lives.
The connection that is made for victims between sex and pain (love and humiliation, closeness and betrayal) is a particularly disastrous one. Frequently cleints will express and/or demonstrate the belief that the only way to be loved or cared for is if they are also being abused ("I knew if I didn't let him keep beating me, I'd always be alone"). Often, in the extreme, physical and sexual abuse are even viewed as a normal part of everyday life. Healthy boundaries do not exist for these individuals, and therefore, healthy relationships are impossible. Victims will actually respond to feelings of loneliness or sadness by abusing themselves (e.g., self-mutilation) if the "significant other" is not available to do so.
One of the more difficult issues that arise is the recollection, by some individuals, of experiencing a certain amount of physical pleasure during a molestation or incest. This adds enormously to the sense of being at fault and "dirty." Thus, one of the aims of treatment is to educate survivors as to normal physiological responsiveness. The realization that their feelings are/were normal helps tremendously toward alleviating the sense of shame.
Even when individuals have spoken of their abuse prior to group treatment, any pleasurable aspects have typically been denied. The opportunity to relate to others who have shared these feelings, as well as the experience, is part of the healing power of this form of therapy. The sense of isolation, of being "different from the whole world," quickly begins to subside. It is only in revealing the secrets and dealing with the pain that survivors of sexual abuse can and do go on with their lives.
References
1. Incest Survivors' Resource Network, International. (1990). Manual. N.Y. Yearly Meeting, Hicksville, NY.
2. Calam, R.M., (1989) Sexual experience and eating problems in female undergraduates. International Journal of Eating Disorders, 8, 391-399.
3. Blume, E. Sue, (1989). Secret Survivors: Uncovering incest and its aftereffects. John Wiley & Sons, NJ.
4. Koopmans, M., (1990). Yeshiva University/Einstein College. Personal Communication.
5. Op. Cit., Incest Survivors Resource Network.
6. Heiman, M., (1988). Untangling incestuous bonds: The treatment of sibling incest. In M. Kahn & K. Lewis (Eds.), Siblings in Therapy, Norton & Co., N.Y.
7. Ibid.
8. Hartman, M., Finn, S.E., & Leon, G.R., (1987). Sexual abuse experiences in a clinical population: Comparisons of familial and non-familial abuse. Psychotherapy, 24, 154-159.
6 comments:
To be honest, it is very difficult to read this list of characteristic traits. The reason for this is because of how real the situation is. It is hard to know what you know after being sexually abused. You try not to let it define who you are, but as Jade once told me "you can't change history". (Which sucks!) You no longer know innocence as a child, but yet you can't go back.
True, you can't change history, but you can change your perception of it
Jade, it sounds as though this is where some DBT could help to change the perception :)
I am just overwhelmed with all of this. I don't understand.
Dialectical Behavioral Therapy can greatly change a person's perception of things. The skills learned there will help overcome trauma
I have learned that with people who have emotional break downs, three concerns usually precede the break down: the fears of sharing the burden b/c you don't want to burden others. The fear of rejection from sharing your burden and the fear that sharing your burden means that you will have to hear about someone else's burden. So if you are feeling overwhelmed, which one of these fears is keeping you from sharing the burden?
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