Peer Support for Abuse Survivors
Sexual Abuse: Surviving the Pain
source: Barbara E. Bogorad, Psy.D, A.B.P.P.
Every year in this country, two million children are brutally beaten or sexually abused. 340,000 new cases were reported in 1989 (U.S. Advisory Board, April, 1991). Of these abused children, 3,000 to 5,000 die every year. In New York State alone, 200 bodies of sexually and physically abused children are found each year and not even identified. These are the ultimate victims.
Children who are neglected or sexually abused are known to have lower IQs and an increased risk of depression, suicide and drug problems. Abused children are 53% more likely to be arrested as juveniles, and 38% more likely to be arrested for a violent crime. During preschool years, abused children are more likely to get angry, refuse direction from teachers, and lack enthusiasm. By the time they reach grade school, they are more prone to being easily distracted, lacking in self-control, and not well-liked by peers. l
Occurrence of Abuse
Specialists in the addiction field (alcohol, drugs and eating disorders) estimate that up to 90 percent of their patients have a known history of some form of abuse. Recent studies (Calam, 19892; Blume, 19893) point out that substance abuse, including "food abuse," is a frequent aftermath of early sexual abuse. Current studies (Koopmans, 19904) demonstrate that the vast majority of children and adolescents who attempt suicide have a history of sexual abuse as well. However, many individuals are resistant to seeking treatment for sexual abuse. This is especially true for males and adolescents. Men are often extremely reluctant to admit to any history of abuse and often fail to identify it as such. Many survivors are in denial of the effects of early abuse and may fail to see any connection with later tendencies toward ongoing abusive relationships, feelings of self-loathing, inability to trust, or problems with intimacy. Some patients denigrate themselves further, claiming that their abuse could not have been "as bad" as that of other victims. All abuse is bad.
Defining Sexual Abuse
Sexual abuse in the extreme includes ritual and cult abuse. Ritual abuse involves a specific rite or form in which the abuse is encapsulated. Cult abuse embraces a "religious" or spiritual belief system, usually Satanic. Cults may consist of individual "dabblers" or small, isolated groups. They may also include generations within families or whole segments of communities. They operate by destroying all bonding for their victims, and surrounding the child with total unpredictability or powerlessness. Drugs or trickery may be employed…sometimes even murder.
Incest is especially common in alcoholic families, where judgment and boundaries are impaired. If the perpetrator always commits the act while under the influence of alcohol or some other substance, (s)he may have no memory of the events. Victims also may or may not remember. The trauma may be so severe that part or all of the abuse is blocked from conscious memory. This may continue for many years until something triggers a "flashback," although the effects of the abuse, emotionally or behaviorally, continue all along. The protective role of such blocking must be explained to patients who may, in fact, experience increasing flashbacks as treatment continues.
My own growing awareness of this led to the start of the
Survivors’ Group Program at South Oaks Hospital in July, 1988. I
began with five women patients. Within a year and a half, I was
easily able to expand the groups and the program to include six
times that many patients from the hospital – men and women,
adolescents and adults. This grew into a full-scale Sexual Abuse
Recovery Program with inpatient, outpatient, and aftercare
components. It was the first unit of its kind on the East Coast,
and was unique for Long Island, despite the pervasiveness of
individuals with life problems stemming from a background of
abuse. Survivors are everywhere.
Reporting Sexual Abuse
Identifying Abused Children
Children subjected to sexual over-stimulation, with or without threats, will develop problems. Those older than five years of age become caught between loyalty to or dependence on the perpetrator, and shame at doing something "wrong." Over time, the child develops low self-esteem, feelings of being worthless or "dirty," and an abnormal view of sexuality. How do you recognize such children? There are many signs:
Specific physical indicators of recent sexual abuse include:
Identifying Adults Abused As Children
Adult incest survivors may demonstrate some of the following symptoms:
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.8
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 patients 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.
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.
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.
copyright © 1998 by The American Academy of Experts in Traumatic Stress, Inc.
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