NYC Psychotherapist Blog

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Saturday, October 22, 2016

Overcoming the Trauma of Childhood Sexual Abuse

Childhood sexual abuse is more prevalent than most people think, and the psychological effects can be much more far reaching than had been recognized in years past. It's only been relatively recently that people have even begun to talk about childhood sexual abuse more openly, and people have sought psychological help to overcome its effects. Years ago, this topic was considered taboo and survivors of childhood sexual abuse often kept these traumatic secrets to themselves, often to their detriment.

Overcoming the Psychological Effects of Childhood Sexual Abuse

Childhood sexual abuse is a very broad topic and there have been many books, articles, and TV programs about the psychological effects. One blog article can hardly do justice to such an important topic.

What is Childhood Sexual Abuse?
Broadly speaking, childhood sexual abuse is any form of sexual touching, kissing, inappropriate undressing or any other form of sexual behavior with a child. Childhood sexual abuse is a boundary violation that often has severe detrimental effects on the child.

Who Engages in Childhood Sexual Abuse?
Anyone who is around a child is a potential sexual perpetrator. Often, the sexual perpetrator is someone who would, under normal circumstances, be trusted with the child, including one or both parents, another family member, a teacher, a religious leader, babysitter, or other people.

Often, people who engage in childhood sexual abuse have been sexually abused themselves and they are repeating this pattern.

Regardless of the circumstances of how or why this occurs, adults who engage in childhood sexual abuse are responsible for their behavior both morally and legally.

Can a Child Ever be Held Responsible for Sexual Abuse?
Many survivors of childhood sexual abuse often feel responsible for the abuse for a variety of reasons. First, let me answer my question with a resounding "No." Children are never responsible for their own sexual violation. However, as adults, as previously mentioned, they often feel that they brought it on themselves in some way which, of course, is not true because children don't have the developmental capacity and often don't have a way to stop the abuse.

Often, when survivors of childhood sexual abuse begin psychotherapy to deal with the aftermath of the abuse, they talk about the sexual acts "feeling good" and they have a lot of guilt and shame about this. When a survivors of sexual abuse tells me this, I help them to distinguish between what might feel good in their body or on an emotional level from their feelings of being responsible.

Perpetrators of childhood sexual abuse have an uncanny way of selecting children that they sense are vulnerable.

These children are often lonely or neglected in some way and they're craving attention. To a child who craves attention, sexualized attention is better than no attention at all. Even if they feel uncomfortable, many children go along with the perpetrator because he or she might be nice to them in other ways: spending time with them, taking an interest in things that interest them, giving them gifts and so on.

If the perpetrator happens to be someone who would normally be considered a trusted family member, friend, or clergy, children who are being sexually abused can become very confused and doubt their own feelings of discomfort or that the abuse is even happening.

In some of the more egregious forms of childhood sexual abuse, perpetrators often threaten the children or threaten to harm a family member if the children reveal what's going on.

Psychological Effects of Childhood Sexual Abuse:
Each person's experience will be different and the psychological effects will be different. Experiences can vary depending upon age, temperament, the relationship with the perpetrator, whether there are explicit memories or only vague feelings or sensations, and so on.

The important point when considering the psychological effects of childhood sexual abuse is that no one goes unaffected because it is such a personal boundary violation.

Often, without realizing it, adults who were sexually abused as children have difficulty with sexual intimacy in their relationships.

Before I go on, I want to caution that not everyone who has difficulties with sexual intimacy has been sexually abused. There are many varied reasons why a person might have difficulty with sexual intimacy, including physical reasons, other types of violations or breaches, depression, anxiety, and so on. So, no one should automatically assume that because they're having problems being sexual with a partner that this means he or she was sexually abused.

The following scenario, which is a fictionalized account and does not represent any one person or persons, illustrates the possible psychological effects of childhood sexual abuse:

Alice was in her early 20s when she met Bob at a friend's party. They were instantly attracted to each other, they had similar interests, and they began dating soon after they met. It was important to Alice that she get to know Bob before they became sexually intimate, so she wanted to wait a while before they had sex. Bob was becoming increasingly fond of Alice, so he didn't mind waiting.

After they had dated for a couple of months, Alice felt like she was ready to be sexually intimate with Bob, and she let him know. After a romantic dinner, Alice and Bob went back to his apartment. His roommate was away, so they had the place to themselves.

Alice felt warm and close towards Bob, and she was excited about taking their dating relationship to the next level. Other than kissing, Alice had never had sex with any of the other young men that she had dated in the past, but she felt that there was something special about Bob.

As they were sitting on the couch, listening to music by candlelight, they began to kiss. Alice enjoyed kissing Bob and she was feeling increasingly passionate. But when Bob touched her breast, Alice froze both physically and emotionally, and she began to feel confused.

On the one hand, Bob's touch felt tender and exciting, but on the other hand, it also started to make Alice feel queasy. She tried not to pay attention to the queasy feeling in her stomach, but it continued to get stronger and her confusion increased.

At the point when Alice felt that she was going to vomit, she pushed Bob's hand away. He realized immediately that she was upset and asked her if she was all right. Alice didn't know what to say. She felt her whole body go rigid and cold, and she felt that she wanted to run out of the apartment. Aside from feeling confused, she also felt ashamed.

Without words to express what was going on with her, Alice told Bob that she had to go and she rushed out of his apartment and went back to the apartment that she shared with friends. Bob was stunned, and he tried to talk to Alice, but she left in a hurry and told him not to follow her.

Over the next few weeks, Bob tried to call Alice. She heard his voicemail messages, but she was too confused, ashamed and guilty to call him back. She didn't even feel comfortable talking to her close friends about what happened. She just knew that she never wanted to feel that disgusting, queasy feeling again. So, she continued to avoid Bob and, after a few weeks, he stopped calling.

This was the beginning of a long line of disappointments for Alice whenever she tried to be sexually intimate with men. Aside from getting an upset stomach and feeling ashamed, confused and guilty, Alice also felt a sudden emotional revulsion whenever she began to be sexually intimate with a man. Each time that she attempted to be sexually intimate, Alice hoped that the experience would be different, but it never was.

By the time Alice was in her 30s, she had experienced so many physical and emotional upsets with sexual intimacy that she no longer wanted to date. She tried to tell herself and her friends that she was "just fine" being alone. But the truth was that she was very lonely and she wanted to overcome whatever was causing her to feel so uncomfortable and mistrustful.

Struggling with this issue on her own brought no relief, so her best friend recommended that Alice see a psychotherapist. Alice had always thought that people who went to therapy were "crazy," but her friend explained to her that, quite to the contrary, many people went to psychotherapy for everyday, ordinary problems, and they weren't "crazy." So, Alice obtained a recommendation from her doctor and made an appointment with a psychotherapist.

During the first session, the psychotherapist took a family history as part of the initial session. This is standard practice. When the therapist asked Alice if she had experienced any sexual abuse or molestation, Alice's first inclination was to say "no," but she hesitated.

She knew that her Uncle John used to touch her breasts whenever no one else was around. She also knew that this began when she was about nine years old. But she wasn't sure what to say about it because whenever he touched her, she felt confused and she continued to feel confused about it.

Uncle John tended to be kind and generous with her, especially after Alice's father died when she was four years old. He took a special interest in her, taking her to the park, teaching her how to ride a bike, taking her to the movies, and listening to her in a way that her mother, who was depressed after Alice's father died, never did any more.

One day, soon after her 12th birthday, when she was alone with her Uncle John, he sat next to her on the couch, as he had many times in the past. However, this time, he offered her a sip of his beer. Alice never tasted beer before and she knew that her mother wouldn't like it, but she also thought that Uncle John would never ask her to do anything that was wrong. So, with some hesitation, she tasted his beer, and he encouraged her to drink more.

She didn't think much about it because it just felt like any other activity that she shared with Uncle John. But after a while, Alice's head began to spin. Uncle John had already drank quite a few beers and he asked Alice to sit on his lap. Alice had not sat on Uncle John's lap since she was about four or five years old, so she thought this was odd. When she hesitated, Uncle John said he felt hurt that she wouldn't do this. Not wanting to hurt his feelings, Alice sat on Uncle John's lap, even though she felt uncomfortable.

As Alice continued to drink more beer, she could hardly keep her eyes open, but she saw the expression on Uncle John's face change. She had never seen him look at her like this, and she wasn't sure what was happening or if she could even trust what she was seeing because she was pretty drunk by then.

But when Uncle John put his hand up her blouse and began fondling her breast, she felt confused. On a physical level, part of her felt good and excited, but and her stomach was also queasy. All the while, Uncle John was telling her how beautiful she was and that she was his favorite niece.

Soon after that, she passed out, and when she woke up, she was in her bed and her mother came home. Uncle John came up to her room to say goodbye. Alice remembered vaguely what happened, but Uncle John looked at her so kindly, the way he always looked, and she began to doubt her own recollection of what happened that day.

The next time that Uncle John babysat for Alice, she turned down his offer to drink his beer and she told him that she didn't feel comfortable sitting on his lap. Uncle John turned away from her and turned on the TV. He refused to talk to her, and this upset Alice greatly. He was the only one who took any interest in her in the family, and she loved him very much.

When she could not get him to pay attention to her, she went up to her room, feeling very lonely and sad, and she cried herself to sleep until her mother came home.

The following time, it was much the same, and Alice felt desperate for Uncle John's attention. So, she told herself that it wasn't so bad, after all, to drink beer with Uncle John and sit on his lap. When she told him this, Uncle John transformed into her Old Uncle John, kind, attentive and warm.

She didn't drink as much beer as she did the first time, but she acquiesced to Uncle John's wishes and allowed him to fondle her breasts. She fought off the queasy feeling in her stomach and told herself that this was a small price to pay to have Uncle John's attention.

So, this continued on without Alice revealing this to anyone. Uncle John told Alice that no one would understand the "special relationship" that they had together and he told her not to tell anyone so it would remain special between the two of them.

Around the time that Alice turned 15, Uncle John no longer wanted to spend as much time with Alice, which she didn't understand. He had many excuses as to why he wasn't available. But Alice found out from her mother that Uncle John was now spending more time with Alice's cousin, Lisa, who was a year younger than her.

One day, when Alice went over to Lisa's house to look for Uncle John, she found the door open so she walked in. She walked into Lisa's bedroom, where she heard Lisa and Uncle John laughing. At first, she could not see anything because the room was dark.

Then, when her eyes adjusted to the darkness, she saw Uncle John having sex with Lisa. She was stunned. It was obvious that they were both very drunk, and Uncle John shouted to Alice, "Get out of here! You're too old for me now! Lisa's my favorite niece now" and Uncle John and Lisa both laughed at Alice.

Lisa ran out of the house and never told anyone what she saw. After that, she never wanted to spend any time with Uncle John. Whenever she saw him at family functions, he acted like the Old Uncle John, as if nothing had happened. This confused Alice, and made her doubt what happened to her with Uncle John and what she saw when she went to Lisa's house. She thought to herself, "How could this be the same Uncle John who always took care of me?"

All of these thoughts were swimming around her head after the therapist asked her about childhood sexual abuse. Over time, Alice was able to talk about what happened and she realized that her uncle was a pedophile, and she was sexually abused as a child. She also began to connect the queasy, frozen feeling that she had as an adult when she was sexual with men to the feelings that she had as a child with Uncle John.

Alice had to work through a lot of anger, sadness, and bitterness. Just talking about the abuse and knowing that she got emotionally and physically triggered whenever she was sexual was not enough to resolve her trauma.

Talking about it was only the beginning. Alice's therapist used EMDR therapy, which is a mind-body oriented psychotherapy, to work through the trauma. It took time and effort, but Alice was able to overcome her trauma and, eventually, she had a healthy relationship with a man that she met soon after that.

The psychological effects of childhood sexual trauma can occur at any time. Many people don't realize that the sexual abuse is effecting them, and they often blame themselves for any sexual difficulties that they have as adults.

Very often, regular talk therapy is not enough to overcome the trauma. It might provide you with intellectual insight about what happened and how it is effecting you, but it's often not enough to help you heal.

Mind-body oriented psychotherapy, like EMDR, is often more effective in overcome sexual trauma and trauma in general.

The fictionalized case that I presented is about a girl, but sexual abuse also occurs to boys. It can be just as confusing and depressing for a man to deal with these feelings when they are triggered as it is for a woman.

Getting Help in Therapy
If you're a survivor of childhood sexual abuse, you're not alone and you can overcome your trauma with help from a licensed mental health professional who specializes in this area.

To find out more about EMDR therapy, see my article:  EMDR Therapy - When Talk Therapy Isn't Enough.

I am a licensed NYC psychotherapist, hypnotherapist, EMDR, and Somatic Experiencing therapist.

To find out more about me, visit my website: Josephine Ferraro, LCSW - NYC Psychotherapist

To set up a consultation, call me at (917) 742-2624 during business hours or email me.