Surviving Childhood Sexual Abuse: How Can Therapy Help?
10th May, 2011
Q. What are the main psychological effects of childhood sexual abuse?
A. This depends very much on the type and duration of the abuse. Some of the factors that will inevitably make a difference include:
* Was the attacker a stranger, or a loved and trusted family member or family friend?
* Did the abuse just happen once, did it happen several times, or was it ongoing over a long period of time?
* Was the abuse painful or very frightening?
* Did the abuser try to make you feel guilty or responsible for what happened?
*If you tried to tell someone about the abuse, how did they respond? Did they believe you? Did they comfort and reassure you? Or did they try to blame you for what happened? Did they make sure that the abuse stopped? Or did they try to ‘brush it under the carpet’?
All of the above factors, and more, will affect any difficulties experienced in later adult life.
For instance, victims of any traumatic assault or assaults may experience some symptoms of post-traumatic shock, such as flash-backs, nightmares, or hyper-vigilance (feeling excessively on-guard most of the time, or in certain situations).
People who were abused by trusted adults may have problems with trusting people later in life which can lead to difficulties in relationships and friendships.
Abusers who blame the child they are abusing can instil a deep sense of guilt and shame in their victims, which can pervade their lives as adults.
Children who have to endure painful and/or frightening assaults from their abusers often learn to dissociate (to feel like they aren’t in their body) to enable them to get through the ordeal. In later life this can lead to feelings of spacing out and numbness.
If children seek help and are believed and supported, they are much more likely to recover from their ordeal. Children who are disbelieved or blamed are more likely to decide that they are powerless, that no-one will help them and that it is pointless trying to seek help in the future. They are also much more likely to carry emotional damage from the abuse with them into their adult life.
In addition to these factors, most people who have suffered childhood sexual abuse will find that it impacts in some way on their adult sexual relationships. Factors here may include pain from physical injuries, or due to physical tension, flashbacks during sex, guilt or shame about feeling aroused, numbing out, difficulties communicating with partners about what is pleasurable and difficulty in saying ‘no’ to unwanted sexual advances.
Q. How can counselling help with these kinds of problems?
A. Counselling offers a safe space to talk through what has happened and how it is affecting you now. Often traumatic events in childhood stay ‘stuck’ in our memory from the perspective of the child we were when they happened. Looking at them from the perspective of the adult we are now enables us to view them more realistically.
Looking at the patterns of behaviour we may still be acting out in our present life can also be helpful. Some of these patterns may include trying to deal with unwarranted feelings of guilt by always trying extra hard to be a ‘good’, ‘helpful’ or ‘worthwhile’ person (or the opposite, driving people away by being angry, unreliable or untrustworthy); being attracted to people who will hurt us, or failing to notice or communicate our feelings because we believe no-one wants to hear about them anyway.
Counselling can help us identify any of these kinds of patterns that are making us unhappy. It can also help us look at how we unwittingly keep them going and how we can go about changing them.
Q. What about Trauma Approaches?
A. These are very helpful in looking at specific incidents or types of incident that may be causing symptoms such as flash-backs, nightmares, hyper-vigilance or phobias. A couple of common approaches to trauma are EMDR (Eye Movement Desensitization and Reprocessing) and TIR (Traumatic Incident Reduction). When we’re very frightened, the fear affects the way we store memories of the frightening event and the decisions we make about ourselves at the time. Both TIR and EMDR work by freeing up and releasing traumatic memories so that we can gain a clearer picture and understanding of what actually happened and what impact it really had on us.
Q. I think I may have been abused but I can’t remember. Would hypnotherapy help?
A. Hypnotherapy can sometimes help us to remember and piece together relevant information from the past. However, it isn’t generally a good idea to use hypnotherapy to look for evidence of abuse that you can’t remember. This is because if there are very strong emotions, people under hypnosis can sometimes create images and stories that make sense of the emotions and they may not necessarily be true or accurate. This is why there has been a lot of controversy surrounding hypnotherapy and ‘false memory syndrome’.
However hypnotherapy can be very helpful in other ways for people recovering from abuse. It is highly effective, for instance in soothing anxiety states, helping with sleep, and counteracting negative self-talk in depression. It can build self confidence and self esteem. It can also be very helpful in dealing with fears and phobias; and in overcoming addictions for instance to alcohol, drugs, food, gambling, or sex that some abuse survivors develop in their desire to soothe or comfort themselves or to get temporary relief from depression or anxiety.
Q. I’d like to read more and look at some ways of helping myself with this. What would you recommend?
A. There are some very good books that provide really good support and practical help for adults who suffered abuse as children.
Some titles that have been popular with my clients include:
‘The Courage to Heal’ by Ellen Bass & Laura Davis. This is a guide for women survivors of childhood sexual abuse (includes a section for supporters for survivors).
‘Victims No Longer’ by Mike Lew. A guide for men recovering from sexual child abuse.
‘Reclaiming the Heart’ by Mary Beth McClure A handbook of help and hope for survivors of incest
‘Out in the Open’ by Ouainé Bain and Maureen Sanders. A guide for young people who have been sexually abused.
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