Childhood Sexual Abuse: Its Impact on Adult Life

What is childhood sexual abuse?

Sexual abuse of a child is when anyone (an adult or another child more than 4 years older) threatens, tricks, or forces a child into sexual contact. In addition to rape, sexual contact includes everything from forcing a child to watch sexually explicit films or pictures to talking to a child inappropriately about sex or touching the child sexually.

Most sexual abuse occurs within families by siblings, parents, stepparents, aunts, uncles, or grandparents. Sometimes, however, the abuser is a friend, babysitter, or teacher. Sometimes the abuser may be a stranger.

What determines the importance of sexual abuse in childhood is not the specific abuse that occurred. Its importance depends on the impact the abuse had on the child and what ideas the child developed about the abuse and about the world because of it.

What feelings may childhood sexual abuse create in adults?

As an adult who was sexually abused during your childhood, you may experience the following:

• shame, feeling "dirty" or "bad"
• self-hate
• feelings of powerlessness
• suicidal feelings or feelings that you want to hurt yourself
• feeling isolated
• the inability to make even simple decisions or choices
• fear of success
• the inability to ask others for help or to depend on anyone else
• chronic depression or anxiety.

What other problems does childhood sexual abuse cause for adults?

If you were sexually abused as a child, there may be times when you have trouble being in touch with your bodily feelings. You may not even know when you are hungry, or feel sexual, or are tired. You may hate your body and not take good care of yourself. You may not eat well or get enough sleep. You may use alcohol, food, sex, drugs, or overwork to numb your emotional pain and to manage shame and guilt.

You may have trouble forming close relationships with others. Not surprisingly, trust is often an issue because, when you were a child, your trust may have been betrayed by an adult caretaker. When you grow up, you may be afraid of people and have trouble receiving affection without feeling suspicious that others are using you or will leave you. You may also have trouble saying no to unwanted sexual contact, even though you are always on guard and thinking about protecting yourself. You may also feel guilty about your sexual feelings, which may relate to fears that you caused or wanted the sexual contact you had as a child.

During the abuse, children sometimes learn to numb bodily and emotional sensations. They are able to use an unusual level of detachment to survive. This skill is difficult to "unlearn." Thus, as an adult you may "space out," as you learned to do when you were a child, and so your life may be chaotic or disorganized. You may not be aware of when you are detaching. This inability to think or plan means that your everyday tasks of living may not get done.

The most painful effects of abuse come from the damage done to self-esteem. Many children believe the abuse is their fault, and some learn to hate themselves. You may fear that you will sexually abuse your own children. You may be convinced that there is something different or wrong about you. Because of unconscious anger about the abuse, you may even fear that you will hurt your spouse or children in other ways. And the abuse you suffered as a child is often kept secret, as it was in your family when you were a child.

When should professional help be sought?

Many adults who experienced repeated painful sexual abuse minimize the impact of these experiences. You remember that it happened, but feel it didn't really affect you. You try to live your life by rationalizing that it could have been worse.

You may forget how powerless and desperate you felt as a child to make the abuse stop, and how much you longed to feel safe, secure, and loved. Sometimes the feelings have been so separated from the abuse that remembering it is like watching a movie of someone else's life or seeing a black and white picture. Only certain images may remain.

You should seek professional help about childhood sexual abuse when:

• You have never discussed or revealed it to anyone because you are so ashamed about it.
• Your memories are accompanied by strong feelings of self-hate, shame, depression, or anxiety.
• You are having a lot of trouble functioning at work or in family, social, or intimate relationships.

What can I do to overcome the effects of childhood sexual abuse?

This problem is extremely difficult to work on alone. Seek therapy to discuss it with an expert. Participating in professionally led, same-gender groups of people who have been sexually abused can be an extremely powerful part of the therapy. The baring of the secret to a group of people who have been through similar experiences is powerful because of the mutual support that emerges.

The goals in individual or group therapy are complicated. They involve:

• understanding any anger you may have because your parents were not who you wanted them to be (wanting parents who protected you, for instance)
• learning how to manage your anger in constructive rather than destructive ways
• learning how to take better care of yourself psychologically, socially, and physically
• becoming a better parent yourself
• realizing all the things you did as a child to survive, and respecting these as having been necessary for survival
• becoming aware of your own power as an adult and your ability to change
• giving up older, destructive ways of coping, and developing newer, more empowering ways of coping.

Even learning to trust a therapist or a group is a major accomplishment and a big part of the healing.

You can benefit most from therapy if you can develop a trusting alliance with your therapist. Are you comfortable with the therapist and do you trust him or her? Do you feel listened to? Does the therapist follow your lead? Does the therapist seem genuine to you?

There are several resources you can use to find the right mental health professional. Ask questions and get referrals from people who you know and trust. The following people or organizations may help you begin the search for a competent therapist:

• Your family doctor.
• Your clergyman, school teachers, or school counselors.
• Friends or family members who have been in therapy.
• Your employee assistance program (EAP) at work.
• Community mental health or human service agencies.