1 in every 5 Australian women and 1 in every 20 Australian men have become a victim to the curse of sexual abuse according to statistics. Surprisingly enough 93% of these offenders are male and most of them have received an average of only 5 years of custodial sentence.
Child sexual abuse has crept into every segment of our society. Implications of childhood sexual abuse are both physical and psychological and regrettably they seem to last for years into adulthood.
Most researchers concentrate on the long-term effects of child sex abuse that extend into adulthood rather than its immediate implications. Child sexual assault can have lasting effects on sexuality and sexual development as well as relationships and intimacy.
Most child sexual abuse victims cannot recall exactly how they were abused. Their mind creates a mental block- a disassociation-, which pushes this harsh reality into a corridor of their minds. But from here it can subconsciously affect the process of sexual development and interpersonal relationships throughout the rest of their lives.
What defines child sexual assault?
There is no universally accepted definition for child sex assault. However the practice where an adult takes advantage of his dominant position and manages to force a child into performing sexual activities can be defined as child sexual assault. The child generally lacks the cognitive, emotional and maturational development to understand or consent to such acts.
Child sexual abuse may involve any kind of sexual practice like:
- fondling a child’s genitals or breasts
- oro-genital contact
- digital penetration
- exposure and voyeurism
- child pornography
- vaginal or anal penetration with self or objects
What are the symptoms of sex abuse?
Most sex abuse victims are too shy or hesitant to disclose or share details about the experience of sexual assault. But there are a few characteristic symptoms, which may help you decide whether you or a loved one has been a victim of sexual abuse. Adult survivors of sexual abuse have been observed to show the following symptoms:
- Chronic pelvic pain
- Gastrointestinal distress/ complaints
- Musculoskeletal issues
- Eating disorders
- Sleep disorders like insomnia
- Pseudocyesis (false pregnancy)
- Sexual dysfunction
- Chronic headache or back pain
- Poor self-image and poor body image
- Post traumatic stress disorder (PTSD)
- Dissociative states
- Repeated episodes or self-harm/ self-injury
- Suicidal attempts
- Lying, stealing or running away
- Avoiding contraceptive practices
- Compulsive sexual behaviours
- Psychological sexual dysfunction
- Intolerance or constant search for intimacy
- Wishing/ expecting early death
- Neurotic reactions
- Phobias, obsessions or compulsiveness
- Fear of being touched
After-effects of childhood sexual abuse
Adult survivors or child sex abuse develop certain coping mechanism to deal with the overwhelming feeling following this traumatising experience. Out of all these effects, the child’s sexual development and attitude towards personal relationships seems to be tarnished the most.
Reduced sexual esteem as adults has been described in childhood victims of sexual abuse. On the basis of clinical data, it has been observed that women involved in sexual abuse have particularly reacted with a heightened anxiety about sexual contact (avoidance of relationships) or a paradoxical promiscuity in which the victim devalues her sexuality.
There is also evidence that in cases where the abuse was exceptionally gross (physical intrusiveness, frequency, duration and closeness to the offender), there was an increased frequency of precocious sexual activity and teenage pregnancy. 17% of sexually abused adults during childhood have reported that they experience problems like dissatisfaction in their personal relationships owing to their negative beliefs and attitudes about the institution of sexual intercourse. They have reported the following problems:
- Inability to enjoy sex and feeling like it is an obligation
- Difficulty feeling aroused
- Having disturbing sexual images or thoughts
- Inappropriate sexual behaviours or sexual compulsiveness
- Vaginal pain
- Inability to get an orgasm
- Erection/ ejaculatory difficulties
- Detachment, dissociation or emotional distance during sex
- Being scared of sex and avoiding it
- Feeling guilt, fear, anger or disgust when touched by a partner
Sexually abused children not only fail to develop a healthy sexual identity but they also tend to look upon the world as an unsafe place and lose faith in relationships. They have suffered a blow in their mental construction of others as trustworthy. This impact is especially profound in instances where the abuser was a close relative.
A community study of Australian women revealed that a history of sexual abuse adversely affects the child’s relationship in adult life and increases the likelihood of divorce and separation. The adult survivors of sexual abuse also report that their partner’s are controlling and uncaring which further fuels the dissatisfaction in their relationship. Conversely some victims may grow up to be dominating and emotionally detached adults. All these reactions can be traced back to the expectations, projections and interpretations that these individuals possess because of their traumatising childhood experience.
Treatment for sexual abuse
There is no specific pattern for the symptoms that appear in adult survivors of sexual abuse. A treatment plan is drafted based on the survivor’s symptoms and behaviour sequelae involving the coping strategies adopted. The treatment plan should be developed on an individual, group, dyadic and family treatment modalities especially if reintegration of the child or the offender in the family is planned. Here are the therapies that can be adopted:
Group therapy: This is the most appropriate treatment for child abuse but it can be combined with other treatment modalities as well. Groups can comprise of victims, siblings of victims, mothers of victims or adult survivors of child abuse based on the individual receiving treatment. These groups may be limited to specific issues like relapse prevention, sex education or protection from further sexual abuse or they may be open ended where each individual shares their experience and how they dealt with it.
Individual psychotherapy treatment: One of the major parts of this treatment is alliance building. The concerned individuals have to learn to trust the therapist and believe that a change is both possible and desirable.
Dyadic therapy treatment: This is aimed to enhance or repair damage to a mother-daughter, father-daughter, husband-wife relationships. It is an extension of the individual treatment and it also involves dealing with issues addressed in individual treatment.
Family therapy: This should be considered the last part of the treatment process and it involves reunification with the family, which is considered in the best interests of the child.
The treatment modalities that can help individuals recover from the trauma of sexual abuse are:
Trauma focused Cognitive behaviour therapy: This may involve looking at the thoughts and cognitions that have been formed around the traumatic experience. The abused victim is taught to process the feelings about the situation and incorporate new information and different perspectives. Parents and caregivers are introduced in the sessions when required.
Eye movement desensitization and Reprocessing (EMDR): This is a form of psychotherapy which is based on the theory that a traumatic event can overwhelm the normal human coping mechanism because they are inadequately processed and stored in a separate memory. The aim of this therapy is to process this memory and develop healthy coping mechanisms by working with the mind-body connection.
Play therapy: This therapy involves the child expressing their feeling through games and activities which is a form of communication children use. Toys used are sand trays, dollhouses and various games to help the children recover.
Art therapy: This uses the child’s creativity to improve their physical mental and emotional well-being.
Dialectical behaviour therapy: This focuses on teaching the clients four key skills: interpersonal effectiveness, mindfulness, emotional regulation and distress tolerance. This is especially useful when combined with group therapy.
If you want help with dealing with sex abuse or have experienced sexual abuse, Australia Counselling links you with professional counsellors and psychologists in Melbourne, Perth, Sydney, Brisbane, Adelaide and regional areas of Australia. Just visit our Abuse- emotional, physical, sexual page to see counsellors and psychologists listed in your local area who work with these issues.