# Long-term effects of childhood sexual abuse



## David Baxter PhD (Sep 12, 2004)

Long-term effects of childhood sexual abuse
by Deborah Marcet, Psy.D

In general, the severity of the aftereffects of sexual abuse on the victim depends on a variety of characteristics. These include: the duration and frequency of the incest, the type of sexual activity, the use of force or aggression, the age at onset, the age, gender, and relationship of the perpetrator, passive submission or willing participation on the part of the child, overt or disclosed incest with lack of assistance, parental reaction, and institutional response.

Initial incest aftereffects and their symptoms develop at the time of the abuse or shortly thereafter. They may be transient and remit over time spontaneously or with assistance of some sort. Alternatively, as the child develops they may persist and become long-term or may develop in delayed fashion.

Long-term aftereffects and their symptoms are defined as those which develop two years or more post-abuse. They may be chronic manifestations of acute aftereffects or develop in a delayed fashion. These effects can be categorized into the following groups: emotional reactions, self-perceptions, physical and somatic, sexual functioning, interpersonal relating, and social effects. 

*Emotional Reactions* 
generalized anxiety and fear 
depression with suicidal ideation and attempts 
helplessness and powerlessness 
self-estrangement and emotional deadness 
repression and suppression of feelings that can become so intense that the adult survivor will victimize others, go crazy, or cause others to abandon or reject her
 *Sexual Functioning*
socially and sexually withdrawn or indiscriminately sexually active 
difficulty engaging in sexual activities within a committed intimate relationship 
potentially influences sexual development in a variety of ways 
sexual problems such as desire disorders, arousal disorders, orgasmic disorders, coital pain, frequency and satisfaction difficulties
 *Self-Perceptions* 
predominantly negative 
feel stigmatized and different from others 
sense of badness and shame 
feel inherently unlovable 
strong feelings of confusion 
often self-blame is present
 *Interpersonal Relating* 
difficulty trusting others, especially others whose gender is the same as their abuser 
relationships characterized as one-way, empty, superficial, guarded, idealized, or conflicted 
tendency to feel trapped within intimate relationship and unable to allow closeness beyond a certain point 
although men may be feared, may seek out a dominant or older man who will take care of her and protect her, or an immature partner who requires her attention but gives little in return, or may end up in another abusive relationship 
conflicted relationships with parents and siblings, especially if incest was of the nuclear family type 
difficulties with persons perceived as authority figures 
problems in parenting
 *Physical/Somatic* 
related to the negative feelings 
feeling betrayed and disgusted by their bodies 
discomfort, chronic pain, and infection often related to the more trauma specific areas of the body such as breasts, thighs, buttocks, genitals, or genitourinary organs 
gastrointestinal and respiratory effects related to the locus of the assault such as nausea, gagging, vomiting, and choking reactions 
rectal discomfort, pain, hemorrhoids, constipation, and diarrhea are associated with anal trauma 
generalized physical effects such as migraine headaches, tempero-mandibular jaw (TMJ), high blood pressure, frozen joints, ringing in the ears, hyper alertness, and hyper-vigilance
 *Social Effects* 
isolation, rebellion and antisocial behavior or 
over functioning and compulsive social interaction 
mistrust and rebellion against any authority or organization perceived as oppressive 
lack of faith or trust in a loving deity and an unwillingness to accept a male god and/or religion oriented towards and dominated by males 
impaired ability to function well occupationally and socially or 
pattern of successful school, social, and occupational functioning characterized by pleasing behavior and caretaking of the needs of others 
much more likely to experience re-victimization both inside and outside the family (than non-victims)
 
_Source:_ Courtois, Christine A. Healing the Incest Wound: Adult Survivors in Therapy. W.W. Norton, 1996


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## Kanadiana (Sep 13, 2004)

All of that absolutely true from my own experiences.

I can't believe how far I've "overcome"so much and changed but this stuff, longterm, is so dammed hard to get ontop of.

The longer its NOT dealt  with, the more eroded the self esteem and such, and the more problems are added to relationships and life. Its a CHRONIC NEGATIVE PROGRESSIVE BACKWARDS movement, SO the quicker and sooner help is received so this negative progression is stopped, then the quicker CHRONIC POSITIVE PROGRESSIVE MOVEMENT can happen. LOGICAL PROGRESSION.

Don't go backwards ... stop and start going forwards NOW.

The beauty is .... TODAY ... is WHEN to begin the shift of progression from negative to positive...and perservere. 

Yes. It's hard and overwhelming sometimes ... suicide sounds good? but thats not what people want. They want to be alive while they live and like themselves, their lives and relationships. Use whatver works, including people to help whenever it gets too tough.

I speak from not having received help soon enough to be able to shift the direction of my progressions in time for me to have been the kind of person I was meant to be ...  of course it  just got  worse and worse and myself, my life,my relationships, everything, paid for 
that. NO... this is NOT a guilt trip. I have no shame or guilt about any of it...just deep sadness that  any of it happened to begin with, and that this stuff hurt me and my loved ones for so long. 

at 50, scanning my life with awareness and objectivity, I can SEE how things could have shifted direction ... but didn't for many reasons ... don't let this happen to you. Let my losses be your gains sort of thing  

Yes ... I feel pretty strongly about this stuff. These days there is no need for people to "hide" ... all the info, help and support needed IS available and very close at hand ... its there  for the finding... and we're worth the  effort.

As I said ...cuz I KNOW ... YES, there IS love and happy life after even the most horrendous abuses and experiences. IF you don't believe that, take it on faith at face value and perservere until you start seeing PROOF that this is so.

Now that I've said all that, I'm still working on my own positive progressive movement forward ... it works. Stumbles happen ... get up and drive on anyways. If you can't push yourself ... let someone else push you  

In spite of all the crap ... life happens ... so why not do it better?


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## Me (Sep 13, 2004)

What if you have no effects?? I was molested by a relative at an early age, and then again in pre teen years.  I have none of the symptoms shown in the first article, never pushed the episodes into my sub-consciousness, or even told anyone.  I often feel guilty that I don't have effects.  Does this mean that I enjoyed it and didn't see it as traumatic?  I almost feel like I was a part of the abuse because no threats were made by the abuser, and i was old enough to "know better". This idea sickens me, and then makes me feel a different kind of shame.
I have always wondered why it didn't effect my life in a negative way.  I just sit back and wait for the abuser to die, and then I figure it will truly be over, as I don't have to pretend to like the person when I see them, or be polite when I talk about them to other family members.  I get no other negative feelings around this person other then hate.  I also make sure this person isn't around other kids I care about.  
I wish that I felt some of the things mentioned, because at least then I would feel "normal".  Instead, I just pretend it didn't happen and get on with life.  Is this all going to come back and bite me in the butt later in life?
Some answers or insight would be great
Thanks[/quote]


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## Kanadiana (Sep 13, 2004)

Me said:
			
		

> What if you have no effects?? I was molested by a relative at an early age, and then again in pre teen years.  I have none of the symptoms shown in the first article, never pushed the episodes into my sub-consciousness, or even told anyone.  I often feel guilty that I don't have effects.  Does this mean that I enjoyed it and didn't see it as traumatic?  I almost feel like I was a part of the abuse because no threats were made by the abuser, and i was old enough to "know better". This idea sickens me, and then makes me feel a different kind of shame.
> I have always wondered why it didn't effect my life in a negative way.  I just sit back and wait for the abuser to die, and then I figure it will truly be over, as I don't have to pretend to like the person when I see them, or be polite when I talk about them to other family members.  I get no other negative feelings around this person other then hate.  I also make sure this person isn't around other kids I care about.
> I wish that I felt some of the things mentioned, because at least then I would feel "normal".  Instead, I just pretend it didn't happen and get on with life.  Is this all going to come back and bite me in the butt later in life?
> Some answers or insight would be great
> Thanks



Hi Me ... It's pretty common to feel pleasurable responsiveness to the touches or aspects that  feel good. Bodies just respond as do emotional needs for attention, support etc. Its  a case of both/and (good/bad) for many people. Confusing and conflictual. Especially  as we get older and start to judge ourselves negatively for any pleasures or needs we had filled by someone who manipulated or molested us and abused our lack of trust and own neediness. There are many forms of vulnerability and an abuser will use whatever they want to get  what they want. 

I can't answer if this will come kick you in the butt some time later. Don't know. But if you  are questioning your own reactions and feelings and are bothered by  what happned to you ... and want to talk about things, trust yourslf and find that  release for yourself I'd suggest  Numbness and anger are pretty typical feelings from what  I know and hear. 

Don't judge any of it ... understand what it means  to your and your life now, sort of thing.

Take care ... Kanadiana


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## David Baxter PhD (Sep 14, 2004)

Another excellent reply, Kanadiana. 

And a very important point: do not confuse a physiological response to physical stimulation with consent or complicity.  

This is an especially common source of confusion for male victims, who wonder if the fact that they may react physically is a sign that they are homosexual (when the perpetrator is male).


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## Kanadiana (Sep 14, 2004)

David ...thanks for the acko. It's just experience and talking to others. Awareness. Just "spot" ceratin things" Whatever. I think in the end, its all justpractical common sense a lot. Just math? 

ME .... hi again ... I have somemore responses to some of what you said. By the way, I'm a woman, 50, grown kids, childhood and other abuse issues, so yeah, have been pretty crazy and confused and all other emotions. I understand a lot of what you're sying 

Okay ... you said you often feel guilty that you don't have any effects ... but you do. You describe them now in what you say about how you think and feel about what happned, about the guy who molested you, about yourself and your feelings, and self-esteem -feeling guilty/shamed etc ... THOSE are all CURRENT negative effects of what that experience left you with after the fact ... so this stuff IS kicking your butt NOW simply by disturbing your peace of mind and causing you to have negative feelings about yourself ... I'd make a wild  guess that your "self-harm" is linked to your experienced with this guy somehow. Makes total sense to me. 

Everything you say shows that your ARE negatively effected NOW by what happened and that its really interfering with your thinking, self-esteem and happiness... and plain old sense of well being and inner peace. This guy is really not your problem anymore... its what he's left in your mind from the experinces thats the problem. His death will only make him gone, how him and your experiences with him effect you will not be  gone, they can only be understood and your thinking and responses about them changed  through understanding and not allowing what was, to effect what IS anymore.

I was hugely enraged when my stepfather died and left the world scott free while I suffered the after effects ... hatred? Oh yeah. big time for a long time. I can visit his grave now though and feel sad and wonder ... "what made you thus that you could be so heartless and selfish" So cold to a childs heart and mind, and body. ??????? Our relationship was very  mixed up ... my abuser was ALSO my protectorand was nice to me sometimes ... that sorta thing. Harsh. Hard to come to terms with. Thank god there is more understanding in society for all of this stuff. Victims less often vistimized ... "shoot the messanger" sort of thing. 

Mixed feelings mean for a lot of inner conflict. Conflicted emotions and reactions. Both/And. Passive or even willing submission for whatever reasons, are STILL against a childs will. The guy was out of line. Period. He overpowered and manipulated your will and your body. Hatred? Understandable ... you were carelessly used.

Well ... I hope I haven't been too out front with my thoughts and things? 

(hug) Kanadiana


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## Me (Sep 15, 2004)

Kanadiana and david, thank you both for your replys.
I am female.  I never eally connect my feelings of hate to the abuser as an "effect", as I just asumed that hate was a natural thing to feel towards a person like that.  
Kanadiana, thank you for being so open.  I had kind of hoped that his death would be the end, kind of a closure, but I guess that maybe I am just kidding myself.
I am glad that having no "effects" as I put it, isn't so unusual, and maybe the abuse just effected me differently.  As a preteen, I thought I was so grown up, and mature.  Looking back I think, Hey, I should have stopped that.  He didn't threaten me, but I never thought to just say "no"  Now I see that HE did know better, and wether i think I should have/ could have stopped it, he never should have put me in that position in the first place.  Unfortunalty, it just makes me hate him more !!  But it helps to know that I am not wiered, or somehow brought it on myself, or even subconsiously wanted it to happen.
Thanks for your insight and for sharing with me


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## Ash (Sep 15, 2004)

Me said:
			
		

> But it helps to know that I am not wiered, or somehow brought it on myself, or even subconsiously wanted it to happen.



Although that's a normal response, I'm glad that you have figured out that it's wasn't your fault.


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## Kanadiana (Sep 15, 2004)

Me said:
			
		

> Kanadiana and david, thank you both for your replys.
> I am female.  I never eally connect my feelings of hate to the abuser as an "effect", as I just asumed that hate was a natural thing to feel towards a person like that.  .......... Now I see that HE did know better, and wether i think I should have/ could have stopped it, he never should have put me in that position in the first place.  Unfortunalty, it just makes me hate him more !!  But it helps to know that I am not wiered, or somehow brought it on myself, or even subconsiously wanted it to happen.
> Thanks for your insight and for sharing with me



Hi Me ... believe me, (you? LOL) you're reactions are normal (typical) of a lot of people. The hatred is a good thing because it says you're aware your innocence was used and abused I would say  Even if parts feel good and a kid wants the "feels good" and  even approaches the abuser for it ........ the kid ony does so because the abuser has manipulated and taken advantage of an innocents neediness for selfish.

Survivors have NOTHING to be ashamed of. The shame is in the "doer and deed itself, not in the done to".

I have no problem wishing my abusers "gone from the world" because they were the types to do these things to anyone at any opportunity. Pedophiles in other  words because thats their safest chance of not getting caught. 

Well ... when an abuser/pedophile dies it does bring a sense of relief and SAFETY ... they can't hurt anyone anymore. A lot of fear/hypervigilance and guilt are put to rest when the  offender is laid to rest, so to speak. 

I'd love to see the cycles stop  ... but all I can do is stop itsimpact on my current life and future. Its  all I have.

Gotta run ... take care


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## nicole6385 (Oct 4, 2004)

*Help*

I was sexually abused by my brother for 5 years of my life. I never told anyone until last year when I starting getting into a serious relationship. I told my boyfriend about it and he didn't really have a lot to say (who would?) Of course he comforted me and told me that it wasn't my fault and blah blah blah. I read a book on a woman who was sexually abused by her father and in her therapy she had to tell her parents. So I decided to tell my parents. I found out that the same exact thing happened to my mother and her brothers. Even though she has been through the same situation as me, I don't feel comfortable talking openly about it with her. 

Anyways, my point is... Before I told anyone about what happened to me when I was younger I didn't really even think about it that much and just like "Me" said I didn't really consider it abuse. Now that I've come out and told people about my trauma it's constantly on my mind and even more of a problem than it ever was. Oh I forgot another thing. Something that really disturbed me is that when I was reading that book I mentioned about a woman who was sexually abused by her father, when I got to the parts about the actual molestation it really aroused me. I'm extremely ashamed about this and I was wondering if there is a reason why I felt that way. Thanks.


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## sammy (Oct 4, 2004)

Hi Nicole...welcome to the forum...

I can't really answer your last question...maybe you were detached from seeing it as incest for that moment or so, and it was just male and female imagery or thoughts...

You said your mother has experienced the same?
I wonder if, in the future, you might both be able to share more deeply with each other about how you feel.

You are beginning to feel what was previously pushed down, and that is not necessarily bad... I know when I repressed some 'bad' feelings in the past, unfortunately I lost the capacity to feel some good things too.
When the feelings started to come out...it was worth it eventually.

Maybe your mom, though, is still not allowing herself to feel the hurt or anger of what happened to her.
I'm not saying be her therapist, or anything, but maybe...in the future, at an appropriate moment, you two may be able to help one another.


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## nicole6385 (Oct 4, 2004)

Thanks Sammy for your advice. My mom has seeked help for what happened to her. She has been seeing therapists all her life and she claims they don't work. I'm the type that needs to find that out for myself. Maybe they didn't work for her, but they can work for me. Who knows? 

When I told my mom what happened she blamed it on herself, even though she didn't live with me during those years. She just starting crying and saying it was her fault and she kept apologizing. I told her that it was NOT her fault what so ever and that she could not help it at all, she was not even living in the same house as us. So I don't know what to say about that. 

Because of all of this that has happened I'm afraid to have children. I'm much to young right now only being 19. But I would like to be a mother someday. I am so scared to have more than one child though and I'm afraid if I have one I'm going to want another one and if I just listent to my heart and go ahead and have the other child, what if I worry the entire time about what is going to happen to him/her? I can't live in fear of my child like that forever. I can't ALWAYS keep an eye on them 24/7. I don't know how to address that matter either.


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## David Baxter PhD (Oct 4, 2004)

nicole6385 said:
			
		

> My mom has seeked help for what happened to her. She has been seeing therapists all her life and she claims they don't work. I'm the type that needs to find that out for myself. Maybe they didn't work for her, but they can work for me. Who knows?


Therapy does work. Sometimes it does take a bit of trial-and-error to find the right therapist for you and even then it takes time and hard work -- it is not something that "works" overnight by any means.



> When I told my mom what happened she blamed it on herself, even though she didn't live with me during those years. She just starting crying and saying it was her fault and she kept apologizing. I told her that it was NOT her fault what so ever and that she could not help it at all, she was not even living in the same house as us. So I don't know what to say about that.


This is one of the reasons seeing a therapist can be so helpful: it is freeing... trying to talk to someone you know and care about means you are always holding something back, no matter how caring and supportive and loving that person is -- you are afraid to worry the other person, or to otherwise upset him or her, or to burden him or her. With a therapist, you don't have any of those inhibitions: that's what s/he is trained to do and paid to do -- listen and give advice objectively, not subjectively.



> Because of all of this that has happened I'm afraid to have children. I'm much to young right now only being 19. But I would like to be a mother someday. I am so scared to have more than one child though and I'm afraid if I have one I'm going to want another one and if I just listen to my heart and go ahead and have the other child, what if I worry the entire time about what is going to happen to him/her? I can't live in fear of my child like that forever. I can't ALWAYS keep an eye on them 24/7. I don't know how to address that matter either.


Again, this is something a therapist can help you with. The so-called "cycle of violence" or "cycle of abuse" is far from inevitable. For example, when it comes to physical abuse, the data do indicate an increased *statistical risk* of later aggressive behavior for physically abused children but this still means that only about 11-12% of abused children go on to become abusers themselves: 88-89% do NOT. It is similar with children of alcoholics: some do go on to become alcoholics or addicts but many do not, partly because they have seen first hand evidence of the negative results.


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## sammy (Oct 5, 2004)

Hi Nicole...
Yes, mothers feel an awful lot of _false_ guilt sometimes...they just want to be able to make everything right for their children...
I hope that she can learn that it wasn't her fault..

and also that _you_ can... 
and that you can also get hope for the future about having kids.


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## nicole6385 (Oct 6, 2004)

Thanks David and Sammy. I'm not really concerned that I'M going to do something to my children. I'm more concerned with my son abusing my daughter or vice versa. I've babysat children a lot since the incidents and I have never experienced any desire to do onto a child that what done onto me. I'm truly not concerned with that. It's just my children. I read in a book that you are suppose to show them what "good touches" and "bad touches" are. (Not SHOW them, but explain to them. Like specific areas and such.) Do either of you think that woudl work?

I would really like to try a therapist, but I really can not afford it right now. I'm 19 and I live with my boyfriend. I don't really how to choose a therapist or to find one. Can you guys give me any tips?


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## David Baxter PhD (Oct 6, 2004)

The "Good Touch - Bad Touch" approach is, I believe, used in elementary/primary schools here in Canada and probably is a good one.

For finding a therapist, often a good place to start is your family doctor. Depending on where you live, there may be clinics which offer free services or geared-to-income fees; universities will also often have such clinics.


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## nicole6385 (Oct 8, 2004)

Sounds good! Thanks a lot for all of your help. If I have any more questions I will definitely turn to you David. Once again, Thank you.


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## Aladdin (May 15, 2005)

My girl is now 4 years old and there is so many effects that i can see.it is a bit scarry.My ex wife layer told me that on 7 she will be normal with counsling.sometimes like now im feel if im going mad and do something to him because he are going to get free,she is still to young to give evedence,so he is free to do the same again to some one elses angel.


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## mr furious (May 22, 2005)

My girlfriend(17) recently told me her uncle molested her for 5 months. She was 11 at the time. She has told only me and her best friend. When she told me I told her things like it wasn't your fault etc.. When I tried to get her to actually talk about it, she asked me why I was making a big deal out of it, and she told me she was over it. But she also told me she thinks about it all the time. She still see's him almost every weekend. And they seem to get along well. I, on the other hand have to supress myself from smashing his face in(which  only hasn't happened because she asked me not to do anything). I don't know what to do. I want her to talk about it, but I don't want to force it out of her. Any suggestions?


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## David Baxter PhD (May 23, 2005)

Respect her wishes. Be supportive but don't try to force her to talk about it. She will do so when she's ready to or needs to -- but that may be a long way away.

Survivors need that control. If you were to force her to talk about it, it would be like another assault.


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