Anything that is “wrong” with you began as a survival mechanism in childhood. Dr. Gabor Maté

Being sexually abused as a child, particularly when it’s by a trusted adult, can have devastating consequences that ripple across all areas of a person’s life. The connection between the abuse and the struggles people are having aren’t always obvious.

In many cases, people struggle with PTSD symptoms such as panic attacks, flashbacks, anxiety, racing or intrusive thoughts, hypervigilance, anger or explosiveness, risky or self-sabotaging behaviors, eating disorders, bipolar-like symptoms, ADHD-like symptoms or physical symptoms such as migraines or chronic immune diseases. Many survivors, even when they don’t remember the abuse, struggle with boundaries, will resort to self-soothing strategies such as alcohol, cutting or other self-harming, over working, or intense exercise, and can find themselves in abusive relationships again and again, or being taken advantage of and not understanding why this continues happening to them.

When there is childhood sexual abuse, there can be a profound effect on a person’s sense of self, and their understanding of boundaries. I’ve heard it described as, “When someone does this to you, it’s as if they are reaching inside you and stealing your soul. You no longer have rights to yourself. You do not exist.”

As adults, it is sometimes hard for us to understand or remember that children rely entirely on their caregivers for survival. This is a biological instinct. So, when a child is confronted with an abusive caregiver or trusted adult, there is an instinctive drive to “make it OK” – this drive is part of the human resilience. Unfortunately, often “making it OK” means internalizing the belief that they are bad, because it is more tolerable (and essential for survival) than their caregiver being ‘bad.’ In addition to internalizing these “I am bad” messages about themselves, children often cope by dissociating or disconnecting from their bodies and by escaping into their own minds. This behavior can continue long after the abuse stops, as a learned behavior for escaping emotional pain, or when a flashback occurs.

Many times, their sexuality develops linked to the abuse, for example, a person might need to imagine a violent experience in order to become aroused, or their bodies responded by becoming aroused during the abuse. This is not unusual and not “bad”. Maybe they felt special, or craved the attention even though there was a felt sense that this was wrong. I’ve heard survivors say that they thought that’s how you showed love, or that they believe they seduced their abuser, or that they didn’t know until later that it was wrong because aspects of it seemed positive (being praised, given attention, given or bought gifts). It can be incredibly confusing and can result in deep shame.
If I, as a child, claim that something awful has happened—that someone has done something terrible to me—and everyone around me acts as if nothing is the matter, then either I must be crazy, or all of them are. And when you’re a kid and your life depends on all these people, there is no choice: of course, I must be crazy. E. Sue Blume, Secret Survivors

The disconnect from or discomfort with their bodies, combined with the confusing messages they received about love and trust, can result in a lack of trust in their own perceptions and senses. They don’t have access to their intuition, or because they were told either overtly or covertly that their intuition was wrong by the “trusted” abuser, they don’t know how to reconcile this irreconcilable conflict and learn instead not to rely on or flat out ignore their own signals. As they go through life, they might not recognize the “red flags” that others who can rely on their intuition do recognize.

How Can Therapy Help?

“If we can share our story with someone who responds with empathy and understanding, shame can’t survive.”

~Brené Brown

I have been witness to the incredible resilience of the human spirit, and have seen that despite often unimaginable abuse, people can and do heal and learn to trust themselves again — to feel whole again.

People decide to seek therapy for different reasons. Maybe their lives have become unmanageable or they’re tired of merely surviving, or perhaps circumstances around them have become overwhelming or have made the memories of the experiences resurface, which has been the case for many with the #metoo movement and media coverage of sexual assault. Sometimes they’ve been managing OK but life becomes more stressful and the added stress overwhelms their coping strategies and they can no longer cope like they used to.

A life cycle change can be a catalyst, too, for example, they have a child or their child reaches the age when they themselves were abused, or for example, they enter into a relationship that forces them to confront intimacy issues.

And conversely, sometimes people decide to seek therapy not because they are overwhelmed but because they have reached a place of greater stability and that gives them the ability to process the pain. Or they have a supportive partner or life situation that creates the necessary space.

There is no one way to heal; there is no right or wrong to healing. Often, we are impatient with ourselves and want to move past our pain quickly and decisively, we want to be “over it.” Sometimes we thought we were over it only to have the pain come back again under different circumstances, which can feel frustrating and demoralizing, making us wonder if we will ever heal. Sometimes we berate ourselves for avoiding the pain, so we can enter this cycle of avoidance and self-judgment, a shame spiral.

Therapy can help survivors learn to see their problematic behaviors and body reactions as signals; they can begin to let go of some of the judgment and look at their behavior and reactions with curiosity and compassion rather than shame and self-hatred. There is a significant shift when people understand what their bodies are experiencing and why they react the way they do when activated. They start learning how to interpret these signals and begin to feel safe in their own bodies.

With therapy, survivors can begin to see that their thoughts, emotions, reactions, and choices all make sense given the experiences they’ve had. They realize that they have been reacting very normally to very abnormal circumstances. Once they can step back from judgment and begin understanding where those self-sabotaging impulses come from and what the resulting behaviors are doing for them, they can begin finding different ways of dealing with and addressing their pain.

And as they find new ways of dealing with or addressing their pain, they begin to trust themselves; they gain a felt sense of their ability to tolerate the distress and emotion that comes up. They begin to feel a sense of mastery and increased confidence. They begin to have a choice.

One question I am often asked is whether it is necessary to talk about the abuse in order to heal from it. And no, I don’t believe it is necessary, but I do believe there is tremendous healing power in telling your story. More often than not, as people begin to heal, they begin telling their story — but very much in their own time, and in their own way.

I’ve found that as people begin telling parts of their story, or maybe even talking about the fact that they can’t talk about their story yet, and they feel heard and understood, and validated, the more they want to share. And as they share, perhaps they begin to uncover damaging beliefs they’ve held, and they find that the power the story had over them diminishes.

Healing will not make it so the abuse didn’t happen; you have been shaped and scarred by what you’ve experienced, and it will always be a part of who you are. But there is no doubt in my mind that you with time and support, your story will take on a different shape, and it will become only a part of who you are, not the entirety. It will be a chapter but by no means the whole book, and that you can feel whole and happy.

“I am on the road to healing and there is no turning back.” ~Sunik

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Sincerely,

Larissa Pasut, AMFT