Sexual Abuse

September 26, 2011

One out of four women will be sexually assaulted in her lifetime. Since the 1970s, the general public has been exposed to information and education regarding the prevalence of sexual violence against women and children, the lasting effects of sexual trauma, and the development of rape crisis programs. In the 1980s, the United States saw the emergence of the “Self Help” and “Recovery” movement, and the shift in perspective from “victim” to “survivor.” More recent issues regarding sexual assault since the 1990s include the short- and long-term effects of sexual trauma on the survivor, the impact of sexual assault on the friends and family members of the survivor, the “date rape drugs,” the delayed/false memory debate, and the impact of and changes in public policy.

Sexual abuse can be defined as any activity where an individual is used to meet the physical or emotional sexual needs of another person, with disregard to the needs of the victim. Children and adult women of all ages have the potential to be sexually abused or assaulted. Examples of covert sexual abuse, or using an individual to satisfy emotional sexual needs of another, include voyeurism, exhibitionism, witnessing someone else’s sexual violation, exposure to pornography, romanticized relationship with parent or adult, exposure to inappropriate nudity, or exposure to masturbation. Overt sexual abuse involves being forced to meet the physical needs of another person. Examples include being touched or massaged in a sexual manner, sexualized back rubs or hand holding, genital or breast fondling or rubbing, oral sex, anal sex, intercourse, mutual masturbation or being used for masturbation, penetration with finger or objects, sexual torture, and rape. Other experiences that include violations of physical and emotional sexual boundaries can also have negative affects. These include a lack of accurate information about puberty or sexuality, lack of right to privacy, too much information too early in a child’s development, sexualization by exposure to inappropriate adult sexual behavior, enmeshment in a parent’s adult sexual relationships or problems, living with parents who either repress or overdo affection and sexuality or parents who are involved in affairs, uncomfortable hugs that last too long, wet or lingering kisses, or seductive dancing.

Sexual abuse of children includes sexual stimulation or contact that is inappropriate for the age and emotional development of the child. Statistics indicate that between 100,000 and 500,000 children are sexually abused each year. It is estimated that 500,000-1,000,000 children in this country are involved in prostitution and pornography. Most children are sexually abused by someone they know; family members, family friends, neighbors, or other adults involved in their lives.

The impact of sexual abuse goes beyond physical injury and often results in significant emotional difficulties.
Research has shown that children who have been sexually abused often show behavior problems such as opposition to authority, aggression, school problems, and poor social skills. These children also may show symptoms such as depressed mood, anxiety, fear, sleep problems, and physical complaints. They often have low self-esteem, poor social skills, and mistrust others. Some children develop posttraumatic stress disorder (PTSD), which is characterized by a traumatizing event (in this case, sexual abuse), intrusive reexperiencing of the event (such as flashbacks, intrusive thoughts, nightmares), persistent avoidance of stimuli that are associated with the event, and physiological reactivity (paying close attention to cues and emotions, increased levels of adrenaline, increased startle response).

Adult survivors of childhood sexual abuse often experience effects lasting into adulthood that are difficult to overcome without treatment. This may include PTSD symptoms, as well as other body, sexual, mood, anxiety, and self-perception issues. These women may have difficulty with eating disorders, drug and alcohol abuse, self-mutilation, self-destructiveness, failure to be aware of body signals, or poor body image. They may have sexual problems such as believing that sex is dirty, aversion to being touched, difficulty integrating sex and emotions, feeling betrayed by their bodies, “promiscuous” sexual experiences, or avoidance of sex. They may also experience depression, fear of being alone or in the dark, feeling crazy, anger or intense hostility toward the gender of the perpetrator, or limited tolerance for happiness. Self-destructiveness, perfectionism, poor body image, and low self-esteem are common. Relationship problems are also common, including trust issues, pattern of being a victim, power and control issues, and choosing ambivalent relationships.

In our culture, adult women continue to struggle with power and authority in relation to men. Rape is sex without consent and represents the total surrender of power, control, and autonomy over one’s body. There are different types of rape including stranger rape, date rape, acquaintance rape, marital rape, gang rape, ritualistic abuse, office rape, and many women are also subjected to sexual harassment.

Women who are sexually abused or assaulted as adults have similar reactions to those of children who are sexually abused, and adults who were sexually abused as children. It is estimated that 4 million women in the United States have suffered from long-term psychological distress related to being raped, often including a diagnosis of PTSD. Due to cognitive maturity that most children have not yet developed, adult women who have been raped may feel that they were partially responsible for the assault. Many women are told, or believe themselves, that if they dressed or behaved in a particular manner, or made certain decisions, they hold some of the blame for the attack. One important part of treatment involves the survivor acknowledging that the assault was in no way her fault.

Treatment in the form of individual and group therapy, recovery groups, and psychoeducational tools can be successful. Treatment for sexual abuse generally include goals such as committing to treatment and forming a therapeutic alliance, acknowledging and accepting the abuse, recounting or “telling the story” of the abuse, breaking down and then expressing feelings, resolving responsibility and survival issues, grieving, restructuring cognitive distortions, self-determination, education and skill building, and forgiveness (of self and possibly the perpetrator).

Not only must sexual abuse survivors cope with the emotional and physical trauma of the events that occurred, they also often must face the police reports, medical assessment and treatment, and the legal system. Although more than 100,000 women report being raped in this country, approximately 60-90% of women who are raped do not report the assault. In part because of unreported rapes, less than 10% of rapists go to jail. There are various reasons why a woman would not report a rape, such as fear due to the rapist’s threats, fear of blame or insensitivity from the police, wanting to forget that it happened, not wanting others to find out, and planning not to go to court. Reporting the rape right away is important because the police can provide for the survivor’s safety needs, direct her to the appropriate community resources, take her for treatment and for a physical examination that will include collection of evidence. Reporting is also important for the safety of other women; many rapists are serial rapists and will act again.

Obtaining medical attention after sexual assault is important to avoid potential problems, even if the rape occurred weeks prior. A pregnancy test and tests for and treatment of sexually transmitted diseases (STDs) are generally part of the medical examination and treatment process. It is also important for the survivor to consult counseling and psychological support after an assault as well as treatment for any physical injuries. An evidentiary exam includes collecting evidence to show that recent sexual intercourse occurred, documenting signs of force or coercion, and to identify the perpetrator.
Prosecuting and convicting a rapist is generally a long process that is extremely difficult, and often frustrating, for the survivor. Many prosecuting attorneys screen rape cases before making an arrest, making a decision regarding how “good” a case is and the likelihood of a conviction. Survivor attributes, offender attributes, circumstances of the assault, rape laws, and the police investigation all affect the legal case.

Public policy (and the media’s coverage) related to sexual assault and abuse reflects changes in our society during the last 30 years and although these changes are positive, there is a long way to go. For example, the pornography industry continues to grow, particularly with the widespread use of the Internet. The male fantasies played out in pornography often portray a woman as a submissive, compliant sexual object. They often depict forms of sexuality that are aggressive and sometimes represent torture. Many forms of pornography act out sexual assaults and rapes, with the women smiling and accepting the man’s domination and control. Another example includes recent changes in laws concerning marital rape. Until the late 1970s, wives were widely considered property of their husbands. This perspective led to the belief that forced sex between a husband and wife was not considered rape and therefore also not considered a crime. Most of the states in our country have changed laws regarding marital rape, though there are some states that still exclude marital rape from their laws.

The media has brought the prevalence of “date rape drugs” to the awareness of the general public. The drug Rohypnol is a medication that is prescribed in countries other than the United States for treating insomnia or to be used as a sedative. Although this drug is illegally and recreationally used in this country, it has been associated with date rape as it can induce blackouts, memory loss, and decrease in resistance. Many women have involuntarily and unknowingly ingested this drug, sometimes slipped into a drink by an unknown attacker. Gamma-hydroxybutyrate (GHB) has been abused for its sedative effects as well when used by an offender.

In the past 10 years, the repressed memory/false memory of sexual abuse debate has been discussed at length with varying opinions. The debate centers on the question of existence of an individual repressing (the mind subconsciously “chooses to forget”) childhood sexual experiences that are later uncovered as an adult. There are many reports of uncovered memories that individuals believe are true and accurate. Because these individuals had no conscious memory of the abuse until many years later, others speculate that these are in fact false memories that have no basis in truth. Some believe that the false memories were suggested by therapists and psychologists, and accepted by individuals while in treatment for other problems. The False Memory Syndrome Foundation was founded by the parents of a cognitive psychologist who believed that she uncovered repressed memories of childhood sexual abuse by her father. Some parents accused of childhood sexual abuse have (often successfully) sued the therapists of individuals who claim to have uncovered repressed memories of abuse.

The prevention of childhood sexual abuse and the sexual assault of adult women consistently remains a significant priority. It is imperative that parents teach their children body safety (appropriate boundaries regarding private body parts and what to do when another child or adult attempts to violate those boundaries) and dispel myths related to sexual abuse (occurs across all socioeconomic levels and racial lines, children can be offenders, etc.). Parents need to be emotionally and physically available to their children, protect and guide them, keep open communication, and not be afraid to ask direct questions. Parents with a history of sexual abuse should do their own personal work on remaining related issues.

Adult women can also take steps to protect themselves from rape and other sexual assault. Active measures such as making smart choices, carrying protection (i.e., Mace), looking confident when walking alone, locking car doors when driving alone, being familiar with your surroundings, and taking a self-defense course are all positive ways to protect oneself from sexual assault.

See Also: Domestic violence, Incest, Posttraumatic stress disorder, Psychotherapy, Rape, Sexual harassment, Sexually transmitted diseases, Stalking

Suggested Reading

  • Bass, E., & Davis, L. (1988). The courage to heal. New York: Harper & Row.
  • Ledray, L. E. (1994). Recovering from rape. New York: Henry Holt.
  • Lees, A. B. (1998 workshop Raleigh, NC). Sexual abuse: Helping adult and child survivors. Tucson, AZ: Carondelet Management Institute.

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