A big obstacle to recovery is that often survivors of child sexual abuse (CSA) do not know that the problems they have are related to past experiences of CSA. In fact, in my research 60% of the participants did not link their mental health problems to their history of sexual abuse. They were completely unaware of the significant impact sexual abuse had in their emotional, physical, and mental life.
Instead they thought something is wrong with them and with their way of thinking. They became angry and frustrated with themselves for being depressed without obvious reasons, having anxiety attacks that don’t make any sense, and for being ‘utterly defective’. What some professionals easily overlook is that the ‘average’ person does not link her/his emotional state today to experiences they had 30 years ago and which they might have partly forgotten.
When health professionals do not take a thorough personal history and ask if the person has experienced any forms of abuse, survivors will not know the right questions to ask that give them access to the help they need. More often than not they don’t really know what they might need. Their lack of understanding the origins of their problems was compounded when they approached public mental health services’ for help. Research has shown that public mental health services don’t always inquire about a person’s history of sexual, physical, or emotional abuse.
This invisibility of sexual abuse is a tragedy. Without understanding the link between sexual abuse and psychiatric disturbances, survivors end up blaming themselves for being weak, stupid, crazy, unlovable, defective, and many other negative characteristics. Often enough it leads to self-hate and self-harming behaviours that in turn re-enforce negative self perception. Survivors’ mental health spirals downwards and recovery is seriously hindered. They might spend years and years in mental health care without little or no improvement.
The invisibility of CSA in society and in mental health settings combined with survivors’ childhood conditioning of being silenced, their coping strategies of avoidance and dissociation, family’s and friends’ limits of knowing how to deal with survivors’ pain and disorganised life, and the inability to link the problems survivors have to their experiences of abuse prevent people not only from being effective in seeking professional help but also from themselves from future emotional, physical, or sexual harm.
Sexual abuse harms a person in many different ways. How deeply a person is affected by sexual abuse depends on a number of variants. In general we can say that the impacts of abuse depends on the age of the child, the relationship between child and perpetrator, the frequency, the duration, the severity, the presence of threats, and the availability of support and care. Most survivors who seek help struggle with cognitive contamination, impaired social functioning, impaired memory processing, negative self-relations and identity, learned helplessness, physical health problems i.e. irritable bowl syndrome, sleep disturbances, disordered eating, mood disturbances, abuse of drugs and alcohol, to name just the most obvious.
Although the above mentioned symptoms are not always due to sexual abuse, it may be useful to ask yourself, whether any forms of sexual abuse, physical abuse, emotional abuse, or neglect have occurred. When you have been abused and you can make the link to your problems, you can start dealing with the abuse and begin your journey of recovery.