Wednesday, September 5, 2012

Dissertation on shame. Chapther 2.3 Consequences of sexual abuse


2.3 Consequences of sexual abuse


There is an abundance of literature on the consequences of sexual abuse. The most common consequences from sexual abuse which I have found in the literature on the subject seems to be; strong feeling of guilt and shame, negative self-image, reduced trust in ones self and others, isolation, sexual problems, pain sensations, psychosomatic conditions, anxiety and depression, hallucinations, sleeping problems, self-harm, suicide, re-victimization, and aggressive behavior

Ensink (1992) has carried out a study where 100 women that have experienced child sexual abused were evaluated for symptoms they had had later in life. The conclusions from this study show that women that have experienced child sexual abuse seem to be often wrongly diagnosed and treated as psychotic patients with poor results. The results show that:
64 percent have hallucinations
50 percent try to harm themselves
45 percent try to commit suicide
38 percent have symptoms consistent with multiple personality disorder
33 percent have experienced a dissociative state of being (having experienced a loss of
time and place and not being able to remember what happened in a given time
period)

There seem to be few studies concerning in particular the effects of sexual abuse on men. One study carried out by Gil and Johnson (1993) of 10 men show that these men felt:
- Unable to live up to the ideal image they meant society has of being a man.
- Being a failure for not having control over their lives and for not being able to protect
themselves.
- No feeling if intimacy with sexual partners.
- Difficulty in maintaining a close relationship with others.

Research on attachment between child and abusive parent or other caring persons can be characterized as a traumatic relationship (Bowly 1988; Ainsworth, Behar, Walters and Wall 1978) or as a traumatic-binding (James 1994).  Children living under such destructive and traumatic relationships will often be harmful for the child’s self-image, ability for adjustment in their relationships with others, and limit the possibility for establishing intimate and stabile relationships (Roche, Runtz and Hunter 1999).

Post-Traumatic Stress Disorder (PTSD) is another growing category for sexually abused victims. This condition is characterized by a re-experience of the traumatic sexual abuse through dreams, thoughts, and flashbacks. Victims will often develop an aversive way of being with social withdrawal. They might feel numbness or depression, or hyperactivity and always on the alert (Allen 2001; Horowotz 1986; Putman 1997)

Dissociation is also a condition which characterizes many victims of sexual abuse. It seems that the individual tries to protect oneself from extreme painful experiences (both physical and psychological) by not remembering how the experience with all its details, the experience is remembered bit by bit. Small fragments can be remembered through hallucinations or flashbacks. Sometimes these fragments of memory can create a basis for the development of other personalities without the individual being aware of it (Putman 1997). Some can experience that their self becomes divided and that they seem to be able to experience themselves from outside their own body or being observers to their own actions. This is called depersonalization and represents an alienation of the individual’s relationship to the world and to them selves. Putman (1997) argues that as many as 85-100 percent of all those who have a multiple personality disorder can tell a traumatic childhood history. Physical violence or sexual abuse combined with physical violence in the childhood years seems to be the greatest risk factor for developing a dissociation disorder (Mulder, Beautrais, Jouce and Fergusson 1998).

Other conditions that appear commonly with sexual abuse victims are attention problems, learning difficulties, amnesia for the episode which triggered the trauma, hearing of voices and seeing ghosts, aggressive outbursts, speech with a different en peculiar voice, fantasy friends that take control over ones actions, and clear and separate identities. Psychotherapy will therefore often focus in the splitting of the self with victims of sexual abuse (Shirar 1996; Siberg 1996).
 Kaare T. Pettersen
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