Sexual Abuse Treatment Psychoeducation

Sexual Abuse Treatment Psychoeducation

Written by Morgan McCoy, Coastal Center for Collaborative Health blog writer

It’s common for people who have experienced sexual abuse to feel complex emotions some of which can include shame, fear, and isolation. America has a long history of systemic denial and minimization of sexual abuse. This history involves survivors of sexual abuse being met with avoidance and denial from their support systems, religious and educational institutions, and even legal and medical professionals who they were told are there to protect them. This can compound with the trauma of their abuse and can create an even higher sense of isolation, fear, and shame. According to Mintz (2012) it has been shown that sexual abuse thrives in environments with unequal power relationships, environments of isolation and social disconnection, in emotionally disempowered young people, in ideologies that rationalizes abuse, institutional settings that shield individuals from public scrutiny, and institutions intent on protecting their reputation and safeguarding themselves from liability (para. 12). Research has shown that some common factors in the experience of survivors of childhood sexual abuse are they were usually abused by someone they knew, the abuse often started when they were very young, the abuse generally happened over many months or years, and the abuse was often accompanied by threats, verbal, emotional and sometimes physical abuse, (Healey, 2015, p.1.). Breaking the societal silence around sexual abuse is important to its healing. Below is information around common experiences of survivors of sexual abuse. 

Post-Traumatic Stress Disorder

According to the National Center for PTSD, the most widely studied long-term psychological consequence of experiencing sexual assault is Post Traumatic Stress Disorder (PTSD). The symptoms someone experiences must exist in the categories of intrusion symptoms, avoidance, negative alterations of cognition and mood, and marked alterations in arousal and reactivity. PTSD can also have the dissociative symptoms of depersonalization (feeling of being detached from the self), and derealization (feeling of being detached from one’s surroundings). In other terms, PTSD can be understood as a person’s ability to integrate their emotional experience following a traumatic event is disrupted, for example they may be struggling to stay present, understand what is happening, and integrate their feelings and make sense of the traumatic experience (Saakvitne, 2000). It’s common for people with PTSD to remember different sensory aspects of the traumatic memory but they are fragmented and not processed together as a cohesive whole, for example remembering sounds and smells but not sights. Avoidance and intrusive symptoms can be thought of as existing as opposites, as well as each maintaining the functioning of the other. Avoidance is an attempt to escape from painful feelings while intrusive memories are attempts to process and integrate the trauma, (Paivio, 2023, p.22). After a traumatic event affective avoidance is what can cause PTSD to develop. The more people try to avoid thinking about the experience the more often it will come up, often during inconvenient times. Since traumatic experiences, such as sexual abuse, are unforgettable and often outside of someone’s ordinary experience, it’s not easy to integrate into one’s current meaning systems. It can be helpful for people who’ve experienced sexual violence to find a trauma therapist to learn coping skills to manage the distress and to help process the experience and incorporate it into a coherent narrative that allows them to create new meaning around the event.

Secondary Wounding

Sexual abuse is a relational injury and can make it hard for survivors to trust other people. According to Katz (2019), in addition to the perpetrator typically isolating the victim to enact the crime and to ensure to avoid consequences, survivors can also feel unsafe or unwelcomed to talk about what happened with family, friends and institutions due to them minimizing, ignoring, or not believing what happened is true. Aphrodite Matsakis, an expert in the field of PTSD, coined the term “secondary wounding” in her book I Can’t Get Over It (1992). According to Caprioli & Crenshaw (2017), secondary wounding of victims of sexual assault is when a response to a disclosure blames or shames the individual or disbelieves or minimizes the abuse and can leave people revictimized. It can sometimes be worse for a victim than the original act of violence, especially if it comes from someone the person is closely attached to. According to McOrmond-Plummer (2014), “secondary wounding may compound the original trauma, or in some cases cause the survivors to feel even worse than the rape itself,” (p.30). Sources of secondary wounding can come from someone’s family and friends, or helping professionals such as police, emergency workers, teachers, school systems, therapists, advocates, and lawyers and also can come from messages from society and the media. It can happen through words and messages and most often is in the form of nonverbal communication.  

Sexual Abuse Treatment 

One of the main factors that contribute to whether someone won’t develop PTSD after a traumatic event is if they have a safe support system. Research has shown that positive and supportive social reactions to abuse disclosure predicted greater perceived control over recovery and less PTSD symptoms, (Ullman & Peter-Hagene, 2014, p.1). There are various forms of treatment options for people who have experienced sexual abuse some including: art therapy, Prolonged Exposure (PE), Cognitive Processing Therapy (CPT), Stress Inoculation Training (SIT), Eye Movement Desensitization and Reprocessing (EMDR), and more often used with children and adolescents is Trauma Focused Cognitive Behavioral Therapy (TF-CBT).

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References

Caprioli, S., & Crenshaw, D. A. (2017). The Culture of Silencing Child Victims of Sexual Abuse: Implications for Child Witnesses in Court. The Journal of Humanistic Psychology, 57(2), 190–209. https://doi.org/10.1177/0022167815604442. 

Healey. (2015). Tackling child sexual abuse (Healey, Ed.). The Spinney Press. 

Katz, Lori. “Why Victims of Sexual Trauma Feel Alone and Isolated.” Psychology Today, Sussex Publishers , 18 Aug. 2019, www.psychologytoday.com/us/blog/healing-sexualtrauma/201908/why-victims-sexual-trauma-feel-alone-and-isolated.  

McOrmond-Plummer, L., Easteal, P. W., & Levy-Peck, J. Y. (Eds.). (2014). Intimate partner sexual violence : a multidisciplinary guide to improving services and support for survivors of rape and abuse. Jessica Kingsley Publishers. 

Mintz, Steven. (2012) “Placing Childhood Sexual Abuse in Historical Perspective.” SSRC The Immanent Frame, 12 July 2012, tif.ssrc.org/2012/07/13/placing-childhood-sexual-abuseinhistorical-perspective/.  

Paivio, S. C., & Pascual-Leone, A. (2023). Emotion-focused therapy for complex trauma : an integrative approach (Second edition). American Psychological Association. 

Saakvitne, K. W., Gamble, S., Pearlman, L. A., & Lev, B. T. (2000). Risking connection: A training curriculum for working with survivors of childhood abuse. The Sidran Press. 

Ullman, & Peter-Hagene. (2014). SOCIAL REACTIONS TO SEXUAL ASSAULT DISCLOSURE, COPING, PERCEIVED CONTROL, AND PTSD SYMPTOMS IN SEXUAL ASSAULT VICTIMS: Social Reactions and PTSD. Journal of Community Psychology, 42, 495–508. https://doi.org/10.1002/jcop.21624.