What are the Effects of Sexual Abuse and What are the Treatment Options?

The term sexual abuse refers to any sexual contact that occurs without explicit consent from the victim. Types of sexual abuse include:

• Attempted rape
• Fondling or unwanted touch (molestation)
• Penetration of the victim’s body (rape)
• Being forced to perform sexual acts, such as oral sex or penetrating the perpetrator’s body

Sexual abuse may occur once (isolated incident), or it may occur repeatedly over a period of time.

What is force?

Perpetrators may use physical pressure, emotional coercion, psychological force, or manipulation to coerce a victim into non-consensual sex (RAINN, 2022). At times, a perpetrator may use threats to force a victim into complying. Threats may include hurting the victim if they don’t comply, hurting the family, or using other intimidation tactics to get the victim to comply.

Who are the perpetrators?

The majority of the time, the perpetrator is someone that the victim knows. According to the Department of Justice (2017), 8-10 rapes are committed by someone the victim knew. Furthermore, of sexual abuse cases reported to authorities by children, 93% of juvenile victims knew their perpetrator (Department of Justice, 2017). Perpetrators may also include strangers that the victim does not know.

Half of the perpetrators are over the age of 30, 25% are between the ages of 21-29, 9% are 18-20 years old, and 15% are seventeen and younger (Department of Justice, 2017). Perpetrators of sexual crimes usually have extensive criminal histories with prior convictions. Additionally, if a perpetrator is released from prison, the chances of them reoffending are likely (Department of Justice, 2017).

What is rape?

Rape is a form of sexual abuse in which “penetration, no matter how slight, of the vagina or anus with any body part or object, or oral penetration by a sex organ of another person, without the consent of the victim” (FBI, 2022). The term “date rape” also known as “acquaintance rape” often refers to someone that the victim knew.

For example, this could be a coworker, classmate, a neighbor, a friend’s significant other, and various other roles. In other instances, the victim may not know the perpetrator at all. This is known as stranger rape. Stranger rape occurs in several different ways:

• Blitz sexual assault: the perpetrator quickly and brutally assaults the victim with no prior contact, usually at night in a public place
• Contact sexual assault: the perpetrator flirts with the victim, tries to convince the victim to follow the perpetrator to their car, or otherwise tries to coerce the victim into a situation where the sexual assault can occur
• Home invasion sexual assault: the perpetrator breaks into a home, sexually assaults the victim, then leaves

Survivors of rape, whether the perpetrator is an acquaintance or stranger, often blame themselves for behaving in a way that encouraged the perpetrator to perform the sexual assault (RAINN, 2022). However, it is important to remember that rape or any other form of sexual abuse is not the victim’s fault.

Child sexual abuse.

Child molestation is any sexual contact with a child. Many children who are molested are too young to know what is happening and may not fight back. Some abusers use the child’s cooperation in these cases as “evidence” that no one was harmed.

Examples of child molestation might include fondling or demanding sexual favors from a child. Furthermore, children do not need to be touched to experience sexual abuse. Voyeurism is the act of watching a child undress or shower (DSM, 2022). Adults who expose their genitalia to children are also committing abuse.

Incest.

Incest describes sexual contact between family members who are too closely related to marry. While incestuous sexual activity may occur between consenting adults, this is not common. Most reported incest occurs as child abuse. Over one-third of American sexual assault survivors under the age of eighteen are abused by a family member (Department of Justice, 2017). However, incest is an underreported crime, so the actual number of incest survivors may be higher.

Effect of sexual abuse.

The effects of sexual abuse can be severe and long-lasting. Effects may include physical, psychological, and emotional disturbances. It is important to remember that not all victims of sexual abuse are the same. Therefore, the effects of sexual abuse will not impact two victims the same.

There is no right or wrong way to react. As the body and mind process the devastation of sexual violence, many different emotions, behaviors, and physical responses appear and disappear and may reappear (WCSAP, 2002). Below is a list of some common experiences that survivors may have:

• Shame
• Guilt
• Denial
• Minimizing
• Difficulty trusting others
• Difficulty setting clear and concise boundaries
• Lack of safety
• Isolation
• Amnesia
• Disassociation (out-of-body experience)
• Anesthesia (numbness or disassociation from the body)
• Physical (may have physical complaints related to areas of their body affected by the assault)
• Emotional (expressive, disoriented, or controlled)
• Cognitive (unable to block out the assault, forget parts of the assault or replay the assault in their mind and try to conquer it)

Other related issues that may occur are eating disorders, physical changes, changes in sexuality, acute stress disorder or posttraumatic stress disorder, personality changes, attachment issues, substance abuse, self-harm, depression, anxiety, suicidal ideations, or anger.

Long-term effects may include:

• Continued anxiety
• Poor health
• Hypersexuality
• Sense of helplessness
• Fear
• Flashbacks
• Nightmares
• Mood swings
• Chronic depression
• Sleep disturbances
• Panic attacks
• Disassociation
• Phobias
• Paranoia
• Relationship difficulties
• Withdrawal/isolation
• Physical pain

If you, or someone you know, has been a victim of sexual abuse, you can use the Washington state directory at https://www.wcsap.org/help/csap-by-city to contact the right authorities in your area. Additionally, you can also call 800-656-HOPE to speak with a representative on the national RAINN (Rape, Abuse, & Incest National Network) hotline for sexual abuse.

The hotline is available 24 hours a day, 7 days per week. Survivors may also wish to get a physical exam at the hospital immediately following the assault. Immediate crisis intervention after an assault can be life-saving.

Treatment of sexual abuse.

Many survivors of sexual abuse develop mental health conditions after the assault occurred. Having a mental health condition does not mean that you are “weak” or “broken.” People who have survived sexual assault can seek help from a licensed mental health professional. Due to the complexity of sexual abuse cases that occur, a survivor must seek help from a mental health professional that specializes in trauma-focused therapy.

Some forms of effective therapy include Eye Movement Desensitization and Reprocessing (EMDR), Internal Family Systems (IFS), Trauma-Focused Cognitive Behavioral Therapy (TF-CBT), Dialectical Behavior Therapy (DBT), Somatic Experiencing, and Play Therapy. Therapy offers a safe space for survivors to get help without judgment.

If you, or someone you know, is a survivor of sexual assault and are ready to talk to someone about your experience, please schedule contact me. It is also important to note that a survivor can seek help at any point after the assault occurred, whether it be right after the assault occurred or years after. Sometimes talking to a therapist right after the abuse occurred may be too much for the victim to process. Remember, it is never too late to talk to someone about the abuse experienced.