Childhood Sexual Abuse: Its Impact on Adult Life

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KEY POINTS

• Any sexual activity, even if the child agrees, between a child and an adult may be sexual abuse.
• As an adult who was sexually abused during childhood, you may have strong feelings of anger, self-hate, shame, depression, or anxiety. Your feelings may cause you a lot of trouble dealing with work, family, and other relationships. You may have never discussed or revealed the abuse to anyone because you are ashamed.

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What is sexual abuse?

Any sexual activity, even if the child agrees, between a child and an adult may be sexual abuse. It may include:

• Touching a child’s genitals or rubbing of an adult's genitals on a child
• Intercourse or oral sex
• Showing genitals to a child
• Showing sexual pictures to a child
• Using the child to make pornographic pictures or videos

Abusers are usually someone you knew, such as a relative, friend, neighbor, babysitter, or teacher. They may have gotten you to trust them and their activities with you. However, it is never OK for an adult to have sex with a child, even if there were times when you did not try to stop them.

What problems can childhood sexual abuse cause?

As an adult who was sexually abused during childhood, you may feel:

• Ashamed. You may feel dirty or guilty because you feel that you caused the sexual abuse when you were a child. You may use alcohol, food, drugs, or overwork to numb your emotional pain and to manage shame and guilt. You may hate your body and not take good care of yourself.
• Self-hatred. Many children believe abuse is their fault. You may still feel that way and be convinced that there is something different or wrong about you.
• Powerless. You may also have trouble saying no to unwanted sexual contact, even though you are always thinking about protecting yourself. As an adult, you may accept others hurting you physically, sexually, or emotionally because you feel it’s normal or what you deserve.
• Suicidal, or like you want to hurt yourself or others. You may have a lot of anger about having been abused as a child. You may hit or hurt your partner or children when you are upset. You may fear that you will abuse your own children.
• Isolated. You may keep the abuse you suffered as a child secret, particularly if the abuser was a family member or close family friend.
• Unable to make even simple decisions or choices. During the abuse you may have learned to go numb and detach from what was happening. As an adult you may still "space out" when you feel stressed or anxious. This can make it hard to think, plan, or do everyday activities.
• Fearful and always on guard. You may startle easily, have trouble sleeping, and feel tense when you are around other people.
• Unable to ask others for help or to depend on anyone else. You may have trouble relating to others. When you were a child, your trust was betrayed by an adult. When you grow up, you may suspect that others are using you, will leave you, or will hurt you.
• Out of touch with your own body. At times, you may not even know when you are hungry or tired. You may not eat well or get enough sleep.

You may also have problems with depression, anxiety, post-traumatic stress disorder, eating disorders, and substance abuse.

If you were abused as a child, it can help to talk to a therapist about it, especially if:

• You have never discussed or revealed the abuse to anyone because you are ashamed about it.
• You have strong feelings of anger, self-hate, shame, depression, or anxiety.
• You are having a lot of trouble dealing with work, family, and other relationships.

How is it treated?

Several kinds of therapy may help.

• Cognitive behavioral therapy (CBT) is a way to help you identify and change views you have of yourself, the world, and the future. CBT can make you aware of unhealthy ways of thinking. It can also help you learn new ways to think and act.
• Eye movement desensitization and reprocessing (EMDR) helps you cope with feelings and thoughts about distressing past events. You move your eyes back and forth, usually following the therapist's hand or pen, while you recall the event. Over time, you become less upset about the event.
• Group therapy can help you deal with work and relationships. It takes place in a group of 6 to 10 people, under the guidance of a therapist.
• Support groups can help you understand that you are not alone. Groups also provide a safe place to share feelings. Same-gender groups of people who have been sexually abused can be very helpful.

The goals in individual or group therapy may include:

• Understanding anger you may have towards your family or close friends
• Learning how to manage your anger in healthy ways
• Learning how to take better care of yourself
• Becoming aware of your own power as an adult and your ability to change

Medicines may help if you have anxiety, depression, or obsessions (ideas that you can't stop thinking about). Your healthcare provider will work with you to select the best medicine. You may need to take more than one type of medicine.

How can I take care of myself?

• Get support. Talk with your family and friends. Consider joining a support group.
• Learn to manage stress. Ask for help at home and work when the load is too great to handle. Find ways to relax. For example take up a hobby, listen to music, watch movies, or take walks. Try yoga, meditation, or deep breathing exercises when you feel stressed.
• Take care of your physical health. Try to get at least 7 to 9 hours of sleep each night. Eat a healthy diet. Limit caffeine. If you smoke, quit. Avoid alcohol and drugs. Exercise according to your healthcare provider's instructions.
• Check your medicines. To help prevent problems, tell your healthcare provider and pharmacist about all of the medicines, natural remedies, vitamins, and other supplements that you take. Take all medicines as directed by your provider or therapist. It is very important to take your medicine even when you are feeling and thinking well. Without the medicine, your symptoms may not improve or may get worse. Talk to your provider if you have problems taking your medicine or if the medicines don't seem to be working.
• Contact your healthcare provider or therapist if you have any questions or your symptoms seem to be getting worse.

Get emergency care if you or a loved one has serious thoughts of suicide or self-harm, violence, or harming others. Also seek immediate help if you have chest pain or trouble breathing.