By Dr. Elaine Ducharme

#MeToo. The recent events that have come to light regarding the sexually inappropriate behavior of Harvey Weinstein have shocked many. We have also learned that Olympic doctor Larry Nasser has sexually assaulted multiple women under his care. The reality is that sexual abuse is more common than most realize. The #MeToo campaign has given so many women the courage to speak out. For this I am grateful. Living with the secret of sexual victimization has so many short and long term effects.

I have spent well over 30 years specializing in the treatment of trauma and abuse. I have had a number of kids tell me that while they hear a lot about bullying in school, they learn very little about sexual abuse. So let’s talk about it now.

Sexual abuse is a crime of power and control. It is unwanted sexual activity with perpetrators, using force, making threats or taking advantage of victims unable to give consent. It often has little to do with sex. Rather, it is a violation of a person’s boundaries. It is different from a robbery in that the weapon is a penis, a finger or some other object. What is stolen is a childhood, the ability to ever trust or feel safe, the ability to feel clean. Even one’s sense of realty is challenged since most perpetrators tell their victims the abuse was their own fault or that this is what love is about. These things are very difficult to reclaim. They cannot be turned into the Lost and Found. Sometimes, even after many years of therapy, trust, intimacy and a true sense of safety are hard to find. Most of the time the victims are also told that they must keep this secret or something terrible will happen to them or their loved ones.

Sexual abuse also can happen to adults. Most of us recognize rape as a crime. But many don’t recognize that forced sexual activity within the context of a relationship is still abuse. And when an adult is forced to engage in sexual activity in order to get or keep a job, as in the case of so many of Harvey Weinstein’s victims, it is clearly abuse.

We don’t like to talk about sexual abuse. But the facts are startling. And we must pay attention. Some statics reflect a decrease in sexual assaults. However, there is a problem in that only 30% of sexual assault cases are reported to authorities. Regarding incest, a large number of cases of sibling incest go unreported. I believe the statistics below reflect the underreporting. The Center for Victims of Crime reports:

• 1 in girls and 1 in 20 boys is a victim of child sexual abuse. Other studies suggest the rate of sexual assault among boys is higher.
• Self-report studies show that 20% of adult females and 5-10% of adult males recall a childhood sexual assault or sexual abuse incident;
• During a one-year period in the U.S., 16% of youth ages 14 to 17 had been sexually victimized.
• Over the course of their lifetime, 28% of U.S. youth ages 14 to 17 had been sexually victimized;
• Children are most vulnerable to CSA between the ages of 7 and 13

Most of the time the perpetrator is known to the victim. The effects of abuse can occur at 3 different times.

• While the abuse is occurring
• When the abuse is discovered and reported for the first time
• When victims have difficulty functioning later in life

Children who were abused often manifest serious disturbances in the immediate aftermath of the abuse. They may complain of headaches or stomach aches. They may suddenly start wetting the bed or seem withdrawn. Others try to pretend it didn’t happen and aim to protect the non-offending parent in cases of incest. Still others begin a pattern of self destructive behaviors such as cutting, drug and alcohol abuse and eating disorders.

As adults, individuals who were sexually abused generally experience more serious problems than their non abused counterparts. Feelings of guilt, shame and difficulties with intimacy abound. Drug addictions and sexual acting out are not uncommon. Males who were sexually abused as children by other males may experience feelings of sexual identity confusion as well as a particular shame that somehow this should never happen to boys. If the victims do not deal with these experiences, they are likely to somehow continue the cycle of abuse in some way by marrying a perpetrator or being unable to protect their own children.

The outcome is best when the abuse is short term, reported quickly and the victim is believed. However, if the abuse is extensive and lengthy, the vicim is not believed and not protected from further abuse, or the effects have included substance abuse, recovery is much more complicated. Even under those circumstances, recovery is clearly possible. The goal is to acknowledged that the abuse happened, work through the feelings and issues related to the abuse but to make sure the abuse is not a life sentence! Recovery is definitely not about forgiving the perpetrator. It is about letting go of the pain. In my book, Must I Turn the Other Cheek I talk about how premature forgiveness can actually hinder recovery. But, letting go helps victims regain control of their lives.

If you have been a victim of sexual trauma, as a child or adult, please reach out for help by a psychologist or other mental health professional trained in dealing with these types of abuse. Remember, you were not responsible and you deserve to heal. Let’s work together to get more information about sexual abuse into the schools and homes.

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