Adult Survivors of Child Sexual Abuse and Physical Abuse

Like adults, children who have suffered a sexual or physical abuse experience significant psychological and emotional distress. For them, the experience can be even more traumatic because unlike adults, they are traumatized during the most critical growth period of their lives, or when they are:

  • Forming assumptions about self, others and the world
  • Coming to terms with their own feelings and opinions
  • Developing coping and relationship skills.

Their reactions to the abuse can affect their subsequent psychological and social maturation, leading to atypical and potentially dysfunctional development. Put another way, if left untreated, the effects of sexual and physical abuse in childhood are usually more dynamic and interactive than those suffered in adulthood.

The Effects of Childhood Abuse on Adult Survivors of Child Sexual Abuse and Physical Abuse

Effects are likely to occur in stages:

  • Initial reactions to victimization
  • Accommodation to ongoing abuse
  • Long-Term Elaboration and Secondary Accommodation Reflection

For adults who were abused in childhood, and who received no counseling or support at the time, some of the initial reactions may abate over time. But more often, the reactions fester until they reach the point that counseling becomes necessary. Therapy often focuses on three issues:

Treatment Objectives for Adult Survivors of Child Sexual Abuse and Physical Abuse

The key objective of counseling intervention with adult survivors of childhood sexual and physical abuse is to facilitate trauma resolution and foster healing and growth.

Normalization of the Reactions of Adult Survivors of Child Sexual Abuse and Physical Abuse

Validation of the survivor’s suffering to the abuse and the effects on his or her psychological functioning is a key objective. It is important to note that certain coping strategies allowed the victim to deal with the abuse. But these strategies often become maladaptive in adulthood and limit their ability to live a full life with enriching interpersonal relationships.

Education of Adult Survivors of Child Sexual Abuse and Physical Abuse

It is also important to educate the adult survivor about the prevalence and later psychological effects of childhood sexual and physical abuse.  It helps de-stigmatize their own experience and normalize their responses. The survivor can better understand their own range of behavior with: information about the lasting effects of childhood sexual and physical abuse; the types of difficulties experienced; and the common symptoms that survivors encounter.

Both normalization and education are critical, particularly at the beginning of the counseling process, because they prepare the survivor for the healing process. Once the survivor has entered counseling, it is also imperative as part of this preparation to clarify what he or she can expect as they work on their abuse issues. The survivor should understand that the healing process will not be easy and that the memory of the abuse will not go away easily.

Therapy can provide a calm and safe environment and a structured process so that a survivor can:

  • Acknowledge memories and associated pain
  • Assess the influence these memories have on behavior
  • Start to integrate the memories with his or her adult self

It is this integration that allows the survivor to process the memories and pain to the point that they no longer interfere with control of behavior and responses.  Rather than continue to be controlled by maladaptive behavior patterns and responses, he or she will be able to take control of his or her own life as if they and their abuse experience are “frozen in time.”

Treatment Phases and Structuring the Healing Process for Adult Survivors of Child Sexual Abuse and Physical Abuse

The initial phase of therapy with adult survivors of childhood sexual/physical abuse focuses on two goals: building trust between the therapist and the survivor and preparing the survivor for the healing process. The survivor shares his or her story at his or her own pace, which allows the therapist to assess which therapeutic techniques may be most beneficial.

It is difficult for some survivors to tell their story. Their memories are fragmented and all jumbled up, making it difficult to verbalize what happened and when. There is often a feeling of being overwhelmed by the abuse. Many survivors cannot differentiate between episodes of abuse and convey their belief that their childhood was stolen from them. At this stage, survivors work to put their childhood back together into a recognizable, cohesive whole by focusing on specific incidents or episodes.

The middle phase of therapy is where the brunt of the work is done. It involves re-processing the trauma, or:

  • Acknowledging that the abuse occurred
  • Acknowledging the effects of the abuse
  • Experiencing and releasing some of the feelings associated with the trauma that typically have remained repressed
  • Exploring feelings toward the abuser, parents, siblings or caretakers
  • Making cognitive reassessments of the abuse (such as why it happened and who was responsible)

At this point, the abusive episode can no longer remain “frozen in time.” The abused child must be integrated with the adult self so that they work together as a unified whole rather than function as two parts that conspire against each other. Emphasis is also placed on cognitive restructuring, educating the survivor and formulating new coping strategies. A clear line is drawn between the past and the present, leaving the individual feeling more in control and determined to deal with the effects the abuse has had on his or her life.

In this phase, the survivor develops a stronger sense of self, new coping skills and perhaps new world views. The survivor actively engages in healing, assessing and making decisions about the available options. This is also a stage marked by the exploration of possibilities, which can lead the survivor further along the path to integration. As such, this is also a good time for group work, self-esteem and assertiveness training, stress management and/or self-defense classes.

The last phase of the healing process is the culmination phase. The survivor becomes empowered to make his or her own choices and decisions without relying on the therapist. Instead, the survivor establishes or strengthen support networks through friends, coworkers and family members.

Michael Mruz specializes in the overarching therapeutic approach which involves Mindfulness and Compassionate Practices and Acceptance and Commitment Therapy.