Adult Survivors of Child Sexual Abuse
- Overview Paper
What is Child Sexual Abuse?
Although there are many descriptions of childhood
sexual abuse, for the purpose of this document it is considered
to be the use of a child for any form of sexual activity or behaviour
by an adult or adolescent. It is a betrayal of trust by someone
who has power over the child.1
Who is an Adult Survivor of Child Sexual Abuse?
Any adult who was sexually abused as a child is
a survivor of childhood sexual abuse. The majority of statistics
in this document refer to the abuse of children under the age of
17. Sexual abuse occurs in all communities, ethnic backgrounds,
religions, cultures, and social and economic classes, and is experienced
by both males and females.2,3
Vocabulary
The words “victim” and “survivor”
are used throughout this document, but their limitations are acknowledged
in that these terms may discount the aspects of a person’s
life that are healthy and productive. The term “thriver”
is now sometimes used to describe people who are not only surviving
but flourishing. It better reflects the idea that sexual abuse is
something that happens to people and should not be considered the
core of their identity. In this document, the terms “victim”
and “survivor”, which are commonly used in the abuse-related
literature, designate a person who has experienced sexual abuse
in his or her childhood.
Who is Sexually Abused?
The Ontario Health Survey Supplement*, carried out
between 1990 and 1991, reported that 4.3% of males and 12.8% of
females reported any unwanted sexual acts before their 17th
birthday, and 3.9% of males and 11.1% of females in this sample
reported severe sexual abuse.4 Previously, the Badgley
Report* used broader definitions of child sexual abuse
and reported higher prevalence rates. In that study, 31% of boys
and 54% of girls under the age of 21 reported sexual abuse, and
8.2% of boys and 17.6% of girls reported severe sexual abuse.5
The Canadian Incidence Study of Reported Child Abuse and Neglect
(CIS) studied investigations by child welfare service providers
in 1998. As its title suggests, this study deals only with child
abuse and neglect reported to child welfare authorities. Some reports
of sexual abuse are investigated by police without any involvement
of child welfare service providers, and these statistics are not
reflected in the study. Among substantiated cases of sexual abuse
against children under the age of 16 reported in the CIS, 69% of
the victims were girls and 31% were boys.6
Some evidence suggests that girls and boys are at similar risk
of being sexually abused before puberty.7 However,
adolescent (and adult) females are at greater risk of sexual abuse
than adolescent (and adult) males. Therefore, there may be more
female than male adult survivors of child sexual abuse.
Who are the Abusers?
The report of the CIS states that, among substantiated sexual
abuse cases, non-parental relatives represented the largest group
of alleged perpetrators (44%), followed by biological fathers (8%),
stepfathers (8%), other acquaintances (8%) and babysitters (7%).
A childs friends (peers) and family friends were each identified
as the alleged perpetrator in 5% of substantiated cases. Teachers
were identified in 4% of cases, and other professionals, strangers
and a parents boyfriend/girl-friend were each identified in
2% of cases. In 5% of substantiated sexual abuse cases, mothers
were identified as the alleged perpetrator (3% biological mothers
and 2% step-mothers).8 It is possible that cases of abuse
within the family are under-reported because of the risk of breaking
up the family and are, therefore, under-represented in this study.
Furthermore, the CIS statistics do not reflect those cases which
may be more severe that are reported only to police.
- In the Ontario Health Survey Supplement, respondents were
asked to indicate whether an adult had committed any of the following
acts while they were growing up: exposed themselves to you
more than once; threatened to have sex with you; touched the sex
parts of your body; tried to have sex with you or sexually attacked
you. The last three items were identified as severe sexual
abuse. In the Badgley Report, respondents were asked whether any
unwanted sexual acts had ever been committed against them; two
items (unwanted touching of sexual areas and attempted or achieved
intercourse) approximated severe abuse.
2
Connecting Child Sexual Abuse to Adulthood
The ripple effects of abuse can be difficult to pinpoint, even
though abuse may affect every area of someones life. These
effects are not necessarily permanent, but they can feel overwhelming.
Recognizing the connection between present effects and past sexual
abuse is not easy. Drawing this connection can be helpful for the
healing process but is not always necessary.9
Why Do Many Survivors Delay Talking About Child Sexual Abuse?
In Canada, it is estimated that the vast majority of male and
female sexual abuse victims do not report sexual abuse.10 Some
survivors delay disclosure because they fear they will be threatened
by their abuser, are worried they will not be believed or that they
will be blamed and possibly punished, feel guilty and ashamed, or
want to protect their families and sometimes the perpetrator.11
Other concerns include a feeling of responsibility for the
abuse, a sense of confusion and betrayal because they were physically
aroused by the abuse, difficulty in finding the right time to talk
about the past, and an inability to recognize child sexual abuse
as abusive, perhaps because they were led to believe that it was
normal.12 Survivors should be encouraged not to confuse
the abnormality of the abuse with their own identity: the abuse
was abnormal, but they are perfectly normal.
Caregivers must make themselves more aware of symptoms exhibited
by both male and female survivors. This knowledge will help families,
doctors, teachers and protective service workers to identify and
report alleged sexual abuse to the proper authorities.
Coping Skills
Many survivors develop addictions or compulsive behaviours in
an effort to mask their abuse-related emotions.13 Survivors
often experience shame about these coping skills or strategies,
which have been used to numb the pain of the abuse.
Similarities and Differences in Male and Female Survivors
Every individual is unique. Therefore, the effects of child sexual
abuse are not exactly the same. Although the majority of research
indicates that there are more similarities than differences between
male and female survivors,14 there are, nevertheless,
several differences that merit mention. Although a characteristic
may be identified here as male or female, it may also apply to survivors
of the other sex.
Similarities Between Male and Female Survivors
- Boys and girls are both more likely to be abused by someone
they know,15 and the perpetrator is most often a heterosexual
male.16 This perpetrator often holds some form of power
and control over the victim and is in a position of trust.
- Some survivors may struggle with depression; low self esteem;
self blame; dissatisfaction with life; anxiety; dissociation (a
splitting between the mind and body); difficulties in relationships;
a tendency to be over-controlling or too submissive; an inability
to trust oneself and others; problems defining healthy sexuality;
3
self-destructive behaviours, including contemplation of or attempted
suicide; dealing with anger; stress related illnesses; addictions;
eating disorders; and acting out sexually.17
- In the 1990 Mental Health Supplement to the Ontario Health Survey,
56% of male and 56% of female respondents who reported child sexual
abuse also indicated a history of physical abuse.18
Predominantly Female Concerns
- There is a greater chance that the abuse will take place in
the home and be perpetrated by somebody related to the victim.19
- Female survivors are at greater risk of abusing alcohol.20
- They have increased chances of being re-victimized as teenagers
and young adults.21
- They are more likely to receive support when dealing with their
recovery issues.22
- Compared with men, women tend to deal with their sadness and
depression in the early stages of recovery, whereas their anger
seems to surface later in the healing process.23
- Women appear to have greater difficulty in recalling specific
details connected to the abusive situation.24
- Among victims of child sexual abuse, girls are fondled more
often than boys.25
Predominantly Male Concerns
- Boys are more often abused by teachers, coaches and baby-sitters.26
- As a result of sexual abuse at the hand of a male perpetrator,
males struggle with their sexual identity and fears of homosexuality.
Men who experienced child sexual abuse also find it more difficult
to define their gender roles.27
- Both male survivors and their parents are more likely to try
to minimize the impact of the sexual abuse.28
- Male survivors are more likely to abuse drugs.29
- Boys are more likely to be sodomized than girls.30
- Men are more likely to experience anger and rage in the early
stages of recovery, whereas their feelings of grief tend to surface
later in the healing process.31 Men have more struggles
with feelings of powerlessness, and the chances of active and
violent revenge fantasies are greater.32
- Far fewer men than women consider their early childhood sexual
experiences to be sexual abuse.33 Gender socialization,
different physiological responses of the sexes and culturally
determined expressions of sexuality may cause boys to be neutral
or positive about their sexual experiences, but the long-term
effects (e.g. on self esteem) are negative.34
Discussing the impact of childhood sexual abuse on men and women
helps to identify common and unique needs for healing. Each person
needs to recognize and respect his or her uniqueness when coming
to terms with the past.
4
Stages of Recovery
Every individuals recovery process is unique. However, most
share some similarities. Survivors may experience the following
stages of recovery:35,36
Denial: It is not unusual for people to be trapped in this
stage for many years after the physical nature of the abuse has
ended. Many survivors develop addictive or compulsive behaviours
while attempting to mask the feelings and emotions connected to
child sexual abuse.
Confused Awareness: At this stage, people begin to recognize
the connection between their past trauma and present concerns. This
new awareness may introduce feelings of anxiety, panic and fear.
Reaching Out: Survivors can be in a situation in which
the perils of silence become more painful than the risk involved
in speaking out. Receiving individual counselling and/or joining
support groups may play a role in the healing process.
Anger: After they reach out and become more aware of the
impacts of the abuse, survivors often deal with intensified anger.
This anger is an expected, natural part of the healing process.
Thoughts of disclosure and confrontations may dominate this stage.
Anger may be channelled towards anyone who excused or protected
the abuser, anyone who did not believe their disclosure of the abuse,
and anyone they feel should have been concerned but never took steps
to help.37
Depression: At this stage, adult survivors may recall the
negative messages or criticisms that they received from their abuser
as a child. If these seem valid to the adult survivor, they may
cause him or her to become depressed. When faced with
depression, survivors often feel powerless and unable to make
positive changes. If symptoms and triggers of their depression are
identified and an appropriate support team is found, the chances
of their being overwhelmed with feelings of despair may be minimized.38
Clarity of Feelings and Emotions: For adult survivors of
child sexual abuse, a key component to healing is to express and
share their feelings.39 This can be achieved by survivors
learning to acknowledge and identify a wide variety of feelings
and emotions, as well as finding ways to release them without hurting
themselves or others.40 A good support team can be extremely
valuable at this time.
Regrouping: This phase involves many positive changes in
survivors attitudes and feelings. In this stage, they develop
a new sense of trust in others but, most importantly, they start
to trust themselves. This phase includes learning from the past,
examining the present and planning for the future. Many survivors
have suggested that this stage represents a transition from merely
existing to actively living.
Moving-on: This stage includes a shift in focus from the
negative experiences of the past to positive plans for the future.
Painful feelings and emotions do not dominate memories from the
past. Positive coping skills developed in earlier stages are enhanced
and assist survivors in moving on with their lives. Several coping
skills that can help survivors to move on include learning to love
and accept themselves, recognizing and celebrating personal growth,
creating a healthy support team, grieving current losses as they
occur, learning to deal with stress effectively, and recognizing
when it is time to let go of painful feelings connected to the past.
5
How Family and Friends Can Help
There are a number of ways in which family and friends can support
an adult survivor of child sexual abuse:41-43
- Listen in a way that supports and validates the survivors
feelings.
- Let them know that you believe what they are telling you.
- Make yourself available for the survivor.
- Encourage survivors to seek help.
- Let survivors disclose details of the abuse at their own pace.
- Ask survivors what they need from you to feel safe and supported.
- Take care of yourself and get help if needed.
- Educate yourself on recovery issues.
A Message For Survivors
Survivors may have suffered on their own as a child, but they
should recognize that many people are willing and able to help now.
Healthy connections with safe and supportive people can help someone
overcome the hurt. Men and women survivors can contact such resource
people at
- Sexual Assault Crisis Centres
- Crisis Centres
- Hospitals
- Doctors offices
- Womens Shelters or Transition Houses
- Crisis Lines
- Child Welfare Agencies
- Social Service Agencies
Many of these organizations are listed in the emergency telephone
numbers on or near the first page of the local telephone directory.
Suggested Readings
National Clearinghouse on Family Violence.
A Directory of Services for Adult Survivors of Child Sexual
Abuse 2002. Ottawa: Health Canada, 2002.
For Females
Haines, Staci. The Survivors Guide to Sex: How to Have a Great
Sex Life - Even if Youve Been Sexually Abused. San Francisco,
CA: Cleis Press Inc., 1999.
Rivera, Margo. Fragment by Fragment: Feminist Perspectives
on Memory and Child Sexual Abuse. Charlottetown, PEI: Gynergy
Books, 1999.
For Males
Lew, Mike. Leaping Upon the Mountains: Men Proclaiming Victory
over Sexual Child Abuse.
Jamaica Plain, MA: Small Wonder Books, 1999.
Wilken, Tom. Men Recovering in Group from Childhood Sexual
Abuse: Rebuilding Your House of Self Esteem. Ottawa: Commoners
Publishing Society Inc., 2002.
For Family, Friends and Loved Ones
Engel, Beverly. Families in Recovery: Healing the Damage of
Childhood Sexual Abuse, 2nd ed. Lincolnwood, IL:
Lowell House, 1999.
6
References
1. |
Tom Hay, Child Sexual Abuse (Ottawa: National
Clearinghouse on Family Violence, 1997): 1.
|
2. |
Hay: 2.
|
3. |
Frederick Mathews, Combining Voices: Supporting
Paths of Healing in Adult Female and Male Survivors of Sexual
Abuse (Ottawa: National Clearing-house on Family Violence,
1995): 11.
|
4. |
Harriet L. MacMillan, Jan E. Fleming, Nico Trocmé,
et al., Prevalence of Child Physical and Sexual Abuse
in the Community Results from the Ontario Health Supplement,
Journal of the American Medical Association, 278, 2 (1997):
131-134.
|
5. |
C. Badgley, Child Sexual Abuse in Canada:
Further Analysis of the 1983 National Survey (Ottawa: Health
and Welfare Canada, 1988).
|
6. |
Nico Trocmé and David Wolfe, Child
Maltreatment in Canada: Canadian Incidence Study of Reported
Child Abuse and Neglect: Selected Results (Ottawa: Minister
of Public Works and Government Services Canada, 2001): 24.
|
7. |
Mathews, Combining Voices: 12.
|
8. |
Trocmé and Wolfe: 20-21.
|
9. |
Ellen Bass and Laura Davis, The Courage to
Heal: A Guide for Woman Survivors of Child Sexual Abuse (New
York: Harper Row Publishers, 1988): 33-34.
|
10. |
Frederick Mathews, The Invisible Boy: Revisioning
the Victimization of Male Children and Teens (Ottawa: National
Clearinghouse on Family Violence, 1995): 15. |
11. |
Beverly Engel, Families in Recovery: Healing
the Damage of Childhood Sexual Abuse, 2nd edition.
(Lincolnwood, IL: Lowell House, 1999): 25-26.
|
12. |
Steven N. Gold, Barbara A. Lucenko, Jon D. Elhai,
et al., A Comparison of Psychological/Psychiatric Symptomatology
of Women and Men Sexually Abused as Children, Journal
of Child Abuse & Neglect, 23, 7 (1999): 684.
|
13. |
Adrienne Crowder, Opening the Door: A Treatment
Model for Therapy With Male Survivors of Sexual Abuse (Ottawa:
National Clearinghouse on Family Violence, 1993): 52.
|
14. |
Gold et al.: 684.
|
15. |
Patricia A. Washington, Second Assault
of Male Survivors of Sexual Violence, Journal of Interpersonal
Violence, 14, 7 (1999): 714.
|
16. |
Mathews, The Invisible Boy: 27.
|
17. |
Eliana Gill, Treatment of Adult Survivors
of Childhood Sexual Abuse, 2nd edition (Walnut
Creek, CA: Launch Press, 1990): 49-54.
|
18. |
Harriet L. MacMillan et al., Childhood
Abuse and Lifetime Psychopathology in a Community Sample,
American Journal of Psychiatry, 158 (2001): 1881-1882.
|
19. |
Gold et al.: 684-685.
|
20. |
Gold et al.: 684.
|
21. |
Gold et al.: 684-685.
|
22. |
Gold et al.: 689.
|
23. |
Crowder: 33.
|
24. |
Crowder: 33.
|
25. |
Crowder: 32.
|
26. |
Crowder: 31-32. |
7
27. |
Marlyn Gill and Leslie M. Tutty, Male Survivors
of Childhood Sexual Abuse: A Qualitative Study and Issues for
Clinical Consideration, Journal of Child Sexual Abuse,
7, 3 (1999): 20.
|
28. |
The Finkelhor-Browne Traumagenic Components
List. [Online]. [accessed 09 March 2002]. Available on Internet:
http://olbers.kent.edu/godfrey/Public/ Sar/conseq.html.
|
29. |
Gold et al.: 684.
|
30. |
Crowder: 32.
|
31. |
Crowder: 31-33.
|
32. |
Crowder: 33.
|
33. |
C.S. Widom and S. Morris, Accuracy of Adult
Recollections of Childhood Victimization, Part 2: Childhood
Sexual Abuse, Psychological assessment, 9, 1 (1997):
34-36.
|
34. |
Crowder: 31. |
35. |
Tom Wilken, Men Recovering in Group from Childhood
Sexual Abuse: Rebuilding Your House of Self Esteem (Ottawa:
Commoners Publishing Society Inc., 2002): forthcoming.
|
36. |
Mathews, Combining Voices: 35-36.
|
37. |
Engel: 154-155.
|
38. |
Wilken: pages forthcoming.
|
39. |
Bass and Davis: 154-155.
|
40. |
Wilken: pages forthcoming.
|
41. |
Brenda J. Saxe, From Victim to Survivor: A
Group Treatment Model for Women Survivors of Incest (Ottawa:
National Clearinghouse on Family Violence, 1993): 169-173.
|
42. |
Vancouver-Richmond Incest and Sexual Abuse Centre,
When Your Partner Has Been Sexually Abused: A Guide for Partners
(Vancouver, 1994): 8-9.
|
43. |
Mathews, Combining Voices: 23-36.
|
8
Adult Survivors of Child Sexual Abuse was prepared by Thomas
R.Wilken for the National Clearinghouse on Family Violence.
The contributions of the following individuals are gratefully acknowledged:
Glenn Cheriton, Commoners Press; Sophie Sommerer and Lynn Austin,
Health Canada.
Également disponible en français sous le titre :
Les survivants et survivantes adultes de labus sexuel dans
lenfance
The opinions expressed in this document are those of the author
and do not necessarily reflect the views of Health Canada.
This publication can be made available in alternative formats
upon request.
For further information, contact:
National Clearinghouse on Family Violence
Family Violence Prevention Unit Public Health Agency of Canada (PHAC)
Health Canada (Address Locator: 1909D1) 9th Floor, Jeanne
Mance Bldg., Tunneys Pasture Ottawa, Ontario K1A 1B4
Telephone: 1-800-267-1291 or (613) 957-2938 Fax: (613) 941-8930
TTY: 1-800-561-5643 or (613) 952-6396 Web Site: http://www.phac-aspc.gc.ca/nc-cn
E-mail: ncfv-cnivf@phac-aspc.gc.ca
© Her Majesty the Queen in Right of Canada, represented by
the Minister of Public Works and Government Services Canada, 2002
Cat. H72-22/12-2002E
ISBN 0-662-33311-X
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