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âHow Long, O Lord?â
Exploring the Long-Term Effects of Child Sexual Abuse
âHow long, O Lord? Will you forget me forever? How long will you hide your face from me? How long must I wrestle with my thoughts and every day have sorrow in my heart? How long will my enemy triumph over me?ââPsalm 13:1â2
Rough estimates are that one in three girls and one in seven boys will experience at least one episode of molestation by the time they reach age eighteen. One in ten of those will be the victims of ongoing sexual abuse. Between 70 percent and 90 percent of all cases of sexual abuse are perpetrated by family members, trusted friends, youth leaders, or caregivers. Sexual abuse occurs in an atmosphere of secrecy and shame, and the majority of incidents are never reported. This means the real number of victims can never be known, but they are all around us, and they have been wounded in ways few people can imagine. Their abuse has impacted every aspect of their lives.
While the intent of this book is to explore and address the spiritual issues of the sexual abuse survivor, it is important to understand how all-encompassing the effects of sexual abuse can be on the entire psyche of a survivor, and how many areas of functioning can be impaired. The purpose of this chapter is to help readers place the wound to a survivorâs spirituality within the context of the totality of their abuseâs impact across their lifespan.
Before moving on, it is important to note that the effects of child sexual abuse on its survivors are not the same for everyone. Some survivors, despite their pain, are able to lead relatively healthy lives. For others, the impact of abuse is long-term and permeates every aspect of their lives. However, even among those who struggle, few will experience all of the following potential effects of abuse. It is hoped that readers will recognize what is true for them and what is not. And it is crucial that survivors not minimize their experience of abuse if it does not fit into every category of injury mentioned here.
Nonetheless, many survivors do experience daily reminders of what they have suffered, and it can feel as though their lives are defined by the abuse. They might wonder if a day will ever come when they do not think about what happened to them. They long for a time when their behavior is not dictated by fear, shame, anguish, and a deep need to protect themselves from further pain. Memories may pummel their minds at unexpected times and inappropriate places, and they are often unable to control these intrusive images and feelings. Even when the perpetrators are dead, in prison, or far removed from them by distance and/or lack of contact, survivors may still feel as though their abusers have triumphed by virtue of the ongoing effect of these memories on their everyday lives.
Other survivors may not even recognize that what happened to them was sexual abuse at all. Sometimes the gradual grooming of a victim and the blurring of boundaries cause the survivor to be unable to name the abuse for what it was. Some perpetrators are so subtle in their behaviors that it is difficult to know when they have crossed the line from inappropriate to abusive. Even something as noninvasive as forcing a child to disrobe, urinate, or bathe in front of the offender when the child is past the age of needing adult supervision can be considered abuse. A good guideline is whether the behavior made a victim feel uneasy or uncomfortable, causing him or her to develop an aversion to the perpetrator. Unfortunately for these survivors, without being able to label what they experienced as sexual abuse, they are all the more confused by the long-term effects of their victimization.
The areas of functioning that are affected by sexual abuse can include self-image, emotions, relationships, occupational functioning, health problems, sexuality, and spirituality. The severity of symptoms can be influenced by the duration and frequency of abuse, the age at onset of abuse, and the type of sexual activity. Use of force or violence, the relationship between victim and perpetrator, and the familyâs response to reported abuse are additional considerations. The overall atmosphere of a victimâs childhood home may also impact how they respond to the abuse and how they think and feel about themselves and the abuse they suffered. Children raised by dominating parents will be all the more fearful to disclose and more likely to blame themselves, not being able to name the abuse for what it was.
As we explore these different areas, remember that there is no particular way a survivor should react to sexual abuse. These are merely many of the typical ways in which survivors may be affected.
Impact on Self-Image
Almost universally, sexual abuse survivors have an extremely poor sense of self. Often, they learn to define themselves by the cues they receive within the context of the abusive relationship. They then spend so much energy learning to read the cues of the abuserâhis facial expressions, his moods, his vocal and body cues, and any signs of arousalâthat they become experts in the art of interpreting the body language and nonverbal communication of others., This was a survival strategy developed to anticipate the abuserâs wants and needs in order to keep him happy and thus avoid or minimize abuse. As a result, survivors are highly oriented to other people and to their external environment, which they scan constantly for potential danger. Conversely, they have little to no awareness of their own internal world. Many times, survivors will tell me that they donât really know who they are. They are afraid of expressing any kind of opinion or want, lest it cause displeasure or anger in another. This results in them not having opinions or preferences at all. These are people pleasers who try to go with the flow and always acquiesce to the wants and needs of others.
Survivors almost always view themselves with loathing and disgust. They may carry shame around with them as a constant burden and frequently verbalize a sense of their own worthlessness. It is virtually impossible for many of them to view themselves as worthwhile individuals with gifts, traits, and talents that others might value. This comes from an innate belief that the abuse happened because they were bad and deserving of punishment. Perpetrators often reinforce these beliefs with statements to that effect. We will discuss this more in future chapters.
Another area related to self-image is the way in which sexual abuse survivors view their bodies. Many of them felt betrayed by their bodies. It was their body that caused them their deepest pain, and they want nothing to do with it. Some survivors believe they somehow caused their bodies to respond to the abuse with arousal or physical desire and thus hate themselves and their bodies for behaving in what was a strictly instinctual response. In either case, a common aftereffect is for survivors to be completely cut off from any kind of body awareness. In some, this is so extreme that the body may exhibit symptoms of disease or injury long before the survivor actually notices them. Many are overweight, as if to deter any sexual attention at all, and dress in large, loose clothing to cover up the physical manifestations of their gender or sexuality. Excess weight and baggy clothing act as a buffer between them and the world. Other survivors may be quite thin. They diet to extremes, exercise to excess, or starve themselves in a seeming attempt to punish their bodies for what happened. Being too thin is another way of desexualizing the body by eliminating the curves that might attract someoneâs attention.