The Effect of Childhood Sexual Abuse Experiences on Adulthood

Introduction

Childhood sexual abuse is a profoundly distressing experience that can have far-reaching and diverse effects on survivors as they transition into adulthood. This essay delves into the intricate web of consequences that male survivors of childhood sexual abuse face during their adult lives. By examining the psychological, sociological, and physical dimensions of this issue, while considering the ethical and legal implications, this essay aims to provide a comprehensive understanding of the challenges faced by these survivors. Drawing upon my own experiences in counseling practice, particularly within an organization dedicated to male survivors of sexual abuse and rape, I have gained insight into the profound impact of such experiences on individuals. This essay explores the importance of employing theoretical frameworks to enhance the counselor's ability to support survivors without becoming traumatized themselves. Furthermore, it sheds light on the prevailing societal preconceptions about male victims of sexual abuse, making it even more challenging for them to disclose their experiences.

Barriers to Disclosure

Research conducted by Scott, D. Easton et al. (2013) in their study, "Would you tell under circumstances like that? Barriers to disclosure of child sexual abuse for men," underscores the need for further investigation into the complexities of disclosure among male survivors. Despite an increase in awareness of sexual abuse of boys due to media coverage of abuse scandals, celebrity disclosures, and mainstream films, there remains a significant stigma surrounding childhood sexual abuse (CSA). Male survivors may grapple with confusion about their sexual orientation, especially if they experienced a physical response during the abuse. This confusion, coupled with societal attitudes and stereotypes about masculinity, can compound the challenges they face. It is essential to recognize that sexual assault and rape can affect anyone, irrespective of their gender, size, strength, appearance, or sexual orientation.

The Feminization of Victimhood

Much of the discourse on sexual assault and rape predominantly focuses on female victims, contributing to what can be termed as the "feminization of victimization." As a member of The British Association of Counselling and Psychotherapy (BACP), I understand the pivotal role of ethical practice in ensuring the well-being of both clients and counselors. Addressing sexual abuse is a complex task, and the BACP (2018) emphasizes the importance of counselor resilience, defined as "the capacity to work with the clients' concerns without being personally diminished." It is crucial to share a personal reflection, acknowledging the existence of a parallel process in which counselors need to work through their own experiences before assisting clients with similar issues. This underscores the significance of self-care in the counseling profession.

Coping Mechanisms and Silence

From a counselor's perspective, a significant portion of my clients comprises middle-aged men who have never disclosed their childhood abuse experiences. Fear of judgment and a misplaced sense of guilt and shame have kept them silent for years. In their silence, these survivors have developed coping mechanisms, such as gambling, alcohol, and drug dependencies, as a means to manage the turmoil within them. Dr. Daniel Sumrok's (2017) insightful article on Adverse Childhood Experiences (ACEs) aptly characterizes these addictions as "ritualized compulsive comfort-seeking." These coping mechanisms are a normal response to the adversity experienced in childhood, akin to bleeding being a normal response to being stabbed. This might explain why only 1 in 6 men in the UK, estimated to be around 5 million men, who have experienced rape or sexual abuse, choose not to report their ordeal (RSVP, 2018). The reluctance to disclose remains a significant challenge for male victims, warranting continued research and a holistic approach that integrates scientific knowledge to support survivors with compassion, empathy, and appropriate interventions.

Incorporating Ethical and Multimodal Approaches in Counseling

As a person-centered (PC) counselor, I have often drawn upon other therapeutic modalities in my client work, guided by ethical considerations and the specific needs presented by my clients. The core of person-centered therapy lies in creating a safe and comforting environment that empowers clients to explore their past experiences and understand how these experiences have shaped their self-perception and abilities. This approach values the client's autonomy and aims to facilitate positive changes in their lives. It is crucial to recognize that both male and female survivors of sexual assault share many common issues post-trauma, including anxiety, flashbacks, nightmares, guilt, and shame, all of which can be equally severe and valid.

However, gender-specific challenges do exist. For instance, female survivors must grapple with the trauma of potential pregnancy after rape, while male victims may face an increased risk of contracting sexually transmitted diseases (STDs) following male-on-male rape. In such cases, a counselor may find it necessary to navigate the complexities of confidentiality and legal obligations, as confidentiality has its exceptions and limits. While there are legal requirements to report certain crimes like terrorism, drug trafficking, and money laundering, there is no legal mandate to report child abuse, although many counselors may choose to do so based on their professional ethics. Additionally, individual agencies may set their own limits on confidentiality.

Facilitating Personal Growth

Several factors can hinder a person's ability to grow and heal, including low self-esteem, a lack of self-reliance, and resistance to new experiences. The person-centered approach acknowledges the profound influence of a person's social environment and personal relationships on these factors. Therefore, therapy is offered in a neutral and comfortable setting, fostering a sense of authenticity and openness that enables clients to explore and understand themselves better.

While therapists typically strive to create a safe space in which clients can address their life challenges, it is equally essential to value and encourage narratives that reveal the coping strategies clients developed during their childhood in unsafe environments. As K. Etherington (2006) points out, recognizing and respecting these survival mechanisms is crucial. Moreover, clients may return to using substances to cope with their emotional pain as distressing symptoms and memories resurface, as highlighted in "Comprehensive Treatment for Adult Survivors of Child Abuse and Neglect" (2017). Hence, pacing disclosure and offering resources like journaling, relaxation techniques, and creating resilience toolkits are integral parts of the therapeutic process.

Adapting to Cultural Sensitivity

Dave Mearns aptly reminds us that as person-centered counselors, we are guests within the clients' unique world of experience, emphasizing the importance of tailoring therapy to the individual's context. It's worth noting that person-centered counseling may not always align with Western cultural norms, as Mearns suggests (cited in "Culture and the Therapeutic Relationship: Perspectives from Chinese Clients" by Jenny Jim and Nancy Pistrang, 2007).

The necessity for therapies to be culturally sensitive or responsive has long been recognized, with Nagayama Hall (2001) asserting that there is both a scientific and ethical imperative to develop culturally sensitive therapy. Such therapy involves customizing psychotherapy to specific cultural contexts. Various models for culturally sensitive therapy exist, some applicable across cultural groups, while others are designed for specific cultural backgrounds. However, there is a dearth of empirical research on the effectiveness of different therapeutic approaches with diverse cultural groups and what truly makes a therapy culturally sensitive.

Power and Empowerment in Person-Centered Counseling

Within the person-centered framework, power dynamics are fundamental, as counselors aim to facilitate the client's self-discovery and empowerment. Considering my clients' cultural backgrounds, it becomes evident that every family's beliefs about childhood and child-rearing can significantly differ due to cultural influences. Culture plays a pivotal role in shaping societal norms, dictating what is deemed acceptable or not.

Research indicates that childhood trauma can significantly contribute to the development of psychological disorders. During my training, I encountered clients who were unsure of their role within the counseling process, sometimes assuming that they would be provided with answers rather than actively participating in their own healing journey. Interestingly, Irvin D. Yalom highlights the legitimate need for researchers to compare different forms of psychotherapy treatment. Standardized therapies, where all subjects receive the same level of therapeutic intervention, provide a valuable framework for such research comparisons.

Depression emerges as one of the most commonly reported symptoms among adult survivors of childhood sexual abuse, with these survivors facing a four-fold greater lifetime risk for a major depressive episode when compared to individuals who have not experienced abuse or neglect. A physiological underpinning contributes to this heightened vulnerability to depression, where severe or chronic stressors can alter the brain's response to stress, rendering survivors more susceptible to depression when confronted with contemporary life stressors. In my counseling practice, clients have often been prescribed antidepressants to manage their lifelong struggle with depression, a disorder compounded by the stigma associated with it. Lisa Thompson and Becky Willetts (2019) argue for a fundamental societal shift in our response to, understanding of, and support for sexually abused and exploited individuals, highlighting the importance of comprehending a person's trauma and coping mechanisms as vital components of their recovery. Clients have recounted difficulties concentrating, losing track of conversations, experiencing sleep disturbances, and feeling emotionally distant in their relationships due to the intensified pressures of life.

While antidepressants may provide relief for some, it is essential to recognize that they may not offer a definitive solution. As adults, our personality traits can often be traced back to our childhood experiences. Shame, guilt, self-deprecation, and emotional trauma are deeply intertwined with the experience of sexual abuse, often shrouded in years of denial. The visual arts can provide a unique avenue for survivors to express their experiences when words fail them. In line with interventions for some of my clients, psychological education has proven invaluable in providing clients with facts and evidence to help them understand their reactions to abuse. Chapter 3 of "Comprehensive Treatment for Adult Survivors of Child Abuse and Neglect" (2000) underscores the therapeutic value of such an educational approach, as it aids clients in understanding and managing their responses and symptoms. By comprehending their own trauma responses and working through their personal narratives, clients can begin to normalize their experiences and explore the profound impact of their abuse on their personal relationships. Avoidance behaviors, another enduring consequence, often emerge as a coping mechanism employed by clients to temporarily alleviate emotional pain.

Dissociation represents one prominent form of avoidance, with dissociative symptoms frequently arising during childhood as a means to escape abuse or emotional distress. Clients have described their ability to numb body parts at will or to detach themselves and observe the abuse from a distance. However, dissociation becomes problematic when clients lose control over these experiences, and during therapy, I have observed clients reliving their traumas while staring unresponsively. Jacqui Dillon aptly describes dissociation as existing in two distinct worlds, one public and seemingly normal, and the other private and shrouded in horror. This stark contrast underscores society's tendency to generalize and stigmatize, potentially contributing to clients' self-identifying with a disorder.

Conclusion

In conclusion, the harm inflicted by childhood sexual abuse can be particularly devastating when the perpetrator is someone known and trusted, as the emotional attachment and sense of betrayal can outweigh the perpetrator's relationship to the survivor. This type of abuse has consistently been linked to enduring adverse consequences for survivors throughout their lives, though the severity and nature of these effects can vary significantly from person to person. Even in cases of severe impact, there is room for hope and healing, emphasizing the pressing need for continued research in this area, with a particular focus on discerning gender differences in the experiences of sexual abuse survivors. Understanding and addressing the complex aftermath of childhood sexual abuse is crucial in supporting survivors on their journey towards healing and recovery.