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What can adult survivors of child sexual abuse teach psychologists? Dr Vicky Gunn Learning and Teaching Centre.

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Presentation on theme: "What can adult survivors of child sexual abuse teach psychologists? Dr Vicky Gunn Learning and Teaching Centre."— Presentation transcript:

1 What can adult survivors of child sexual abuse teach psychologists? Dr Vicky Gunn Learning and Teaching Centre

2 Introduction Some background research information on extent and long-term consequences of child sexual abuse. Some background research information on extent and long-term consequences of child sexual abuse.

3 From a scan of USA research evidence: First and foremost, exposure to unwanted sexual attention in childhood is not uncommon….. First and foremost, exposure to unwanted sexual attention in childhood is not uncommon….. ………………..there is consistent evidence to suggest that 5-10% of children are exposed to severely abusive acts involving actual or attempted sexual penetration. ………………..there is consistent evidence to suggest that 5-10% of children are exposed to severely abusive acts involving actual or attempted sexual penetration. (Fergusson & Mullen, 1999)

4 Impact of child sexual abuse Depression, anxiety Depression, anxiety Risk-taking behaviours (self-harm; aggression; eating disorders) Risk-taking behaviours (self-harm; aggression; eating disorders) Relationship fear Relationship fear Sexual fear / sexualization Sexual fear / sexualization Low self-esteem Low self-esteem Fragmented self (post-traumatic stress disorder/ dissociative disorders) Fragmented self (post-traumatic stress disorder/ dissociative disorders)

5 Perspectives from practice

6 Pain kept in the family: geneaologies of abuse Grandmother +Grandfather Grandmother + Grandfather (abused as child) (abuser) (abusive)(abuser) Father + Mother Sibling Sibling + Partner Sibling Sibling Sibling (abuser) (abused by father) (abuser)(abused by father) Child Child Child Child Child ChildChild Child Child Child Child Child Child ChildChild Child (abused by grandfather and (abused by father) (overly protected father)emigrate)

7 The power of emotional pain Sometimes Ill just be walking down the road and suddenly Ill feel such pain, like Ive been sliced by a knife. Other days the pain just goes on in my head constantly. Sometimes Ill just be walking down the road and suddenly Ill feel such pain, like Ive been sliced by a knife. Other days the pain just goes on in my head constantly.

8 The weight of memory Things would be basically ok; Id be coping; and then thered be an anniversary; his death was really hard. Id be ill for weeks after the anniversary.

9 Memories, triggers and crisis Awareness of the persons potential trigger points, as they are revealed by the individual, is critical to understanding when things may be harder. Awareness of the persons potential trigger points, as they are revealed by the individual, is critical to understanding when things may be harder.

10 The power of shame At my deepest, darkest inside, I feel to blame… At my deepest, darkest inside, I feel to blame…Jonie (Kuafmann, 1992)

11 Dissociation and keeping a distance When it happened I would imagine myself out of my body, up onto the ceiling, looking down at what was happening…it was like looking along a long tunnel.

12 A natural, protective response to overwhelming traumatic experiences, dissociation can become an automatic response to stress. Kisiel, & Lyons (2001)

13 Revictimization – losing safety Childhood trauma, particularly sexual abuse, may set in motion chain reactions of trauma across the life cycle… Childhood trauma, particularly sexual abuse, may set in motion chain reactions of trauma across the life cycle… (Banyard, Williams, Siegal, 2001) Women survivors, are more likely to experience unwanted intercourse with both acquaintances and strangers due to the misuse of the perpetrators authority [than non-victims of CSA]. (Messman-Moore & Long, 2000)

14 Resilience Not everyone who is sexually abused seeks psychological support; Not everyone who is sexually abused seeks psychological support; Not everyone who is abused seems to have clinically recognisable levels of distress in adulthood; Not everyone who is abused seems to have clinically recognisable levels of distress in adulthood; little attention has been paid to survivors who do not exhibit negative consequences or who manifest resilience. (Hyman & Williams, 2001)

15 Surviving Lack of resilience does not mean weakness; Lack of resilience does not mean weakness; Survivors have complex relationships between emotional strength and emotional hyper-sensitivity; Survivors have complex relationships between emotional strength and emotional hyper-sensitivity; Some survivors become manipulative to survive. We might not like this. Some survivors become manipulative to survive. We might not like this.

16 For the scientists in the audience Links between: physical stress responses, neuro-endrocrinology (especially allostatic load imbalance) and the neurophysiology of memory – might be a useful way to begin to explore the physiology of resilience and survival. Links between: physical stress responses, neuro-endrocrinology (especially allostatic load imbalance) and the neurophysiology of memory – might be a useful way to begin to explore the physiology of resilience and survival.

17 Listening to the Survivors testimony:

18 How does listening to the following make you feel? We were hyper-alert beings, watching for shadows, listening for footsteps, sniffing the air for a certain fragrance, waiting for the open hand or fist to connect to our bare skin in a flurry of searing pain. For many survivors, even our sleep was disturbed by sexual violence and abuse. Our bedrooms, instead of being a sanctuary, were traps where we were the prey. Susan Jeavons

19 Developmental psychology, ego strength, and dealing with what we dont want to hear

20 An example from recent research Sample of 114 subjects, aged 10-18, wards in psychiatric care (ie extreme group). Sample of 114 subjects, aged 10-18, wards in psychiatric care (ie extreme group). The prototypical picture of sexual abuse was weekly genital or anal intercourse by a family member who was moderately close, lasting between one and three years. (Kisiel & Lyons, 2001)

21 The hearers anger How could they? I used to get so angry listening to what my client was saying that Id fantasize about going to get the person who did it. The trouble is, Id stop listening to my client and get caught up in my anger.

22 The hearers grief I could never view the world in quite the same way. I had a reasonably protected childhood. All the usual stuff of family rows and stuff, but I was physically safe. Now I walk down the street looking at people, wondering, are they doing it?

23 The hearers frustration I couldnt understand why she kept going back to visit her family. Shed say, I have to go home every weekend. I mean, I knew in my head why, but in my gut I just wanted to scream TELL THEM TO GO TO HELL. I couldnt understand why she kept going back to visit her family. Shed say, I have to go home every weekend. I mean, I knew in my head why, but in my gut I just wanted to scream TELL THEM TO GO TO HELL.

24 Rationalizing extent: from disbelief to moderation to acceptance Personal defence mechanisms in the face of someone elses pain = powerful: Personal defence mechanisms in the face of someone elses pain = powerful: Sometimes easier to disbelieve; Sometimes easier to disbelieve; Sometimes easier to make simplistic assumptions about how survivors should be; Sometimes easier to make simplistic assumptions about how survivors should be;

25 Freuds rationalization: Lolita syndrome – ie the seductive child Lolita syndrome – ie the seductive child Oedipal theory – Oedipal theory – What role does our own shame at not being able to protect children lead us to consider disclosures as potentially about fantasy?

26 Mental illnesses expressed through social constructions Post-modern society obsessed with issues of sexual abuse. Post-modern society obsessed with issues of sexual abuse. Delusional disorders take societal contextual forms for expression. Delusional disorders take societal contextual forms for expression. Some people who disclose may suffer with delusional disorder (attached to false memory syndrome) – Some people who disclose may suffer with delusional disorder (attached to false memory syndrome) – Munro challenges this latter point (Munro, 1999) Munro challenges this latter point (Munro, 1999)

27 Comfort zone Fall back to the emphasis on fantasy? Fall back to the emphasis on fantasy?OR Recognize that some folk may have forms of delusional disorder, but not at the expense of negating the sheer scale of child sexual abuse within the population? Recognize that some folk may have forms of delusional disorder, but not at the expense of negating the sheer scale of child sexual abuse within the population?

28 Survivors of child sexual abuse teach us about the limits of ourselves and our humanity. Survivors of child sexual abuse teach us about the limits of ourselves and our humanity. Medicalizing survivors as other may make the truths they present more palatable, but palatable for whom? Medicalizing survivors as other may make the truths they present more palatable, but palatable for whom? Engaging with survivors may set off our own trains of emotional stress. Engaging with survivors may set off our own trains of emotional stress.

29 References Banyard, V., Williams, L. & Siegal, J. (2001) The Long-Term Mental Health Consequences of Child Sexual Abuse: An Exploratory Study of the Impact of Multiple Traumas in a Sample of Women, Journal of Traumatic Stress, 14(4), Banyard, V., Williams, L. & Siegal, J. (2001) The Long-Term Mental Health Consequences of Child Sexual Abuse: An Exploratory Study of the Impact of Multiple Traumas in a Sample of Women, Journal of Traumatic Stress, 14(4), Fergusson, D. M. & Mullen, P.E. (1999) Childhood Sexual Abuse: An Evidenced- based Perspective, Sage: London. Fergusson, D. M. & Mullen, P.E. (1999) Childhood Sexual Abuse: An Evidenced- based Perspective, Sage: London. Hyman, B. & Williams, L. (2001) Resilience Among Women Survivors of Child Sexual Abuse, Affilia, 16: Hyman, B. & Williams, L. (2001) Resilience Among Women Survivors of Child Sexual Abuse, Affilia, 16: Kaufmann, G. (1992, 3 rd edn.) Shame: The Power of Caring, Schenkman: Rochester. Kaufmann, G. (1992, 3 rd edn.) Shame: The Power of Caring, Schenkman: Rochester. Kisiel, C.L. & Lyons, J.S.(2001) Dissociation as a Mediator of Psychopathology Among Sexually Abused Children and Adults, American Journal of Psychiatry, 158(7): Kisiel, C.L. & Lyons, J.S.(2001) Dissociation as a Mediator of Psychopathology Among Sexually Abused Children and Adults, American Journal of Psychiatry, 158(7): Messmann-Moore, T. & Long, P. (2000) Child Sexual Abuse and Revictimization in the Form of Adult Sexual Abuse, Adult Physical Abuse, and Adult Psychological Mistreatment, Journal of Interpersonal Conflict, 15: Messmann-Moore, T. & Long, P. (2000) Child Sexual Abuse and Revictimization in the Form of Adult Sexual Abuse, Adult Physical Abuse, and Adult Psychological Mistreatment, Journal of Interpersonal Conflict, 15: Munro, A. (1999) Delusional Disorder: Paranoia and related illnesses, Cambridge. Munro, A. (1999) Delusional Disorder: Paranoia and related illnesses, Cambridge.


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