1. Educational Overview On the Impact to Adult Survivors of Child Sexual Abuse. September 2014

2. Why Learn about Childhood Sexual Abuse? The bulk of child sexual abuse is perpetrated either by a family member or someone known to the child. Females are more likely to be abused within the family and males more likely outside the family. The most common pattern of sexual abuse begins with non threatening, mild and possibly pleasurable attention and sexual contact. The average age of the child when abuse begins is between 8 and 12. The average duration of the abuse within a family is 4 years.

3. Continued: Most child sexual abuse does not involve force but it does involve some form of manipulation. The abuse almost always gets the child to keep the secret by scaring and threatening him / her into silence. The impact of childhood sexual abuse is more severe when no help or support is available for the victim. The lives of the children who have been sexually abused are altered and much of their energy is used in coping with the impact.

4. Child Sexual Abuse is: A violation of power perpetrated by a person with more power over someone who is vulnerable. This violation takes a sexual form but it involves more than sex. It involves; an adult profoundly breaching the child’s trust an adult violating the boundaries between adult and child an adult profoundly violating the child’s core being It is a devastating and selfish crime, the most important thing to remember is that it is the experience of a child. (Wendy Maltz)

5. Sexual Abuse is About: Powerlessness Betrayal Violence Isolation Blackmail Emotional, Physical and Sexual Abuse Damage to the Survivors Sense & Core of Self

6. Other Issues to Consider are: How long the abuse occurred How often it happened The identity of the abuser.. Who they are. The age of the child when it began and finished Age of abuser How many involved

7. Disclosure within a Family is: Traumatic The Family will never be the same again Maybe the mother has to choose between believing her partner or believing her child She is shocked and requires support Partners of survivors require support

8. Finklehor’s Theory of Sex Offending A factor that may make it more likely for an adult to entertain sexual feelings towards a child. (Fantasy) A factor that may make it easier for an adult to act on the basis of these feelings by reducing his internal inhibitors for doing so. (Justify) A factor that may make it easier for an adult to act on the basis of these feelings by reducing external inhibitors for doing so. (Planning) A factor that may increase the likelihood of the child accepting, co-operating in or failing to avoid a sexual approach made by an adult. (Vulnerable Child)

9. Child Sexual Abuse is Uniquely Traumatic: Researchers, Finklehor and Browne have identified 4 main trauma–inducing factors specifically unique in child sexual abuse that create cognitive and emotional developmental changes in the child in order to cope with the trauma. Traumatic Sexualisation Betrayal Powerlessness Stigmatisation

10. Child Sexual Abuse Affects Emotional Growth and Development: Kepner (1995) suggests that child sexual abuse has interrupted and affected the natural cycle of emotional growth and development because it has had to alter in order for the child to survive and keep some level of dignity. As a result the natural processes of; Attachment Assimilating Accomplishment Differentiation …have been reshaped to accommodate the trauma. Therefore recovery is about having another ‘go’ at re-establishing the natural cycle of emotional growth and development in those areas which have been affected, redirected, distorted and fixated.

11. Shame and Child Sexual Abuse Shame can be defined as not feeling worthy of being loved. Shame creates dissociation as a means of coping with the overwhelming feelings which engulf a child. The child perceives that, ‘if I was lovable Mummy would notice what was happening. Since she has not noticed it shows I am not worthy of loving’. Or, ‘if Mummy really loved me she would rescue me since she has not rescued me it shows she does not love me’. The feelings of shame evoked in the child by this enormous emotional distress create a necessity to split and dissociate from these feelings in order to survive.

12. Shame has a tremendous impact on our lives: It goes to the very core of our being It affects our self esteem Has an impact on our identity Has an impact on our ability to be and enjoy intimacy It can affect the whole of our personality :

13. Some Creative Adjustments / Coping Mechanisms used by children to cope with feelings of being sexually abused are: Psychological / Cognitive Coping Mechanisms Inner Wisdom (don’t tell) Denial of Impact / Distorted Sense of Personal Reality Dissociative Reactions (eg. numbing) Physical Coping Mechanisms Personal negligence / self harm Addictions / compulsions Running away delinquent or deviant behaviour Relational Coping Mechanisms Withdrawal and isolation from others Co-dependence Relational addictions and dependence on others Repeating abuse or abusing others

14. The Post Trauma Abuse Issues Are: Dissociation Survivors describe this experience as being disconnected from the here and now or going off, drifting into space. Partners describe their observations of dissociation as; ‘light on no one home’ or ‘spaced out ’. Sudden Regression Survivors describe this experience as; ‘they no longer able to feel their age but actually feel much younger and quite vulnerable’. Their partners share that when the survivors is in this state they do not appear to be able to view things in an a adult ego state but rather only in a child ego state. Dis-organised Thought Processes Survivors describe that this experience occurs when their level of stress is high affects they way they think. They share they can no longer think straight or they know what to say but can go blank and not able to speak. Sensory Impairment This impairment is noticed when a survivor either reacts in an ‘over the top’ manner or under reacting’ to an event. This means that their response is not the normal one to the event.

15. Adult Survivor’s Children Have Shared: That there are difficulties at times of living with a parent who is a survivor of child sexual abuse. That they have mood swings and irritable behaviour. Never knowing what is right or wrong as their responses are so un-predicatable. Not being ‘there’ for them (dissociated state). They become over protective at times. They have to be the parent to their parent.

16. The Healing Relationship The development of the relationship between you and your client is going to be the therapy for a survivor who has been abused and traumatised. The Person to Person Relationship is : The Foundation The Process The Goal….for Healing

17. Working in a Phenomenological Manner Means that you are only working with what the client brings in to the therapy room. As all of the client’s history and what troubles him or her is being played out in each session. To work with what the client gives you is a safe structured way to pace the therapy. It is also learning to work with what surfaces for the client.

18. How Does this Approach Work? Looking at Sexual Abuse as an interruption to the natural cycle of emotional growth and development this approach allows for the opportunity to re-establish a healthy and natural cycle of growth and development. By pacing the process By developing awareness Increasing self knowledge Developing self acceptance Enhancing relationships Increasing understanding

19. The Gift of Resistance Resistance in therapy is a very important positive aspect of recovery. It allows for a re-assessment of the therapeutic process and explore what is happening. Resistance is a creative adjustment / coping mechanism and we need to acknowledge this positively with our clients. Inform the client that resistance is a form of self support. As a therapist you may have gone too deep, too quickly with your client. It may also be a sign of the client being affected by ‘shame’. Ask the client what is not in place for them right now to feel safe to continue with the therapy.

20. The Kepner Model of Giving Support and Working The survivor’s sense of self is so fragile therefore it is important to know how they are looking after themselves because of the work they have decided to do regarding their abuse. James Kepner (1995) has produced an assessment tool to see where a survivor of child sexual abuse is on their road to recovery and healing. It allows the person to see what they have already achieved and what else they may need to explore.

21. Education Helps to: Empower Enhance Self esteem Normalise the traumatic stress response Address the impact of shame Encourage emotional growth and development Allow a person to move from victim to survivor