May is Mental Health Awareness Month. Childhood sexual abuse impacts mental health in extraordinary and long-lasting ways. The impact varies depending on factors such as the severity and duration of the abuse, the age at which it occurred, and the support system available to the survivor. Here are some common ways childhood sexual abuse can affect mental health:
Post-Traumatic Stress Disorder (PTSD)
Survivors may experience intrusive memories, nightmares, flashbacks, and intense emotional distress related to the traumatic events.
Depression and Anxiety
Childhood sexual abuse is associated with higher rates of depression and anxiety disorders. Survivors may experience persistent sadness, loss of interest, feelings of worthlessness, and excessive worry or fear.
Self-Esteem and Self-Worth Issues
Survivors often struggle with low self-esteem, self-blame, shame, and guilt. They may have a distorted self-image and work to develop a positive sense of self.
Trust and Intimacy Difficulties
The betrayal of trust in childhood can lead to difficulties in forming and maintaining healthy relationships. Survivors may have problems with trust, intimacy, and establishing boundaries.
Substance Abuse and Addiction
Some survivors turn to substance abuse to cope with the emotional pain and distress caused by the abuse. This can lead to addiction and further exacerbate mental health issues.
Dissociation and Emotional Numbing
Survivors may develop coping mechanisms such as dissociation, where they disconnect from their thoughts, feelings, and memories. This can result in emotional numbness and difficulties connecting with and expressing emotions.
Sexual and Relationship Problems
Survivors of childhood sexual abuse may experience sexual dysfunction, sexual aversion, or engage in risky sexual behaviors. They may also struggle with healthy sexual boundaries and have challenges in intimate relationships.
It is important to note that everyone’s experience is unique, and not all survivors will develop the same mental health outcomes. Seeking professional help from trauma-trained therapists can significantly assist in the healing process and recovery. In addition, there are also essential ways that loved ones, parents, and caregivers can help in easing the mental health impact of sexual abuse and in preventing it altogether.
Children Use Actions More Than Words
Children and teenagers rarely tell you what they are feeling or experiencing, but they will show you. When young people are traumatized and hurting, they often lack the verbiage to explain what is happening inside, so instead-they act out. In our past, as a society, we did not make space for conversations about sexual abuse, which only perpetuated the silence that encased this epidemic.
Today, thankfully, we live in a society that has cracked open these conversations, and there truly is no excuse for any victim of sexual violence to suffer alone in silence. These conversations are complicated. We must have age-appropriate trauma-informed daily discussions with our young people about their bodies, consent, emotional regulation, and coping. Trauma-informed means we seek to understand behavior, not label, blame, or accidentally shame. You ask, “What happened” instead of, “Why did you do that”? You try to understand the reasons behind the behavior in a way that helps the person feel seen, heard, and less ashamed. Telling people that it’s ok not to feel ok and sharing with them that they are not alone and that you believe them are all powerful ways to offer a young person a safe space to navigate their confusion around their trauma.
How do I Talk to a Young Person About Mental Health Struggles Associated with Sexual Abuse
One of the best ways to engage young people in a meaningful conversation is when they are otherwise engaged in play or activity. The brain and development of young people are different and direct questioning does not often result in positive outcomes; it can have the opposite effect. A young person will be put on guard when directly questioned about possible sexual abuse. Putting them on the defense due to the fear, shame, and guilt accompanying sexual abuse. When trying to get them to open up about something scary, fear-inducing, or traumatizing, it is best to do so when their brains and bodies are otherwise engaged and in passive ways instead of direct. Young people are incredibly resilient, and their brains have an incredible way of protecting them, which can be challenging. Some strategies that have positive outcomes:
Normalize Talking About Hard Things
When raising a young person, pepper in prevention education throughout your conversations so your child knows the correct terminology for their body. This empowers them to know who is allowed to touch them and who is not. Do this while changing diapers, during potty training, and at the doctor’s office as they grow up. Just make quick matter-of-fact statements about this because they will not tolerate or entertain a long conversation about consent and body awareness. You can quickly drop ideas and thoughts throughout your regular daily routine with them, which helps to build an overall education and awareness. When a child is getting dressed, it’s a perfect time to talk about body awareness, consent, who is allowed to touch them and who is not.
We teach our son a song and dance where we sign; STOP Don’t touch me there (hand goes out in a stop sign). This is my no-no square (draw a square with your fingers out front around their lower body). Then we discuss how their body is there’s, and no one is allowed to touch them without permission, and even then, only a doctor or parent should touch genitals, and that is only for a quick cleaning or examination, and there should always be another trusting adult in the room.
As your child grows into a teenager and their bodies begin to change, and hormones start to engage, you can still have these conversations; in fact, reminding your young person about body autonomy at this age is just as important, if not more important, because young people begin to explore and discover their sexuality, they need to understand boundaries. How to set a boundary and how to maintain it. Telling someone when a boundary is violated. Remind them of consent often.
When you need to ask more probative questions, engaging when they are playing or during physical activity is always best. When brains are already involved with coloring, drawing, putting together a puzzle, shooting hoops, and running. It can be easier for them to talk about more emotionally overwhelming topics. But again, do not expect a full-on engagement as it is near impossible for children. Do not force the conversation. Ask questions. Let them know you love them; you are willing to hear anything and will never judge or shame them for anything they share.
Plant the Seeds
One of the most challenging jobs as a parent is knowing that often, we are not the ones our children will turn to when they need to talk or want to ask questions. It’s awkward for them, and at the end of the day, as parents, loved ones, and caregivers, they may never talk to us. In normalizing the conversations around engaging tough topics, give them plenty of resources, be open, and acknowledge that you know it may be odd for them to speak to you about whatever they need help with. It is ok, and there are some alternative people, places, and entities to whom they can talk, like trusted friends, family, and hotlines. Provide resources that acknowledge the impact that sexual abuse has on mental health so they know you understand and can feel less alone in their experiences.
Being a seed planter for children and young people helps them understand that there are many resources they can access. Resources allow them to know that their struggles are normal responses to sexual abuse. Like any seed, it may take a while for that seed you planted in your child to take root and grow within them. Your job is to plant the seed and nurture them in the best ways you can. You cannot control the outcomes; you cannot force a young person into dealing with their trauma-that is an inside job. But, by planting those seeds, you are giving them language, skills, and hope that there are ways to cope.
Teach them to Cope
We support young people dealing with sexual abuse by teaching them how to cope with hard stuff. We build resilience in children by teaching them to feel their feelings and to normalize trauma in a way that gives them space to talk, feel, heal, and deal with it. If children have tools to work through mental health struggles that naturally arise from sexual abuse, they are less likely to reach for harmful coping mechanisms such as substances, disordered eating, criminality, and other unhealthy behaviors. If they feel like they have ways to deal with the overwhelming emotions they are experiencing, they will be less apt to need or want to run or escape.
Tips and Tools
When you witness a child struggling, please encourage them to try and use their words or artistry to draw or paint, and permit them to be mad or sad by supporting them when they cry. Tears are necessary for healing; hold them and tell them it is ok to cry. Teach them to process anger rather than fear or avoid it; by hitting pillows and allowing them to scream in a safe place, taking them to a boxing or martial arts class. Anger is not always processed through words. People need a physical release from anger.
Meditation, deep breathing, singing, or music distract the brain when overwhelmed. These are excellent tools to help reground them and ease their short- and long-term suffering. Science has proven that mindfulness can help rewrite necessary pathways in our brains. This allows healing and recovery from the mental health impacts of sexual abuse.
Seeing a therapist. Using a chat line. Engaging a support group. These tools help young people connect with others with similar experiences and struggles. Do not be resistant to the use of medication.
Medication is a Powerful Healing Component
Some medication can be a helpful component of comprehensive treatment for mental health struggles resulting from sexual abuse. Medication alone is unlikely to resolve all the emotional and psychological effects of abuse, it can be beneficial in the following ways:
Medications such as antidepressants or anti-anxiety medications can help alleviate symptoms associated with depression, anxiety, and post-traumatic stress disorder (PTSD). Medication regulates mood, reduces anxiety, and improves sleep patterns. Making it easier for survivors to engage in therapy and other forms of treatment.
Survivors of sexual abuse often experience mood swings and emotional instability. Medications like mood stabilizers can help regulate fluctuations and promote emotional balance. Reducing the intensity of emotional highs and lows.
Addressing Co-occurring Conditions
Many survivors of sexual abuse also struggle with co-occurring mental health conditions such as bipolar disorder or substance use. Medication can be a valuable tool in managing these conditions and preventing them from exacerbating the effects of abuse.
Enhancing Focus and Concentration
Some survivors may experience difficulties with concentration, attention, and cognitive processing. Medications such as stimulants or selective norepinephrine reuptake inhibitors (SNRIs) can improve focus and cognitive functioning. This makes engaging in therapy and daily activities easier.
Supporting Overall Well-being
Medication can provide relief from debilitating symptoms and help survivors regain a sense of stability and functioning. Medication can improve overall well-being. It can enhance capacity to participate in therapy, self-care, and other healing strategies.
Normalize these pervasive emotions by making them feel supported instead of isolated. Childhood sexual abuse takes so much away from our young people. It is ok to be mad or sad. Teaching young people how to process the emotions associated with the common mental health impacts of sexual abuse gives lifesaving tools. This enables them to grow, heal and recover.