THE TROUBLED CHILD COMES OF AGE 

Childhood Sexual Abuse (CSA) and Posttraumatic Stress Disorder (PTSD)

Childhood Sexual Abuse (CSA) is a sexual act imposed on a child who lacks emotional, maturational, and cognitive development to give consent.

The torture doesn’t stop when the abuse stops. The trauma can live forever. Often, it becomes traumagenic and turns into co-occurring physical and mental health problems, in adulthood.

The stress of mentally re-experiencing the abuse can be life threatening. The human mind concocts strange and creative but unhealthy ways to deal with the pain of trauma.

Many CSA victims double-think (find explanations and excuses why it happened to them, why they were singled out, and try to use those ill-figured and self-loathing excuses to explain the abuse away) or sometimes they double-self (dissociate, an avoidant, psychological coping strategy, where the mind distances itself from the experience) through memory loss which is very common among the CSA population.

In the therapeutic world, these are all forms of avoidance, defense memory blockage. CSA trauma can turn into severe and protracted behavioral, emotional, interpersonal, and psychological impairment.

Many CSA victims suffer posttraumatic stress disorder (PTSD), which overwhelms their ability to cope.

Posttraumatic Stress Disorder (PTSD) is diagnosed as follows and as detailed in the DSM-IV (American Psychiatric Association, 2000, pp.218-220):

A. The person has been exposed to a traumatic event in which both the following were present:

1) The person experienced, witnessed, or was confronted with an event or events that involved actual or threatened death or serious injury, or a threat to the physical integrity of self or others

2) The person’s response involved intense fear, helplessness, or horror. Note: In children, this may be expressed instead by disorganized or agitated behavior

B. The traumatic event is persistently reexperienced in one (or more) of the following ways:

1) Recurrent and intrusive distressing recollections of the event, including images, thoughts, or perceptions. Note: In young children, repetitive play may occur in which themes or aspects of the trauma are expressed.                     

2) Recurrent distressing dreams of the event. Note: In children, there may be frightening dreams without recognizable content.                                                

3) Acting or feeling as if the traumatic event were recurring (includes a sense of reliving the experiences, illusions, hallucinations, and dissociative flashback episodes, including those that occur on awakening or when intoxicated). Note: In children, trauma-specific reenactment may occur. 

 4) Intense psychological distress at exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event. 

C. Persistent avoidance of stimuli associated with the trauma and numbing of general responsiveness (not present before the trauma), as indicated by three (or more) of the following:

1) Efforts to avoid thoughts, feelings, or conversations associated with the trauma

2) Efforts to avoid activities, places or people that arouse recollections of the trauma

3) Inability to recall an important aspect of the trauma

4) Markedly diminished interest or participation in significant activities  

5) Feeling of detachment or estrangement from others

6) Restricted range of affect (e.g., unable to have loving feelings)

7) Sense of foreshortened future (e.g., does not expect to have a career, marriage, children or normal life span)

D. Persistent symptoms of increase arousal (not present before the trauma), as indicated by two (or more) of the following:

1)       Difficulty falling or staying asleep
2)       Irritability or outbursts or anger
3)       Difficulty concentrating
4)       Hypervigilance
5)       Exaggerated startle response                                    

E. Duration of the disturbance (symptoms in Criteria B, C, D) is more than 1 month.

F. The disturbance causes significant distress or impairment in social, occupational, or other important areas of functioning.

If this sounds anything like you, you need professional help. Let us work together in finding you the help you need either through a referral or through self-help resources.

If you are uncomfortable sharing in a public forum email Renee Cummings at probonotherapy@earthlink.net

photo courtesy arttherapy.wordpress.net