What is sexual abuse?
‘Sexual abuse’ is sexual behaviour between two people, one of whom (the victim) is aged 16 years or younger and does not want the behaviour to occur. The abuser can be an adult, or a child or young person and can be male or female. The victim can be a boy or girl.
The abusive behaviour can be a single act, or can involve many acts, carried out over several years. In some cases, force is used by the abuser, but other victims are bribed, or persuaded, to comply. Some victims are misled into believing that the abuse is ‘normal’ and realise only later that it is not, e.g. when they start talking to friends.
Psychological effects of sexual abuse
After the first abusive acts, many (but not all) victims (survivors) react emotionally, e.g. by feeling anxious, or ashamed. After months, or years, most (but not all) survivors, develop psychological symptoms. Depression and anxiety are common, but many people also develop Post Traumatic Stress Disorder. This usually involves the person being unwilling, or unable, to talk and think about the abuse, or about anything that reminds her/him of the abuse. In addition, distressing memories of the abuse often force themselves into the person’s mind, e.g. in the form of nightmares or vivid memories while awake (‘flashbacks’). These symptoms usually vary over time. There can be long periods when the person is unaffected but then something can ‘trigger’ the symptoms, which can then become severe for weeks or months. The ‘trigger’ often occurs when something reminds the person of the abuse, e.g. seeing the abuser, watching a TV programme about abuse, or having children of his/her own.
In most cases, survivors of sexual abuse have these, or other symptoms, for years before telling anyone, or seeking psychological help. This can cause other problems to develop, e.g. some people develop relationship difficulties, because of their anxiety about sexual activity with their partner. Others attempt to ‘blot out’ their unpleasant nightmares and memories by using drugs and alcohol. Many survivors of abuse who are parents become overprotective of their children. One problem which does not occur: victims of abuse are no more likely than anyone else to become abusers.
Treatment of the effects of sexual abuse
The psychological effects of sexual abuse can be treated very effectively by ‘trauma-focused’ therapy, such as cognitive behavioural psychotherapy. ‘Trauma-focused’ means that the treatment involves talking in detail about the abuse and about the survivor's feelings about the abuse. Doing this can be frightening, but the therapist introduces this gradually, at a speed decided by the person and gives advice about how to cope with feelings such as anxiety or guilt. As well as dealing with the abuse itself, therapy can also help with any problems which have developed because of the abuse, e.g. reliance on drink and drugs, relationship difficulties or low self esteem.
The involvement of the police
Almost all sexual abuse is a criminal offence. It should usually therefore be reported to the police, who have specialist officers to deal with victims. However, some victims prefer not to involve the police. Psychological therapists will not contact the police against the wishes of the person they are working with (although, if children are currently at risk from the abuser, the therapist has a duty to pass on information to protect other potential victims).