Working with sexually abused children: Insights from adult survivors

In a qualitative study of adult women's experiences of having been sexually abused as children, research participants reported their recollections of their responses, as children, to sexual abuse and of their relationships with mothers and peers.

Childhood responses to sexual abuse included attempts to escape, fear, guilt and shame. Attempts to escape encompassed physical resistance as well as mental processes, such as daydreaming and dissociation. Despite numerous such attempts to escape, in the context of immobilising fear, many still blamed themselves for the sexual abuse. Many also experienced shame, a profound sense of exposure and humiliation. Relationships with mothers were dominated by feelings of loss and betrayal which, in several cases, had persisted into adulthood. Relationships with peers were characterised by isolation, with underlying fear of rejection and humiliation. Physical and verbal abuse, by a wider range of perpetrators, was common.

Several conclusions for therapy with sexually abused children are drawn: Attention to the full range of attempts to escape sexual abuse, in the context of immobilising fear, could help dispel children's sense of guilt about sexual abuse. The experiences of guilt and shame should both be addressed. In not blaming mothers for sexual abuse, any negative aspects of the child's experience of his or her relationship with mother should not be inadvertently minimised. The fear of exposure or rejection underlying poor peer relationships should be addressed as part of attempts at improving peer relationships. Isolation accruing from other forms of child abuse by a wider range of perpetrators needs to be addressed.