Sexual harassment is common in middle school, according to research published in the journal Children and Youth Services Review. Although 43% of middle schoolers reported experiencing verbal sexual harassment, few bullying programs address this highly prevalent form of bullying.

According to the U.S. Department of Health and Human Services (DHS), 28% of adolescents in grades 6-12 experience bullying, suggesting sexual harassment may be more common than traditional bullying.

Sexual Harassment in Middle School

The study followed 1,300 children in Illinois for five years, beginning in middle school. Verbal sexual harassment was the most prevalent form of harassment in the group. Twenty-one percent of students reported experiencing physical forms of sexual harassment, including sexual assault. Fourteen percent of students were victims of sexual rumors, and 9% had been the subject of sexual graffiti in locker rooms and bathrooms.

Sixteen percent of students reported homophobic harassment such as name-calling and jokes, and 5% said they frequently experienced this form of harassment.

[fat_widget_right]An open-ended portion of the survey asked students to report their most upsetting experiences with sexual harassment. Many students minimized the seriousness of their experiences, with 14% saying the bullying was “not really sexual harassment.” Many claimed the perpetrators were just joking. Despite this dismissiveness, students still reported finding their experiences very upsetting.

Sexual Harassment and Bullying

Boys were significantly more likely to be sexual harassers, whether their targets were male or female. Boys who experienced sexual harassment often reported that the perpetrators were close friends. Harassment was most common in school hallways. Classrooms, locker rooms, gym class, and lunch rooms were also common sexual harassment locations.

African-American students often reported harassment from older students and romantic partners. White students experienced more victimization at the hands of their friends and same-age peers.

The study highlights the role of sexual harassment in bullying, while pointing to the dearth of anti-sexual harassment training in most anti-bullying programs. The study’s authors say the dismissive attitude many students have toward sexual harassment is especially troubling and should be addressed by anti-bullying initiatives.

References:

1. Espelage, D. L., Hong, J. S., Rinehart, S., & Doshi, N. (2016). Understanding types, locations, & perpetrators of peer-to-peer sexual harassment in U.S. middle schools: A focus on sex, racial, and grade differences. Children and Youth Services Review, 71, 174-183. doi:10.1016/j.childyouth.2016.11.010
2. Facts about bullying. (n.d.). Retrieved from https://www.stopbullying.gov/news/media/facts/#listing
3. Sexual harassment common among middle school children, study finds. (2016, December 9). Retrieved from https://www.sciencedaily.com/releases/2016/12/161209184825.htm

I imagine it took a lot of courage to share this deeply painful experience with a doctor and to write in and share it here, too. It seems like you are ready to begin to address the past trauma and take a look at how it might be impacting your life in the present.

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While I cannot make a diagnosis with the information you provided here, it does sound possible that you are dealing with posttraumatic stress (PTSD) related to the sexual abuse you experienced as a child. Whether or not you actually meet the diagnostic criteria for PTSD, there is probably a connection between your past abuse and the problems you are dealing with today. These problems—difficulty trusting, unexplained anger, periods of depression, conflicted feelings about children, and nightmares—are warning signs that an underlying issue needs to be addressed.

Whether or not you actually meet the diagnostic criteria for PTSD, there is probably a connection between your past abuse and the problems you are dealing with today.

We are very adaptive beings. We figure out what we need to do to survive a situation. As a child, you probably developed coping mechanisms that allowed you to get through the trauma of sexual abuse and survive. Unfortunately, the coping mechanisms that facilitate survival in a traumatic environment can create problems when they are applied in a healthier environment. For example, you say you have difficulty trusting people; as a child who was sexually abused by your stepfather, learning not to trust people was an adaptive way to prevent abuse at the hand of others. Using mistrust as a way to prevent further abuse probably also allowed you to feel a sense of control over your life. As an adult, however, this mistrust may prevent you making yourself vulnerable to others, which is a key ingredient to happy, healthy relationships.

The good news: there absolutely is hope for healing from this. I have worked, successfully, with many people over the years who have similar stories. We have worked together to help them heal from the pain of the past traumas and to gain insight into how the traumas impact their lives in the present. This insight creates the opportunity to find new ways of being in the present—ways that don’t create obstacles for living full, healthy lives.

I encourage you to find a therapist near you who can partner with you on this journey. You deserve to live a full and healthy life, too!

Best wishes,

Sarah

I was recently reading a blog post and noticed that someone in the comment section asked the question: “What does it mean when we refer to someone as a survivor?” We hear about “survivors” of domestic violence and “survivors” of sexual assault all the time, but what does it mean when we refer to people in this way? I thought this was a good question to explore.

The description provided by the National Crime Victim Law Institute states a survivor is “a person who endures adversity, moves through it, and perseveres, or a person with resiliency who remains undefeated.” I like that definition. Below, I describe how this definition applies to the four stages that trauma survivors might experience as they heal.

Stage 1: Silence

People who experience adverse situations, such as a traumatic event involving actual or threatened danger, face incredible challenges. The initial stage following a traumatic event is often a time of silence for the victim. It’s common for recently victimized people to refuse to talk about what happened. This may be due to a number of things, including stigma, isolation, shame, guilt, confusion, or denial about the event.

A person emerging from trauma may have low self-esteem at first and may feel overwhelmed and disconnected from the rest of the world.

Stage 2: Victimhood

[fat_widget_right]Eventually, the traumatized self may start to long for change as the ongoing suffering interferes with daily life tasks and a need to grow and recover begins to form. As this need grows, it allows the person to begin exploring ways to move through the trauma. According to available research, there is often a tug-of-war taking place within the individual between a need to be safe and protect emotions and a need to grow and confront the traumatic memories.

The person may feel compelled to talk openly with everyone about what happened and the suffering he or she experienced. Some people will likely be more willing than others to listen. For people working their way through the stage of victimization, having someone to listen and support them as they process the event can be critical to their ability to move forward into survivorhood. Many people find support groups helpful during this stage and may seek counseling or other support.

Stage 3: Survivorhood

Once a person processes the traumatic event and continues transitioning away from the victim experience, he or she often begins identifying as a survivor. During this stage, a person has had an opportunity to talk about his or her experience and has gained some sense of clarity. He or she may begin to identify the ways in which he/she persevered and the strengths that helped make moving forward possible. The person hasn’t forgotten the event, but he or she has a greater understanding about what the event means and the impact it has made on his or her life.

Reaching the stage of survivorhood doesn’t happen overnight. It may take months or even years to work through the victim stage and reach the point where one feels that the wounds are healing and a sense of relief is possible. Also, the process of healing is not linear. Survivors take one step forward and two steps back sometimes, and moving through it all and persevering may coincide with feeling hopeful one day and damaged and wounded the next. People in the survivor stage tend to spend less and less time feeling wounded as they continue learning new tools and recognizing themselves as resilient.

Stage 4: Thriving and Transcendence

Most people I’ve worked with seem content reaching the stage of survivorhood. They feel like they are managing challenges better and have a greater awareness about themselves and their experiences. Other people, The person hasn’t forgotten the event, but he or she has a greater understanding about what the event means and the impact it has made on his or her life.however, have told me they’re not done growing, and some of them have even said they don’t want to be called a survivor.

This group becomes the thriving group, people who transformed their experiences into a meaningful personal narrative and will not be defined by their adversity. They feel healed and safe, and take appropriate risks in seeking connection with others, such as asking a new neighbor out for coffee. They don’t feel the need to tell their stories unless it benefits someone else. “Thrivers” feel motivated to take part in the community and may seek out volunteer opportunities or other ways to help others.

Of course, this is only one model of healing and one definition of what it means to be a survivor. Every person who experiences a distressing event may have his or her own ideas about what it means to pull through a traumatic time or event.

Reference:

Matsakis, A. (2003). The rape recovery handbook: Step-by-step help for survivors of sexual assault. Oakland, CA: New Harbinger.

“I’ve been fine for years. Now I have nightmares every night and can barely function at work. What’s going on?”

“I thought I was over it. I even went to therapy as a kid! Why is it all coming back again?”

“I feel like I’m falling apart, but the abuse was years ago. Does this mean I’m getting worse?”

One of the first things survivors of sexual abuse ask me when they come into my therapy office is, “Why now? Why are these feelings and memories coming back now?” Often, the underlying question is, “I was fine before, but now I’m struggling. Am I going crazy?”

If you’re having this experience—being suddenly overwhelmed by a past trauma—let me reassure you the same way I reassure the people I work with in my office. No, you’re not going crazy! As difficult as it may be to believe, a sudden reemergence of old feelings is often a sign that you’re ready to heal on a deeper level.

Recovery from Trauma Happens in Stages

Healing from a trauma such as sexual assault or abuse happens in stages. In the first few days after an assault, we tend to shut down because the emotions feel so overwhelming that we can deal with them only in small doses. For ongoing sexual abuse or molestation, this shutdown state may last for the entire time the abuse occurs. Eventually, in the days, weeks, and months after an assault occurred or the abuse ends, we usually find ways to “put the past behind us,” to regulate our emotions and to build a stable life. We may still experience some triggers or have some nightmares, and we don’t typically forget about what happened, but over the years we start to feel “normal.”

Then, sometimes, all those feelings come roaring back. What’s going on?

When the fear, the anger, the sadness, the helplessness, the heartache—all the emotions that were perhaps too painful, too complicated, or just “too” in the immediate aftermath of the trauma—suddenly reemerge, your new task is to sit with those emotions and let them have their say.

In my experience as a therapist, what’s happening is that some deep, inner part of you finally feels safe and stable enough to address the leftover emotional fallout that’s been patiently waiting for years. Your job right after the trauma and in the years since the trauma occurred has been to find stability. You developed successful coping mechanisms that let you function in the world without falling apart. Those are invaluable skills that are going to get you through the next part of your recovery.

You Are Strong Enough to Feel Vulnerable Now

When the fear, the anger, the sadness, the helplessness, the heartache—all the emotions that were perhaps too painful, too complicated, or just “too” in the immediate aftermath of the trauma—suddenly reemerge, your new task is to sit with those emotions and let them have their say. They’ve been patiently waiting for you to develop the strength to cope with them successfully, and if they’ve shown up for you now, after all this time, they think you’re finally ready. You are strong enough to feel vulnerable for a while.

So what do you do? How do you cope without getting overwhelmed?

• Know that you are not regressing or going “crazy.” Reassure yourself that these seemingly new emotions are a normal part of the trauma-recovery process and that they won’t stick around forever. These emotions don’t mean you’re moving backward in your healing or that you’ll always feel this way. There is an end!
• Recognize that “the only way out is through.” These emotions will go away, but only after you let yourself feel them. Emotions give us valuable information about ourselves and the world, so you need to learn to listen to them. This is your opportunity to learn that skill.
• Go slowly. If all these emotions feel overwhelming and scary, you can take them in small doses. I often recommend setting a timer for 15 or 10 or even five minutes every day, and using that time to feel whatever you’re feeling right then. When the timer goes off, stop. (This is where your strength comes in!) It may be hard to feel at first, or hard to stop feeling, but that’s why you’re practicing. This exercise helps you build confidence that you can turn off the flood of emotions, which can help reduce anxiety about letting yourself feel.
• Give yourself credit for your progress. As you work through this stage of the healing process, you may find yourself caught up in one emotion for a while. You may go through a week-long period of sadness, for example, or a month of feeling really angry. People sometimes feel stuck when this happens and forget that they haven’t always felt that way and are therefore not likely to feel that way forever. Keeping a journal or talking about your feelings with a supportive loved one can help you see that you’re moving forward.

If you need additional support or resources, a therapist specializing in trauma recovery can help. If you need immediate help regarding sexual assault or abuse and you’re in the United States, you can call the 24-hour National Sexual Assault Hotline at 1-800-656-HOPE (4673) for support, resources, and referrals.

Related Reading: 

• Can You Have Trauma Symptoms Without Experiencing Trauma?

• 4 Steps to Erasing the Trauma of Painful Memories

• Trauma and Re-Experiencing: The Intrusion of Past into Present
• Resensitization: Coming Back to Life after Trauma

Sexual assault, a difficult subject for many people to talk or even think about, is an unfortunate reality for the approximately 250,000 people who are sexually assaulted in the United States each year.

April is nationally recognized as Sexual Assault Awareness and Prevention Month, and April 7 is the designated Day of Action. These campaigns exist as a means to raise awareness of sexual assault in the U.S., so that people not only begin to think about sexual assault and its implications, but start doing something about it, as well.

You have the power to make a difference. Here are eight ways you can help raise sexual assault awareness and also work to prevent its occurrence in the future.

1. Educate Yourself about Sexual Assault

Sexual assault is any unwanted sexual contact that a person is coerced or forced to participate in against their will. According to the results from a Centers for Disease Control and Prevention (CDC) survey released in 2014, nearly one in five women has experienced rape or an attempted rape in her lifetime. Research also paints a grim picture for males. Studies show that one in six men experiences some form of unwanted or abusive sexual experience in his lifetime, as well.

Sexual assault impacts the lives of both men and women, and the resulting trauma often goes far beyond the event itself. People who experience sexual assault are more likely to experience posttraumatic stress, depression, anxiety, suicidal thoughts, drug and alcohol addictions, problems with intimate relationships, and difficulty at school and/or work.

You can help raise national awareness of sexual violence simply by educating yourself and your family. There are several national organizations that provide information and resources on sexual violence. Two of the leading organizations are:

• RAINN (Rape, Abuse, and Incest National Network) is the largest anti-sexual violence organization in the United States. RAINN operates the National Sexual Assault Hotline 24-7, which anonymously links callers to a counselor at a rape crisis center nearest them. RAINN also offers online support, resources, and information.
• The NSVRC (National Sexual Violence Resource Center) creates and shares resources to help prevent and respond to sexual violence in the United States and around the globe. They coordinate Sexual Assault Awareness Month (SAAM), operate an online resource library, sponsor national conferences and events, and help integrate research with community projects.

2. Volunteer

There are many ways you can personally get involved in the fight to raise awareness and prevent sexual violence in your local community.

You can volunteer at a crisis center, staff a hotline, participate in fundraising events, advocate for survivors, help raise awareness and improve safety measures on college campuses, or get creative and host your own educational or advocacy event.[fat_widget_right]

3. Lobby Your Representatives

You can speak for those who do not have a voice or are not able to express it. Congress needs to hear from citizens who support legislation to improve the criminal justice system, provide support to survivors, and help prevent further violence. The RAINN Action Center has pre-written letters and tweets available to send to members of Congress asking them to support measures related to sexual assault prevention and support. You can use the RAINN hashtag #ActWithRAINN when posting about sexual violence advocacy measures this month.

4. Use Social Media

Connect with the cause and share it on social media to help increase awareness among those in your network. You can use the RAINN hashtag #ActWithRAINN to talk about the cause and connect with @RAINN01 to stay informed.

The NSVRC hosts a twitter discussion every Tuesday in April at 11 a.m. PDT. Follow the conversation or get involved through the hashtag #TweetAboutIt.

5. Learn How to Help Those Who Experience Sexual Assault

It can be difficult to know how to reach out to a loved one who has experienced sexual assault. Below are some tips to help if you are unsure of what to do:

• Lend a compassionate, nonjudgmental ear. Many people just want to be heard. They do not necessarily need advice or comments.
• Be patient and considerate. Don’t try to force your friend or loved one into seeking support or taking action if he or she is not yet ready for it.
• If the person plans to seek support or medical attention, offer to be there. As simple as it may seem, your presence alone can make a significant difference.
• If someone you know is sexually assaulted, your reaction can have an impact on his or her recovery from the trauma. Do not question what he or she was wearing or why he or she was not able to stop the assault. One of the most important things you can say to a sex abuse survivor is, “I believe you.”

6. Engage the Community

Consider reaching out to your local community to help with prevention efforts. You might talk to bar owners about the role their employees can play in prevention, seek support from faith-based or youth organizations, or encourage college faculty and staff to raise awareness and improve safety on campus.

7. Become an Advocate against Military Sexual Assault

Military sexual violence is one of the most overlooked forms of sexual assault. An estimated 19,000 service members become victims of military sexual assault each year, and at least half of those victims are men, with an estimated 38 military men being sexually assaulted every day. Unfortunately, many of these cases go unreported, as survivors rarely speak up.

You can also get involved and spread the word about prevention and support programs for military sexual violence survivors. RAINN operates a Department of Defense Safe Hotline and website for victims of military sexual assault to obtain crisis intervention, emotional support, and other related resources.

8. Donate

There are several nonprofit organizations against sexual violence that rely mostly on monetary donations from supporters to survive. Even if you cannot volunteer or take any other action, you can still help the cause by providing a donation to the organization of your choice. In addition to RAINN and NSVRC, there are several other nonprofit organizations working to prevent sexual violence and provide support, including:

• 1 in 6: an organization that helps men who have experienced sexual abuse.
• MCSR (Men Can Stop Rape): an organization that seeks to prevent male violence against women by redefining masculinity and male strength.
• NAESV (National Alliance to End Sexual Violence): an organization that helps educate the policy community about federal laws and legislation that prevent and work toward ending the cycle of sexual violence in the United States.

In addition to national organizations, there are a variety of support and prevention resources available on the local level as well. Get involved in your community. If you are unsure what projects exist near you, the NSVRC provides an online directory of local organizations and projects working to eliminate sexual violence.

We hope you will join us during Sexual Assault Awareness and Prevention Month in supporting several important organizations working toward a safer community for all. On April 7, the Day of Action, we urge you to pick out at least one item and help us create a ripple effect of positive change for those who are suffering, those who have been victimized, and for those who we hope never have to experience the trauma of sexual assault.

References:

1. Help Someone You Care About. Rape, Abuse, and Incest National Network. (RAINN). Retrieved from: https://rainn.org/get-help/help-a-loved-one
2. Kearl, H. (April 1, 2013). 10 Ways to Mark Sexual Assault Awareness Month. American Association of University Women. (AAUW). Retrieved from: http://www.aauw.org/2013/04/01/sexual-assault-awareness-3/
3. Penn, N. (2014). Military Sexual Assault: Male Survivors Speak Out. com. Retrieved from: http://www.gq.com/long-form/male-military-rape
4. Prevalence and Characteristics of Sexual Violence, Stalking, and Intimate Partner Violence Victimization — National Intimate Partner and Sexual Violence Survey, United States, 2011. (2014). Centers for Disease Control and Prevention. Retrieved from http://www.cdc.gov/mmwr/preview/mmwrhtml/ss6308a1.htm?s_cid=ss6308a1_e
5. RAINN Action Center. Rape, Abuse, and Incest National Network. (RAINN). Retrieved from: https://rainn.org/public-policy/rainn-action-center
6. Resource Directory. National Sexual Violence Resource Center (NSVRC). Retrieved from: http://www.nsvrc.org/organizations?tid=8&tid_1=All
7. SAAM Day of Action (2015). Sexual Assault Awareness Month. National Sexual Violence Resource Center (NSVRC). Retrieved from http://www.nsvrc.org/saam/current-campaign/day-of-action
8. The 1 in 6 Statistic. 1 in 6. Retrieved from: https://1in6.org/the-1-in-6-statistic/

Of course you are concerned! Anytime we see a behavior like that in a child and she or he is unable or unwilling to explain the change, we fear the worst. Your primary responsibility is to protect your daughter. Your mother and father-in-law may get offended and angry, but that can’t be a reason to ignore your fears.

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Since you are working from intuition, it may be worth looking into having an evaluation done with a good, reputable child therapist to explore if anything has happened with your daughter. It is true that you don’t want to plant ideas in her head, but you also want to find out if something scary or inappropriate has happened and help her process it. A good therapist can do that without planting ideas. It may be that your father-in-law has been inappropriate with her. If so, you will want to connect her with professional supports as soon as possible.

Your mother and father-in-law may get offended and angry, but that can’t be a reason to ignore your fears.

It also might be that she had a bad dream about him and is now scared of him. It may be that he was stern with her and she got upset and doesn’t want to engage with him. Without knowing more, it is hard to know how to proceed. I don’t want to diminish your concerns—until you know for certain that he is a safe person for her, absolutely continue to make sure that you supervise their interactions.

How receptive do you think your mother and father-in-law would be to a conversation that explored whether they had noticed a change in the way your daughter is reacting to him? If you approach it from a place of curiosity rather than accusation, you may be able to learn more. If nothing untoward has happened, they may be concerned and confused as well.

That said, if you want to wait to address any of this with them until you have more information, you can certainly do so. You know your family dynamics and should proceed in the safest way possible for everyone, particularly your daughter.

Best of luck,
Erika

A friend, loved one, or family member pulls you aside to talk. He or she is normally quiet and reserved; this seems out of the ordinary.

“I have something very important to tell you. It’s very hard for me to say,” the person admits. “I have been sexually abused.”

How do you respond?

Do you recognize how powerful this moment is for the person talking?

For mental health professionals and non-mental health folks alike, being in the position of listener may seem daunting. In my work as a therapist, I have encountered many survivors of sexual abuse at various stages of the healing process. Most often, such people describe abuse starting in childhood and reoccurring throughout life.

In addition to the trauma inflicted by the abuse itself, many survivors, if not all, describe a bad experience when they chose to disclose the abuse to someone they trusted. Disclosing abuse is an enormously important and highly stressful event that can mark a golden opportunity for the survivor to begin the healing process.

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If navigated poorly by the listener, however, it can easily be a step backward.

Many survivors of abuse hold on to memories of their abuse for years, typically denying, avoiding, or dissociating from them. It often takes an unthinkable amount of trust and vulnerability to motivate a survivor of abuse to disclose these events and make them “real.”

For those of us who have been on the listening end, it can be difficult to know what to do. The experience can be scary, and the unexpected and uncharted nature of the event may make us feel anxious. We may feel dismissive or defensive if the person identified as the abuser is a close friend, loved one, or family member. In some situations, inadvertently or otherwise, we may even shift blame to the victim by saying things like, “Why didn’t you say stop or call for help?” or, “Were you drunk when this happened?” or, “What were you dressed like?” These reactions are antithetical to the help that the survivor worked so hard to seek.

Before we cover what a person in the position of listener should do, let’s explore what may have prevented a survivor from disclosing abuse earlier. Sexual abuse, especially if perpetrated by someone the survivor knows and has an ongoing relationship with (family member, friend, friend of a friend, etc.), typically comes with threats if the survivor speaks up or alerts authorities. Aside from direct threats from the perpetrator, survivors will often harbor their own fears of consequences of disclosure, including:

• Threats that the abuser will harm nonabusing peers or loved ones
• Fear of judgment, embarrassment, alienation, and abandonment from nonabusing peers or loved ones
• Consequences to the survivor’s social structure and/or family, especially if the abuser is a valued person within his or her social or family structure
• Worry that because the events were so confusing to the survivor, he or she will not be able to properly communicate what happened
• Concern that because the trust of nonabusing adults or peers had previously been damaged, he or she cannot turn to them for protection or help
• In the event of childhood sexual abuse, the child may fear dissolving the only relationship he or she currently has

When someone tells you about his or her experience with sexual abuse, simply saying “I believe you” is the most valuable form of help you can offer. Validation is the first step in breaking the cycle of fear and isolation. Survivors of sexual abuse are often groomed or primed by their abusers to fear the revelation event, so feeling socially rewarded for it will introduce a much-needed new perspective and sense of safety. Additionally, feeling believed when disclosing abuse may also lead to breaking the person’s negative coping skills (denial, avoidance, dissociating). Once the abuse has been revealed and validated, the person may finally feel able to fully confront the reality of what happened and begin the healing process.

Abuse often leaves the survivor feeling powerless. An individual who has felt out of control of his or her body, emotions, and environment may feel a rush of empowerment and hope knowing that someone believes his or her truth. It might even be the impetus to the survivor going to the authorities or seeking legal protection.

What happens when we react with skepticism, blame, or defensiveness? The fears and paranoia nurtured and reinforced by the abuser are validated instead. Rather than seizing an opportunity for healing, the survivor may feel rejected and thus retreat into hiding. In psychotherapy, we call this retraumatizing. When a person feels retraumatized, it may stand as an obstacle for the person to seek help in the future.

If someone you know and love tells you that he or she has been sexually abused, remain calm, listen and speak with empathy, and leave the person no doubt that you are on his or her team. You may help the person take the first step out of a very dark place.

Reference:

Sanderson, C. (2006). Counseling adult survivors of child sexual abuse (3rd ed.). London; Philadelphia: Jessica Kingsley.

It is the nature of abuse within families to be as behaviorally nuanced and emotionally complex as the individuals involved. Relationship abuses nearly inevitably reveal a life-draining and self-perpetuating dynamic of power and control. It is within this dynamic that abuse is perpetuated.

Abuse may manifest as physical (throwing, shoving, grabbing, blocking pathways, slapping, hitting, scratches, bruises, burns, cuts, wounds, broken bones, fractures, damage to organs, permanent injury, even murder), sexual (suggestive flirtatiousness, propositioning, undesired or inappropriate holding, kissing, fondling of sexual parts, masturbation, oral sex, or any kind of forceful sexual activity), or emotional (neglect, harassment, shaming, threatening, malicious tricks, blackmail, unfair punishments, cruel or degrading tasks, confinement, abandonment).

Abuse may also involve what I call strategic accusation in an attempt to maintain perceived leverage in the context of families and social circles—for instance, communicating to family and friends that the victim has engaged in affairs that have not occurred, or even using the mere threat of spreading such a rumor. There may also be implicit threats, such as, for instance, the open display of weapons. Perpetrators may drive recklessly in order to generate fear and emphasize a position of control.

Financial or what you might call economic abuses may also exist. For instance, many perpetrators maintain individual, or even secret, bank accounts as a way to withhold money. They may also ensure that bills and credit cards be placed under the name of the victim as a measure of self-protection.

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In all of these, the dynamic of abuse commonly takes shape in varying modes of manipulation, intimidation, aggression, and terrorism.

And though we often think of abuse as being inflicted by a perpetrator on a victim, or else between two perpetrators, we must be careful to recognize another disposition, an often secretly performed dynamic of abuse, that is inflicted by an emotionally troubled person onto himself or herself.

Recognizing that those trapped in such dynamics embody varying forms of what psychology has long referred to as sadism and masochism, psychologist David Shapiro (1981) instructed:

Each disposition involves, in its own way, a defensive, usually angry assertion of will; each is driven by a sense of inferiority, shame, or humiliation; each is deeply and self-consciously concerned with relative position, rank, and measure, with superiority and inferiority—but the sadistic person from the superior position, and the masochistic person from the inferior one.

The sadistic impulse occurs when a person dominates others as a way of attempting to gain in a surrogate what they lack within themselves and in life: control. The masochistic impulse occurs when a person grasps for such control through harmful forms of self-soothing.

Eating disorders, cutting, and substance abuse are indicative of a masochistic coping style and often of entrenched emotional dominance or avoidance within a family system.

Child abuse occurs far more commonly than most people realize. The Centers for Disease Control and Prevention began a study in the 1990s that has tracked child abuse and reported that there are more than three million reports made each year involving more than six million children, and that between four and seven children die each day due to abuse or neglect in the United States.

And then there is violence between lovers. Michael Johnson (2006) identified four major types of intimate partner violence—situational couple violence, intimate terrorism, violent resistance, and mutual violent control—and defined them “in terms of the control motives of the violent member[s] of the couple, motives that are identified operationally by patterns of controlling behavior that indicate an attempt to exercise general control over one’s partner.”

Intimate terrorism, which most frequently involves men abusing women, is the most extreme form of domestic violence. Another form of chronic domestic violence is a pattern in which both husband and wife are controlling and physically violent, two intimate terrorists battling for control, what Johnson labeled “mutual violent control.” These types of chronic abuse are products of two quite different evolutionary histories and psychological profiles: “one type broadly sociopathic and violent, the other deeply emotionally dependent on their relationship with their partner” (Skolnick and Skolnick, 2003).

Lipman-Blumen (1984) defined power in relationships as “the process by which individuals gain the ability to impose their will on others.” Abuse is often preceded by a more subtle power dynamic. Newman (1999) noted that early stages of abuse may be primarily emotional and difficult to detect:

For instance, when a husband anticipates his wife’s angry response to his desire for her to do more around the house, he may decide not to voice his concerns in order to avoid conflict. Thus, she has successfully exerted power over him [by preventing him from speaking his mind] without any direct confrontation. Such invisible power is important since it can maintain inequality even in those marriages that appear harmonious and conflict free.

Victims of relationship abuses often enter into therapy in the midst of a dualistic emotional experience—an affectionate emotional bond interlaced with anger, resentment, and fear.

Those who find themselves in therapy are obviously often experiencing painful and isolating feelings and possibly ambiguity of emotions, such as love and anger, which may be felt simultaneously. Unless a therapist is highly empathic, victims may be unwilling to expose themselves. The first tasks in therapy should always be to empathize with the person amid the emotions brought into the therapy room and to ensure an immediate plan for safety should a disclosure of abuse be made.

References:

1. Centers for Disease Control. Adverse Childhood Experiences (ACE) Study. Retrieved from http://www.cdc.gov/violenceprevention/acestudy/index.html.
2. Johnson, M.P. (2006). Conflict and control: Gender symmetry and asymmetry in domestic violence. In Violence Against Women (12) 11, 1003-1018. Thousand Oaks, CA: Sage Publications.
3. Lipman-Blumen, J. (1984). Gender roles and power. Englewood Cliffs, NJ: Prentice-Hall.
4. Newman, D.M. (1999). Sociology of families. Pine Forge Press: Thousand Oaks, CA.
5. Shapiro, D. (1981). Autonomy and rigid character. United States: Basic Books.
6. Skolnick, A. S., and Skolnick, J. H. (2003). Family in transition (12th ed.). Boston: A&B.

It can be hard to know for certain whether what you have been experiencing is, in fact, a series of previously repressed memories or something else. It is very possible to rediscover memories that have been tucked away and buried for years and not just traumatic ones. Sometimes a smell, a sound, a place, or an experience brings something back to us in vivid detail that had previously been hidden. Sometimes we just get a glimpse of it, an impression, but the effect can be quite unsettling and even disturbing.

I have had the experience of suddenly recalling an event from decades earlier with vivid detail. I had to call a family member to confirm if what I was remembering was accurate (it was). My event was not traumatic or upsetting; I was far more troubled by the fact of its absence than by its reappearance.

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It is possible that your memory, triggered by your experience with your friends’ children, is accurate. You may be remembering an event or an amalgamation of a series of events. It is not unusual for children to engage in play with dolls that explores sexual themes. What seems troubling is the violent nature of the play you are describing. Perhaps you were acting out something you witnessed or heard about. My hope would be that, if you had experienced something so violent in your childhood, someone in your family would have known or been aware that something had happened. Is there anyone you can check in with who might know if what you are remembering happened or who can lend insight?

In regards to your dream about possible child pornography, our dreams are often a way of processing information that we aren’t able to make meaning of during our waking hours. Your dream may be connected to an experience you had, but it may also be something else. If your dreams and memories are causing you distress, which it sounds as if they are, I strongly urge you to connect with a licensed professional to explore what may be at the root of this and how to reduce your distress in the present.

The second part of your question, however, brings up another set of concerns. You mention being drawn to abusive relationships in your older years. No matter the reasons or the root causes, this is something I strongly encourage you to get support with. If you find yourself in an unhealthy relationship or unhealthy patterns of relationships, there are steps you can take to change that. A history of abuse in childhood can contribute to adult relationship patterns, but that history doesn’t limit or determine the kinds of relationships we are capable of having.

Best of luck,
Erika

Thank you for writing. I am so sorry this happened to you. It frankly makes my blood boil. This breach and exploitation is exactly what therapists are never supposed to do. To me, it’s akin to incest. I’m glad you’re reaching out about it. Despite whatever conflicted feelings you might be having, please know that this was not your fault in any way. Maintaining that professional wall and keeping the boundary between healer and client is solely the responsibility of the therapist. Psychological safety and doing no harm is our top priority. It’s heartbreaking that your therapist so violated the sanctity of the relationship.

Of course, from a psychological viewpoint, this kind of gross violation of boundaries and trust will bring up all kinds of conflicted and traumatic feelings for the client. (This is one of many reasons that such a breach indicates the therapist has lost her way in the profession.) What’s especially tragic is that this experience may have parallel emotional resonance for those who were abused or neglected as children. One of the most common misperceptions by victims of such abuse is that they think, somehow, in a desperate effort to make sense of a painfully chaotic phenomenon, that they “caused” or “brought on” the abuse. Therapy is set up so that it really is all about the client; when this kind of abuse transpires, how can the client help but think (among other things) that the violation is somehow “about me”? Trust me: This is about a malpracticing therapist.

The feelings you’re having are quite understandable; however—and I hate to say this—they most likely won’t just go away on their own. You allude to this in your letter in that, five years hence, the pain lingers. In a way, it means you have a communicative psyche that needs some sustained, loving attention; you deserve the care and guidance of a competent therapist to help you heal. The fact other therapists wanted you to press charges may be a sign of how seriously we take our oath as healers—it’s enraging when we hear of violations of that oath. However, you are not obligated to do anything that feels too scary or overwhelming. You may want to press charges at some point, you may not. That doesn’t seem to be what you’re needing right now, and such a decision can come later, if ever. It’s not your job to “police” anyone. We don’t want to create a situation wherein we “blame the victim.”

The first step is a healing process wherein you can reintegrate and reconnect with whatever had to be dissociated or sacrificed to live with the hurt of this abuse. Other decisions will likely follow of their own accord.

I’m curious as to your statement that “most people don’t believe a woman can abuse another woman.” Since that falls outside the range of my own experience, I would want to know more about that, i.e. who “most people” are. Most people in your circle of family and friends? Potential authorities who would evaluate this case? Has your mistreatment at the hands of others ever been doubted?

You are alluding to what I call the double whammy of trauma—first there is the painful abuse itself, and then (and this is often what causes the real hurt and disruption) the denial or minimization of the abuse. It’s possible that we can heal from hurtful events if those who participated acknowledge both the event and their participation, followed by their amending such behaviors. With the repetition of abuse and denial, and no commitment by the abusers to cease, we begin to wonder if we are in fact “exaggerating” or even “crazy.” A painful split emerges between mind and body, as we doubt our own perceptions, memories, and physical reality. This takes a lot of time to heal, to reconnect with and trust our own emotional experience and intuition, but repair is possible. Your perspective on these events may shift once the fractures begin to heal.

You may need to tell your therapist—and I’m hoping you have one you trust, or want to find one—that you’re not interested in pursuing any reporting or recriminatory actions just now. It sounds like you need now to put yourself first, make sense of what happened, and engage in a healing process with someone who will cherish the trust you give to him or her. It is a privilege for us to be trusted, and it’s something we have to earn. Don’t feel in any hurry—in fact, I’d encourage you to go at a pace that feels right to you.

I’m sorry this happened, but so glad you wrote in. I hope this answer helped in some small way. Please don’t give up on finding the right person, in spite of this awful breach. Warmest good wishes to you.

Kind regards,
Darren

Following a traumatic event, several symptoms may arise in a person. Posttraumatic stress manifests in a variety of ways: reexperiencing the trauma via nightmares and flashbacks, avoidance of people and places that trigger memories of the event, elevated states of anxiety and arousal, and being in near-constant fight-or-flight mode, to name a few. These symptoms may last days, weeks, months, or years following traumatic experiences such as wartime combat, childhood abuse, rape, kidnapping, natural disaster, traumatic injury, or sudden death of a loved one.

Processing the emotions tied to these memories is often unsettling, and recovering from traumatic experiences typically requires a great deal of support and guidance. The good news is that there are several websites and organizations devoted to helping those who have been subject to trauma. Many are geared toward military veterans; however, plenty of sites focus on recovery for those who were victims of other forms of trauma, such as abuse or assault, whether as children or adults.

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We’ve compiled a list of the 10 best online resources for PTSD and trauma—GoodTherapy.org excluded—in 2013. As with our previous top 10 lists, our selections are based on quality and depth of content, presentation, and functionality.

• National Center for PTSD: The U.S. Department of Veterans Affairs hosts this site dedicated to research and education on trauma and PTSD in the lives of veterans. There is an informational section for veterans and their loved ones, as well as for professionals who are researching and providing care for those experiencing PTSD.
• Make the Connection: This site focuses specifically on offering “shared experiences and support” for veterans. The emphasis is on the power of support in the recovery process; veterans can locate local resources and access a wide range of information on dealing with PTSD as well as transitioning from service, the death of family or friends, and alcohol or drug problems. The video gallery features several personal stories of military veterans who have found hope and recovery in spite of flashbacks and other experiences. Online self-assessment screenings are also available to determine if a veteran has PTSD, depression, or a substance-abuse issue.
• Posttraumatic Stress Disorder Alliance: This network of professional and advocacy organizations has come together to provide an array of educational resources for those experiencing PTSD and their friends and family. In addition to combat veterans, the site is geared toward those who have experienced rape, physical assault, other forms of sexual assault, domestic or intimate partner violence, serious injury or accident, shooting or stabbing, sudden death of a loved one, childhood illness, witnessing a serious crime, and natural disaster. The PTSD Alliance also offers two free, downloadable booklets in their “resource center” to guide people through recovery.
• Gift From Within: This international nonprofit for survivors of trauma and victimization is in its 20th year of service. The site is rich with resources, information, and useful tools for those recovering from trauma of many kinds. In the “trauma support” section, tips from survivors for therapists, guided meditations, and stories from “support pals” can be accessed. In the bookstore, visitors can sift through a number of titles organized by topics, such as children and teens; healing and recovery from illness; healing and recovery for survivors and supporters; PTSD treatment, trauma, and violence; sexual abuse—male and female; and sexual assault, rape, and domestic violence.  There are also DVDs on PTSD available for purchase.
• Real Warriors: Another site devoted to combat veterans and their loved ones, Real Warriors is an engaging, content-rich resource for help with the “invisible wounds” of war. The general message is that no one goes into combat and comes home unchanged, and that cultivating resilience and “real strength” is essential to recovery. Videos and podcasts are available for viewing and download, and veterans are encouraged to reach out and get the help they need. Several veterans share their personal stories of PTSD on the site, and others are encouraged to do the same. There is also a military crisis line and live chat number for those who need immediate assistance.
• My PTSD: This site is primarily a network of forums for those who are experiencing PTSD. Specific forums are designated for combat, domestic violence, sexual abuse, and traumatic stress, as well as a general PTSD discussion thread. There are also smaller threads for topics such as book clubs, events, studies and research, and recommending trauma physicians. In the “articles” section of the site, several insightful pieces are available on a variety of helpful topics such as finding negative core beliefs, recovery, effective treatments for PTSD, and treating the trauma of rape with cognitive behavioral therapy, among others.
• Trauma Survivors Network: In partnership with hospitals across the United States, the American Trauma Society created this community-oriented network of people and their families recovering from trauma. Through the Trauma Survivors Network, people can access local trauma center information, peer support groups, peer visitation opportunities, a parent and family handbook, survivor stories, a community forum, and more. TSN’s “NextSteps” program helps survivors to become autonomous self-managers while recovering from trauma. There is also a “family class” for those who are in caregiver and support roles for those who are experiencing PTSD.
• Sidran Institute: The Sidran Institute is a nonprofit organization devoted to helping people understand and recover from PTSD, dissociation, and co-occurring issues such as substance abuse, self-harm, and suicidal ideation. The site offers educational articles, resources, and information for adults, adolescents, and children who have survived trauma, as well as for schools, community support groups, and mental health and victims services professionals. Trainings are also available through the site for those who wish to deepen their knowledge of PTSD and other trauma-related issues.
• PTSD Association: Along with being greeted by a PTSD self-assessment test, visitors to this site will find a large body of useful information pertaining to PTSD. Founded by Ute Lawrence-Fisher, who survived the “most horrific car pile-up in Canadian history” in 1999, the PTSD Association aims to help those who are recovering from trauma to reclaim their lives. Clinical information, personal stories, coping strategies, and related links are among the resources available.
• National Child Traumatic Stress Network: With informational sections for parents and caregivers, medical professionals, military children and their families, and educators, the National Child Traumatic Stress Network (NCTSN) covers all bases of child traumatic stress. Established by the U.S. Congress in 2000, the NCTSN offers guidance, tools, and links for coping with and recovering from neglect, natural disasters, sexual or physical abuse, terrorism, grief, refugee and war-zone trauma, traumatic illness, early childhood trauma, and school, community, or domestic violence. Numbers for various child and adolescent crisis lines are also provided.

Have a website you would like to see in our Top 10? Recommend it here.

Thanks for writing in, and for the excellent question. I’d first like to congratulate you for having what appears to be an unusually expansive empathy, in that you are trying to do right by your fiancé in terms of your mutual sex life, his issues and sensitivity around trauma, and, of course, your own feelings about all this. Obviously, this is a complex question, which accounts for the long-ish answer you’re about to get.

The first thing that comes to mind here is: There’s something not sexy about this for you; sex is a little like humor in the sense that it tickles us or it doesn’t. Your fiancé’s request to carry out what sounds like a role-play scenario doesn’t seem to hit the eros chord for you, and nothing’s more of a turn-off than forcing yourself to do something too edgy or discomforting.

Part of the uneasy factor is that the requested scenario seems to parallel your fiancé’s sexual abuse, which is still fresh for you (just having heard about it). Let me say here that what defines “healthy sexuality” could—and has—filled volumes upon volumes. It is a never-ending debate in my field. My own guidelines for “healthy” sex would mean, first and foremost, that the sex is consensual and safe for all parties. Other than that, the spectrum is infinitely broad. I know heterosexual men who like wearing stockings, and gay men who act brutish and tough in the bedroom. Working with sexuality means you’re dealing with the unconscious, and 10 different therapists would give you 10 different interpretations of what your partner’s sexual preferences are “really about.” As indicated, however, I get the impression from your letter that something about this feels uncomfortable, perhaps a bit unsafe, and I think that is at the core of what needs to be dealt with between you.

My clinical experience has shown me that a dynamic sexuality often includes a sense of experimentation, emotional expression, and spontaneity. There’s nothing at all wrong with role playing, though when the “play” part becomes rigidified, with an endlessly repeated “script,” to the point where mutual expression seems muzzled, where the sex has to be a certain way or someone will be unhappy, then it’s time to take a step back and see how things can be loosened up. Playfulness and humor, too, can be a way of masking or deflecting emotion, but if sex becomes too serious or heavy, it becomes stifling. Just as important here is the fact that what happens in the bedroom so often mirrors what is happening, emotionally and relationally, in the relationship itself. Sexuality is another spoke in the wheel of relating, not a separate wheel unto itself, though we often think of it that way. This leads me to wonder if you ever feel kept at a distance or put in a position of power in your emotional lives together.

I’m not exactly sure how dark or heavy a “flavor” we’re talking about here, though it sounds like (I’m assuming) you would be in the “perpetrator” role; if I assume that these scenarios have a sadomasochistic tinge, perhaps your fiancé is asking you to take the “S” role in a way you’d rather not. I’m imagining it might be painful to play a role in which you are hurting your beloved in a way parallel to earlier, horrifying experiences.

Whether these scenarios are healthy for a person to enact really depends on context and their psychological history (and is a source of intense debate among therapists). I believe that, for some people, allowing scenarios derived from trauma to emerge in a sexual context might actually give a person control and power over a previously painful narrative; they are able to “make use” of the trauma in a way they can control and derive pleasure from, a way of telling their story their own way, which now offers pleasure and not just pain. Ironically, allowing trauma memories to mingle with consciousness, even under the cloak of sexual fantasy, is a step forward for some who have completely dissociated or disconnected from such awful memories. For other people, such enactments can take on a compulsive flavor, where satisfaction can be found only by acting out one’s feelings and experiences this way, which inevitably makes their actual sexual partners feel distant and/or controlled. Where one draws the line between playful expression of one’s sensibilities and a darker, more destructive and harmful behavior is up for debate and highly dependent on specifics.

I think the only way to resolve this, since it so directly involves so many facets of your relationship, is to handle it relationally—that is, with your fiancé. This isn’t something you can figure out on your own. Dialogue is essential. I’d first decide what you are and aren’t willing to try in bed. Would you be up for trying a “light” version of his scenario, or exploring it, to see if there are aspects of it that can be treated as a kind of game, where play and spontaneity are included? Could it be seen as a kind of foreplay, where (again, not knowing the specifics) you could employ a little spanking or tying up or a scenario that is sexy to both of you and not too edgy or overwhelming? Or is it all just a big turn-off and not your “thing” at all?

I’d then sit down and relate as honestly as you can. You obviously care about him a great deal, want to please him but have concerns about his request. I’d try to stick to your own feelings. Saying, “I’m not sure this is a good way to resolve your issues” sounds a little therapisty; you might try saying, “The idea of this makes me (uneasy, uncomfortable, etc.).” Can a compromise be reached? Can the two of you let your sexual imaginations come up with something you both find desirable?

Try not to think too hard about what will help your fiancé resolve his trauma. Frankly, just having an open conversation wherein you are honest about your feelings, while empathic toward his, will likely be a healing experience for both of you. I honestly do not think any partner’s job is to help the other resolve any issues; that’s what therapists are for. Honest relating and working through things respectfully and lovingly is itself healing.  You can support him in his therapy work, of course, but you, too, are on a journey, and one person’s trauma does not “cancel out” the other’s desires or wishes to feel heard, respected, and safe—sexually and otherwise.

Thanks again for writing. Hope that helped.
Darren