In my work with adult survivors of sexual assault, I am beginning to notice a pattern of behavior that I have termed “wounded attachment.” The impact of childhood sexual assault has reverberating effects on almost every facet of survivors’ livelihood, from relationships with family, friends, partners, spouses, and children to their jobs, finances, faith, etc. It is as if sexual assault redefines one’s pattern of and trajectory in life.

Sexual assault is the act of forcing, enticing, intimidating, or coercing another person to engage in a sexual activity, from fondling to coitus, when the other person is unwilling or unable (as is the case of one who is underage, drugged, or unconscious). Imagine yourself as a child, seeing the world through a child’s eyes, and then being introduced to a violent act—an act that serves to not only damage one’s physical body and mental/cognitive mind-set, but also disrupt one’s spiritual being.

This one act for some—repeated acts of violence for others—does untold amounts of damage to one’s psyche. Yet the resilience I’ve witnessed from many who choose to live their lives after the violence is remarkable. Unfortunately, for many the damage is such that many are unaware of how it has skewed their way of looking at the world. This sometimes is displayed in the relationships subsequent to the sexual assault.

Far too often, survivors believe that once the assault ends, it is done and they don’t need to talk about it. Yet the choices made, the decisions not made, and the relationships that come afterward tell a different story. Wounded attachment is an insidious component that I have seen repeatedly in my work with adult survivors of childhood sexual assault. What is wounded attachment? It’s the unconscious way of being attracted or attached to someone or something that reminds the survivor of or reinforces the wound/trauma, or in this case the sexual assault. At its core, it’s the way in which survivors subconsciously seek out relationships that reinforce the wounded aspect of themselves.

[fat_widget_left]Sometimes it is displayed in the choice of employment/work. For example, survivors may find themselves working at a job that belittles them, makes them feel worthless, or where they feel like they have to make everyone else happy at the expense of their own happiness, thereby reinforcing their wounded concept of self. Another example is when a survivor is continually engaged in romantic relationships that serve to reinforce the wounded parts of self.

As a child, depending on when the assault occurred and the developmental stage in which it occurred, the person seeks to please the adult and gain affection, attention, nurturing, love, trust, etc. A child who has been sexually assaulted blurs that idea of love, nurturing, trust, attention, and affection, and begins to believe that the only way to receive love, attention, etc., is to please the “assaulter.” This remains in effect as the child matures into adulthood.

Although the assault is no longer occurring, if the child did not receive any type of counseling, intervention, or effective treatment to process and repair the damage to the mind, body, and psyche, then this adult is continuing to live out the wounds experienced as a child. As such, the adult becomes caught in a cycle of relationships that reinforce the wounded attachments. Awareness of this plays a crucial role in helping adult survivors of sexual assault move toward recovery, resiliency, and healing.

My family moved to England from the United States when I was very young. My first memories are British ones. I remember learning to tie my school tie, and being proud of the little sword and shield crest on my tiny blazer. When I was 7, we moved back to America.

Shortly after arriving back in the United States, my older brother began his sexual advances. I have never been able to find out what had happened to him before he began to repeat the behavior, or when and where it occurred, but I am sure he was abused at a point prior to moving back to America. The behaviors he adopted and the activities he was interested in experiencing were far too advanced for a boy of 10 years old to come up with on his own. I had tried to get these answers from time to time over the years, but my mother was far too delusional or ashamed to ever give any real information.

The first interval of sexual activity occurred over the first two years in the US, and escalated quickly until we were discovered. It wasn’t until about a year ago that I learned exactly how that happened. She must have stumbled on us during a “session” in his room, but didn’t react right away. My memory of this is mostly blocked out.

What I do remember happened later in the evening. She angrily grabbed my younger brother and me and shoved us into the van and drove like crazy to a park nearby. I assume she left my older brother at home out of shame, or merely because she didn’t know what to do. My father was out of the country for work, probably somewhere in Europe. It was in the winter time, that much I remember. The heater was cranked up to the max and we were in snowsuits. I wanted to get out of the van at the park, but she refused to let us out. We three sat there for hours in silence. I got more and more scared and confused. What had she been thinking?

Eventually, I worked up the courage to ask her if I was in trouble. She looked at me with wild black eyes and started to snap, then, as suddenly as she started yell, she stopped. I can’t recall hearing any actual words. I was petrified, and I didn’t even know why. I wanted out of that van immediately. My mind raced feverishly through ways to escape and protect my younger brother without arousing her anger. I came up dry, but luckily, she grew tired of the pointless sitting and drove us home without another word.

Lasting Aftershock
Two weeks went by with no mention of that night, and then my father returned home from his trip. Normally, we loved it when he came home; we typically got small presents, and we got to hear stories of the friends we had left behind in England. This was not to be such a day. I was summoned to the living room to sit on the couch next to my older brother and wait for mother to finish talking to father in their bedroom. They came in and sat across from us. I knew immediately that doom was imminent.

We were both then subjected to an intense and specific interrogation, so laced with shame and disgust that I had to bury my 9-year-old head in the couch cushions. I wept with total abandon. I have been trying to remember the specific details of this morning, but can’t seem to get there. A lot of my childhood has dark windows of redacted information — blank spots surrounded with shame and sorrow, but silhouetted by the clear details around them. I remember it ending at some point when I eventually stopped crying and sat up to see that I was alone in the living room. I ran to my room and hid under my bedclothes. Mother came to me later to tell me I was to stay away from my older brother and that he was clearly “sick” and something would have to be done with him. I look back now on that day and cry only for him. Whatever had happened to me could not have compared to what she had done to him.

Several decades later, I have drawn the conclusion that my mother suffered from borderline personality disorder. She is yet undiagnosed. I have become an apt student of everything related to those with borderline personality, and I try to share what I have learned where it is appropriate to do so. One of the defining characteristics she would manifest regularly was the projection of shame and revulsion regarding anything remotely sexual. I have pieced together a few loose theories on why this is, but not enough to really write about. As traumatic as the sexual abuse eventually became for me, it paled in comparison to what she did to both of us as a result of the discovery.

The “All-Good Child”
This event touched off a campaign of hers to emotionally destroy my older brother. He was painted black with an indelible ink that would never wash away. He was the “all-bad child” for the rest his childhood. I was elevated to the status of the all-good child. It was never that simple, and if we could have gotten together to figure it out, maybe we could have defeated her emotional polarization of our characters. But then again, we probably never stood a chance. A side effect of my mother’s “splitting” was that my brother started sneaking back into my room at nights to continue the sexual advances. This continued for two more years before I got strong enough to resist him and smart enough to keep a buck knife under my mattress. One night I put the blade to his face and made my unwillingness to participate clear. He never bothered me again.

When I turned 15, I met my first girlfriend. She was a visitor at my church, a guest of a single mother and her daughter. One Sunday after the church service had ended, my mother walked up to my girlfriend and me, grabbed us both by the shoulders, and pushed us roughly off to the side of the sanctuary and into an office cubicle. She brought in my girlfriend’s host mother and our pastor, and called her little meeting to order. She began by telling everyone there about my sexual abuse in graphic detail. I had never told a soul what had happened to me those years past, and she just trotted it out like a juicy rumor. When she had finished humiliating me, she moved on to my girlfriend, who had apparently been molested by one of her mother’s boyfriends a few years earlier. Until this point, my girlfriend knew nothing of my abuse, and I had known nothing of hers.

My mother’s apparent goal was to get it all out into the open as to prevent our involvement that she saw ending in debauchery, depravity, and most likely shameful pregnancy. My girlfriend broke up with me over the phone a week later. I couldn’t blame her. My mother in full witch mode was a soul-chilling experience.

Fear into Obedience
I spent the rest of my time before leaving for college trying to please my mother, mostly out of fear. It would take some time away and separation from her to be able to look back and think critically about the time before I realized the truth about her. She reacted to anything remotely sexual with hysteria every time. Even things that were barely risqué resulted in meltdowns for her. A movie with a sex scene (no matter how PG), led her to fits of anger and projected shame. I would do anything in my power each time to escape her presence or distract her with whatever I could. Her shame, unchecked, always seemed to focus on her poor son, or worse, on the older brother who would be forever painted black.

I became a master at reading her moods and deflecting or distracting her scrutiny. My style of survival clashed with that of my brother. Where I chose capitulation, he opted for open rebellion. My great regret from all of this conflict was ever siding with her to spare myself. I’ve since been told that doing this to survive was nothing I should feel ashamed of, but I’ll bet my older brother suffered greatly as a result. I haven’t ever been able to talk to my brother about any of this, but I hope that one day we might try.

I suspect that when our mother passes away, there might be a window of time where we can find a common fraternal safe haven to talk candidly about our horrid upbringing. This is probably wishful thinking, as he has presented a lot of the hallmark traits of a narcissistic personality disorder. I have kept my distance from him for the last few decades. My younger brother was mostly shielded from our mother’s emotional abuse, and I see him once every few months. Since I have suspected my mother’s borderline personality, I have shared a little here and there with him, but for the most part we don’t talk about our childhood. I can’t help but feel that this is building to a conclusion of some sort. Her instability has gotten much worse in the last few years, and her alcohol abuse worsens as well. My father’s enabling has allowed her to continue on unchecked in her madness, but she has turned on him as well.

Healing from Shame
Coming to terms with my childhood has only come about since I sought out a therapist. I actually found her using Goodtherapy.org’s therapist finder application. I have been working with her for almost a year now, and have made a lot of discoveries, both good and bad. I write a blog of my own to make sense of what I was forced to be and what I am trying to become, but this particular story doesn’t want to fit in there anywhere. It’s too rough, too raw, too painful. While I have banished my mother from my life, her ghost still comes to call from time to time.

I write this now as a cleansing ritual to scrub her influence from my mind and spirit. I have reclaimed my life. Memories of pain like these ones have no place in my future except as footnotes. I hope that in sharing this story I can share the hope that comes from deep within me — the hope that we can heal ourselves from anything we’ve had to endure. The transmutation of shame into healing is the greatest magic I have ever seen, and it brought me to tears to see it for the first time in my own life. My greatest wish is to find a way to show this magic to anyone else who has ever needed it.

One of the reasons many children do not tell anyone about being sexually abused is because they fear that their loved ones will not believe them. Often, their abuser is a friend or family member, and although children may know that what occurred is wrong, they may be confused and worried that their caregivers will think they have misconstrued the behavior. Children who feel neglected or maltreated by caregivers may feel reluctant to disclose abuse, and many abusers threaten children, creating more reasons for nondisclosure. However, when children do reveal abuse, getting them to explain the abuse in a way sufficient to lead to prosecution can be challenging.

Various methods of interrogation are used on child-abuse victims, including open-ended questions, yes/no questions, “What happened?” questions, and “How did that make you feel?” questions. For the most part, open-ended questions and “what” questions tend to provide the least amount of detail. Children often are unable to articulate the details of their abuse. And while “how” questions that prompt children to reveal their physical reactions and feelings allow them to detail their personal experience in great detail, this is the most rarely used form of interrogation. To explore which method would provide the most accurate recollection of abuse and elicit emotional responses that could demonstrate credibility to jurors, judges, and therapists, Thomas D. Lyon of the Department of Psychology at the University of Southern California recently examined transcripts from more than 100 child-abuse cases.

Lyon discovered that when children were asked closed-ended questions such as yes/no, their responses were narrow and they exhibited little emotion. Similarly, when they were asked “What happened?” they were hesitant to reveal details and appeared emotionally undisturbed. But when children were asked how the abuse made them feel and what their physical reactions were, the responses were extremely vivid and consistent. They demonstrated emotional responses and used words such as angry, sad, afraid, confused, “sick to my stomach,” and dirty. They manifested facial and physical reactions that allowed those interviewing them to see the damage of the abuse in ways that the children could not articulate when prompted with direct questioning. “Children can be surprisingly articulate about their reactions to sexual abuse, despite their apparent lack of affect in describing the abuse itself,” Lyon said. He hopes that these findings will motivate interviewers, prosecutors, and mental health professionals to evaluate physical and emotional reactions of abuse as a means to gather details from child sexual abuse victims.

Reference:
Lyon, Thomas D., Nicholas Scurich, Karen Choi, Sally Handmaker, and Rebecca Blank. ‘How did you feel?’: Increasing child sexual abuse witnesses’ production of evaluative information. Law and Human Behavior 36.5 (2012): 448-57. Print.

Children who have been victims of maltreatment can develop emotion regulation problems that affect many areas of their lives. Some survivors of abuse can experience symptoms of posttraumatic stress, anxiety, and depression throughout life. Coping and relational skills learned in childhood form the foundation from which future behaviors evolve. It has been hypothesized that women who survived maltreatment, in the form of physical or sexual abuse or neglect, will have sexual challenges in adult relationships. To test this theory, Alessandra H. Rellini of the Department of Psychology at the University of Vermont conducted a study involving 192 women ranging in age from 18 to 25.

The study focused on how emotional regulation, childhood maltreatment, sexual expression, sexual satisfaction, and relationship intimacy were associated in the context of committed adult relationships. The women in the study completed online surveys describing the type of abuse they experienced and their level of intimacy, affectionate expression, and sexual satisfaction in their current relationships. Rellini found that the more severe the childhood abuse was that the women experienced, the more unsatisfied they were in their adult relationships. This was true with respect to general and sexual relationship satisfaction. The severity of abuse also directly predicted the severity of emotional regulation impairment, which could be indirectly influential of satisfaction.

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In contrast to Rellini’s predictions, however, the findings did not demonstrate any association between emotional regulation impairment and intimacy or emotional expression. This was rather surprising, as previous research has suggested that abuse survivors tend to have challenges sustaining emotionally healthy sexual relationships. One factor that may have contributed to these results is the broad categorization of abuse used in this study. Specifically, this study did not examine sexual abuse separately from emotional or physical abuse to determine each type of abuse’s independent effect on emotional regulation. Despite this limitation, Rellini believes her findings provide evidence of unique correlations between childhood maltreatment and adult relationships for women, but more work needs to be done. “Research is now needed to explore the stability of such findings over time in order to determine the time course and sequencing of change between the studied variables,” she said.

Reference:
Rellini, Alessandra H., Anka A. Vujanovic, Myani Gilbert, and Michael J. Svolensky. Childhood maltreatment and difficulties in emotion regulation: Associations with sexual and relationship satisfaction among young adult women. Journal of Sex Research 49.5 (2012): 434-42. Print.

A biography of Marilyn Monroe by Lois Banner, professor of history and gender studies at the USC Dornsife College of Letters, Arts, and Sciences, reveals a complicated woman determined to be the best at everything. Published around the fiftieth anniversary of Marilyn Monroe’s death (August 5, 1962), Marilyn: The Passion and Paradox also reveals Marilyn Monroe’s troubled psyche and tragic childhood, including her childhood experience with sexual abuse, which led to a life-long struggle with sexual addiction. In an act that continues to strike us for its bravery—especially in a society like ours that is obsessed with objectifying women—Marilyn Monroe acknowledged and spoke publicly about her struggle with the consequences of childhood sexual abuse.

Banner builds on Monroe’s own statements to create a picture of a woman battling sex addiction and seeing herself as an object to be possessed by men and women. In one particular interview she gave to the British press, she stated “I sometimes felt I was hooked on sex. I could not stop having sex with almost every man I met.” Her persona as America’s “sex symbol” speaks loudly to America’s twisted relationship to sexuality, which takes tragic self-objectification and makes it something desirable rather than identifying it as a defense to trauma that causes suffering and requires treatment.

Aside from celebrities having affairs and sometimes excusing this behavior under the guise of “sexual addiction,” our society does not talk about the topic, and therefore we do not fully understand sexual addictions. The first thing to note is, oddly enough, sex addiction is never about sex. It is about a repetition of trauma and a craving for intimacy. Sex becomes the tool a person uses in order to find love and acceptance. Of course, the aim is never satisfied because the intimacy created through frequent sexual encounters is never really intimate or loving.

Sex addiction is a byproduct of trauma coupled with loneliness, pain, and the need to be loved and accepted. It is a substitute for these needs, a counterfeit way to meet real desires. However, it always fails to meet those needs and desires and subsequently creates a greater need for more sex in order to mask what one is truly missing. In Marilyn Monroe’s case, this craving for affection probably developed early on in life as she was moved around from foster parent to foster parent. In addition, having been sexually abused by men as a child, she would likely have equated sex with attention, and attention with love.

Studies show a high correlation between childhood abuse and sex addiction in adulthood. “Sixty percent of sexual addicts were abused by someone in their childhood” (Book, 1997, p 52). If your caretakers failed to protect you, or worse, inflicted the pain, you end up repeating what you know; you are attracted to the kinds of people who will fail to protect you or cause you harm. Having been sexually abused early on in life, a child grows up emotionally starved for love and mistakenly comes to equate love with sex. To bear the pain, one begins creating a fantasy where love means sex. And so, slowly, sex becomes a tool to satisfy any kind of need, whether that be loneliness, fear, anxiety, or shame. Worse, contemporary society constantly sexualizes us, especially young women, by teaching them how to become an object for someone else’s pleasure, not a participating subject. From the TV shows that we watch to the magazines that we read, we learn about sex as a performance and, for women in particular, we are taught that our bodies are a tool to be used in order to attract people. This further prevents survivors from seeking out treatment, as our society rewards unhealthy behavior and seldom teaches us how to view sexuality in a healthy way.

Sexual addiction has many different forms: compulsive masturbation, sex with people who are prostituted, anonymous and often unsafe sex with multiple partners, multiple affairs outside a committed relationship, habitual exhibitionism, habitual voyeurism, inappropriate sexual touching, repeated sexual abuse of children, abstaining from having sex altogether, or episodes of rape (Book, 1997). Addictions are quick fixes in order not to experience pain. Adult survivors of childhood sexual abuse often find it hard to trust another, to create real intimacy, to overcome feelings of shame and rejection, and to be present in intimate relationships. Sex, then, becomes a way to create a fantasy world, to tell oneself that you are sharing with another, that you are intimate and therefore present in the relationship. But, since sex addicts don’t necessarily enjoy sex with other people, and the need for intimacy is never fulfilled, one is then compelled to act out sexually—hence the addiction.

[fat_widget_sex_left]Most people who experience sex addiction do not understand why they are acting out sexually or why they have constant thoughts of either having sex with someone or masturbating. Sometimes they associate these thoughts with being in love, when love is far from the relationship. Each new sexual encounter brings relief and the promise of a new beginning. It also brings an unconscious desire to understand the pain of childhood sexual abuse. Yet as each encounter ends, and the need is not satisfied, the person feels more helpless, more alone, more ashamed. Slowly, a preoccupation with a new sexual encounter develops, and its promise for a new beginning gives rise to fantasies of intimacy, love, and affection. Perhaps the worst pain inflicted by childhood sexual abuse, which can be easily seen in the powerful and disruptive negative thoughts of someone who is addicted to sex, is the person’s lack of self-esteem, the idea of being damaged. Thus, rather than experiencing sex as a self-affirming, pleasurable activity, it is a source of pain, shame, and suffering.

Sexual addiction is a symptom of a bigger problem, and treating the symptom does not solve the problem. Underneath the symptom, one finds a codependent, wounded soul. As a young girl, Marilyn Monroe was treated as a sexual object and like many adult survivors, she became addicted to sex, suffering in silence. In treating sexual addiction, one needs to move beyond the symptoms and work with the survivor on issues regarding shame, self-esteem, and trauma. Yet therapy also needs to go a step further: In analyzing our culture’s view of women, sexuality, and relationships, we can begin to understand how ideology contributes to negative views of sexuality and women. Perhaps the greatest task for both the client and the therapist is to explore what it means to be a subject rather than an object in a relationship—to begin creating spaces where both women and men value each other and celebrate sexuality, not as a means to an end, but rather as a ground for pleasure.

By slowly peeling away the layers, Banner’s book reveals the complexity of a human being. Through Marilyn Monroe’s tragic story, we are reminded of the painful scars created by childhood sexual abuse that, when left untreated, continue to bleed throughout one’s life.

References

1. Banner, L. (2012). Marilyn: The passion and the paradox. New York: Bloomsbury Publishing.
2. Book, P. (1997). Sex & love addiction, treatment & recovery. New York: Lucerne Publishing.

While the terms “pedophile” and “child molester” are often used interchangeably, they do not mean the same thing. A pedophile is a person who is attracted to children, but not all people with pedophilia molest children. Many individuals who are attracted to children never act on their attraction, and some seek help in order to keep from harming children.

Pedophilia is considered by some to be one of the most difficult social problems to understand. The 5th edition of the Diagnostic and Statistical Manual classifies pedophilia as a paraphilia, distinguishing it from pedophilic disorder: It is diagnosable as a mental health condition when it causes distress to the affected individual or to someone who is unwilling or unable to consent. Thus, according to this classification, having an attraction to children and not acting on it does not indicate a mental condition.

New research shows that pedophilic disorder may be neurological in nature, lending further support to the position that an attraction to children is not a choice. Some may find this difficult to accept, as those who do act on their desires and molest children have the potential to cause serious and lasting harm to many children. They may repeat their crime over and over until stopped by the criminal justice system. Many people may believe that, once caught, people who molest children deserve to spend the rest of their lives in prison, but the reality is that many of these individuals will eventually be released.

Upon release from prison, offenders are often required to enter rehabilitation programs, which are meant to redirect pedophilic urges and help a person refrain from harming children. These programs are often viewed with skepticism, as many believe that a person who molests children cannot be rehabilitated and that pedophilic urges will always lead to the sexual abuse of a child. However, there are several perspectives on the issue.

The Difference Between Pedophilia and Child Molestation

Psychological perspectives on child molestation vary greatly, but experts agree that most people who molest children fall into one of four categories:

1. Children or teenagers under the age of 16 who are sexually curious and may experiment with younger children.
2. Adults who have a brain condition, intellectual disability, or other mental health issue.
3. Individuals who have an antisocial personality and may use children sexually but have no particular sexual desire for children.
4. Individuals who are older than 16 and experience ongoing sexual desire for children. Sexual desire for children, or pedophilia, can be identified and treated or controlled with therapy and medication.

Ninety-five percent of all known instances of child molestation are committed by people with pedophilia. Other individuals may molest children for the above reasons, out of sexual frustration, or in order to maintain power or exert control.

Though nearly all those who molest children have pedophilia, many people with pedophilia will never molest a child, and some work to eliminate their attraction to children through various forms of treatment and therapy.

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Non-Offenders

Dan Savage, who frequently writes on the topic of human sexuality, has published several accounts of people who, despite their attraction to young children, avoid being alone around children and are able refrain from committing acts of molestation. It is generally acknowledged that it may take a significant amount of self-control to avoid offending and that pedophiliac inclinations typically mean a person with pedophilia will find it difficult to have a healthy sexual relationship.

In several European countries, Savage points out, people experiencing a sexual attraction to children are often able to seek treatment confidentially. In the United States, however, an individual who discloses pedophilic tendencies may be arrested, as therapists and physicians are required by law to report anyone who poses a threat to children. This law, in addition to the stigma surrounding pedophilia and the limited number of resources available to those seeking help in the U.S., is likely to discourage non-offenders from seeking professional help, help that may enable them to continue to keep from offending.

Free and confidential prevention and treatment programs–such as Germany’s Prevention Project Dunkelfeld–may help those who are attracted to children refrain from acting on their desires. Some European countries do have lower child molestation rates than the United States, and this fact may be connected to the availability of treatment.

Many people who are attracted to children are horrified and frightened by their preferences and attempt to do everything they can to keep from harming a child. They may wish to attend therapy, explore ways to curb their desires, or take medication. Making treatment available and accessible to individuals before they offend may reduce instances of child molestation.

Chemical Castration

Chemical castration is one method that may keep child molesters from reoffending. Many states in the U.S. offer voluntary chemical castration in exchange for earlier release. Some states, such as California, mandate castration for offenders with multiple convictions as a condition of release. The treatment has been shown to greatly reduce sexual desire in men who are attracted to children and to lower rates of recidivism.

Those who have not yet harmed a child and who are committed to avoiding doing so may find relief from their desires through chemical castration. In some cases, an antidepressant, which may have the effect of further limiting one’s sex drive, is also prescribed.

Sexual desire cannot be completely eliminated by castration, a fact that leads many individuals to question the efficacy of the treatment and the risk of releasing offenders who may still experience some sexual desire for children. Another objection stems from the fact that the person undergoing treatment must be relied on to take their medication regularly. However, chemical castration has been shown to be effective for many individuals and thus is likely to protect many children who would potentially be victims of sexual abuse.

Group Therapy

Many therapists use group therapy as a type of treatment for people with pedophilic tendencies. Groups can provide a safe environment to discuss inappropriate and harmful urges, and the support of a group of individuals facing similar challenges may give some people the strength to avoid offending or reoffending.

However, when someone is involuntarily enrolled into group therapy and has no particular desire to stop offending, a support group can become a different environment. Other members may, knowingly or unknowingly, support a high-risk offender’s further attempts at molestation. But because mandated group therapy may be of benefit to some convicted offenders or those who are at risk for offending, group leaders may not wish to withhold a potentially helpful treatment from anyone. They may, however, choose to carefully screen participants prior to program entry and during treatment.

Aversion Therapy

Aversion therapy pairs an unpleasant stimulus such as an electric shock, pinch, or flick along with a pleasant stimulus. Sex offenders may use aversion therapy to attempt to eliminate their attractions to children. While this therapy can be effective, it often poses ethical problems, as therapists cannot shock their patients. It can also be difficult to maintain consistency with this type of treatment. Further, when aversion therapy does work, it is unlikely to do more than eliminate the attraction to children. It likely will not help people develop an attraction to age-appropriate adults if they do not already experience such an attraction.

Fake Porn

Psychologists have still not reached an agreement about whether pedophilia is a sexual orientation or a mental illness. Those who believe it is a sexual orientation may advocate the use of fake porn, depicting animated or CGI children, as a way for those with pedophilic tendencies to achieve sexual release. Some therapists have reported that this method has been successfully used to reduce an individual’s desire to molest a child.

However, other therapists point to studies demonstrating the effect pornography can have on sexual desire and express concern that such pornography may actually create or increase a desire to sexually abuse children. Many also question the ethics of making such pornography, even when it does not involve actual children.

References:

1. Early Diagnosis and Effective Treatment. (n.d.). Retrieved from http://www.childmolestationprevention.org/pages/focus_on_the_cause.html
2. Goode, S. D. (2010). Understanding and addressing adult sexual attraction to children: A study
   of paedophiles in contemporary society. New York, NY: Routledge.
3. Jenkins, P. (2004). Moral panic changing concepts of the child molester in modern
   America. New Haven, CT: Yale Univ Press.
4. Kaplan, M. (2014, October 5). Pedophilia: A Disorder, Not a Crime. Retrieved from http://www.nytimes.com/2014/10/06/opinion/pedophilia-a-disorder-not-a-crime.html?_r=0
5. Kincaid, J. R. (1998). Erotic innocence: The culture of child molesting. Durham, NC: Duke
   University Press.
6. Nanos, J. (2014, March 1). Can Chemical Castration Help Pedophiles Tame the Beast Within? Retrieved from http://www.bostonmagazine.com/news/article/2014/02/25/chemical-castration
7. Schwartz, C. (2011, December 7). What Science Reveals about Pedophilia. Retrieved from http://www.thedailybeast.com/articles/2011/12/06/what-science-reveals-about-pedophilia.html
8. Seto, M. C. (2008). Pedophilia and sexual offending against children: Theory, assessment, and
   intervention. Washington, DC: American Psychological Association.

There are a number of different experiences that can cause a child to develop maladaptive coping tendencies. Children who are emotionally or physically abused, neglected, or raised in extremely stressful environments may internalize their emotions. Likewise, children who have experienced sexual abuse may dissociate as a way of defending themselves from the psychological harm that results from sexual abuse. Trauma suffered in childhood increases the risk for dissociative behaviors. Auditory hallucinations are one form of dissociation and are evident in individuals with mental illnesses such as schizophrenia. To better understand how childhood trauma, dissociation, and hallucinations are related, F. Varese of the School of Psychology at Bangor University in the United Kingdom recently led a study comparing the dissociative behaviors, childhood traumas, and cognitive discrimination of 45 individuals with schizophrenia and 20 participants with no prior hallucination history.

Because dissociation is recognized as a pathway for hallucinations and an outcome of childhoodtrauma, Varese sought to determine if the frequency and type of trauma influenced hallucinations and the capacity to determine real and imagined events in the participants. Using a signal detection performance task (SDT), Varese found that the participants with a history of childhood sexual abuse were the most likely to experience dissociative behaviors that resulted in hallucinations. The frequency of abuse was directly related to the level of dissociation, with the most severely abused participants exhibiting the highest levels of hallucinations. The findings also showed that the participants with infrequent hallucinations had lower levels of abuse and dissociation than those who experienced more hallucinations. Varese believes that further research is needed to determine if adult stress and trauma rather than childhood trauma contributed to the intermittent hallucinations in the participants with sporadic dissociative behaviors. In sum, these results suggest that a better comprehension of the type of abuse suffered may be the key to developing effective treatment strategies for individuals who experience hallucinations. Varese added, “Future research should examine whether other cognitive processes associated with both dissociative states and hallucinations (e.g., deficits in cognitive inhibition) may explain the relationship between dissociation and hallucinatory experiences.”

Reference:
Varese, F., Barkus, E., Bentall, R. P. (2012). Dissociation mediates the relationship between childhood trauma and hallucination-proneness. Psychological Medicine, 42.5, 1025-1036.

Professor Paul Bebbington, head of the Department of Mental Health Sciences at the University College London, told the Congress of the Royal College of Psychiatrists 2011, that children who are abused or engage in non-consensual sexual intercourse are at a significantly increased risk for the development of schizophrenia. In a recent article, Bebbington explained that when this type of abuse is experienced before the age of 16, it contributes to more than 15 percent of all psychotic problems, including schizophrenia. “The worse the abuse, the more it increases the risk of developing psychosis. Someone who has experienced non-consensual sexual intercourse before the age of 16 is 10 times more likely to develop the mental disorder,” Bebbington told the Congress. He added, “This is especially significant because sexual abuse is common in childhood. Eight in every 100 people have experienced molestation while one per cent of men and three per cent of women report having had non-consensual sexual intercourse under the age of 16. It is possible to calculate that if childhood sexual abuse ceased, there might be as much as a 17 per cent reduction in people suffering from schizophrenia.”

Bebbington was is senior author of new research which has shown that this type of abuse is linked to psychosis. The research also revealed that sexual molestation and even unwelcome sexual talk, was also linked to the development of mental health problems. Bebbington said, “The increased risk of psychosis may be linked to the intrusive nature of childhood sexual abuse and having no control over what is happening to you. It has disastrous effects on self-esteem and psychological well-being, and is linked to paranoia and suspiciousness – even in people who don’t go on to develop psychosis.” Bebbington added that services should be made available to all victims of this type of abuse in order to prevent the mental health problems associated with these traumas from developing.

Group therapy can be the most nurturing and also the most challenging form of therapy. It is highly effective. While it doesn’t replace individual therapy, it can be a great adjunct and a final step in the healing process.

Group therapy is very relevant for survivors of childhood abuse and in fact for any traumatized individual. Isolation and separation from communal support is a primary characteristic of trauma, and that is exactly what group therapy provides. Enduring recovery cannot occur in isolation, it can only take place within the context of relationships. The group serves as a symbolic societal witness to each victim’s experience, as it is retold and relived in the group process. Fundamental societal functions – being made to feel safe and seen, sharing emotional distress, validating one’s experience, minimizing shame, recognizing and encouraging strengths and taking personal responsibility are now played out within the group interaction. The successful group environment provides a corrective emotional experience in which past dynamics of self-blame, lack of trust, and silencing of the victim will be evoked and then worked through. These groups offer a quality of support and understanding that is simply not available in the survivor’s regular social environment. (more…)

As discussed in Part I of this series, surviving a traumatic event often results in negative and harsh altered beliefs about yourself. A traumatic event can also impact your sense of worth, meaning, and trust.

After a traumatic experience, you may believe that you are no longer worth anything: that you do not deserve things, do not have a right to have your needs met, or deserve to be happy or content. This erosion of your sense of worth and conviction that you deserve and have a right to things like safety and kindness  impacts real-life decisions you make. For example, if you no longer believe that you have a right to stand up for yourself, then you might not say anything when a boss inappropriately berates you. Learning how to reclaim your rights and increasing your conviction in your inherent worth are truly difficult steps in the healing process.  Reading the United Nations’ Universal Declaration of Human Rights might help you begin this recalibration process.

Traumatic experiences also damage your sense of self by shattering the beliefs, morals, philosophies, and ethics that gave your life meaning. The beliefs that once made sense, like good things happening to good people and bad things happening to bad people, no longer fit with the real-world experiences you went through. Due to this disconnect between beliefs and experiences, you may feel that life is now bereft of any moral or ethical bearings, as if you have awoken in a counterfeit world.

This disconnect can also manifest itself as questioning your spiritual or religious beliefs. This can result in decisions that your beliefs are no longer accurate, or in a new or deeper sense of spirituality or religious devotion. While any of these reactions are painful to go through and difficult for friends and loved ones to understand, each of these reactions is an understandable and normal way to make sense of the trauma.

Intertwined with spiritual beliefs are the beliefs that each of us carry about the orderly nature of the world. Whether or not we acknowledge it, most of us function in the world presuming that there are cause-and-effect relationships at work, like “I am nice to the cashier at the grocery store and she bags my produce in a gentle manner.” Posttrauma, the orderliness of the world is called into question, because trauma is not part of any casual relationship that you, the victim, initiated or willingly participated in. The tarnishing or breaking of this belief can lead you to think that there is no order whatsoever in the world and that none of your actions make any sense. However, as your healing progresses, you will grow to a place where you can balance the truth in both of these tenants: sometimes the world is an orderly place, and sometimes there is no rhyme or reason.

A final aspect of self that is altered through a traumatic event is your sense of community. All of us are social creatures—even those of us who are on the shyer end—and some of our sense of self comes from the social relationships we have. Because a traumatic event distorts our belief that, on the whole, people are trustworthy, and because you may have experienced secondary wounding experiences (painful, possibly even traumatizing experiences following the trauma inflicted by people who are trying to help or who are in an official helping role—for example, a police officer blaming a woman for the sexual assault she experienced) you may find yourself questioning the trustworthiness of people in general, which in turn negatively impacts your ability to be in healthy and nourishing relationships.

A deeper discussion of how trauma interferes with healthy relationships will be the focus of the next few articles, but in the meantime know that you are not damaged, toxic, or beyond all hope. If you engage in the healing process and find your way to grow through the traumatic events of your past, you can and will reclaim the healthy and whole relationship with yourself that you have an inherent right to. Know that there are trained professionals who are ready and willing to help guide you through this process.

Even though there can be life long debilitating psychological effects, sibling abuse may be the most ignored—if not accepted—form of domestic abuse (i.e. sexual, physical, emotional). Why is this kind of abuse ignored or minimized? There is a lot that is swept under the rug in the guise of “sibling rivalry.” And American law does not consider this a prosecutable offense unless a child is turned in by their parent(s). In other words, parents would have to be willing to file an assault charge against their own child. So parents keep this type of abuse within the family. And a lot of the time, they even blame the victim.

First some statistics: In an article entitled “A Major Threat to Children’s’ Mental Health,” Hart & Brassard reported that “There is evidence that brother-sister sexual relationships may be five times as common as father-daughter incest.” Finklehor and Baron, who are prominent researchers in the area of child abuse, state that “sibling sexual abuse is prevalent in a remarkably large quantity of individuals from virtually all social and family circumstances.” And a survey of 796 undergraduates of six New England colleges found that 15% of the females and 10% of the males reported having some type of sexual experience involving a sibling (Sibling Abuse – Wiehe). In this same publication it states that parents are aware of sexual abuse among siblings 18% of the time, emotional abuse 69% of the time and physical abuse 71% of the time.

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Sexual abuse aside, how do we define or recognize abuse among siblings? When there is an inequity in power between two adolescents and one uses control over the other to repeatedly hurt, threaten, or degrade, that is abusive behavior. Even name calling and ridicule can wear away at a child’s self worth and self-esteem. “Children are especially vulnerable to degrading remarks because it is during their childhood years that they are developing a positive sense of self.” Unfortunately, most parents see this behavior as sibling rivalry. And while most emotional and even physical abuse, should and can be handled by parents rather than the law, first parents have to recognize that it is abuse.

Sexual abuse is another story. Most incidents of sexual abuse by siblings go not only unreported but also undetected by parents. Most times, the siblings themselves recognize that what is happening is wrong and certainly it is recognized by society as wrong. So unlike physical and emotional abuse, this should be easier to detect by parents. But most kids don’t tell. They don’t tell because the older sibling is an authority figure, or because they are threatened or scared, or because they don’t realize that it is abuse because they blame themselves as much as their sibling for what is happening. And unlike physical or emotional abuse, it is happening secretly because the older sibling knows that they have crossed a line.

What causes one sibling to abuse another?

1. Acting out anger at parents on sibling or acting out anger at an older sibling on a younger sibling.
2. Parents overwhelmed by their own problems not paying attention.
3. Inappropriate expectations – older sibling given too much responsibility or freedom.
4. Mirroring parents behavior.
5. Viewing the behavior as normal by parents.
6. Socialization of males as dominant over females.
7. Contribution of victim. “Research supports the hypothesis that the behavioral patterns of the abused child tend to invite further abuse” (Wiehe). It becomes a vicious cycle.
8. “It is important to note that this interactional cycle theory does not blame the victim!” Rather it identifies a pattern in order to treat and help prevent further abuse.

What are the long-term effects of sibling abuse?

Time does not necessarily heal. Adult victims of childhood sibling abuse generally have lower self-esteem and are overly sensitive and insecure. They have trouble with relationships and repeat the victim role in their other relationships. They can have sexual functioning problems. There is continued self-blame at the same time that anger at their perpetrator is played out with others.

So how do parents and other family members distinguish between abusive and normal (sibling rivalry) behavior?

1. Is it age appropriate?
2. Does one child appear to be a constant victim?
3. Is the purpose of the behavior humiliation, sadism, to cause suffering, a result of a continual explosive anger?
4. Was the behavior planned, has it happened before, does the perpetrator feel remorseful?
5. Was property destroyed or animals abused?
6. The length and the degree of the behavior. One-time incidents, if serious enough (i.e. sexual abuse), can create a life long problem. Whereas name calling, ridiculing, and even teasing if done consistently and at certain vulnerable ages (i.e. between six and seven years and/or between eleven and twelve years of age) can also create life long problems.

We need to build awareness and educate families about the difference between abusive and normal behavior among siblings. Listen to children and believe them. Good supervision and encouraging openness about discussing sex while informing children to “own their own bodies” and respect others are simple, logical steps towards protecting our children from abuse by siblings, cousins and other children.