Counseling Survivors of Childhood Sexual Abuse and Their Partners CSL 6794.01 Class 9 November 8, 2016

Definition of Childhood Sexual Abuse and Incest Childhood sexual abuse is a sexual act imposed on a child who lacks emotional, maturational, and cognitive development The majority of incidents of childhood sexual abuse are committed by men against young girls. Parent-child incest, which in most cases means father/stepdaughter-daughter, is consistently reported as the most damaging type of incest, followed by sibling incest perpetrated by brothers.

It is thought that fathers often approach their daughters because they fear intimacy with adult women or feel inadequate in their relationships with adult women. The incidence of mother-daughter sexual abuse is unknown because it is a grossly underreported crime. Less than 1% of MDSA members report any intervention as a child. There are many reasons, including: - the extreme rarity of the offender seeking treatment, the victim reporting the abuse, or the authorities discovering the crime - therapists, social workers, doctors, teachers, etc. know very little about this form of abuse and/or do not consider it a possibility

- perpetrators overwhelmingly appear like "normal" caring mothers - lack of protection by physically or emotionally absent fathers OR abusive fathers - low physical evidence that can not be seen on routine physical examination Abuse is sometimes conducted under the guise of normal medical care or hygiene

The Legal System and the Counseling Process There are a number of conflicts between the goals of the legal system and the emotional and therapeutic needs of survivors. Sexuality counselors need to be aware of the existence of potential conflicts in the two processes so that therapeutic progress is not thwarted. As a plaintiff, the woman must continually view herself as a person without power – an approach that is in direct conflict with her emotional need to focus on the strengths she possesses in order to initiate healing.

Treatment Issues for Survivors of Childhood Sexual abuse and Their Partners Children’s sexual experiences should be associated with good feelings and with pleasure. Children who have been sexually abused have no control over this process and are thus prevented from developing their knowledge and sexual experience at their own pace. Children introduced to sexual acts that are not appropriate of their age or level of development become confused and experience “traumatic sexualization.” Sometimes adult survivors report good feelings related to the sexual abuse and feel even more ashamed and responsible because they feel that way.

The acts were out of their control, and their freedom of choice was removed because they were children who were asked to behave sexually as adults. Survivors of childhood sexual abuse typically present in counseling with issues related to self-image and self- esteem, both of which negatively influence their sexuality. It is important for the Sexuality Counselor to remember that incest survivors differ notably from rape and sexual assault survivors.

Reasons for Seeking Help Depression Anxiety, Fears and Nightmares Eating Disorders Dissociative Patterns

Somatic Concerns Interpersonal Problems

PTSD and False Memory Syndrome Posttraumatic stress disorder (PTSD) is frequently experienced by adult survivors of childhood sexual abuse The “False Memory Syndrome” is an issue related to posttraumatic stress disorder Briere describes the syndrome as a “label , applied to those who report recovered memories, of previously ‘repressed’ or disassociated memories of sexual abuse Briere suggests that from the False Memory Syndrome (FMS) perspective, such false reports usually arise from psychologically vulnerable and suggestible women exposed to therapists who by virtue of malice, avarice, or incompetence directly or indirectly implant false memories of abuse.

Counselors who tell clients that they man not remember the sexual abuse, but they exhibit all the symptoms of an abused person are contributing to the creation of false memories Herman describes three stages of recovery from traumatic memories: Safety Remembrance and mourning Reconnection

Male Survivors of Childhood Sexual Abuse Although most adult survivors who come to counseling are women, many men have also been sexually abused as children by adult males, not necessarily by a father but instead by youth group leaders, extended family members, and members of the clergy.

3 Myths of Male Sexual Abuse “Real men” would fight or resist the abuse Sexual response to abusive behaviors “shouldn’t” happen Offenders are homosexual and forever “taint’ the victim

Many of the issues faced by male survivors are similar to those faced by females, but males ten to struggle more with issues of homophobia and vulnerability. Male survivors are more likely to direct rage and anger at other as a result of intense societal pressures to “behave like men” or engage in sexual “acting out” behaviors

The Development of Sexual and Relational Problems Once survivors have gained new understanding about the issues and aftereffects of their abuse, they are better able to understand the relationship between sex and sexual abuse and can develop new skills for relearning touch and sexual behaviors.

Five common sexual problems and symptoms that may result from childhood sexual abuse Lack of sexual interest: inhibited sexual desire, fear of sex Difficulty becoming aroused and feeling sensation: lack of lubrication in women, lack of erection in men Difficulty experiencing orgasms: lack of orgasm in women, inhibitied ejaculation in men Difficulty averting orgasm: premature ejaculation in men, rapid orgasm in women Difficulty with intercourse for women survivors: muscle spasm, pain, discomfort, fear of penetration

Most Common Sexual Problem for Survivors According to Maltz (2001a), lack of sexual interest seems to be the most common specific sexual problem for survivors.

The Process of Sexuality Counseling for Incest and Their Partners There is a three-phase process for counseling adult survivors of incest and their partners: Alliance building, safety, and stabilization Deconditioning, mourning and resolution Self and relational development

Questions That Sexuality Counselors Might Ask to Assist in Making a Clinical Diagnosis Who knows or whom have you told about your childhood incest experience? Who supports you regarding your incest experience? How has the incident affected your feelings about yourself and your relationship How has the incident affected your daily life?

How has the incident affected your sexual relationship? How do you create safety in your world? What was your involvement in the legal process and hoe to you view law enforcement?

Intervention Strategies for Survivors of Childhood Sexual Abuse and Their Partners Deal with Guilt, Blame, and Shame Photographs Confront the issue Empty Chair technique Clarifying responsibility

Gaining Self-Control Wilderness Therapy Keeping a Feelings Record Challenging Myths Initiating and Declining Sex Learning to Communicate Openly.