The dangerous consequences of early sexual abuse stay well into adulthood, affecting relationships, work, family, and life in general. Adult incest researchers may demonstrate few of the following symptoms: Fear of sleeping alone, nightmares, night terrors; Poor body image, poor self-image in general; Drug addiction, alcohol addiction and compulsive behaviors, obsessions; Self-abuse, skin-carving (also addictive); Feeling suicidal; Phobias, panic attacks, anxiety disorders; Difficulties with anger/rage; Issues with trust, intimacy, relationships; Issues with boundaries, control, abandonment; Pattern of re-victimization, not able to say "no" and Signs of posttraumatic stress disorder.
Sexual Abuse; Was It My Fault
Certain issues appear repeatedly. For example, victims typically blame themselves for the sexual abuse, even if they were two or three years old at the time of the event. Guilt and shame are expressed, along with intense feelings of rage8
If the sexual abuse was committed by an individual of the same sex (i.e., a man abusing a boy), questions regarding sexual orientation tend to arise in the patient ("I must be gay; after all, a man raped me!"). Female victims will frequently develop sexually promiscuous lifestyles in an effort to "conquer" the situation and bring it under their control. In other instances individuals will largely withdraw from any social or sexual interactions in order to avoid the feared stimuli, and turn toward extremely isolated lives. The connection that is made for victims between sex and pain (love and humiliation, closeness and betrayal) is a particularly disastrous one.
Frequently patients will express and/or demonstrate the belief that the only way to be loved or cared for is if they are also being abused ("I knew if I didn't let him keep beating me, I'd always be alone"). Often, in the extreme, physical and sexual abuse are even viewed as a normal part of everyday life. Healthy boundaries do not exist for these individuals, and therefore, healthy relationships are impossible. Victims will actually respond to feelings of loneliness or sadness by abusing themselves (e.g., self-mutilation) if the "significant other" is not available to do so.
Sexual Abuse and Guilt
One of the more difficult issues that arise is the recollection, by some individuals, of experiencing a certain amount of physical pleasure during a molestation or incest. This adds enormously to the sense of being at fault and "dirty." Thus, one of the aims of treatment is to educate survivors as to normal physiological responsiveness. The realization that their feelings are/were normal helps tremendously toward alleviating the sense of shame.
Even when individuals have spoken of their abuse prior to group treatment, any pleasurable aspects have typically been denied. The opportunity to relate to others who have shared these feelings, as well as the experience, is part of the healing power of this form of treatment. The sense of separation, of being "different from the whole world," soon starts to subside. It is only in disclosing the secrets and managing the pain that survivors of sexual abuse can and do go on with their lives.