It is generally understood that childhood experiences have a significant impact on adulthood development. On the one hand, if children are provided with positive experiences, they develop into fully-functioning and healthy adults. Such children leverage their positive experiences to establish strong relationships. On the other hand, children who suffer such issues as sexual abuse are robbed of the opportunity to develop into healthy adults. Nearly always, negative childhood experiences yield poor adult outcomes. While many experiences hamper healthy development in adulthood, childhood sexual abuse has the most profound impact. Many adult survivors of childhood sexual abuse grapple with deep pain and immense anguish that strip them of happiness and fulfillment. The sexual abuse that they suffered during childhood is directly responsible for their negative experiences.
Adult Survivors of Child Sexual Abuse
In the recent past, dozens of survivors of sexual abuse have gained the courage to confront their abusers. For example, many actresses have come forward with allegations of sexual abuse perpetrated by Hollywood producer Harvey Weinstein. These allegations have emboldened more women to report their experiences. Thanks to the courage that these survivors of abuse, American society now understands that sexual assault does not go unpunished. While it is encouraging that women are coming forward, there is a group of survivors whose experiences have remained untold for too long. These are the individuals who suffered sexual abuse as children. In their article, Singh, Parsekar and Nair (2014) provide statistics on the scale of childhood sexual abuse. According to this trio, in 2002, as many as 73 million boys and 150 million girls had suffered some form of sexual abuse. These numbers show that childhood sexual abuse is a global problem and that the US joins other countries which have failed to shield its children against abuse.
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The Dynamics
From the discussion offered above, it is clear that childhood sexual abuse is a serious problem that requires the implementation of urgent intervention. In order to understand this problem further, it is vital to examine its dynamics. The relationship between adult survivors of child sexual abuse and the perpetrators of the abuse is among the key elements of the dynamics. There appears to be agreement within the academic community that the survivors and perpetrators are often in relationships of trust. For instance, Middleton, Sachs and Dorahy (2017) confirm that the perpetrators are usually known to the survivors. These perpetrators could be the victim’s father, uncle or close family friend. This dynamic shows that sexual abuse is not usually perpetrated by strangers. Instead, the perpetrators are usually individuals that are well known to the survivors. The close relationship between the perpetrators and their victims makes tackling child sexual abuse more daunting.
Other issues that define the dynamics of the experiences of adult survivors of sexual abuse during childhood are power differences and cover-ups. In most cases, the abuse is perpetrated by an individual who wields immense power over the victim (Collin-Vezina et al., 2015). For example, the perpetrator could be a father who is expected to provide guidance and protection. For many victims, the power that their perpetrators wield makes it difficult to report the abuse that they have suffered. It has also been observed that the perpetrators often attempt to cover up their actions. The allegations of abuse committed by clerics in the Catholic Church underscore the role that cover-ups play in hampering the delivery of justice. It has been claimed that despite understanding that priests were abusing children, the Church failed to take any action (Dale & Alpert, 2007). In most of the cases, the priests were simply moved to other parishes where they continued to perpetrate abuse against defenseless children who expect clerics to protect and guide them. Given the complex dynamics of the abuse that adult survivors have experienced, one is able to understand why most of these survivors are reluctant to report. For the world to make any meaningful progress in its quest to eliminate child sexual abuse and to promote healthy adult development, it must empower victims to speak out.
Effects
The academic community has examined various aspects of adult survivors of childhood sexual abuse. Among these aspects are the effects that the abuse has had on the lives of survivors. Vaillancourt-Morel (2016) partnered with other researchers to investigate the sexual health of the survivors. Their findings indicate that abuse has damaging impacts on the sexual activities and general health of the survivors. They noted that a worryingly high proportion of the survivors avoided sexual relationships and intercourse. Moreover, some of the survivors tend to display compulsivity regarding sexual affairs. These observations are significant as they underscore the damaging impact of childhood sexual abuse. The abuse that the victims suffered causes them to experience trauma whose effects last well into adulthood, thereby undermining healthy sexual development. It is worth noting that Vaillancourt-Morel and her team are not isolated in their recognition of the ill impacts of sexual abuse on the sexual development of the survivors. Their findings are confirmed in a study that Cynthia Roller (2009) conducted in collaboration with other scholars. According to these researchers, childhood sexual abuse has significant effects on the sexuality of the adult survivors. Roller and her team noted that many survivors engage in risky and reckless sexual behaviors. For example, while some survivors have multiple sexual partners and engage in unprotected intercourse, others become users of dangerous substances with many more participate in sexual intercourse at early ages (Roller, 2009). These researchers also observed that there are survivors who refrain from sexual intercourse and relationships altogether. For these survivors, the fear and trauma that resulted from their abuse hampers their efforts to establish fulfilling sexual relationships. What is clear from the findings by these researchers is that childhood sexual abuse robs survivors of the opportunity to form rewarding relationships or exposes them to highly risky sexual behaviors.
Sexual health is not the only issue through which the effects of child sexual abuse manifest. Researchers have also established that poor health outcomes in adulthood can result from the abuse. For example, Irish, Kobayashi and Delahanty (2010) performed a literature review with the goal of determining how childhood sexual abuse affects survivors in adulthood. They noted that the survivors reported such poor health outcomes as gastro-intestinal problems, pain, obesity, cardiopulmonary symptoms and gynecologic symptoms (Irish, Kobayashi & Delahanty, 2010). The observations that Irish and his team made show that there is a direct link between childhood sexual abuse and poor physical health outcomes. It is clear that the negative impacts of abuse extend beyond childhood. If it is truly dedicated to protecting children and allowing individuals to develop in a healthy fashion, society needs to institute measures that safeguard children.
In an earlier discussion, it was stated that power dynamics discourage victims of abuse from reporting the harm that they have suffered. Apart from these dynamics, the fear, shame and sense of guilt that the survivors experience also hamper their efforts to seek justice. Helene Flood Aakvaag (2016) partnered with four other researchers to examine the psychological damage that sexual abuse case. In their article, they identify guilt and shame as some of the adverse outcomes of the abuse. Essentially, the survivors blame themselves for the abuse. Another important observation that Aaakvaag and her team made is that the level of shame and guilt that survivors of abuse suffer varies by gender; women tend to have more intense experiences of these outcomes. The study that these scholars conducted went beyond exploring the relationship between shame and guilt and childhood sexual abuse. They also examined how these outcomes affect mental health. According to the researchers, shame and guilt set the stage for the development of such mental health issues as depression and anxiety (Aaakvaag et al., 2016). What is evident from the article by these authors is that childhood sexual abuse has far-reaching impacts on the emotional and mental health of adult survivors. It is therefore not surprising that these survivors struggle in their efforts to form intimate relationships.
The various negative effects of childhood sexual abuse examined above show that the survivors deserve sympathy and support. However, there are some research findings which raise questions about the perspective that society should adopt in its consideration of the survivors. It has been noted that there are some survivors who go on to become the perpetrators of the same abuse that they suffered. Carolyn Blank et al. (2018) studied the link between experiences of childhood sexual abuse and the perpetration of this abuse. According to their findings, some survivors of abuse endorse the abuse and identify with perpetrators. This observation is indeed worrying as it underscores the immense harm that childhood abuse can cause. Action needs to be taken to provide survivors with the support that they need so that they become defenders of the dignity and rights of children instead of perpetrators of abuse.
Social Forces Contributing to Problem
For society to be successful in its war against the sexual abuse of children, it needs to understand the role that social forces play. Extensive research has been carried out in this area. One of the factors identified as among the contributors to the problem is poverty. Freeman and Temple (2010) noted that children and adolescents from economically deprived neighborhoods are at a greater risk of experiencing sexual abuse. Moreover, they also suggest that poverty discourages children from reporting abuse. Compared to their counterparts from more affluent backgrounds, poor children experience fear and lack the resources they need to file reports with relevant authorities. Another important factor that Freeman and Temple blame for childhood sexual abuse is parental arrangement and the structure of the family. When a child is living with one parent or their grandparent, their risk of being sexually abused is higher (Freeman & Temple, 2010). This insight should challenge society to strengthen families so that they are better able to protect children against predators.
Low education levels, being part of households with many children and a history of abuse in the household are other factors that have received blame for child sexual abuse (Antai, Braithwaite & Clerk, 2016). When parents lack adequate education, they are unable to defend their children against abuse. The pressure that parents with many children face also makes it difficult for them to monitor the children to ensure their safety. As Antai, Braithwaite and Clerk observed, children who are from households where abuse has occurred before face an elevated risk of suffering abuse themselves. Overall, the home environment is a critical social determinant of abuse. It is important for parents to take steps to secure their children. Governments should implement poverty eradication programs so as to eliminate the risk factors for abuse.
The US is among the countries that are grappling with child sexual abuse. This fact is despite the highly industrialized structure of the American economy. That abuse of children occurs in a country that is as developed as the US indicates that economic strength does not necessarily offer protection against abuse. To understand the global nature of child sexual abuse, it is important to examine the social dynamics that surround this issue in other countries. Ruben Ayala (2009) worked together with a team of researchers to understand the social factors that determine sexual abuse in Mexico. Their findings indicate that such factors as poverty, violence in the home and substance abuse are among these factors. Among the most intriguing observations that they made is that high levels of self-esteem has a protective impact with regard to childhood sexual abuse. Essentially, this observation means that children who are confident are more likely to fight off abusers. From the study that Ayala and his colleagues conducted, it can be seen that child sexual abuse is a global problem which is defined by a wide range of social factors.
Myths and Misconceptions
Among the factors hindering the war against child sexual abuse is that many do not understand this problem. There are various myths and misconceptions that hamper understanding. That there is a link between sexual orientation and experience of childhood sexual abuse is among these myths. As Sivagurunathan (2018) and fellow researchers caution in their article, many believe that male survivors of sexual abuse become gay. Another myth that Sivagurunathan and his colleagues address is that male survivors are complicit in the abuse that they suffered. This misguided belief robs the survivors of their victimhood and impede their efforts to seek support.
That schoolyards and playgrounds serve as the setting for most cases of child sexual abuse is another misconception that surrounds this problem (Katz-Schiavone, Levenson & Ackerman, 2008). Many people are persuaded that the risk of sexual abuse is greatest in areas designed for children. While there is some truth in this belief, it fails to capture the reality of sexual violence against children. It has been established conclusively that such environments as the home are where most incidences of sexual abuse of children occur. The abuse is perpetrated by individuals who are well known to the children. Unless society understands this fact, it will be nearly impossible to fully eradicate child sexual abuse.
In an earlier discussion, it was noted that most adult survivors of sexual abuse live with feelings of shame and guilt. These feelings can be blamed on myths and misconceptions. Concerns have been raised that the victims of abuse must have done something that invited the abuse. This myth is particularly perpetuated in cases where the victim was aroused or appeared to enjoy the experience. Those who believe this myth fail to recognize that children simply lack the mental maturity needed to understand such complex issues as sexual abuse. Society needs to reform its perspective and view victims as individuals who have suffered horrific experiences which will leave them scarred well into adulthood.
Example for Illustration
In order to fully understand the damaging effects of child sexual abuse, it is helpful to consider an example. As I perform my social work duties, I often encounter individuals who are dealing with the pain of sexual abuse. Nicolas is on such individual. I met him on one of my recent field assignments. Nicolas is a 17 year old young adult who stayed with his alcoholic and abusive mother who abused him when he was only 9 years old. His father abandoned him when he was 2 years old. The case of Nicolas is one of the most unusual that our agency has handled. Most cases of sexual abuse are perpetrated by male relatives of the victim. For example, I have personally handled a case where a 12 year old girl had suffered years of sexual abuse in the hands of her own father. My interaction with Nicolas enabled me to understand that the impacts of sexual abuse are devastating , regardless of the survivor's gender. As a result of the abuse, Nicolas had become reclusive, deeply sad and worryingly afraid. His professor is among the parties that I spoke with regarding Nicolas' experiences. She shared that for weeks, Nicolas had isolated himself from his classmates. She added that Nicolas had also recorded poor academic performance and that his class attendance was spotty. All the symptoms that Nicolas displayed pointed to the fact that the sexual abuse had left him traumatized. It is indeed unfortunate that the very parents who are trusted to protect their children can become perpetrators of abuse. Through the intervention of our agency, Nicolas has been placed in a foster home. I conduct monthly visits to ensure that he is recovering as expected and that his new home provides him with the environment that he needs for full healing.
Owing to my interaction with Nicolas, I gained a deeper understanding of the dynamics of sexual abuse. One of the issues that this interaction revealed is that as confirmed through research, in most cases, perpetrators of abuse are known to the survivor. In the case of Nicolas, his mother who had an obligation to ensure his safety left him with wounds that may never heal. Another issue that this case revealed is that weak social systems are to blame for some cases of child sexual abuse. The social systems are needed to hold parents to account and ensure the safety of children. Nicolas came from a home without a father figure. Furthermore, his extended family failed to offer the support that he needed. Essentially, Nicolas was from a highly dysfunctional family that did not recognize the impact that the family environment has on the development of children.
That substance abuse often accompanies child sexual abuse is another issue that became clear in my sessions with Nicolas. He challenged me to acknowledge that alcoholism impairs the judgment of parents and other individuals who abuse children. It is worth noting that the fact that their judgment is impaired does not absolve perpetrators. This fact simply shows that substance abuse is one of the correlates of sexual violence and abuse. Moreover, by understanding the role of substance abuse, social workers and other practitioners charged with the mandate of attending to the needs of children can remove vulnerable children from dangerous environments. By placing Nicolas in foster care, our agency shielded him from further abuse.
Reflection
My agency has adopted a process designed to facilitate learning and accountability. This process involves supervision. All social workers are assigned supervisors to whom they are required to report and provide updates on their field assignments. Given how unusual Nicolas' case was, I felt the need to disucss the case with my supervisor. Our discussion focused on the risk factors for child sexual abuse and the measures that social workers can adopt to prevent the abuse. We agreed that parental substance abuse and poverty are the main risk factors exemplified by the case of Nicolas. His background of poverty meant that he was unable to access the help that he needed desperately. Moreover, the fact that his extended family offered no support made it difficult for Nicolas to seek help and report the abuse. My supervisor and I found it unfortunate that there are thousands of vulnerable children like Nicolas who are suffering in silence and have no one to whom they can turn.
As noted above, in my discussion with my supervisor, we examined the role that social workers can play. My supervisor insisted that social workers needed to be proactive. Instead of waiting for children to report cases of abuse, they need to reach our to children they suspect are being subjected to abuse. However, he cautioned that social workers must exercise sensitivity, caution and empathy when dealing with child victims of sexual abuse. They need to understand that the children have lost confidence and trust in adults and that by assuring the child that all will be well, a social worker can gain the child's trust. That placing survivors in foster homes is important is another theme that emerged in my discussion with my supervisor. Nicolas is now a young adult whose life holds immense promise. The progress that he has made is largely thanks to the intervention by our agency.
It is true that support from third parties help victims of sexual abuse to deal with trauma. However, as my supervisor made clear, no meaningful progress can occur unless the survivor decides to take action. Nicolas is making encouraging progress because he chose to seek help and pursue his aspirations. He has refused to allow the abuse that he suffered to define his life. Other adult survivors need to reclaim their lives. This is the key to healing and dealing with trauma. However, if the survivors feel overwhelmed, they should trust that the social work community is able and willing to offer support and services.
In conclusion, child sexual abuse is still a serious menace. Thanks to the work of researchers, insights into this problem have been gained. It is now understood that complex power dynamics and the vulnerability of victims are among the main factors that are fueling the abuse. Such other issues as poverty and harmful cultural practices also play a role. The abuse has been linked to a number of adverse outcomes in adulthood. Depression, feelings of guilt and shame, anxiety and low self-esteem are some of these outcomes. The abuse has also received blame for unhealthy sexual development. Survivors cannot be expected to heal on their own. Society needs to develop programs that provide the survivors need to heal and to prevent the negative effects of abuse.
References
Aaakvaag, H. F., Thoresen, S., Wentzel-Larsen, T., Dyb, G., & Roysamb, E. (2016). Broken and guilty since it happened: a population study of trauma-related shame and guilt after violence and sexual abuse. Journal of Affective Disorders, 204, 16-23.
Antai, D., Braithwaite, P., Clerk, G. (2016). Social determinants of child abuse: evidence of factors associated with maternal abuse from the Egypt demographic and health survey. Journal of Injury and Violence Research, 8 (1), 25-34.
Ayala, R. C., Rivera-Rivera, L., Angeles-Llerenas, A., Diaz-Ceron, E., Allen-Leigh, B., & Ponce, E. L. (2009). Factors for sexual abuse during childhood and adolescents in students of Morales, Mexico. Revista de Saúde Pública, 43 (3). DOI: http://dx.doi.org/10.1590/S0034-89102009000300015
Blank, C., Nunes, K. L., Maimone, S., Hermann, C. A., & McPhail, I. V. (2018). Is childhood sexual victimization associated with cognitive distortions, self-esteem, and emotional congruence with children? Journal of Sexual Aggression. DOI: https://doi.org/10.1080/13552600.2018.1509574
Collin-Vezina, D., Sablonniere-Griffin, M., Palmer, A. M., & Milne, L. (2015). A preliminary mapping of individual, relational, and social factors that impede disclosure of childhood sexual abuse. Child Abuse & Neglect, 43 , 123-134.
Dale, K. A., & Alpert, J. L. (2007). Hiding behind the cloth: child sexual abuse and the Catholic Church. Journal of Child Sexual Abuse, 16 (3), 59-74.
Freeman, D. H., & Temple, J. R. (2010). Social factors associated with history of sexual assault among ethnically diverse adolescents. Journal of Family Violence, 25 (3), 349-56.
Irish, L., Kobayashi, I., & Delahanty, D. L. (2010). Long-term physical health consequences of childhood sexual abuse: a meta-analytic review. Journal of Pediatric Psychology, 35 (5), 450-61.
Middleton, W., Sachs, A., & Dorahy, M. J. (2017). The abused and the abuser: victim-perpetrator dynamics. Journal of Trauma & Dissociation, 18 (3), 249-58.
Parsekar, M. M., Parsekar, S. S., & Nair, S. N. (2014). An epidemiological overview of child sexual abuse. Journal of Family Medicine and Primary Care, 3 (4), 430-5.
Roller, C., Martsolf, D. S., Draucker, C. B., & Ross, R. (2009). The sexuality of childhood sexual abuse survivors. International Journal of Sexual Health, 21 (1), 46-60.
Sivagurunathan, M., Orchard, T., MacDermid, J. C., & Evans, M. (2018). Barriers and facilitators affecting self-disclosure among male survivors of child sexual abuse: the service providers’ perspective. Child Abuse & Neglect. DOI: https://doi.org/10.1016/j.chiabu.2018.08.015
Katz-Schiavone, S., Levenson, J. S., & Ackerman, A. R. (2008). Myths and facts about sexual violence: public perceptions and implications for prevention. Journal of Criminal Justice and Popular Culture, 15 (3), 291-311.
Vaillancourt-Morel, M., Godbout, N., Sabourin, S., Briere, J., Lussier, Y., & Runtz, M. (2016). Adult sexual outcomes of child sexual abuse vary according to relationship status. Journal of Marital and Family Therapy, 42 (2), 341-56.
