Psychotherapy Services in South West London

Dynamics of Trauma Child Sexual Abuse

Recent media attention regarding the prevalence of sexual abuse in child care settings confirms that sexual abuse is likely to remain a salient issue within our society. There are four traumagenic dynamics areas of child sexual abuse can affect development. 1. Traumatic sexualisation. The dynamics are that perpetrators exchange attention and affection for sex, they fetishes sexual parts of children, they transmit misconceptions about sexual behaviour and sexual morality, children are rewarded for sexual behaviour inappropriate to their developmental level. The psychological impacts consist of aversion to sex or intimacy, negative associations to arousal sensations and sexual activity, confusion of sex with love, confusion abut sexual identity and sexual norms. Problems include sexual preoccupations and compulsive sexual behaviours, precocious sexual activity, promiscuity, prostitution, flashbacks, difficulty in arousal or orgasm, avoidance of phobic reactions to sexual intimacy and inappropriate sexualisation of parenting. 2. Stigmatization. The dynamics are the perpetrators blame or denigrate victims, pressure children for secrecy, blame children for events and define them as damage goods. The psychological impact consist of guilt, shame, lowered self esteem and sense of differentness from others. Problems include isolation, drug alcohol abuse, criminal involvement, self harm and suicide. 3. Powerlessness. The dynamics are that children feel unable to protect themselves, there is difficulty making others believe, fear is repeatedly experienced, perpetrators use force or trickery to involve children. The psychological impact consist of anxiety, fear, a lowered sense of efficacy, the need to control, identification with the aggressor, and perception of the self as a victim. Problems include phobias, nightmares, depression, somatic complaints, eating and sleeping disorders, dissociation, running away, becoming a perpetrator, delinquency, aggressive behaviour, bullying, truancy and unemployment. 4. Betrayal. The dynamics are that perpetrators violate children’s expectations that others will provide care and protection, trust and vulnerability are manipulated and there is a lack of support and protection from parents. The psychological impact consist of anger, hostility, grief, depression, extreme dependency, impaired ability to judge the trustworthiness of others and mistrust. Problems include isolation, discomfort in intimate relationship, clinging, aggressive behaviour, delinquency, marital problems, vulnerability and exploitation. In therapy the wider context in which sexual abuse takes place and the complex interaction between the inner and outer worlds of the survivor will be addressed.

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