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|HEALING FROM CHILDHOOD SEXUAL ABUSE|
| WHY DO I
You need to heal because some therapist wants your money. You are totally normal and have no need to start the so-called therapy. You need to heal because your spouse thinks that you are crazy and recommended that you see a shrink.
Now, seriously. You are doing it for yourself. The goal should be to improve the quality of your life. Sexual abuse caused you mental and perhaps even physical damage. Your treatment will mitigate these consequences. Healing from child sexual abuse can do the following:
Reduce your anxiety
Victims of intrafamilial sexual abuse are frequently depressed, constantly worry, and feel obligated to please others. They mentally persecute themselves for the slightest imperfections in their behaviors.
Resolve your nightmares
Adults sexually abused as children tend to have frightening dreams. Each nightmare evokes great fear and affects the person for many days. Anxiety, depression, and psychosomatic illnesses result from the ongoing stress. The nightmares and also daytime flashbacks naturally disappear when you process the traumas of your past in full consciousness. By contrast, trying to ignore or suppress the bad memories only makes your nightmares worse.
Improve the clarity of your mind
All abused children dissociate inside their minds. The victims lose contact with important parts of their brains and are left without higher reasoning power. They feel uncertain, cannot recognize harm and danger, and are easily fooled and manipulated by others. Intelligence quotient (IQ) has no effect on this dissociative deficit. Even with an IQ of 160, you will not do any better than someone with an IQ of 80. You may have a doctoral degree and still be a battered wife who unconditionally obeys her abusive husband.
Improve your physical health
Childhood sexual abuse causes hardly any direct physical harm, but the mental damage leads to psychosomatic illnesses over time. The victim may have a heart attack, or may injure herself due to dissociation and inattention, or may develop a chronic and often deadly disease.
Give you a feeling that you are in charge of yourself
Many healed survivors experience tremendous improvement in the way they deal with the world. They dump their abusive and controlling partners and set their own course. They stop serving others and get rid of their guilt for everything that goes wrong. They are free. They know when they behave right and when they cause harm to others. They treat others with respect and expect the same kind of treatment.
Give you a healthy look at the world
Sexually exploited children often develop addiction to abuse. They believe in the existence of supernatural powers and readily submit to these imaginary forces. They are totally obedient and blindly trust a perceived authority. Even if they are able to recognize that an authoritarian is harmful, they are easily persuaded to obey his will. Many victims of intrafamilial sexual abuse become active supporters of evil people in the position of power while they believe that they are supporting model citizens.
Make you stop swinging between extremes
Victims of childhood sexual abuse often lose their most important mental faculties and cannot tell the difference between right or wrong. To get along, they follow the guidelines written in some book or obey the instructions of a perceived authority. This external control and the guilty feelings every victim has can produce extreme reactive behaviors that are fostered by abusive partners. Even a suggestion made in joke may drive the confused survivor to exceptional performance. The results please others, but the victim is depressed and exhausted. Most of her suffering is self-inflicted. She is addicted to bad treatment and does her best to get it. You know the battered woman who barely makes it to the emergency room, but refuses to send her husband to jail. She "loves him." Amazingly, she is self-confident at work and manages hundreds of company employees.
Allow you to have a quality sex life
Victims of intrafamilial sexual abuse invariably have disrupted sex lives. They may be afraid of having sexual intercourse with persons whom they genuinely love. This subconscious fear may result in sexual frigidity. The condition is usually negotiated in two ways. The adult survivor of intrafamilial sexual abuse may feel that it is her duty to submit to her partner's sexual demands. She may compulsorily engage in sex, but may remain passive and mentally detached. Or, she may totally avoid sex and physical touch. She may not allow her emotionally intimate partner to touch her hand or foot, and she panics when he tries to talk her into having sexual intercourse. In another extreme, adults sexually abused as children become highly sexually active. They may compulsively explore variety of sexual expressions and with many partners, or may see their worth only in their ability to satisfy the sexual needs of others. Such adult survivors act out their childhood abuse. They do not have sex for themselves, but for the benefit of someone else. Deep inside, they feel angry, hungry for physical contact, and sexually unsatisfied.
Resolution of these extreme attitudes toward sex should result in a committed relationship that includes both mental and physical aspects. Sex will no longer be something that you frantically avoid or compulsively seek. It will be an integral part of your overall existence. The quality of your sexual experience (the way you express and perceive your sexuality) should dramatically improve. Sex will stop being the only way you can interact with your partner. Sex will not be taboo, mandatory, or bothersome. You will have sex for yourself, and not for your partner. You will learn to refuse to have sex when you do not feel like engaging in it, and will be able to ask for sex when you desire it.
Your healthy sexuality will also affect other areas of your life. You will be able to plan the number of children you wish to have, and will be able to decide for yourself whether to have another child or to have an abortion. Your sexuality and the sexual functions of your body will no longer be controlled by your partner, your parents, your church, your president, or your society, but by you. Your body will belong to you, and you will be able to freely decide what to do with it. Examples of sexually abused women and men who have lost the ability to decide for themselves can be encountered every day in TV and radio talk shows. We can hear:
"Dr. XYZ, please, help! My boyfriend wants me to have unprotected sex."
"Dr. XYZ, for me, as a Christian, is it proper to engage in oral sex?"
"Hello, Dr. XYZ, will it displease God if I have an abortion?"
You do not need to be told what someone else's mind thinks. You can be your own "man" (woman). All you need to do is heal from childhood sexual abuse, and you will naturally restore a good deal of your lost emotional intelligence.
Improve the relationship between you and your family
The behavior of a victim of intrafamilial sexual abuse can take many unhealthy forms. Some women lose interest in their children, some are domineering, and some become abusive. The victim longs for love and affection, but she has no idea what they are. She repeats the pathological patterns of her childhood and drives good people away. She wants a caring husband, but when he tries to be tender, she pushes him away. She is afraid of being betrayed. Her trust was broken by a close person in a despicable way, and she unconsciously sabotages her adult relationships.
Make you understand abuse and protect yourself and your children
You will learn about the indicators and effects of sexual abuse, will be able to tell what kind of people is dangerous, and will be able to protect yourself and your children.
Make you enjoy life
Your energy will no longer be spent on fighting the intangible forces from the past. You will no longer serve others, but will give and receive. You will have free time for yourself. You will feel, smile, and laugh.
Make you a good person
You will stop supporting bad people. You will not elect crooked judges and politicians to office. You will monitor their behaviors and hold them accountable for their crimes against individuals, the country, and humanity. You will become a responsible citizen.
By contrast to the benefits of treatment, untreated sexual abuse may turn you into an abuser. In addition, you are likely to develop multiple personality, bipolar disorder, borderline personality disorder, Alzheimer's disease, Parkinson's disease, and cancer. You may space out and have accidents. You are likely to abuse drugs, alcohol, sex, and food, and you may commit suicide.
Shame is a form of fear. It affects us when we feel that our behavior contradicts our moral beliefs. Shame surrounding sex and issues of dominance is among the strongest forms of shame. A girl may be ashamed to tell her parents about starting her menstrual periods; a youngster may be afraid to disclose to his parents that he has had his first sexual encounter, and a young woman may be ashamed to tell others that she has become pregnant. Shame continues to affect us also in adulthood. A woman buying the pill may blush, and a man shopping for condoms may put a few extra items in his shopping basket not to look like a pervert. Some embarrassed shoppers may wait for a suitable moment, and when the sales person is of their own sex, they dare to make their purchases. But no matter how troubling these experiences may be, they are in no way comparable to telling someone about being raped, and certainly not about being raped by a close family member.
Should you be ashamed for being raped? Yes, you have a good reason to be ashamed. You feel that you should have told someone right after the first incident. But after the first incident you were ashamed for what happened. You did not tell. You hoped that you would not be raped again, but you were. You were also ashamed the second time, and the next time, and the next time. Shame prevented you from revealing your secret. What you did was a normal psychological reaction. Even adult women who are raped do not report their abuse. They are ashamed. A young child is much more likely not to tell. The abuser was able to harm you repeatedly because of your shame. You have not overcome the old shame. You are afraid and feel that you are the only one who has been abused. You are mistaken. You are not the only one. Almost everyone has been abused sexually to some degree. Thousands of children in the Catholic church have been abused. Their stories are no longer a holy secret. Tell others about your ordeal. Tell and help stop abuse. Children are worth overcoming your shame. Do it for the little girl inside you.
But I can neither see a therapist nor buy a book about childhood sexual abuse. If my friends saw me around a shrink's office or buying the book, they would know that I was sexually abused. And they would tell others. You know how people are.
You seem to have a valid point, but you do not understand the facts. People can tell that you are a victim of childhood sexual abuse just by looking at you. Your demeanor, your expressions, your hairstyle, your car, and your everything scream incest! In addition, there is a whole set of visible indicators of childhood sexual abuse. Experts can tell. Your secrecy and pretending will not fool them. Stop hiding and get help.
FEAR AND TRUST
Trust is a critical component of healing from intrafamilial sexual abuse. The victim may worry about these issues:
After being abused by a close person in childhood, incest victims often wonder if they can learn to trust again. The betrayal is so fundamental and so mentally insidious that being violated, misused, and cheated by others becomes an expectation of many a victim. In response, personal relationships are often unemotional, guarded, distant, or are forced to fail. The voluntary breakup is preferred to being potentially found undesirable by a partner. How can a person with such a mindset genuinely allow herself to trust anyone again? And this is where the core of the problem lies.
A mentally healthy person does not trust or mistrust, but spontaneously judges every instance of her life and compares the unique situations with the wealth of her personal experiences. The ability to correctly evaluate personal relationships and one's wellbeing is part of emotional intelligence. It helps a person decide whether or not to trust and to what degree. By contrast, a severely abused person always suffers from prominently reduced emotional intelligence. To get by, she relies on habits and belief-based reasoning. She tends to trust fully and unconditionally, or she may not trust at all. Her inability to correctly evaluate a specific situation makes her default to her beliefs and habits. If she trusts someone completely, no number of contradicting facts is able to make her change her mind. Similarly, if she mistrusts someone, even the slightest hint of a perceived rejection or criticism may freeze her relationship with the other person. Such a relationship is doomed to fail because no person is perfect. Differences in opinions, priorities, and preferences will emerge some day, and she will be unfit to negotiate them constructively. One particular problem for an incest victim is discrepancy between words and deeds. The victim almost always judges a man by his words and ignores his acts and intentions. If he is a smooth talker, he is believed, and his behavior is unimportant. But when he has a sense of humor and jokingly tells the incest victim things she is unable to understand because of her lacking emotional intelligence, she will take his teasing statements at their face value. She will consider him untrustworthy, even though his behavior may be impeccable. An especially troublesome challenge for an incest victim, particularly one with multiple personality, is posed by mixed emotions. A healthy person, when innocently teased, will have the "gotcha" feeling and will understand the intention of the deception correctly and view the whole matter positively. But an incest victim with low emotional intelligence will perceive the statement as a blatant lie. And even though she recognizes it is a lie, she will be angry with the guy because he tells her such "stupid things!"
So, the issue is not how to learn to trust again. The issue is whether you are able to understand the intentions of others, whether you can correctly interpret their behaviors, and whether you can understand that trust is a process and a dynamic relationship, rather than a permanently fixed state. Unfortunately, incest victims can never completely undo their brain damage. They struggle with their low emotional intelligence for the rest of their lives.
WHY DO I NEED A THERAPIST?
You need a therapist because she is an expert in her field. When you become sick with a physical illness, you see a doctor who identifies your illness and prescribes you pills. The medication does your healing. Healing from intrafamilial sexual abuse is different in two important aspects. The right "pills" are in your mind, and your mind is not working right. This is why you need a therapist. She will lead you through your treatment, explain things to you, and help you resolve your traumatic experience.
You are unlikely to heal yourself alone. Your mind is damaged in an invisible way. What you consider normal is, in fact, pathological (not healthy). Your addictions to bad partners, exploitation, and suffering are dear to you. The therapist will make you identify your harmful behaviors.
The therapist will use psychological techniques to recover the memories of your trauma from your subconscious mind. You would not know how to do this without her help. She will interpret the information that you recover. Again, because of your mental damage, you could not do this alone.
Brain damaged? Me? I have a Masters Degree in Business Administration. I can manage a billion dollar project. Do not give me this nonsense about brain damage. I can work 12 hours a day, including the weekends, and I get results. They did not make me a vice-president for being brain damaged.
Is that so? Anyway, the therapist will teach you about healthy behaviors and relationships. She will point out what is beneficial and what is harmful. She will show you how your current behavior affects your wellbeing and the people around you, and will suggest alternative responses.
CHOOSING A THERAPIST
Finding a good therapist is critically important. Do not choose her (or him) the way you selected your last dentist. Do some research. Find out how long she has been working with victims of sexual abuse and how long she has been in town. Ask many questions about her style of therapy, possibility of hospitalization, and how she responds to emergencies. Verify her credentials by contacting the professional organizations that licensed her. This verification will not indicate that she is a good therapist, but you will know that she is legitimate. Check that she has a malpractice insurance. Try to get recommendations from Alcoholics Anonymous, Rape Crisis Center, or similar organization that is familiar with local therapists. You will have a choice of several professionals. They all do therapy, but their education and prices vary. Naturally, just being a certified health professional does not mean that the doctor is treating victims of sexual abuse. Those who do heal victims of sex crimes represent a tiny fraction, and those who are good at it are very few. In a city of a million people, you may find fewer than ten qualified specialists. And if you want someone who is good at treatment of multiple personality, which typically arises from years of severe abuse, you may find only a handful of experts in the entire state.
Psychiatrist is a tittle with a stigma, and most psychiatrists appear to be men. They love to use drugs, and are cold and domineering. They consider a therapy successful when they suppress the patient's symptoms, usually along with her essential mental functions. The many pills that are prescribed often permanently damage the patient's brain in the long run. Researchers of mental illnesses are aware of this problem and avoid working with medicated patients. The patients have not only the deficits attributable to their original illnesses, but also additional damage caused by the pills.
Some traumatized patients, such as victims of intrafamilial sexual abuse, may welcome the use of medication. Pills can restore their calm in minutes, and the patients "get well" without re-experiencing their traumas or spending years in therapy. Of course, the patients do not resolve their original traumas; they just become unable to feel their physical and emotional pain. And since they do not learn from the past and do not feel any discomfort at the present, the patients are unable to avoid future harm to themselves or to their children.
The very best psychiatrists try to avoid waging chemical warfare against their patients. The doctors are sensible experts who use drugs only when absolutely necessary. Unfortunately, psychiatrists of this kind probably do not exist, and even if they did, you could not afford them or find them. The very fact that they studied the use of "brain medication" reveals their overall philosophy. Even if they try to avoid medication, they will resort to this solution when things turn for the worse. Avoid psychiatrists if you can. In addition, a psychiatrist can harm you in other ways.
Research shows that doctors (and especially psychiatrists) are former victims of childhood sexual abuse and act out their unresolved issues on their patients or family members. The common expression of the psychopathology is manifested in the form of sexual dominance coupled with mind control and censorship of secrets. For example, gynecologist Darwish Hasan Darwish raped his patient while she was under hypnosis and fathered her child . Psychiatrist Christopher Allison was found guilty of multiple counts of indecent assault on his patients and two counts of patient rape . Psychiatrist Dr. Michael Haslam was found guilty of attacking and raping his patient . Dr Kenneth Pope, the former head of the ethics committee for the American Psychological Association, reports that psychiatrists, child psychiatrists, and psychologists are significantly over-represented in sex crimes . Psychiatrists represent 6% of all doctors, but account for 33% of all sex crimes committed by doctors .
Psychologist is highly educated (like a psychiatrist), but she is not allowed to administer medicine. Most psychologists have a doctoral degree (Ph.D.) The general belief among psychologists is that you must be a Ph.D.; otherwise, you are nobody. This is why psychologist is an occupation with a high ratio of doctoral degrees. The degree does not mean much and does not reflect her ability to be a good therapist. Ask for references before you commit yourself to a particular therapist, and do not hesitate to go elsewhere when you feel that you are not getting what you expect.
Social Worker is another title among mental health professionals. These people do not have as high education as psychiatrists and psychologists have, but they are the workhorses in the field. Doing therapy with them is usually the best choice. Qualifications of these workers vary widely, from incompetent to outstanding professionals with extensive clinical knowledge. Some of them have several titles attached to their names. This is a sign of their formal training and should be viewed positively. A bureaucrat with many titles is always a crook, but this case is different. Therapists with many titles will probably cost more, but they are usually worth it. The common titles are:
LSW = Licensed Social Worker
LCSW = Licensed Certified Social Worker
LMSW = Licensed Master Social Worker
LPC = Licensed Professional Counselor
LICSW = Licensed Independent Clinical Social Worker
LMFT = Licensed Marriage and Family Therapist
The titles are used by most states of the USA, but some states use unique alterations. The important point is that the title should contain the word licensed or registered. These words imply official training and certification. It takes college, thousands of hours of supervised clinical practice, and the Masters Degree to obtain these titles. You cannot get them by graduating from high school. More information about licensing requirements, training, restrictions, and specialization of social workers can be found on the internet [1,2].
Some states, most prominently Colorado, allow officially untrained individuals to practice psychotherapy. All that is needed is a simple test and registration with the state for tax purposes. These therapists often charge the current rate and are not any cheaper than those with official training. In addition, the USA allows the clergy to do counseling and psychotherapy without a state certification. Surprisingly, as reported by psychcentral.com, the licensed therapists are disciplined four times more frequently by the state than the unlicensed therapists are.
WHAT SHOULD I WATCH FOR?
Beware of a therapist who
You do not have to submit to any form of physical examination, and you can negotiate how much you are willing to reveal. The choice is yours. Yes, you can refuse. Yes, there is a way between a total refusal and total submission. But if you are unable to show the healer your body, how likely is it that you will be able to show her your mind? Taking off your skirt or pants may be a challenge, but having your mind totally naked, exposed, and vulnerable is a very different thing. Prostitutes often have no difficulty with exposing and renting their bodies to paying customers, but some of these ladies of the night have tremendous difficulties with sharing of their thoughts, beliefs, and feelings. Consider how you feel about the therapist's request, and then ask why she wants to see your body and how this information will help her in your treatment. If you get a bogus answer, it is probably time to leave and find a new therapist.
If you reject the medical examination to hide your harmful behaviors (tattoos, injection marks, skin rash, hickeys, contusions, scars, burn marks, etc.), you will sabotage your treatment. The therapist will not understand the extent of your mental problems and psychosomatic illnesses, and will be ineffective in helping you.
Ideally, you would like to have a healer who understands all the issues of sexual abuse. You would like her to know what sex crimes consist of, how they harm the victim in the short and long terms, how the brain reacts to the trauma, and how to undo the consequences. In reality, your healer will not have all these qualifications at the top level, and you will have to settle for less. But working with the imperfect healer is still your best chance to heal.
WHAT YOUR THERAPIST CANNOT DO
Your therapist cannot heal you. Only you can. She can give you guidance, but you are responsible for your healing. You will have to re-experience your trauma and incorporate the painful moments into your personal history. You will have to undergo a lengthy process of changes of your habits and values. And when you change, your significant others will have to cope with the new you. They either adjust to you or leave you.
Your healing will not be a one-hour session twice a week; it will be a 24-7 job. Most of your healing will happen between your therapeutic appointments. You will be thinking, analyzing, reminiscing, re-experiencing, and aching.
The therapist cannot force you to heal. If you do not want to work on your health or if you look for excuses and are determined to sabotage therapy, you may never heal. This will be the first time in your life you will be doing something for yourself, instead of doing it for others. This new experience will feel strange to you, and you will have a million reasons to avoid therapy, especially when it becomes distressing. Your natural reaction will be to avoid pain. You will have to overcome this mentality and work toward the final goal. There will be many times when you will be sure that the therapist is making you feel worse than you felt before. Your perception will be correct, but your interpretation will be wrong. Think about this issue in terms of treatment for tetanus infection. You may see just redness and swelling on your skin, but your doctor takes this big needle and buries it deep into your rear end. The piercing of your muscle and the horrendous pain attributable to the medicine make you feel many times worse. You know that without the painful medicine you would die, so you accept the treatment. Likewise, untreated childhood sexual abuse can kill you.
WHY MY THERAPIST WANTS TO KNOW EVERYTHING ABOUT MY ABUSE?
Many patients believe that therapists are too inquisitive and eager to learn the details of sex acts. The therapist must be enjoying the stories; otherwise, she would not be asking.
The reason behind the sensitive questioning is therapeutic. The therapist needs to learn what kind of trauma happened to the patient, what was done, by whom, and how often. The therapy could not proceed without the knowledge. Once the therapist knows, she needs to make sure that also the whole mind of the patient knows. The healer could hypnotize the patient and learn a lot of information about the trauma, but the patient might not be aware of the facts upon reentering consciousness. So, introducing the patient to the facts about her traumas is an important part of treatment. The therapist needs to decide how much and how quickly can be revealed to the patient's conscious mind. Too much too quickly may be overwhelming and may cause breakdown of therapy or may drive the patient to commit suicide.
Once the patient is aware of her past, the therapy enters a new phase. Now the recovered information needs to be explained to the patient and incorporated into her cognitive schemes. Victims of sexual abuse typically have reduced emotional intelligence and are unable to comprehend their abuse. Even after years of therapy, they may still ask, "Why did he abuse me?" They may desire to confront their abusers to hear the answer to this question. A healthy mind readily resolves the meaning of traumas, but an external source needs to clarify things when traumas damage the brain. When the damage is significant, the patient needs to hear the explanations repeatedly and over a long time before she accepts them and they become part of her psyche.
The described mechanisms in sexually abused minds justify the therapist's probing and digging. She wants to learn about the patient's abuse not because she gets aroused by the information, but because the patient has to learn what happened to her and needs to have her experiences justified. Practically all victims of child sexual abuse have grossly distorted memories of their personal history. The correct versions of the past need to be recovered from the unconscious and subconscious minds, and the stories need to be acknowledged by the conscious mind. If the therapy does not address these issues directly and in detail, it will not succeed. The unresolved information will preserve its traumatic nature and will torment the patient with dissociative phenomena, bad feelings, anxiety, crippling fear, and nightmares.
WHAT CAN I DO TO SPEED UP MY HEALING?
Your question reveals that you are thinking like most victims of intrafamilial sexual abuse do. You are concerned with performance and completing a task, instead of living a quality life. Relax. You cannot outrun your treatment. It will take as much time, pain, and effort as it takes.
Although you cannot significantly shorten your healing from sexual abuse, you can ensure that it will be on track and you will get well. An important part of your healing will be self-education. Get books about child sexual abuse and learn why you are behaving the way you are. Read publications about recovery from sexual abuse and learn what to expect. When crises develop in therapy, you will understand why. You will be reacting to the subconscious forces within you. The forces will cause you pain and discomfort. By knowing what is happening to you and what the likely result will be, you will reduce your anxiety.
Get a trusted friend you can talk to about everything that goes on in therapy. This person does not need to be an expert, but she should be a good listener who can share your emotions, offer you moral support, understanding, and a helping hand. You will be very needy and vulnerable. This friend will help you get through the worst times.
But I am paying my therapist! Isn't this her job? I don't care that she has forty other patients like me. If she wants to be a therapist, she has to put up with some extra time after work. All I am asking for is one additional hour a month. Is that so much to ask for?
No, it is not so much to ask for. This is one of the usual consequences of sexual abuse. The victim has the mentality of a child and sees only her needs. Look at the situation from the therapist's viewpoint. She spends 9 hours at the office, and then additional time with her patient who is in crisis. What you call "1-hour emergency session" becomes a 3-hour daily routine for her, including the weekends. She goes to bed at midnight, and before she wakes up in the morning, she gets three phone calls from her patients who want her to settle their domestic disputes. The next day, you expect her to smile at you, have all the right answers, and compassionately listen to your personal problems. Please, be considerate and ask for an extra session only when you have a real emergency.
Healing from child sexual abuse requires a great deal of time and energy. Even if you do not have an appointment with your therapist on a given day, you will need to spend time on your healing. You may already feel that you are overworked and have no time to rest. How could you possibly start your treatment under these circumstances?
Your lifestyle and thinking are affected by your abuse. The mental consequences of your abuse push you to do things that you really do not need to do. An essential part of your healing will be setting priorities and taking care of yourself. You will need to delegate authority and let your kids do what they can. Here are a few examples how you can get time and energy for your recovery:
Healing with a therapist is expensive. The more qualified she is, the more she will want to charge, but some highly qualified therapists only ask for what is considered a fair price in their profession. You will have to shop around. Optimum therapy should have two to four sessions a week. More than four visits per week will not heal you sooner, because you will need time to process the recovered information after each appointment. Unfortunately, many patients cannot afford more than one weekly session. This is considered inadequate, and the rate of therapy success noticeably decreases.
The current rates (in 2016) in the USA are about $40-$80 per one 50-minute session with a novice social worker or counselor, $100 with 5-year experience, and $150-$180 with 10 or more years of experience. The prices increase to about $250-$350 with a psychologist or psychiatrist. In general, the typical cost is between $2 and $3 per minute! You will need good health insurance or you will need to have a yearly income of at least $50,000 to afford the therapy. At two 50-minute sessions a week, a 5-year therapy costs between $50,000 and $75,000. There may also be the cost of hospitalization, which may be $5,000 per week. Furthermore, the insurance company may decline to pay the cost if they believe that the hospitalization was not "medically necessary." And some insurance companies limit the number of therapy hours they are willing to pay for. If therapy goes on for too long (up to a few years in the 1990's), they simply deny that the therapy is effective and will refuse to pay for it. Nowadays, insurance agencies may consider an inpatient therapy "ineffective" after a month! But it takes six to twelve month just to stabilize a patient and develop her trust before discovery of sexual traumas can begin.
The given price ranges do not reflect the real cost of today's treatment. After the mass revelations of child sexual abuse during the 1980's and 1990's, many perpetrators successfully sued their victims and their psychotherapists. The lawsuits deterred doctors from pursuing this line of work. In addition, healers of multiple personality were ridiculed by their disbelieving colleagues for practicing folly. As a result of the backlash, few new professionals started working with sexually abused children during the last fifteen years. The currently available healers are likely to have many years of experience and will charge their patients accordingly.
To get your money's worth, find a therapist who is an expert in dissociative disorders, namely multiple personality or dissociative identity disorder. The actual technique the doctor uses is important, too. Some doctors only do hypnosis, while others only do eye movement desensitization and reprocessing (EMDR). Both techniques have limited uses and will only go a limited way in therapy. Ideally, you want someone who is a generalist and knows the various techniques of working with the conscious and unconscious minds. Good therapy does not require hypnosis or EMDR, and these techniques alone are not enough to heal a patient. By contrast, both hypnosis and EMDR activate very useful control mechanisms that would be unachievable by other methods.
Some therapists offer free consultations to groups. This work is often done under the auspices of some organization, such as Alcoholics Anonymous. The quality of this treatment is questionable in some instances, but some healers are doing a great job. The advantage of these sessions is that you meet other people like yourself. Their abuse will educate you that your case was nothing unusual. This will help you overcome a lot of your shame. In addition, you will find friends and reduce your social isolation during the years of treatment.
In addition to professionally managed groups, there are also groups led by victims of sexual abuse. Several women get together at some public room that is reserved for their meeting. They discuss their emotions, experiences, what works, and what does not. Many of these groups publicly declare their agenda, while others operate in a secretive way. They may have names, such as "Bible study club" or "Women's issues club" or "Women's group."
Try to avoid groups that only talk about personal empowerment or make you buy audio tapes that repeat chants and messages, such as:
I am strong. I can do anything. I feel no pain.
I am strong. I can do anything. I feel no pain.
I am strong. I can do anything. I feel no pain.
Such treatment methods do not work and only promote dissociation from reality. Religion uses the same method. Every Sunday, a preacher repeats the same positive messages, but the desperate parishioners do not benefit from the laudation. None of their personal problems is solved. They just dissociate, become dependent on the preacher, and bring him MONEY every Sunday. In order to heal, you must face reality and acknowledge both the good and the bad in life.
Some forms of dissociation are beneficial in the short-term, but may become counterproductive if they are overused and become the preferred way of solving problems. Yoga, meditation, or hypnosis can give you tremendous mental boost and optimism, and can make you feel relaxed both mentally and physically. Do them more than once a week, and you are guaranteed to make dissociation your usual way of dealing with everyday challenges. You will lose your ability to critically evaluate reality and will be making disadvantageous choices. You will feel good despite your increasing problems. You will ignore them until they hit you with full force.
If you prefer to heal yourself alone, you will spend very little money, but your isolation will almost certainly hinder your progress. You may not be able to do hypnosis, to ask yourself forbidden questions, to correctly interpret your repressed memories, and to devise optimum approaches to your treatment. The quality of your life will not improve as rapidly as it might, and you are likely to get stuck at many crossroads. You should enter therapy for at least one year.
If therapy with a professional is not an affordable option for you, you will need to find alternative solutions to your problem. Self-education can only take you a limited distance. You will probably never resolve your past trauma without someone guiding you during the process and skillfully controlling the amount of trauma you are able to tolerate. You may consider finding a job that comes with the needed health insurance. This may be your best option.
Unfortunately, there are things money cannot buy. Even if you have the funds to start therapy, there is no guarantee that you will find a qualified therapist. Professionals who deal with childhood sexual abuse are relatively available. The patients may get better, but are never healed, because their dissociative disorders are not addressed. Healers of incest who understand and work with multiple personality are rare. Even during the heydays of MPD therapy in the 1980's and 1990's, only a few percent of healers believed that the condition existed, and far fewer treated it. After 2000, MPD (DID) healers became endangered species. If you search for healers of MPD nowadays, you may find only several specialists in a major metropolitan area. Denver, for example, has only 3 experts treating multiple personality. The few available professionals are often booked well in advance. Rural areas and sparsely populated states may have no healers of multiple personality.
When you start the long journey of healing from sexual abuse, you may worry about the following: How will my treatment affect my family? Will I be able to take care of them? What if I go crazy? Who will take care of my children? Can I rely on my husband? Will the disclosure diminish my status in the eyes of my children? Will Mom ever believe that Dad raped me? Will my brothers and sisters know?
No one can tell you exactly what will happen, but your life will change. Therapy will affect your sex life and change the relationship with your extended family. Chances are that your husband will leave you. He married you for what you were, and he may be unable to accept the new you. You may lose all your relatives. When you disclose your abuse to other family members, your siblings will be reminded of their abuse as well. They will hate you for that. Your mother will hate you, and your father, assuming he is the rapist, may take you to court for slander or sue your therapist for implanting in your mind false memories of sexual abuse.
Some family members may support you, but do not count on it. You need to have realistic expectations. If your mother did not detect your abuse in childhood or knew about it and did nothing, do not expect her to behave differently now. The pathology of your family is not your concern. Your priority should be your healing. You should not be worrying about the attitudes of your relatives. You can only change yourself. Do not waste your time and energy trying to change the minds and behaviors of others. It does not work! If people ever change, it is because they truly want to, and not because they do so in response to external pressure.
To heal from sexual abuse, you do not have to tell other family members about what was done to you, and you do not need to confront your abuser directly in person. You will know when you are healed. You will have no problem with the past and with your current relationships. If you still agonize about your inability to win your abuser's love or worry about how the disclosure of your abuse will affect your relationship with other family members, you are not healed. You may have to do whatever needs to be done to close this chapter of your life. If you lose all your relatives in the end, so be it. Your overall wellbeing must take precedence over your naive wishes, social expectations, or feelings of others. Recovery from incest is a costly war that requires great sacrifices for a greater good. There is no victory, just peace of mind. Unfortunately, many incest victims, usually those with multiple personalities, have difficulty with seeing their abusive relatives as evil and decisively breaking up all ties with them. The victims often have close relationships with their abusers and even allow them to watch young children. Sadly, this undesirable behavior is the norm, and not an exception.
As for your sex life, expect that you won't be able to have sex for weeks or months for several years. At some point, you will have to tell your loved one what happened to you and why you need abstinence from sex to heal. You do not have to explain every detail, but be clear enough to express the gravity of your experiences and the psychological consequences. How and where you say it is not that important. Choose a form that fits you best, but be sure that both you and your partner can fully concentrate on the issue and have time to discuss it in full depth. During this time, you will learn why your partner was interested in you when you first met. If he or she wanted to be with you for your intellect, character, and personality, and saw you as a person, rather than a sex object, you are likely to have a supporting partner in your healing. But if sexual attraction was the only thing that brought you together, your relationship will not survive.
ACCEPTING THE DIAGNOSIS
When you enter therapy for sexual abuse, your doctor may diagnose you with a "mental illness." The diagnosis does not change what you are, but the label puts you in a category. Be sensible. Psychology and psychiatry are poorly understood sciences, and even professionals often disagree about a diagnosis. You may visit five different mental health experts, and each of them will call your condition by a different name. Of course, all five cannot be right. Let's hope that one of them will recognize your real problem. And problems you have. Surviving childhood rape without some adverse consequences is not possible. The abuse affects the brain, the mind, and the body, but this complex picture is rarely acknowledged by doctors. They typically focus only on one of the aspects, the one they are familiar with. Here are some of the most likely labels therapists will put on you:
Multiple Personality Disorder (MPD) or Dissociative Identity Disorder (DID)
Multiple personality is the most characteristic mental condition resulting from intrafamilial rape and other forms of extreme abuse in childhood. If you hear voices inside your head or do not remember how you got from home to work, you probably have MPD. This condition is very common, but very little known and understood by therapists. If your therapist diagnoses you as a "multiple" (person with MPD), you can consider yourself lucky. The doctor probably knows her job and can help you heal. Most multiples are misdiagnosed and treated for all kinds of exotic illnesses that are only construed in the minds of highly educated but poorly qualified psychiatrists.
This is a special condition of MPD, when the affected person has only two personalities. This simple condition almost never exists in real life. People with MPD have many more than two personalities.
No one can explain this disorder. Doctors usually list a set of symptoms that may or may not appear in the patient. In general, these vague signs are caused by a combination of several dissociative mechanisms.
Borderline Personality Disorder (BPD)
This is another dissociative disorder with vague definitions and unclear symptoms.
Attention Deficit and Hyperactivity Disorder (ADHD)
If you do not fit in the above categories, doctors may put you in this one. Also this illness is a dissociative disorder. Part of it is attributable to multiple personality and part is caused by other dissociative modes.
Posttraumatic Stress Disorder (PTSD)
PTSD means that a person suffers from many symptoms that are associated with a traumatic experience. The manifestations include nightmares, disrupted sleep, depression, exaggerated responses to sensory stimuli, panic attacks, phobias, daytime drowsiness and mental states between consciousness and sleep. The diagnosis of PTSD does not mean that the therapist acknowledges that you are a victim of childhood sexual abuse. Some professionals correctly recognize the patient's specific complaints, but are unable to arrive at the correct diagnosis: long-term consequences of childhood sexual abuse. The expression "childhood sexual abuse" is nowhere in the doctor's written opinion despite his correct assessment of the individual symptoms and behavioral manifestations.
This illness results from dissociation that produces severe neural damage. The subject may succumb to uncontrolled emotions, may have sensations and somatic experiences that have no obvious medical cause, or may be incapacitated on one side of the body. Medication or simple relaxation can calm down the undesirable effects, and the subject can return to normal functioning thereafter.
This is serious; you have not reached the normal level of mental development. The problem is not your education, but the structure of your brain. To protect itself against abuse, your subconscious mind reacted in ways that resulted in this condition. Do not blame yourself or the child inside you. There was nothing the child or you could have done.
Autism or Asperger's Syndrome
This is similar to mental retardation. The mental development of the abused child became affected in negative ways, and higher mental functions failed to materialize. The autistic state can be general and permanent, or may only show when a specific personality has control over the body.
This dissociative disorder involves MPD and complex modes of dissociation. The syndrome only acknowledges some of the obvious symptoms and ignores many others.
Schizophrenia could be caused by childhood sexual abuse, but this scenario is only hypothetical. Some incest patients may exhibit symptoms that are seen in true schizophrenics, and some clinicians incorrectly diagnose the patients with schizophrenia. This scenario is common. See the page Multiple Personality for detailed information. Most cases of true schizophrenia seem to be caused by medical, industrial, and agricultural chemicals.
You do not have to accept the diagnosis. If they put a label on you, educate yourself about the illness you allegedly have. The internet is an excellent resource. If you are positive that your therapist is not too bright, find a new one.
THE DAMAGE DONE
Sexual abuse in childhood leaves major imprint on the child. Some of the worst damage happens to the brain and its functions. The damage typically leads to mental and psychosomatic illnesses, or to behaviors that cause secondary harm to the victim. She grows up with the damage and fails to notice that her functioning, thinking, and behavior are abnormal. The people around her, who are also victims of intrafamilial sexual abuse, show the same kinds of behaviors, and the consequences of childhood traumas remain unrecognized. Below are the typical consequences of child sexual abuse.
RELATIONSHIP WITH YOURSELF
One common problem of incest victims, especially those with pronounced dissociative disorders, is an inability to correctly perceive oneself as a human being. A healthy person consists of the physical body, prime needs, emotions, and reason. Fragmentation of the mind in response to abuse creates variety of personalities and related cognitive entities that lack some or most of the mentioned ingredients of a whole person. Therapists unfamiliar with dissociative disorders often conclude that the patient does not love herself and has a low opinion of herself. This conclusion often masks the fact that the blamed personality may have no understanding that her body is part of her. She may believe that she can exist without the body and does not need to care for the body. By contrast, some personality may be unable to love her boyfriend or husband. This problem is caused by major loss of emotional intelligence. The personality has no idea what emotion, love, or caring is. These deficits are only treatable by allowing the fragmented or damaged personalities to merge with the rest of the brain. Education or simulation of the appropriate responses cannot heal the subject. The goal should always be restoration of the lost, isolated or inaccessible parts of the brain.
WHEN WILL I GET BETTER?
Have realistic expectations. Childhood sexual abuse leaves behind permanents scars, no matter how much treatment you get. You cannot totally erase the impact of your traumatic childhood, but you can mitigate the effects. You may go from day-to-day survival to inner peace and enjoyment of life. Do not expect to reach your full theoretical potential you would have achieved without being abused, but strive for it. It should be your goal in therapy. The word goal does not stand for your performance or social status, but your happiness. Look at your treatment philosophically and adjust your goal accordingly. Consider how much time it takes to get burned and how much time it takes to heal the wound. The ratio is not encouraging. Now think about the many times you were raped and the many years of your abuse. Healing from sexual abuse is a lifelong process. You will be getting better, but some unrelated issue may throw you off course from time to time. These things happen and may affect your therapy. Expect ups and downs with an overall upward trend.
Therapy for sexual abuse usually lasts between three and ten years. Five years is considered average. Frankly, healing within three years is unrealistic. Nobody can completely heal in such a short time, but something nice often happens at about this time. You may recognize that the worst is over and that you are progressively getting better. It will take another two or three years before you return to normal living. You will still think about your abuse, but only a few times a year and only very briefly.
The described scenario applies to a good outcome. The majority of therapists healing sexual abuse will acknowledge that something traumatic happened to you and will try to negotiate your overwhelming experiences. Sadly, very few therapists will be able to recognize that you have a whole set of dissociative disorders. You may never be treated for these problems and may leave therapy superficially healed in a few years. For example, one prominent therapist who treated several dozen victims of childhood sexual abuse claimed that none of her patients had multiple personalities. In view of the high prevalence of multiple personality among incest victims, the assertion contradicts statistics. Multiple personality will add a few years to the length of treatment. Patients with MPD should expect to be in therapy six to eight years on the average.
Even if you get the best psychotherapist who knows everything about the consequences of childhood rape, there is no guarantee that your treatment will be a success. Many people are so mentally damaged or so afraid to uncover their pasts that they leave therapy and never heal. Others flatly deny that they were abused and refuse to talk about child sexual abuse. The behaviors are indicative of the difficulties treatment has to overcome.
One of the problems patients face is the pain of their memories. This is why they dissociated from their abuse as it was happening. By digging out the past, you will not get better, but worse. And do not fool yourself by thinking that you are more mature now and able to face the childhood pain. You will re-experience the trauma from the perspective of the vulnerable child, and not from the perspective of an adult that you are now. You will feel just as vulnerable today. The difference will be that somebody (the therapist) will acknowledge your worries, explain them, and give you support and guidance. Only after you recall the most painful details and process them in full consciousness, will you be free. Your nightmares will disappear, and you will think in healthy ways. You will start enjoying life, instead of overworking yourself to death. Your improvement will be gradual, and you will become more sensitive. It will seem to you that the previous memories caused you less pain. This is so because you will have re-connected with your emotions.
The most dangerous, shameful, and demeaning memories are usually the last ones patients recall (when the patient is more sensitive), and the details of the traumatic events continue emerging for months and years. Get ready for a roller-coaster ride over the next few years. You will re-experience the trauma over and over. You will remember something new during every encounter with the past. Your fear will eventually wane to the point that the scenes will become unimportant and you will stop thinking about them. This is what your healing from sexual abuse will be like.
It is essential that you properly understand the meaning of the word "healing." Healing from sexual abuse is a process that has no clear beginning and end. You may think that the years of your healing are lost years, and once you are healed, your life will be wonderful. You are willing to sacrifice those "X" number of years of your life to get well. Then you will be fine. This approach reflects your religious mentality: Suffer now, and you will have a wonderful life when you die. You will go to heaven.
Suffering and healing are part of life, but suffering should not become your goal. Life is a constant struggle, even when things are going well. During healing from childhood sexual abuse, you will have many sad and frantic moments. But do not forget to live. Enjoy the maximum benefits of the bad times as much as you possibly can. You live today. When you die, that is it. Do not make your life unnecessarily miserable in the hope that your suffering on earth will increase your rewards in heaven. You exist only once. Then you turn into dust.
But Reverend Thingummy said ... I don't know what to believe.
Well, Reverend Thingummy would benefit from extensive psychotherapy. Belief in the existence of the supernatural, miracles, heaven, life after death, or reincarnation is caused by childhood sexual abuse and dissociation. Such baseless ideas are produced by a malfunctioning brain. Incidentally, the staunchest proponents of the supernatural have numerous signs of sexual abuse.
WHAT IF MY CHILDREN ARE ABUSED?
Honey, Good Luck. Dealing with your own abuse is a big burden, but learning that your children have been violated by either you or other close person is probably devastating. Given the prevalence of intrafamilial sexual abuse, the possibility that your children have been abused sexually is very high. If you find out that they were abused, you will need strong moral support and will need to set your priorities. You will have to choose what you value more. Do you want to stay with a husband who abuses both you and the kids, or do you put him in jail? Many women in your situation stay with their abusive partners. The women are so damaged that they prefer misery to a good life. The reasons why they stay make no difference. The victims embrace abuse and are unfit to protect themselves or others.
There can be little consolation in your situation, but when you deal with your own abuse and hit the rock bottom, you will not sink any deeper when you also learn about the abuse of your children. The real problem is that you will be overwhelmed and unable to protect them. And that is serious. If you do not save them, who will?
You will have to deal with the perpetrator. Do not let him walk free. He will abuse someone else, and it will be partly your fault. By forgiving crimes, we will never stop intrafamilial abusers. Do your best to punish him, but do not take the law into your own hands. The existing U.S. legal system often protects rapists and almost always severely punishes victims who harm or kill their abusers. Do not get locked up in jail. Your children need you. If you want to do something about sexual abuse, educate yourself by reading other pages on this website so that you know what you are up against.
You will also have to deal with your children. They will need therapy and a strong mom. A close friend can help you with child care. You will have other problems to take care of. You will be hurting, yet you will have to work and earn money. You will be far from considering any social involvement, but it is important that you find other survivors in your situation and learn about the available resources and ways of coping with problems.
Best of Luck.
The internet is a free and important resource. It will help you find a therapist and give you information about organizations that deal with sexual abuse. In addition to the internet, it is a good idea to educate yourself by reading books. Several titles are listed below.
Be careful when choosing the sequence of your reading. Many sexually abused women believe that their main problem is sexual performance and start their education from that angle. In reality, sex is the last thing that should be on your agenda. Taking a break from sex for several weeks or months is not only beneficial, but may become necessary. First you need to recover from your abuse, then you need to establish a caring relationship with yourself, and only then should you consider working on your social, intimate, and sexual relationships with other people.
The Courage to Heal
by Ellen Bass and Laura Davis ISBN 0-06-095066-8
This is an excellent book for women recovering from child sexual abuse. The book is suitable for lay people who look for practical approaches to their problems. The book includes numerous personal stories and examples from the daily lives of adult survivors. Price: about $22.50.
by E. Sue Blume ISBN 0-345-36979-3
This is probably the most comprehensive book about the signs and consequences of intrafamilial sexual abuse. A big portion is dedicated to seeking help and healing. The book is written for the general public. Price: about $6.00.
by Renee Fredrickson ISBN 0-671-76716-X
A great, practically oriented book for the general public. The book discusses the nature of repression, gives examples, and offers guidelines for memory recovery and overall resolution of sexual traumas. Price: about $10.00.
The Sexual Healing Journey
by Wendy Maltz ISBN 0-06-092155-2
A great book dedicated to the transition from the psychological consequences of sexual abuse to a healthy sex life. Written for the general public. Price: about 13.00.
Women who Love too Much
by Robin Norwood ISBN 0-671-73341-9
This very popular book is about women from harmful families of origin. Many practical examples depict the mentality of such women. The book includes a section about recovery. Price: about $7.00.
by Dr. Susan Forward with Craig Buck ISBN 0-553-28434-7
This book shows how trauma and harmful family environment during childhood affect the lives of adults. Almost half the book is about healing. Price: about $6.50.
Men who Hate Women/The Women who Love them
by Dr. Susan Forward with Joan Tores ISBN 0-553-28037-6
This book reveals why abused women are attracted to abusive partners. One section of the book covers healing. Price: about $6.00.
The quoted prices are years old. Current prices could be 50% higher. The publications can be obtained at most bookstores nationwide. Search amazon.com to find out if the books are currently available. This website has no association with the authors, publishers, or booksellers. The books are mentioned solely because of their perceived merit. Naturally, many new books have been written in recent years and may be better than the listed ones.
 Who Practices Psychotherapy. Retrieved April 30, 2008 from https://www.cybershrink.org/who.html
 Social Work. What You Should Know About Licensed Social Workers and Their Services. Retrieved April 30, 2008 from http://www.op.nysed.gov/socwkb.htm
 Nigel Bunyan. October 3, 2001. Gynaecologist 'raped me in hypnosis and fathered my child'
 The Dangers of The Psychiatrist's Couch. http://www.psych-crimes.com/dangers.htm
 Psychiatrist jailed over patient rape. December 10, 2002.
 Psychiatrist guilty of raping patient. December 12, 2003.
 Sentencing Date to be fixed in Psychiatric Sexual Assault case.
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