Child sexual abuse affects a child’s identity, role, coping strategies, ability to learn, ability to trust, and sense of safety and security both as a child and sometimes for the rest of life. (See Short Term Effects and Long Term Consequences.) Because sexual abuse is so invasive and impactful, the sense of self is radically altered. A child has not developed the ability to assign blame or responsibility for behaviors of others, and therefore, when bad things happen, tends to hold himself responsible. A pervasive sense of guilt and shame develops, and because children are not apt to talk about sexual abuse for years, this entire process is internal. No one is aware of the child's burden of responsibility, guilt, and shame.
Child abuse victims go through a grief process and experience shock, denial, anger, guilt, anxiety, and depression. They have nightmares, act out, develop somatic complaints, begin to look for ways to relieve the pain, and, as adolescents, tend to use drugs and alcohol more than others, and run away, get involved in prostitution, and be involved in destructive relationships more often. They are angry at their offender and they are angry at their mother, who they believe did not protect them. If the perpetrator is their father or step-father, they struggle with ambivalence along with hurt and anger. As adults, victims tend to get involved in relationships with individuals who will abuse their children.
Children who have experienced sexual abuse will experience grief reactions caused by trauma and multiple losses in their lives. Counseling will help them process emotions, recover from trauma, and address ways that the sexual abuse affected thought processes and beliefs. Many complexities are involved in sexual abuse, including betrayal bonds with the offender, Stockholm syndrome (also related to loyalty to the offender), the victim's feelings towards the mother, learned helplessness, attachment disorder, and other mental health disorders that may occur as a consequence of the sexual abuse.
All children are vulnerable to sexual abuse due to their size and lack of maturity. Sexual abuse and incest occur in all races, countries, cultures, and religions. See statistics. Once a child has been sexually abused, she is at higher risk of being abused again, either by the same abuser or another. Children who experience sexual abuse usually demonstrate warning signs that can alert caregivers. When mothers do not pick up these warning signs, victims feel betrayed and angry.
Sexual abuse is a traumatic event and sometimes results in posttraumatic stress disorder (PTSD). The sexual abuse and trauma symptoms are sometimes misdiagnosed as Attention Deficit Hyperactivity Disorder (ADHD) and Bi-Polar disorder. If the child has not disclosed the abuse, adults are not aware of the trauma and its consequences. The entire world view of the child is altered by sexual abuse. Many of the effects of sexual abuse and symptoms of PTSD are markers that alert mothers to the possibility of sexual abuse. Some of these are depression, dependency, mistrust, hostility, vulnerability, anxiety, fear, self-blame, guilt, low self-esteem, nightmares, phobias, somatic complaints, lack of emotionality, learning problems, running away from home, aggression, and mimicking the sexual behavior and abusing others.
Victims feel helpless and powerless and need their mothers to listen, understand, support, and love them through the healing process. If the mother is not there, the chance of healing is minimized, and the probability of long term consequences is maximized. Although the word survivor is the preferred term, many victims never achieve survivor status, and many have never told anyone about the abuse. Many continue to anesthetize the pain with a variety of substance and process addictions. Others remain cut off from genuine intimacy because of their inability to trust and form healthy adult relationships.
Siblings of sexual abuse victims are considered secondary victims as their lives are impacted by the experience of the victim. It is also possible that, if the offender is a family member or is known by the sibling, he has also experienced sexual abuse but has not disclosed. Mothers and other family members may also be considered secondary victims due to the negative life impact and ongoing residual effects of a child's sexual abuse.