Sexual Abuse Definition, Signs, and Treatment

When we take time to consider ourselves and realize we are holistic beings, made up of body, mind, soul (emotions), and spirit, it might seem odd at first that discussions around one of our most essential bodily functions – sex – are often fraught with such a high level of discomfort. Sexuality goes to the core of our being, intersecting with all of those parts listed above, so there is no getting around the deeply personal nature of the subject.

On top of that, add whatever shame narratives parents, pastors, teachers, and other people in our lives have inflicted on us, and the discomfort begins to make sense. When our unprocessed sexual narratives include components of abuse, however, there will almost always be significant shame attached.

A Couple of Definitions

Because of the conflicting emotions often present in sexual abuse, i.e. shame and arousal side by side, in varying degrees, as a result of the contact, people who have been victimized may go for years without fully identifying their victimization as abuse. Our bodies are programmed to enjoy physical touch, which means a conflict is set up inside when the touch is inappropriate.

Sexual Abuse Definition

For the purpose of this article, let’s start with Merriam-Webster’s online legal sexual abuse definition:

• the infliction of sexual contact upon a person by forcible compulsion
• the engaging in sexual contact with a person who is below a specified age or who is incapable of giving consent because of age or mental or physical incapacity

One of my professors in grad school gave this sexual abuse definition: “Whenever a child or adolescent is used by an older or more knowledgeable other for sexual pleasure. When power (including age, position, sophistication) is used you can have abuse that is age inverted—for example, a 13-year-old abusing a 14-year-old, because of the power dynamic where he might corner her, disempower her, threaten her future so she feels there is no recourse for her but to submit.”

Potential Signs of Sexual Abuse – Children and Adolescents

If you have a relationship with a young person and are suspicious that they may be a victim of sexual abuse, there are some potential signs you can look for. These are only potential signs. If you see enough to cause you concern, be very careful about how you escalate awareness of the situation.

There is a narrow path to walk between speaking up about what you believe are valid signs of sexual abuse and making wrongful allegations based on incorrect assumptions. Reputations, marriages, and livelihoods are so easily destroyed by such allegations, so it is best to move cautiously.

Having said that, here are some potential signs of sexual abuse (from the www.rainn.org website):

Physical signs:

• Bleeding, bruises, or swelling in the genital area
• Bloody, torn, or stained underclothes
• Difficulty walking or sitting
• Frequent urinary or yeast infections
• Pain, itching, or burning in the genital area

Behavioral signs:

• Changes in hygiene, such as refusing to bathe or bathing excessively
• Develops phobias
• Exhibits signs of depression or post-traumatic stress disorder
• Expresses suicidal thoughts, especially in adolescents
• Has trouble in school, such as absences or drops in grades
• Inappropriate sexual knowledge or behaviors
• Nightmares or bed-wetting
• Overly protective and concerned for siblings, or assumes a caretaker role
• Returns to regressive behaviors, such as thumb sucking
• Runs away from home or school
• Self-harms
• Shrinks away or seems threatened by physical contact
• Falling grades or substance use (teens)

If you see enough signs to cause concern and have a relationship with the person that would make checking in appropriate, see how they respond to a light how-are-you-doing kind of inquiry. If you are in a position of direct responsibility (parent, guardian) and the person is non-responsive, think about arranging for them to talk to an age-appropriate counselor (see treatment below).

If you are not in a position of direct responsibility, see if you can find a stable friend/advisor who will keep your conversation confidential, and try running your impressions by them. If you want to talk to someone anonymously, you can call the National Child Abuse Hotline at 1-800-422-4453 (1-800-4-A-CHILD) 24/7.

Treatment for Sexual Abuse

If you are a parent of a child and you suspect they have suffered sexual abuse, remember one of three things is possible, especially as regards behavioral signs. 1) the signs are caused by some other traumatic influence in their life, 2) the signs are a response to some internal emotional disturbance, and 3) the signs indicate some kind of abuse is happening, possibly sexual.

Most children are impressionable and we can traumatize (or re-traumatize) them if we grill them for answers about something they are barely able to think about themselves. The younger they are, the less they will be able to process it. The neocortex (the thinking part) of the brain continues to develop up to about age 24, so they literally do not have the brain to think about it in the early stages of development.

Be circumspect in your conversation. Higher level questions are better. For example, “Did someone do something that made you sad or scared?” as opposed to, “Did someone touch you in a way that made you uncomfortable?” If the conversation ends with the child corroborating your concerns:

Establish Safety

Take (or if it is not your child, inform and encourage the parents to take) whatever steps are necessary to separate the child from the perpetrator to prevent further victimization. If the perpetrator is an immediate family member, it will probably get ugly before it gets better, but the important consideration is the safety of the child.

You are not required by law to report the perpetrator, but depending on your circumstances, it is encouraged that you do so to prevent others from being victimized. Understand though, that once the authorities are involved, consequences could include jail time, and legal fees, and destroyed relationships and livelihoods. You have to decide how to proceed based on your particular circumstances, but be careful who you talk to and how you talk to them.

Find a Counselor

There are counselors who specialize in working with sexually abused children. Ideally, this is the kind of counselor you want for your child. You can search online for “counseling practices” and call one for a referral, or go to the psychologytoday.com website and type your zip code in the Find-a-therapist field.

Click on “Child or Adolescent” on the left side menu. A list of therapists in your area who work with children or adolescents should come up. Click on them to read their approach, then call one who looks promising and ask if they work with children who have been sexually abused.

Be Patient and Firm

Children need to know they are loved and know they are boundaried. Most are vulnerable and sensitive, and many are brilliant manipulators who know how to play on our heartstrings to manipulate us. When they have been injured, especially in such a shaming way, it is easy to go overboard to try and “make it okay” for them by not enforcing normal household rules.

Read the room. Make the best assessment you can about your child’s emotional state, and calmly apply as much structure as seems appropriate. The more that you can keep the home environment status quo, the more quickly they are likely to normalize their experience and move forward. Stopping all functions and treating them like an invalid will likely have the opposite effect.

What Can I Expect from Treatment?

First and foremost, be patient. Children under the age of thirteen are likely to encounter a therapist who is kind, gentle, and knows how to move carefully through stories of trauma. Moving too quickly through a painful narrative can be re-traumatizing for the victim.

Depending on the personality of the child and the severity of the impact of the experiences, therapy might take weeks, months or years. Some therapists will wait patiently for the child to bring it up themselves, playing with toys or coloring in coloring books. When the child is willing to bring it up spontaneously is usually the point at which they are ready to begin to move through it.

Let the therapist be the arbiter of what content to share with you from the session, if any. As a parent, you will be curious about how things are going. You may even want a minute-by-minute report of what transpired. This level of detail is unlikely to be helpful. Fixating on the minutiae is a recipe for micromanaging yourself or your child, trying once again to fix it for them.

The more you can trust the process and allow your child to heal at his or her own pace, the better the chances for a positive outcome. Most therapists will give you some idea of how things are going, and if there is anything that would be helpful coming from you or changes to the home environment, they will let you know.

If you or someone close to you is an adult child of sexual abuse, depending on how much emotional work you have done, this process could be very triggering. If you have unprocessed emotional trauma, it may come to the surface in unexpected ways. Be curious and kind to yourself about what is coming up for you in the way of thoughts and feelings.

You may be surprised by it, but you don’t have to let it drive the bus. If you find yourself emotionally unsettled as you move through it, it’s a good idea to find a counselor for yourself, if you don’t already have one. A counselor can help you get some separation between your experience and your child’s experience.

When we have significant unprocessed trauma narratives in our life, like a soldier with PTSD, we may find that when those places get triggered, we suddenly feel panic or anger, or like we are 6-years-old. This is not the secure, functional adult position from which we want to be supporting our child.

If seeing a counselor is something you have been meaning to do, but keep putting off, the stress of parenting your child through this process could push you toward a tipping point. Anxiety is a monster that grows larger when we feed it with avoidance. Better to admit we need help and take the steps to get it sooner rather than later when it’s become a necessity.

Normalizing Our Experience

Because of the deep shame associated with sexual abuse, if we don’t remain vigilant it is easy to slip into making value judgments. Depending on our own shame narratives around sex, we might find ourselves unintentionally looking at our child with revulsion, or pity, or suspicion, as if they somehow played a part in causing it.

Understanding the fact that people who sexually abuse others are emotionally damaged, that shame in the face of helplessness is normal and can be alleviated, that any sense of being at fault for the abuse (by the one victimized) is a falsehood and not to be entertained, and that no one can take any action against me that says a single thing about my value as an amazing, unique reflection of the image of God on the Earth, is the beginning of healing.

If you attend a meeting for victims of abuse, you may hear them say, “I was victimized, but I am not a victim.” If I believe I am a victim, I believe I am helpless. If I believe I am a victim, I believe it is unsafe to move forward. If I believe I am a victim, I believe people or the world owes me for my suffering.

If we take the attitude that I was victimized but it does not define me, it means I have power and choices. I can take preventive measures, steps toward my own healing, look for paths that will lead toward growth, and be hopeful for the future. This is the path on which we embark when we begin to seek help with a counselor.

By having the patience to move step by step through the process, we have the opportunity to commit to a way of life that welcomes change and newness every morning, until the dark memories of the past cease to have any controlling impact on the present.