Common Symptoms Experienced by Adult Survivors of Child Sexual Abuse
Childhood sexual abuse can have long-lasting debilitating effects throughout the life of a survivor. The impacts of sexual trauma are profound and far-reaching, affecting every aspect of an individual's life—physically, psychologically, cognitively, and socially. But why is this so?
Why Trauma Survivors Experience Lasting Symptoms
Trauma is said to be something experienced with our whole selves. In The Body Keeps the Score, Dr. Bessel van der Kolk states, “We have learned that trauma is not just an event that took place sometime in the past; it is also the imprint left by that experience on the mind, brain, and body. This imprint has ongoing consequences for how the human organism manages to survive in the present.”
During the formative years, children begin to establish a sense of self and identity by interpreting their experiences, making conclusions about their self-worth, and then construct a narrative about the world from those experiences. As the brain continues to develop into adulthood, those core belief systems create structural changes in the brain through the formation of neuropathways and become the foundation to how they see themselves, form relationships, and react to situations.
For example, when a child is raised in a supportive and nurturing environment with clear boundaries, consistent routines, and respectful communication, they can interpret the world as being safe, establish trusting interdependent connections, and tend to be flexible with their expectations. They may also form healthy core beliefs, such as: “I am ___” (e.g., capable, smart, strong, lovable, etc.). Unfortunately, sexual abuse can misconstrue how the child sees themselves, view the world, and relate with others. When sexual trauma is experienced, the child may then make conclusions that “I can’t trust anyone,” “it’s my fault,” “I am ___” (e.g., bad, worthless, dirty, unlovable, a burden, damaged, powerless, weak, a failure, inadequate, etc.).
When these destructive conclusions become the child’s misperceived reality, all future experiences get filtered through this belief system, which may then lead the individual to feel sad, anxious, ashamed, fearful, confused, and lonely. Sometimes, in an attempt to manage these uncomfortable emotions, an individual attempts to cope by engaging in unhealthy behaviors (e.g., substance use, risky sexual behavior, disassociation, emotional numbing, self-harm, sleeping too much, eating disorders, etc.). When an individual uses these maladaptive coping behaviors to deal with triggering situations and distressing emotions, neuropathways are again strengthened.
What Wires Together, Fires Together
Trauma Response in the Brain & Body
Many victims of sexual abuse experience biological responses that are considered normal in an effort to cope with an abnormal situation. The limbic system, which acts like a command center, is a complex set of structures within the brain that is responsible for the fight-or-flight stress response. When the limbic system is activated, the adrenal and pituitary glands rapidly release stress hormones, such as cortisol, adrenaline, and norepinephrine, which start a chain of physiological responses in the sympathetic nervous system that aid in survival.
When experiences are interpreted as dangerous, the brain and body gear up for survival to either fight or flee from the situation. The brain sends a signal to release stress hormones into the bloodstream. The body responds by dilating pupils to improve eyesight, airways open, heart rate increases, and oxygen-rich blood is diverted from the digestive system and redirected to the muscles. When the threat is alleviated and the danger has passed, the parasympathetic nervous system, which acts as the rest-and-digest response, helps to regulate bodily functions. Muscles relax, heart rate slows, pupils constrict, blood pressure lowers, and energy conservation resumes.
When someone endures abuse and neuropathways are reinforced by negative core beliefs, the limbic system responses can become compounded and may result in a myriad of longer-term symptoms that impair everyday functioning. Repeated activation of the stress response can have an increasingly negative effect on the body. Chronically high levels of stress hormones may lead to long-term physical ailments, including immunosuppression, kidney damage, intestinal problems, headaches, hyperglycemia, weight gain, insomnia, irritability, depression, anxiety, and hypertension, which increases the risk of heart attacks and/or strokes.
Adverse Childhood Experiences Study
In 1995, Kaiser Permanente and the Center for Disease Control and Prevention conducted a longitudinal study using 17,337 participants to measure the effects of 10 adverse childhood experiences, referred to as ACEs, (e.g., emotional abuse, physical abuse, sexual abuse, mother treated violently, household substance abuse, household mental illness, parental separation/divorce, incarcerated household member, emotional neglect, and physical neglect). This monumental study concluded that the higher the score, the more at risk a person is for developing heart disease, cancer, diabetes, alcoholism, engaging in illicit drug use, experiencing financial stress, depression, suicide attempts, unintended pregnancy, sexual violence, poor academic achievement, and premature death.
The study found that 64% of adults in the United States reported they had experienced one type of ACE, and 17.3% of adults reported they had experienced four or more types of ACEs. Seeing how prevalent ACEs are, combined with the associated physical and psychological effects, it has been estimated that ACEs-related health consequences carry an estimated economic burden of $748 billion annually.
Common Symptoms of Trauma
While every survivor's journey is unique, there are common symptoms and challenges that many may face as they navigate their path to healing, which can include:
Physical
- Chronic Pain: Backaches, neck and shoulder tension, headaches, joints, nerves, gastrointestinal issues, etc.
- Sleep: Insomnia, hypersomnia, nightmares, parasomnia, paralysis, etc.
- Miscellaneous: Fatigue, shallow breath/hyperventilating, dry mouth, nausea, vomiting, heart palpitations, shaking, sweating, hypervigilance, jumpy, restlessness/fidgeting, etc.
Psychological
- Addiction: Illegal drugs, prescription medication, alcohol, smoking, vaping, etc.
- Avoidance: situations, places, and people that remind of the trauma, eye contact, procrastination, lack of motivation, indecisiveness, emotional expression, intimacy, relationships, etc.
- Dissociation: Flashbacks, emotional numbing, flat affect, and disconnect from thoughts, feelings, memories, or reality, etc.
- Low Self-Esteem: Struggle with feelings of guilt, shame, self-worth, overly critical of oneself, self-blame, feeling fundamentally flawed, negative self-perception, a belief that they are never good enough, perfectionistic, etc.
- Mood: Dysregulated & intense emotions, easily overwhelmed & overstimulated, suicidal ideation, paranoia, anxiety, depression, panic attacks, rage, despair, helplessness, hopelessness, irritability, etc.
- Unsustainable Coping: Disordered eating, substance abuse, risky sexual behavior, pornography, self-harm, neglecting medical needs, aggression, impulsive reactions, over-compliance, gambling, uncontrolled shopping, compulsive exercise, excessive use of social media & video games, etc.
Cognitive
- Concentration: Difficulty making decisions, delay in processing information, impairments with focus, ruminating or intrusive thoughts, overthinking, dwelling, obsessing, etc.
- Executive Functioning: Difficulty with planning, organizing, time management, coordination, self-control, problem-solving, and decision-making.
- Memory: Challenges with encoding, recognition, retention, and recall.
Social
- Communication: Evading deep topics, unexpressed needs, verbalizing boundaries, arguments, passive/aggressive, blaming, circumventing confrontation, defensiveness, interrupting, etc.
- Intimacy: Avoiding physical touch, heightened sense of vulnerability, feeling unsafe, challenges with establishing and maintaining boundaries, fear of abandonment, inability to form deep connections, difficulty forming relationships, unhealthy attachments, etc.
- Isolation: Withdrawing from social interactions and activities, which leads to feelings of loneliness, inability to reach out for support or ask for help, not leaving the house, etc.
- Relationships: Dysfunctional relationships with family, friends, and romantic partners, being overly controlling, codependency, unrealistic expectations, inability to trust, etc.
Coping & Managing Trauma Symptoms
While all of the aforementioned explains ‘why’ common long-term symptoms occur after childhood sexual abuse and outlines ‘what’ these common debilitating symptoms are, it can leave one feeling both overwhelmed and/or reassured. It is normal to feel either or both emotions simultaneously. Reassurance may come with the insight that, “I am not crazy, and my emotions are not crazy, but what happened to me was crazy” and the realization that “there’s a reason why I feel/act this way.” Rest assured that the healing journey doesn’t have to end there.
Dr. Dan Siegel, clinical professor of psychiatry at the UCLA School of Medicine, coined the phrase, ‘name it to tame it’ where he explains that the more you notice and identify your emotions and body sensations, the easier they are to manage. Ideally, discerning the ‘what’ and ‘why’ of these symptoms will aid survivors in reducing shame by fostering self-compassion and an understanding of thoughts, emotions, and bodily reactions to the endured trauma while also increasing their ability to effectively cope when triggered. Survivors can learn how to respond rather than react to triggers through intentional behavior shifts by repeatedly practicing grounding techniques and healthy coping strategies. By doing so, the structures of their brain can adapt, grow and change through the process of neuroplasticity that ultimately make these changes easier to maintain.
Among these initial steps toward recovery is to acknowledge that the abuse happened and the impact it had on one’s life. Acknowledgement is a healing practice that involves looking at the past and present with clarity and showing yourself compassion for where you’ve been and where you are now. A second healing practice is becoming more mindful. Mindfulness is purposefully paying attention with kindness and curiosity to the present moment. Lastly, one of the final steps toward reclaiming hope is to identify an aspirational goal toward well-being. Aspiration is a healing practice that involves directing your thoughts and actions toward healing. This past, present, and future approach encompasses a holistic framework for trauma healing.
Despite survivors experiencing many complex symptoms, it is essential to recognize that healing is possible. While sexual trauma is not your fault, healing is your responsibility. Many individuals have embarked on the journey of healing, diligently doing the work and finding their way to a place of thriving. Their stories serve as beacons of hope, reminding us that despite the darkness of the past, there is light ahead. Remember, healing is not linear; it's okay and normal to have setbacks along the way. Keep moving forward, one step at a time, and trust that brighter days lie ahead. By embracing patience throughout the journey, seeking support, allowing yourself to feel, and nurturing self-compassion, healing becomes a possibility and a tangible reality. Take care of yourself, honor your journey, and believe in the power of resilience to transform pain into strength. Together, we can create a future where victims of abuse not only survive but thrive.
Saprea's Healing Resources
At Saprea, we are dedicated to educating others about the impact of child sexual abuse, promoting healthier behavior patterns, addressing maladaptive survival responses. Leveraging the latest research, we offer a wide array of resources designed for survivors and their support networks.
Saprea Healing Webinar
Saprea administers a free 4.5 hour interactive and educational healing webinar designed to help adult female survivors jumpstart their healing from home. The webinar is led by a clinical therapist who specializes in trauma recovery, along with a co-facilitator. Survivors will have the opportunity to participate in classes, engage in group discussions, mindfully connect with their body, and build a community with fellow survivors.
Saprea Retreat
Saprea provides a free four-day retreat in Utah for adult women survivors of childhood sexual abuse that is clinically informed and led by a team of licensed therapists and case managers. The retreat teaches survivors about the impacts of trauma, provides opportunities to apply healing tools, and builds a community of support. Afterwards, participants are invited to continue their learning in subsequent online courses that builds a deeper understanding and application of healing principles.
Saprea Support Groups
Saprea offers in-person and virtual survivor-led support groups with individuals that have shared experiences and motivation to build a community of emotional safety, understanding, and a desire for growth. Facilitators receive training to lead these research -backed and clinically informed groups in a confidential and nurturing environment wherein survivors can connect with one another, provide validation, empathy, and solidarity in the healing journey.
In addition to healing services for adult women survivors of childhood sexual abuse, Saprea provides education for prevention of abuse and works to increase the public’s awareness of the issue. Learn more about Saprea, a 501(c)(3) nonprofit, and what you can do to get involved.
About the Author
Rachel Gardner, L.C.S.W.
CLINICAL THERAPIST
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