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Sexual Abuse

Reviewed by Psychology Today Staff

Sexual abuse is any sexual activity that occurs without consent. Also referred to as sexual assault or sexual violence, it includes unwanted sexual touching, forced oral sex, and rape, among other sexual acts. No matter which act occurs, it’s not the survivor’s fault that they were assaulted—and help is available to begin healing from such abuse.

Understanding Sexual Abuse

Sexual violence is a pervasive problem. The abuse can lead to shock, fear, sadness, and in some cases, an anxiety or depressive disorder. But therapy, coping skills, and social support can relieve the burden and help survivors heal.

Personal, societal, and legal hurdles often prevent survivors from disclosing the abuse and receiving the help they deserve. Although the #MeToo movement and the national discussion that ensued helped to address sexual harassment and assault, there’s still a long way to go to create cultural change and stop sexual violence.

How common is sexual abuse?

Sexual violence is a pervasive problem. In America, one in three women and one in four men experience sexual violence in their lifetimes, according to the National Institutes of Health. And those numbers are likely an underestimate due to the shame and fear that prevent many survivors from reporting abuse.

What are the psychological consequences of sexual abuse?

Sexual abuse can be traumatic. In the two weeks following an assault, 94 percent of women in one study reported experiencing symptoms of post-traumatic stress disorder such as flashbacks, insomnia, hypervigilance, and avoidance. They also struggled with anger, anxiety, and depression. Yet up to 90 percent of survivors may recover naturally with time, research suggests. Mental health professionals are always available to help process this painful experience.

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Healing from Sexual Abuse

Survivors of sexual violence may experience physical injuries due to the assault, as well as anxiety, depression, and post-traumatic stress disorder. This can harm one’s health, career, and relationships.

Therapy can often effectively address the trauma of sexual abuse. Survivors learn how to identify and understand their emotions, process their memories, develop coping skills, apply stress-management strategies, and restore their confidence.

To find a therapist with experience treating sexual abuse or trauma, visit the Psychology Today Therapy Directory.

How do you leave a sexually abusive relationship?

Although it can take a long time and multiple attempts, most people eventually leave abusive relationships. To make this decision, women have reported that it was crucial to 1) Confront reality and recognize that the abuse will not end 2) Release feelings of self-blame to reclaim self-esteem 3) Accept support and perspective from loved ones or a mental health professional 4) Reach a transition point with regard to feeling personally overwhelmed or consideration for a child’s well-being.

What therapies can help survivors recover from sexual abuse?

Trauma-focused therapies can be especially effective for survivors overcoming sexual assault.  These include Cognitive Processing Therapy, Prolonged Exposure Therapy, and the somewhat controversial Eye Movement Desensitization and Reprocessing Therapy. Art therapy may also be a valuable outlet for individuals to process the trauma. If a dissociative disorder is present as a coping mechanism, it is important to treat the disorder so that its root cause can be addressed. 

Helping Survivors of Sexual Abuse

Powerful forces often prevent survivors from disclosing or reporting sexual abuse, from the fear of retaliation to the potential of reliving a traumatic assault. But when survivors do decide to come forward, unwavering support from friends and family members can help them process the experience and move forward.

What are the signs of sexual abuse?

If you’re concerned that a loved one is suffering sexual abuse, asking them directly can lead to relief, support, and treatment. The signs that an adult may have been sexually assaulted include:

• Anxiety about specific situations that didn’t previously prompt anxiety

• Avoiding specific people or places

• Persistent sadness or depression

• Low self-esteem

• Disturbed sleep or nightmares

• Self-harming behavior

Suicidal thoughts

• New sexually transmitted infections

What can I do to support a survivor of sexual abuse?

The most important thing to do is to simply listen and believe your loved one. Validate their emotions, ask questions, and avoid casting judgment. Help them explore options and resources, such as seeking medical attention, reporting the crime, calling an abuse hotline, or seeking therapy. Although you may have strong opinions, set those aside—the survivor should make every decision for themselves when they feel ready to do so.

Child Sexual Abuse

There are few offenses more painful to contemplate than child sexual abuse. Parents or loved ones may hesitate to raise such a concern with their child, but if they are worried, they should gently but directly ask. Ending any contact with the perpetrator and beginning therapy can help survivors of childhood abuse begin to heal, regardless of how recently the event occurred.

What are the signs of child sexual abuse?

The signs that a child may have been sexually assaulted include:

• Sexually transmitted infections

• Genital injuries including bruising or bleeding

• Inappropriate sexual behavior or sexual knowledge

• Regressing to past habits such as bed-wetting or thumb-sucking

• New fear of removing clothing to change or bathe

• New fear of being alone at night or having nightmares

• New discomfort or anxiety around certain adults

• Excessive worry or fear

• Extreme agitation or angry outbursts

• Withdrawal from family and friends

What should I do if I learn that a child has been sexually abused?

If parents or caretakers are concerned about sexual abuse, they should gently but directly ask. While some children may bring up abuse themselves, many do not.

If an incident is suspected, avoid putting the child in situations in which they might encounter the potential offender or be in an unsupervised situation with an adult, until the matter is resolved.

If an incident is confirmed, report it. Reaching out to a rape crisis center, domestic violence center, or sexual assault hotline can help. (The National Sexual Assault Hotline number is 800-656-4673.)

Once the abuse has been reported, discuss next steps for the child with a doctor and mental health professional.

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