Recognizing common symptoms of childhood sexual abuse can help parents, caregivers, teachers, social workers, counselors and childcare staff alert the appropriate authorities and take proper steps to protect the welfare and safety of our children. It is far too often that I hear stories of adults, who fail to recognize that something is wrong with their child and attribute concerning changes in their kids’ behavior to temperament, age or other misguided explanations.
Because of this, I want to take a quick look at 11 common psychiatric symptoms experienced by victims of childhood sexual abuse but please keep in mind that this is not a diagnostic guide or a substitute for professional consultation. I have tried to clump together common symptoms that bring people (both children and adults) to the therapy office due to past history of childhood sexual abuse but this is by no means a comprehensive list and any of those symptoms taken separately may have other etiologies.
Depending on the age, specific nature of the sexual trauma and the temperament and coping skills of each person, the clinical presentation may look differently. If you have experienced any form of childhood trauma, abuse or neglect, you may identity with some of the behaviors and patterns discussed below. In that case, I would highly suggest seeking out some help.
1. Dissociation. Dissociation is probably the most common defense mechanism the mind employs to protect itself from the trauma of sexual assault. It is the escape of the mind from the body in times of extreme stress, sense of powerlessness, pain and suffering.
2. Self-Injurious Behavior (cutting, self-mutilation). Self-mutilation is another way survivors of trauma employ in an effort to cope with the experience of severe emotional and psychological pain. Some research shows that during cutting or self-mutilation, the brain releases natural opioids that provide a temporary experience or sense of calm and peace that many, who cut, find soothing.
3. Fear and anxiety. An overactive stress response system* is among the most common psychiatric symptoms in survivors of sexual trauma. This is manifested in extreme fear, social anxiety, panic attacks, phobias and hyper vigilance. It is as if the body is in a state of constant alert and cannot relax.
4. Nightmares. Just like the intrusive terrorizing memories of war veterans, survivors of sexual abuse often experience nightmares, intrusive thoughts and disrupted sleep.
5. Substance Abuse. Abusing substances is a common coping mechanism for people, who have experienced trauma. Even the “normal” experimentation with drugs of adolescence is not so “normal,” especially if you raised your kid to know the impact of drugs on the central nervous system, the consequences of addiction and the long-term effects of habitual drug use.
6. Hypersexualized behavior. This is a common reaction to pre-mature sexual exposure or a traumatic sexual experience. If a child is too young to be excessively masturbating or is engaging in pre-mature sexual play or behavior, this is typically a sign that the child has witnessed, been a participant in or has been exposed to adult sexuality. In adolescence and adulthood, this can take the form of promiscuity, illegal sexual activity such as prostitution or participation in pornography, escort services, etc.
7. Psychotic-like symptoms. Paranoia, hallucinations or brief psychotic episodes are not uncommon for survivors of child sexual abuse.
8. Mood fluctuations, anger and irritability. Children are often unable to verbalize their feelings so instead, they act out on them. Sometimes, the same is true for adults. Mood fluctuations, irritability and disrupted neurotransmitter systems in the brain that present as depression, mania, anger and anxiety are common among trauma survivors.
9. Disrupted relationships and difficulties maintaining long-term friendships or romantic partners. Following the aftermath of sexual abuse, people are not experienced as safe, trustworthy and available so maintaining long-term relationships based on honestly is difficult and often tumultuous.
10. Regressive behaviors (mostly in children). Enuresis (bed wetting) and encopresis (involuntary soiling ones’ underwear with feces) in a previously potty-trained child, unexplained and sudden temper tantrums or violent outbursts, as well as clingy, uncontrollable or impulsive behaviors that were previously missing from a child’s way of being with others is another common indicator of something gone terribly wrong.
11. Physical complaints, psychosomatic symptoms or autoimmune responses of the body. Many clinicians from different schools of thought have written on the subject of the way the body stores and remembers trauma in response to the mind rejecting, forgetting or dissociating from the experience. Psychoanalysis terms these reactions “unconscious” as they express an experience out of language, out of words and often out of what is perceiveable by an individual.
When the unthinkable happens such as in several of the clinical cases described by Dr. Bruce Perry in his book “The Boy Who Was Raised as a Dog and Other Stories from a Child Psychiatrist’s Notebook: What Traumatized Children Can Teach Us about Loss, Love and Healing,” the mind copes by mobilizing the body to express something that is otherwise inexpressible with words. We see in Dr. Perry’s neuroscientific approach to the understanding and treatment of traumatized children how the physical brain responds to the experience of trauma and how the mind communicates and eventually heals from this experience in the safety of the therapeutic relationship.
For more information on this subject, visit www.childtrauma.org