Sexually Abused Child Trauma Response by Age Group
March 30, 2011
Sexually Abused Child Trauma Response by Age Group
It can often be very difficult to recognize whether or not a child is being abused, both for parents and for professionals.
Children respond to sexual assault in many different ways according to their age, gender, personality and family circumstances. Their behavior will always reflect how they feel as children tend to communicate through their behavior. Children frequently find it extremely hard to talk about what is happening to them, especially when they’ve been told to keep it a secret or have been subjected to coercion, bribery or threats. Children very rarely lie about sexual abuse. They may underplay the effects of the abuse or change the identity of the perpetrator in an attempt to protect the family, but they have not been found to lie about the occurrence of the abuse itself.
Generally speaking there are two main behavioral indicators of trauma following sexual abuse. Regression to an earlier developmental stage or loss of developmental tasks previously achieved and failure to learn or distortion of new developmental tasks.
Signs of Trauma Responses in Preschoolers (age 2-5)
- They may become anxious and clingy, not wanting to separate from their parents at day care or the baby-sitter’s house.
- They may seem to take a backward step in development (regression), sucking their thumbs, wetting their beds, refusing to go to sleep, or waking at night when they passed those stages long ago.
- They may become aggressive in their play with other children, with their parents, or with their own toys.
- They may play the same game over and over, like piling blocks and knocking them down, dropping toys behind furniture and retrieving them, or crashing the same two cars over and over again.
- They may express ‘magical’ ideas about what happened to them which alters their behavior (ex: “Bad things happen when I get too happy”).
- Though they say they are having fun in an activity they may look sullen, angry, or intense in a way that to an adult it doesn’t look like they are having fun.
Signs of Trauma Responses in School Age Children (age 5-13)
- They may revert to developmentally earlier coping mechanisms, such as an ego-centered view (i.e. thinking that someone died because they had bad thoughts about the person).
- They may compensate for feeling helpless during the crisis of the abuse by blaming themselves for what happened. Thinking that thtey caused the event gives children a sense of power and control while helplessness painfully reminds them of being young and totally dependent.
- Their lack of control over the abuse may make them feel that their future is unsure, which can lead some children to act recklessly.
- They may experience a significant change in school performance. It’s not uncommon for children to have great difficulty concentrating and performing in school following trauma. On the other hand, they may become intensely focused on schoolwork to the exclusion of other activities in an effort to cope.
- They may test out rules about bedtime, homework, or chores. School age children believe in rules. When something bad happens, even if they obeyed the rules, they become oppositional and testy.
- They may have interruptions in their friendships.
- They may experience sleep disturbances, nightmares, and difficulty falling asleep.
- They may engage in reckless play. Where the preschool child will crash their truck a hundred times, the school age child might physically engage in dangerous games as a way of exhibiting a sense of control that was lost during the abuse.
Signs of Trauma Responses in Teenagers (age 13-18)
- They often feel that no one can understand what they are going through and there is a marked shift in relationships with parents and peers.
- They may get involved in risky behaviors, such as experimenting with drugs, sexual activity, or refusing to go to school as a way of handling anxiety and countering feelings of helplessness. They feel their future is limited and may believe they are damaged for good by the abuse so planning for the future is pointless.
- They develop a negative self image because they were not able to avoid or alter what happened to them.
- They are likely to engage in revenge fantasies against the person or people responsible for the abuse and then feel guilty about their vengeful feelings.
- They may experience a shift (either an intensification or withdrawal) in the normal developmental tasks of their age, such as dating, friendships, or sense of autonomy. They may isolate themselves, be depressed and at risk of suicide.
Some More Specific Behaviors Of Children Following Sexual Assault.
Many young children lose bladder/bowel control following sexual assault. It can be frustrating for parents and cause extra work. It can be humiliating and embarrassing for children. It is easy for adults and children to focus on the consequences of wetting and soiling e.g. changing sheets/clothes, washing, rather than the reasons why it happens.
All children bed wet from time to time when they are sick, stressed or anxious. Children who have been sexually assaulted will often bed wet every night and sometimes more than once a night. Bedwetting can be linked to feelings and may be a result of nightmares. Extreme fear can cause loss of bladder control and may serve the purpose of waking a child from a terrifying dream.
Bedwetting can also result from feelings of helplessness when children feel a loss of ownership and power over their body when it has been used by someone more powerful than they are. Bedwetting can be a reflection of children regressing in many ways, following sexual assault, when they lose a number of skills they previously had. Children may regress to a younger state to try and get their needs met. Bedwetting and soiling may also occur because a child separates from their genital/urinary/anal areas. They may lose the ability to respond to their body cues and therefore become less able to regulate their toilet habits. Sometimes children may be scared to actually go to the toilet. They may have experienced sexual assault in a bathroom or their fears may focus on the toilet itself.
All children have bad dreams from time to time but children who have experienced sexual assault often have nightmares every night sometimes more than once. They may have recurring dreams which are all the more frightening because they know what is coming. Nightmares can make children terrified of the dark and bed time.
Their dreams are likely to reflect their fears and their sense of lack of control. Looking at the content of their dreams can help them to talk about what has happened.
Lots of children develop aches and pains that have no physical cause. These will often have a connection to an aspect of the assault. Sometimes if a child has experienced physical pain during the assault, their body can retain the memory of this pain. Children may also think that something is broken inside of them. Repeated pain can also be a way for children to gain the extra love and attention they need at the time. Sometimes emotions manifest themselves physically for children because they do not have the ability to put it in to words.
A clingy child can test the patience of a saint! This behavior which is so common after sexual assault is a communication of a real need to be reassured of being lovable and of being secure. Children are attempting to rebuild a sense of safety and trust through their relationships with close adults. They are trying to restore a sense of good touch by demanding affection and cuddles. In essence, they are trying to heal their wounds. Constant physical and verbal demands can be difficult for parents but can be modified by identifying what the child needs and putting limits on when and how they are met. Clinginess can also reflect fears which can be reduced by talking about them.
Aggression in children after sexual assault tends to be related to fear and anger. It can be a direct communication that states “I am never going to be hurt again”. Anger is a healthy response and a necessary part of the recovery process from any trauma. It needs to be expressed in a safe and constructive way with firm limits against hurting yourself or others. To do this, anger needs to be acknowledged and recognized by the child and the adult. A child needs opportunities to discharge their anger. If this, for whatever reason, does not happen then anger is likely to come out through aggression. This causes the child more problems as their aggression prevents other people seeing or understanding the child’s needs.
Aggression also stems from fear and a need to protect themselves from further hurt.
Being aggressive can also cause a child to punish themselves and confirm their low self esteem because they have no friends and are always in trouble.
When children are sexually assaulted their sense of what is right and wrong becomes distorted. What they had previously learned about bodies and sexual activity becomes invalid. If a child was shown how to light a fire, for example, it is likely that the child will attempt to repeat what they saw. If children have learned that they get attention by being sexual with one person they may well repeat the behavior with another person. If children have experienced sexual feelings, which are common in children who have been sexually assaulted, they are likely to try and recreate those reactions. They may begin to sexually act out with other children to try and make sense of what has happened to them. Their curiosity about sexual matters may have been activated years before they develop the intellectual ability to understand. Children may want to sexually act out on other children to make them feel less vulnerable in the same way they may be aggressive. The trouble they may get into as a result of this behavior then confirms their view of themselves as dirty and bad.
Sexual acting out by children needs to be distinct from what is natural curiosity. Sexual acting out usually involves a difference in power between the children and may involve coercion/force or blackmail and a repetition of an adult sexual activity.
Normal sexual activity between children is about exploration not gratification (Martinson 1991 in Hunter 1996). Up to the age of 5, children are interested in touching their private parts and looking and touching the private parts of others if they have the opportunity. From 6 to 10 children have learned that sexual activity should be hidden and will masturbate secretly. They may create situations with their peers that involve looking and possibly touching. (Attempted or actual penetration and activities using force are not normal). They are likely to be curious about adult bodies. Early adolescents will masturbate and begin to develop relationships that involve a range of touching.
Sexual acting out in children who have been assaulted will involve either the child repeating what has been done to them on other children or getting other children to do to them what the offender did. It can also involve children approaching adults in a sexual way. It does not mean that the child automatically becomes an offender but it is an indication that professional help is needed.
Triggers & Recovery
Everyone who has suffered a trauma will react when they are reminded of it. The things that remind us can be called ‘triggers’ and they cause similar feelings to those experienced during the trauma. Very often these ‘triggers’ are not known to the adult because they relate to an aspect of the assault the parent may not know about. Some examples include the smell of beer or smoke; the feel of a beard; the color of a car; someone resembling the offender; a song or a game. Some are obvious, others are not. Often children can be triggered by unrelated things going wrong because that triggers their feelings of helplessness.
When children are triggered then their behavior tends to reflect the fact that they are experiencing similar feelings to the ones they felt during the assaults. Parents should be encouraged to discuss with the child what sort of things trigger them, so they are all aware of situations when it may occur.
The behaviors that children exhibit after sexual assault do tend to pass in time as children regain a sense of safety and self control. When the feelings that drive the behavior are explored, they become less powerful and the behavior becomes more manageable. Establishing a link between the feeling and the behavior is important as it gives you an understanding of what is happening.
Children can and do recover from sexual assault. The long term effects of sexual assault are often caused by secrecy, fear and denial of feelings. The more open and honest you can be about what happened the easier it is for children to be the same and the quicker the recovery.
Psychological Effects of Child Sexual Assault
Child sexual assault can have a number of effects both physical and psychological that last both in the short term and the long term. Outline below are some common effects which can occur as a result of childhood sexual assault.
- Fear. The offender may swear the child to secrecy and say something bad will happen if they tell. Coercion, bribery, or threats usually accompany sexual abuse. Overwhelmingly, the child is afraid to tell be cause of what the consequences might be, such as punishment, blame, not being believed, and ultimate rejection or abandonment.
- Helplessness/Powerlessness. Children in this situation often feel that they have no control over their own lives or even over their own bodies. They feel that they have no choices available to them.
- Guilt and Shame. The child knows something is wrong, but blames him or herself, not others. The offender will often encourage the child to feel that the abuse is his or her fault and as a consequence, is a “bad” person.
- Responsibility. The offender coerces the child to feel responsible for concealing the abuse. The child then believes they are responsible for preserving the secret in order to keep their family together and to maintain appearances at all costs. The burden of this responsibility interferes with all normal childhood development and experiences.
- Isolation. Incest victims feel different from other children. They must usually be secretive. This further isolates them from non-offending parents and brothers and sisters. This isolation often leads to the child being labeled as “different,” “a problem,” or in some way different from their siblings.
- Betrayal. Children feel betrayed because they are dependent upon adults for nurturing and protection and the offender is someone who they should be able to love and trust. They may also feel betrayed by a non-offending parent who they believe has failed to protect them.
- Anger. Children most often direct their feelings of anger in several ways.
1. They may direct it outward at perceived “little things.”
2. They may direct it inward, affirming their feelings of low self worth/value.
3. Almost never direct their anger towards the abuser while still in a relationship with them. Anger is most often dealt with as an adult.
- Sadness. Children may feel grief due to a sense of loss, especially if the perpetrator was loved and trusted by the child.
- Flashbacks. These can be like nightmares which happen while the child is awake. They are a re-experience of the sexual assault as it occurred at that time. As an adult, a survivor may experience the same type of omnipotent fear that they experienced as a child. Flashbacks can be triggered by many things. By a smell, a mannerism, a phrase, a place, or a wealth of other environmental factors that may have significance.
Adult Survivors of Childhood Sexual Assault
There are many reactions that survivors of rape and sexual assault can have. But for adult survivors of childhood abuse there are reactions that may either be different or stronger than for other survivors. These include:
- Because your personal boundaries were invaded when you were young by someone you trusted and depended on, you may have trouble understanding that you have the right to control what happens to you.
- Like many survivors, you may experience flashbacks.
- This is often the most difficult emotion for an adult survivor of childhood sexual abuse to get in touch with.
- As a child your anger was powerless and had little to no effect on the actions of your abuser. For this reason you may not feel confident that your anger will be useful or helpful.
- Being abused as a child means the loss of many things- childhood experiences, trust, innocence, normal relationship with family members
- You must be allowed to name those losses, grieve, and then bury them.
Guilt, Shame, and Blame
- You may carry a lot of guilt because you may have experienced pleasure or because you did not try to stop the abuse.
- There may have been silence surrounding the abuse that led to feelings of shame.
- It is important for you to understand that it was the adult who abused his/her position of authority and should be held accountable, not you.
- Learning to trust again may be very difficult for you.
- You may go from one extreme to the other, not trusting at all to trusting too much.
- You have undoubtedly developed skills in order to cope with the trauma.
- Some of these are healthy (possibly separating yourself from family members, seeking out counseling, etc.)
- Some are not (drinking or drug abuse, promiscuous sexual activity, etc.)
- Low self-esteem is a result of all of the negative messages you received and internalized from your abusers.
- Because entering into an intimate relationship involves trust, respect, love, and the ability to share, you may flee from intimacy or hold on too tightly for fear of losing the relationship.
- Your first initiation into sex may have been nonconsensual.
- You may experience the return of body memories while engaging in a sexual activity with another person. Such memories may interfere in your ability to engage in sexual relationships which may leave you feeling frightened, frustrated, or ashamed.