When the False Memory Foundation became active, questioning the validity of sexual abuse accusations, many in the therapeutic and child-protective communities suddenly became quiet, fearing lawsuits or accusations that the therapists or investigators themselves were the source of these beliefs that sexual abuse had occurred. This has been true in some cases, especially when a custody dispute is involved, but caution is warranted.

Sadly, many in the therapeutic community at large are confused, some have reverted back to the mentality of the 70s and earlier, doubting clients’ allegations of sexual abuse, and unaware of both the frequency and destruction to its victims. Recently, it has been my professional experience that reported accusations are less often believed, even those that appear very likely.

Impact of Sexual Abuse

What is the result of sexual abuse to a girl? It is important to remember that each situation is unique, with its own set of reactions and consequences. Thus, there will be no attempt to provide a list of symptoms. The following factors must be considered to understand the issues faced by each victim:   age of the girl for each incident of abuse and the developmental factors involved   the severity, type, and frequency of the abuse  the relationship to the perpetrator, with a trusted or needed adult having considerably greater devastation  the response of the family or other support people • the length of time before the abuse is reported  the success of the therapeutic interventions  the personalities of the victim and the perpetrator  family dynamics creating other pathology  threats made by the perpetrators to maintain secrecy  the spiritual beliefs of the abused girl, before, during, and after the abuse  ongoing consequences, such as a pregnancy or sexually transmitted diseases  later actions, such as promiscuousness or becoming a perpetrator of sexual abuse  Considering all the various factors becomes a necessity of the therapeutic intervention.

A cookie-cutter approach is obviously impossible, and the process of therapy is, of necessity, unique and different in each situation. This article will attempt to focus on a summary of the aspects of successful therapy, but is not meant to be a self-help article that replaces professional counseling. It may be helpful for counselors to highlight an aspect of therapy that has been missing for a particular girl who is struggling with the devastation of sexual abuse.  Telling the Abuse StoryMost healing begins when the victim tells the story of the abuse, and is believed. It needs to include all of the details, especially those that are embarrassing or shameful. Some children will not tell their parents, but will tell a teacher or counselor. The story needs to be repeated at least five or six times to supportive caring individuals. Whatever threats were directly or implicitly made by the perpetrator are an essential part of the narrative.

Providing Safety

Healing will not occur if the perpetrator has ongoing access to his victim. When a family member abuses a girl, the challenge is obvious. How will a girl be separated from a parent or sibling if they are the abuser? If the father or stepfather is the abuser, what will happen if he is the financial support for the family? What if the girl really loves the abuser and does not want to be separated from him? If the abuser is an older sibling (who may have also been abused), how will they both receive help and support while providing safety and protection?  Releasing the Feelings There is arange of common emotional experiences in abuse that need to be acknowledged and released in the therapeutic encounter.

Shock and denial are the most common initial reactions. These may subside, but might also intermittently reoccur. Nightmares become a frequent method of attempting to deal with the trauma that is not faced directly. The healing process does not begin until the truth is faced. Fear and anxiety become a central focus and need to receive immediate attention until they are resolved. EMDR (Eye Movement Desensitization and Reprocessing) and other methods are excellent tools to rapidly reduce the anxiety. If this is not quickly and successfully addressed, the feelings become overwhelming and intolerable. This phase of therapy generally needs to be done in an intensive daily program of therapy.

Shame and guilt are often difficult emotions to resolve. For some, they are so overwhelming that suicide seems to be the only option. Many sexually abused girls experience the majority of their shame after becoming a teenager, when they are able to analyze their abuse in the new light based on their understanding of sexuality. At earlier ages, they may have been more aware of the emotional discomfort, physical pain, or the confusion they experience. Many children, in their egocentric view of the world, believe it is their fault, that they did something bad to deserve the abuse. Pedophiles especially capitalize on this tendency, leaving abuse victims with a pervasive sense of badness.

The release of the shame and guilt involves two steps. The guilty party must be identified, giving the shame and guilt back to the perpetrator where it belongs. Secondly, the victim must forgive herself and accept God’s forgiveness for anything that was legitimately her fault, such as disobedience that led to the abuse. Betrayal is devastating when the abuse occurs by a trusted caretaker. A child’s very life depends on the provisions of this individual, especially at younger ages. Children must be provided safety for there to be any opportunity for healing.

They must also express these feelings of betrayal.  Confusion is rampant. Touching may feel pleasant or even sexually stimulating, causing a girl to seek sexual touching following her abuse, especially if her father is absent physically or emotionally. At young ages, children may not understand yet that this type of touching is wrong. Threats to ensure silence add to the confusion, as do statements by the perpetrator that the child wanted, liked, or chose the abuse. These feelings must be revealed and addressed.  Helplessness and hopelessness are prevalent, especially for younger girls who are abused more than once. If children can figure out some method of protection after the first incident, they feel empowered. However, any repetition results in their feeling helpless and at the mercy of the stronger, more powerful abuser. Learning competence in these areas of helplessness becomes the challenge for healing, often including learning that they do not have to keep secrets and can ask for, and receive, help. Physical defense training may even be an option. Many girls who have been abused go through a stage of being overly controlling in unrelated areas to make-up for the hated feelings of helplessness.

Sadness and grief represent what is most often the longest stage of healing. Tears to release this pain are generally repetitive. The emotional intensity may be similar for different events, especially for younger girls, but in general, the more severe, repetitive and extensive the pain, the longer the grief will last. Even with successful therapy, many girls reexperience the grief in the future, when current events remind them of their loss. For example, many sexually abused girls have feelings that emerge during their first sexual encounter, marriage (where it feels like sex is now expected), the birth of a child, or when their children reach the age when they were abused themselves.  Anger is often a difficult emotion for girls who are raised in a Christian home, but is usually the source of protection when used in a healthy manner.

It is necessary to find the strength to say that abuse is wrong, that it is not acceptable and will not be tolerated. As girls learn to protect themselves and intuitively sense danger, they become prepared to take appropriate precautions when anger is acceptable. Anger needs to be directed toward the cause of the pain or it may be misdirected toward self or God, leading to depression. It is very freeing to release anger and allow the Lord into that area for His healing.  Anger is similar to food poisoning— we must get it out of our system in order to recover and feel better. Although it is not appealing, and should be done in private—in a therapy office, support group, or secure, safe place. Also, anger must come out in a manner appropriate to the age when the abuse occurred. Loneliness and loss will be overwhelming at times, even for those girls who are surrounded by loving family and friends, although their presence helps tremendously.

The abuse usually occurs when a girl is alone. If it is not immediately reported, which is generally the case, there is no one there for comfort and care when the feelings are overwhelming. Love and understanding are necessary for much longer than most people anticipate. Our society is quite good at immediate support following a trauma, but rarely does that support continue as long as needed.  Identifying the Lies and DistortionsThe events that occur to us as children strongly influence our conclusions about ourselves, others, God, our world, our feelings, and our rights. These thoughts and convictions are the invisible, but destructive, scars from the abusive event. A major requirement for healing is identifying and replacing the specific lies and deceptions with the truth.  This process of therapy usually follows the release of many feelings. It can, and usually does, take time.

The traditional weekly counseling session is generally sufficient in this phase, allowing time to replace each lie with God’s truth. Many of the lies can be identified by the exaggerated words of “always,” “never,” “everyone,” etc. Specific Scriptural references are helpful to counteract the lies, usually one at a time. The “renewing of one’s mind” takes time and many repetitions of the truth. Common lies abused girls believe about themselves. When a girl is sexually abused, she often believes many of the following lies: “It was my fault. I deserved it. I’m bad. I’m not lovable. I’m helpless. I can’t protect myself. I’ll always be broken. It’s useless to fight back. I’ll get hurt more if I cry or yell or struggle. Sex is the only way to get attention.”  Common lies about others. Eventually, abused girls also begin believing lies and distortions about other people. Some examples are: “No one is safe. Everyone hurts children. No one cares. People know what’s happening and they do nothing (most children believe adults know everything). No one will believe me. No one will help me. People will blame me. If people find out, they’ll know I’m bad, dirty or unworthy.”

Lies about our world. Conclusions about one’s world are usually based on childhood. So a girl who has been sexually abused may conclude some of the following: “Life is always scary. There’s no safety anywhere. Life is full of pain and then you die. Life is not worth living. Life means being alone and not really mattering to anyone. My needs will never be met.”  Lies about God. The most destructive lies a girl comes to believe are those concerning God, ones that separate her from His love and healing. The following are a few examples: “God doesn’t exist. God doesn’t love me. God is mean and He wants children to be hurt. God is indifferent. God is absent. There is no God. God loves others, but not me because I’m bad. I can’t trust a God who allows little children to be hurt. The abuse is God’s fault. What good is a God who doesn’t protect. God doesn’t answer my prayers because I prayed and prayed for the abuse to stop.”  Choosing to Forgive and Move OnForgiveness is extremely significant, deserving of entire books dedicated to this topic alone.

To touch on it only briefly misses the essential significance in the process of recovery for any girl who has suffered sexual abuse. Can one really forgive such egregious and destructive actions?  Forgiveness is a decisional process, one that usually only follows the order of the previously presented issues in healing (telling the story, providing safety, releasing the feelings, and identifying the lies and distortions). Without forgiveness one remains bitter, defensive, distrustful and unable to have intimacy. Choosing not to forgive is likely to cause ill health, career difficulties and interpersonal conflict in all relationships. So despite the horrible actions of the perpetrator, forgiveness must occur.  Forgiveness is not easy.

Many books suggest steps of forgiveness that often help those abused to understand specifically where the resistance is occurring. As we acknowledge our own, and everyone’s, need for forgiveness, we begin on that pathway. Giving up our right for revenge and leaving that to God is a second step. Forgiveness does not necessarily mean reconciliation. Restoration requires repentance, and without true repentance on the part of the perpetrator, a renewed relationship is unadvisable. Expect forgiveness to take time.  Moving on to wholeness depends on three factors: (1) the severity of the destruction in the past, (2) the opportunities in the present, and (3) the possibilities for the future. Pray to see the healthy balance between healing and wallowing in the pain. Risking trust and loving again is always a challenge for a girl who has suffered from sexual abuse. Abuse shatters trust and often sets up a pattern of suspicion and emotional defensiveness. Loving again will involve some uncertainty and hurt. Although challenging, for some trust can start with small steps, like trusting God, for He is the only One who is totally trustworthy.

Those who have been abused must also learn to trust themselves. Many fear that the next betrayal will destroy them. However, often the exact opposite is true because they have already survived once and know the path to recovery. Humans are marvelously and wonderfully created to heal. In the physical arena, we get back on our bike even after falling off and breaking an arm, and are similarly capable of healing from emotional damage.  The greatest tragedy of abuse is when it prevents trusting innocent people or situations, both now and in the future. As trust is gradually reestablished, those who are abused learn the truth of each person’s strengths and weaknesses, as well as the areas where each individual is more or less trustworthy. Rather than generalizing from the abuse suffered previously, encourage girls to ask the Lord to give them wisdom to see the truth in each person and situation. Dream new dreams. Isaiah 61:3 asserts: “God will bestow a crown of beauty instead of ashes and the oil of gladness instead of mourning.” In the depth of pain or grief, it often seems that it will never pass. But in time healing comes, and while seeking the Lord, He provides new dreams and possibilities.

Set and reach for new goals. For many victims of abuse, it is necessary to take a new lease on life—learning to enjoy small, daily activities or taking on new challenges in school, at work or with family and friends. It is essential to learn to trust again, to be positive, and to enjoy life today.  _Arlys Norcross McDonald, Ph.D., is a licensed clinical psychologist who has specialized in the treatment of trauma and anxiety for more than 30 years. She is the owner and director of the McDonald Therapy Center, a unique day-treatment intensive program in San Diego. Dr. McDonald is adjunct faculty at both Biola University and Bethel University, and is the author of Repressed Memories, Can You Trust  Them?_