The impact of child sexual abuse and the long-term effects thereof

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Self-esteem and personal power

Sexual abuse also being the abuse of power often leaves a victim with a sense of powerlessness. The victims of sexual abuse often have to deal with these losses, which affects their self-confidence for the rest of their lives. Spies, O’Neil and Collins (1998:370) are of the opinion that “when adults have been abused as children, their personal boundaries, their right to say ‘no’, as well as their sense of control in the world have all been violated. As a result the child may also become powerless as an adult survivor. It is noted that many children are told directly that they will never succeed, that they are stupid, or that they’re only good for sex. It is clear that with messages like these, the child will have difficulty in believing in him/herself”.
In research done by Spies (1996:47), authors like Sanderson (1990) and Dolan (1991) note that one of the most difficult tasks for any therapist is to deal with adult survivors of sexual abuse who need to identify themselves with their own bodies again. The abuse had taken away their sense of power especially regarding the way their bodies have endured the abuse. These survivors often result in self-mutilating behaviour. They punish their bodies for taking part in the abuse especially when they experienced any possible sense of pleasure. By self-mutilation survivors gain a sense of control over their bodies, which creates a scenario in which they can experience control.
Wyatt, Gunthrie and Notgrass (1992) in Spies (1996:50), refers to this behaviour as a coping mechanism that the adult survivor needs in order to survive. Spies (1996:51) refer to other coping mechanisms, which many adult survivors use to survive or cope with their sexual abuse trauma. These mechanisms are:
• Self-mutilation.
• Suicide.
• Eating disorders.
• Substance abuse.
• Sleeping disorders.
Spiegel (1990:252) reported on the psychological damage caused by abuse and noted that, “along with the pain and fear comes a marginally bearable sense of helplessness, a realization that one’s own will and wishes become irrelevant of events, leaving a damaged or fragmented sense of self”.
On the opposite side of the behaviour extreme, some sexual abuse victims may have unusual and dysfunctional needs to control or dominate. Aggressive and delinquent behaviour most often noticed in male victims, seems to develop from a need to be tough,powerful and fearsome to compensate for basic feelings of powerlessness. When victims become offenders, thereby re-enacting their own abuse, it may be in a response for a need to regain the sense of power that was lost during their own abusive experience (Finkelhor, 1995:65).

Relationship with the body

Children experience and learn about their world through their bodies. “Hunger, fear, love, acceptance, rejection, support, nurturing, terror, pride, mastery, humiliation, anger – all of what you know as emotion – begin with sensation and movement on the body level” (Bass & Davis, 2002:217). The child’s body can also be seen as the way he/she developed and learned about trust, intimacy, protection and nourishment. In the case of sexual abuse, children learn that the world is not a safe place where their needs will be met. Bass and Davis (2002:217) concur that when a child experiences the world as unsafe, he/she will behave in a certain way to adapt. All the problems survivors experience with their bodies namely: splitting, numbing, addictions and self-mutilation, to name a few – begin as attempts to survive the pain of abuse and especially the feeling of powerlessness.
According to Spies et. al. (1998:372) “sexual abuse had been perpetrated through the body, since many survivors blame their bodies for responding, for being attractive, for being womanly, for being small or large, for being vulnerable or for being susceptible to stimulation and pleasure. In order for these adults to survive they avoid these feelings or numb themselves as best they can”.

CHAPTER 1 General introduction and framework of the study
1. Introduction
2. Proposed title
3. Problem Formulation
4. Purpose, Goal, and Objectives of the study
4.1 Purpose of the research
4.2 Goal
4.3 Objectives
5. Research question and hypothesis
6. Research Approach
7. Type of Research
7.1 Applied Research
7.2 Intervention Research
8. Research Design and Methodology
8.1 Data Collection
8.2 Data Analysis
9. Pilot Study
9.1 Literature Study
9.2 Testing of questionnaires and measuring instruments
9.3 Feasibility of the study
10. Description of universe, population, sampling and sampling methods
10.1 Universe
10.2 Population
10.3 Sample and sampling methods
11. Definition of main concepts
11.1 Sexual abuse
11.2 Re-victimization
11.3 Forensic procedures
11.4 Person-Centred Approach
11.5 Training programme
12. Ethical considerations
13. Framework of the research report
CHAPTER 2 A Person-Centred Approach as frame of reference for the development and implementation of a training programme for state prosecutors
1. Introduction
2. Historicity of the Person-Centred Approach
2.1 The influence of Carl Rogers
3. Underlying theory of the Person-Centred Approach
4. Psychological conditions of the Person-Centred Approach
5. Characteristics of conducting research from a Person-Centred Approach
5.1 Meeting the respondent as an equal
5.2 Emphasis on the frame of reference of the respondents
5.3 The process orientation of the Person-Centred Approach
5.4 Research based on a person centred philosophy seeks authenticity
5.5 The Person-Centred Approach to the value system of others
6. The theoretical base of the Person-Centred Approach in this study
6.1 Discussion of the different propositions
7. Conclusion
CHAPTER 3 The impact of child sexual abuse and the long-term effects thereof
1. Introduction
2. Definition of sexual abuse
3. Types of sexual abuse
3.1 Familial Abuse
3.2 Extra familial Abuse
4. Progression of sexual abuse
4.1 Phases of sexual abuse
5. Family dynamics of incest
6. Degree of trauma from sexual abuse
6.1 The type of abuse
6.2 The identity of the perpetrator
6.3 The duration of the abuse
6.4 The extent of the abuse
6.5 The age at which the child was abused
6.6 First reactions of significant others at disclosure
6.7 The point at which the abuse was disclosed
6.8 The personality structure of the victim
7. The impact of child sexual abuse
7.1 Loss
7.2 Complex post-traumatic stress disorder
8. Long-term effects of sexual abuse
8.1 Self-esteem and personal power
8.2 Feelings
8.3 Intimacy
8.4 Sexuality
8.5 Relationship with the body
8.6 Children and parenting
9. Conclusion
CHAPTER 4 Re-victimization of the sexually abused child during court procedures
1. Introduction
2. Traumatic experiences
3. Difficulties experienced by children during the court process
3.1 Oral evidence
3.2 Court delays
3.3 Multiple interviews
3.4 Confronting the accused
3.5 Cross examination
4. Roles and boundaries of a prosecutor
4.1 Role of the prosecutor
4.2 Interdisciplinary teamwork
4.3 Time and effort of the prosecutor
4.4 Vertical versus horizontal case prosecution
5. Working with the severe traumatized child
6. Preparing the child for court: the prosecutor’s responsibility
7. Interventions that are effective in addressing the re-victimization
7.1 Joint interviews and multi disciplinary teams
7.2 Victim support and court preparation
7.3 Testimony via Closed circuit television
7.4 Giving the child a say
7.5 Multicultural issues
8. Conclusion
CHAPTER 5 Empirical research findings
1. Introduction
2. Purpose of the research
2.1 Goal
2.2 Objectives
3. Research question and hypothesis
4. Research approach
5. Type of research
5.1 Applied Research
5.2 Intervention research
6. Research design and methodology
6.1 Data collection
7. Discussion of empirical data
7.1 Qualitative data analysis
7.2 Quantitative data analysis
CHAPTER 6 Conclusions and recommendations
1. Introduction
2. Assessment of the purpose, goal and objectives of the study
2.1 Purpose of this study
2.2 Goal of this study
2.3 Objectives
3. Research question and hypothesis
3.1 Research question
3.2 Hypothesis
4. Conclusions
4.1 Literature study
4.2 Empirical study
5. Recommendations
5.1 The Person-Centred Approach
5.2 The state prosecutor working with the sexually abused child
5.3 Training
5.4 Further research
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