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Why Boys Do Not Tell About Sexual Abuse

Why Boys Do Not Tell About Sexual Abuse
By Karyl McBride, Ph.D.
Created Jun 12 2012 – 3:14pm

The dark cloud over PennState revealing a sexual abuse Penn Statescandal also holds a painful overcast shade for male victims of sexual abuse. The news of the cover-up and victimization of boys at this prestigious university has understandably caused a flurry of confusion, surprise, and concern for parents, educators, football fans, and all who care about children. Having worked in the sexual abuse treatment field for three decades, I’ve seen the difficulty for boys and men in reporting sexual abuse. Why is this so? Cover-ups, denial, and internalizing feelings seem to dominate rather than vulnerable exposure of abusive acts perpetrated on male victims. In general, people don’t like to believe these things happen. It is difficult to understand that adults can be sexually attracted to children. For most healthy individuals, this concept does not compute.

But, let’s take a look at why it is particularly difficult for males to report sexual abuse when it involves them. We know from studies done on sex offenders in prisons, that boys and girls are sexually abused at alarmingly high rates and most are shocked by the statistics. It is also well documented that sexual abuse of boys is underreported. Why?

It is difficult for any child to report sexual abuse because they feel guilty, they may have received threats from the offender, they fear they won’t be believed, and they don’t want to cause family problems. But for male victims, there are additional barriers to disclosure:

1. In our culture, boys are socialized not to be victims. “If I am a victim, can I then also be a man?” Big boys fight back and are not supposed to be victims or it somehow obliterates their identity of “manhood.”

2. Guys are expected still, to tough things out and not ask for help. Fewer men, for example, seek therapeutic treatment and many are still adverse to this concept unless dragged to therapy by their families or spouses. Family therapist, Terry Real, wrote eloquently about this issue in his much-needed book about male depression titled: I Don’t Want To Talk About It. Asking for help is still seen by many males in our culture as a sign of weakness.

3. It’s likely an understatement that our society is still somewhat homophobic? It’s getting better, but we have seen much in the current news about this issue still rearing its ugly head in military circles, same sex marriages, and legislative changes and discussions. So, for a young boy who is molested by a male offender, the issue of sexual identity comes into play. We see young males in therapy asking the question frequently: “If I am abused by a male and I am also male, does that mean I am gay?” Little children, ages 8-10, ask this question frequently in therapy, and teen male victims often just choose to suffer in silence because of this fear. “Will my peer group label me as gay if I tell?”

4. When young boys are touched in the genital area, they can have an erection. It is visible to them, different from female victims. The touching can feel good to both boys and girls and then cause great confusion. “Did I want this?” “If it feels good, is it my fault?” “If there is pleasure, I must be the one in the wrong.”

5. When young boys are sexually abused by female offenders, there is another interesting mind assault. If a young male is getting attention sexually from an older woman, he is often seen as lucky. Boys can be experimental with sex and that is often regarded, as “boys will be boys.” And if the offender is the child’s mother, you can only imagine the difficulty in reporting, and the devastation for the child.

6. Often boys report that they don’t view the sexual acts perpetrated on them as that abusive. They minimize or deny the impact to avoid feelings of helplessness or confusion.

So taking these reporting issues for boys and putting them in the context of the male world of football, one can see the great impediment to reporting something as vulnerable as being sexually abused. If I’m a big tough guy…this did not happen to me. It is more typical for young male victims to use coping strategies like becoming aggressive to overcome the feelings of helplessness, or trying to numb the feelings with drugs or alcohol. In many cases they internalize the trauma and become depressed.

In a college football environment, the players are still young, developing men. The coaches, as well as other instructors, play an almost parental-like role with these young people. The power differential is obvious and the effects devastating when the power of the leader is misused in a secretive, abusive, and flawed manner that actually encourages a wall of silence for compliance that results in reward.

The bottom line is that it is up to adults to protect young people and the need for further education for parents and educators in this arena remains a constant call for clarity and direction. While much has been done in prevention and education regarding child sexual abuse, unfortunately there is more to do. We can start with creating emotionally safe environments for males to disclose sexual abuse and let it be known to boys that this can happen to them too. Boys should be taught more realistic roles to emulate other than the classic tough guy.

And finally, let’s not forget that sex offenders are the prime narcissists in this culture. Their lack of empathy is palpable. They are most concerned with getting their own sexual and power needs met and therefore the impact on the victim… is not on their radar.

(Some resources taken from Virginia Child Protection Newsletter, Volume 29, fall 1989)

Additional Resources:

Book: Will I Ever Be Good Enough? Healing the Daughters of Narcissistic Mothers http://www.amazon.com/Will-Ever-Good-Enough-Narcissistic/dp/1439129436/ref=sr_1_1?ie=UTF8&s=books&qid=1252439024&sr=8-1

Audiobook: Will I Ever Be Good Enough? Healing the Daughters of Narcissistic Mothers http://www.willieverbegoodenough.com/buy-the-book.php

Website: http://www.nevergoodenough.com  and http://www.karylmcbridephd.com

Survey: Is This My Mom? Use this to assess if your parent has narcissistic traits. It is applicable for men as well.  http://www.willieverbegoodenough.com/survey.php

Research: Interview You? http://www.willieverbegoodenough.com/for-men.php

FB Parties for Adult Children of Narcissists: http://www.facebook.com/DrKarylMcBride

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Physical and Sexual Abuse

Posted by James Browning on April 29, 2013

Abuse: Touching someone’s body without their permission, hitting, punching, pinching, slapping, tickling, pulling hair, hitting with objects, banging the head, so that marks are left on the person…Punching someone to the point of knocking them off their feet, slamming them into walls or hard objects, strangling or choking someone…Intimidating someone with the threat of violence, punching walls or throwing objects. …you might think that because some other member of your family was receiving the blows you are not a victim of physical abuse, but (you were) if the underlying fear is, “When will it be me?” Physical sexual abuse is bodily sexual activity with a child or touching in a sexual way. It includes: intercourse, oral sex, anal sex, an adult masturbating a child or having a child masturbate an adult, sexual hugging, sexual kissing, and sexual touching. Many people who have been molested or incested feel responsible for what happened, feel that they caused it to happen or wanted it to happen. I have also heard clients express acceptance since it was the only kind of attention that they received. You are not responsible and it is not acceptable behavior. A child will not seek out sexual encounters except what may be age-appropriate sex play with other children. It is the adult’s responsibility to set appropriate boundaries and protect the child. Taken from “Adults Abused as Children” by Licia Ginne, LMFT http://www.latherapists.com/articles.html

“The consequences of your denial will be with you for a lifetime and will be passed down to the next generation. Break your Silence on Abuse!” – Patty Rase Hopson

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I Was in Denial About My Childhood Sexual Abuse

This is a very painful subject for me, something I really don’t like to talk about.  However, since the month of April is childhood abuse month, I figured I would tell a small part of my life story.  I was sexually abused from age 3 until age 7.  I continued to act out sexually on a nearly a daily basis until I entered recovery at age 33.  It took me three years of recovery and therapy to finally admit that I was sexually abused as a child.  Because of the circumstances, I was in complete denial about my abuse and my abuser.

Scan59The reason I was in denial is because the girl that abused me was just a little older than me, maybe 6 months or a year.  When my family moved away from our home country to a university setting in the United States, I didn’t know many children that spoke my native tongue.  She did and it was a relief that I could speak to her and she could speak to me and we could understand one another.  I was around 3 years old at this time.  I don’t remember all of the details of our relationship, but a few points do stand out.  I recall the time we hid from our parents (her idea) and we snuck into the university swimming pool that was located about 2 miles from our apartment complex.  Apparently our parents called the police and everyone was looking for us while we enjoyed ourselves at the pool.  I don’t recall what occurred when we came home but knowing my parents, it wasn’t good.

I trusted this girl a lot, so when she decided we should play sexual games together, I went along with her.  I do recall the words to this day she spoke to me in my native tongue stating, “don’t tell your parents.”  I didn’t tell my parents, not until 30+ years later when I entered recovery.  Even then, I minimized the fact she abused me for 4 years, I was still in denial.  Amazing how I always thought my parents suspected something but when I asked them about it, they said they never knew.  She and I were together almost every day and the sexual activities were basically based on what she wanted to do to me, with me, and with other boys at the apartment complex.  I don’t know where she learned all these things, but I suspect her older siblings or parents had something to do with it, perhaps with pornography and or an extremely liberal stance on human sexuality.  I may never know the answers, nor do I wish to pursue them.

I do know that this sexual abuse and what I thought was “love” has affected the rest of my life up until I entered recovery.  I believed this girl loved me, that she and I would be together forever.  Why else would she want to do sexual things with me?  Allowing her violate me sexually was the way I showed her that I too loved her.  As an adult, I repeated this same love = sex behavior thousands of times.  For a majority of my life, I had the belief that being sexual with a woman meant I loved her and she loved me.  A woman who wanted to be sexual with me, who initiated sex with me, who pursued me sexually was a woman that loved me: this is what I believed for 30+ years.  This idea was ingrained in me by my abuser, an idea I still struggle with on occasions.  I’m not attempting to minimize by saying that it could have been worse, I could have been abused by an adult, but in actuality, the fact that it was another child, masked the abuse, keeping me living in denial for so long and in turn pursuing a false sense of love.  The abuse was not traumatic, it was what I used to consider consensual; I believed it was because I enjoyed it.  As an adult, I reenacted various things we did together, with other women, ultimately believing I was fulfilling some great fantasy locked within the depths of my mind.  The saying “follow your fantasy and you’ll find your wound” makes perfect sense to me now.

GiselaI don’t like the fact that I was sexually abused.  When I finally broke through the denial, with the help of my therapist, I was a complete mess.  However, it allowed for God to begin healing this wound that I had held onto for so long.  Being labeled a victim of childhood sexual abuse was not pleasant, it made me feel dirty, it made me feel like I was worse than I really am.  One of my friends in recovery let me know that I am no different today (the day I finally acknowledged it as sexual abuse) than I was yesterday (when I was “just” a recovering sex addict).  This helped me tremendously.  Breaking through the stigma of dirtiness and brokenness was difficult but necessary.  I still struggle with negative intrusive thoughts about the abuse and being unwanted or being broken.  However, I have come to understand that feeling “unwanted” is just a lie and also, God can’t fix me if I’m not broken….

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Adult Manifestations of Childhood Sexual Abuse

Adult Manifestations of Childhood Sexual Abuse
Full PDF article and figures can be found here:
http://publichealth.lacounty.gov/wwwfiles/ph/media/media/TPH-409.pdf

Background

While childhood sexual abuse (CSA) continues to be a major public health problem, an equally severe and silent epidemic are the estimated 39 million adult survivors of childhood sexual abuse in the United States who continue to exhibit aftereffects of CSA that predispose them to adverse psychosocial outcomes throughout their adolescent and adult life.

Early childhood traumas such as sexual abuse can have lifelong effects throughout adulthood, and the cost to society is high. Ninety percent of cases go unreported and untreated, as the symptoms of CSA are often misdiagnosed and unappreciated.

This article attempts to provide clinicians with awareness of the neurodevelopmental effects of CSA, the adult clinical symptoms, and the adverse psychosocial outcomes of CSA. It will also present tools to help identify the aftereffects of CSA in adulthood and provide mandated reporting protocols.

Definition

Sexual abuse is defined as any sexual activity that a child cannot comprehend or consent to. It includes acts such as fondling, oral-genital contact, and genital and anal intercourse, as well as exhibitionism, voyeurism, and exposure to pornography. A central characteristic of any abuse is the dominant position of an adult that allows him or her to force or coerce a child into sexual activity. Researchers have determined that child sexual abuse victims come from all cultural, racial, and economic groups. The lack of a universal definition of CSA contributes to the complexity of data collection and estimates.

Incidence and Prevalence

Currently, CSA prevalence in the U.S. is not known, but estimates vary from 12% to 40%. Incidence studies suggest that while on average 5.5 children per 10,000 enrolled in day care are sexually abused, a greater number of children (8.9 children per 10,000) are sexually abused in their home. Further CSA studies suggest that 53% of the abuse occurs in the home, 57% report the perpetrator was a family member, and 65% report repeated abuse. Overall, studies show that 1 in 3 females, and 1 in 6 males have experienced childhood sexual abuse by the age of 18.

While nearly 90,000 cases of child sexual abuse are reported each year in the U.S., between 88%-90% of CSA cases are estimated to be unreported and interestingly, between 21%-49% of CSA victims appear asymptomatic following victimization. The lack of disclosing a history of sexual abuse contributes to the lifelong effects of the abuse.

Neurodevelopmental Damage of CSA

Controlled studies have shown that adult survivors of child sexual abuse (ASCSA) are more likely to exhibit adverse psychopathologies in adulthood, and neuroimaging studies confirm that exposure to sexual abuse in childhood alters the neurobiology and neurostructures in the brain, leading to scarring, an abnormal neurohormonal response to future stressors, and predisposes the victim to a lifetime of negative consequences.

Neurological damage from sexual abuse alters early brain development, increasing the risk for psychopathology in adolescence and adulthood (Table 1). The hippocampus, responsible for new learning and memory, plays a critical role in recording emotions that are attached to a stressful event such as sexual abuse. The hippocampus is known to be very sensitive to stress. During stress, high levels of glucocorticoids are released, and over time (as observed among CSA victims, including those re-victimized) elevated levels of glucocorticoids damage neurons in the CA3 region of the hippocampus and lead to atrophy. While the hippocampus has been shown to regenerate neurons, stress inhibits neurogenesis.

Abnormalities of the hippocampus have been shown to be associated with pathological fear, mood imbalances, and anxiety reactions in trauma-related disorders (also hallmarks among ASCSA).

Magnetic resonance imaging (MRI) studies have demonstrated a 12% left hippocampal volume size reduction among adults who have been sexually abused in childhood as compared to healthy controls (Figure 1). Similar reductions are exhibited among subjects with trauma-spectrum disorders such as depression, dissociation, PTSD, and borderline personality disorder. In addition, the amygdala, responsible for emotional and fear regulation, is affected by early sexual trauma, resulting in similar psychopathologies.

Studies suggest sexually traumatized children are also less able to utilize both brain hemispheres to process experiences. The corpus callosum, a longitudinal fissure that connects the left and right cerebral hemispheres, is shown to be abnormal in sexually abused children. Generally, the left side of the brain processes positive emotions and logical thinking, and the right processes negative emotions such as fear. When the corpus callosum is not operating properly these processes are unable to function at the same time, thus supporting theories why many abused individuals divide people into “all good” or “all bad” and exhibit mood swings, as observed in borderline patients.

Adult Manifestations of CSA

There is no adopted definition to identify the symptoms exhibited among ASCSA; however, evidence-based research has confirmed long-term effects of CSA in adolescence and into adulthood. Later in their lives, many ASCSA, whether reported or not, exhibit psychopathology, acting-out behaviors (social dysfunction), relationship problems (interpersonally), somatic symptoms, and sexual disorders.

CSA survivor studies suggest that ASCSA use health care services more often than the general population, are shown to exhibit more somatic symptoms that do not respond to medical treatment, and present more severe and complex symptoms.The response to sexual abuse during childhood varies, and is largely dependent on 1) age at onset; 2) severity; 3) duration; 4) relationship to the perpetrator; 5) the child’s resiliency; and 6) stability of and support from the family.

Childhood survivors might initially seem unaffected by the trauma; however, by adolescence and adulthood, the consequences eventually become symptomatic, resulting in eating disorders, dissociation, phobias, obsessions, borderline personality disorder, depression, anxiety, bulimia, obesity, post traumatic stress disorder, hallucinations, conduct disorder, substance abuse disorder, panic disorder, antisocial personality disorder, affective disorder, and impaired sense of self.

Behavioral Effects of CSA 

Acting out

Children are limited in their physical, cognitive, and emotional development and, thus, dependent upon adult and often sibling caregivers to provide love, trust, and support. Once a child is violated however, shame and stigma often follow, as well as fear that disclosing the abuse will result in re-victimization, loneliness and isolation, physical violence, and death. Poor coping skills are common among this cohort, such as substance abuse, tobacco use, overeating, addiction, lying/stealing, poor academic performance, expectation of early death, poor adherence to medical treatment, suicide, anger, prostitution, and increased risk of sex crimes.

Relationship problems

Controlled studies identify an association between childhood sexual abuse and adult relationship problems. Adult manifestations of CSA increase the risk of intimate partner violence victimization and perpetration, rape after 18 years of age, low self-esteem, intimate relationship problems, divorce, interpersonal problems, victim-perpetrator cycle, superficial idealization of sexual relationships, and the inability to trust others.

Somatic symptoms

Evidence illustrates that CSA also results in biophysical changes. ASCSA show a decreased threshold for pain. Other effects include a heightened sensitivity in the pelvic or abdominal region, various bowel symptoms, musculoskeletal disorders, back pain, severe headaches, gastrointestinal problems, sleep disorders, asthma, and pseudocyesis.

Sexual disorders

Adult manifestations of CSA increase adolescent and adult risk of exposure to sexually transmitted diseases, compulsive sexual behaviors, early sexual activity, extreme masturbation, sexual promiscuity, poor sexual adjustment, poor contraceptive practices, and teen pregnancy.

Functional amnesia

Functional amnesia (dissociative amnesia–dissociative disorders) can develop after severe trauma, such as child sexual trauma. This is especially true among children experiencing severe sexual trauma or in those aged 5 years or younger. Functional amnesia among CSA cases varies widely, from 19% to 88%. While theories about amnesia and delayed recall of CSA vary and may be controversial due to false memories, it is important to recognize that later in adolescence or adulthood, the victim may not recall the experience. Additionally, if the abuse occurred in middle childhood, ages 6-12, the victim may 1) develop false memories that the abuse ever occurred; 2) be in denial; or 3) be unaware that the type of experience was determined to be sexual abuse. 

Role of the Clinician

The clinician plays an important role in caring for adult survivors of childhood sexual abuse. Because the presenting symptoms can be somatic in nature, the role of CSA in the patient’s illness or presenting symptoms can be overlooked.

Despite never reporting the abuse, 85% of adult survivors of child sexual abuse favor physician screening. Directly asking patients about the occurrence of abuse has been shown to elicit more positive responses compared to self-reporting, 29% versus 7% respectively. Further, especially among adolescent patients, it is important to remember that early disclosure of sexual abuse by the victim is critical to reducing the effects of CSA and to helping reduce psychological distress later in life. Symptoms of ASCSA can vary greatly and, in fact, the patient can be asymptomatic.

Evidence-based research suggests that many interventions can be useful in this population. For example, coping-skill interventions seem to help diminish or prevent post traumatic stress disorder and related adult aftereffects of CSA. Physicians can use the SAVE universal screening tool (Table-2) for childhood sexual abuse in adulthood, developed by the Florida Council Against Sexual Violence. This useful tool screens patients for sexual violence.

Physicians should also be familiar with their own hospital, clinic, or HMO policies and procedures regarding sexual violence reporting, as well as the use of specific reporting forms. The California Medical Training Center develops instructional materials and conducts training in clinical forensic medicine techniques for physician and other health care professionals, social workers, and related reporters.

 

James M. DeCarli, MPH, MPA, CHES
Injury and Violence Prevention Program
Los Angeles County Department of Public Health

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Effects of Childhood Sexual Abuse, Part 5

Effects of abuse, part 5
By Paul Irby Special to the Abilenian
Abilene Reporter-News
Posted May 6, 2009 at 3:59 p.m

Since December, Mental Health Matters has featured one story a month examining the effects of childhood sexual abuse on its victims. Different dimensions to the individual have been considered, which include cognitive, emotional and behavioral. This order was chosen to illustrate the progression of abuse effects, beginning with how a child sees the world and self resulting in emotional experiences that lead to the behaviors which are the first noticeable signs. The behaviors that were last discussed were linked primarily to emotions such as fear, anger, depression and anxiety. This month’s article again focuses attention on the behavioral components that usually don’t manifest until puberty and later. The hope is that by discussing these issues, some insight will be gained into the possible motivations of these behaviors.

One important area to consider, especially in understanding victims of sexual abuse, is the impacts the abuse can have on the survivor’s sexual behaviors. As the person enters into puberty and subsequent arrival of sexual desire, there are two extremes that could possibly manifest.

The first is hypersexuality, which should be understood as an atypical promiscuity among peers. This hypersexuality in the life of an abuse victim is often misinterpreted by family and friends as evidence that the abuse may not have been as traumatic as once thought. However, nothing could be further from the truth. Many victims become hypersexual because sex for them was always something forced beyond their control and this hypersexuality is a means of having control over when and with whom they have sex. Another possible reason for the hypersexuality is to use sex as a means of retribution for their abuse. Sex in this context is seen as a tool for manipulation and self-gratification. One motivation for hypersexuality is linked most commonly among those who had a same-sex abuser. When a child has a same-sex abuser, this can cause confusion and concern in the victim that somehow the abuse will “make me homosexual.” Those with a same-sex abuser may become hypersexual in an attempt to concretely prove and reinforce to themselves that he/she is not homosexual. This understanding should not be somehow aligned with the myth purported in our society that gays and lesbians are pedophiles or that sexual abuse is a “cause” of same-sex attraction.

The other possible extreme of sexual behaviors manifested in the life of a sexual abuse victim is that this victim becomes asexual, which should be understood as having extremely low or no sexual desire. For the abuse survivor who is asexual, often it is because sex for them is so closely associated with their abuse/abuser and is viewed as a filthy violation.

Addictions also develop in the lives of abuse victims. Having worked with some victims who also had a history of substance addictions, a common scenario has developed. Stemming from the original notion that he/she is different from other people because of the abuse, in early adolescence any social invitation is viewed as a chance to “feel normal and accepted.” Often at social gatherings this person is offered his/her first drink or hit of a drug. Accepting this offer again can validate acceptance and “normalcy,” and often has the added affect of numbing the child from feeling depressed, fearful or angry. Add to this a predisposition for addiction and an addict is born.

It is important to keep in mind that hypersexuality, asexuality and addictions occur in a variety of arenas for a variety of causes, and not every person who possesses these signs are victims of sexual abuse. As we have discussed, it is the underlying motivation behind them that links them with abuse.

Paul Irby, M.A., is a licensed professional counselor with the Ministry of Counseling and Enrichment. Mental Health Matters is facilitated by the Mental Health Association in Abilene.

© 2009 Abilene Reporter-News. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.