Long-term health outcomes of childhood sexual abuse

Author(s):Debra Rose Wilson, PhD, MSN, RN, IBCLC, AHN-BC, CHT, Mariesa R. Severson, MSN, RN, WHNP, ICCE

Psychological consequences of trauma were first seen in veterans of war and described in the literature as shell shock. By 1980, the diagnosis of post-traumatic stress disorder (PTSD) was listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM), which guides healthcare practitioners with diagnosis, treatment, and reimbursement. For years we have been studying the psychological changes that are the sequelae of childhood trauma. These long-term consequences include a higher incidence of depression, intrusive flashback memories, hypervigilance, maladaptive coping skills, dysfunctional social skills, and an overactive stress response. Research examining the more holistic effect of trauma has exploded due to recent events, such as 9/11, terrorism, and traumatized troops returning from war.

As holistic nurses, we understand that even when the effect seems to be psychological, social or biology is also influenced. The mind and body interact on every level. The ripple effect of early childhood trauma has more than psychological effects. Biology of the brain and immune function are influenced. The child is forever changed. Here we examine the influence of childhood sexual abuse on the long-term health and the nursing care of adult survivors.

Stress

Walter Cannon first described the fight-or-flight response in 1914 as the complex physiological response that prepares the body for fighting or fleeing. The sympathetic nervous system responds to a stressor, suppressing the calming effects of the parasympathetic system. The hypothalamus in the brain secretes hormones that in turn influence the kidneys and the brain. The cascade of chemicals has a ripple effect on many systems, including the respiratory, gastric, cardiovascular, endocrine, renal, and immune. A major part of the brain/hormone/immune interaction, the hypothalamic-pituitary-adrenal axis, becomes involved and further influences physical and psychological functioning.

Adrenocorticotropic hormone is released from the brain and anti-inflammatory steroids such as cortisol suppress the immune system. Ability for healing and even normal cell maintenance is reduced. With altered immune cell levels, the body has increased inflammation, susceptibility to infection, allergic response, and cell mutation. Natural killer cells, for example, whose job it is to correct the cell mutation of cancer, diminish in number. The effect is cumulative: The longer the stress is perceived, the greater the severity of imbalance.

Early trauma changes the brain

When trauma and stress happen early in life, the effects are far more profound and long-lasting. Biological brain development is influenced by genetics, nutrition, social interaction, and experiences. Almost no new brain neurons are formed after birth. There is, instead, a constant rewiring of the existing neurons. New connections are made and old connections are disconnected. This understanding of the plasticity of the brain is what drives rehabilitation after a stroke.

Trauma and early negative experiences affect the development and even structure of the brain. Women who were sexually abused as children show significantly diminished brain volume on brain scans. The structure and function of the hippocampus (responsible for learning and memory), for example, are different when compared to individuals who weren’t traumatized. The medial prefrontal cortex, amygdala, and other neural circuitry of the brain are also changed. The brain shows a sustained and pervasive stress response as the child grows, and this has a long-term effect on immune function. Brain wave patterns change. The brain’s response to inflammation and healing is altered. Neurotransmitter levels adapt to these new abnormal levels. The biological changes in the brain are even more profound if the abuse was early, pervasive, or severe.

Long-term health issues for survivors of childhood sexual abuse

The range of potential adverse health outcomes is extensive and childhood sexual abuse can be seen as a risk factor for many diseases. Those who experienced childhood sexual abuse are one and a half times more likely to report serious health problems.

The figure below shows common long-term sequelae of childhood sexual abuse. Because of the holistic nature, it’s difficult to categorize the conditions into traditional systems or paradigms.

Childhood Sexual Abuse

(Click to download PDF)

Used with permission from Perspectives in Psychiatric Care.

Psychological issues for this population often include anxiety, poor self-esteem, dysfunctional relationships, eating disorders, and PTSD. PTSD results from a threat to self or others accompanied by “intense fear, horror, or helplessness,” according to the Veteran’s Administration National Center for PTSD. Maladaptive coping such as denial is overused. Those with a history of childhood sexual abuse have increased reports of fear, anxiety, insomnia, headaches, aggression, anger, hostility, poor self-esteem, and suicide attempts. Higher rates of depression are reported. Depression has also been shown to be associated with impaired immune functioning. Increased cytokines (inflammation) and cortisol (stress) have been identified as mechanisms by which immune system function is impaired and related to depression. Incidences of dysfunctional relationships, intimate partner violence, and self-destructive behavior are higher.

Higher rates of some physical diseases, such as sexually transmitted diseases, hepatitis, or pelvic inflammatory disease, can be attributed to the common behavioral issues for this population that include promiscuity, substance abuse, and/or sexual dysfunction. But for those traumatized early in life, there exists a clear and increased risk of lung disease, ulcers, cardiac disease, diabetes, and cardiac disorders. The high incidence of inflammatory disorders, such as rheumatoid arthritis and allergies, is an example of the imbalanced immune system’s overreaction. Prolonged stress and exposure to cortisol, for instance, cause wounds to heal slowly, indicating an underreacting immune system.

Autoimmune disease

The role of childhood sexual abuse in the development of autoimmune disease is worthy of special attention. Trauma in early childhood predisposes the individual to autoimmune diseases in later life. Some of the strongest evidence linking autoimmune disease to childhood trauma is a retrospective study of over 15,000 adults who were enrolled in the Adverse Childhood Experiences study. Autoimmune disease processes commonly seen in this population are fibromyalgia, Crohn’s disease, irritable bowel syndrome, type 1 diabetes, and rheumatoid arthritis. Patients with a history of childhood sexual abuse may develop fibromyalgia and use outpatient health services and analgesics more frequently. Adult survivors of childhood sexual abuse also report increased pain associated with other medical conditions. Cardiovascular diseases, such as arteriosclerosis and ischemic heart disease, are directly related to maladaptive immune function and inflammation and occur in higher rates in adult survivors of childhood sexual abuse. It’s important to remember that any of these disease processes can occur in people who weren’t sexually abused as children.

Healing is possible

Healing from childhood sexual abuse is possible at any point in life. Nurses should be familiar with local providers for counseling, stress-management training, and holistic care of these survivors. Nurses should take an active role in advocating for the client in the referral process when the history of childhood sexual abuse is identified. The human cost of healing survivors of childhood sexual abuse is still far greater than the cost of preventing childhood sexual abuse from occurring in the first place. Being sexually abused as a child has a lifelong impact on health. Once again we are reminded that an awareness of the holistic perspective is vital for competent nursing care of victims of childhood sexual abuse.

Now that you have read the article, see how you would handle these example scenarios. There is no one right answer.

Scenario #1 Mrs. B. Raider is a 60-year-old menopausal client who presents at her physician’s office following a stressful event of being laid off from her job. When reviewing her record, the nurse notices that this is Mrs. Raider’s 10th visit to the clinic in the last year. She notes a history of back pain, migraine headaches, depression with use of selective serotonin reuptake inhibitors, irritable bowel syndrome, alcoholism, and fibromyalgia. Mrs. Raider has difficulty making eye contact when asked why she is here today, and states that she has been having persistent pelvic pain. She says she is unmarried, not sexually active, and divorced less than a year.What clues about her history might indicate sexual abuse? What support groups, stress-management training, or nursing interventions may be helpful? Note: To answer the first question, refer to the Childhood Sexual Abuse figure earlier in this article.
Scenario #2 Miss Clarissa Kent is an 18-year-old homeless, obese woman who presents at an urban free clinic with complaints of malodorous vaginal discharge, fever, and pelvic pain for the last 48 hours. She has no contact information, is unaccompanied, and reports a history of I.V. drug abuse. She states she fears she might be HIV-positive. When the nurse inquires about her work-related status, the young woman explains that she recently chose to work for a local escort service to support her drug habit and pay the bills. She reports a long history of poor health and bulimia since she began middle school. She admits to attempting suicide in the past; following the event, she dropped out of school and ran away from home. She says she did this primarily because of the way she was being “treated” by her alcoholic stepfather for most of her life. After sharing this she looks away and states she doesn’t want to talk about it, and asks to see the physician.What might you say to make her more comfortable continuing her story? What resources exist in your community to help this young woman? What might you say and do if she disclosed a history of sexual abuse?
Scenario #3 Mr. Howell accompanies his wife Rebecca to labor and delivery for the birth of their first baby. The nurse notices that Mr. Howell is very protective of his wife, and that his wife isn’t answering many of the questions that are being asked. Rebecca allows her husband to speak on her behalf and is resistant to changing into the hospital gown or letting the nurse put on the fetal monitors. She seems to become tense and pulls away when light touch is used to help her with relaxation. When the nurse tries to explain the need to do a vaginal exam to check the progress of cervical dilation and effacement, the couple admits that they don’t understand what she is referring to and add that they only established prenatal care about a month ago. They haven’t attended any prenatal classes. When the nurse attempts a vaginal exam, Rebecca is unwilling to adequately open her legs or relax her perineum sufficiently. The nurse explains that the female provider Mrs. Howell has seen for the past month isn’t on call and that a male provider will instead attend their birth. Rebecca begins to suddenly sob uncontrollably, as Mr. Howell becomes angry and defensive towards the nurse. What changes and accommodations could the nurse have made that would have been more sensitive to the needs of Rebecca Howell. What behaviors and symptoms might indicate a possible history of sexual abuse?

 

Selected references

Bremner JD. Effects of traumatic stress on brain structure and function: relevance to early responses to trauma. J Trauma Dissociation. 2005;6(2):51-68. doi:10.1300/J229v06n02_06.

Dube SR, Fairweather D, Pearson WS, Felitti VJ, Anda RF, Croft JB. Cumulative childhood stress and autoimmune diseases in adults. Psychosom Med. 2009:71(2):243-250. doi: 10.1097/PSY.0b013e3181907888.

Goodwin RD, Stein MB. Association between childhood trauma and physical disorders among adults in the United States. Psychol Med 2004;34:509–520.

Sachs-Ericsson N, Blazer D, Plant EA, Arnow B. Childhood sexual and physical abuse and the 1-year prevalence of medical problems in the National Comorbidity Survey. Health Psychol. 2005;24(1):32-40.

U.S. Department of Veterans Affairs. (2011). National Center for PTSD. http://www.ptsd.va.gov/professional/pages/forensic-validity-ptsd.asp. Accessed September 20, 2012.

Wilson DR. Health Consequences of childhood sexual abuse. Perspect Psychiatr Care. 2010;46(1):56-64. doi: 10.1177/0123456789123456.

Wilson DR, Warise L. Cytokines and their role in depression. Perspect Psychiatr Care. 2008;44(4):285-289. doi: 10.1111/j.1744-6163.2008.00188.x.

 

Debra Rose Wilson is a professor at Walden University in Minneapolis, Minnesota, and Middle Tennessee State University in Murfreesboro, Tennessee. Mariesa R. Severson is assistant professor at Middle Tennessee State University School of Nursing.

28 COMMENTS

  1. as I read some of the stories it was hard to stop the tears from falling. I was abused by a youth pastor, my mother was chasing drugs and men at that time and too busy to notice. I mostly blame god because I thought I was making all the right decisions. I went to church 6 out of 7 days a week. looked after my nephew minded my manners at school and made good grades. I reported the crime to the police and nothing happen to the abuser. two years later he struck again then, was caught in 2012. I though I had blocked those memories and was ready to seek justice so I contacted the police department when I originally filed when I was a minor. I requested police reports and to reopen the case . Not knowing the second victim had requested the same. ( funny how God works) early this year he plead guilty and ws sentenced to 11 years for his crime against me. When I went to the sentencing every emotion came back. I was that scared 11 year old girl. I was terrified and I kept smelling the scent of the old house, his cologne, hearing him sing choir helms in my head. I starting crying uncontrollably. There was no weight lifted he had already attacked 3 more girls since my attack so I felt worst. If the police would have convicted him then they could have given me more piece of mind or even offered couseling. here I am depressed after opening an old wound because there still is no justice. I received a lifetime of tears and pain feeling victimized for what? So he can be sexually satisfied? This world id so messed up, imagine a leader of the community praying on sunday but abusing young girls whom already come from broken homes. Then you have the congregation hiding and defending this man to save face. Yes, this all happen in the black church.

  2. I’m so happy I found others who feel the same way I thought I was going crazy in in my adult hood. I didn’t know unexpressed situations could destroy and haunt who I am. I never really got the chance to find me. I’m 34 and I’ve made alot of poor choices. I feel like a bad mom because I’m not truly happy inside. I’m a alcoholic and a smoker now. I been having health problems as well. I’m depressed and underweight. It’s like I’m trapped in being molested by my brother,my girl cousin and boy cousin which caused me to believe that’s who I am just a sex convenience. Reading posts today tells me I need to fix it before it’s too late.

  3. My niece just died from an overdose. She always kept her distance from me. She was actually named after me. I found out that she was molested by her father at a young age. I didn’t know this until today. Her funeral was on Monday. I could never figure out what her problem was. I always thought she was born with evil in her. I know that sounds terrible. When I saw her in her coffin she looked horrible. I couldn’t believe how this had taken a toll on her. She was in her addition for 5 months. Well, her father and 2 of my other brothers had molested me from the age of 6 to 10. I have had horrible problems in school as a child. Bad grades. horrible relationships.. It was a miracle that I finished college. I have always lived a reckless life from a very young age I wanted to find and do any drug I could. I went to a rehab and it straightened me out drug wise. But I still drink alcohol. I have my life together and am a great mother but I do have an autoimmune disease. Psoriasis. It goes away if I stop drinking for a week. My niece has a very rare disease called Eosiniphillic Esophaghitis , which went away eventually. Coincidentally I had the same diagnosis for about 1 year a couple of year ago. It is horrible. I always thought she was faking it because she just seemed like a phony. But then I got it. I feel horrible now. All along I could have helped her. It wasn’t until she was dead from drug addition that I had to find out all these ugly details. I would have done everything to help her. There was hope for her, but now she is dead and buried. I still can’t believe what happened to her.

  4. I was severely abused by my father from age 12-18. And this article hit right on the money. I have an autoimmune disease that started when I was 15. Severe depression, migraines, joint pain, anxiety, weight problems. I didn’t tell anyone about the abuse until I was 18. Most of my family didn’t believe me, so I was very isolated and became extremely suicidal for some time. I am now 27 and still struggle with the effects of the abuse. My love life/sex life and close relationships still suffer from it. Thankfully a couple years ago I was able to get some counseling, lost a lot of weight and tried to get a handle on my health. While I do feel better, I still deal with my autoimmune disease and the pain and other symptoms that come with it. Also still have regular migraines, anxiety, depression, and nightmares. Though I think some things we survivors may never overcome, just learn to handle them the best we can.

  5. I grew up at the age of six being continually mollested by my step dad.my mother had little to no time for me so she blatantly choose to not see the effects of the abuse was having on me.i was failing most of my classes in elementary so i needed special tutoring.it took 5 years for my mother and step father to divorce and for it to end.i never spoke on the matter til i was 23 years old i have been subjected to 5150 and 5250 holds and have never felt worth much it has lead to a divorce since i wasnt always able to have something nice to say when i spoke of what happened family my ex wife and people in general pretty much just laughed in my face.now im 30 years old and am able to briefly talk about this so ill end this with it would be nice for both men and woman who are survivors of sexual abuse to be empathised equally.

  6. I am humbled by the ripple this article has made, and continues to make. While this article is getting a little old, it still is true and evidenced-based. We do better understand how the trauma influences immune function since this was written.

    Your stories touch my heart and I wish you all gentle and loving healing paths. You can see you aren’t the only one. Many of you will go on with your healing to make change and protect other children, and I thank you now.

  7. My husband shared about his childhood sexual abuse after about seven years of marriage. This article is in sync with so many things he has experienced and as a spouse, have witnessed. Rage, distrust, anxiety, general feeling of numbness to everything. He has had several back surgeries, and still has chronic back pain and was diagnosed with Chron’s disease about 10 years ago. Nothing seems to help. pills, counseling, nothing. It’s a constant struggle. I would also like to say how important it is for articles like these or anything media related, to ALWAYS say women AND men when talking about abuse or using examples of people who were abused. Only using the word women, continues the isolation abused men feel and the under-education regarding male CSA victims.

  8. I wish this article wasn’t so old.

    My brother had already been raping my sister and my parents did nothing even though they knew.

    When he forced me to give his friend a hand job, I knew I was alone and nobody would protect me. I buried the memories for 40 years and now they’re flooding back in.

    I wish there was somewhere or someone for men to talk to. The only thing I found online states that I can have no expectation of privacy and they can use my information in any way they see fit.

    When women speak up, the sympathy flows freely and there is help available. Probably dozens of “hotlines”.

    This is the first time I can connect my autoimmune disorders to my PTSD. I never knew it was related. Psoriatic nails and arthritis. Anismus and Irritable Bowel Syndrome. 2 sinus surgeries in the last 9 years, the second one giving me an iatrogenic disorder called “empty nose syndrome”. That’s the most torturous one that will probably be the ultimate straw that breaks my back.

    I tried contacting my old counselor only to be turned away because I now live abroad.

    Now alone. Nobody to talk to. Sometimes it sucks being a man.

  9. I am 34yrs old, I was sexually abused sin I was 5 or 6 and then again age from 8 to 10 can’t really re call but every other times I constantly get flashbacks from different scenes is crazy how it just gets stuck in my head and seem to never go away. But this whole week I been thinking about and trying to seek help as I been dealing with it on my on. With constant drug abuse, food, sex and just peer anger. I am either happy at time or completely shitty person not just to myself but to my own family. I really never talked about this touchy but very touchy subject but I have to break free or I am gonna die from this. God please help me

  10. My dad began molesting me when I was 3 years old. The abuse lasted until I was in middle school. I was molested by an exchange student living in my moms house when I was 7. My school mate molested me when I was 12. I was raped violently at 15 losing my virginity and continued for months by a boy from school that I liked. I was molested by a doctor when I was 18. I was raped again when I was 21 which was very violent. And raped again by another man when I was 21. I am now 23. It has been a very hard long journey of self harm self abuse. I started shooting up heroim at 15 and struggled with it ever since. I just got 1 year sober yesterday. Fighting for my life. It’s never been easy and don’t know if it will ever get easier. I used to suffer from a lot of horrible nightmares of abusers coming back and doing it again. My rapist would always have blood in his eyes. I try to always think positively and attract positive things. A man once told me that maybe so much sexual abuse has happened to me because I think of it and fear it so much. So these past 2 years I have tried to stop obsessively think and fear it. It has helped and since I’ve stopped thinking of it as much, it hasn’t happened since. I suffered from bulimia in high school. I used to cut myself. I have had a serious drug problem since the age 13 with hard drugs. I’ve been arrested many times as a young teen and served 3 months when I was 15. I have had a large cyst in my ovaries for at least 15 years. I constantly have bad pelvic pain my whole life. Sometimes crippling pain that I can’t walk or stand. But I hate feeling that way and people asking what’s wrong with me and why I’m holding my stomach. I got jaundice a liver disease and was hospitalized for 1 month when I was 19. I’ve been anemic and also had a thyro glossal cyst in my neck that I had to get surgically removed last year. I had a little bit of therapy when I was younger but nothing since. I do wish to seek therapy but need to find the right person as I don’t open up easily and constantly feel judged. Anyways I wish everyone the best and sending love to you all. Reading other people’s stories help. Makes me feel less alone in this daily struggle. ♥️

  11. I feel worthless because of my childhood molestation. I feel like I’m dirty all the time and it’s a matter of time before someone uses me or runs out of my life which sucks. I didnt love myself for decade’s I’m probably suffering from many diseases because of my sexual abuse history (poor diet, alcoholic, I believe early arthritis)I’ve caused tons of pain and trauma on my body and mind due to sexual abuse. I blame myself my parents and God for allowing my brother to touch me and for the little girls at the baby sitters house who forced me to eat their vagina and also the 16 year old boy that touched me and another girl all the time while he masturbated and called us in one by one to fulfill his many fantasies. I’ve never had a good relationship with a guy due to my insecurities and my traumatic past. I’m depressed most of the time due to my past. I recently told my parents at least 2 to 3 years ago my dad blamed me for not telling him when it occurred and wanted to know who it was and acted as if he did not believe me I expressed my pain to my mother in anger what took place during a heated argument. I blame others for a lot of things that went Terribly wrong in my life. I’m dirty non loving materialistic and broken inside due to my trauma I have dreams of being a famous singer actor and dancer but I doubt myself because I dont think I’m good enough I grew up with a abscent alcoholic father my mom was always working and never had time for any of her kids my older brother got the most time with my mom and dad which I’m jealous of. I somehow have to move forward with my life and I dont know where to start but I’m starting with my body so I can at least have some type of control over my life I’m leaving and moving far away from my dramatic family so I can follow my dreams and be successful

  12. ………..fascinating. I can identify with every comment made so far. To the authors of the article, thank you. I was violated from 5 through 12 years of age. As adults molest victims are naturally attracted to each other and most don’t ever know or realize this. The mess it makes of one’s life is difficult for others to grasp. No doubt discussing it is therapeutic. Over 2,000,000 people disappear without a trace every single year on this planet. Most of them children. I have a pretty good idea what happens to them. The problem is huge. The theft of the innocence of a child should be a capital crime.

    I feel like every one that commented is long lost family. Wishing all of you happiness.

  13. My father died when I was two years old of a mysterious cause. My mother remarried almost immediately and from the age of less than three my stepfather begin sexually abusing and raping me not to say anything of the mental anguish he put me through. Even my mother said he never had a good thing to say about me. I began being sick at 10 years old developing Iritis and reiters syndrome. I learned years later that he had infected me with chlamydia. That activated my HLA b27 gene which is been an aggravation my whole life. I didn’t leave home until I was almost 19 and my psychologist tells me this is the worst case of childhood sexual abuse that he’s ever heard. I have ptsd and depression. My sleep is unrestful because of the horrible dreams I still have. I am 72 years old. I have taken antidepressants since I was in my 20s as well as tranquilizers and sleeping medicine. I have been married several times but cannot choose a companion who is not abusive in someway. I am highly intelligent but just don’t know how to get beyond all I have been through. I need help; whether it’s supported communities or something else. I’m very likable except my family members who hold me somewhat responsible for what I’ve gone through. I cannot love their father.

  14. My wife was abused. We mace been married 30 years. She has always had pelvic pain. Head, neck and back pain. So many trips to the ER. She has depression, anxiety, mood swings. She had had two affairs. At 48 she has had a hysterectomy, gallbladder removal and a triple cardiac bypass. Right now I’m laying next to her and she’s having another nightmare from her childhood. Those nightmares seemed to get worse with age.

  15. I was sexually abused for years by my older brother, not to metion by my moms so boyfriends. Then she married one. The abuse was like a compatision between my step dad and brother, I have not learned to cope. I got busted for drugs recenty and have been an alcoholic all of my life, I will soon go to a drug treatment center where i hope to get some help for both. I have bad allergies thyroid problems, arthrities and no telling what else at this point. I only hope I can gain self-esteem, respect for myself, love myself, and learn how to not self-destruct. I wish all of us the best, it’s not something i would wish upon my worst enemy.

  16. I don’t know what to think but seek closer to God. Abusing drugs is increasing my anxiety.I do feel much better when I write down my feelings of anger ,betrayal,..etc…I just keep prayer and learning to forgive not forget and let go because as I can see it will kill me from the damage I put on my body for not LETTING GO. It will take time but FORGIVE!

  17. Thank you. Excellent article. We need more sensitivity to the needs of those dealing with the effects of abuse/trauma. Thank you for the scenarios, to help us to think through how we might respond in situations. Thank you.

  18. My wife was molested as a child also. She is now 39 years old. She was diagnosed with IBS, rheumatoid arthritis, low iron, low vitamin D, ulcers, stones in gall bladder which was removed, and also has symptoms of fibromyalgia, as well she has anger issues, anxiety, and depression…
    What must she do to heal from her child abuse. She has been in counseling for her abuse. This was about 10 years ago. She cpuld bare the pain of all her symptoms but as of lately they have been too much to bear. She will be gettinan ultrasound soon to see if she has a bleeding ulcer since she has been coughing up brown stuff. Anyways what would be the best options for her?

  19. For 2 years now I’ve had progressively worse erectile dysfunction, pain and associated rectal and pelvic pain..much deterioration. .without doctors knowing cause. .I was horribly abused and tortured as an infant and child. by a parent who was clinically psychotic and I even used to black out as an adult. I overcame so much of the abuse several years ago..but now with these new symptoms that will not heal I believe strongly I am reexperiencing the sexual abuse. .as a man it is very humiliating. Best of luck to all…prayer does help

  20. I am a survivor of long-term sexual abuse who became a psychotherapist in the long process of learning and healing which continues ever onward. I believe strongly in the power of our own expression of our truth to heal our body-mind-spirit, and scientific research confirms this is so. In recent months, I have taken time out from my private practice and have written every week with an Amherst Method writing group for 1 weekly two-hour session. As the research of James Pennebaker has shown, this has been powerfully effective. My chronic joint pain and all the symptoms associated with my long-term thyroid disorder have disappeared.

    Find a safe place to write with others, a place where you can read out loud or choose to “pass” until you feel ready. When our body-mind can express its pain and shame and truth directly, our bodies can stop having to do all the work (indirectly) for us.

    May we all heal and help others to learn along with us. We have within us what we need to become well. Buried within, we have the capacity to live fully as whole and joyful beings. Let’s help each other do it!

  21. Thank you so much! For years I have struggled and still struggling with the emotions attached to my childhood and multiple forms of abuse I suffered. I have gone so many years just not thinking. About it. I was molested the first time by my fathers half bother at 5 years old. I have so many feelings of shame ,fear anxiety. And I know why I found this article after googling long term effects of child molestation just looking for a clue as to why I am always feeling fear and anxiety jus

  22. Healing IS possible-don’t let your mind convince you otherwise. Listen to your Heart!

    Thank you, Debra Rose and Mariesa, for a tremendous article! ?

    I experienced CSA and wound up with PTSD and a dissociative order when they manifested 15 years ago (at age 37) after memories surfaced. Therapy, time, and my spiritual practices have helped me thrive. But I am absolutely convinced in CSA’s permanent biological impacts. I now have an autoimmune disease and Fibromyalgia. NOT a coincidence-

  23. Start with what feels right. Therapy? Take stress management classes. Learn self care. Take a class in writing or journaling. If you are a natural writer, start writing it all down. Perhaps some group work for adult survivors? There is support out there in major cities and some nuggets of support in smaller communities too. Choose to change your approach and decide to make progress towards feeling whole again. Take along some peace and love for your healing journey that I send. Breathe

  24. Thank you for this it puts into perspective and understanding of what I’ve gone through for many many years! Thus far the only relief I have found is to self medicate; not so good but to have some sense of normal this is what I do.
    I would prefer finding other methods but do not know where to start.

  25. Boy did this article hit home and it is right on the money. I never knew my x husb was abused until during our divorce process. The last 6 yrs his anxiety skyrocketed, and major depression kicked in, many gasto problems, compulsiveness, reckless, addictive behavior, mixing of many meds, and a lot of rage. Finally culminated in an affair which caused too much damage to the marriage. He was/is never content. Only found out recently about his severe sexual abuse as a child lasting at least a year.

  26. This article is so true.I have fibromyalgia, depression, diabetes, heart disease, insomnia, anxiety,and an unexpressed feeling of constant rage. I was abused as a child from age 5 to age 14. One of my two sisters suffered the same fate before my family moved to another state. We share the same health problems. Reading this article made me want to cry and scream “Not fair”. We shouldn’t have to continue to suffer for what someone else did to us all those years ago. I plan to see a counselor now.

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