Link between Sexual Abuse and Feelings of Shame in Victims

Link between Sexual Abuse and Feelings of Shame in Victims Women and Shame: Exploring the Link Between Sexual Abuse and the Shame Experienced by Victims Abstract Change in the culture of the United States and other countries is allowing for more discussion on the topic of sexual abuse, but it has yet to become the norm. Survivors of sexual abuse experience various negative consequences, including shame and posttraumatic stress disorder (PTSD). Shame includes, but is not limited to, feeling trapper, powerless, and isolated (Brown, 2006). PTSD experienced by survivors of sexual abuse can lead one to withdraw and succumb to the negative and detrimental effects of sexual abuse (Wilson & Scarpa, 2014). To reduce the severity of PTSD and combat the negative effects of shame on those who experience it, specifically female survivors of sexual assault, it is suggested that there be a focus on deep and sincere connection provided by supportive women figures and other women who have experienced sexual abuse. This support, in addition to individual and group psychotherapy, may provide the needed empowerment to overcome shame and decrease PTSD symptoms ex perienced by survivors of sexual abuse. Women and Shame: Exploring the Link Between Sexual Abuse and the Shame Experienced by Victims Sexual abuse is disturbingly prevalent, particularly among college students. The American Association of Universities (AAU) found that the prevalence of sexual assault in college was 22.2% for undergraduate women, and, of the women who were in their senior year of college, 27.2% reported having been sexually assaulted during their four years (Cantor et al., 2015). However, disclosing this information has not always been easy and still proves to be a challenge. It is a barrier that is at times insurmountable for victims of sexual abuse. Unfortunately, in the United States today, and all around the world for that matter, the act of sexual abuse is not taboo—exposing it and talking about it is (Turner, 1993). Despite research statistics indicating that 16% of adult American women will experience abuse before the age of 18 (Jackson, Calhoun, Amick, Meddever, & Habif, 1990), society has shied away from the discussion of sexual abuse become commonplace in America. Moreover, sexual abuse and its negative effects are all encompassing and prove difficult to overcome. Sexual abuse can lead to posttraumatic stress disorder (PTSD) and symptoms of depression and anxiety. Sexual abuse also affects the relationships that survivors have with others. Survivors may feel that their experience is a private narrative that should not be shared with others, or they may be concerned that others may not think that what happened to them was truly rape or assault; therefore, victims may not choose to disclose this experience to anyone (Filipas & Ullman, 2001). In order to change this negative thinking, women need to provide deep and sincere connection to female abuse survivors that will allow them to feel supported and empowered. Because feelings such as fear, shame, doubt, and confusion post abuse may lead to avoidance coping and a potential diagnosis of PTSD, understanding the negative effects of sexual abuse is vital to understanding how supportive women can help female victims to overcome feeling trapped, powerless, and isolated. According to the American Psychiatric Association (APA), PTSD is a psychiatric disorder that can occur in people who have experienced or witnessed a traumatic event, including rape or other violent personal assault (â€Å"What is Posttraumatic Stress Disorder,† 2017). People who suffer from PTSD experience disturbing thoughts and feelings related to their traumatic experience for long periods of time after the event has passed. A study done by Feiring and Taska (2005) found that women who had experienced sexual abuse and reported high levels of shame after one year were at greater risk for experiencing high levels of shame after six years, as well. This type of residual shame is characteristic of PTSD in that survivors experience it for long periods of time after their traumatic experience. If more can be done to help survivors of sexual abuse within the first year after their experience, they may be empowered to combat the negative effects of shame and overcome the statistics. This help can be provided through support, understanding, patience, and providing a safe place for survivors of sexual abuse to share their experience. PTSD due to sexual abuse is not the only psychological disorder that affects victims. Research done by Molnar, Buka, and Kessler (2001) found that sexual abuse occurring during childhood was highly correlated with the onset of 14 various psychological disorders in women. In addition, research done by Wilson and Scarpa (2014) indicated that childhood sexual abuse is associated with higher amounts of PTSD symptoms than other forms of childhood abuse. When considering the implications of PTSD, the long-term effects it has on those suffering it, and the potential onset of 14 various psychological disorders (Molnar, Buka, & Kessler , 2001), childhood sexual abuse can lead to a lifelong struggle with mental health and shame if not addressed. Female survivors of sexual abuse can receive the necessary support through deep and sincere connection with other women—connection that is needed to combat PTSD. Sexual abuse is not a one-time action. Sexual abuse of any type leaves one with feelings of worthlessness, shame, and insecurities that require intensive care and effort to overcome. Women cannot be left alone post abuse to question their worth. Researchers have looked to strengthen the link in the relationship between shame and sexual assault in order to provide more clarity for those seeking answers. Studies demonstrated that shame is often a mediator between an experience such as sexual assault and PTSD (DeCou, Cole, Lynch, Wong, Matthews, 2017). While few studies have been done to examine what role social connections play in the recovery process, Hyman, Gold, and Cott (2003) suggested that the most influential predictor of PTSD—self esteem might be able to offset feelings typically experienced with shame. Because shame is a mediator between sexual assault and PTSD, targeting it by means of connection will minimize its power and role in bringing those symptoms to the forefront. In addition, because 70% of sexual abuse victims will tell someone about their experience—typically a friend (Fisher, Daigle, Cullen, & Tanner, 2003), overcoming the barriers that delay disclosure may prove helpful in providing a safer and more supportive environment for survivors of sexual abuse. Survivors may be able to seek the support they need and share the motions that they are feeling in a much more efficient manner (Ullman, Foynes, & Tang, 2001). Because of the safety that close relationships can provide, the focus on their role in recovery must be emphasized, because survivors can benefit by sharing the emotions of that experience instead of carrying them alone. One of the most prevalent emotions felt by victims of sexual abuse is shame. Shame is an intensely painful feeling or experience of believing one is flawed and therefore unworthy of acceptance and belonging. This strong emotion can lead survivors to feel trapped, powerless, and isolated (Brown, 2006). No victim of sexual abuse should have to face these experiences and emotions alone. Although the shame experienced by female victims of sexual abuse can be a difficult psychological construct to measure consistently across sample populations, deep and sincere connections among women, along with individual and group psychotherapy, may play a vital role in empowering females to combat the negative effects of shame. Women who maintain supportive interpersonal relationships post-abuse are uniquely empowered to feel less trapped, powerless, and isolated. Interpersonal Relationships While those directly involved with sexual abuse are the true victims, friends, peers, and family members to whom this negative experience is disclosed are also impacted by the negative consequences. Victims of sexual abuse are typically not prepared for what they experience, and neither are those they reach out to for support. Each person to whom this information is disclosed responds differently. Wile the majority tend to respond positively, there are some who do respond negatively (Ahrens & Campbell, 2000). Some results have shown that negative reactions include, but are not limited to, feelings sorry for the victims, blaming the assault on the victim instead of the perpetrator, and minimizing the seriousness and effect of the event (Popiel & Susskind, 1985). This negative response typically comes from a place of unpreparedness. Sexual abuse has far-reaching effects, and those who are indirectly affected (and their response to the survivors) should be examined. By providing education to peers and familial supports, in addition to providing a safe place for survivors of sexual assault to disclose their abuse experience, peers and familial supports will likely respond in a way that fosters trust, confidence, and courage. According to George, Winfield, and Blazer (1992), the majority (59% to 91%) of sexual assault victims disclose the event to family and friends because they view them as helpful and/or supportive. Very few report the information to formal agencies such as the police, the hospital, or a formal rape center. Research done by Ullman (1996) tested friends of rape victims and determined that participants did not feel more distressed than normal when they were told their friend was a victim of sexual assault. The results further showed that the friends were angry at the perpetrator and wanted to seek revenge but otherwise maintained positive feelings towards the survivor (Ullman, 1996). Because the results can vary from friend to friend, it is imperative that friends, family members, and supporters of survivors of sexual abuse are educated on their role in the process of recovery and healing. Sexual abuse affects more than just those who experience it first hand, it also impacts those who are trusted enough to help bear the weight and seriousness of this horrible experience. Exploring shame, one of the consequences of sexual abuse more thoroughly, will provide clarity to the healing process that survivors of undergo and the important role that women play in empowering female survivors to overcome their experience. Oftentimes, abuse-related shame is created by the secretive context under which it takes place, including threats to stay silent and not disclose the event to anyone and condemnation from the perpetrator towards the victim (Feiring & Taska, 2005). This shame can then lead one to feel trapped, powerless, and isolated (Brown, 2006). Shame requires a sense of self and an ability to compare oneself against a cultural standard (Feiring & Taska, 2005). Having a better understanding of shame will not only allow female survivors of sexual abuse to take steps towards healing, but will also help peers, family members, and friends to support survivors along this path. Feeling Less Trapped The word trapped is often thought of in the context of not being able to escape. Female survivors of sexual abuse often feel trapped by their experience. Researchers found that a consistent result of shame is an avoidance response so severe tat the individual prefers to hide rather than expose themselves (Barrett, Zahn-Waxler, & Cole, 1993). Additionally, shame promotes cognitive avoidance which is an intentional effort to avoid dealing with a stressor (Berliner & Wheeler, 1987). Because shame produces avoidance, both cognitively and behaviorally, survivors, as well as those who support them, need to understand the significant effect that deep and sincere connections can have on survivors while working through abuse-related shame. Turner (1993) stated that â€Å"the process of sharing feelings with others and realizing that other people feel the same way provides a sense of relief and makes people feel less frightened and not so alone† (para. 12). Being able to reach out for h elp and seek connection, the opposite of avoidance, will likely improve the survivor’s ability to overcome shame and empower her to fight the feelings of isolation that she experiences. Feeling Less Powerless As suggested by Brown (2006), sexual abuse survivors find that producing effects strong enough to counter the shame caused by sexual abuse very difficult. Because shame produces so many emotions, survivors have difficulty feeling empowered enough to get to the core of their abuse and begin healing. Survivors are often stuck in the secondary emotions: shame, guilt, anxiousness, helplessness, and hurt (E. Harwood, personal communication, November 1, 2017). In a study done by Berliner and Wheeler (1987), survivors of sexual abuse typically got to the core of their abuse and began healing by gradually exposing their abuse situation through talking about or abreaction, the expression and emotional discharge of repressed emotion (Merriam-Webster Dictionary, 2017). If female survivors of sexual abuse can experience abreaction, in addition to the support of deep and sincere connections with other women, then they may be able to reach the core of their abuse and begin to explore to real emotions that they are feeling. Survivors will likely gain power over their abuse each time it is exposed through the help of therapists, peers, and family supports. Survivors may begin to feel empowered and start to overcome the complexity of the shame that they experience. They may also find the power to keep seeking connections necessary to overcome feelings of isolation. Feeling Less Isolated The confusion, betrayal, and loneliness that survivors of sexual abuse experience are conflicting emotions and tend to run deep. Because sexual abuse can come by means of close friends, family members, trusted individuals (or associates), isolation seems to be the fitting response when considering that a trusted person could be the perpetrator of such acts. Survivors typically need to rebuild trust, and this can be done through forming deep and sincere connections with women among whom they feel comfortable or women who have experienced something similar. Bass and Davis (1988) found that as women speak to each other about past traumatic experiences, they are able to put more distance between themselves and the pain. That ability led survivors to feel less victimized and more connected with those to whom they were talking (Bass & Davis, 1988). If female survivors can come to trust the deep and sincere connections the form with fellow women, ten they will be able to feel less isolated through talking about their experiences. In addition, survivors will likely feel more empathy and sympathy from those around them and begin to feel that they are not alone but rather surround by people who understand them and their experiences. They will begin to feel connected. Empowerment through Connection Human beings thrive off of feelings of belonging. On Maslow’s Hierarch of Needs, the need to belong is most important after basic needs and safety and security. Further, it is often said that the opposite of addiction is not sobriety but rather connection. If connection is powerful enough to help one to overcome or avoid addiction completely, how important is it then for one seeking to overcome the shame that comes from sexual abuse? Baumeister and Leary (2000) described the â€Å"need to belong or need to develop and maintain meaningful social bonds as a ‘fundamental human motivation’ that lies beneath a myriad of human interaction and behavior†(P#). On that premise, the desire for connection and feelings of belonging come naturally and should not be ignored. In a study done by Llabre and Hadi (1997) that examined children in Kuwait who had experienced trauma, data showed that girls who experienced trauma and perceived low levels of support experienced the highest levels of PTSD symptoms. By providing support to female survivors of sexual abuse through deep and sincere connection from fellow women, these PTSD symptoms may diminish. Whether survivors of sexual abuse prefer avoidance or connection, as observed earlier, friends and familial support must be understanding. If the proper support can be given to victims soon after the abuse occurs, then they symptoms of PTSD may decrease and the natural desire for connection and belonging will likely be satisfied. That help alone may empower female survivors of sexual assault to push through the shame they feel and move forward through the process of healing. The need for connection is not merely a desire to have friends. Satisfying the need for connection can help one to avoid depression, anxiety, and loneliness. The need for connection also elicits goal-oriented behavior (Baumeister & Leary, 2000). In a study done on 160 women who had experienced sexual abuse in their childhood, women who perceived that they had social support reported a significant reduction in depression and other symptoms of PTSD (Hobfoll et al., 2002). Knowing that a need for connection will inspire goal-oriented behavior and combat depression, loneliness, and anxiety, support provided by women can help to counteract the feelings of isolation and powerlessness that female survivors of sexual abuse experience. By building and strengthening deep and sincere connections, survivors will feel less isolated and be empowered to combat the negative effects of shame. Sharing Experiences   While group therapy and individual therapy are great additions to the therapeutic process, sharing the experience outside of therapeutic groups is an additional support. According to a national study done in Sweden, 46% of all Swedish women surveyed had experienced some form of sexual violence since the age of 15 (Ormon, Sunnqvist, Bahtsevani, Tostensson Levander, 2016). Because of these results, further research was done in a women’s general psychiatric clinic. The follow-up study found that women preferred to share their abuse experiences with their peers more so than with staff (Ormon, Sunnqvist, Bahtsevani, Tostensson Levander, 2016). This research demonstrated that survivors of sexual assault tend to be more willing to disclose their experience to trusted women or those who have experienced something similar. Because of this level of trust that is extended to those without therapeutic licensure, fellow women must be aware of the impact they have o those who wish to sh are their experiences. Deep and sincere connection outside of individual and group psychotherapy may supplement the help that is provided there. While research on the view point of friends and family is minimal, some research has been conducted on the matter. Ahrens and Campbell (2000) reviewed the responses of friends to survivors and found that those to whom the information is disclosed are conflicted by wanting to help and support but feel powerless and unhelpful. These same researchers surveyed college students again and found that women are more empathic, especially if they have their own history of sexual assault, blame the experience on the survivor less often than men, and see more positive changes in their relationship with the survivor (Ahrens & Campbell, 2000). Contrary to these findings, Banyard, Maynihan, Walsh, Cohn, and Ward (2010) cited significant responses indicating that friends to whom sexual assault is disclosed feel anger and distress. Because of the inconsistency in responses to sexual assault, there is a need to continue educating peer and familial supports on the role the play in the healing process. By providing this education and spending more time talking about their role, survivors may be able to find deep and sincere relationships with those to whom they disclose their experience to and will likely be able to overcome the shame that stems from sexual assault. Conclusion A community, a culture, a friend, or a family member that provides safety and refuge for survivors of sexual abuse is positioned at the forefront of changes that need to be made. Sexual abuse is experience by more friends and family than is made known and healthy and positive support is owed to them. While sexual abuse is an emerging topic in the world of open discussions, understanding the trail of negative effects that is left behind in its wake is only beginning to be explored. PTSD experienced by survivors of sexual abuse is long term and fosters feelings of inadequacy and hopelessness. In addition, survivors that experience high levels of PTSD within the immediate year following their experience are likely to maintain that high level for a minimum of six years (Feiring & Taska, 2005). PTSD can also accompany 14 other psychological disorders that women are prone to develop after experiencing sexual abuse (Molnar, Buka, & Kessler, 2001). It is difficult and potentially impossible to determine a fix-all for symptoms and effects of PTSD, but it is not impossible to challenge it. PTSD can be challenged and combatted through deep and sincere connection that allows survivors of sexual assault to feel empowered, heard, and supported. Fortunately for survivors of sexual abuse, studies have also shown that they will often be positively received when disclosing their traumatic experience to friends, family, and trusted figures (Ahrens & Campbell, 2000). Unfortunately, there will be some who perceive them negatively, blame the vent on them, and cut off communication and support (Popiel & Susskind, 1985), but by allowing for sexual abuse to be a commonplace conversation and providing safe settings for that to happen, the negative reactions be minimized further. With this positive support, female survivors of sexual abuse will begin to work through the negative effects of abuse-related shame: feeling trapped, powerless, and isolated. Survivors of sexual abuse, women in particular, need each other. By providing deep and sincere connection to those effected by sexual abuse, they will likely feel empowered to overcome the shame that envelops them, because they will feel connected, they will feel included, and they will ex pose the abuse that they experienced. Additional research on the effects of deep and sincere relationships among women should be conducted to better understand their influence as more is being done to provide help for survivors of sexual abuse. Providing education on the importance of supportive peers and families and the positive effects that they have on victims may decrease the amount of psychological disorders and long-term effects that sexual abuse can leave in its wake. 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Childhood abuse, perceived social support, and posttraumatic stress symptoms: A moderation model.  Psychological Trauma: Theory, Research, Practice, and Policy,  6(5), 512-518. doi:10.1037/a0032635 Appendix Figure 1. Type of response experienced by survivors of sexual assault when disclosing their experience to family and/or friends. Adapted from â€Å"Assault-Related Shame Mediates the Association Between Negative Social Reactions to Disclosure of Sexual Assault and Psychological Distress,† by C. DeCou, T. Cole, S. Lynch, M. Wong, & K. Matthews, 2017, Psychological Trauma: Theory, Research, Practice, and Policy, (2)9, p. 169.