the last track we discussed the three core defenses commonly used by survivors
of childhood sexual abuse of memory repression, dissociation and denial; as well
as the role Timeline Exercise plays in uncovering the secret of sexual abuse.
On this track, we are going to begin to look at what happens
in the sexually abused child when the pressure to release his or her secret pain becomes stronger than the defenses being used to hide it. These efforts to hide
the abuse result in Secondary Consequences such as narrow range of emotions, emotional
flooding, emotional numbing, and shortened attention span. At
the end of this track how I will discuss how a written dialoguing was beneficial
with this client.
Wendy, age 17, experienced violent incest from her father between the ages of eight and twelve, when her parents divorced.
It might be noted at this time that 33% of girls are
sexually abused before the age of 18 and 16% of boys are sexually abused before
the age of 18.
Wendy's, emotional and physical reaction to
her abuse started to materialize in secondary consequences. It is these secondary
consequences that came to the attention of Wendy's teachers and the reason she
was referred to me. Wendy flew into a rage over minor issues with her classmates,
cried for no reason and was always requesting permission to go home to check on
something. She couldn't remember what books to take home for homework and her
grades are suffering. To help Wendy, of course, I needed to help her look beyond
the "symptoms" and realize these feelings and behaviors are most probably
the result of the sexual abuse she experienced between the ages of eight and twelve.
Sexually Abused Children - 4 Secondary Consequences
#1 - Narrow Range of Emotions
let's look at a narrow range of emotions. As you know, survivors of sexual
abuse swing between either a narrow range of emotional experiences or extreme
emotions of anger, rage, deep grief and sorrow. However the subtle emotions such
as, happiness, bliss, annoyance, sadness, hurt and fondness were unavailable for
Wendy. Wendy stated, "I was furious when I couldn't find my car keys. I mean
why couldn't I just feel annoyed with the situation? Yesterday, I cried for hours
and became so depressed, when I thought Susie, my best friend, disapproved of
These narrow range of emotions are usually
limited to painful or negative emotions.
#2 - Emotional Flooding
In addition to a
narrow range of emotion Wendy experienced emotional flooding. Wendy defenses
temporarily ceased to work, causing her to feel overwhelmed with emotional pain.
Her flood of emotions often could not be connected to any particular event. Wendy
stated "This makes me so angry. I just get upset or really, really sad and
they get upset at me and I don't know why. Sometimes, I feel so fearful, like
something isn't right, but I don't know what. I am always checking to make sure
things are alright, like always checking to make sure that I have my car keys
or running back into the house to make sure I gave water to my dog. I feel overwhelmed
all the time." Think of a client you are currently treating. Does he or she
experience Wendy's narrow range extreme emotions? Or emotional flooding, feeling
overwhelmed? Or does your client experience emotional numbing?
#3 - Emotional Numbing
Wendy faced with the possibility of remembering the abuse she had kept hidden
from her conscience memory, she often experienced emotional numbing. As
you know, emotional numbing, a secondary consequence of sexual abuse, is a carry
over from Wendy's survival techniques. She used emotional numbing to get through
the four years of sexual abuse by her father. Wendy stated, "At times it
is almost as if I "think" my feelings rather than physically experience
them. It is like I know I have feelings, but somehow they are missing at times.
Like I stop them."
#4 - Shortened Attention Span
In addition to a narrow range of emotion,
emotional flooding, and emotional numbing Wendy had a shortened attention span
and confused thinking. As you know, disjointed and disorganized thoughts are internal
defenses the subconscious uses to prevent remembering the sexual abuse experienced.
Wendy, explained, "I'm pretty organized most of the time, but if I tried
to talk about my childhood or think about my dad touching and using me that way,
I get totally confused. It's as if somebody just stirred up my thoughts with a
big stick." Wendy's confused thinking was usually intermittent and seemed
to become more intense when she tried to focus on remembering the abuse.
about your Wendy, for a moment. Does she exhibit a narrow range of emotions,
emotional flooding, emotional numbing, shortened attention span or confused thinking?
If so, are you using written dialoguing?
With Wendy I found
written dialoguing most beneficial. Wendy was able to write both sides of a conversation
between her and her father. By doing so, Wendy dialoguing added the benefit of
receiving feedback about her innermost thoughts. I feel spontaneously writing
feedback caused Wendy to draw from her subconscious. As you will see, it provided
her with an opportunity to express her anger and hurt and get a response.
following is a dialogue Wendy wrote to her sexually abusive father, Joe:
Wendy: Tonight I screamed "I hate you." I really don't hate you, but I'm very
angry at you. When I was younger, I wanted you to hold me and take care of me,
but you violated that trust! You touched and used me as you wanted. I should have
been able to trust you! My life was so shitty because of you.
Joe: What do
Wendy: You know damn well what I mean. I was afraid to be near you
for fear of what you would do next.
Joe: But you don't understand how bad things
were for me with your Mom. I loved you.
Wendy: Bullshit! Other people have
hard times and love their kids, without doing the things you did to me. You just
used me to satisfy yourself.
Joe: I loved you.
Wendy: Well, a lot of good
your love did me. I guess I know you loved me, but I could never understand why
you hurt me. I wanted to tell you, but now you are not here and I don't know if
I'll ever see you again.
Joe: I can help you now. I love you. I'll give you
my love in many ways and through many people. I will give you love especially
through yourself! You will love yourself, soothing I could never do. You will
become healthier and healthier.
Wendy: Thank you. Thank you for caring. I'm
still pissed that it wasn't different, but I'm learning to get through my feelings
and release them. I'm starting to stand up for myself and ask for what I need
in my life. I'll talk to you soon.
Father: Okay. Good bye for now.
wrote this brief dialogue in a hurried fashion on a tablet in my office in
5 minutes, head bent, pen grasped tightly, and quickly sobbing. When she read
it to me and ended, she had a calm affect. If you would like to try a written
dialogue with your Wendy, consider replaying this track to review the idea just
prior to your session.
Now that we have reviewed the secondary
consequences of narrow range of emotions, emotional flooding, emotional numbing
and shortened attention span, the next track will discuss additional secondary
consequences created by hiding the secrets of sexual abuse. These secondary consequences
are feeling hopeless and helpless, nightmares and flashbacks. You will receive
the technique of self-discovery exercises.
Peer-Reviewed Journal Article References:
Bonanno, G. A., Keltner, D., Noll, J. G., Putnam, F. W., Trickett, P. K., LeJeune, J., & Anderson, C. (2002). When the face reveals what words do not: Facial expressions of emotion, smiling, and the willingness to disclose childhood sexual abuse. Journal of Personality and Social Psychology, 83(1), 94–110.
Chard, K. M. (2005). An evaluation of cognitive processing therapy for the treatment of posttraumatic stress disorder related to childhood sexual abuse. Journal of Consulting and Clinical Psychology, 73(5), 965–971.
Stappenbeck, C. A., George, W. H., Staples, J. M., Nguyen, H., Davis, K. C., Kaysen, D., Heiman, J. R., Masters, N. T., Norris, J., Danube, C. L., Gilmore, A. K., & Kajumulo, K. F. (2016). In-the-moment dissociation, emotional numbing, and sexual risk: The influence of sexual trauma history, trauma symptoms, and alcohol intoxication. Psychology of Violence, 6(4), 586–595.
Online Continuing Education QUESTION
What are five secondary consequences of sexual abuse? To select and
enter your answer go to .