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Section 2
Secondary Consequences of Childhood Sexual Trauma: Disclosing Secrets

CEU Question 2 | CEU Test | Table of Contents | Child Abuse
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In 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
First 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 my outfit."

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
When 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.

Think 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.

The 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 you mean?
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.

Wendy 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 2
What are five secondary consequences of sexual abuse? To select and enter your answer go to CEU Test.

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