In the first two tracks we discussed narrow range of
emotions, emotional flooding, emotional numbing, confused thinking, feeling hopeless
and helpless, nightmares and flashbacks, eight of the secondary consequences a
sexually abused child can experience as the pressure to release the pain becomes
stronger than the defenses being used.
On this track, we will
continue to look at the last of the secondary consequences resulting from living
with the secrets of childhood sexual trauma. The secondary consequences are: panic
attacks, body objectification, chronic fatigue and minor illnesses. At the
end of this track, we will look at using a Comfort List to calm a panic attack.
We will also look at how "a view through the eyes of others" and an
"I feel when" exercise can provide opportunities to discuss various
self-perceptions your client is dealing with.
As you know,
panic attacks begin with overwhelming feelings of dread, pain and helplessness
and can provide indicators regarding unresolved pain. Seventeen year old, Patty
was sexually abused by Jake, a neighbor when he lived near her family 10 years
ago. She began experiencing panic attacks as she began to deal with the trauma
of her childhood sexual abuse, which she described as, "My heart would race
and I couldn't catch my breath. I get so frightened. There is this sense of doom,
right around the corner, I'm going to die. One time I went to the emergency room
because I thought I was having a heart attack."
to panic attacks, body objectification is another secondary consequence
Patty experienced. She didn't see her body as her home or her own, but rather
as an object. As she put it, "I didn't care what happened to my body. I saw
it as defective, imperfect parts, not whole. It didn't have any real meaning or
value to me." Another group member Kayla, age 14, experienced violent oral
sex by her babysitter. Kayla also did not care what happened to her body and would
mutilate and scar it with a paperclip, which she would run up and down her left
forearm. Consider your Kayla. Is her perception of her own body as an object or
a part of who she is?
In addition to panic attacks and body
objectification, Kayla also struggled with the third consequence of chronic
fatigue. As you are aware, it takes a great amount of energy to suppress the
pain associated with childhood sexual abuse and this can result in both emotional
and physical exhaustion. Kayla described her fatigue as, "A total lack of
energy. My friends call to go bowling or the movies, and I just don't want to
go. I am tired all the time. I'm not sad or bummed, just too tired!"
Chronic Minor Illnesses
to chronic fatigue, is the fourth and final of the secondary consequences,chronic minor illnesses. As you know, the same energy it takes to suppress
the pain that causes chronic fatigue can also surface as ongoing minor illnesses
or accidents. If you recall Patty from the beginning of this tack was the 16
year old abused by her neighbor, Jake when she was six. She had a health history
filled with accidents and illness. Patty's suffered from frequent headaches. Her
accidents included falling down the stairs, spraining her ankle. She stated, "I
just don't feel very well and seem to always be tripping over something."
She had no idea the accidents and illness were related to the abuse she experienced
while her neighbor still lived in the neighborhood. In her journal she writes,
"I remember being healthy up until the age of 6 or so and then all of a sudden
I couldn't play soccer or baseball anymore, because I was sick all the time. And
accident prone, you bet! I was always falling over my own feet or bumping into
walls. I remember the first time my neighbor abused me. I think I was five or
six." Think about your Patty? Does her health history provide any clues to
her sexual abuse?
I found three techniques to be beneficial with the secondary consequences of panic attack, body objectification, chronic
fatigue and chronic minor illness. These techniques are Comfort list, a view through
the eyes of others and an "I feel when" exercise.
3 Techniques Beneficial for Secondary Consequences of Sexual Abuse
#1 - Comfort List Technique
Comfort List exercise I suggested Patty use to help her during a panic attack, began in a quiet session. I asked Patty to write down a list of things
that helped her relax. I told her, "There are no right or wrong answers.
This is an individualized list that is unique to you."
Patty's Comfort List:
2. Hug my teddy bear.
Call Karen if Sandy isn't home.
Pet my cat.
Take a warm bath.
Write ten times, "I'm safe. Jake can't hurt
Go for a run.
Listen to my walkman.
11. Watch MTV.
to Patty that this was to work through and calm her during her panic attack. Patty
thought it was a good idea to keep this list under her pillow where she could
easily grab it.
#2 - "A
View Through the Eyes of Others"Technique
With Patty I also found it beneficial to work on "a
view through the eyes of others" exercise. Patty finished the following
statements about what she believed different people in her world would say about
her Patty stated, "My best friend would describe me as quiet and caring;
The person(s) who sexually abused me would describe me as easily frightened; Someone
who dislikes me would describe me as weird; My mother would describe me as pretty
and smart; My father would describe me as his little girl; My brother(s) and /or
sister(s) would describe me as a squirt." After she used this exercise over
a period of several sessions, she started to experience a broadening of her perspective
of her own self image.
#3 - "I Feel
With Kayla, I used the "I feel
when" exercise, which I have found often helps survivors who have difficulty
identifying and expressing feelings. Kayla struggled at first to complete this
exercise, which as you are aware, when drawing a blank or experiencing tension
may signal a repressed memory.
Kayla completed the "I feel" statements
as follows, "I feel okay when I am walking outside; I feel affectionate when
I receive a compliment and hug; I feel hurt when my kids at school make fun of
me; I feel loving when I am taking care of my cat; I feel shy when I am put on
the spot to speak; I feel anxious when I have to say no to my friends; I feel
happy when I have the energy to do things with my friends; I feel ashamed when
a boy looks at me funny; and I feel confused when I am tired and have to think
On this track, we have reviewed the secondary
consequences of panic attacks, body objectification, chronic fatigue and minor
illnesses. This brings us to the three stages of recovery and the Family Mottos
Technique which will be discussed on the next track.
Peer-Reviewed Journal Article Reference:
Assink, M., van der Put, C. E., Meeuwsen, M. W. C. M., de Jong, N. M., Oort, F. J., Stams, G. J. J. M., & Hoeve, M. (2019). Risk factors for child sexual abuse victimization: A meta-analytic review. Psychological Bulletin, 145(5), 459–489.
Franz, M. R., DiLillo, D., & Gervais, S. J. (2016). Sexual objectification and sexual assault: Do self-objectification and sexual assertiveness account for the link? Psychology of Violence, 6(2), 262–270.
Levenson, J. S., & Grady, M. D. (2016). The influence of childhood trauma on sexual violence and sexual deviance in adulthood. Traumatology, 22(2), 94–103.
Online Continuing Education QUESTION
If your client is experiencing panic attacks, body objectification,
chronic fatigue and minor illnesses, what are three techniques you might consider
utilizing? To select and enter your answer go to .