Friday, August 2, 2013

Recovery and Sexual Trauma and Abuse, IDAA 2013 CME, Keystone Colorado

Recovery and Sexual Trauma and Abuse
Aug.2, 2013
CME IDAA Keystone

Wings Foundation
Alison  Terry, MA
David Jensen, BA

Allison Terry MA

Director of Wings - large network for Adult Survivors of Childhood Sexual Abuse

There are only a few support groups available today.

Impact of childhood sexual abuse
1 in 4 girls sexually abused before 18
-89% by someone they know, relative or acquaintance
1 in 6 boys sexually abused by someone they know
-60% by someone they know

Most abuse happens before the age of 12
--median age of abuse is 9 yo and occurs on average over a 4 year period

90-95% of cases are never reported to the police

At least 10% of people sexually abused in childhood will have periods of complete amnesia of their abuse, followed by experiences of delayed recall

Sexual abuse occurs when a person’s physical or emotional self is violated through sexual actions such as pornographic picture taking, indecent exoposure, lewd comments, sexual innuendos, fondling or intercourse

Child hood sexual abuse occurs when the victim is under the age of 18, regardless of the age of the perpetrator or the relationship betweeen the victim and the perpetrator

Impact of unresolved trauma
  • relational consequences
  • --attachment disorders, ongoing peer and intimate relationship struggles, unhealthy boundaries with others, unhealthy relationships

-physical consequences
--chronic medical conditions, including, migraines, gastrointestinal disorders, fibromyalgia, throat/mouth problems

-cognitive difficulties
  • persistent arousal state/hypervigilances

(It is impossible to know who is a survivor or who isn’t by looking solely at their behaviour)
-psychological consequences
---guilt,shame , self blame; grief, depression, risk of suicide; PTSD; Dissociative Identity Disorder,; Eating disorders/Distorted Body Image;sexuality issues(hypersexuality or reluctance to get into sexual relations;difficulty regulating affective states
Adverse Childhood Experiences (ACE) Study (17,000 over 10 years -80% white or hispanic, 10% black - many college educated - represented US population)
ACE Categories
  • emotional abuse (by parents)
  • physical abuse (by parents)
  • sexual abuse (by anyone)
  • emotional neglect
-physical neglect
-mother treated violently
-household substance abuse
-household mental illness
-parental separataion or divorce
-incarcerated household members

2/3 of population had 1 of these
if one was present 87% chance of one other problems

Sexual abuse one of the highest categories - 22% -only defined as touching offences 
Highest incidence of adverse effect - 25 % - household substance abuse

For someone with ACE score of 5 or more 3.8 x likely to have 3 or more marriages
--26 x likely to have sexual intercourse before age 15

Correlation between adverse childhood events and interpersonal violence

Women with 4 or more ace score 900% more likely to be raped, 500% more likely to have interpersonal violence

With every increase childhood trauma doubling likelihood of rape or domestic violence

Drugs and alcohol - 
Male child of 6 or more ACE - 4600% chance of becoming IV drug users
50% of alcoholism and drug abuse correlated with childhood trauma

Impact of childhood trauma on adults

Suicide Attempts
ACE score 0 -  less than1% attempt suicide
ACE Score 6 - 16% attempt suicide

Coping or Self Harm?

The risk factors underlying these adult disesaes (heart disease, substance abuse , liver disease, etd) are effect short term coping skills (smoking, self medication, weight gain, etc)

Previously effective coping skills lose their utility and eventually become self-harming.

Provide ‘trauma sensitive care’
Support groups - not intended to stop suicide or substance abuse ,but treating ACE indicators, specifically childhood sexual abuse, making a real benefit
87% after treatment had fewer suicide thoughts and action
80% after treatment had less substance abuse
80% fewer episodes of self harm

Treatment of childhood sexual abuse trauma improves relationship skills
  • better able to ask for needs
  • -better parent
  • better able to set and enforce boundaries
  • ability to function in daily life

Majority agree groups make a difference positively in their lives

80% of those who are treated have sexual abuse 20 years or more in the past

-difficulty with caregiver
-fear of being out of control or over dependent
-discomfort with touch
-teen pregnancy or promiscuiity
  • prostitution

Mental Health
-dreams or nightmares
-phobias of needles, vaginal exams or other invasive procedures
-recall of childhood sexual abuse memories

Common triggers
1- control or loss of control
2 - pain injury bodily damage invasion
3 dependency on partner, caregiver, doula
  1. mistrust of authority figures, strangers
  2. shame and being judged over body image

-s\he has a very good reason for
-- feeling this way, acting this way, thinking in a way

Have questions on an intake form and follow up on thise

How respond
-always convey calm concern
  • acknowledge difficulty of disclosure
  • reinforce survivor’s control of disclosure process
  • acknowledge survivor’s feelings
  • assess survivor’s well -being

What to say?
When you do not have time to discuss it.
-I’m very sorry
-No one deserves to be treated that way
-I ‘ll try to be especially mindful, is there anything I can do to make you more comfortable
When you do have time 
-“i’m glad you told me, you might discoover some things during this process that reminds you in some way of your previous abuse
-would you like to discusss it

Wings Foundation Conference OCt. 5, 2013
Aschutz Medical Campus
“soaring to new heights’
First National Conference focused - Adult Survivors of Child Sexual Abuse 
  • service providers, survivors, loved ones, therapy
  • Keynote speakers - Dr. Suzie Burke RN LPC PhD
  • Dr. Robert C. Scier - the Brain in Trauma, Dissociation, and Chronic Disease


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