Abuse—physical, verbal, or emotional maltreatment—can leave psychological wounds that

are harder to heal than bodily injuries. Intense, often negative feelings may plague the
survivor, and he or she may struggle to cope and lead a happy, peaceful life. Distressing
memories, anxiety, blocks to intimacy, and trust issues are common, although many people
are able to overcome or minimize challenges like these.

SEXUAL ABUSE

 It is any harm which affect psychologically, emotionally and physically rendered to

both the gender, male and female.
 It is also referred to abuse which is for fairly long time or otherwise it would be
referred to as sexual assault, rape, molestation, harassment.
 Sexual abuse, also referred to as molestation, is forcing undesired sexual
behavior by one person upon another.
 The offender is referred to as a sexual abuser or (often pejoratively) molester.
 The term also covers any behavior by any adult or older adolescent towards a child
to stimulate any of the involved sexually.
 When the victim is younger than the age of consent, it is referred to asstatutory
rape or child sexual abuse.

Types of Sexual Violence

Rape: forced sexual intercourse, including vaginal, anal, or oral penetration. Penetration
may be by a body part or an object. Rape victims may be forced through threats or physical
means. In about 8 out of 10 rapes, no weapon is used other than physical force. Anyone
may be a victim of rape: women, men or children, straight or gay.

Acquaintance Rape: Acquaintance assault involves coercive sexual activities that occur
against a person’s will by means of force, violence, duress, or fear of bodily injury. These
sexual activities are imposed upon them by someone they know (a friend, date,
acquaintance, etc.).

Child Sexual Abuse: sexual contact by force, trickery, or bribery where there is an
imbalance in age, size, power, or knowledge.

Dating and domestic violence: any act, attempt, or threat of force by a family member or
intimate partner against another family member. Dating and domestic violence occurs in all
socio-economic, educational, racial, and age groups. The issues of power and control are at
the heart of family violence. The batterer uses acts of violence and a series of behaviors to
gain power and control.

Drug facilitated assault: when drugs or alcohol are used to compromise an individual’s ability
to consent to sexual activity. In addition, drugs and alcohol are often used in order to
minimize the resistance and memory of the victim of a sexual assault. Alcohol remains the
most commonly used chemical in crimes of sexual assault, but there are also substances
being used by perpetrators including: Rohypnol, GHB, GBL, etc.

Incest: sexual contact between persons who are so closely related that their marriage is
illegal (e.g., parents and children, uncles/aunts and nieces/nephews, etc.). This usually takes
the form of an older family member sexually abusing a child or adolescent. Incest is
considered by many experts to be a particularly damaging form of sexual abuse because it is
perpetrated by individuals upon whom the victim trusts and depends. In addition, support
can also be lacking and pressure to keep silent powerful as fear of the family breaking up
can be overwhelming to other family members.

Sexual exploitation by a helping professional: sexual contact of any kind between a

helping professional (doctor, therapist, teacher, priest, professor, police officer, lawyer, etc.)
and a client/patient.

Hate Crime: the victimization of an individual based on that individual’s race, religion,
national origin, ethnic identification, gender, or sexual orientation. While any targeted group
can experience rape and sexual assault as a form of hate crime, there are two groups that
are often noted for being victims of this particular form of hate crime.

Sexual harassment: unwelcome sexual advances, requests for sexual favors, and other
verbal or physical conduct of a sexual nature in which submission to or rejection of such
conduct explicitly or implicitly affects an individual’s work or school performance or creates
an intimidating, hostile, or offensive work or school environment.

WHO ARE THE PEOPLE WHO ABUSE ?

Religious leaders-When individuals in positions of trust and/or authority, especially

religious leaders, breach their trust by committing sexual acts on children, or failing to report
such acts, they must be held accountable for their actions (or inaction)

Drug addicts- Sexual addiction and substance abuse feed off each other, and it is not
uncommon for one to lead to the other. Those who are abusing drugs or alcohol may
engage in promiscuous behavior when they are high. That not only creates an association of
being high with sex, but also a more intense high since neural pathways are being affected
by both behaviors. Certain drugs, such as ecstasy, are known for their effect on sex. When
someone wants to enhance their sexual experience they may turn to certain drugs to
increase endurance, intensify sensations, and prolong the encounter.

More powerful authorities- powerful people when gain control and authority , they want to
become superior to everyone so a method used by them to gain superiority is by sexually
abusing the women.

Pedophilia or paedophilia is a psychiatric disorder in which an adult or older adolescent

experiences a primary or exclusive sexual attraction to prepubescent children, generally age
11 years or younger. Pedophilia is termed pedophilic disorder in the Diagnostic and
Statistical Manual of Mental Disorders (DSM-5), and the manual defines it as
a paraphilia involving intense and recurrent sexual urges towards and fantasies about
prepubescent children that have either been acted upon or which cause the person with the
attraction distress or interpersonaldifficulty

IDENTIFACTION OF SEXUALLY ABUSED PEOPLE

PHYSICAL SIGNS

Marks/ burses

Sweating and palpitations

Bleeding

Disabled looks

PSYCHOLOGICAL SIGNS

Fear

Anxiety

Depression

Suicidal tendency

Lack of trust

Loss of appetite

Loss of sleep

Nightmares

Lack of smile

Melancholic mood

Aloofness

Loss of physical stamina

Suspiciousness

Negative attitude towards marriage

Hatred towards opposite sex

PSYCHOSOMATIC SIGNS

Loss of speech

Stomach ache

Head ache

Indigestion

Nausea

EMOTIONAL SIGNS

Trauma

Aggression

Anger
Irritability

Restlessness

Inability to enjoy

Lack of trust

Inability to form close relationship

Aloof

Submissive

Unable to express opinion

Fearful

Avoidant of social interaction

Avoids public places

Lack of recreational activities

Low self-esteem and confidence

Self conscious

Excessive crying

SOME VICTIMS DO ACTS SUCH AS :-

Sexually experimental

Early initiation

Excessive masturbation

TREATMENT

1. CHILD

Types Of Therapy:

Individual Counseling -Children (ages 3-12) and teenagers (ages 13-18) who have been
sexually abused Individual counseling sessions are typically 50 minutes, once per week.

Crisis Intervention -Crisis intervention counseling is offered to individuals who have

recently experienced rape, sexual abuse, or are currently in crisis from past abuse.

Trauma Focused Cognitive Behavioral Therapy (TF-CBT) - TF-CBT is one of the primary
treatments of choice when working with victims of trauma, including rape and sexual abuse.
It is used to assist trauma victims in reframing the irrational and negative thoughts and
beliefs related to the trauma. TF-CBT allows the therapist to present educational information
to clients, have the clients practice the new information in sessions, allow the client to create
a trauma narrative of their experience, and then process the feelings around their trauma
incorporating their new education. Parents and caregivers are brought into sessions when
appropriate.

Eye Movement Desensitization and Reprocessing (EMDR)- EMDR is primarily used

when working with victims of trauma, such as rape and sexual abuse, and a clinician is
required to receive additional training to be certified in this type of treatment. Thanks to
EMDR, S.A.C. therapists are able to help clients move through unresolved issues stemming
from rape and sexual abuse and reach a place of healing not as easily attainable with
regular, longer term psychotherapy.

Play therapy is theoretically based and assists children in expressing their feelings related
to sexual abuse through activities and games. Children communicate through play as adults
communicate through language. For this reason, play therapy offers children a safe and
comfortable way to express and process their thoughts and feelings about their trauma. Play
therapy uses sand trays, art, dollhouses and games in sessions to help children recover
from the sexual abuse.

Art therapy is a mental health modality that implements the creative process of art-making
to improve and enhance physical, mental and emotional well-being. By resolving conflicts
and problems through external, symbolic means, old patterns of thinking, or cognitive blocks,
are often bypassed. Art therapy’s theory is predominately psychodynamic but can be used in
conjunction with other treatment methods.

Dialectical Behavior Therapy (DBT) is a behavioral intervention that focuses on teaching

clients four sets of key skills for daily life functioning: interpersonal effectiveness, emotion
regulation, distress tolerance and mindfulness skills. DBT has been found to be effective in
multiple controlled clinical trials, and is especially effective when individual therapy is
combined with group therapy

ROLE OF COUNSELLOR :-

 learning touch distinctions (i.e. good touch/bad touch;

 learning about private parts;
 learning skills for avoiding abuse, including saying ‘no’, screaming for help, running
away;
 knowing the difference between ‘good secrets’ and ‘bad secrets’;
 realizing the idea that sexual abuse is never the child’s fault
 knowing the need and ways to report abuse.

2. ADULT

Exposure therapy often works well when the sexual abuse results in a specific fear. For
instance, a child sexual abuse victim who is afraid to go into the room where the abuse took
place or who fears women who wear clothing similar to those worn by an abuser may benefit
from such an approach.

Eye movement desensitization and reprocessing therapy (EMDR) uses subtle eye
movements to help “rewire” the brain and change the way the survivor processes the abuse.

Cognitive behavioral therapy (CBT) can help survivors abandon maladaptive approaches.
A man who was abused as a child, for instance, might be so afraid of intimacy that he avoids
romantic relationships. CBT can help him uncover the automatic thoughts that cause him to
avoid intimacy, enabling him to steadily work toward healthy relationships and behaviors.

Counselling- any professional guidance in resolving personal conflicts and emotional

problems. There are many different counselling approaches, and they often draw on
psychological theory and techniques. Many counsellors have related qualifications and
accreditations. However, counselling is only now becoming a regulated field of care. It is a
good idea to check the qualifications and expertise of any counsellor before establishing an
ongoing professional relationship with them.

Sexual assault services- Sexual assault services exist in all states and territories of
Australia. While their main focus is on recent sexual assault victims, adult survivors of child
abuse comprise approximately a quarter of clients seen by these services.

.Complementary therapy- range of practices and techniques outside of those usually

practiced by accredited psychotherapists and counsellors. Complementary therapies have
become increasingly popular in many different areas of health over the last thirty years, and
mental health is no exception. Examples of complementary therapies in mental health
include practices based on yoga, reiki and other meditative traditions, as well as techniques
that incorporate dance, massage or other physical activities.

3. MARITAL RELATION

CBT- Organised desensitization ( reducing fear of similar things in the abuse situation, eg-
fear of man moustache. ) and modifying and replacing the irrational beliefs to rational ones.

PSYCHOTHERAPY- Encourages victims to talk about unpleasant and repressed memories.

Reduce shame, guilt and self- blame.

GROUP THERAPY- it encourages ventilation of one’s feelings as one can openly discuss
about the trauma one faced when he/she was being sexually abused.

EMDR- eye movement desentisation and reprocessing therapy, uses subtle eye movements
to help “rewire” the brain and change the way the survivor processes the abuse

RECREATIONAL ACTIVITIES- physical exercise, sports which help in overcoming trauma

of the victim.

SUPPORT GROUPS- such as spiritual organisation, meditation centres, reki , yoga, head
massage, acupressure.
ONLINE COUNSELLING-

DISORDER REALTED TO BEING SEXUALLY ABUSED :-

Anxiety: People who have experienced abuse may be afraid of people or situations that
remind them of their abuse experiences. They may be scared to be alone, frightened of
strangers, or fearful of sexual intimacy, depending on the nature of the abuse they
experienced. Disrupted sleep, compulsive behaviors, panic attacks, and other indications of
anxiety are somewhat common in survivors of abuse.

Anger: Survivors of abuse may feel intense anger at their abusers, at those who knew of the
abuse and failed to intervene, and even at themselves for being abused, particularly when
they believe they could or should have stopped it. Anger is a natural and normal response to
being abused, and survivors can learn to manage their anger in a constructive manner that
will facilitate healing.

Dissociation: A lack of feeling, numbness, confusion, and out-of-body experiences may

occur during or after abuse to help the victim avoid the pain and fear associated with abuse.
In rare cases, memories of abuse may be repressed, so that the victim does not have any
conscious memory of the abuse.

Mood Issues: Depression, irritability, and mood swings affect many survivors of abuse.

Posttraumatic Stress (PTSD): Nightmares, hypervigilance, flashbacks and other symptoms

of PTSD may occur. Survivors are likely to avoid certain settings and situations that remind
them of the abuse.

Shame: Guilt and shame are often experienced when a survivor believes that he or she
deserved the abuse, was responsible for it, or failed to stop it. Challenging these beliefs in
therapy can help a person transform these feelings.

Self-Destructive Behavior: Sometimes survivors will self-medicate, with drugs or alcohol for
example, or engage in self-harm, such as burning or cutting themselves. Other times, people
may seek out scenarios in which the abuse is repeated, neglect their personal health and
hygiene, or sabotage any potential for success. These behaviors are often representative of
low self-esteem, which is a common symptom of abuse.

Trust Issues: Learning to trust others after abuse has occurred can be challenging,
particularly with regards to intimacy.

Psychotherapy for Abuse Survivors

Therapy can help a person express and process difficult emotions associated with the
abuse, develop self-compassion and self-care strategies for managing moments when he or
she feels emotionally overwhelmed, and learn to trust again.

Group therapy has demonstrated effectiveness in providing social support to help abuse
survivors cope with and transform their feelings of shame, guilt, and alienation from others
as they interact and bond with other people who have lived through similar experiences. For
those who fear the vulnerability and exposure they may experience in a group
setting, working one-on-one with a therapist can be a more intimate and personalized
experience