Mar 14

Recovery from Childhood Sexual Abuse

I have written previously about how childhood abuse, particularly sexual abuse, can result in poor health outcomes HERE. The recent conviction and sentencing of Cardinal George Pell, as well as the Royal Commission into Institutional Responses to Child Sexual Abuse in Australia has brought this issue to the forefront of many people’s lives. While the effect of Childhood Sexual Abuse (CSA) is significant and its prevalence is disturbing there are also those who experience what is referred to as Post Traumatic Growth (PTG). This article briefly examines the effect of Childhood Sexual Abuse (CSA), its frequency as well as the potential for PTG. I appreciate that this topic evokes strong emotions, so I will endeavour to keep this article as factual as possible. This is not because I have no strong emotions about the subject, but as I have not personally experienced this type of abuse I don’t feel it is the appropriate place to express an opinion. Additionally, I prefer to focus on finding meaning and purpose in life  where possible, by living in the solution rather than the problem.

Prevalence of Childhood Sexual Abuse

Prevalence rates of CSA worldwide are often difficult to confirm, as individuals may be unwilling to disclose information or complete questionnaires related to their own experiences. Recent data suggests that 1 in 4 (25%) women and 1 in 6 (17%) men reported being sexually abused. The Centers for Disease Control and Prevention (CDC) also states 25% of women and 16% of men reported sexual abuse as children. Based on data from several western counties, between 64% and 86% of perpetrators were well known to the victim, which may also explain possible barriers to disclosure. Regardless of the exact percentage of individuals who have experienced CSA, the figures are concerning and the impact considerable.

Effects of Childhood Sexual Abuse

For many, childhood was a time for playing, laughing and learning. Parents and extended family provided them with a secure and safe place to learn, love, laugh and grow into physically and emotionally healthy adults. While many children may have experienced a happy childhood, there are those who suffered trauma through sexual abuse. Children who experienced CSA often experienced negative outcomes as result of this trauma. The impact of CSA on an individual’s well-being is significant. CSA is strongly associated with a greater risk for major depression, physical illness as well as increased anti-social and criminal activity. Female survivors are more likely to be involved in abusive relationships, risky sexual behaviour and self-harming. As parents, both genders place their offspring at greater risk of dysfunctional behaviours due to generational patterns of abuse they may inadvertently pass onto their children. The Royal Commission into Institutional Responses to Child Sexual Abuse suggests, CSA can have a ripple effect on families, communities and society in general due to the impact on mental health, relationships and social integration. It appears that CSA impacts not only the survivor but society as a whole.

Current Treatments

Interventions in the treatment of CSA survivors can take many forms. Cognitive behavioural therapy (CBT) can be effective for both behavioural problems, as well as psychological distress. Group therapy can be an effective intervention in the treatment of ongoing issues resulting from CSA. As well as mainstream services such as, general practitioners (GPs), psychologists and community health services, specialist sexual abuse services that address the mental, social, financial and legal issues that can affect CSA survivors can also be helpful. Body-based therapies such as massage, yoga and Eye Movement Desensitization and Reprocessing (EMDR) therapy are also showing promising results in the treatment of trauma in CSA survivors.

Post Traumatic Growth

Despite the trauma of CSA and its subsequent effects in later life, there is potential for positive adjustment, commonly referred to as Post Traumatic Growth . PTG can be defined as the positive psychological change in individuals following significant trauma. These positive changes can manifest in improved personal relationships, a more resilient sense of self, as well as a more positive attitude towards life in general. Research suggests that a positive change in self-perception, personal relationships and world view has occurred in many adults who were sexually abused as children. For some people PTG may be cherishing current relationships, being the best parent, you can be, or finding religious or spiritual growth. Sometimes appreciating the level of control, you now have as an adult that you did not have as a child can also be empowering. Some researchers argue that it is the perception of the traumatic event, rather than the event itself, which determines the level of PTG experienced. As the late Friedrich Nietzsche stated, “If you know the why, you can live any how.” Finding meaning despite the experience may hold the key to recovery. As one woman subjected to CSA stated “I am not a victim. I am a survivor!” My experiences with people from all walks of life have convinced me that finding strength and hope in spite of life’s difficulties is what humans are good at.

Wishing you all the best in your journey

Phil Miranda

 

NOTE: I appreciate this article may be triggering for some people. If you or anyone you know is at risk of self harm or suicide then please follow this link to the Australian Mental Health Helplines website. International readers can use this link Global Mental Health Resources for a list of helpline numbers. If there is imminent risk of harm then please call the emergency services in your region.

Sources:
Centers for Disease Control and Prevention (2010). Adverse child experiences study. Retrieved from http://www.cdc.gov/nccdphp/ace/prevalence.htm
McElheran, M., Briscoe-Smith, A., Khaylis, A., Westrup, D., Hayward, C., & Gore-Felton, C. (2012). A conceptual model of post-traumatic growth among children and adolescents in the aftermath of sexual abuse. Counselling Psychology Quarterly, 25(1), 73-82.
Newsom, K., & Myers-Bowman, K. (2017). “I am not a victim. I am a survivor”: Resilience as a journey for female survivors of child sexual abuse. Journal of child sexual abuse, 26(8), 927-947.

Feb 20

Sleep and Mental Health

Most of us know how it feels to not have a good night’s sleep. We can feel lethargic and irritable. Sleep is so important that even after as little as 24 hours we can start to be affected. Compare this to food and water. Generally, people can last a week or more without food and a few days without water, however, after just one full day without sleep our general health and well being suffers. Of particular concern is the effect lack of sleep has on our cognitive functions and our overall mental health. This post examines some of the current research on lack of sleep and poor mental health outcomes.

The Effects of Sleep Deprivation

You don’t need to have a sleep disorder to be sleep deprived. Work and family commitments can affect how much time we are able to allocate for sleep. Stress and lifestyle factors can also influence both the quality and quantity of sleep. Sleep deprivation can affect us both physically and mentally. Lack of sleep can contribute to memory problems, cardiovascular disease as well as behavioural problems. Poor sleep is also associated with weight gain and type 2 diabetes. There is some suggestion that sleep deprivation has been used as a way to control prisoners of war as well as recently being used as an interrogation method, essentially as torture. I won’t expand on these claims further but as usual, do your own research if you have any doubts as to the importance of sleep. Sleep is clearly important for both our physical and mental well-being but is often neglected as being crucial in an overall health plan.

Sleep Disorders and Mental Health

Recent research by Delhikar et.al (2019) found a relationship between individuals with Obstructive Sleep Apnea (OSA) and memory impairment. Their study demonstrated reduced auto-biographical memory recall, as well as an impaired ability to remember specific events from the past. The authors state this effect on memory is a contributing factor to depression in individuals with OSA. Krizan and Hisler (2018) found a link between restricted sleep and increased anger. They suggest losing as little as two hours sleep over a couple of nights was enough to produce increases in anger particularly when exposed to unpleasant situations. Additionally, they present studies that show short sleep duration is a major contributor to depression and substance abuse.

Anecdotal evidence would suggest that being continually tired whether by a sleep disorder or shorter sleeping hours would contribute to feelings of irritability and depression. Being tired just doesn’t feel good and some of you may be thinking, I don’t need science to tell me that. While it is true our own experience is what really matters, I feel it is helpful to realise the science behind it is validating that experience. The relationship between poor sleep and poor mental health is of course reciprocal. Individuals who experience depression or anxiety may have trouble sleeping and individuals who have trouble sleeping may have increasingly poor mental health. Hopefully the information presented so far has helped you to realise the value of sleep as part of your mental health approach.

Improving your Sleep

Regardless of your current situation there are steps you can take to improve your sleep. Many of them are common sense, such as, avoiding caffeine close to bedtime, reducing alcohol and tobacco and making sure your bed and bedroom are comfortable. Improving sleep quality is often referred to as sleep hygiene or sleep health. As it is beyond the scope of this post to provide solutions to every person’s individual sleep requirements and situation, I will provide a link to a great resource on sleep health. Tuck.com provide a comprehensive website on all aspects of good sleep as well as the relationship between mental health disorders and sleep. I have no affiliation, either financially or personally with this site but feel it is a great one stop resource for improving sleep. If you feel that your sleep quality or quantity is affecting your health, then do your own research as well as discussing with your health professional. Make sleep a part of your overall health plan and particularly an important part of your mental well-being. Sleep well.

Wishing you all the best in your journey

Phil Miranda

Sources:
Delhikar, N., Sommers, L., Rayner, G., Schembri, R., Robinson, S. R., Wilson, S., & Jackson, M. L. (2019). Autobiographical Memory From Different Life Stages in Individuals With Obstructive Sleep Apnea. Journal of the International Neuropsychological Society, 1-9.
Krizan, Z., & Hisler, G. (2018). Sleepy anger: Restricted sleep amplifies angry feelings. Journal of Experimental Psychology: General. Advance online publication. http://dx.doi.org/10.1037/xge0000522
Tuck, Advancing Better Sleep (2019) Everything you need for a great night’s sleep. Retrieved from http://www.tuck.com