Acting Out After Sexual Abuse

Sexual abuse is extremely traumatic and may lead to short- or long-term behavioral issues, known as ‘acting out’, either resulting from or concurrent with physical health issues.

The American Academy of Experts in Traumatic Stress puts the figure for victims of sexual abuse in the USA at 12 to 40 percent. This figure varies according to contributory social factors such as economic status, ethnicity and environment. Correlation of many surveys conducted across the United States concluded the average figure for women who have experienced sexual abuse is 20 percent, with half having been abused in childhood. Figures for male survivors are problematic to collate due to lack of reporting although estimates put the figure around 15 percent, predominantly occurring in childhood.

Psychological Problems

Disproportionately more abuse survivors than those not abused are affected by long-term health and behavioral symptoms. Sexual abuse takes away power, body autonomy and choice. Issues that may be triggered including:

• Eating disorders
• Body dysmorphia (belief of physical ugliness leading to social interaction and relationship dysfunction)
• Sleeping disorders, such as insomnia
• Depression and/or anxiety
• Post-traumatic stress disorder
• Dissociative states, such as poor memory and an intense disconnection to one’s surroundings and in rare cases multiple personalities
• Self-harming/mutilation/cutting
• Suicidal thoughts and attempts
• Briquet’s Syndrome (‘hysteria’ or psychosomatic illness) when mental health issues trigger physical symptoms
• Fatalistic beliefs including expected early death

Survivors may make poor choices with regard to social relationships and may find it difficult to obtain and maintain employment. They may be quick to anger and exhibit antisocial behavior. Personality problems and lack of regard to personal hygiene may make a survivor seem different to the outside world, compounding problems with interaction.

An extremely common consequence of abuse is the development of an addiction. This leads to physical health issues common to the various types of addiction, and the addiction may be symptomatic of other psychological issues.

If the abuse was perpetrated by a parent or trusted guardian, the potential exists for the abuse pattern to be repeated with the abuse victim becoming an abuse perpetuator. ‘Normal’ parenting received during childhood becomes repeated as ‘normal’ when becoming parents. This is statistically more common in male survivors. If the abuse they suffered is not addressed, the survivor may not be aware their abusive behavior is unacceptable and damaging both to themselves and their victim.

Social behavioral problems that survivors may exhibit include compulsive lying, truancy from school and work, theft, absconding from home and intimacy issues in all forms of relationships. Control is removed from the survivor, leading to boundary and power issues as an adult and the need to have control.

Intimacy issues around sexually problematic behavior can arise, such as dysfunction in performance of sex, ignorance of and lack of use of contraception and
compulsive sexuality enactment such as poor choices of sexual partner, nymphomania or becoming involved in prostitution or pornography. The knowledge of how to give and what is informed consent is damaged by the abuse suffered.

Physical problems such as obesity and related complications may arise. Rarely, phantom or false pregnancy known as pseudocyesis have been known to occur. Survivors may report chronic headaches or migraines, pelvic pain, gastrointestinal pain, bowel problems, genital health issues, muscular and skeletal problems, and respiratory ailments such as asthma and chronic back pain. All may occur in conjunction with related psychological problems.

Surviving and Thriving

Abuse blurs boundaries between adult and child, and between adults when the survivor is grown. Many will exhibit problems with creating and maintaining relationships, be they romantic, platonic or familial. Many will push boundaries and test the limits of relationships that exist. Choices to be made are informed by distorted historical data. There is no blame to be placed on the survivor regarding any of the problems that may develop. There is no way to know what affect the abuse may have. Awareness of potential problems and knowledge of how to access treatment is essential; guilt is misplaced and symptomatic. Ultimately, the abuser bears the guilt and the responsibility for their actions. The survivor is not responsible for the cause of their symptoms, but in order to thrive, she or he needs to access the treatments available.

Every person who has suffered abuse reacts in different ways. Not all survivors will develop problems and act out, and not all those who suffer such problems will have experienced abuse. There is no set pattern for how a survivor of abuse may act, but help is available. The first and hardest step is to recognize help is needed and to ask for it.