Prevalence of the Problem of Parental Sexual Abuse of Children

Estimates of child sexual abuse vary – and are generally considered to be on the low side. What is reported as child sexual abuse is only a glimpse of the true picture. Although child sexual abuse is reported about 80,000 times a year, the real number is undoubtedly much higher. According to the National Center for Victims of Crime, incest is the most common form of child abuse with studies showing that 43 percent of children who are abused have been abused by family members. More than 10 million Americans, according to other research, have been victims of incest. Other estimates show 20 million Americans have been victimized by parent incest as children. Child abuse researcher David Finkelhor estimates that 1 million Americans are victims of father-daughter incest.

Child sexual abuse can be committed by a parent or step-parent, sibling, or other relative and take place within the family. It can also occur outside the home, perpetrated by a neighbor, teacher, child-care worker, friend, or neighbor.

After Sexual Abuse – What Happens with the Child

After a child has been sexually abused, they may develop a variety of feelings, thoughts and behaviors that are both confusing and distressing. It is important to note that no child is psychologically prepared to deal with or cope with the type of sexual stimulation that occurs with repeated abuse. Experts warn that even children as young as two or three, who cannot possibly know that the sexual activity is wrong, will develop problems as a result of not being able to cope with the overstimulation.

When a child is five or older and cares for the sexual abusing parent, the child can become trapped in conflicting feelings of loyalty and affection and the sense that the sexual activity is drastically wrong. Should the child attempt to break away from the sexual relationship, he or she may be threatened by the abusing parent. These threats may take the form of violence or loss of love, or both. Taking place within the family, where few secrets are maintained indefinitely, the sexually abused child may also bear the brunt of other family members’ anger, jealousy, and/or shame. In addition, the sexually abused child may fear the family will break up if others outside the family learn about the abuse.

Children who are the victims of prolonged sexual abuse usually develop low self-esteem, a sense of worthlessness, and a distorted or abnormal view of love and sex. Often withdrawn, such children may look upon all adults with distrust. The children may even become suicidal.

As they mature, without treatment, children who have been sexually abused by a parent may have difficulty relating to others in anything other than on sexual terms. Some children grow up themselves to be sexual abusers of children, while others become prostitutes, or have other serious problems when they become adults.
In many cases, just looking at the child reveals no indication of sexual abuse by a parent or others. In other words, there may be no external signs of the abuse that are obvious. Only a physical exam by a doctor can detect some of the signs of sexual abuse.

There are other signs, however, that may indicate the presence of child sexual abuse. A child who has been sexually abused may develop the following:

• Aggressiveness that is unusual
• Conduct problems or delinquency
• Depression, or withdrawal from family members and friends
• Nightmares or sleep problems
• Refusal to go to school
• Show aspects of sexual molestation in drawings, fantasies, and games
• Unusual interest in or avoidance of anything of a sexual nature
• Secretiveness
• Seductiveness
• Suicidal thoughts or actions
• Talk about their body as dirty, damaged, or say that there is something wrong in the area of their genitals

Sexually Abused Children Need Professional Treatment

It is a myth that children who have been sexually abused are destined to have their lives forever ruined, or that they are “damaged goods.” Treatment professionals acknowledge that while the sexual victimization of children is incredibly damaging, quick and appropriate treatment is the best way to speed the healing. Intervention is critical as well, since most cases of family sexual abuse will continue for years unless it is stopped.
Once the children have become adults, healing the sexual trauma inflicted upon them in their youth can take a long time, especially if they have repressed memories of the abuse. But all child sexual abuse victims can benefit from treatment and become fully functioning and healthy children and adults.

Child and adolescent psychologists can help the sexually abused child to regain a sense of self-esteem, to cope with the incredible feelings of guilt surrounding the abuse, begin to overcome the trauma, and dramatically reduce the likelihood of developing further problems as an adult.

Following intervention, treatment of the sexually abused child may take the form of individual and/or group therapy. In any case, treatment is a complex process involving a multidisciplinary team. In family sexual abuse situations, all members of the family should be involved in treatment. For a more in-depth look at the subject, see Child Sexual Abuse: Intervention and Treatment Issues, a report from the U.S. Department of Health and Human Services (HHS), posted on the Child Welfare Information Gateway.

Treatment Issues for the Child Victim

Each child who has been sexually abused by a parent will have different treatment issues. Some will have one or more of the following, although there may be others not indicated here, depending on circumstances.

• Trust – The child’s ability to trust other people has been seriously jeopardized by the sexual abuse by a parent. Not only has the parent, who is supposed to be the caregiver and nurturer, violated the boundaries of acceptable behavior, they have exploited the child for their own selfish purposes. The child may also suffer other maltreatment at the hands of the parental abuser, such as violence, neglect, and psychological abuse. In treatment, the therapist seeks to create circumstances in which the child has positive experiences with adults in order to ameliorate the damage done by the abusing parent. This may involve rehabilitating the parents and/or creating positive adult relationships with foster parents, other relatives, or mentors. Trust and absolute honesty are required in order for the therapist to make progress with the abused child.

• Emotional reactions – Three of the most common emotional reactions to child sexual abuse are feeling responsible and guilty, having an altered sense of self and self-esteem, and anxiety and fear.

o The offending parent may have made the child feel responsible for the abuse, for their own well-being and/or the consequences of the abuse. The child may also feel guilty that he or she didn’t stop the abuse or guilt and shame over any positive aspects of the abuse (physical pleasure, special attention from the abuser, the control the abused child has over other family members). The therapist works to have the child accept intellectually and emotionally that they are not at fault for the abuse. They did not cause it and they didn’t deserve it. It was the responsibility of the parent to stop the abuse, not the child.

o Guilty feelings along with the intrusive nature of the sexual abuse cause children to feel a diminished sense of self and low self-esteem. This manifests in both physical and psychological ways as the child feels different from other children. Helping the child to recover goes beyond encouraging them to feel whole again. It encompasses ego-enhancing activities such as doing well in school, participating in sports, getting involved in activities such as the Boy Scouts or Girl Scouts.

o Children who have been sexually abused have considerable anxiety and fear attached to the trauma. They may even develop phobic reactions to the event, the parent, to experiences that remind them of the abuse. Helping the child to overcome such fears and anxieties involves various therapies, such as play therapy, discussions, or interventions in the child’s environment. First, however, the therapist has to ensure that the child is not being sexually abused or at risk of being sexually abused.

• Behavioral reactions – One serious behavioral reaction to child sexual abuse is sexualized behavior. This may include excessive masturbation and open or sexual interaction with other people. Such behavior may become worse the longer it goes on. Therapists teach behavioral controls and channel the child’s energies into more appropriate behaviors. Left untreated, sexualized behavior in the child may lead to being first an adolescent offender and then an adult offender. Other behavioral problems – aggression, running away, self-harm, substance abuse, sleep and eating problems, toilet training, and suicidal behavior – are treated by:

o Helping the victim understand the relationship between the abuse and their emotional or cognitive reaction to it

o Helping them see the self-destructive nature of the behaviors

o Helping them find more appropriate expression for their emotions

o Behavioral interventions to reduce problem behavior

o Group therapy for older children, as appropriate

• Cognitive reactions – A very important aspect of therapy for the sexually abused child is to help them understand the meaning of the abuse. This includes a discussion of what is appropriate and inappropriate touching, why sexual activity between adults and children is wrong, and why a parent was sexual with them. Group and/or individual therapy may be used at this point. And explanations that will satisfy a young child may no longer work as the child gets older. A therapist will need to address the issues on a more sophisticated level as the child matures.

• Protection from future victimization – Children need to be taught how to protect themselves from being victims in the future. This may involve how to say no, telling someone about the abuse. However, the therapist needs to be aware of the potential for the child to feel overwhelmed by placing even partial responsibility for keeping themselves protected.

Outlook for Treated Children

There is no cut-and-dried formula that dictates how long treatment will need to continue for children who have been sexually abused by a parent. Each individual reacts differently, depending on the type and duration of the sexual abuse, age and sex of the child, any other maltreatment of the child that occurred simultaneously, relationship with other family members, psychological, physical and other factors. Treatment is a very complex process, often involving years of therapy, first as a child, and later as an adolescent and into adulthood. Other family members should also participate in therapy, in order to address the underlying causes for the sexual abuse and to learn more effective ways of addressing such urges, as well as developing better parenting behavior.

For the sexually abused child, working to restore their sense of self and self-esteem, reducing anxieties and fears, learning appropriate behaviors, and developing the ability to trust others again all takes time. In some cases, it may take years. As previously stated, adult children, who have repressed memories of the sexual abuse, may require very lengthy treatment to overcome the damaging effects.

Experts say that early intervention and involvement in treatment poses the best chance for a successful recovery. Children, especially, are not prepared to handle the onslaught of emotional and psychological effects of sexual abuse by a parent. They have so many issues to address that it may seem overwhelming to the child. Therapists need to foster and develop complete trust and honesty with the child. Alternating male and female therapists may be advisable in some circumstances. Helping the child to heal includes forensic interviews, medical exams, and victim advocacy. Treatment also is part of an ongoing process that may involve the courts and legal system, child protective services, family therapy and other considerations.

The only way the child will overcome sexual abuse by a parent is with professional counseling. Children need help to heal on many levels. They cannot do it on their own. Left untreated, they will never be able to reach their true potential.

As a family member or an outsider (neighbor, friend, teacher, minister, etc.), if you suspect that a child has been sexually abused by a parent, notify your state and local child abuse protective services agency, or call law enforcement. Early intervention and treatment is absolutely necessary to help the child overcome sexual abuse by a parent. Treatment can be effective, can even save the life of the child. But someone has to take the first step to get help for the child.

When I was approached to create a program about sex addiction I knew that this would be new territory for much of the television audience. I also understood that this disorder had become truly commonplace in this country and the stories of the suffering of the afflicted needed to be told.

Not only that, but it is time that we begin to take account of the lack of health in our interpersonal lives, and how profoundly childhood trauma has come to bear on our relationships and choices.

According to the Society for the Advancement of Sexual Health, a “conservative estimate of those who could meet the criteria for sexual addiction and compulsivity is that of about 3–5% of the United States population.” It is unfortunately too easy to make light of this disorder and my hope is by showing the profound pain that underpins the problem this disorder can begin to be taken seriously.

Sex addiction is really no different than any other addictive process. There is a loss of control over the behaviors that do not stop, even when the individual wishes they would. And there are mounting consequences as the result of the behavior, yet it still does not abate. Consequences meaning untoward effects upon important areas of a person’s life—relationships, health, work, or school; financial or legal status. And very frequently the sex addict can identify traumatic experiences in childhood such as physical abuse, emotional abuse, or neglect, and most often sexual abuse. There is evidence that some of the same brain systems involved in chemical addiction are responsible for the distortions of drive that manifest in sexual addiction.

I am frequently asked, “How do you know if you are a sex addict?” Dr. Patrick Carnes was one of first professionals to work with sexually addicted people and he designed the Sex Addiction Screening Test (SAST). The Society for the Advancement of Sexual Health offers screening tests for this condition. CLICK HERE to find out more.

These screening tests are not conclusive but they are suggestive and you may want to seek formal evaluation by a professional trained in this area of you are concerned that you meet criteria for this problem. The treatment for sexual addiction can be very arduous. Dr. Carnes believes that it can take generally 3-5 years to completely treat this disorder. It takes a great deal of work, often as you see from the “Sex Rehab” program, requiring looking at material that is quite painful.

If you believe you may be involved with a sex addict you, too, will have to be prepared to do a good deal of work if that relationship is going to survive. We generally tell couples not make any impulsive decisions when sex addiction emerges as a problem.
We often find that when couples commit to one another and if both partners are willing to participate in treatment, the outcome can be surprisingly good. If you are the partner of a sex addict, you must remember that there is a reason you were attracted to this person. And whatever those issues might be they will carry over to your next relationship as well.

The media is replete with stories about sexual transgressions that have many of us shaking our heads. When many of these cases are examined it is often the case that sex addiction is a prominent feature. Here once again it is very easy for the public to decry the transgressions as merely the excesses of wealth and power but the fact is that it is often the behavior of someone who is not well.

Yes, indeed, the behavior may have continued had the individual not been caught. But the same can be said of any addiction. After all, it is usually the family who brings in a drug addict once their addiction comes to light. And when the family fails to successfully intervene it is other consequences that bring the drug addict to treatment. Whether it is the courts because of legal consequences, or the medical system because the addict falls physically ill from their using, there is always something that brings the addiction out of the shadows. The very same is true of sexual addiction.

Finally, I want to point out how courageous the individuals were whom viewers are following on VH1’s “Sex Rehab.” Many of them are doing very well in their recovery and I want to extend my deepest gratitude to them for allowing the viewing public to learn from their experiences. It was a privilege to serve them in the initial phases of their treatment. They serve as in inspiration to us all.

On “Sex Rehab with Dr. Drew,” Kendra admits that she was molested from the age of 2 until she was finally emancipated at the age of 14, and that she was raped in her teens.

Dr. Drew says that most children who are sexually abused grow up to believe that their only worth is for sex and points to Kendra’s story as a prime example.

On the website she shares with her husband, www.meettherossis.com, Kendra tells of her struggle to climb up from a troubled childhood to the glamorous life of a Hollywood celebrity.

The oldest of five children, Kendra was born in East Hampton, Massachusetts and spent several years bouncing between her own less-than-ideal home and foster homes until she finally gained her emancipation at age 14. After that she took on the responsibility of raising her two much younger sisters. She entered the adult film industry in 1998 and quickly became a star and favorite of the Howard Stern Show.

During her intake interview, Kendra tells Dr. Drew that as a result of being molested and rape at such an early age she quickly came to believe that "sex equaled love." She confesses that she has cheated on everyone she has ever been in a relationship with and is now trying to get help for her addiction because she does not want to cheat on her husband.

In Playing With Fire, Fleury writes. “Graham was on me once or twice a week. An absolute nightmare, every day of my life."

James was a well-known Canadian junior hockey coach. He served 3½ years in prison after being convicted of sexually abusing players, including Sheldon Kennedy, who went public with accusations. James currently coaches junior hockey in Europe, and the Canadian Press said he has been unavailable for comment.

Fleury’s book says the experience drove him to alcohol and drug abuse, and he admits failing 13 drug tests during his 16-year career.

He wrote that he didn’t divulge the story while still in the NHL because, "I could see how it would play. I would have been stigmatized forever as the kid who was molested by his coach. The Victim."