Silva Neves Specialist Psychotherapy in Central London W1 & EC1

Childhood sexual abuse has tremendous long-term emotional, psychological, sexual and relational effects on the survivor. Healing from childhood sexual abuse is possible.

The impact of child sexual abuse in adult survivors are:

Low self-esteem or self-hatred

Depression

Guilt, shame and blame. Survivors often feel guilty because they think they attracted the abuser, or they made no attempts to stop it. They can also feel a lot of shame because they experienced physical pleasure when erogenous zones were touched.

Sleep disturbance. The trauma of sexual abuse may create a lot of anxiety, which disturbs sleep. The bedroom may also be a traumatic place if the abuse occurred in the child's own bed.

Lack of trust for anyone. Many survivors were betrayed by the very people that were supposed to love and care for them (family, teachers, etc.) who insisted they loved them even whilst abusing them. It is not surprising that learning to trust someone as an adult can be extremely difficult.

Re-victimisation. Many survivors find themselves in abusive relationships or dangerous situations.

Flashbacks. Many survivors re-experience the sexual abuse as if it were occurring in the present moment. This is usually accompanied by images of the abuse. These flashbacks are often triggered by an event, every day actions such as the touch of a hand, or smells that remind the survivor of the sexual abuse.

Dissociation. This is a process where the mind detaches itself from the experience because it is too much to process at the time. This loss of connection to thoughts and feelings is a coping mechanism, but it can affect the survivors' life by repressing feelings.

Sexuality and intimacy problems. Many survivors have to deal with the trauma that their first sexual experience was an abuse. Survivors can have sexual dysfunctions such as vaginismus (impossible to have penetrative sex), erectile dysfunction, sexual shame. Gay men who have been abused by men in childhood may also experience a lot of shame about their sexual orientation. Heterosexual men that have been abused by men may feel that their masculinity has been compromised. Survivors also experience difficulties being intimate with their partners as adults.

'I have come to believe that caring for myself is not self indulgent. Caring for myself is an act of survival' Audre Lorde

Adult survivors of sexual abuse use coping mechanisms to attempt to soothe their trauma. Some of the coping mechanisms are:

Grieving for a childhood that they never had: innocence, nurture, warmth, safety, positive relationships with family members. During their grieving they may experience deep sadness, jealousy and intense anger. These feelings may go inwards (self-hatred and depression) or outwards (blaming their partners, projecting anger onto others, pushing people away in order to avoid intimacy).

Alcohol and drugs. Substances can act as an escape from intense feelings, especially when experiencing terror and helplessness.

Eating disorder. A compulsive control of food intake can be a way to take back control over their body, the control that was denied in the abuse.

Self-harm. Burning or cutting the skin are some ways for a survivor to relieve intense anxiety triggered by memories of the abuse.

As a psychosexual & relationship therapist and a trauma therapist, I often work with the trauma of sexual abuse, and I have seen change and healing happen before my eyes.
It is important not to stay silent. It is important to heal. Healing is possible. When it happens, it is the most precious gift that you can give to yourself and an act of love to your body.

'Fairy tales are more than true: not because they tell us that dragons exist, but because they tell us that dragons can be beaten' G.K.Chesterton

Sexual violence is any sexual act or attempt to obtain a sexual act by violence or coercion.
It includes unwanted sexual comments or advances, acts to traffic a person or acts directed against a person's sexuality, regardless of the relationship to the victim.
It is widespread and is considered to be one of the most traumatic, pervasive, and most common human rights violations.

I specialise in male victims of sexual violence.

What is Rape?
Under the Sexual Offences Act 2003, it is an offence for any male to penetrate with his penis the vagina, anus or mouth of a female or male without their consent. Male rape became recognised in law in 1994 but the 2003 legislation made victims of rape gender neutral.

What is assault by penetration?
Assault by penetration is when any male or female penetrates the vagina or anus of another person without their consent. The offence is committed where the penetration is by a part of the body (for example, a finger) or anything else (for example, an object) for sexual intent.

What is sexual assault?
Sexual assault is when any male or female intentionally touches another person sexually without his or her consent.

What is consent?
It is a permission or agreement. This is something that must be clearly established between two people before any kind of sexual act or behaviour can take place.
You can change your mind at any time.
In the UK, it is not possible to give consent if you are under the age of 16.

How often does male sexual violence happen?

Much more often than people think.

Figures published by the Office for National Statistics (2007) tell us that at any given time 11% of boys under 16 are victims of some form of sexual abuse.

At current population, that’s over 700,000 victims. This indicates that there are in excess of 2 million adult male survivors of childhood sexual abuse in the UK.

The same reports tell us that in adulthood, 3.5% of men have been sexually assaulted, constituting 905,000 assaults and 120,000 rapes.

That’s over a million sexual assaults against adult men. Over 1,000 men report being raped to the police every year and the police and government admit this is likely to be less than 10% of the real number.

What are the common effects of male sexual violence?

Emotional Shock, feeling numb.

Disbelief or Denial.

Embarrassment. Worried about what family and friends might think. This often leads to feeling silenced and being in isolation.

Shame. Feeling disgusting.

Guilt. Blaming oneself.

Depression.

Powerlessness. Not feeling in control.

Disorientation. A general sense of feeling confused.

Flashbacks. Reliving what happened as though it was happening now.

Fear. General fear. Or fear of having contracted a STI such as HIV.

Anxiety. Panic attacks. Feeling overwhelmed.

Anger.

Physical Stress. Physical pain. Loss of appetite.

Low self-esteem

Drug and alcohol addiction

Sleep disorders

Eating disorders

Grief

Post-traumatic stress disorder (PTSD)

Poor self perception

Sexual dysfunction

Social dysfunction

Dysfunction of relationships (including parenting)

As a psychosexual & relationship therapist and a trauma therapist, I often work with the trauma of sexual violence, and I have seen change and healing happen before my eyes.
It is important not to stay silent. It is important to heal. Healing is possible. When it happens, it is the most precious gift that you can give to yourself and an act of love to your body.

What is a relational trauma?
It is a trauma particularly inflicted on one person by another, and is characterized by a “violation of human connection.” (Herman, 1992).

Relational trauma, often called attachment injuries, occurs when one person betrays, abandons, or refuses to provide support for another person with whom he or she has developed an attachment bond.

Relational traumas include:

Sexual abuse in childhood perpetrated by someone whom the victim developed an attachment bond.

Parental neglect in childhood, including lack of warmth, love, hugs. Or lack of basic needs such as shelter, food and safety.

Severe parental neglect in childhood, including physical violence by one or both parents to the child. Alcoholic parents. Depressed parents. Verbal abuse by one or both parents to the child.

Sexual violence in adulthood perpetrated by someone whom the victim developed an attachment bond.

Partners of sex addicts and sexual betrayals: when a spouse has one affair or mutliple affairs, sexual acts outside of the committed relationship.

What is childhood neglect?
Child neglect, or child abuse, refers to any behaviour by parents, caregivers, other adults or older adolescents that implies a significant risk of causing physical or emotional harm to a child or young person. Such behaviours may be intentional or unintentional.
Child abuse and neglect include:

Physical abuse

Emotional maltreatment

Emotional neglect, including withdrawing of care.

Sexual abuse

Witnessing family violence

The consequences of experiencing child abuse and neglect will vary considerably. For some adults, the effects of child abuse and neglect creates significant psychological disturbances. In other adults, the effects are less debilitating. It often depends on the frequency and duration of maltreatment and if more than one type of maltreatment has occurred. It also depends on who the perpetrator(s) were.

Chronic maltreatment is defined as "recurrent incidents of maltreatment over a prolonged period of time" (Bromfield & Higgins, 2005).

Adverse Childhood Experiences:
The most important is how the child perceived their experiences at the time. Something believed to be a 'minor' incident can be perceived as huge by the child. However, there are some adverse childhood experiences that are always traumatic. These include:

Lived with a parent or primary carer who got divorced or separated

Lived with a parent or primary carer who died

Lived with a parent or primary carer who served time in prison

Lived with anyone who was mentally ill or suicidal, or severely depressed for more than a couple
of weeks

Lived with anyone who had a problem with alcohol or drugs

Witnessed a parent, or primary carer, or other adult in the household behaving violently toward another (slapping, hitting, kicking, punching, or beating each other up)

Was ever the victim of violence or witnessed any violence in his or her neighborhood

Experienced economic hardship “often” or “very often”, for example: the family found it hard to cover costs of food and housing

Acute school bullying

The common symptoms of childhood neglect and adverse childhood experiences:

Post-traumatic stress disorder (PTSD) or Post-traumatic stress (PTS).

Dissociation. Avoiding or numbing feelings.

Depression and suicidal thoughts.

Anxiety.

Alcohol and substance abuse.

Compulsive behaviours.

Eating disorders and obesity.

Sleep disturbances.

Sexual and relationship problems.

High risk sexual behaviours.

Aggression and violent behaviours.

Physical symptoms such as IBS and medically unexplained physical pain.

A trauma is a single life event, or a series of life events that were disturbing or non-nurturing and has a long lasting psychological impact on the person causing the loss of functions such as, for example, keeping a job or social relationships.

There are four types of traumas:

Incidents that threatened the person's life, or was perceived as threatening the person's life.

Witnessing acts of violence.

Hearing or seeing the death of someone close to the person.

Sexual abuse.

Events that are traumatic include:

Sexual abuse in childhood

Physical abuse in childhood

Sexual assault

Physical assault

Combat

Being held hostage or imprisoned

Terrorism

Torture

Natural and man-made disasters

Accidents

Receiving the diagnosis of a life threatening illness

Other types of traumas: Relational Trauma
A relational trauma is a trauma that is particularly inflicted on one person by another, and is characterized by a “violation of human connection.” (Herman, 1992).

Relational trauma, often called attachment injuries, occurs when one person betrays, abandons, or refuses to provide support for another person with whom he or she has developed an attachment bond.

Relational traumas include:

Sexual abuse in childhood perpetrated by someone whom the victim developed an attachment bond.

Parental neglect in childhood, including lack of warmth, love, hugs. Or lack of basic needs such as shelter, food and safety.

Severe parental neglect in childhood, including physical violence by one or both parents to the child. Alcoholic parents. Depressed parents.

Verbal abuse by one or both parents to the child.

Sexual violence in adulthood perpetrated by someone whom the victim developed an attachment bond.

Domestic violence.

Partners of sex addicts and sexual betrayals: when a spouse has one affair or mutliple affairs, sexual acts outside of the committed relationship.

Research in traumatology reveals that untreated trauma disrupts the nervous system and significantly alters the brain functioning.
Untreated trauma is the underlying cause of many mental health and behavioural disorders including depression and addictions.
Untreated trauma can remain undiagnosed for years. Often, trauma has its roots in early childhood development. An event in later life can trigger mental and physical symptoms that become distressing and overwhelming for the individual.

Symptoms relating to untreated trauma and childhood attachment problems include:

Post Traumatic Stress (PTS) or Post Traumatic Stress Disorder (PTSD)

Anxiety

Depression

Addictions

Risk-taking behaviours

Feeling helpless

Feeling hopeless

Obsessions

Compulsive behaviours

Phobias

Irritability, anger and rage, mood swings.

Guilt

Shame

Poor concentration

Violent behaviours

Poor sleep patterns

Dissociation

Withdrawing

People trying to cope with unresolved psychological trauma often resort to self-medicating with substances such as alcohol and drugs or with behaviours such as eating disorders, sex, gambling. These coping mechanisms often have an impact on the person’s relationships and sexual life, which means that many people with unresolved trauma find it difficult to maintain healthy and stable relationships.
Without treatment, it is difficult to recover from the effects of unresolved trauma and its lasting impact on the mind and body.

PTS stands for Post-Traumatic Stress.
PTSD stands for Post-Traumatic Stress Disorder.

The symptoms of PTS are:

Re-experiencing the traumatic event in a range of sensory forms. This phenomenon is called a flashback.

Avoiding reminders of the trauma by avoiding or numbing emotions. In some cases, we call it dissociation.

Chronic hyperarousal of the nervous system. This is called disregulated arousal.

It is important to note that these symptoms are normal to experience immediately after traumatic event. If some of these symptoms persist one month after the traumatic event, a diagnosis of PTS can be formulated.
It is also important to remember that not everybody who has survived a traumatic event will develop PTS. Some people never do.

When the symptoms of PTS are chronic, they can lead to psychological disturbances such as:

Acute anxiety and panic attacks.

Sleep disturbances.

Loss of appetite.

Sexual dysfunctions.

Difficulties with concentration.

Difficulties with relationships.

PTSD is a specific psychological condition. It manifests with the same symptoms as PTS but it is more severe causing a high level of daily dysfunction.

Both PTS and PTSD can be treated with specific psychological trauma therapy.

Many mental health problems have its roots in untreated trauma and its deep-seated psychological disturbances.
Unresolved trauma requires specific trauma-focused treatment. I am specifically trained to treat trauma. In my modality, I work towards regulating and restoring the emotional and psychological balance without re-triggering the nervous system with the traumatic materials.

My trauma therapy modality is integrative, which means that I use a range of psychological interventions to suit the client best.
My main modalities and interventions are:

EMDR (Eye Movement Desensitisation and Reprocessing)

Body-Psychotherapy (Regulation of the nervous system)

Transformational Chairwork Therapy

Rewind Technique

Inner Child Therapy

CBT (Cognitive Behavioural Therapy)

Transactional Analysis

Gestalt

Psychodynamic

Trauma therapy works in three phases:

1- Symptom reduction and regulation.

2- Processing traumatic memories.

3- Consolidation and integration.

Trauma resolution works in addressing the past, the present and the future.

It is important to note that generic talking therapy is often not sufficient to resolve trauma. It is necessary to employ trauma-focused therapy for trauma resolution.

'The wound is the place where the light enters you' Rumi

EMDR stands for Eye Movement Desensitization and Reprocessing.
It uses the natural healing functions of the brain to heal itself.

Old disturbing memories are stored in the brain in isolation. This prevents learning and healing from taking place. The old distressing material just keeps getting triggered over and over. In another part of your brain, you already have most of the information you need to resolve this problem; the two just cannot connect. Once EMDR starts, a linking takes place. New information can come to mind and resolve the old problems.

It allows for the rapid re-processing of traumatic memories into a functional state.

EMDR has received the most positive outcome in research with 30 worldwide randomised controlled trials. Five out of seven indicates that EMDR is most effective to treat PTS and PTSD.

EMDR is now the recommended treatment for trauma in the UK by The National Institute for Health and Clinical Excellence (NICE) (2005)

I often practice Transformational Chairwork Therapy as part of trauma therapy.
Chairwork in a powerful therapeutic method addressing deep level of trauma re-processing. It can be used specifically for relational trauma, sexual abuse, neglect in childhood, healing after an affair, and the Inner Child therapeutic process.
There is a variety of ways that Chairwork can be used, it is a dynamic method with therapeutic guidance which provides healing and long-lasting positive changes.