The numbers on sexual abuse are, to say the least, shocking: around 8% of men and 20% of women in the general population have been victims in their childhood of some type of sexual activity, initiated by an adult, without being unable to account for their consent or understanding of what was happening. These data are even more alarming if we consider that a large part of the cases are not detected or reported.
Research on sexual abuse also indicates that it causes serious consequences in its victims, whether it is sexual abuse during childhood or during any other stage of life. This is a very difficult and painful experience.
Fortunately, psychological intervention can help victims of sexual abuse overcome the short- and long-term consequences of such an experience. In this article we will develop What does psychological intervention in sexual abuse consist of? and how it can help victims move forward.
First of all, in order to fully delve into the fundamental role of psychological intervention in the treatment of these patients, it is essential to recognize what we understand by sexual abuse. This theoretical construct has been defined in multiple ways and has been modified over time; But we could agree that sexual abuse is considered any situation in which one person attacks the sexual freedom of another.
In sexual abuse, there is usually a hierarchical relationship—in terms of power, age, economic position—; an asymmetry between one person and the other, which enables the exercise of violence.
As we mentioned previously, many cases of sexual violence go unreported. The victims remain silent. This is due to the abuser’s threats, which are expressed explicitly or implicitly. Consequently, victims carry with them the psychological effects of abuse: they feel shame about what happened, guilt, helplessness, helplessness or fear. Furthermore, sexual abuse can result in physical harm. Living with a burden as heavy as trauma due to sexual abuse, over time, can cause endless negative consequences that we will develop below.
Psychological and neurobiological consequences of sexual abuse
The consequences of sexual abuse are serious. If not treated, they can perpetuate themselves to the point of causing great amounts of suffering in the victims. The relationship between sexual abuse and mental health disorders is close.
In the socio-emotional area, victims of sexual abuse present higher levels of depression, withdrawal and anxiety. A very common disorder among victims is post-traumatic stress disorder (PTSD), which is included among anxiety disorders, and is characterized by the presence of reexperiencing episodes (also called flashbacks), in which the person imagines and feels the traumatic experience in a vivid and recurring way. In addition, They tend to present behavioral problems such as aggressive behavior, especially during adolescence and youth ; They usually have problems in relationships with peers and lower academic performance than people who have not suffered sexual abuse.
As if this were not enough, the consequences of sexual abuse can also be detected at a neuronal level: deregulation in the levels of cortisol, a hormone that is modulated depending on exposure to stress, has been found in victims of this type of abuse. . However, neuroendocrine alterations are not the only ones that occur at a biological level due to sexual abuse. Systematic reviews of scientific research on this topic also found that The consequences of sexual abuse are tangible in structural, functional and neuropsychological alterations.
Psychological interventions for sexual abuse
Just as each situation of sexual abuse is particular, so are the psychological interventions that mental health professionals must design to treat the victim. The objective of any intervention is to apply theoretical knowledge of psychology in order to help people understand the psychological difficulties that could be affecting them. The most common type of psychological intervention for the treatment of sexual abuse today is individual psychotherapy with psychologists duly accredited as such. Furthermore, it is the one with the most empirical evidence regarding its effectiveness; specifically, under the approach of cognitive-behavioral therapy.
It is not the same for everyone: intervention in children
Beyond this, as we mentioned, it is not always possible to apply the same treatment for all patients. Without going any further, we could think about the ages of the victims of sexual abuse: although many victims are adults, many others are just children.
Due to their young age, children cannot receive treatment that focuses primarily on the use of verbal language, since it is a psychological function that is still developing. In general terms, psychological intervention in cases of child sexual abuse should focus on work on the child’s environment and caregivers, that is, family work is essential, with the aim of providing children with a validating and supportive environment to grow. For their part, with younger children you should work with the use of more symbolic and not so literal expressions.
There are other types of psychological interventions that also have some evidence and that could be useful to promote optimal emotional and cognitive development for children who have been victims of sexual abuse. For example, it has been proven that group therapy, psychodynamic play therapy, animal-assisted therapy, and parent-child interaction therapy can bring benefits to victims of child and adolescent sexual abuse.
Psychotherapy as an intervention par excellence in adults
For adults, the psychological intervention in sexual abuse par excellence is that which is carried out within a framework of individual psychotherapy. Although it varies depending on the approach used by the therapist, we could agree based on the literature on the subject that, in a large part of the treatments for sexual abuse, the following instances are carried out.
First of all, the person is offered the opportunity to vent, to express their emotions, feelings and psychological effects perceived as a result of the abuse. In this initial stage of treatment, the therapist carries out interventions with the aim of helping the patient to cognitively and emotionally deal with the abuse. He is encouraged to re-experience his emotions linked to the trauma in a safe place and progressively. This will lead the patient to name her emotions and identify the intensity with which they occur.
Subsequently, It is necessary to intervene on the feelings of guilt and shame, which are so common among victims of sexual abuse. For example, cognitive-behavioral therapy works with these feelings by reevaluating and modifying biased thoughts in order to adjust them to reality.
This process is called cognitive restructuring. On the other hand, many therapists focus on identifying the victim’s personality; They seek to work on their weaknesses and strengthen their virtues. Ultimately, psychological interventions in sexual abuse help the victim identify the situations in which she feels anxiety or fear as a result of the experience of abuse. For example, You may have difficulty bonding sexually with other couples, or to feel great threats or dangers in circumstances where there are none. A common intervention is to develop exposure hierarchies with patients, detailing all the specific actions they fear as a result of the abuse and ordering them according to how difficult it would be for the patient to carry out them. Then, with the help of the therapist, work will be done so that patients are able to execute these actions gradually and progressively.
In conclusion, psychological intervention in sexual abuse has different facets and modalities that must be applied by an expert mental health professional to help victims according to their particular circumstances. Many times, it is difficult for victims of sexual abuse to dare to talk about their situation, even having lost contact with the abuser. However, it is crucial to emphasize the importance of receiving therapeutic treatment to move forward with the help of a professional capable of empathizing, containing and providing the necessary help to build a valuable life.
