The effects as an adult can be severe and take years to work through. Often survivors spend years in therapy to overcome the effects of their childhood abuse that has crippled them from functioning normally as adults (Wiehe, 1997). Poor self esteem is a common effect. As children, victims of sibling sexual abuse tend to feel worthless, unwanted, inferior, unloved, and inadequate.
These feelings of worthlessness are often associated with guilt and shame which frequently leads to self-blame for the abuse. These kinds of symptoms can affect a person’s psychological development. Survivors can become overly sensitive to comments or criticism. Even looking for hidden negative meanings in positive messages.
Difficulty with interpersonal relationships and relationships with the gender of the offender are common problems of adult survivors of sibling sexual abuse. (Wiehe, 1997) Survivors tend to be suspicious and untrusting of others. They find it hard to become close to someone and trust them and often have problems controlling anger. Often survivors repeat the victim role in other relationships and enter into abusive relationships with both friends and romantic partners. Even as adults it can be difficult to view negative relationships as abusive because they tend to normalise
their abuse. Survivors can also have the opposite reaction and transfer their emotions about their experience of abuse to the offending gender in general. For example, they may feel fearful or hateful towards all men because the abuse was perpetrated by a brother who is also a man.
Self-blame and guilt are common emotions connected to sibling sexual abuse. The survivor feels that they had somehow allowed themselves to be abused and feel shameful and guilty for not being able to prevent the abuse from occurring. Often survivors blame themselves into adulthood.
These feelings can be made worse if during disclosure, a victim is blamed or not believed. (Wiehe)
Survivors often have extreme anger about the abuse which can be expressed in angry outbursts, anger at men, or anger provoked by various situations. Most survivors have to continually work towards controlling their anger especially when it is being directed inappropriately. Anger at their siblings or other family members can make it difficult to maintain relationships with the family of origin. (Wiehe, 1997) This can be very difficult for a survivor who may experience feelings of grief and loss due to the changes in the relationships in the family.
Sexual dysfunction is a common effect of sexual abuse. Survivors tend towards two paths; avoidance of all sexual contact or sexual compulsiveness or promiscuity. (Wiehe) Even though it is not as common, some victims of sexual abuse can act out and abuse others. This is called “repetition compulsion” and is an attempt for the victim to take him or herself out of the victim role and into a new role where he/she is no longer powerless. Boys who have been molested tend to repeat the abuse as girls tend to repeat the abuse as victims. Girls do not assume the role of sexual aggressor as often as boys but research shows that those who do usually have a background of lengthy and extreme abuse. The more common reaction of sexual compulsiveness or promiscuity could be viewed as an unconscious effort to overcome or deny their feelings of powerlessness, shame, and anger. Abuse contains elements of distrust, secrecy, danger, and physical or emotional abuse which is often recreated in the survivors’ promiscuous encounters in adulthood. It can also be seen as a confusion of boundaries between affection, sex, and abuse. It happens as a result of the developmentally inappropriate and personally dysfunctional ways a child’s sexuality was shaped. (Wiehe, 1997)
Some survivors also react by turning to drugs, alcohol, or eating disorders. These are used as coping mechanisms and eating disorders stem for a need to have control.
The emotional or psychological problems most commonly associated with sexual abuse are depression and post-traumatic stress disorder (PTSD). Depression can be evident in a child shortly after the initial incidence of abuse. The severity of the abuse is NOT correlated with the intensity of depression. Incidents of depression as adults are high. According a survey by Vernon Wiehe, 26% of survivors experienced depression that required hospitalization and 68% had attempted suicide, with 50% of those having more than one attempt. Anger and depression are often seen together. Depression can be defined as anger turned on oneself. PTSD is associated with symptoms of depression, general anxiety, anxiety attacks, and flashbacks. These symptoms can be triggered by events that remind them of abuse such as sexual activity or being alone at night or when in the presence of the perpetrator. Because survivors tend to push abuse out of their memory, repress, disassociate, or block-out memories, PTSD is an anxiety disorder which the survivor re-experiences the abuse. This can be a full flashback, or an emotional or physical memory or it may even be re-experienced in dreams (Wiehe, 1997).
Post-traumatic Stress Disorder can appear in children shortly after abuse or many years later as adults. PTSD is an anxiety disorder that can occur after someone has been through a traumatic event. SECASA defines PTSD as having the following criteria:
1. The person has experienced an event that is outside the range of usual human experience and that would be markedly distressing to almost anyone.
2. The re-experiencing of the trauma in at least one of the following ways:
a. Recurrent and intrusive recollections of the event.
b. Recurrent distressing dreams of the event.
c. Sudden acting or feeling as if the event were recurring.
d. Intense psychological distress at exposure to events that symbolise or resemble an aspect of the traumatic event.
3. A numbing of responsiveness or reduced involvement in the external world some time after the trauma, indicated by;
a. Diminished interest in activities and/or
b.Feelings of detachment or estrangement from others and/or
c. Constricted affect; unable to have loving feelings or to feel anger
4. In addition, at least two of the following symptoms must be present
a. Hyper-alertness or being easily startled.
b. Sleep problems.
c. Guilt about surviving or behavior required to survive.
d. Problems with memory or concentration.
e. Avoidance of activities that arouse recollection.
f. Intensification of symptoms if events symbolize or resemble the traumatic event.
The national center of PTSD states that symptoms of PTSD can be terrifying and can disrupt one’s daily life. PTSD symptoms usually start soon after the traumatic event, but they may not happen until months or even years later. They may also come and go over a period of many years. Many people who develop PTSD get better over time but some (about 1 out of 3) may continue to have symptoms and need to seek treatment to better cope. There are four symptoms of PTSD; reliving
the event, avoidance, numbing, and feeling “keyed up” or hyperarousal. People experiencing PTSD may also have problems with drinking or drugs, feelings of hopelessness, shame, or despair, employment and/or relationship problems (including violence and divorce), and physical symptoms. Treatment for PTSD is available including cognitive-behavioral therapy, EMDR (eye movement desensitization and repressing), medication such as SSRI (selective serotonin reuptake inhibitor)
Major depressive disorder, commonly known as depression, is another common psychological effect of sexual abuse. This can be in combination with PTSD or other emotional disorders.
Depression can severely disrupt one’s life, affecting your appetite, sleep, work, and relationships.
Symptoms of depression include;
- Constant feelings of sadness, irritability, or tension
- Decreased interest or pleasure in usual activities or hobbies
- Loss of energy, feeling tired despite lack of activity
- A change in appetite, with significant weight loss or gain
- A change in sleeping patterns, such as difficulty sleeping, early morning awakening, or sleeping too much.
- Restlessness or feeling slowed down
- Decreased ability to make decisions or concentrate
- Feelings of worthlessness, hopelessness, or guilt
- Thoughts of suicide