The primary emotional effect for victims of child sexual abuse is fear. Following disclosure, children fear the consequences of disclosure, as well as re-occurrence of the abuse. This places the child in a painful and stress-filled situation. He or she may have been groomed to feel it was his or her responsibility that the abuse occurred, or that, if they disclose, no one will believe them. If victims disclose, they are afraid that the abuse will reoccur or that the perpetrator will retaliate. Sometimes the child demonstrates these fears in an overt way, and mothers can see what is occurring in the child. Sometimes the child says nothing, but the fear is manifested through nightmares, night terrors, or other forms of anxiety.

Sexual abuse victims develop fears related to the abuse, such as fear of people, situations, and sensations. They become fearful,and this often includes fear of emotional upset or fear of conflict. They may develop phobias related to aspects of the abuse and experience anxiety or panic attacks. They may become suspicious or they may do the opposite and act against the fear by approaching people or situations without fear when others would be fearful. They may fear all men, or the opposite, they may approach all men. They may dislike being touched, or they may have no physical boundaries, inappropriately touching others without permission. Many sexual abuse victims fear intimacy and have difficulties in establishing close relationships.

The emotion of fear is biochemical, not just a "feeling." Fear is related to brain chemistry and brain function. Cortisol is a stress hormone that is released during times of fear. This hormone causes cascading effects in the body and initiates the release of other hormones. If the fearful response is chronic - in other words, the thing that is feared returns again and again - neurochemical processes adapt, and brain structures are affected. Individuals with PTSD who have experienced childhood sexual abuse have hippocampal shrinkage - the hippocampus does not develop as it would normally. Developing children are not meant to live in fear and have cortisol flooding their systems on a regular basis. This stress has an effect on body, brain, and immune system, and may result in physical illness.  



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