of child sexual abuse
need to process through their grief reactions. The child has experienced losses in many areas, and mourning is a necessary part of grief. If victims do not mourn these losses, they are more likely to demonstrate trauma
symptoms. Short term effects
and long term consequences
of sexual abuse are intensified if this grief process does not occur.
A child victim of sexual abuse has experienced loss of trust
, freedom, and identity.The child's ability to process these losses will affect her life as an adult, decreasing her ability to trust, be independent, be self-aware, have positive self-esteem
, and have a sense of control over her life as an adult. Victims need to grieve their abandonment, numbness, lost relationships, damage to self, loss of innocence, damaged world-view, damaged belief and values, loss of childhood, and loss of self.
Stages of a child's grief include:
- Shock and emotional numbness. The first reactions to trauma are shock and a feeling of numbness. These are normal coping responses. This period provides a buffer so that the person can absorb the news and begin to adapt. The length of time and the person's experience of this stage depends on individual personality and history and external circumstances. A child will usually have no understanding of what has happened to him. If pain, fear, and threats were involved, the child has no way to process these experiences. He may continue paralyzed by the fear and anxiety. Memory of the event may be repressed.
- Denial. Denial is the response of the mind to trauma. The mind looks for an alternative explanation to the painful event or to the reality of a situation. When faced with intense loss or trauma, the mind has a protective device to prevent the person from being completely overwhelmed and unable to function. This protective device is denial. Denial has different forms, such as denying the event itself, denying the seriousness of the event, denying parts of it, or denying responsibility. Even when the mind comes to terms with reality, the emotions may not follow. Victims may have nightmares, other trauma symptoms (See PTSD), or somatic symptoms and not view these as related to the traumatic event.
- Anger and rage. These are normal, healthy grief responses. When loss occurs, people ask "why me?" and are angry at others, self, and God. However, a child may or may not know that what happened to her was wrong. The offender may normalize the abuse or provide rational explanations. The child victim is confused and lost. Anger may be acted out, not at the perpetrator, but at other children or other adults. Anger is a warning sign of abuse.
- Guilt. Guilt is a normal, expected response to grief. Adults may assume responsibility for a loss or ask themselves what they could have done differently. They blame themselves. They may feel sad or ashamed. A child often feels an unrealistic responsibility for adult actions. This is seen during divorces or when a parent leaves the home. At these times the child sometimes thinks that something they did caused the event. It is common for child victims of sexual abuse to feel responsible and guilty about the abuse.
- Anxiety. The child experiences anxiety as a result of loss of control, loss of freedom, and a sense of helplessness. He will worry about being believed, be afraid of other people's reactions to the disclosure, and be afraid of the perpetrator. If the perpetrator has access to the child, the child victim may live in a perpetual state of chronic anxiety. This state of stress will cause reactions in the child's body, brain, and immune system, and may result in ongoing emotional and psychological problems and physical illness. Anxiety may lead to panic attacks, phobias, and negative and obsessive thought patterns.
- Depression. Feelings associated with grief are similar to symptoms of depression. A child victim may experience sadness, tiredness, loss of interest in everyday activities, have problems sleeping, and cry often without apparent reason. During a grief process this is normal. Sometimes appetite is affected. It is important to pay attention to the child's response during this stage as she may engage in self-destructive ways to soothe herself, such as eating disorders, cutting, or substance abuse. Depression can result in hopelessness, hostility, anger toward self, loneliness, despair, and suicidal thoughts. Child and adolescent victims of sexual abuse often talk about or act out thoughts of suicide. Professional consultation and intervention is critical if your child is depressed.
Tasks of the grief process include:
- Overcoming denial and accepting losses.
- Feeling the pain and working through it.
- Adapting to the current life, role, and sense of self and the world.
Mothers can observe their child's grief experience, provide comfort and support, and intervene as necessary. Safety, structure and routine will assist your child in moving through the stages of grief. Your presence and availability will reassure her that she is not alone.