Television, radio, newspapers and newsmagazines are full of stories about sexual abuse. Priests or ministers abusing congregants, rape by strangers or by dates, even parents abusing their own children are some of the horrifying news grabbing today's headlines.

What is sexual abuse? Why is it so devastating? What are the effects of it? How long do the effects last? Can victims recover or even heal from the trauma? In this article we will examine this deplorable scourge. In addition, we will look at what is involved in the arduous process of recovery from sexual abuse.

Definition of Sexual Abuse

The term sexual abuse covers a wide variety of inappropriate sexual behaviors and actions. It includes a vast realm or spectrum from so-called "victimless" crimes as voyeurism (peeping) and indecent exposure to child molestation, incest and rape.

Voyeurism and indecent exposure may not seem, at face value, to be sex abuse, but they are often the "gateway" acts that start an offender on a path that leads to the more serious ones. To include the whole gamut of offenses, our definition of sexual abuse must be broad. Sexual abuse occurs when one person invades the physical or psychological space of another without consent or performs sexual acts on the victim. As a result of this invasion, the victims suffer physical or psychological harm or both.

One prevalent myth that surrounds the crimes of sexual abuse is that the offender is acting out of sexual needs and desires, and that the goal of these actions is sexual gratification. Research indicates that for most offenders, however, the primary motive is power. The offender has a compulsion to overpower and control another person. For some offenders, the motivation is intense anger toward women and a desire to wreak vengeance for real or imagined wrongs. The offender does not view a victim as a real person, but as an object to satisfy the need for power and control.

Scope of the Problem

How pervasive is the problem of sexual abuse? How many people are affected by it? According to statistics compiled by the Rape, Abuse and Incest National Network (RAINN), there were 261,000 victims, aged 12 or older, of rape, attempted rape or sexual assault in 2001. One out of every six American women, or a total of 17.7 million women, have been a victim of either a completed or attempted rape in their lifetime. Ninety percent of American rape victims in 1999 were women, while 10 percent were men. Three percent of all American men (about 2.78 million) have been victims of sexual assault.

Almost half (44 percent) of rape victims are under age 18. Seven percent of girls (aged 5 to 8) and 3 percent of boys (aged 5 to 8) reported that they had been sexually abused. This figure increases in the 9- to 12-year-old age group to 12 percent of girls and 5 percent of boys.

These figures, as shocking as they are, do not tell the whole story. Crimes of sexual abuse are highly likely to go unreported. Many victims believe that they are somehow at fault for the abuse and are full of shame and guilt. Also, many fear reprisal if they report the offense. Again according to RAINN, only about 28 percent (less than 1 in 3) of actual rapes and sexual assaults were reported to the police. Among children the statistics of silence are even greater. Of children in grades 5 to 12 who had been sexually abused, 48 percent of the boys and 29 percent of the girls told no one, not even a friend.

Since the likelihood of capture, prosecution and conviction diminishes the longer the time between the assault and the report, keeping silent allows the abuser to continue to abuse without fear. Some researchers estimated that only 5 percent of all rapists ever spend any time in jail for their crimes; 19 of 20 do not.

Effects on the Victims

The effects of sexual abuse differ depending on the age of the victim, the type of abuse (whether it is rape or childhood sexual assault) and the severity and duration of the abuse. The psychological symptoms resulting from violent assaults fit the diagnostic criteria of Acute Stress Disorder and Post Traumatic Stress Disorder.

These two syndromes are clinically very similar. The former defines symptoms that arise within two days of a traumatic event and last no more than four weeks after the event. The latter diagnosis is used either when the symptoms arise some time after the precipitating event, or when the symptoms of Acute Stress Disorder last longer than four weeks.

The root cause of the symptoms is the intense fear generated by the assault. The victim persistently reexperiences the abuse in the form of recurrent and intrusive memories, dreams and flashbacks. The victim cannot stop thinking about the assault, no matter how hard he or she tries. The memories invade sleep in the form of terrifying dreams, which prompt many victims to avoid sleep. In many cases, the victim relives the experience through flashbacks—intensely vivid mental images, which cause the victim to believe that the assault is happening right at that moment. Things, places, situations and feelings that remind the victim of the assault often trigger these symptoms.

For example, a woman who was raped by a man in a blue jacket may start to feel fearful whenever she sees a businessman in a navy blazer. Additionally, victims may experience bodily symptoms (racing heartbeat, rapid breathing, sweating and dizziness) when they encounter mental or physical reminders.

Three months after an attack, a rape survivor expressed these feelings as quoted in the Texas Department of Health Advocate Training Manual, 1994. "Sometimes I think the feelings are more intense now than they were at first. I was on the trolley and two guys came and sat down across from me. They looked like the two that raped me. I could almost feel like I was being grabbed again. I just have to keep thinking intellectually it won't happen, but my gut reaction is so intense . . ."

In response to this fear, the victims begin avoiding those things that remind them of the trauma—refusing to talk about the event and attempting to avoid thoughts or feelings associated with it; refusing to participate in activities or going to places that remind them of the assault; and withdrawing from normal activities, people or feelings. Many victims believe they will never have a normal life with a career, marriage and children. In addition, victims often exhibit increased arousal, startlingly easily. They are often more irritable, bursting into rage more quickly. They may have great difficulty sleeping. Concentration suffers, and the sufferer is often in a state of heightened vigilance, constantly on the lookout for danger.

It is important to note that these symptoms are the body and mind's normal fear responses to extremely threatening situations. War veterans, firefighters, police officers and kidnap victims are only a few examples of people who experience these symptoms as a result of their exposure to life-threatening incidents. The fear responses are natural defense mechanisms designed to protect us from extreme danger.

With time and therapeutic support, the symptoms can fade and the victim can reorganize his or her life along more normal lines. Sometimes these symptoms do not arise for months or even years after the event. Children, especially, repress the troubling memories and only begin experiencing the effects in adulthood.

Signs of Sexual Abuse

If a child is being sexually abused, his or her normal behavior may change. He or she may become depressed; have trouble sleeping or eating; or become angry, withdrawn, anxious and afraid. He or she may be afraid to be separated from you and cling to you.

Experts look for two other factors that often indicate, when they occur together, that sexual abuse is occurring: (1) Sexual preoccupation (or knowledge that is inappropriate for the child's age) and (2) physical complaints, such as rashes, headaches or stomachaches that have no medical explanation.

If your child tells you that he or she has been abused, say you are glad he or she told you. Do not pressure the child, but draw him or her out with careful questions. Tell your child that you believe him or her—fear of parental disbelief often keeps children from reporting abuse. Case notes have shown that few children lie about sexual abuse. Tell your child that the abuse was not his or her fault. Make it clear that you do not blame the child, as most children will feel guilty about what happened.

You may want to have your child examined by a doctor. Try to find a doctor who has had some experience dealing with abused children and who will be sensitive to your child's feelings. You may also need to contact the local authorities to report the abuse. In many areas, professionals (such as a doctor who examines your child) are required to report sexual abuse to the authorities.

Differences Between Adult and Child Sexual Assault

The following is a case history of a sexually abused child. Tommy was an outgoing, cheerful, fun-loving 6-year-old boy. He showed interest and ability in sports, so his conscientious, dedicated parents enrolled him in a city-sponsored softball team. Tommy's coach was well-respected and a successful coach. He took great interest in Tommy, praising him and singling him out for much attention. He scheduled private coaching sessions with the parents' permission. However, the "coaching" Tommy was receiving was not related to softball. After two years of special attention, Tommy was devastated to see his beloved coach turn away from him and begin to spend time with a younger boy.

Tommy seemed to recover from his disappointment, but two years later, he began getting into trouble in school. He was expelled for fighting and then charged with assault. He was sentenced to a counseling program for boys in trouble. During the individual sessions, he confided to the therapist what his coach had done. Charges were brought against the coach (a prominent person in the community).

Tommy and his family were outcasts in their small town. Tommy went through several years of acting-out behavior. At the age of 15, he attempted suicide twice. His parents were grief-stricken and guilt-ridden. They blamed themselves. Tommy's mother became clinically depressed. After many years of therapy and hard work, Tommy graduated from high school and started working.

Sexual assault of adults is a violent, vicious and traumatic attack. The perpetrator, whether known to the victim or not, is acting out of a need to overpower and control. Thus, he or she is willing to use whatever force is necessary to achieve that purpose. The victim, having the advantage of being an adult, knows that the rape is what it is—an attack and an isolated incident. The trauma is overpowering and difficult to heal from, but the adult has the ability to begin to deal with it as soon as he or she chooses to face it. For children, however, healing may not begin for years, sometimes even decades after the abuse. This is because of the mental and emotional immaturity of the child and the method of attack that child abusers often use.

Abuse of children is done most often by someone they know, even someone they trust. The assailant "grooms" the victim, gradually building a friendship with the child. Slowly, by degrees, he (child abusers are mostly male) begins exposing the child first to "innocent" touching and then progressing to more sexualized activities. At each step, he reassures the victim that he won't hurt the child. By so doing, he overpowers the child's natural reluctance and fear.

This results in a host of confused and conflicting feelings in the victim. On the one hand, the child feels physical pain, fear and rage. But these feelings are soothed away by the accomplished molester and "explained away." On the other hand, the attention lavished on the victim makes the child feel special and loved. All children have the need for these feelings to be satisfied. The abuser twists these natural emotions into a means for him to get his own needs met at the expense of the child's well-being.

To add to the victim's confusion, the acts themselves may be physically pleasurable. They may feel good, but the child feels ashamed or "dirty" because on a deep level he or she knows that the acts are wrong.

Additionally, the child receives a mixed message about trust. The abuser is often someone the child should intrinsically trust—a family member, a teacher, a coach or a neighbor. The child ought to be able to feel safe around such a person, but the acts bring pain. So, what is the message the child receives? "This person says I can trust him not to hurt me, but he is hurting me. So there is something wrong with me. If this person who is supposed to protect me from harm is actually harming me, who can I trust to protect me?"

Considering the complex and contradictory emotional fallout of childhood sexual abuse, it is understandable why a child's mind seeks to protect itself from this pain. The feelings are overwhelming. The mind often represses the memories and feelings until adulthood when the person will cognitively be more able to deal with it.

Even in adulthood, however, the intense pain and feelings can devastate the individual. The adult has an enormous task to heal from the abuse. He or she must deal with the memories and flashbacks, feel the pain and anger and acknowledge their effects on his or her life, and face the feelings of shame, guilt and self-blame that accompany them. Survivors of childhood sexual assault experience a mourning phase in which they grieve for their lost innocence and happy childhood. Other challenges on the way to recovery include learning to trust again and developing healthy interpersonal boundaries.

Secondary Victims

Crimes of sexual abuse involve more than the perpetrator and victim. They spread out their tentacles like an octopus to include the parents, siblings, friends, mate and potential mates of the original victim. Support, or lack of it, can help or hinder the victim's recovery from the trauma.

Family members have strong emotional reactions to the assault. They are distressed that the survivor has been injured and may be fearful that the injuries are permanent or life-threatening. They are also very angry at the perpetrator for injuring their loved one, at the survivor for not "fighting hard enough" or being "careful" enough and at themselves for not preventing the attack or not being "protective" enough.

Family members can also feel a desire for revenge against the attacker. They may even act on this desire. Family members often feel guilty that they were not able to protect the survivor. Relatives and friends feel a great sense of loss for the survivor, themselves and the family. A common feeling is that "things will never be the same."

Spouses and potential spouses experience these emotions too. They also may believe some of the myths about rape and sexual abuse. They may not be able to recognize that these crimes are not about sexual relations but about anger, power and control. Therefore, spouses may feel that adultery has been committed and the sanctity of the marital relations has been violated. Many survivors experience sexual difficulties after their attack, which the spouse often interprets as rejection. Because of these factors, the divorce rate among survivors of sexual assault is quite high.

Additionally, adult survivors of childhood sexual abuse have great difficulty in developing and maintaining normal, healthy intimate relations with spouses, especially after they have begun to process their experiences. The stresses on the relationship while the survivor is healing can often be overwhelming to the relationship.

Many times family members may fear to accept the truth of the sexual abuse. This often happens in cases of incest. The nonoffending parent may fear the breakup of the family, and out of that fear will refuse to believe the child's report. This is particularly true in instances where a wife may fear that she will lose her husband if she acts on what her child is telling her. She may accuse her child of lying about the abuse or discount the report in some other way.

Another situation where parents may refuse to act occurs when one sibling abuses another. Whenever a victim is disbelieved, or worse, accused of "making it up," the trauma is magnified. This is called "secondary wounding." As a result of this wounding, the victim suppresses the memories. When the victim finally begins the healing process, he or she must also be healed from the secondary wounding.

The healing process takes time but can with patience and love resolve into stronger, happier relationships. For that to happen, all family members must be educated to the effects of sexual abuse and assault and be committed to provide the support and encouragement each needs for the family to heal.

Biblical Examples

Sexual abuse is not new. It has been perpetrated since the beginning of recorded history. The Old Testament of the Bible contains three specific instances of sexual abuse. The first incident is described in Genesis 19:30-38. This case involved Abraham's nephew Lot and two of his daughters. The daughters initiated incestuous relations with their father, perhaps in the mistaken belief that the entire world had been destroyed (this occurs shortly after the destruction of Sodom and Gomorrah) and they were the only humans left on the earth

The second incident is described in Genesis 34. It involved the rape of Jacob's daughter, Dinah, by Shechem the Hivite. In this case, the Bible makes it clear that she was raped. "Now Dinah the daughter of Leah . . . went out to see the daughters of the land. And when Shechem the son of Hamor the Hivite, prince of the country, saw her, he took her and lay with her, and violated her" (Genesis 34:1-2).

Clearly, the emotional reactions of family members toward a rape victim have not changed down through the millennia. When Jacob first heard that his daughter had been defiled, he waited until his sons came back from taking care of the herds in the fields. When Dinah's brothers heard about the rape, they "were grieved and very angry, because he had done a disgraceful thing in Israel by lying with Jacob's daughter, a thing which ought not to be done" (Genesis 34:7).

In the meantime, Shechem had asked his father to arrange a marriage between him and Dinah. He offered to pay as dowry anything Jacob and his sons required. Jacob's sons, however, wanted vengeance. So they lied to Shechem and his father and demanded that the entire city be circumcised. Shechem and his father agreed to this condition. After the city had complied with it, Simeon and Levi, Jacob's sons, attacked the city, killed all the men and took Dinah back with them. The rest of Jacob's sons plundered the city and took all its wealth. Jacob remonstrated with his sons because of their actions, but they defended themselves by saying, "Should he treat our sister like a harlot?" (Genesis 34:31).

Jacob, apparently, was willing to overlook the rape of his daughter to keep peace with the Hivites. He responded like many family members of sexual abuse victims who turn a blind eye to the reality of the abuse to avoid confronting the abuser. His concern seemed to be more for how his sons' actions would impact his relations with his neighbors than for his daughter.

No doubt the punishment exacted by Jacob's sons was excessive. And, to be sure, there were other issues involved. However, the emotional reactions of Jacob's sons were the same as many family members of abuse victims today. They were angry, distressed and wanted to avenge their sister's honor.

The next account concerns the rape of Tamar, King David's daughter, by her half-brother, Amnon (2 Samuel 13). Amnon desired Tamar, and he devised a scheme to get her alone with him in his house (2 Samuel 13:1-10). Once there, he asked her to lie with him. She resisted and even told him that if he wanted her, all he had to do was ask their father. She told him that King David would allow them to be married if Amnon requested. She begged him not to rape her (2 Samuel 13:11-13). This passage shows that she did not consent.

The next verse shows that Amnon's goal was not honorable. "However, he would not heed her voice; and being stronger than she, he forced her and lay with her" (2 Samuel 13:14). Clearly, he was only interested in forcing his will on her. The law of God states that if a man seduces a virgin, then he is to pay the bride-price and marry her (Exodus 22:16). However, once Amnon had forced Tamar, he rejected her and ordered her out of his house. Tamar begged him not to reject her saying, "This evil of sending me away is worse than the other that you did to me" (2 Samuel 13:16).

Clearly, Tamar attempted to follow God's law, but Amnon was not willing to do so. His aim was to force Tamar to do as he willed. His motivation was to have power and control over Tamar—the same motivation driving sexual abusers.

Tamar's reaction to this attack is also typical of sexual abuse victims, with allowances for cultural differences. She tore her clothes and put ashes on her head (signs of mourning) and cried (2 Samuel 13:19). After telling her full brother, Absalom, what had happened, she stayed secluded and depressed in his house. Many victims of a sexual attack withdraw from their previous activities and from associating with other people. The Bible does not record what happened to Tamar after that. She may have stayed in isolation for the rest of her life, or she may have recovered.

King David was "very angry" (2 Samuel 13:21), but he took no direct action. Absalom was also extremely angry. He hated Amnon (2 Samuel 13:22). Amnon's rape of Tamar set in motion events that led to his own death at the hand of Absalom (2 Samuel 13:23-39) and ultimately to Absalom's attempt to usurp his father's throne. David's inaction allowed Absalom to have the opportunity to feel angry and embittered toward his brother. Absalom chose to use his desire for revenge as an excuse for committing murder. He also felt anger towards his father for failing to protect and avenge Tamar. He allowed himself to brood on these wrongs and become so embittered that he felt justified in overthrowing his father.

God's Instructions to Prevent Sexual Abuse

God created sex for two main purposes: reproduction and love between a husband and wife. Sex is reserved for the marriage relationship only, and the Bible upholds virginity and abstinence outside of marriage. Exodus 20:14 and Deuteronomy 5:18 forbid adultery. The penalties were very strict. Both parties were to be put to death (Leviticus 20:10). Betrothal was considered as binding as marriage, so if a man had sexual relations with a betrothed woman, the penalty was the same as for adultery.

God also put hedges around relationships within families. In Leviticus, chapters 18 and 20 list in detail those relationships with which sexual intimacies are forbidden. They include fathers and daughters, sons and mothers, sisters and brothers, grandparents and grandchildren, aunts and nephews, uncles and nieces, as well as the spouses of these relationships. God states in Leviticus 18 that these laws are in response to the practices of the Egyptians who believed that the Pharaoh's line descended through the female line. Therefore, for father to pass on the office to his son, it was necessary for brothers to marry sisters.

Close intermarriage allows for recessive genetic traits to be more often expressed and passed down. Some of these traits cause disabilities and infirmities with tremendous suffering. By not allowing close family members to marry and have children, these traits do not appear as frequently. Also, having sexual relations between close family members blurs the boundaries between the roles of parent/child and spouse.

Parents are supposed to protect their children from harm, not exploit them to fulfill their own desires. Parents are commanded to raise children who love and obey God (Deuteronomy 6:1-2, 7; Ephesians 6:4). A parent who violates the laws of Leviticus 18 is clearly not obeying these commands. A family member who violates these laws is also failing to uphold the God-ordained roles of the family. The parent's role is to teach, guide, nurture and protect children until they are able to be fully functioning adults. If a parent steps out of that role into that of a sexual partner, the child's ability to enter into a healthy adult relationship with a mate and into a healthy relationship with God is severely hampered.

Much additional information is available on the subject of sexual abuse. Many Web sites offer both information and help. However, it may be wise to search out Web sites that are sponsored by reputable national organizations. Protection of privacy and assurance of safety and emotional well-being are important considerations. A list of helpful Web sites might include www.rainn.org and www.human-nature.org/ as well as many other sites. The first-mentioned of these, the Rape, Abuse and Incest National Network, is the nation's largest anti-sexual assault organization. RAINN operates the National Sexual Assault Hotline at 1-800-656-HOPE and carries out programs to prevent sexual assault, help victims and ensure that rapists are brought to justice.

Sexual abuse is not the victim's fault. It is the responsibility of the abuser. If you know someone who has been sexually abused, you can help by offering support to the victim. Victims need to hear repeatedly, "It wasn't your fault." Victims need to hear that they can recover. They need to know that they are not alone and that others have not stopped caring for them. They especially need to understand that God still loves them. And, finally, they need to understand how to break the sexual abuse trauma cycle to further the process of emotional and spiritual healing. Our final article in the series on abuse will address breaking the cycle of abuse.

References/Further Reading

•American Psychiatric Association, Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition,1994.
•J. Nevid, S. Rathis and B. Greene, Abnormal Psychology, 1994.
•Texas Department of Health, Sexual Assault Prevention and Crisis Services. Advocate Training Manual, 1996 ed.
•The Rape, Abuse and Incest National Network (RAINN), www.rainn.org, for statistics about rape and sexual abuse. UN
•Helen Richards has an M.S. in counseling and is an educational therapist at a psychiatric facility in Dallas, Texas. She attends UCG in Dallas. John Cafourek is pastor in Salem, Oregon, and has an M.A. in counseling psychology.