As a survivor of childhood sexual abuse, seeing a therapist or counselor is a powerful decision to make for yourself. Professional therapists help both adults and children resolve emotional conflicts, process memories of abuse, and provide a safe space to discuss paths to improve their current (and future) relationships and sexual experiences.
There is no single method therapists use to help sexual abuse survivors. There are many therapeutic approaches to consider, and finding one that is the best fit for you is always possible. A diverse range of therapies are used to help abuse survivors reconcile their experiences, regain confidence and approach their futures with new strength. They can help you, as well.
Let’s look at several kinds of therapy for survivors of childhood sexual abuse that you might consider for yourself or your child. We’ll explain what each therapy is and what you can expect from a typical therapy session.
What is Therapy?
When you hear the word “therapy,” you likely imagine a gray-bearded man, with a pad and pencil, asking you questions as you lay on an uncomfortable couch. Let’s erase that cliché from your mind and define therapy as it stands today.
Therapy, also called psychotherapy or counseling, is the experience of meeting with a therapist to encounter and recover from unhealthy behaviors, feelings, emotions, beliefs, and experiences.1 Therapists usually hold a graduate degree in sociology, psychology, or counseling, and as we mentioned, can specialize in any number of specific modes of therapy.2
While it’s hard to say exactly what your own personal therapy session will be like, (they are always unique to you), there are common threads that all therapists and counselors follow. Most therapy sessions happen one-on-one between you and the therapist. You’ll likely meet them at their office, but many therapists also organize group therapy sessions or even make house calls. And of course, all therapy sessions are completely confidential.
Together, you and your therapist will discuss the goals you have for your sessions together. Therapy is not a one-sided conversation, but a compassionate, trusting relationship. The therapist’s job, regardless of their specific credentials, is to encourage you to share your feelings and experiences so that, as a team, you can explore what they mean to you and how to eliminate their negative influence from your life. Depending on their specialty, you’ll approach your experiences of sexual abuse from any number of lenses. Let’s learn about some of them.
Psychoanalysis is the oldest professional form of therapy. This kind of counseling relies on “talk therapy”. In talk therapy, the therapist asks you questions about your past in an attempt to help your current problems. Psychotherapists very much believe that your current patterns of thought and behavior all flow from previous experiences, especially experiences during childhood and adolescence.
It will be important to talk about your abusive experiences with your therapist. Psychotherapy will highlight these experiences extensively. Other therapies use these experiences as a launch pad for other forms of treatment, so be prepared to work up to sharing your painful experiences with your therapist, no matter which kind you choose.
Psychoanalysis, and in fact every kind of therapy, is as much a self-learning process as it is a self-healing process. Sexual abuse therapy has to begin with the experiences themselves—how you remember them and feel about them. The ways you present the problem and your current coping methods will also be discussed and considered at length3. Sharing like this is a painful and courageous experience, but with a trusted therapist to guide you, the struggle will be worth it.
Cognitive-Behavioral Therapy (C-BT)
This kind of therapy has also proven very helpful for survivors of sexual abuse. Cognitive-Behavioral Therapy, or C-BT, is all about how your thinking affects your behavior, and vice-versa.
It’s actually a combination of two separate therapies. The first is cognitive therapy, which focuses on your patterns of thinking and perception. How you think about your past, present, and future as a survivor has followed you since the abuse itself, and many of these thoughts are distorted and causing you problems. The second is behavioral therapy. This type instead focuses on your immediate reactions to situations or memories – anger, sadness, rage; and teaches you that how you behave affects how you feel.4
C-BT combines these approaches. You and your therapist will look at how you perceive and think about your history of abuse. Once you identify and accept your thinking as unhelpful, you’ll then work together on how best to change your behavior to reduce these kinds of thoughts and find more healthy outlets. Then, you’ll discover that many of your automatic thoughts, and not your history itself, are preventing you from working toward better behaviors.
As an example, an adult survivor of sexual abuse may avoid intimacy with friends or romantic partners. C-BT would help him understand where his thinking is flawed and gets him in trouble (“I am incapable of being intimate”) and then transition into teaching him real-world behavioral changes he could practice to make healthy, intimate relationships (starting with conversations, for instance). This brand of therapy is one of the most versatile and popular today, and its positive effects for survivors of abuse is truly impressive.
The therapies we’ve talked about so far are just the tip of the iceberg. Many other kinds, or combinations of kinds, can help you confront the uncomfortable emotions, distorted thoughts, and negative behavioral patterns a history of abuse forces you to deal with.
Exposure Therapy, for instance, slowly exposes you to a specific frightening situation so that you become “desensitized” to it. For example, a child survivor of abuse may be terrified to re-enter the room where he or she was assaulted. They may eventually “generalize” this fear, and be scared of that kind of place or event in any context. You and your therapist will work to incrementally “expose” yourself to the situation and specific environment in a safe, supportive way. Doing this trains your body and mind to no longer fear the specific situation.
Narrative Therapy is another option, where you distance yourself from your experience by telling your story of abuse.6 You and your therapist brainstorm ways to objectify the negative parts of an abusive experience and “reframe” them to empower your decisions.
There is also EMDR, or Eye Movement Desensitization Therapy7. This technique is used to help trauma survivors and victims of PTSD uncover “fragmented” memories that cause continual stress. It uses eye stimulation in specific patterns to help you make new associations with forgotten memories and positive stimuli your therapist introduces. It sounds like science fiction, but both the World Health Organization and the American Psychiatric Association recognize EMDR as highly effective.
Taking the First Step
Almost everyone can benefit from therapy sessions at one point or another during their lives. Survivors of sexual abuse see tremendous results in their quality of life after devoting themselves to therapy. Hopefully you can see what a vital role therapy can play in your own process of healing. There are many options to consider, and many paths to take toward living a fuller, more meaningful life after abuse.
Are you considering therapy? Are you currently working with a counselor or psychiatrist?
Tell us what therapy was like for you or which ones listed here seem the most encouraging. There is support in many forms, and therapy can play a large, positive role in your own resilience and recovery.