Adult survivors of sexual abuse

Abstract

Introduction The motivation for writing this paper arises from my experiences in the Women's Clinic at the Royal London Homoeopathic Hospital from June 1993 to December 1995. The prevalence of sexual abuse in my patients was high. Approximately 60-70% women I saw had some experience of sexual abuse in their past histories. This finding was not entirely surprising. Ribberink et al. found 65% attendees at a gynaecology out-patient department had suffered severe sexual abuse incidents. ' Presenting at a gynaecology clinic may be one 'acceptable' way of seeking help in the aftermath of sexual abuse. 2 Research suggests that many women have experienced sexual violence in their lives (see incidence figures below). The silence surrounding the extent of sexual abuse has largely been broken by the work of women and children's organizations (e.g. Childline) and research since the 1970s. However, it still remains largely a taboo subject. One cannot treat the consequences of sexual abuse without a framework of understanding its context within society. The United Nations World Congress on Human Rights in Vienna in 1993 formally recognized sexual exploitation and violence against women as a human rights issue. 3 In this light, it is problematic to speak of 'treating' survivors of sexual abuse. To speak of treating survivors of sexual abuse without recognizing its context may mean falling into the problem of individually pathologizing the woman rather than seeing sexual abuse as a human rights violation against women. Kelly points out that 'Once sexual abuse is written about as if it was a medical problem, it has the potential for implying that it is not the abuse of male power which needs to change, but individual women and their symptoms. ' 4 The title of this article implies that I will be looking at what sexual abuse causes (which needs to be treated) rather than what causes sexual abuse. The latter issue may be far more important in terms of prevention. The causes of sexual abuse are not clear, but it is clear that it is predominantly perpetrated by men against women. Attempts to predict which men are more l ikely to rape or sexually abuse have failed to come up with a clear portrait of the perpetrator? It is clear that men may also be victims of sexual abuse, and that women are also capable of sexually abusing children. However, these situations are rare in the current literature.