Symptoms of Childhood Sexual Abuse

Characteristics of Childhood Sexual Abuse (CSA)

Sexual abuse creates fear, shame and guilt in the victimised child. Physical damage may heal but the emotional and psychological scars remain for a long time. Perhaps the most severe damage is caused by betrayal. Betrayal by an adult, especially when that adult is supposed to be protecting and caring for you, is devastating. The Fear has several components: anticipation of pain, anticipation of disapproval by the perpetrator and worry about threats to other family members. Shame seems to be built into most of us, especially when the abuse is incestuous. There's also the possibility that the victim absorbs the abuser's shame and guilt. Guilt is often felt by a survivor because she or he has become sexually aroused during the abuse. Guilt is also frequently felt when the survivor does -- or doesn't -- report the abuse. Many survivors feel guilty because "they went back for more", or didn’t say "No."

The helplessness and powerlessness of a child assaulted by an adult is real, terrifying and breeds lasting consequences.

For both abused girls and boys. Dissociation -- the separation of mind from body -- enables a child to survive the horror by imagining that the abuse is happening to someone else.

Symptoms in Adult Survivors

Among the effects of CSA are the following. Sometimes these symptoms do not appear for decades.
  • Nightmares
  • Flashbacks
  • Distrust
  • Sexual hangups
  • Physical ailments
  • Depression
  • Guilt
  • Fear
  • Anger
  • Confusion



  • Self-mutilation
  • Relationship difficulties
  • Self-doubt
  • Voices
  • Hallucinations
  • Suicidal thoughts
  • Addictions
  • Powerlessness
  • Helplessness
  • Negativity


These may be direct images, almost recollections, of the abuse or they may be symbolic. While non-abused people also suffer occasional nightmares, survivors experience repetitious, terrifying dreams in which they feel helpless and suffocatingly trapped.


Sickening sensory images suddenly occur which vividly bring back the smells, sights, sounds, physical and emotional feelings of the abuse.


With good cause, survivors are usually distrustful of the opposite sex, authority figures -- and themselves.

Sexual hangups

Inhibitions and fears about sexual activity range from mild to severely disturbed.

Physical ailments

The emotional, psychological and physical stress of abuse often takes its toll in physical illness as the body "remembers" being betrayed.


Feelings of worthlessness, apathy, self-loathing, can drown a survivor.


A mixture of self-blame for the activity, feeling bad about hating the abuser, horror at partial enjoyment, and possibly, absorption of some of the abuser's guilt feelings.


Childhood sexual abuse teaches the victim that the world is an untrustworthy place. Fear can infiltrate every aspect of the survivor's life.


Unfortunately often directed inward, anger can be a liberating emotion when the survivor directs it at the appropriate targets.


Uncertainty about what the abuse means (how can pain be love? Why is a caretaker betraying me?) overwhelms the child -- and festers in the adult.


To avoid the pain and guilt of blaming the perpetrator (especially in cases of incest) the victim may physically hurt herself or himself. Self-mutilation ranges from tattoos and nipple-rings to cutting, sexual violence and enemas. [HW writes: "tattoos and body piercings are considered a beautiful thing by some individuals. These practices are celebrated, not condemmed, by many tribes and cultures around the world."]

Relationship difficulties

Clearly a distrustful, confused, angry survivor is likely to have difficulties relating with other people.


Childhood sexual abuse is frequently accompanied with verbal abuse. Accusations of being stupid make a deep impression on a helpless, victimised child. This feeling of powerlessness persists into adulthood.


Frequently the various parts of the survivor, including the derogatory messages about being bad, stupid, unwanted, unlovable, etc., are "heard" as thoughts or even sounds.


Somewhat like Flashbacks but which the survivor "sees" in front of her, like blood on the bathroom floor. Hallucinations may also be "negative", i.e., not seeing something (like car keys) which are actually there.

Suicidal thoughts

Self-blame to the extreme. When the pain becomes too much to bear, suicide may seem to be the ultimate solution. Slow suicide. Also an attempt to dampen down the pain. May range from the legal (alcohol, cigarettes, gambling, prescription drugs) to the illegal (e.g.,street drugs). A feeling of having been stripped of dignity and effectiveness. A feeling of being held down, of being directed by others.


Generally noticing what's wrong, rather than what's right. Expecting the worst.



Victims of any kind of trauma are likely to find themselves revictimised.

Sometimes the new victimisation happens in similar circumstances, sometimes in situations that seem to bear no resemblance to the original incident.

Why does this happen? Because we all seek -- mostly subconsciously -- to repeat what we've already experienced. (This applies to good things, too, of course). So a person betrayed as a child will often feel drawn to a person who ends up betraying her.

And this may be because our experience of abuse is interpreted by our primitive brains as being our fault. This becomes ingrained in a neural network

The symptoms of shame, guilt and low self-esteem make it easy for a victim to accept the familiar and hard to accept respect and love from a mentally-healthy person.


A survivor's memories of abuse are often challenged or denied by other family members, health professionals and the public at large.

The recovery of "repressed memories" is a major controversy.

My view is that repressed memories can and do surface years after the abuse. They can also be manufactured wittingly or unwittingly by therapists. In which case they are not really memories, but beliefs.

All memory is malleable. Our memories are not like videos. They are not uncontaminated records of exactly what happened. Memories are influenced by our thoughts, desires, cultures, by the movies we've seen and the conversations we've had.

To rise victorious over CSA, it is not necessary, nor is it possible, to know exactly what happened. That it did happen is horror enough.


Closely connected to the fallibility of memory is denial. We deny we've been abused. Family members deny it. Society in general prefers to deny it. And for some people this is how they survive and go on with their lives. For others, cracking the nut of denial is the major step forward in their healing.


Should the perpetrator be confronted? There is no simple yes or no answer to this question. Confrontation can range from letter writing to in-person to court proceedings. It can be a plain "I know what you did" or an expensive lawsuit. The more "outsiders" are involved, the more you need corroborative evidence to back up your accusations.


The Key Identity is The Key: whether you identify as a victim, a survivor, a victor or ...?

Responsibility for self.

To overcome the effects of CSA requires a decision to take responsibility for oneself. And then to take appropriate actions about taking care of yourself. Some of the specifics towards that are:

  • Groups: therapy, self-help, support, 12-step, religious...
  • Thought-stopping
  • Affirmations
  • Gratitude diary
  • Love
  • Individual psychotherapy
  • Hypnotherapy
  • Emotional freedom techniques

"Before I saw Dr. Knight, I had many unresolved issues. I had tried counselling and psychotherapy since suffering sexual abuse and toxic family environment but nothing seemed to get me the closure I needed. Hypnosis is the best investment I have ever made in my life. It allowed me to truly let go of my past. After completion of my treatment with Dr. Knight, I felt an immense relief and peace of mind that I had not felt since I was a young child. I have found Dr. Knight to be highly skilled and passionate about his work. After only one session of hypnosis with him, I already felt better. It took only three sessions to resolve years of issues. Hypnosis allowed me to regain my self-confidence and to let go of the sexual abuse I had suffered in the past. I highly recommend Dr. Knight. He is Montreal's best kept secret! Many therapists can get the patient to speak of the problems and then they do not know what to do afterward when all is out in the open. Not Dr. Knight. He offers guidance and support in every step of the way, until true healing of the heart and mind occurs. Thank you Dr. Knight I will never forget what you did for me!"

- Jessica Dupré