Vilenica, S., Shakespeare-Finch, J., & Obst, P. | School of Psychology and Counselling, Queensland University of Technology, Brisbane, Australia | Published in Counselling Psychology Quarterly<\/em><\/p>\n\n Childhood sexual assault (CSA) is one of the most devastating of all traumatic experiences, with population studies documenting survivors experiencing higher levels of pathology than survivors of other traumatic events. Yet recent research has demonstrated that far from being permanently crippled by their experiences, many adult survivors of CSA manage to heal and move forward in their lives to experience a rich and fulfilling existence.<\/p>\n\n In this article, two case studies are presented to provide a detailed account of how people who have experienced CSA may find a pathway to healing. Our data demonstrate that meaning making \u2014 spiritual or otherwise \u2014 is a pivotal part of acceptance of CSA and ensuing growth. The case studies amplify the unique journeys of two women along with underlying similarities in their pathways to healing. Clinical implications of the research are discussed and specific strategies for encouraging healing and growth are outlined.<\/p>\n\n Keywords:<\/strong> child sexual abuse, child sexual assault, post-traumatic growth, meaning making, healing<\/p>\n\n Sexual assault in childhood is one of the most personally impactful traumas an individual can experience (Frans et al., 2005; Hapke et al., 2006). After exposure to a traumatic event, many people experience initial, short-term post-traumatic symptoms that in most cases abate with time, with only a minority of people going on to develop post-traumatic stress disorder (PTSD; Bonanno, 2004).<\/p>\n\n For those who experience childhood sexual assault (CSA), however, the trajectory for post-traumatic symptoms is significantly different. Those who experience CSA are not only more likely to develop PTSD at some stage \u2014 compared to survivors of other sorts of trauma \u2014 but also more likely to endure lifelong PTSD symptoms (Rodrigues, Vande Kemp, & Foy, 1998), a testament to how powerfully impactful sexual trauma can be.<\/p>\n\n The negative effects following CSA are wide-ranging and highly individual. Commonly reported concerns include:<\/p>\n\n Perhaps the most devastating outcome associated with CSA is the negative impact on one’s sense of self. People with a history of CSA often report long-standing, negative core beliefs about themselves \u2014 perceptions of the self as “wrong,” “damaged,” or somehow separate from others (Isely et al., 2008; Zinzow et al., 2010). These negative core beliefs have been reported by both those who endured repeated abuse over many years and those who experienced a single intrusive contact abuse act (Isely et al., 2008; Molnar, Buka, & Kessler, 2001).<\/p>\n\n Contributing to these negative core beliefs is an inherent dynamic of CSA, which often involves feelings of complicity and responsibility for the abuse, as well as deep feelings of shame and guilt on behalf of the child (Coffey et al., 1996). All of these factors, compounded by the occurrence of this particular trauma during the formative years, have the potential to be profoundly devastating to a child’s developing sense of self.<\/p>\n\n Current theories of coping after trauma emphasise how traumatic events can be powerful enough to shake the foundations of belief systems \u2014 the fundamental assumptions people hold that provide a sense of predictability and meaning in life (Calhoun & Tedeschi, 2006; Janoff-Bulman, 2006).<\/p>\n\n Janoff-Bulman (1989) conceptualised these fundamental assumptions in three primary areas:<\/p>\n\n These core beliefs are threatened by traumatic events due to the dissonance between previous experience and current reality. Healing then becomes a process of learning to integrate new knowledge about the unpredictability of life, malevolence, and senselessness into a transformed understanding of oneself (Calhoun & Tedeschi, 2006; Janoff-Bulman, 2006).<\/p>\n\n When trauma occurs during childhood and adolescence \u2014 the life stages where assumptive worlds begin forming \u2014 the impact appears less about shaking established foundations and more about shaping emerging ones. Many healed and healing survivors of CSA report that only later in life, at the point where they acknowledged how deeply the abuse had negatively affected the way they saw themselves and their world, did the real pain and real healing begin (Bogar & Hulse-Killacky, 2006; O’Dougherty Wright et al., 2007; Woodward & Joseph, 2003).<\/p>\n\n The active process of transformation \u2014 or reconstruction of inner global views \u2014 has been termed “meaning making”<\/strong> (Joseph & Lindley, 2005; Park & Ali, 2006) and appears to be an important component of wellness and growth after trauma (Park, 2010). Meaning making refers to active cognitive engagement to restore or resolve ruptures within one’s global sense of meaning after a life-shattering event.<\/p>\n\n In action, meaning making may manifest as:<\/p>\n\n Research has confirmed that post-traumatic growth (PTG) can be an outcome of the shattering of assumptions that accompanies highly stressful life events, with greater PTG found in those with higher levels of deliberate rumination (Cann, Calhoun, & Tedeschi, 2010). PTG can include positive changes in self, a strengthening in relationships with others, and a change in spirituality or philosophy of life (Calhoun & Tedeschi, 2006).<\/p>\n\n The two women discussed in this article are participants in a larger ongoing research project examining pathways to healing and growth after sexual assault in childhood. Participation was based on self-selection on three primary conditions:<\/p>\n\n The women were 52 (Participant 1) and 44 years of age (Participant 2) at the time of interview. The case studies were chosen for their representativeness of broader themes in the study, the clarity with which the women reported their healing journeys, and their disparity in terms of the onset and duration of offences.<\/p>\n\n Participants were recruited via a general public invitation through a state-wide radio station. Participation involved a 90-minute semi-structured phone interview covering a brief history of the assault, the initial and later effects of the abuse, what contributed to their healing, and any potential benefits participants felt to have come out of their healing journeys. Each interview was transcribed verbatim.<\/p>\n\n Data exploration was conducted using interpretive phenomenological analysis (IPA)<\/strong>, an idiographic approach where each participant’s narrative is individually analysed before any generalisations are made to other cases (Langdridge, 2004).<\/p>\n\n Participant 1 describes the seismic change that occurred at the core of her being as a result of the first rape:<\/p>\n\n “I died, meaning the person I was or was developing into was no more. That person still isn’t here today. That person was shattered the moment of that first abuse. I didn’t know who or what I was. I became segregated within myself. It was like being, my whole soul had been splintered into thousands of pieces and I didn’t know how to put it together again.” \u2014 Participant 1<\/p>\n<\/blockquote>\n\n Both women reflected on the self-beliefs they held before their healing journey began:<\/p>\n\n “I didn’t have any real values or beliefs, because it didn’t matter what you believed in or what values you had, because they could be taken away from you. There was always in the back of my mind the idea that I wasn’t good enough, that I was guilty for what had happened to me or what I let happen, so nothing good should happen to me unless I pay for it.” \u2014 Participant 1<\/p>\n<\/blockquote>\n\n “I couldn’t handle being less than perfect, I just had to be. If I was less than perfect then I was that hideous slimy creature that I thought I was because I had been raped. What I couldn’t articulate at the time was really profound shame.” \u2014 Participant 2<\/p>\n<\/blockquote>\n\n The sexual assault had a profound impact on the way the women came to view themselves. Beliefs of being unworthy, guilty, or hideous stem from deep feelings of shame and perceived guilt over the assaults \u2014 incorrectly internalising the assaults as something they contributed to and were responsible for.<\/p>\n\n Both women spoke of holding global negative beliefs about others, the world, and their place in it:<\/p>\n\n “I trusted no one, the moment it happened the first time. I didn’t believe in role models because of my belief that everyone had something bad happen to them. I believed all the men were going to abuse me.” \u2014 Participant 1<\/p>\n<\/blockquote>\n\n “After those two events I had a really weird idea of what my value was in the world. I assumed that my value to boys and men was sex, and so I had way, way too many sexual relationships with people because I thought that is what boys want and they are going to take it so I might as well give it to them.” \u2014 Participant 2<\/p>\n<\/blockquote>\n\n As a way of coping as children, both women used avoidance and dissociation from their experience:<\/p>\n\n “In my 20s it didn’t have an effect on me. Of course it did, but I believed that it was just something I could tell people. It was like in the third person. It was this little girl, but it wasn’t me.” \u2014 Participant 1<\/p>\n<\/blockquote>\n\n “I hadn’t given much thought to being sexually assaulted, it was just something that I thought of as\u2026 I went to school and I was sexually assaulted. It was all the same.” \u2014 Participant 2<\/p>\n<\/blockquote>\n\n Without the defence mechanism of dissociation, life could become overwhelming to the point of unbearable. Staying disconnected from the emotional intensity of the trauma provided the women a measure of functionality in their daily lives before they were ready to honestly accept their experiences.<\/p>\n\n For both women there came a time when avoidance of the depth of their experiences could no longer be maintained. Both were confronted with the necessity to accept the truth of what they had been through:<\/p>\n\n “I suppose the biggest influence \u2014 I planned a trip around Australia, the first time I was ever going to be alone in my life. It was pretty terrifying to think of that but I knew I had to do that. I knew I had to get out of my life as it was and get away from it all to be able to focus on being able to heal.” \u2014 Participant 1<\/p>\n<\/blockquote>\n\n “It was exactly 10 years after the first rape that I acknowledged what had happened and called it what it was. That was actually when it became really overwhelming. To call it rape. It was like a pit of horror to take the lid off the box and actually look inside.” \u2014 Participant 2<\/p>\n<\/blockquote>\n\n During this stage, each woman confronted significant insights about their inner worlds:<\/p>\n\n “I learnt that I can be by myself and not be scared of being by myself. Accepting all my faults and believing that I was a good person and it wasn’t my fault and I wasn’t guilty of that happening to me. Mostly I did it by myself, reading books and sitting with myself, and learning how to meditate.” \u2014 Participant 1<\/p>\n<\/blockquote>\n\n There naturally came a time for both women when each sought counselling to work on deeper issues stemming from the abuse. Both emphasised the crucial importance of trust in the therapeutic relationship:<\/p>\n\n “Finding someone I trusted was a huge thing, because if you don’t trust the person you are talking to then you won’t bring it out, you just won’t, you will hide stuff.” \u2014 Participant 1<\/p>\n<\/blockquote>\n\n “There were no particular strategies or revelations; it was just the slow work of healing.” \u2014 Participant 2<\/p>\n<\/blockquote>\n\n Both women reported that it was in working with their counsellors where they began to look at their core beliefs and learn how to create new, self-congruent ones:<\/p>\n\n “Learning how to focus on me and not turn away from myself and what had happened to me. And learning how to gradually change the way I was thinking, and change my ideas and values and beliefs, because everything was negative. I started looking at me, and trying to find the real me, because I had lost that person all those years ago.” \u2014 Participant 1<\/p>\n<\/blockquote>\n\n “I suppose the healing was going through and looking at my world view and my view of myself and unpicking it all and putting it back together again was the real nuts and bolts thing. It was the process of becoming a whole person and not a rape survivor.” \u2014 Participant 2<\/p>\n<\/blockquote>\n\n Understanding the way their global views were shaped by their traumatic experiences was deeply healing for both women. Negative beliefs of the self and world began to change through the process of first understanding what beliefs were held, knowing how they came to be, and then uncovering why they were untrue.<\/p>\n\n Both women reflected on the transformation that came through integration and acceptance of the trauma:<\/p>\n\n “Now I just see me. I am not defined by the abuse anymore. The abuse, although traumatic, was just a part of my life, there is so much more to me. My life is my own, I want to give, not take, and feel being a part of this world.” \u2014 Participant 1<\/p>\n<\/blockquote>\n\n “It is like a scar that has healed, you can see the scar is still there but there is not a wound there anymore. It is not a horrible disfiguring scar anymore \u2014 it is a part of lots of other things that have happened in my life that have all made me who I am now.” \u2014 Participant 2<\/p>\n<\/blockquote>\n\n Both women spoke of how their lives were enriched by working through their suffering:<\/p>\n\n “There is so much that has come good out of, dare I say, being abused. Everything that happened to me has eventually helped me be the person I am today. It has helped prepare me for other parts of my life.” \u2014 Participant 1<\/p>\n<\/blockquote>\n\n “It has made me an optimistic person, knowing that you do get better and that you can survive really traumatic events. And being able to listen to other people who have trauma in their lives and being able to bring compassion into their lives.” \u2014 Participant 2<\/p>\n<\/blockquote>\n\n The preceding exploration of the impact of CSA revealed how the experience of sexual trauma shaped the fundamental, global beliefs of the women reviewed in this article. Far from holding positive views of benevolence, meaningfulness of the world, and worthiness of self (Janoff-Bulman, 1989), both women reported that sexual trauma had a fundamentally negative impact on their emerging global views.<\/p>\n\n Despite the offences occurring at widely disparate times and differing in duration, the beliefs the women held were remarkably similar \u2014 highlighting the critical effect that sexual trauma exerts on emerging beliefs, regardless of whether the assaults occurred during childhood or early adolescence.<\/p>\n\n This study shows that for women who suffered CSA, the modification of beliefs occurred when they understood:<\/p>\n\n Through counselling, both women began to understand the fundamental beliefs they held \u2014 beliefs that formerly were out of their conscious awareness because they were so entrenched in patterns of thought. The conditions under which beliefs changed appeared to be when the thought of facing their fears became less frightening than continuing to live under them.<\/p>\n\n An important finding (echoed in the larger study) is that the conditions under which beliefs came to be changed almost exclusively arose via the assistance of another, most often within a therapeutic relationship. Working within a trusted therapeutic relationship that provides acceptance and non-judgement can provide individuals with the safety required to look deeply at their often conflicted belief structures so that change can occur.<\/p>\n\n What occurred as a result of re-working their beliefs of self, world, and others was a total change in their inner relationship \u2014 moving from hostile and negative to connected and optimistic. Both women reported a fundamental change in their view of self: from once feeling defined by the abuse to now knowing that it is but one part of the larger whole that makes up who they are.<\/p>\n\n They accepted the abuse as part of the whole individual, rather than as the dominant or defining feature. This was the process of becoming “a whole person.”<\/p>\n\n The clinical implications of this study point specifically to the crucial role that beliefs play in one’s perception of reality, and as a consequence, how people come to see themselves, others, and their world.<\/p>\n\n Far from being static, negative beliefs can be highly malleable and can be fundamentally changed through awareness \u2014 and awareness itself can be curative (Chodron, 1997). When working with those who have suffered CSA, clinicians should:<\/p>\n\n As is clearly evidenced here, change, healing, and growth after CSA is not only possible but perhaps an inevitable outcome of re-working belief structures \u2014 and one that is vital to establishing a healthier, more authentic way of being.<\/p>\n\n Belik, S.L., Stein, M.B., Asmundson, G.J.G., & Sareen, J. (2009). Relation between traumatic events and suicide attempts in Canadian military personnel. Canadian Journal of Psychiatry, 54<\/em>, 93\u2013104.<\/p>\n\n Bogar, C.B., & Hulse-Killacky, D. (2006). Resiliency determinants and resiliency processes among female adult survivors of childhood sexual abuse. Journal of Counselling and Development, 84<\/em>, 318\u2013327.<\/p>\n\n Bonanno, G.A. (2004). Loss, trauma, and human resilience. American Psychologist, 59<\/em>, 20\u201328.<\/p>\n\n Calhoun, L.G., & Tedeschi, R.G. (2006). The foundations of posttraumatic growth: An expanded framework. In L.G. Calhoun & R.G. Tedeschi (Eds.), Handbook of posttraumatic growth<\/em> (pp. 3\u201323). Abingdon: Lawrence Erlbaum Associates.<\/p>\n\n Cann, A., Calhoun, L.G., & Tedeschi, R.G. (2010). The posttraumatic growth model. In T. Weiss & R. Berger (Eds.), Posttraumatic growth and culturally competent practice<\/em> (pp. 1\u201314). Hoboken, NJ: Wiley & Sons.<\/p>\n\n Coffey, P., Leitenberg, H., Henning, K., Turner, T., & Bennett, R.T. (1996). Mediators of the long-term impact of child sexual abuse: Perceived stigma, betrayal, powerlessness, and self-blame. Child Abuse & Neglect, 20<\/em>, 447\u2013455.<\/p>\n\n Frans, \u00d6., Rimm\u00f6, P.-A., \u00c5berg, L., & Fredrikson, M. (2005). Trauma exposure and post-traumatic stress disorder in the general population. Acta Psychiatrica Scandinavica, 111<\/em>, 291\u2013299.<\/p>\n\n Gold, S.N., Lucenko, B.A., Elhai, J.D., Swingle, J.M., & Sellers, A.H. (1999). A comparison of psychological\/psychiatric symptomology of women and men sexually abused as children. Child Abuse & Neglect, 23<\/em>, 683\u2013692.<\/p>\n\n Hapke, U., Schumann, A., Rumpf, H.J., John, U., & Meyer, C. (2006). Post-traumatic stress disorder: The role of trauma, pre-existing psychiatric disorders, and gender. European Archives of Psychiatry and Clinical Neuroscience, 256<\/em>, 299\u2013306.<\/p>\n\n Isely, P.J., Isely, P., Freiburger, J., & McMackin, R. (2008). In their own voices: A qualitative study of men abused as children by Catholic clergy. Journal of Child Sexual Abuse, 17<\/em>, 201\u2013215.<\/p>\n\n Janoff-Bulman, R. (1989). Assumptive worlds and the stress of traumatic events. Social Cognition, 7<\/em>, 111\u2013136.<\/p>\n\n Janoff-Bulman, R. (2006). Schema change perspectives on posttraumatic growth. In L.G. Calhoun & R.G. Tedeschi (Eds.), Handbook of posttraumatic growth<\/em> (pp. 81\u201399). Abingdon: Lawrence Erlbaum Associates.<\/p>\n\n Joseph, S., & Linley, A.P. (2005). Positive adjustment to threatening events: An organismic valuing theory of growth through adversity. Review of General Psychology, 9<\/em>, 262\u2013280.<\/p>\n\n Langdridge, D. (2004). Introduction to research methods and data analysis in psychology<\/em>. Harlow: Pearson Education.<\/p>\n\n Molnar, B.E., Buka, S.L., & Kessler, R.C. (2001). Child sexual abuse and subsequent psychopathology: Results from the national comorbidity survey. American Journal of Public Health, 91<\/em>, 753\u2013760.<\/p>\n\n Nelson, E.C., Heath, A.C., Madden, P.A.F., Cooper, L., Dinwiddie, S.H., Bucholz, K.K., & Martin, N.G. (2002). Association between self-reported childhood sexual abuse and adverse psychosocial outcomes. Archives of General Psychiatry, 59<\/em>, 139\u2013146.<\/p>\n\n O’Dougherty Wright, M., Crawford, E., & Sebastian, K. (2007). Positive resolution of childhood sexual abuse experience: The role of coping, benefit-finding and meaning-making. Journal of Family Violence, 22<\/em>, 597\u2013608.<\/p>\n\n Park, C.L. (2010). Making sense of the meaning literature: An integrative review of meaning making and its effects on adjustment to stressful life events. Psychological Bulletin, 136<\/em>, 257\u2013301.<\/p>\n\n Park, C.L., & Ali, A.L. (2006). Meaning making and growth: New directions for research on survivors of trauma. Journal of Loss and Trauma, 11<\/em>, 389\u2013407.<\/p>\n\n Rodrigues, N., Vande Kemp, H., & Foy, D.W. (1998). Posttraumatic stress disorder in survivors of childhood sexual and physical abuse: A critical review of the empirical research. Journal of Child Sexual Abuse, 7<\/em>, 17\u201345.<\/p>\n\n Woodward, C., & Joseph, S. (2003). Positive change processes and post-traumatic growth in people who have experienced childhood abuse. Psychology and Psychotherapy: Theory, Research, and Practice, 76<\/em>, 267\u2013283.<\/p>\n\n Zinzow, H., Seth, P., Jackson, J., Niehaus, A., & Fitzgerald, M. (2010). Abuse and parental characteristics, attributions of blame, and psychological adjustment in adult survivors of child sexual abuse. Journal of Child Sexual Abuse, 19<\/em>, 79\u201398.<\/p>\n\n\n\n <\/p>","protected":false},"excerpt":{"rendered":" Healing After Childhood Sexual Assault: Meaning Making and Post-Traumatic Growth Vilenica, S., Shakespeare-Finch, J., & Obst, P. | School of Psychology and Counselling, Queensland University of Technology, Brisbane, Australia | Published in Counselling Psychology Quarterly Abstract Childhood sexual assault (CSA) is one of the most devastating of all traumatic experiences, with population studies documenting survivors […]<\/p>\n","protected":false},"author":3,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"give_campaign_id":0,"_et_pb_use_builder":"off","_et_pb_old_content":"","_et_gb_content_width":"","footnotes":""},"categories":[14],"tags":[],"class_list":["post-482","post","type-post","status-publish","format-standard","hentry","category-resources"],"yoast_head":"\n
\n\nAbstract<\/h2>\n\n
\n\nIntroduction<\/h2>\n\n
The Wide-Ranging Impact of CSA<\/h3>\n\n
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The Role of Belief Systems<\/h3>\n\n
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Meaning Making and Post-Traumatic Growth<\/h3>\n\n
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\n\nMethod<\/h2>\n\n
Participants<\/h3>\n\n
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Procedure<\/h3>\n\n
\n\nResults<\/h2>\n\n
Global Beliefs: The Impact of Trauma<\/h3>\n\n
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Beliefs About Self<\/h3>\n\n
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Beliefs About the World and Others<\/h3>\n\n
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Avoidance and Dissociation<\/h3>\n\n
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\n\nThe Healing Journey<\/h2>\n\n
Turning Points<\/h3>\n\n
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Awareness of the Inner World<\/h3>\n\n
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The Role of Counselling<\/h3>\n\n
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Meaning Making: Reconstructing the Self<\/h3>\n\n
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Transformation of Self<\/h3>\n\n
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Post-Traumatic Growth<\/h3>\n\n
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\n\nDiscussion<\/h2>\n\n
The Process of Belief Change<\/h3>\n\n
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From Defined by Abuse to Whole Person<\/h3>\n\n
\n\nClinical Implications<\/h2>\n\n
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\n\nReferences<\/h2>\n\n