Walks and Thoughts

of Michael Simes

An old Man's Tale:



West Vale

Clay House


Cragg Vale



Pecket Well

Luddenden Dean

Jerusalem Farm

Catherine Slack

Stone Chair

It's Just Like Home:

Hong Kong





Marlborough Sounds


Milford Sound



Blue Mountains

Northern Beaches


A City Of Revolution:




Notre Dame

The Adult Legacy Of Childhood Sexual Abuse

Individual Therapy With Adult Mental Health

Referrals Where CSA Is The Key Factor

Dick Agass And Mike Simes

The following is a summary, drawn from our own experience, from discussions with colleagues and from current literature (references throughout the text), of the possible long-term effects of childhood sexual abuse. There is much dispute in the literature as to whether definite causal links can be established between particular childhood experiences and particular adult conditions, and whether the same features are to be found in the 'non-clinical' majority of abuse victims as in those who present for some sort of treatment (Herman et al, 1986; Browne and Finkelhor, 1986; Fromuth, 1986; Briere and Runtz, 1988). What does seem to emerge is a measure of agreement that sexual abuse creates special and often identifiable difficulties for children already inadequately cared for (Steele, 1986; Bifulco et al, 1991). Helen provides a clear illustration of this point. Her story reveals in some detail the extra damage inflicted by sexual abuse on an already abused and neglected child.

For convenience we have made an artificial distinction between intra- and inter-personal consequences. The extent to which any of these features are present will naturally depend on such variables as the subject's personality, the duration and severity of the abuse, the age and developmental stage at which it occurred and the quality of support that was available at the time.

Long-term effects (1): intrapersonal
  • low self-esteem; no coherent sense of identity or worth; poor sense of personal boundaries
  • depression; sadness, sense of loss (e.g, of childhood)
  • inner 'deadness'; loss of contact with own feelings dissociation (defensive emotional withdrawal): feeling numb, 'outside looking in'
  • loneliness, isolation; feeling 'different', an outsider chronic 'confusion', disorientation; skewed sense of reality anger (inwardly directed); self-blame, guilt; feeling contaminated, stigmatised
  • powerlessness, helplessness; compliance, passivity feeling trapped, not in control of own life anxiety, fearfulness; phobic symptoms
  • negative feelings about own body self-destructive behaviour; self-harm (often cutting), suicidal thoughts/behaviour; alcohol or drug abuse
  • impoverishment of personality; impaired development; learning difficulties; underachievement
  • dissociative experiences: nightmares, flashbacks, intrusive images and thoughts; sleep disturbance 'borderline' symptoms (chronic dissatisfaction with life, confused identity etc.); multiple personality; psychotic symptoms eating disorders
  • tension; psychosomatic complaints; physical symptoms

Long-term effects (2): interpersonal
  • failure of mother -daughter bond; feeling betrayed and unsupported by rest of family
  • relating to family of origin as if still under its control interpersonal problems arising from deep insecurity and distrust (especially of men)
  • 'victim behaviour'; recreating abusive relationships, tolerating very harmful situations; vulnerability to sexual assault and rape
  • anger (outwardly directed): (a) expressed inappropriately or at random (b) used self-protectively to stop others getting close sexual confusion; disturbance of sexual function: (a) aversion to sex (b) compulsive sexual activity
  • prostitution
  • sexual dysfunctions (phobias, aversions, lack of satisfaction)
  • fear of not being taken seriously; fear of being disbelieved, discounted or blamed
  • fear of being unable to love others
  • feeling over-responsible for others whilst own needs unmet ('parentified child' or 'caretaker' syndrome)
  • fears about abusing own children
  • fears about own children: (a) that daughters will be abused (b) that sons will abuse
  • increased likelihood that own children will be abused ('cycle of abuse'): (a) by a father who was himself abused (b) by an abused mother's abusing partner (c) (less commonly) by an abused mother herself