Sexual abuse and sexual assault
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Sexual abuse and sexual assault definitions
The definition of childhood sexual abuse and adult sexual assault varies. Many people default to a legal definition of sexual abuse and assault, however, the law is not the only way people can and should make meaning of their experience.
The World Health Organisation defines child sexual abuse as “the involvement of a child in sexual activity that he or she does not fully comprehend, is unable to give informed consent to, or for which the child is not developmentally prepared… Child sexual abuse is evidenced by this activity between a child and an adult or another child who, by age or development, is in a relationship of responsibility, trust or power, [with] the activity being intended to gratify or satisfy the needs of the other person” (WHO, 1999, p.15).
Adult sexual assault can be defined as “any behaviour of a sexual nature that makes someone feel uncomfortable, frightened, intimidated or threatened. It is sexual behaviour that someone has not agreed to, where another person uses physical or emotional force [or coercion] against them” (CASA Forum, 2014). Sexual assault can also include non-touching behaviours, such as verbal harrassment, and exposing another person to sexual behaviour without their consent, such as masturbating in front of them or making them watch pornography.
Sexual abuse and sexual assault statistics
Childhood sexual abuse, and adult sexual assault, are highly prevalent crimes in Australia, as they are across the world. Australian prevalence rates estimate that 1 in 6 girls under the age of 15, and 1 in 9 boys under the age of 15 experience sexual abuse (ABS, 2017). Two-thirds of the total estimated abuse against children occurs before the age of 11 (ABS, 2017).
Over the age of 15, the rate of abuse against men drops to 1 in 25 (ABS, 2017), while the rate of sexual violence against women stays steady at 1 in 6 (ABS, 2017). Rates of sexual violence against adults from marginalised populations is higher, including: individuals from the LGBTQI+ community; individuals with mental health difficulties; women with disabilities, and; women from indigenous communities (AIFS, 2004; AIFS, 2012; AIHW, 2020a; AIHW, 2020b).
Impacts of childhood sexual abuse, and adult sexual assault
There has been significant research into the impacts of sexual violence on both survivors of childhood sexual abuse and adult sexual assault. Evidence strongly suggests that sexual violence is linked to higher rates of psychological, emotional and social difficulties for survivors across their lifetime (see here, and here, for summaries of this research). This is not to say that survivors do not live full, rich and meaningful lives. It is only to say that the experience of being sexually victimised can create difficulties that survivors are left managing.
While many victim/survivors experience distress or difficulties that are diagnosed using the language of psychiatric disorders (e.g. depression, post-traumatic stress disorder, borderline personality disorder, substance use disorder, etc.), many victim/survivors experience difficulties that can’t always be categorised using these diagnoses. Survivors can also experience feelings of self-blame, shame, isolation, betrayal, helplessness, and de-humanisation, as well as a loss of confidence or self-esteem, a loss of purpose or meaning, and a loss of trust in others or the world in general. Individuals can also question their sexual identity, their ability to be good-enough partners or parents, or their value in/ contribution to the world, with attempted and completed suicides being higher for victim/survivors of sexual violence than any other group of trauma-exposed individuals (Dworkin et al., 2020).
Healing from childhood sexual abuse or adult sexual assault is an individual journey, and survivors can choose from different options (including choosing not to have counselling, or to engage in other healing modalities like yoga, or art therapy, instead).
If survivors choose talking therapy to support them in their recovery, there are generally two different options they can choose: supportive counselling, or direct trauma therapy. Some therapists, like myself, offer both. Regardless of which option a survivor chooses, we know from victim/survivor feedback – to government bodies, researchers, and mental health services – that what survivors really want and benefit from in their therapeutic experiences is: being believed; a non-judgemental attitude from their therapist; validation and normalisation of the impacts of the violence; a clear stance on the blamelessness of the victim/survivor, and; control over what happens in the counselling process.
Trauma therapy
Because sexual abuse and sexual assault are understood to be traumatic events, current Australian guidelines recommend the best therapy option for victim/survivors is therapy that addresses post-traumatic stress symptoms. These therapies include cognitive behavioural therapy or eye movement and de-sensitisation reprocessing (EMDR), directly requiring the survivor to focus on the past memories of sexual abuse or sexual assault. While research indicates that these therapies can be effective for decreasing the intensity of some of the post-trauma symptoms for some victim/survivors, other survivors may not feel ready to directly discuss their experiences, and drop-out rates in these studies can be quite high, possibly indicating the difficulty or harm that some survivors experience when discussing trauma memories too quickly (examples here, and here).
Due to this, other Australian guidelines recommend a phased approach to trauma therapy, especially if survivors have multiple trauma experiences. This phased approach emphasises the importance of establishing safety for survivors first, both within their own lives and within the therapeutic relationship, before discussing or processing trauma memories to avoid possible re-traumatisation.
For more information on how I support clients to process trauma memories, please see my pages on trauma-informed feminist therapy, and EMDR.
Supportive counselling
Some survivors will choose to not directly discuss trauma memories, and choose instead to discuss the impacts of sexual abuse or sexual assault in their lives, and engage in supportive counselling to understand and problem-solve these impacts. This is very important work in addressing the impacts of sexual violence, and a valid choice in terms of recovery from sexual abuse and sexual assault. Victim/survivors should not feel pressured to discuss trauma memories if they do not wish to, but of course, supported to do so safely if they choose to.
For more information on my approach to counselling and psychotherapy, please see my pages on relational psychotherapy, and trauma-informed feminist therapy. I also utilise different experiential techniques and parts work, to support individuals to both understand and alleviate emotional distress and behavioural patterns.
Melbourne trauma psychotherapy 