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August 31, 2012

Many Teens in Intimate Relationships Are Abused by Their Partners

Timothy A. Roberts, MD, LCDR; Jonathan Klein, MD, MPH

Archives of Pediatrics and Adolescent Medicine, April 2003

Abuse in adolescent dating relationships is common, say researchers from the University of Rochester School of Medicine who examined abusive teen relationships and links to other risky behaviors.

Using data from a large national health study of adolescents between 11 and 21 years of age, researchers asked teens whether they had ever had an intimate partner who called them names, insulted them, treated them disrespectfully, swore at them, threatened them with violence, pushed or shoved them, or threw something at them that could hurt them. In the study, the teens also reported whether they used substances such as tobacco, alcohol, and marijuana in the last year. Teens answered questions about whether they had engaged in antisocial behavior, such as destroying property, stealing, lying to parents, or running away, during the past year. Teens also answered questions about their participation in violence, such as fighting, threatening someone with a weapon, or shooting or stabbing someone. The teens were also asked about symptoms of depression.

Both teen girls and boys reported similar rates of abuse by intimate partners; 21% of teen boys and 22% of teen girls said they were abused by intimate partners. Girls who had a history of abuse were significantly more likely to use substances, be depressed and suicidal, and participate in violent and antisocial behaviors. Boys who had a history of abuse were significantly more likely to practice antisocial and violent behavior and be depressed. 

What This Means to You: Abuse by an intimate partner is common among adolescent boys and girls and may increase a teen's risk for depression or participation in other risky behaviors. Signs of abuse by an intimate partner may include: unexplained bruises, broken bones, sprains, or marks; excessive guilt or shame for no apparent reason; secrecy or withdrawal from friends and family; and avoidance of school or social events with excuses that don't seem to make any sense. If your child is being abused, he or she needs your patience, love, and understanding. Talk to your child's doctor or a mental health professional about how to help your child recover from abuse and avoid risky behaviors.

August 28, 2012

Child Sexual Abuse Fact Sheet for Parents, Teachers and Other Caregivers

Developed by the NCTSN Child Sexual Abuse Committee (www.nctsn.org)

What is child sexual abuse?

Child sexual abuse is any interaction between a child and an adult (or another child) in which the child is used for the sexual stimulation of the perpetrator or an observer. Sexual abuse can include both touching and non-touching behaviors. Touching behaviors may involve touching of the vagina, penis, breasts or buttocks, oral-genital contact, or sexual intercourse. Non-touching behaviors can include voyeurism (trying to look at a child’s naked body), exhibitionism, or exposure to pornography. Abusers often do not use physical force, but may use play, deception, threats, or other forms of coercion to engage children and maintain their silence. Abusers frequently employ persuasive and manipulative tactics—referred to as “grooming”—such as buying gifts or arranging special activities, which can further confuse the victim.

Who is sexually abused?

Children of all ages, races, ethnicities, and economic backgrounds are vulnerable to sexual abuse. Child sexual abuse affects both girls and boys across all neighborhoods, communities and countries around the world.

How can you tell if a child is being (or has been) sexually abused?

Children who have been sexually abused may display a range of emotional and behavioral reactions characteristic of children who have experienced trauma. These reactions include:

• Increased occurrence of nightmares or other sleeping difficulties

• Withdrawn behavior

• Angry outbursts

• Anxiety • Depression

• New words for private body parts

• Sexual activity with toys or other children

• Not wanting to be left alone with a particular individual(s)

Although many sexually abused children exhibit behavioral and emotional changes, many others do not. It is therefore critical to focus not only on detection, but on prevention and communication—by educating children about body safety, by teaching them about healthy body boundaries, and by encouraging open communication about sexual matters.

Why don’t children tell about sexual abuse?

There are many reasons children do not disclose being sexually abused, including:

• Threats of bodily harm (to the child and/or the child’s family)

• Fear of being removed from the home

• Fear of not being believed

• Shame or guilt

If the abuser is someone the child or the family cares about, the child may worry about getting that person in trouble. In addition, children often believe that the sexual abuse was their own fault and may not disclose for fear of getting in trouble themselves. Very young children may not have the language skills to communicate about the abuse or may not understand that the actions of that perpetrator are abusive, particularly if the sexual abuse is made into a game.

What can you do if a child discloses that he or she is being (or has been) sexually abused?

If a child discloses abuse, it is critical to stay calm, listen carefully, and NEVER blame the child. Thank the child for telling you and reassure him or her of your support. Please remember to call for help immediately.

If you know or suspect that a child is being or has been sexually abused, please call the federally funded Child Welfare Information Gateway at 1.800.4.A.CHILD (1.800.422.4453) or visit www.childwelfare.gov/responding/how.cfm.

If you need immediate assistance, call 911.

Child Sexual Abuse Myths and Facts Myth:

Child sexual abuse is a rare experience.

Fact: Child sexual abuse is not rare. Research indicates that as many as 1 out of 4 girls and 1 out of 6 boys will experience some form of sexual abuse before the age of 18. However, because child sexual abuse is by its very nature secretive, many of these cases are never reported.

Myth: A child is most likely to be sexually abused by a stranger.

Fact: Children are most often sexually abused by someone they know and trust. Ninety-three percent of reported cases of child sexual abuse are committed by individuals who are considered part of the victim’s “circle of trust.”

Myth: Preschoolers do not need to know about child sexual abuse and would be frightened if educated about it.

Fact: Numerous educational programs are available to teach young children about the difference between healthy and unhealthy touches. These programs can help children develop basic safety skills in a way that is helpful rather than frightening. For more information on educating young children, see Lets Talk About Taking Care of You: An Educational Book About Body Safety, available at www.hope4families.com/Lets_Talk_Book_Information.html.

Myth: Children who are sexually abused will never recover.

Fact: Many children are quite resilient, and with a combination of support from their parents or caregivers and effective counseling, they can and do recover from such experiences.

Myth: Children are almost always sexually abused by adults.

Fact: Surveys indicate that up to one third of cases of child sexual abuse are perpetrated by individuals under the age of 18. While some degree of sexual curiosity and exploration is to be expected between children of about the same age, when one child coerces another to engage in adult-like sexual activities, the behavior is unhealthy and abusive. Both the abuser and the victim can benefit from counseling. 

Myth: Talking about sexual abuse with a child who has suffered such an experience will only make it worse.

Fact: Although children often choose not to talk about their abuse, there is no evidence that encouraging children to talk about sexual abuse will make them feel worse. On the contrary, research shows that treatment from a mental health professional can minimize the physical, emotional, and social problems of abused children by allowing them to appropriately process their feelings and fears.

Tips To Help Protect Children From Sexual Abuse

• Always teach children accurate names of private body parts.

• Avoid focusing exclusively on “stranger danger.” Keep in mind that most children are abused by someone they know and trust.

• Teach children about body safety and healthy body boundaries early (in preschool) and often.

• Teach children the difference between healthy and unhealthy touches.

• Reinforce the message that children always have the right to make decisions about their bodies. Empower them to say no when they do not want to be touched, even in non-sexual ways (e.g., politely refusing hugs) and to say no to touching others.

• Make sure children know that adults and older children never need help with their private body parts (e.g., bathing or going to the bathroom.)

• Educate children about the difference between good secrets (like surprise parties—which are okay because they are not kept secret for long) and bad secrets (those that the child is supposed to keep secret forever, which are not okay).

• Trust your instincts!

If you feel uneasy leaving a child with someone, don’t do it. If you’re concerned about possible sexual abuse, ask questions. For more information, visit the National Child Traumatic Stress Network (NCTSN) at www.nctsn.org. THE BEST TIME TO TALK TO YOUR CHILD ABOUT SEXUAL ABUSE IS NOW.

Original Article

August 21, 2012

Adult Manifestations of Childhood Sexual Abuse

American College of Obstetricians and Gynecologists

Definitions

Childhood sexual abuse can be defined as any exposure to sexual acts imposed on children who inherently lack the emotional, maturational, and cognitive development to understand or to consent to such acts. These acts do not always involve sexual intercourse or physical force; rather, they involve manipulation and trickery. Authority and power enable the perpetrator to coerce the child into compliance. Characteristics and motivations of perpetrators of childhood sexual abuse vary: some may act out sexually to exert dominance over another individual; others may initiate the abuse for their own sexual gratification (5, 6). 

Although specific legal definitions may vary among states, there is widespread agreement that abusive sexual contact can include breast and genital fondling, oral and anal sex, and vaginal intercourse. Definitions have been expanded to include noncontact events such as coercion to watch sexual acts or posing in child pornography (7). 

Prevalence 

The prevalence of childhood sexual abuse in the United States is unknown. Because of the shame and stigma associated with abuse, many victims never disclose such experiences. Incest was once thought to be so rare that its occurrence was inconsequential. However, in the past 25 years there has been increased recognition that incest and other forms of childhood sexual abuse occur with alarming frequency (8). Researchers have found that victims come from all cultural, racial, and economic groups (9). 

Current estimates of incest and other childhood sexual abuse range from 12% to 40% depending on settings and population. Most studies have found that among women, approximately 20% - or 1 in 5 - have experienced childhood sexual abuse (9). Consistent with this range, studies have revealed that: 

Among girls who had sex before they were 13 years old, 22% reported that first sex was nonvoluntary (10). 

Twelve percent of girls in grades 9 through 12 reported they had been sexually abused; 7% of girls in grades 5 through 8 also reported sexual abuse. Of all the girls who experienced sexual abuse, 65% reported the abuse occurred more than once, 57% reported the abuser was a family member, and 53% reported the abuse occurred at home (11). 

Approximately 40% of the women surveyed in a primary care setting had experienced some form of childhood sexual contact; of those, 1 in 6 had been raped as a child (12). 

A national telephone survey on violence against women conducted by the National Institute of Justice and the Centers for Disease Control and Prevention found that 18% of 8,000 women surveyed had experienced a completed or attempted rape at some time in their lives. Of this number, 22% were younger than 12 years and 32% were between 12 and 17 years old when they were first raped (9). 

Common Symptoms in Adult Survivors of Childhood Sexual Abuse:

  • Physical Presentations
  • Chronic pelvic pain
  • Gastrointestinal symptoms/distress
  • Musculoskeletal complaints
  • Obesity, eating disorders
  • Insomnia, sleep disorders
  • Pseudocyesis
  • Sexual dysfunction
  • Asthma, respiratory ailments
  • Addiction
  • Chronic headache
  • Chronic back pain
  • Psychologic and Behavioral Presentations
  • Depression and anxiety
  • Posttraumatic stress disorder symptoms
  • Dissociative states
  • Repeated self-injury
  • Suicide attempts
  • Lying, stealing, truancy, running away
  • Poor contraceptive practices
  • Compulsive sexual behaviors
  • Sexual dysfunction
  • Somatizing disorders
  • Eating disorders
  • Poor adherence to medical recommendations
  • Intolerance of or constant search for intimacy
  • Expectation of early death

Although there is no single syndrome that is universally present in adult survivors of childhood sexual abuse, there is an extensive body of research that documents adverse short- and long-term effects of such abuse. To appropriately treat and manage survivors of CSA, it is useful to understand that survivors' symptoms or behavioral sequelae often represent coping strategies employed in response to abnormal, traumatic events. These coping mechanisms are used for protection during the abuse or later to guard against feelings of overwhelming helplessness and terror. Although some of these coping strategies may eventually lead to health problems, if symptoms are evaluated outside their original context, survivors may be misdiagnosed or mislabeled (5). 

In addition to the psychologic distress that may potentiate survivors' symptoms, there is evidence that abuse may result in biophysical changes. For example, one study found that, after controlling for history of psychiatric disturbance, adult survivors had lowered thresholds for pain (13). It also has been suggested that chronic or traumatic stimulation (especially in the pelvic or abdominal region) heightens sensitivity, resulting in persistent pain such as abdominal and pelvic pain or other bowel symptoms (14, 15). 

Although responses to sexual abuse vary, there is remarkable consistency in mental health symptoms, especially depression and anxiety. These mental health symptoms may be found alone or more often in tandem with physical and behavioral symptoms. More extreme symptoms are associated with abuse onset at an early age, extended or frequent abuse, incest by a parent, or use of force (4). Responses may be mitigated by such factors as inherent resiliency or supportive responses from individuals who are important to the victim (4). Even without therapeutic intervention, some survivors maintain the outward appearance of being unaffected by their abuse. Most, however, experience pervasive and deleterious consequences (4). 

The primary aftereffects of childhood sexual abuse have been divided into seven distinct, but overlapping categories (16):

  • Emotional reactions
  • Symptoms of posttraumatic stress disorder (PTSD)
  • Self-perceptions
  • Physical and biomedical effects
  • Sexual effects
  • Interpersonal effects
  • Social functioning

Responses can be greatly variable and idiosyncratic within the seven categories. Also, survivors may fluctuate between being highly symptomatic and relatively symptom free. Health care providers should be aware that such variability is normal.

References 

McCauley J, Kern DE, Kolodner K, Schroeder AF, DeChant HK, Ryden J, et al. Clinical characteristics of women with a history of childhood abuse: unhealed wounds. JAMA 1997;277:1362-1368 

Koss MP, Koss PG, Woodruff WJ. Deleterious effects of criminal victimization on women's health and medical utilization. Arch Intern Med 1991;151:342-347 

Drossman DA, Leserman J, Nachman G, Li ZM, Gluck H, Toomey TC, et al. Sexual and physical abuse in women with functional or organic gastrointestinal disorders. Ann Intern Med 1990;113:828-833 

American Medical Association. Diagnostic and treatment guidelines on mental health effects of family violence. Chicago: AMA, 1995 

Hendricks-Matthews M. Long-term consequences of childhood sexual abuse. In: Rosenfeld J, Alley N, Acheson LS, Admire JB, eds. Women's health in primary care. Baltimore: Williams & Wilkins, 1997:267-276 

Britton H, Hansen K. Sexual abuse. Clin Obstet Gynecol 1997;40:226-240 

Maltz W. Adult survivors of incest: how to help them overcome the trauma. Med Aspects Hum Sex 1990;24:42-47 

Hendricks-Matthews MK. Caring for victims of childhood sexual abuse. J Fam Pract 1992;35:501-502 

Tjaden P, Thoennes N. Prevalence, incidence, and consequences of violence against women: findings from the National Violence Against Women Survey. Research in Brief. Washington, DC: U.S. Dept of Justice, Office of Justice Programs, November 1998, NCJ 172837 

Moore KA, Driscoll A. Partners, predators, peers, protectors: males and teen pregnancy. New data analysis of the 1995 National Survey of Family Growth. In: Not just for girls: the roles of boys and men in teen pregnancy. Washington, DC: The National Campaign to Prevent Teen Pregnancy, 1997: 7-12 

Schoen C, Davis K, Collins KS, Greenberg L, Des Roches C, Abrams M. The Commonwealth Fund survey of the health of adolescent girls. New York: The Commonwealth Fund, 1997 

Walker EA, Torkelson N, Katon WJ, Koss MP. The prevalence rate of sexual trauma in a primary care clinic. J Am Board Fam Pract 1993;6:465-471 

Scarinci IC, McDonald-Haile J, Bradley LA, Richter JE. Altered pain perception and psychosocial features among women with gastrointestinal disorders and history of abuse: a preliminary model. Am J Med 1994:97:108-118 

Cervero F, Janig W. Visceral nociceptors: a new world order? Trends Neurosci 1992;15:374-378 

Drossman DA. Physical and sexual abuse and gastrointestinal illness: what is the link? Am J Med 1994;97:105-107 

Courtois CA. Adult survivors of sexual abuse. Prim Care 1993;20:433-446

August 16, 2012

About Marital Rape

Know the Facts

  • A marriage license does not require someone to submit to sexual contact on demand.
  • Everyone has the right to say "no" to any kind of sexual contact.
  • Forced sexual contact within a marriage or relationship is no different than if forced by a stranger.
  • Marital rape is agains the law in Illinois.
  • Marital rape is a serious crime.
  • In Illinois, if a person forces his/her spouse to have sexual intercourse without his/her partner's consent, it is sexual assault (rape).
  • A victim of marital rape has the right to report the crime to the police within 30 days of the assault.

Seeking medical and legal help...

Immediate medical attention provides the best medical protection and legal evidence. With your permission, evidence will be collected and other injuries will be documented. Medical attention is confidential and extremely important. Advocates are available to support you through medical procedures.

Remember:

  • Do not wash.
  • Do not clean up or shower.
  • Do not change clothing.
  • Do not douche.
  • Bring a change of clothing.

Marital rape victims have the option to...

Make a police report. It is the responsibility of the police to obtain basic information and attend to the physical well-being of the victim. Police will arrange transportation to the hospital if treatment is desired. The Community Crisis Center has advocates who will discuss this option with you.

If you don't feel safe making a police report from your home, go somewhere else, such as the police station, hospital or the Community Crisis Center to make your report. You may have an advocate from the Crisis Center assist you in doing this.

Forms of Abuse...

It is wrong for your partner to:

  • Force or pressure you to perform sexual acts against your will.
  • Physically attack the sexual parts of your body.
  • Treat your body like a sex object.
  • Control what you do, who you see and talk to, where you go, etc.
  • Put you down, try to make you feel bad about yourself, call you names, make you think you are crazy.
  • Use expressions, actions, gestures, loud voice, or smash things or destroy property to make you afraid.
  • Make and/or carry out threats to hurt you emotionally. Threaten to report you to welfare, take the children, or commit suicide.
  • Physically hurt you in any way.

Your Rights...

Every person, whether male or female, married or single, has the right to:

  • Refuse requests without having to feel guilty or selfish.
  • Feel and express anger.
  • Have one's own needs be as important as the needs of other people.

In a marriage agreement, each person has the right to:

  • Seek mutually satisfying resolutions to conflict.
  • Define your own sexual limits.
  • Feel safe and comfortable expressing yourself
  • Accept responsibility for yourself and your actions.
  • Acknowledge past use of violence.
  • Admit being wrong.
  • Communicate openly and truthfully.
  • Seek professional assistance.

August 14, 2012

The Grooming Process

The following information is excerpted from the book Identifying Child Molesters:  Preventing Child Sexual Abuse by Recognizing the Patterns of the Offenders, Carla Van Dam, PHD, The Haworth Maltreatment and Trauma Press, 2001.  This book is an excellent source of information, and a summary of the research to date on the issue of identification of child molesters.  It should be used with caution, however, and only with direction from qualified professionals, to avoid overreaction to some of the information in the book.  The following is a brief summary of information about the grooming process.   

In this summary, the molester is referred to in the male gender solely for ease of reference, given the reality that a vast majority of child molesters are male.   

The Grooming Process

Generally, studies show that child molesters go through a “grooming” process, which can sometimes take months or years, in an effort to facilitate their molestations.  The grooming process generally involves the following elements:   

• Sexual attraction to children:  This is a pre-existing condition in the molester, and can occur for many different reasons. 

• Justification of interest:  The molester often goes through a psychological process of justifying the attraction to children.  This is described further below.  Dr. Lamb described this as a process of breaking down the molester’s own psychological boundaries to allow the molestation to occur. 

• Grooming of adult community:  Often the molester will go through a process of getting the adult community that surrounds the child to accept and even welcome the molester’s involvement with the child.  This is also described further below. 

• Grooming of child:  This is a process the molester goes through to break down the child’s resistance to sexual activity and to engage the child in the activity.   

Justification 

• This process of justifying the behavior is sometimes called neutralization.  This is the psychological effort the molester goes through to justify the behavior to himself, and to break down any emotional barrier in himself which would prevent him from acting upon the sexual attraction to children. 

• Denial of injury:  The molester denies to himself, and perhaps to others, that any injury to the child could occur.  The molester tells himself things like “This is my way of showing love to the child, I don’t want to hurt the child.”  Many molesters lead themselves to believe that they are helping the child by showing love.

• Denial of victimization:  The molester also denies that the child is a victim, instead choosing to view the child as actively wanting to engage in sexual activity. 

• Condemnation of dissension:  Many molesters actively argue against any societal view that child abuse is wrong.  This is the role taken by the North American Man Boy Love Association (NAMBLA) referred to by Dr. Lamb. 

• More enlightened viewpoint:  Molesters will often take the position that their view is in fact the more enlightened view, as NAMBLA has done.  

Grooming of The Adult Community 

Child molesters will then ingratiate themselves with the adult community surrounding the child, and break down any barriers that exist to access to the child.  This includes exhibiting behaviors such as : 

• Friendliness

• Ingratiating activity such as doing favors, helping out when no one has asked for help, etc. 

• Targeting vulnerable families, such as those with alcohol problems, or single mothers 

Grooming Children 

The child molester will then groom a particular child using techniques which: 

• Choose the most vulnerable child

• Engage the child in peerlike activities (playing with the children, playing games, etc.)

• Desensitization of child to touching (see below);

• Isolating the child (see below); and

• Making the child feel responsible and thus less likely to disclose the abuse. 

A Vulnerable Child 

A vulnerable child, and thus a child more likely to be a target of abuse, would have one of the following characteristics:   

• Needy (and thus vulnerable to positive attention)

• Quiet (and thus less likely to tell)

• Craves attention (and thus vulnerable to attention)

• Younger (less likely to understand or tell)

• Picked on by other children (and thus needing a friend)

• Low self esteem (and thus vulnerable to the positive reinforcement of the molester)

• Trusting (and thus less likely to understand the danger)

• Compliant (and thus vulnerable to an adult telling them it is okay)

• Eager to please (vulnerable to engaging in activity if they are told it is pleasing to the adult)

• Single mother (thus the child generally needs attention and the mother is grateful for the help)

• Unsupervised (and thus vulnerable to the attention of the molester)

Desensitization 

The molester will often go through a process of desensitizing the child to the touch of the molester by engaging in the following types of activity:   

• Tickling games;

• Wrestling;

• Roughhousing;

• Physical-picking up, carrying child, using this as an opportunity to test the child’s reaction to touch;

• Testing child’s reaction slowly---if the child balks at the touch the molester will back off and continue the grooming process

• Testing whether child will tell---if the child tells, the molester will know to move to another child.   

Of course, there may be very innocent explanations for many of the activities noted above.  This list is intended only to generally describe the process of grooming that may be engaged in by a child molester.

Original Article

August 2, 2012

Ten Steps to Healing From Trauma

By Martin V. Cohen, Ph.D.

Whether you have been a crime victim, involved in an accident or natural disaster, or were the victim of childhood abuse, the resulting trauma is similar. Pervasive fear and feelings of helplessness are natural reactions to events you probably had little or no control over. “I was totally traumatized,” and “I thought I was going to die,” are among the most often used phrases used to describe such occurrences. Unfortunately, trauma and the stress that follows, is on the rise at the turn of the new millenium in America.

Fortunately, there are ways to overcome the “aftershocks” of traumatic incidents. A cluster of symptoms consisting of (1) Persistently REEXPERIENCING the event (e.g., flashbacks, nightmares, etc.), (2)AVOIDANCE (e.g., avoiding people, places or activities that trigger memories of what happened) and (3) HYPERAROUSAL (e.g., jumpiness, feeling on edge, irritability, etc.) can be treated effectively with the following steps toward healing this condition. In 22 years of practicing psychotherapy, specializing in treating trauma victims, I’ve seen them work.

1.-- Recognize that your symptoms are normal reactions to abnormal circumstances. Although you may feel like you are out of control or “going crazy,” in reality, you are experiencing what are called post-traumatic stress symptoms.

2.-- Talk about your thoughts, feeling and reactions to the events with people you trust. Then, talk about it some more. Keep talking about it until you have no need to talk about it anymore.

3.--Do whatever it takes to create a feeling of safety and tranquility in your immediate environment. Do you need to sleep with a night light on for awhile? Can you develop a discipline of meditation or listening to soothing music?

4.-- As much and as quickly as possible, resume your normal activities and routines. Traumatic events can throw your life into a state of chaos. The sooner you resume these activities and routines, the more normal your life will feel. Structure can provide feelings of security as you etch your way back to stability.

5.-- You are in a recovery process. Give yourself the proper rest, nutrition and exercise. If you were recovering from the flu you would not forget these health tips. Do the same for yourself as you recover from traumatic stress.

6.-- Take an affirmative action on your behalf. For example, if you were a victim of crime, prosecuting the perpetrator may be an empowering experience. If this is not an option for you, write in your journal. Strike out at the perpetrator with words. Take some action on your behalf.

7.-- Become aware of your emotional triggers and learn to cope with them creatively. You may have a flashback to your trauma by engaging in a similar activity, going to a similar place, seeing, hearing, smelling, tasting or feeling something that reminds you of the original trauma. One way to cope with this is to recognize that you are experiencing an emotional trigger and engage in positive self-talk (e.g., “This is frightening but I am safe now.”)

8.--Try to find some deeper meaning in what happened to you. True, you were victimized but you can become a survivor. Survivors often find that changes in their outlook on life are possible, even preferable. What have you learned from your traumatic experience? Record these insights in a journal or voice them in a support group that is sympathetic to your situation.

9.-- Seek therapy. Psychotherapy, particularly with a certified EMDR practitioner who specializes in trauma, is often very effective in helping people overcome the aftermath of trauma. If you can’t stop thinking about what happened; if you are always feeling anxious and on guard; if you find yourself avoiding your normal routines or if you are experiencing some of the other symptoms of post-traumatic stress, you can probably benefit from professional help. The EMDR International Association can give you a referral to a certified EMDR practitioner in your area (www.emdria.org), telephone (512) 451-5200. If you were a crime victim, most states offer victims assistance to pay for psychotherapy. For more information call the National Organization for Victim Assistance at (202) 232-6682. In California, call the Victims of Crime Program at (800) -VICTIMS (842-8467).

10.-- Be patient with yourself. Healing takes time. Your recovery will have it’s ups and downs. Follow the guidelines in this article and know that you are in a recovery process that will take time.

Remember, you may have been victimized but you do not have to continue being a victim. In this unfortunate case you were rendered helpless but to continue in that status is very limiting. By following the steps outlined above, you will emerge as a survivor. Your traumatic experience can make you a stronger and wiser person. The potential is there for you to learn and grow in ways you may not have considered had the trauma never occurred.

© 2000 Martin V. Cohen, Ph.D.

Original Article