Effects of abuse, part 2

SSRI Ed note: SSRIs can cause more vivid traumatic flashbacks, nightmares.

Original article no longer available

The Abilenian

By Paul Irby
Special to the Abilenian
Wednesday, January 7, 2009

Last month we examined the multifaceted reasons why some children who are sexually abused seem to have more intense and pervasive effects from the abuse and why other children seem more resilient. This month we begin taking a look at what some of those effects can be. Just as the factors leading to these effects are multifaceted, these impacts are multidimensional. Also, keep in mind that the effects mentioned are possibilities, and not all survivors of abuse will experience all of the signs or symptoms detailed in this and subsequent articles. Although we are going to be examining these dimensional impacts in separate articles, they are connected. We know that how we think and what we believe influences the way we feel, and how we feel influences our behavior. Therefore, we begin our discussion with the cognitive or mental impacts sexual abuse can have on its’ victims.

Flashbacks and nightmares are two of the more widely known residual cognitive manifestations. Flashbacks can be triggered environmentally or experienced as unexpected seemingly spontaneous intrusive thoughts. The most common environmental triggers are associated with sight and smell. Seeing the abuser (or even someone resembling the abuser), visiting the location of the abuse, and encountering odors associated with the abuser or location of the abuse are obvious triggers. More subtle triggers are associated with other senses, such as hearing certain phrases, voice tones, inflections and encountering certain textures.

Flashbacks are generally experienced in one of two ways. Either the survivor experiences memories of the abuse like a terribly vivid movie playing in their mind, or they have a memory that causes them to consider all the ways they could have done something differently, further exacerbating the harmful myth that they had a role in perpetuating the abuse.

Nightmares are an issue that deals with the unpredictable and irrational subconscious, and therefore it is difficult to have truly insightful comment. Therefore, my input here is fairly limited. Nightmares can have varying degrees of frequency and intensity. Some experience recurrent nightmares (the same nightmare over and over), while others have different nightmares that reflect or distort what they encountered. Some antidepressant medications, such as Cymbalta, have been associated with more vivid and realistic feeling dreams. Please consult your prescribing physician if you have questions related to medication side-effects.

Beliefs that survivors of abuse develop about themselves and the world around them are other devastating cognitive impacts. Consider for a moment your own experience of sitting in a restaurant and noticing couples or families sitting together and seemingly enjoying a meal. It is most people’s natural tendency to assume the best about those whom we observe. We assume the couple are happy and in love or that the family is healthy and stable.

Between the ages of 10 and 13 children begin to develop more abstract, deductive and inductive reasoning. Along with this development, the abused child comes to the correct understanding that his home life and/or experiences are different from what he has seen on the Disney channel or read about in books. This child who is at school or other social places with peers begins to make the same assumptions as we do. However, these assumptions often lead to the distorted belief that no one else’s home life is like theirs and, therefore, they are different from everyone else.

Being exposed to the trauma of sexual abuse often leads its’ victims to believe that the world or certain aspects of it are untrustworthy and unsafe. This is especially true of the child who is abused by a parent or other family member who is “supposed to be” trusted. It is these core beliefs that the child develops about themselves and the world around them that lead to feelings of depression, anxiety, fear, anger, shame and guilt that will be explored in this article next month.

Paul Irby, M.A., is a licensed professional counselor with the Ministry of Counseling and Enrichment. Mental Health Matters is facilitated by the Mental Health Association in Abilene.