Recognizing common symptoms of childhood sexual abuse can help parents, caregivers, teachers, social workers, counselors and childcare staff alert the appropriate authorities and take proper steps to protect the welfare and safety of our children. It is far too often that I hear stories of adults, who fail to recognize that something is wrong with their child and attribute concerning changes in their kids’ behavior to temperament, age or other misguided explanations.
Because of this, I want to take a quick look at 11 common psychiatric symptoms experienced by victims of childhood sexual abuse but please keep in mind that this is not a diagnostic guide or a substitute for professional consultation. I have tried to clump together common symptoms that bring people (both children and adults) to the therapy office due to past history of childhood sexual abuse but this is by no means a comprehensive list and any of those symptoms taken separately may have other etiologies.
Depending on the age, specific nature of the sexual trauma and the temperament and coping skills of each person, the clinical presentation may look differently. If you have experienced any form of childhood trauma, abuse or neglect, you may identity with some of the behaviors and patterns discussed below. In that case, I would highly suggest seeking out some help.
1.Dissociation. Dissociation is probably the most common defense mechanism the mind employs to protect itself from the trauma of sexual assault. It is the escape of the mind from the body in times of extreme stress, sense of powerlessness, pain and suffering.
2. Self-Injurious Behavior (cutting, self-mutilation). Self-mutilation is another way survivors of trauma employ in an effort to cope with the experience of severe emotional and psychological pain. Some research shows that during cutting or self-mutilation, the brain releases natural opioids that provide a temporary experience or sense of calm and peace that many, who cut, find soothing.
3. Fear and anxiety. An overactive stress response system* is among the most common psychiatric symptoms in survivors of sexual trauma. This is manifested in extreme fear, social anxiety, panic attacks, phobias and hyper vigilance. It is as if the body is in a state of constant alert and cannot relax.
4. Nightmares. Just like the intrusive terrorizing memories of war veterans, survivors of sexual abuse often experience nightmares, intrusive thoughts and disrupted sleep.
5. Substance Abuse. Abusing substances is a common coping mechanism for people, who have experienced trauma. Even the “normal” experimentation with drugs of adolescence is not so “normal,” especially if you raised your kid to know the impact of drugs on the central nervous system, the consequences of addiction and the long-term effects of habitual drug use.
6. Hypersexualized behavior. This is a commonreaction to pre-mature sexual exposure or a traumatic sexual experience. If a child is too young to be excessively masturbating or is engaging in pre-mature sexual play or behavior, this is typically a sign that the child has witnessed, been a participant in or has been exposed to adult sexuality. In adolescence and adulthood, this can take the form of promiscuity, illegal sexual activity such as prostitution or participation in pornography, escort services, etc.
7. Psychotic-like symptoms. Paranoia, hallucinations or brief psychotic episodes are not uncommon for survivors of child sexual abuse.
8. Mood fluctuations, anger and irritability. Children are often unable to verbalize their feelings so instead, they act out on them. Sometimes, the same is true for adults. Mood fluctuations, irritability and disrupted neurotransmitter systems in the brain that present as depression, mania, anger and anxiety are common among trauma survivors.
9. Disrupted relationships and difficulties maintaining long-term friendships or romantic partners. Following the aftermath of sexual abuse, people are not experienced as safe, trustworthy and available so maintaining long-term relationships based on honestly is difficult and often tumultuous.
10. Regressive behaviors (mostly in children). Enuresis (bed wetting) and encopresis (involuntary soiling ones’ underwear with feces) in a previously potty-trained child, unexplained and sudden temper tantrums or violent outbursts, as well as clingy, uncontrollable or impulsive behaviors that were previously missing from a child’s way of being with others is another common indicator of something gone terribly wrong.
11. Physical complaints, psychosomatic symptoms or autoimmune responses of the body. Many clinicians from different schools of thought have written on the subject of the way the body stores and remembers trauma in response to the mind rejecting, forgetting or dissociating from the experience. Psychoanalysis terms these reactions “unconscious” as they express an experience out of language, out of words and often out of what is perceiveable by an individual.
When the unthinkable happens such as in several of the clinical cases described by Dr. Bruce Perry in his book “The Boy Who Was Raised as a Dog and Other Stories from a Child Psychiatrist’s Notebook: What Traumatized Children Can Teach Us about Loss, Love and Healing,” the mind copes by mobilizing the body to express something that is otherwise inexpressible with words. We see in Dr. Perry’s neuroscientific approach to the understanding and treatment of traumatized children how the physical brain responds to the experience of trauma and how the mind communicates and eventually heals from this experience in the safety of the therapeutic relationship.
*I am borrowing the term “overactive stress response system” from Dr. Bruce Perry’s book “The Boy Who Was Raised as a Dog and Other Stories from a Child Psychiatrist’s Notebook: What Traumatized Children Can Teach Us about Loss, Love and Healing.” Many of the symptoms I have listed in this post are also discussed in his book, including dissociation, self-mutilation and hyper sexualized behavior.
The tragedy of child abuse and neglect is in the forefront of public attention. Yet, without a conceptual framework, research in this area has been highly fragmented. Understanding the broad dimensions of this crisis has suffered as a result.[read full description]
To each of our RCbbc Blog Readers who have-are-will submit an NRS Submission, it pleases me that I’m reaching a point in my Submission Drafting that my Counsellor & I will soon send it off to another agency. This may sound complex, yet it’s what a fair amount of the CSA Surviving-Victims require.
Although I had earlier been in contact with some of these same offices previously, I was approaching things in the wrong order. I now understand why some avenues suggest a ‘top down’ mentality, yet for the rest of us we’re happier with a ‘grassroots’ approach.
After Australia’s July 2020 weekend of ‘Black Lives Matter’, ABC’s Afternoon Briefing had Patricia Karvelas interviewing US Prof. Goff (sp.?). For many Survivours of Child Sexual Abuse, much of these debates have carried the same passion as what we’ve felt throughout our lives. Ignorance & turning attention away from are even spoken against in the bible. School lessons. Child care. Sports practice. School camps. A pattern forming…?
Black Lives Matter
JOE MCKENDRY
News of Jeffery Epstein also forms ‘front page news’, including parts of the British Royal Family, upper levels of US & International society. At the targeted end of this game are low income, low SES (socio economic status) population & young adults/teenagers. Suitably, Australia’s Judicial System has begun to publicly deal with more allegations following 2013-17 CARC. Highest of these has been George Pell. Sound familiar…?
From the topics presented since 2013, this RoyalCommBBC.blog has aimed to republish noteworthy journalism, factually-based info & ‘the other side of the coin’ POV. We don’t claim to be a Journalistic Reference to prove legal data; it isn’t to be used as an excuse or a bet; links can be arranged with suitable portals, where need be; as are related channels, following earlier BBC involvement of later ‘guilty’ Nudgee College staff. A later post will be arranged re: queries of Overlack. Seems too surreal…?
Each of these 3 marvellous ABC Documentaries reveal more of the Institutional deceptions of Child Sexual Abuse!Twitter samples – positive + occasional negative feedback, during 3rd Episode.Timely image of Gerald Ridsdale, accompanied by George Pell – early Court appearances.
Straight talk about body parts and a no-secrets policy can protect young kids without scaring them
Natasha Daniels
We can arm kids with knowledge that might save them from being victimized.
1. Talk about body parts early.
Name body parts and talk about them very early. Use proper names for body parts, or at least teach your child what the actual words are for their body parts. I can’t tell you how many young children I have worked with who have called their vagina their “bottom.” Feeling comfortable using these words and knowing what they mean can help a child talk clearly if something inappropriate has happened.
2. Teach them that some body parts are private.
Tell your child that their private parts are called private because they are not for everyone to see. Explain that mommy and daddy can see them naked, but people outside of the home should only see them with their clothes on. Explain how their doctor can see them without their clothes because mommy and daddy are there with them and the doctor is checking their body.
3. Teach your child body boundaries.
Tell your child matter-of-factly that no one should touch their private parts and that no one should ask them to touch somebody else’s private parts. Parents will often forget the second part of this sentence. Sexual abuse often begins with the perpetrator asking the child to touch them or someone else.
4. Tell your child that body secrets are not okay.
Most perpetrators will tell the child to keep the abuse a secret. This can be done in a friendly way, such as, “I love playing with you, but if you tell anyone else what we played they won’t let me come over again.” Or it can be a threat: “This is our secret. If you tell anyone I will tell them it was your idea and you will get in big trouble!” Tell your kids that no matter what anyone tells them, body secrets are not okay and they should always tell you if someone tries to make them keep a body secret.
5. Tell your child that no one should take pictures of their private parts.
This one is often missed by parents. There is a whole sick world out there of pedophiles who love to take and trade pictures of naked children online. This is an epidemic and it puts your child at risk. Tell your kids thatno one should ever take pictures of their private parts.
6. Teach your child how to get out of scary or uncomfortable situations.
Some children are uncomfortable with telling people “no”— especially older peers or adults. Tell them thatit’s okay to tell an adult they have to leave, if something that feels wrong is happening, and help give them words to get out of uncomfortable situations. Tell your child that if someone wants to see or touch private parts they can tell them that they need to leave to go potty.
7. Have a code word your children can use when they feel unsafe or want to be picked up.
As children get a little bit older, you can give them a code word that they can use when they are feeling unsafe. This can be used at home, when there are guests in the house or when they are on a play date or a sleepover.
8. Tell your children they will never be in trouble if they tell you a body secret.
Children often tell me that they didn’t say anything because they thought they would get in trouble, too. This fear is often used by the perpetrator. Tell your child that no matter what happens, when they tell you anything about body safety or body secrets they will NEVER get in trouble.
9. Tell your child that a body touch might tickle or feel good.
Many parents and books talk about “good touch and bad touch,” but this can be confusing because often these touches do not hurt or feel bad. I prefer the term “secret touch,” as it is a more accurate depiction of what might happen.
10. Tell your child that these rules apply even with people they know and even with another child.
This is an important point to discuss with your child. When you ask a young child what a “bad guy” looks like they will most likely describe a cartoonish villain. You can say something like, “Mommy and daddy might touch your private parts when we are cleaning you or if you need cream — but no one else should touch you there. Not friends, not aunts or uncles, not teachers or coaches. Even if you like them or think they are in charge, they should still not touch your private parts.”
I am not naïve enough to believe that these discussions will absolutely preventsexual abuse, but knowledge is a powerful deterrent, especially with young children who are targeted due to their innocence and ignorance in this area.
And one discussion is not enough. Find natural times to reiterate these messages, such as bath time or when they are running around naked. And please share this article with those you love and care about and help me spread the message of body safety!
Sexual abuse is any form of sexual violence, including rape, child molestation, incest, and similar forms of non-consensual sexual contact. Most sexual abuse experts agree sexual abuse is never only aboutsex. Instead, it is often an attempt to gainpowerover others.
Immediate crisis assistance after sexual assault can prove invaluable and even save lives. A person can report sexual assault by calling local police. Survivors may also wish to get a physical exam at a hospital.
Therapycan also be helpful for those who experienced sexual abuse in the past. Some therapists specialize in addressing the trauma of sexual assault. Long-term assistance may be beneficial to some survivors of sexual abuse.
TYPES OF SEXUAL ASSAULT AND ABUSE
Sexual abuse is common, particularly forwomenand girls. Ninety percent of all rapes are committed against women. One in six women in America have experienced rape. One in five girls and one in 20 boys experience childhood sexual abuse.
Sexual abuse and sexual assault are umbrella terms used to refer to multiple crimes. These crimes include:
Rape: Forced sexual contact with someone who does not or cannot consent. Forcing sex upon someone who does not want it, who is intoxicated, or who is not legally old enough to give consent all count as rape.Date rapeis sexual assualt that occurs between people with an established relationship. A handful of states limit their definition of rape to forcible sexual intercourse. Yet any form of forcible sexual contact can have long-lasting effects on a person. Most states now recognize forced oral sex and similar forms of assault as rape.
Child molestation: Child molestation is any sexual contact with a child. Many children who are molested are too young to know what is happening and may not fight back. Some abusers use the child’s cooperation in these cases as “evidence” that no one was harmed. Examples of child molestation might include fondling or demanding sexual favors from a child.
Incest:Incestdescribes sexual contact between family members who are too closely related to marry. While incestuous sexual activity may occur between consenting adults, this is not common. Most reported incest occurs as child abuse. Over a third of American sexual assault survivors under the age of 18 are abused by a family member, according to latest statistics. However, incest is an underreported crime, so the actual number of incest survivors may be higher.
Non-consensual sexual contact: This category includes any unwanted sexual touching, such as groping or pinching. Attempted rape can also fall into this category.
Non-contact sexual abuse: Not all sexual abuse fits neatly into common legal or psychological definitions. For instance, parents who have sex in front of their children or who make sexually inappropriate comments to their children are engaging in sexual abuse. So-called revengepornographysites, which publish nude photos of people without their consent, are another form of sexual abuse.
The laws governing sexual abuse are constantly changing. For this reason, most professionals who work with sexual abuse survivors rely on the person’s feelings, not the law, when determining whether a sexual assault has occurred. For example, marital rape can be deeply traumatic, especially in an otherwise abusive relationship. Yet marital rape did not become a crime anywhere until the 1970s. It is still a challenging crime to prosecute.
SEXUAL VIOLENCE IN THE MILITARY
Sexual violence occurs in the U.S.militaryin high numbers. According to a 2014 report:
Nearly 5% of all women and 1% of all men on active duty reported experiencing unwanted sexual contact.
Nearly half of reports from women involved penetrative sexual assault (rape or penetration with an object). This rate was 35% for men.
Due to the gender ratios in the military, more men experience sexual violence than women. A man in the military is 10 times more likely to be sexually assaulted than a civilian man.
Most perpetrators commit these crimes out of a desire for domination. Offenders often wish to establish control over their “inferiors.” Sexual attraction is rarely the motivating factor.
Sexual violence among service members is an under-reported crime. Studies suggest only one in four survivors of military sexual assault report their attacks. Among male survivors, an estimated 81% never report their attacks.
People who report their assaults often face retaliation. In 2014, 62% of female reporters said they faced retaliation. Many were shunned by colleagues or blamed for the assault. Survivors of both genders may face consequences in their professional lives. Some are even discharged from the military.
Reporters may also face barriers to mental health treatment. Research suggests the military has falsely diagnosed many sexual assault reporters with personality disruptions as an excuse to discharge them. The Department of Veterans Affairs classifies personality disruptions as a pre-existing condition. Thus, it rarely covers the expense of survivors’ mental health treatment.
MALE VICTIMS OF SEXUAL ASSAULT AND ABUSE
Menwho experience sexual assault can face severestigma. U.S. culture promotes astereotypethat men always want sex. Many people believe men cannot possibly be victims of rape.
When men report sexual assault, they often face doubt and ridicule. Others may blame the abuse on the man’s “weakness” or alleged homosexuality.Victim-blamingis especially likely when a man accuses a woman of sexual abuse.
Due to stigma, male survivors can be reluctant to label their experiences as rape or abuse. Some may not mention the event at all. However, a reluctance to disclose can prevent men from getting treatment. Without professional help, some men resort to substance abuse orself-harmto cope with trauma.
SEXUAL ASSAULT AND ABUSE IN THE LGBTQ+ COMMUNITY
The rates of sexual assault forhomosexualandbisexualindividuals are comparable or higher than the rates forheterosexualpeople. Hate crimes account for many sexual assaults againstLGBTQ+people.
Among cisgender women, the lifetime prevalence rates for rape are:
46% for bisexual women.
13% for lesbian women.
17% for heterosexual women.
Rape statistics among cisgender men are limited. The lifetime prevalence rates for sexual assaults other than rape are:
47% for bisexual men.
40% for gay men.
21% of heterosexual men.
Around 64% oftransgenderpeople will experience sexual assault in their lifetimes. This statistic includes transgender people of all sexual orientations and gender identities. Transgender youth are particularly vulnerable to sexual assault. In a 2011 survey, 12% of trans youth said peers or educational staff had sexually assaulted them in a school setting.
Sexual crimes in the LGBTQ+ community are often not reported. Survivors may fear revealing their gender identity or sexual orientation to others. They may not trust the legal system to protect them. Survivors could also fear inciting further violence.
Like other survivors, LGBTQ+ people often encounter stigma after they report sexual violence.Discriminationin the health care system may prevent survivors from getting care. Friends and family may believe stereotypes about LGBTQ+ people and blame the victim. In cases of domestic violence, members of the local LGBTQ+ community may refuse to believe the survivor or hold the offender accountable.
LGBTQ+ survivors of sexual assault canget help from a therapist. Mental health professionals cannot disclose one’s personal information to others. Therapy is a confidential place where one can find support without judgment.
RACE/ETHNICITY AND SEXUAL ASSAULT
In the U.S., certain races andethnicitiesare more likely to experience sexual assault. According to the National Intimate Partner and Sexual Violence Survey (NISVS), the lifetime prevalence rates for rape are:
9.5% of Asian or Pacific Islander women
15.0% of Hispanic women
19.9% of white women
20.7% of black women
28.9% of American Indian or Alaskan Native women
31.8% for multiracial women
The report in question did not include data on male survivors.
Racismcan place racial/ethnic minorities at higher risk of sexual assault. Many people of color are fetishized as “exotic,” hypersexual beings. As such, survivors are more likely to be labeled “willing” participants. Sexual assaults on white people are often punished more harshly than assaults on people of color.
As such, people of color are much less likely to report their sexual assaults. Some people may not trust the legal system to treat them fairly. Others may fear “betraying” their community by disclosing personal information. In some cases, cultural values create extra stigma for people who report. These factors can also prevent survivors from seeking mental health treatment.
CHILDHOOD SEXUAL ABUSE
The sexual abuse ofchildrencan take many forms. It may involve a stranger or someone as close as a parent. A child doesn’t need to be touched to be sexually abused.Voyeuristic actions, such as watching a child undress or shower, count as sexual abuse. Adults who expose their genitalia to children are also committing abuse.
An adult who sexually abuses children may, in some cases, have asexual attraction to children. Yet sexual attraction is not necessary to commit abuse. Often, a perpetrator abuses a child to gain power over them.
Childhood sexual abuse is common. In the United States:
44% of sexual assault victims are under the age of 18.
Children are most vulnerable to childhood sexual assault between 7 and 13 years old.
10% of American children are abused before the age of 18.
Among children who are sexually abused, 20% experience sexual abuse before age 8.
Despite being common, children who experience abuse do not always report it right away. This may be partly due to power the offender has over the child.
Up to 93% of children who have been sexually abused know their attackers well. An offender will often threaten or manipulate the child to prevent them from disclosing the abuse.
Over a third of abusers are part of the child’s family.
73% of child targets do not disclose the abuse for a year or more.
45% of child targets do not disclose abuse until at least five years have passed.
Although sexual abuse in children can be difficult to recognize, detection is possible. If a child shows the following warning signs, there may be cause for concern:
Sexual behaviors or knowledge that are not age-appropriate
The above signs are not necessarily proof a child is being sexually abused. Children may show these behaviors due to another issue. However, one does not need proof to report child abuse. Finding proof is the job ofChild Protective Services. To report abuse, one only needs “reasonable suspicion” that abuse is taking place.
Reporting sexual abuse may prevent a child from having mental health concerns in adulthood. People who experienced sexual abuse as children are at greater risk of substance abuse or eating and food issues. They are also more likely to be sexually abused as adults.
If you think a child is being abused, you can call your state’s Child Protective Services to investigate. You can also call the Childhelp National Child Abuse Hotline at 1-800-4-A-CHILD (1-800-422-4453).
WHAT IS SEXUAL HARASSMENT?
Sexual harassment often falls under the umbrella of sexual assault. While the definitions of both sexual assault and sexual harassment include non-consensual sexual contact, there are some distinct differences.
The term “sexual harassment” is often used in a legal context. According to the U.S. Equal Employment Opportunity Commission, sexual harassment includes:
Unwanted sexual advances or contact
Harassing a person on the basis of their sex
Making offensive comments or jokes about a particular sex
Pressure to go on a date or perform sexual favors
Sexual harassment can occur anywhere, but many of the laws that protect people who may experience sexual harassment refer to harassment in the workplace. The broader definition of sexual harassment can include cat-calling, making sexual gestures or comments toward a person, staring, referring to someone using demeaning language such as “babe” or “hunk,” and giving unwanted or personal gifts.
MENTAL HEALTH ISSUES RESULTING FROM SEXUAL ASSAULT
After sexual assault, survivors may feel their bodies are not really their own. Survivors often report feelings such asshame, terror, andguilt. Many blame themselves for the assault.
Due to the trauma and negative emotions linked to sexual abuse, survivors may be at risk for mental health conditions. Survivors of sexual abuse may develop:
Depression: The loss of bodily autonomy is often difficult to cope with. It can create feelings of hopelessness or despair. It may also reduce one’s sense of self-worth. Depressive feelings may be mild and fleeting, or they can be intense and long-lasting.
Anxiety: The loss of bodily autonomy can also cause severe anxiety. Survivors may fear the attack could happen again. Some may experience panic attacks. Others may develop agoraphobia and become afraid to leave their homes. In some cases, a survivor may develop a chronic fear of the type of person who harmed them. Someone who was raped by a tall, fair-haired man with blue eyes may instinctively dislike, mistrust, or fear all men who match that description.
Posttraumatic stress (PTSD): Someone who survived sexual assault may experience intense memories of the abuse. In some cases, flashbacks may be so disruptive they cause a survivor to lose track of surroundings. A person may also develop a related condition called complex posttraumatic stress (C-PTSD). C-PTSD yields a chronic fear of abandonment in addition to symptoms of traditional PTSD. Some people with C-PTSD also experience personality disruptions.
Personality disruptions: Sexual abuse can sometimes result in personality disruptions such as borderline personality. The behavior linked with personality disruptions could actually be an adaption to abuse. For instance, a characteristic of borderline personality is a fear of abandonment. That fear might not be adaptive in adulthood. Yet avoiding abandonment might have protected someone from sexual abuse as a child.
Attachment issues: Survivors may find it challenging to form healthy attachments with others. This is especially true among children who have been abused. Adults who were abused as children may have insecure attachment patterns. They could struggle with intimacy or be too eager to form close attachments.
Addiction: Research suggests abuse survivors are 26 times more likely to use drugs. Drugs and alcohol can help numb the pain of abuse. Yet substance abuse often leads to the development of different concerns.
Sexual abuse does not only leave psychological scars. It can also have long-lasting health consequences.
A person who is assaulted may sustain bruises and cuts. They could also have more severe injuries such as knife wounds, broken bones, and damaged genitals. Others may developchronic painwithout an obvious physical cause.
Some survivors experience sexual dysfunction andfertility issues. Others may develop sexually transmitted infections. Contrary to myth, it is possible for a sexual assault to result in pregnancy. In cases where a child becomes pregnant, giving birth may be physically dangerous.
COUNSELING AFTER SEXUAL ASSAULT AND ABUSE
Many survivors develop mental health conditions after sexual assault. Having a mental health concern does not make you “weak” or “broken.” People cope with trauma in different ways.
People who have survived sexual assault canget help from a mental health professional. Therapy offers a safe, private place to get help without judgment. You do not have to handle your problems alone.
Sexual Assault of Young Children as Reported to Law Enforcement: Victim, Incident, and Offender Characteristics. (2000). Bureau of Justice Statistics. Retrieved from http://www.bjs.gov/content/pub/pdf/saycrle.pdf
With the anticipation, similar to days before birth of a first child, another form of publication will soon be released. From our smaller presence in earlier days of the 5 yr Child Abuse Royal Commission (CARC), the need to ‘join the dots’ began to call out. Hopefully, with the increased-global visitors of our RCbbc Blog, we’re now able to Share another media: Newsletters! eNews are becoming a greater extension of the 247 work-cycle, allowing wider varieties of audio, visual, text & combinations of media to be exchanged. A business plan is still being developed, yet many feel that these swapping of ideas is helpful.
It’s the disorder that robs people of their ability to feel whole.
When it comes to the disorder that can splinter people into discrete and fractious personalities, it’s important to note that this complex disorder is not uncommon.
Dissociative Identity Disorder (DID), formerly known as Multiple Personality Disorder, is often misdiagnosed. For the sufferer, the experience can be deeply confusing, with a distorted sense of self and long periods of time lost to dissociation.
Caused by childhood abuse, incest and neglect, the disorder often develops as a coping mechanism. It allows young kids to compartmentalize abuse so they can survive when caregivers or family members make them feel unsafe.
DID is described as a complex form of post-traumatic stress and dissociation, which causes a discontinuity in one’s self of self.
Professor Warwick Middleton is a leader in research and treatment on the disorder and has been working in the field for decades. Speaking to News.com.au, he recalls first writing a paper on the condition in 1991.
DID can be categorized as a developmental disorder, where a person’s personality fails to integrate as they develop.
It’s defined as an “identity disruption” and you may know it as “multiple personality disorder.” In some cultures, it may be identified as spiritual or demonic possession.
How do you identify dissociative identity disorder?
They have symptoms that you might have seen depicted in movies like “Sybil” or TV shows like “The United States of Tara.”
Sufferers of the disorder have a complex system of dissociation, which Middleton describes as “splitting off at different times into different identity states.”
“The individual might experience this as internal or external voices, which may argue and which may be associated with particular behaviors. Alternative handwritings. A whole spectrum of things,” he said.
What Middleton describes is a form of dissociation where the sufferer splits off into what appears to be a completely different “personalities.” Sufferers usually have at least two distinct personalities at some point in their life, some may have many more.
Middleton says that the majority of sufferers also fulfill criteria for post-traumatic stress disorder, major depression and somatization, while many of them have eating disorders and social phobias.
“Typically they present in their thirties, having bounced around the system for quite a while,” he said. “Because they hear voices … they’re given antipsychotics. From our research, about 20 percent of them are diagnosed with bipolar disorder.”
“If you look a bit closer they don’t have bipolar. That was just someone identifying them switching between different personality states.”
Losing large periods of your life
People who suffer from DID often have trouble remembering things.
In the autobiographical memory of their life, there are gaps where they have no recollection of what happened or what they did — and not in a regularly reported way, like when you drive home and arrive at your door with little recall of your journey.
It’s about losing big parts of your life to your other “personalities” who take over, commandeering your consciousness. While it might sound like the stuff of movies, the disorder is very real.
From Middleton’s research, he suggests it occurs in about 1.1 percent of the adult population. He describes this as being a “relatively common” condition.
What are people with DID like?
“(People with DID) range in a spectrum — (there) are people who sort of live on the fringes of existence who are chronically mentally ill, bouncing around services to people who are very high achieving, who may work in mental health services themselves.”
Sufferers often report weeks or months of their life passing by them where they have no memory and feel no agency over what transpired in that period.”
In the early nineties, the disorder was not often diagnosed and hardly at all identified by mental health professionals. These days it is much more commonly diagnosed.
Treatment for the disorder
Middleton says his interest in the disorder developed because there was “very little clinical awareness” and it wasn’t a diagnosis routinely made.
The other problem was that the issue of family assault and “incest” wasn’t properly acknowledged within Australia, where he is based, at the time.
“We now know that incest is, unfortunately, very common,” Middleton said.
“Basically in every country in the world where systematic research is done into childhood trauma and the presence of dissociative disorders we get very similar patterns.”
He said with standard treatment like cognitive behavioral therapy, the outcomes are very poor for sufferers of this disorder.
Treatment options with good outcomes include phase-orientated treatment.
Middleton was the first person, along with his colleague Dr. Jeremy Butts to publish research linking childhood trauma with the presence of DID. This paper was published over 20 years ago in the Australian and New Zealand Journal of Psychiatry.
He’s been a long-term director of the Society for Trauma and Dissociation.
Their findings showed that across the world, almost all sufferers of DID had, during childhood, suffered from some form of abuse, be it physical, sexual or neglect.
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Sexual violence among service members is an under-reported crime. Studies suggest only one in four survivors of military sexual assault report their attacks. Among male survivors, an estimated 81% never report their attacks.
