Child Sexual Abuse
by William P. Wilson, M.D.
-- Commentaries from past newsletters --

During my 50 years of practice as a psychiatrist, I have seen many people who have been sorely wounded in childhood. The festering wounds on their souls when bared, sometimes cause me to weep. There are no wounds, however, that are as grisly as those left by child sexual abuse, especially incest. To be honest, I do not remember encountering incest until I became a Christian. Then it seemed to become a common problem. I do not know whether it was that Christians would tell me about the abuse because they knew I would believe their stories and not condemn them, or whether it was that I began to ask about it. As a pagan psychiatrist I did not believe it happened very often probably because Sigmund Freud had said that his patients’ reports of sexual abuse were fantasies. If I had discovered that a patient had really been abused, I would not have known what to do about it, so I didn’t ask.

Early in my Christian life (year 2), though, I had a patient who was very angry. She had reasons to be angry. First she had ulcerative colitis. This disease was, in those days, impossible to treat and the patient suffered great pain and inconvenience because of it. Second, she had been sexually abused by her brother in law. When she told her mother about his actions, she was blamed for the abuse. She was told it was her fault because she seduced him. Third, she later married a man who had become impotent shortly after her second child was born. She and her husband had used all kinds of techniques to have sex to no avail. She enjoyed sex and felt very deprived. This angered her further. Because early on in the days of psychosomatic medicine it was thought that ulcerative colitis was a psychologically determined disease, (It is really an autoimmune phenomenon.) a colleague of mine had suggested she have a lobotomy as a treatment of her colitis. This suggestion had enraged her. With a load of anger she could not work out, she was like a bomb with a proximity fuse. It did not take much to blow her up. It was also obvious that she had generalized her anger to all men including her employment supervisor, me, and any man who crossed her.

Even though there were many things that had hurt her, the thing she always came back to was the sexual abuse. She was filled with a potpourri of emotions including anger, shame and sorrow because of it. I treated her for a year without success before I finally realized that I would had to use Christian interventions if she was to be healed. To be honest, I had never used them before. I really did not know but two at the time. They were salvation and forgiveness. Beginning with the first, we were able to apply the second and bring about real healing.

Because I was now sensitized to the subject, I began to ask about sexual abuse routinely and found more and more of it in my practice. I even found that when I lectured at Christian conferences on healing, and in my comments said that God can heal the effects of sexual abuse, several women in the audience came up and told me that they had been abused. They had never told anyone about it, or if they had their secular counselors did not know how to heal the scars. These women had come to the conclusion that it could not be healed. Most of the time I could do no more than listen to them and pray for them, but from their contact with me they now had hope. That made a difference in their lives.

There have been books written on the subject since I first began to treat these abused persons. Most of them are women but there are many men. Men do not come for counseling as often as do the women simply because they are less often sexually abused. Many have written books about their abuse and healing. All of their stories are moving and their healing certainly witnesses to the fact that God is still Jehovah Rapha, God our healer. One of the best is A Safe Place by Jan Morrison. I shall say more about her and her book later.

I have recently taught courses on ministry to sexual problems at the seminary where I teach, and at Eastern College. In these courses I include at least two lectures on sexual abuse. The subjects I emphasize are incest and rape. My reason is that incest, next to divorce, is the most common cause of psychiatric problems in women that we face today. It is said that one in four children are sexually abused. Most of these are girls who are victims of incest. There are recent studies that have determined that up to 50% of girls are abused mostly by older males, while only 10% of boys are abused. It is interesting that the boys are also most often abused by older males. Only 20% of the boys are victims of incest. Most are abused by unrelated pedophiliacs. Males who are abused have a 25% incidence of becoming homosexual. One of my patients told me that his scoutmaster had abused him many times, and he knew of 30 other boys whom he had abused.

I have seen or heard of children who are sexually abused as early as the second year of life. This age is rare, but beginning around five the incidence increases and I would estimate from my experience that it most commonly begins at age 7 or 8. It may only occur a few times or they may be abused as often as two or three times a week. I have even seen one case where the father started abusing the girl at age 10 and continued to do so until age 25 when she was admitted to the hospital. After she finished college, he had even set her up in an apartment and kept her as a mistress. Needless to say she was a psychological mess. Incestuous activity can start as late as 18 years.

Because the perpetrator knows or learns that prepubertal children can have orgasms, he tries to induce an orgasm in the child by manipulation and then has the child either masturbate him or perform oral sex. In his approach, he tells the child that he has a special love for her and that she is a special child. One father made love to his daughter in the same way he would have an adult. He told his daughter that she should be grateful because he was doing this. He had started having genital sex with her when she was 3 years old and continued until she reached puberty (13 yrs). When she finally realized how wrong the relationship was, she became profoundly disturbed. When asked why she was so disturbed by her teacher at school, she told her what her father was doing. The teacher informed social services who investigated the allegations and found they were true. They referred him to me for examination. He did not have mental disease, and he was not in the least repentant. He tried to justify his actions. I had a hard time completing my examination because he was a clergyman. I knew he knew it was wrong. He said so! I was so appalled at what he had done and his attitude about his sin that I terminated the interview. I just could not go on. He was later prosecuted and sent to prison.

There is an increasing incidence of incest. In 1978 the incidence was 1 in 15 children. In 1987 the incidence had risen to 1 in 10. Recently it rose to 1 in 4. Who are the perpetrators? Ninety-four percent of the girls are abused by their father. 2.6% are boys who are abused by their fathers. Mothers molest their sons 2.8% of the time and mothers molest their daughters 0.5% of the time. I could find no data on other relatives.

What characterized the incestuous activity of the persons who are perpetrators? The specific acts are exhibitionism, fondling, mutual masturbation, oral genital stimulation, genital intercourse, and sodomy (anal intercourse). I recently had a patient whose father did all of these things to his daughter.

Since fathers are the most common perpetrators, what are they like? The least common characteristics are an authoritarian attitude, insecurity in their masculinity, or paranoid personality traits, and a limited ability to form relationships with adults. Most commonly they are dependent, seclusive, dominant in their families, and have sexually unavailable wives. What makes a man do such a thing? To be honest I do not know. They know it is wrong, but they do it anyway. I have interviewed few perpetrators, but the few that I have talked to cannot tell me why they did it. It was not drugs or alcohol, for substance abuse did not enter into the picture in any of the cases I dealt with. The literature cannot give causes either. There are some fancied psychoanalytic theories, but they are not supported by empirical evidence. All we can do is describe what the perpetrators are like and what they are not like.

Their spouses are often frigid, passive, dependant, often chronically ill or disabled. They may be aware of the incest and even encourage it. One of my patients who was abused by her grandfather, was encouraged to go visit with grandfather while the mother and grandmother fixed breakfast each morning. She obediently did what she was told. He put her in his lap and had genital intercourse with her while she was waiting for something to eat. The patient, in her conversations with me, said that she was certain that both her mother and grandmother knew what he was doing. Through the years the patient developed psychosomatic problems that were treated medically without response. When she was treated for the effects of her sexual abuse, she recovered and has lived a life filled with love, joy and peace. The reason she recovered was that she developed a strong faith and lived it out. The use of spiritual interventions was the primary reason for her recovery.

I would like to emphasize that a child is not capable of understanding sex as an act of love nor do they understand its purpose. They do feel pleasure from it, but do not know what that pleasure relates to. It is a fact that boys and girls are capable of orgasm quite early in life. It is likely that orgasms occurs as early as 3 or 4 years of age. In contrast to what psychoanalysis teaches, it is not possible for them to interpret the pleasure they feel as sexual. It simply feels good. Some learn to masturbate themselves and a few will do so repeatedly. Somewhere around 8 or 9 they begin to understand orgasms as having to do with sex. They also know in their conscience that it is wrong to have sex with a parent. Incest is tabooed in every society. It is something that all mankind knows is wrong. This knowledge is written on their hearts. This creates great conflict which then gives rise to a variety of symptoms.

There is a time lag between the development of understanding and the onset of symptoms. It can be quite variable. In the case of the girl abused by her clergyman father, there was a two year delay after she realized what he was doing before she began to be rebellious. Whereas she had been a model child in school she became aggressive, got into fights, refused to obey her teachers and stopped learning. Her sensitive teacher asked what was wrong and the girl told her the truth in spite of her father’s warnings not to tell.

Not all children are rebellious. Others become sexually provocative or promiscuous. They begin this behavior near puberty, but can earlier. When I was working as a lifeguard during my college years, I had a girl of twelve who came to the pool where I worked who had been sexually abused. She lived in an area near us where drugs, alcohol and prostitution abounded. She prostituted herself to older boys and men.

When drugs become available many begin using alcohol, marijuana and cocaine to relieve the emotional pain they suffer. Others because of their pain may withdraw and not establish intimate relationships with others.

The longer term effects of the abuse is that they have feelings of unworthiness and dirtiness. Many end up as prostitutes because of these feelings. They think the only thing they are worthy of being is a sex object. They may subconsciously believe having sex is the only way they can get "love." Others develop a hatred of men like the patient I described early in this essay. Others are unable to respond emotionally to men and sometimes to all persons. One of my patients said she was incapable of love even for her husband and children. She could not love God either. She had learned to turn off her feelings while she was being abused and never turned them back on again. Almost all of them have low self esteem. They do not believe they are capable of being seen as worthy of esteem. One of my patients, who was a professional woman with a doctorate, thought she was the scum of the earth. The interesting thing was that she was brilliant and won awards in every academic endeavor she undertook. Still she had low self esteem.

Sexually abused children are filled with negative emotions. There is an enormous load of shame and its concomitant guilt. This is especially true of those who have had orgasms. For a long time I did not believe that most of them had orgasms, but my more recent experiences have taught me otherwise. This shame arises out of the knowledge that what happened was sin. They do not realize that they are more sinned against that sinning. Even so, the fact that they got pleasure out of the acts makes them believe that they were responsible or partly responsible for the abuse. They are riddled with guilt. This guilt makes it impossible for them to forgive themselves. Sorrow is another emotion they feel. Most of them realize they did not really have a childhood. They were treated sexually as if they were adults. This robs them of their innocence. Others of them develop fear. They are afraid that the experiences they had will happen again. They cannot understand that sexual intercourse is associated with marital love. They are, therefore, often frigid. They had to turn off their emotions when they were abused and cannot make themselves vulnerable in the intimate sexual relationships of marriage.

They are also fearful of rejection. Because of the wrongness of the act, they think if anyone knows they will reject them. They believe that God even rejects them because of what they have done.

Others are filled with anger. They cannot understand how their abuser could have done what he or she did. One of my male patients who had been abused by his older sister said through clenched teeth, "I hate her." There is, however, much ambivalence about their anger. Every child has an inherent love for their father. Since love occludes anger, they find it difficult to own their anger. Even so, the anger is most often there. It has to be dealt with.

Those who have learned to turn off their emotions while being abused, live a life of emotional isolation. Because they had to do this in their intimate relationship with their abuser, any memories of the abuse raise negative emotions. They do not like to feel these. They do, therefore, continue to keep their emotions turned off. It is easier, though, to repress all the memories of the abuse. In many instances they may have to resort to dissociation to be able to relate what happened to them. One of my patients did this on numerous occasions as she painfully related the events that took place. Her emotional pain had been amplified by her mother who used shaming as a method of punishment. She could, therefore, only tell me what had happened by "blacking out." In her dissociated state, she would relive the experience describing what was done and what she felt. Their emotional isolation makes it extremely difficult to establish intimate relationships.

What do we do for people who have suffered abuse and are still suffering as an aftermath? Jan Morrison is a veteran in bringing healing to men and women who have been sexually abused. The Tree of Rest ministry has addressed this problem for teenagers and adults who are being or have been abused. I have worked with her for years and know how effective she is. Since she was a victim of incest and was raped, abused persons identify with her and are able to realize that they can be healed. This motivates them to work at getting well. She is available for conferences and does hold retreats where healing can take place.

As for the rest of us, what can we do? First we can listen to their story. I have never had a person come to me with a story of abuse that turned out to be a lie. In a few cases I have suspected that they were lying, but on more careful investigation their allegations turned out to be true. I have to say that anytime a person tells me they have been abused, I always look for internal consistency in their story. The facts have to be the same on several occasions, and it has to be similar to the stories I have heard from others. They do not vary too much.

Because of my capacity for empathy, I can love them unconditionally and assure them that I will not reject them. This assurance takes some exhortation, but eventually they believe me. Second, I assure them of God’s love. Many of them, though, have a distorted view of God, and can only believe that they are to be the object of his wrath. Third, because they have low self esteem, I try to help them come to see themselves as a loving God sees them. I do not project Him as Father. They have mixed feelings about fathers, so I have them view God as he was incarnated in Jesus. It is, however, a difficult task to describe even Jesus in terms that will allow them to see his desirability. For healing, they must have a personal relationship with God so they must get a right view of him to accomplish this.

Theologians have, through the centuries, tried to describe God. They always come up with the words omnipotent, omniscient and omnipresent. These words describe Him in an impersonal way, though, so it does no good to tell a person who has been so sorely wounded by their father that He is these things. One cannot take a reductionistic approach and say "God or Jesus is love." They don’t know what real love is! To them love is related to abuse, by an omnipotent, omniscient, and omnipresent male. Many of them are told they have been the object of real or special love. To them love is related to either the physical or emotional pain of abuse. Unless we can present Christ in a way that makes him altogether attractive, they will not develop a personal relationship.

Recently I have reread the Living God by Thomas Oden. (I reviewed this book earlier) and he describes God in terms that can be understood best by someone with an intellectual bent. He says about God, "That if purpose exists, there must be a Purposer. If we see design in the world, we must hypothesize a Designer of sufficient intelligence to produce an intelligent world. If mind exists in evolving history, some incomparable Mind must have enabled and created the possibility of minds. If it is so difficult to be a human being without knowing something about God, there must be a sufficient reason for this awareness being so persistent in human cultures and societies, even when suppressed. If such wide consent exists in history to the existence of God, that fact must be accounted for with sufficient reason. If the idea of God is intrinsic to human consciousness then God must exist. From the fact of change we must hypothesize a change agent. If anything moves then something must first have moved everything. There must be a being that causes all causes and moves all movement. If contingent beings exist, then there must be a necessary being. If we experience moral obligation as relentlessly as we do, even against parents, against society, against superego restraints, then we must hypothesize a ground of moral obligation calling us to the highest good and possessed of weightiest moral authority. In addition to all this, it appears to be the case that a perfect being requires the existence of perfect being , other wise that idea is less than the idea of a perfect being." I ask you does this argument for the existence of God tell you who he is as a person? The answer is not exactly.

How then can we present an undistorted view of God? I believe we can present Jesus as the model of God who possesses the following characteristics. First He is love. Scripture describes His love as being deeper, wider, longer and higher than we can fathom (Eph 3:18). Now for a damaged person who has never experienced love we have to define love. I have done this in my earlier writings, but it is summed up in his statement that greater love has no man than he would give his life for his friends, i.e. he dies so his friends can live (John 15:13). Second, we have to see the joy that Jesus had. He was often described as full of joy and left us with His joy (Luke 10:21). Third, He was peace. Jesus claimed to have peace and he gave it to us so that we do not have to worry (John 14:27). Jesus seemed to have peace about his role in life and his ultimate fate. He knew that God was in charge and would protect him all the way. Four, Jesus was the epitome of patience. Even though His disciples were slow learners he, nevertheless, persisted in his training of them. Only rarely did He get out of sorts with them. He loved them unconditionally and this gave Him the patience to deal with their humanity.

To continue, we will cite the fact that He was kind. This was manifested in so many ways that it is hard to pick out one that stands out. For the sexually abused person, the stories of His kindness to the Samaritan woman at the well or the woman caught in adultery stand out. They want someone to be kind to them like He was to these women (John 4:18, 8:3-10). Six, goodness was another characteristic He possessed in abundance. All of His acts were good. Jesus did not inflict pain on anyone. He did not condemn anyone except the Pharisees, he did not damn anyone, nor did he retaliate when he was abused. To top it all off, He forgave those who condemned Him for his murder (Luke 23:34). Seven, faithfulness was manifested in His doing what his father had sent him for. He went willingly to the cross to take our punishment because he was obedient (Phil. 2:8). He was faithful because it was God’s plan. Eight, He was humble. Humility is difficult for most people to understand. It is not assuming a foot in the mud attitude. Instead, it is seeing yourself as God sees you. Jesus knew his Father’s love and, like Abraham with Isaac, he trusted God. He knew who he was and what he brought to give to the world. There was no evidence of pride in His life. Nine, above all, He had self control. All one has to do to discern His level of self control is to read the account of his trial and his crucifixion. He was in complete control of himself and the situation up to his death.

Even though we can paint a picture of a God with these characteristics, it still requires a demonstration of his nature by us. Since Christ lives within us we can let people see Christ in us and hear Christ when we speak. This is something that will most often convince them that God is what he says he is love.

It is difficult to bring healing to the sexually abused. They may have grown up in a chaotic environment. If they have, they may display chaotic personalities, what we call borderline personalities. These are most difficult to treat. Even so, nothing is too hard for God. The Holy Spirit can bring order to their personalities. He can uncover and heal the conflicts that have so disturbed these battered and bruised children of God. I can testify to His healing power in persons who have not profited from all kinds of secular therapies, including drugs and shock treatments.

To close, I want to say that Jan Morrison’s program does wonders for the people whom she ministers to. Jan’s witness is powerful. We made five tapes that include her moving witness to illustrate counseling techniques. The TV camera persons and I were in tears during the five hours we were taping. She concentrates her healing ministry in retreats for men and women. She has a number of presentations for the community, and includes her witness in most of the presentations she makes. In churches she speaks on Caring for Innocence. She can do presentations in schools and will consult with teachers, professionals and agencies. Her retreats are called In Safe Hands. They are three day retreats designed to help the wounded experience the healing love of God. She is available for speaking engagements. We will forward any requests to her, or she can be reached at 336-226-0094 -OR- 757-721-6437. Write to Tree of Rest, 323 West Harden Street, Graham, NC 27253 -OR- Tree of Rest, PO Box 6164, Virginia Beach, VA, 23456. Her book is entitled A Safe Place, and is published by Harold Shaw of Wheaton IL (1990).