Women's Narratives of Healing from the Effects of Child Sexual Abuse

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no literature that explores the meaning of the word itself. In the Merriam-Webster OnLine dictionary, ‘survive’ is defined as: sur-vive intransitive verb 1: to remain alive or in existence: live on 2: to continue to function or prosper transitive verb 1: to remain alive after the death of 2: to continue to exist or live after 3: to continue to function or prosper despite: withstand 28 The women in the community I work in use the word ‘survivor’ to describe themselves, suggesting the word has more meaning to them than that of simply remaining alive. 2.2 Health and Healing The following subsections describe health and healing, beginning with health impacts of CSA, and followed by trauma, therapy, healing and voice. 2.2.1 Health Impacts Child sexual abuse is recognized as a major public health problem. 5,29–31 Women who were sexually abused in childhood are at increased risk of experiencing poverty, underemployment, unemployment, lower education, and increased social isolation compared to the rest of the population. Women who were sexually abused as children experience effects such as shame, fear, isolation, psychological and psychiatric problems, continued abuse and physical distress. There was found to be a relationship between the severity of sexual abuse and impairment in health-related quality of life. 32,33 There is an association between child sexual abuse and various medical conditions, such as irritable bowel-type symptoms, 34 increased risk of HIV infection, 35 and smoking onset. 36 Women who were sexually abused as children often avoid seeing a doctor or a dentist, and either avoid physical examinations or dissociate for that portion of their visits. 6,18,19 Adult female CSA survivors report reluctance in addressing their healthcare needs and avoid visits to healthcare professionals. Several reasons for this include: seeing healthcare visits as intrusive, violating and uncomfortable and, most significantly, triggering painful memories of childhood abuse. Moreover, CSA survivors express difficulty in trusting healthcare providers. 37 12
One of the main findings in a Saskatoon study 2 on the direct medical costs for women who were sexually abused as children compared to the general population, was that the cost of insured health care services was 4.1 times the population average after adjusting for age and gender. The average cost of prescriptions was 9.4 times the population average, and the cost of their emergency hospital visits was 1.5 times the population average. In another report, 1 research participants used significantly more emergency room visits and were more likely to visit the emergency room for pain-related complaints than other participants. It is a common experience for many women who have been sexually abused as children to experience years of misdiagnosis and ineffective treatment for medical and mental health problems. There is evidence of an association between child sexual abuse and medical conditions, including “chronic pelvic pain, gastrointestinal disorders, irritable bowel syndrome, and recurrent headaches” as well as “a higher prevalence of medical problems, somatization, high-risk behaviours, family physician visits, hospitalizations, and surgeries.” 3 Women who reported sexual victimization before the age of 18 were more likely to report poor perceptions of general health, to have sustained a serious injury in adulthood, to have a miscarriage or stillbirth, to have acquired a chronic mental health condition in adulthood, and to have used drugs than women who had not been sexually abused in childhood. 38 The World Bank has estimated that in industrialized countries, “sexual assault and domestic violence take away almost one in five healthy years of the lives of women between the ages of 15 – 44.” 22 Women who have been sexually abused in childhood describe the following effects: guilt, over responsibility, eating problems, fear, triggers/flashbacks, dissociation, drug/alcohol use, suicidal ideation, powerlessness, secrecy, isolation, self blame, erosion of trust, perceptions of helplessness and chronic danger, and hyper vigilance to danger. 39–41 Feelings of powerlessness may be translated into behavioural passivity or, conversely, as controlling behaviour. Examples of long-term effects include depression, anxiety, anger, fear, numbing of feelings, and dissociation. In a literature review of dissociative experiences of women who were sexually abused as children, Joanne Hall defines dissociation as: Significant discontinuity in awareness, perceptions, bodily sensations and/or memory that is self-reported; meets psychiatric diagnostic criteria for a dissociative disorder (American Psychiatric Association, 2000); or is so delineated as a result of psychological measurements, such as the Dissociative Experiences 13
Page 1 and 2: Women’s Narratives of Healing fro
Page 3 and 4: Abstract The health of women is com
Page 5 and 6: For my parents Charlotte & Charles
Page 7 and 8: 3.1.1 Power . . . . . . . . . . . .
Page 9 and 10: C Initial Contact Information 199 D
Page 11 and 12: List of Figures 8.1 A Model of Heal
Page 13 and 14: Chapter 1 Introduction 1.1 Motivati
Page 15 and 16: The therapeutic literature on recov
Page 17 and 18: analysis techniques, holistic conte
Page 19 and 20: Chapter 2 Background and Related Wo
Page 21 and 22: abuse as an issue had a personal as
Page 23: Now that the courts are more open t
Page 27 and 28: the dilemma of the survivor of seve
Page 29 and 30: that the use of diagnostic language
Page 31 and 32: Csordas suggests the object of heal
Page 33 and 34: trajectory perspective, looking for
Page 35 and 36: emember and those who forget, and b
Page 37 and 38: three traits of body memories: marg
Page 39 and 40: Lock and Scheper-Hughes include in
Page 41 and 42: elationships and behaviours. Women
Page 43 and 44: Chapter 3 Methodology This chapter
Page 45 and 46: fixed, or a single unit, but rather
Page 47 and 48: Bloom discusses the role of power i
Page 49 and 50: detachable from the surrounding dis
Page 51 and 52: process of hearing the women tell t
Page 53 and 54: to identify a minimum of two suppor
Page 55 and 56: esearcher inquiry. Making data is a
Page 57 and 58: and there would be no way to identi
Page 59 and 60: The women’s stories of healing we
Page 61 and 62: in the silencing of women’s voice
Page 63 and 64: I chose to eliminate unnecessary de
Page 65 and 66: events or some of the issues she fa
Page 67 and 68: Overview of healing story She began
Page 69 and 70: needs, and to meet them, much as sh
Page 71 and 72: ship with her husband. She uses uni
Page 73 and 74: could not explain, all of which end
Page 75 and 76:
this.” 4.9 Jennifer Jennifer is i
Page 77 and 78:
told her what happened she believed
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4.12 Connie Connie is a full-time g
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Telling her story Sonshine was a de
Page 83 and 84:
4.15 The Researcher and the Women
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Chapter 5 Naming, Remembering and M
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There is little public discourse of
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flashbacks; severe depression; or a
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5.1.1 Memories without a name Nine
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and I even tried with a woman too,
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my case was truly childhood sexual
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As a child, Nel remembers knowing t
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she believed that her mother saw sy
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home . . . I was sent to a neurolog
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As she said, “For me, you don’t
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She described this as not having an
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couldn’t believe, and I mean this
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In the stories, several of the wome
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was collaborative law. 3 Les found
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enough that when I went to high sch
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5.2 Support and Safety Every resear
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that they would not hurt her, and t
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an adult] I told her my story of se
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I went to the Vagina Monologues. An
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Jennifer had a sense early on in he
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The women’s stories indicate that
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if she got it again, which she woul
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Chapter 6 Restorying Life is sort o
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Table 6.1: Restorying. A Chronologi
Page 133 and 134:
Les’s broader story of healing, h
Page 135 and 136:
and she said ‘yes’, and he then
Page 137 and 138:
For M.C., her first naming occurred
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accomplish anything but minimal tas
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For all of the women, their point o
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ecame clear that she had been sexua
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impacts, and then volunteering, whi
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as they are contained in her body t
Page 149 and 150:
While a pattern was found in the wo
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Chapter 7 Body Fee fi fo she smells
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So the (memory of the) molesting ca
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she has a new way of understanding
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have a problem’(body politic), an
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to see a specialist like immediatel
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probably one of the hardest things
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I was a very promiscuous child from
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ut her main focus is cranial sacral
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from my uncle and from the rape tha
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like [breathing in a panicked manne
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For Connie, her body spoke the know
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naming, to disrupting and then recl
Page 175 and 176:
when one of the research participan
Page 177 and 178:
FEE FI FO Fee fi fo she smells his
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The women are healing from the effe
Page 181 and 182:
social world and the individual. Th
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to ‘see’ the wind, or the norma
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meaning was attached to the experie
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the biggest rule being ‘you don
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threatening risk. This is where sup
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the master narrative of one of her
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Chapter 9 Conclusion While comparab
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transcripts were analyzed using hol
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Pattern of Healing When all fourtee
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lation to other research in the are
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The most important finding from thi
Page 203 and 204:
• to investigate the relationship
Page 205 and 206:
14. Kitzinger J. Transformations of
Page 207 and 208:
45. Scheper-Hughes N. A Talent for
Page 209 and 210:
Appendix A K.Wood 503 Copland Cresc
Page 211 and 212:
When a potential research participa
Page 213 and 214:
system, including self-selected pse
Page 215 and 216:
Appendix F Data/Transcript Release
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Women's Narratives of Healing from the Effects of Child Sexual Abuse

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