POLICE ASSOCIATION OF NOVA SCOTIA 97 • Numerous studies have discussed the direct relationship between child sexual abuse and adolescent/adult prostitution. The estimates range from 76 to 90 % of prostitutes having a history of child sexual abuse, the most common form being incest (the sexual abuse of a child by a family member). • Survivors are revealing in increasing numbers that they have been victims of ritual abuse. Studies indicate that this type of abuse, which is characterized by its repetitive and systematic severe sexual, physical, psychological, and spiritual abuse of children, is much more prevalent than originally believed. The aftereffects are severe. COMMON LONG-TERM EFFECTS Each individual’s experiences and reactions are unique to that individual. However, with so many survivors breaking the silence and talking about their experiences, it has become apparent that there are some responses to child sexual abuse that are common to many survivors. • Feelings of extremely low self-esteem or self-hatred are common in survivors. Extreme depression is something with which survivors also battle. • Survivors often experience frequent sleep disturbances and nightmares. Links have been made between this and the fact that children are often sexually abused in their rooms, in their own beds. • Trust is a crucial issue for many survivors throughout their lives. They were betrayed by the very people who cared for them, who insisted they loved them even while abusing them. Often, a sense of a just world is denied children who are sexually abused. Learning to trust can be next to impossible under these circumstances. • Revictimization describes the process whereby women who were sexually abused as children frequently find themselves in abusive, dangerous situations or relationships as adults. Diana E.H. Russell found in her study (1986) that there is a strong relationship between incestuous abuse and later experiences of sexual assault, wife abuse and other forms of sexual victimization. • Survivors with disabilities who experienced sexual abuse in childhood might never have reached a level of independence to escape this abuse and it has become a way of life. Even if they do leave an abusive home, they could continue to be abused by family, caregivers and professionals. • Flashbacks can be frightening experiences, not only for the survivors, but for those around them. During a `flashback’, the survivor reexperiences the sexual abuse as if it were occurring at that moment. It is usually accompanied by visual images, or flashes of images, of the abuse. This is one of the ways of remembering the abuse. Flashbacks are often triggered by an event, action, or even a smell that is reminiscent of the sexual abuse or the abuser. • Dissociation refers to the ability to escape stressful or harmful situations by creating another place for the mind to go. The intense pain of sexual abuse creates a situation where the victim, in order to cope, must try to dissociate from her body to leave the situation the only way she can. In simpler terms, it can be described as a type of daydreaming, a need to find a place for the mind (and ultimately one’s self) to hide while being sexually abused. • Multiple personality can occur among survivors of child sexual abuse. When the abuse is severe, dissociation or `splitting’ can become the only means of escape. By splitting, other alter personalities develop to help the individual survive the abuse. In a recent study of 185 people in treatment for multiple personality, 98% had experienced sexual abuse in childhood. Multiple personality is described as the process of dividing one’s self up into many different parts to handle the many painful experiences of the past. COPING MECHANISMS Coping mechanisms can also be described as Survival Strategies. These strategies have been utilized by survivors in the past, or they are using them at present to help numb the pain of the abuse. They are also used to control feelings, which may threaten to overwhelm survivors. Survivors may (...Adult Survivors of Child Sexual Abuse continued)