I have a very dear friend who has suffered unimaginable abuse. She has shared with me intimate details of her childhood and the things that she experienced.

Not only did she go through sexual abuse but also ritual abuse. If you met her you would never believe that she survived the horrors that she went through, as she is very outgoing and normal.

Fortunately to survive such atrocities, she was able to split off into other personalities.

If you're a parent, grandparent or guardian, the following signs may indicate your child has been molested, according to the National Center for Missing & Exploited Children. Some of these behaviors may have other explanations, but it is important to assist your child no matter what the cause. Also, keep in mind that children do not always demonstrate obvious signs, but may do or say something that hints at the molestation.

The effects of early sexual abuse last well into adulthood, affecting relationships, work, family, and life in general. Individual symptomatology tends to fall into four areas:

1. Damaged goods: Low self-esteem, depression, self-destructiveness (suicide and self-mutilation), guilt, shame, self-blame, constant search for approval and nurturance.

2. Betrayal: Impaired ability to trust, blurred boundaries and role confusion, rage and grief, difficulty forming relationships.

3. Helplessness: Anxiety, fear, tendency towards re-victimization, panic attacks.

4. Isolation: Sense of being different, stigmatized, lack of supports, poor peer relations.

Adult incest survivors may demonstrate some of the following symptoms:

* Fear of the dark, fear of sleeping alone, nightmares, night terrors

* Difficulty with swallowing, gagging

* Poor body image, poor self-image in general

* Wearing excessive clothing

* Addictions, compulsive behaviors, obsessions

* Self-abuse, skin-carving (also addictive),

* Suicidality

* Phobias, panic attacks, anxiety disorders, startle response

* Difficulties with anger/rage

* Splitting/ de-personalization, shutdown under stress

* Issues with trust, intimacy, relationships

* Issues with boundaries, control, abandonment

* Pattern of re-victimization, not able to say "no"

* Blocking of memories, especially between age one and 12

* Feeling crazy, different, marked

* Denial, flashbacks

* Sexual issues and extremes

* Multiple personalities

* Signs of posttraumatic stress disorder

Certain issues appear repeatedly. For example, victims typically blame themselves for the abuse, even if they were two or three years old at the time of the event. Guilt and shame are expressed, along with intense feelings of rage

If the rape or molestation was committed by an individual of the same sex (i.e., a man abusing a boy), questions regarding sexual orientation tend to arise in the patient ("I must be gay; after all, a man raped me!"). Female victims will frequently develop sexually promiscuous lifestyles in an effort to "conquer" the situation and bring it under their control. In other instances individuals will largely withdraw from any social or sexual interactions in order to avoid the feared stimuli, and turn toward extremely isolated lives.

The connection that is made for victims between sex and pain (love and humiliation, closeness and betrayal) is a particularly disastrous one. Frequently patients will express and/or demonstrate the belief that the only way to be loved or cared for is if they are also being abused ("I knew if I didn't let him keep beating me, I'd always be alone"). Often, in the extreme, physical and sexual abuse are even viewed as a normal part of everyday life. Healthy boundaries do not exist for these individuals, and therefore, healthy relationships are impossible. Victims will actually respond to feelings of loneliness or sadness by abusing themselves (e.g., self-mutilation) if the "significant other" is not available to do so.

One of the more difficult issues that arise is the recollection, by some individuals, of experiencing a certain amount of physical pleasure during a molestation or incest. This adds enormously to the sense of being at fault and "dirty." Thus, one of the aims of treatment is to educate survivors as to normal physiological responsiveness. The realization that their feelings are/were normal helps tremendously toward alleviating the sense of shame.

Even when individuals have spoken of their abuse prior to group treatment, any pleasurable aspects have typically been denied. The opportunity to relate to others who have shared these feelings, as well as the experience, is part of the healing power of this form of therapy. The sense of isolation, of being "different from the whole world," quickly begins to subside. It is only in revealing the secrets and dealing with the pain that survivors of sexual abuse can and do go on with their lives.

http://www.aaets.org/article31.htm

No child is psychologically prepared to deal with ongoing or intensive sexual stimulation. Even very young children, two or three years old, may sense that the sexual activity is "wrong," but they are unable to stop it. Children are frequently threatened that if they tell anyone, they will be killed or sent away, or their puppy will be killed; or their whole family will breakup.

Children subjected to sexual over-stimulation, with or without threats, will develop problems. Those older than five years of age become caught between loyalty to or dependence on the perpetrator, and shame at doing something "wrong." Over time, the child develops low self-esteem, feelings of being worthless or "dirty," and an abnormal view of sexuality. How do you recognize such children? There are many signs:

* Withdrawal and mistrust of adults

* Suicidality

* Difficulty relating to others except in sexual or seductive ways

* Unusual interest in or avoidance of all things sexual or physical

* Sleep problems, nightmares, fears of going to bed

* Frequent accidents or self-injurious behaviors

* Refusal to go to school, or to the doctor, or home

* Secretiveness or unusual aggressiveness

* Sexual components to drawings and games

* Neurotic reactions (obsessions, compulsiveness, phobias)

* Habit disorders (biting, rocking)

* Wears long sleeves in hot weather (to hide bruises?)

* Unusual sexual knowledge or behavior

* Prostitution

* Forcing sexual acts on other children

* Extreme fear of being touched

* Unwillingness to submit to physical examination
*


Specific physical indicators of recent sexual abuse include:

* Difficulty in walking or sitting
* Torn, stained or bloody clothing
* Pain or itching in genital area
* Bruises or bleeding in genital area or mouth
* Pregnancy or sexually transmitted diseases, especially in preteens
* Repeated urinary infections or genital blockages

http://www.aaets.org/article31.htm