Sexual abuse is when someone is forced or pressured to do something of a sexual nature against their will. If the victim of sexual abuse is under the age of consent, this is referred to as child sex abuse, which is an invasion and perversion of a child’s physical and mental space. It is an abuse of trust that children expect to have in an adult, and it makes them feel the world is not safe. 

Possessing child pornography, forcing or persuading a child to engage in sexual activity, not taking measures to protect a child from witnessing sexual activity and the inappropriate touching of a child all comes under the term of child sex abuse, which is a crime and is a matter for the police. Both boys and girls are vulnerable to sexual abuse; girls are six times more likely to be affected.

Most children know their abuser, who may also be a member of their own family. Perpetrators of child sex abuse often appear to be pleasant, friendly people. Through a process called grooming, they build a relationship of trust with the child, often offering gifts, treats and attention. A child may come to care about their abuser and want to protect them from getting in trouble; this is one of the reasons that one in three children who are being sexually abused do not report it at the time, along with strong, often over-powering feelings of guilt and self-blame. They may also have been convinced that was is happening is normal, and that no one will believe them if they speak out.  

There may also be a primitive belief that if they don’t tell, it didn’t really happen, whereas speaking about it would make it more real. In many circumstances, cases of child sex abuse are left unaddressed and long-term effects are only revealed in adulthood.

Older children may be bullied or threatened with violence or exposure if they don't agree to sexual acts.This could be by an adult or someone their own age. This is particularly difficult for teenagers now, because of mobile phone technology and social media.

Adults are also affected by sexual abuse. Rape is one form, and it is not limited to attacks by strangers outside the home. Rape is a crime and should be reported to the police. More subtle sexual abuse can also be evident in adult relationships, where one person feels pressured into performing an act which they are not comfortable with. Since 2015 in the UK, coercive control has been a crime that can be punished by a prison sentence.

Many women who have been abused know their aggressor; they could be a partner, relative or friend. In general, men and boys are more likely to be assaulted by strangers or figures of authority, such as a teacher or a relative.

Like children, adult sufferers of abuse very often blame themselves for what has happened to them. They struggle with inappropriate feelings of guilt and shame, rather than report the crime, as they fear that people may feel they are in some way responsible.

• changes in behaviour

• avoiding or refusing to see a particular person

• mental health issues such as depression and anxiety/panic attacks

• the development of an eating disorder

• drop in achievement at school or work

• self-harm

• low self-esteem

• drug or alcohol use

• nightmares

• dread of a medical examination

• STIs and/or pregnancy

• attempting suicide

Men, women or children who have been subjected to sexual abuse understandably struggle to overcome it. Their self-confidence is damaged, often they feel guilty, anxious or depressed. As with all types of abuse there are issues of powerlessness, control and anger which remain unresolved. 

A survivor of sexual abuse may also feel ill at ease in their own body, they may be plagued by somatic symptoms, unexplained physical conditions, or feel extremely numb and disconnected. They may experience dissociation, and/or have little memory of their childhood.

A qualified counsellor provides a safe space where these long-term effects can be spoken about and slowly worked through, to help restore a sense of that person's self-worth. We have therapists on Welldoing who specialise in working with survivors of sexual abuse.