My Turn: Sexual abuse survivors stigmatized by diagnoses

Posted: Thursday, March 10, 2005

With over a decade of experience as a nurse in mental health and chemical dependency and as a graduating social science student at University of Alaska Southeast, I feel obligated to address a potential correlation between girls' sexual trauma and their elevated rates of inpatient psychiatric admissions as adults. Most importantly, however, I want to contend that society often retraumatizes these women by discounting their experiences and by labeling them as dysfunctional.

After years of analyzing women's inpatient histories on mental health and chemical dependency units, I noticed a distinct pattern: many more of these women were sexually assaulted as children than in the general population. Current research substantiates that women who are sexually harmed as children have significantly higher lifetime rates of psychiatric ailments such as anxiety disorders, drug and alcohol dependency, severe obesity, depression, suicidal ideation, and post traumatic stress disorder than women with no sexual abuse history.

What is of more concern to me as a nurse and patient advocate, however, is the fact that when these courageous women finally come forward to share their harrowing incidents, many find their experiences ill-received and often invalidated by society. Attitudes such as "the past is the past, get over it," are a more common response in society than most of us would like to believe. Many family members are shocked because the perpetrator may be a close relative and they refuse to believe that kin would sexually abuse a child. The worst reaction occurs when abused women are made to feel responsible for causing someone to mistreat them as children. By not allowing these women to talk about their assaults, by denying the abuse, or by blaming the injured party, members of the society further traumatize women and steal power from them in the present.

The medical and psychiatric institutions are also partially responsible for reinjuring these women by defining them by their symptoms instead of recognizing them as survivors. Insurance companies require diagnoses; thus practitioners are required to label these women as depressed, alcoholic, or anxious, in order for them to receive therapy. Diagnoses for medical disorders, when they are correct, give us helpful information that can guide our treatment toward a more positive outcome. In many cases, however, diagnoses for psychiatric problems can serve to create illness. Unfortunately, some women begin to define themselves as their psychiatric diagnosis, cementing this label into their personality, and the diagnosis becomes a self-fulfilling prophecy. They cycle in and out of institutions viewing themselves as helpless victims instead of the strong survivors that they are.

Instead of regarding sexually abused women as ill, we could consider their behaviors as one of many coping mechanisms traumatized individuals employ to manage their distress. Although unhealthy, these types of responses functionally evade the underlying pain. I am not rationalizing their present behaviors but attempting to step out of my egocentric role and understand that perhaps it is not illogical to desire to escape from reoccurring anguish.

If we want the approximately 21 percent of the U.S. female population to heal from childhood sexual abuse trauma, we need to empower them. We can do this by listening to, believing, and validating their experiences. We can encourage them to seek treatment from qualified therapists. Additionally, society should not re-victimize these women by stigmatizing them with labels that are difficult to eliminate once applied. Since it is the medical and psychiatric institutions' function to facilitate wellness, these institutions should reevaluate the practice of branding sexual abuse survivors as ill and take a firm stand with the insurance companies to implement the necessary changes to be a part of the cure, not a part of the problem.

Women who were sexually mistreated as little girls and adolescents did not ask for the abuse. Please join me in assisting these brave women on their journey to healing as they learn to cherish and honor themselves for the strong survivors that they are.

• Juneau resident Juanita J. Reese is a licensed practical nurse, a sociology teaching assistant and graduating UAS senior.

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