Treatment Centers

At first it seemed impossible.

The father of six adopted children, an admired athlete, and the founder of a charity that helped disadvantaged children through one of the best college football programs in the country, Jerry Sandusky was beloved in his local community and nationally known through his inspirational autobiography. It seemed impossible that such a man could be a serial molester of so many children over so many years.

The scandal at Penn State University rocked America, only to be quickly followed by a similar one at Syracuse University. Once again it seemed impossible to believe that adults could gain a child’s trust and admiration and then betray such innocence so completely. Not since the Catholic Church scandals in which priests were discovered to have abused hundreds of young children have Americans been so aware of and so touched by the issue of sexual child molestation.

Most Americans understand in a vague way that childhood molestation can cripple victims with struggles that can last a lifetime

The actual statistics are grim:

• One in five children victimized by sexual abuse develop serious long-term psychological problems, such as dissociative mental disorders, posttraumatic stress syndrome, nightmares, flashbacks, and anxiety over sexual issues, according to the American Medical Association.
• Of the women in substance abuse treatment programs, three out of four report being sexually abused.
• Among women who become alcoholics, 90% report parental sexual abuse or violence.
• About 70% of women in one study who were addicted to more than one drug had been sexually abused as young children.
• In another study of over 3000 adults from the University of Colorado, childhood physical and sexual abuse strongly correlated with lifetime substance dependence.
• Boys who have been sexually abused have 14 times the rate of suicide than normal, are 53% more likely to be arrested, and 38 times more likely to overdose on drugs.
• Ninety-six percent of children victimized by rape or sexual abuse know their attackers, most of whom they like and trust. About one-third to one-half of the girls and one-fifth to one-tenth of the boys are abused by family members. One study found that half of all victims are held down, struck, shaken or otherwise treated violently during the episode.
• One in four girls in up to one in six boys under age 18 years old have gone through at least one event of childhood sexual abuse. Boys are more likely to die or be seriously injured during the episodes. Children ages seven to 13 years old are more likely to be sexually abused than older or younger ones.

When you consider that there are over 90,000 reports every year of child sexual abuse in the United States, then you understand that many people are affected at a great cost to themselves and society.

Dr. Rita Teusch is a psychologist providing therapy to survivors of childhood sexual abuse, who as adults, now suffer from substance abuse disorders. In her description of one particularly difficult case published in the journal Psychiatric Services, Dr. Teusch describes how difficult it was to treat and gain the trust of one such woman, considered untreatable by several of her colleagues. She and "Ms. H’ came to the realization that her "despair, hopelessness, and pain were understandable responses to her past and her traumatization (from drug abuse)." She was using drugs to create the same feelings of denial, despair, shame and helplessness that she had felt when she was a child victim of sexual abuse. Drugs became "her dirty little secret" and source of shame in the same way she had experienced her brother’s abuse of her. Just as she had felt helpless to stop him as a child, now she felt helpless over her drug addiction.

"I helped her see that trauma was now being played out in her own mind," Dr. Teusch wrote. "She had identified with the perpetrator, and just as her brother had done when he sexually abused her, she was abusing herself with drugs. … her frequent rejection of help functioned paradoxically to maintain her commanding belief that … "nobody is there to help me."

The good news is that victims such as Ms. H can and do recover. A recent study from Florida State University led by Professor Jesse Cougle found that 58% of women who had histories of rape and sexual abuse and who also developed posttraumatic stress syndrome recovered within two years, and a minority demonstrated a natural ability to recover and did it on their own.

"What makes our findings unique is the recovery component," Dr. Cougle wrote in the journal Psychological Trauma. "Most studies of this kind have looked at risk and resiliency or the factors that determine who develops PTSD and who does not. We found factors that influence recovery."

However, some people who have been sexually abused or raped as children do not face their issues until they enter a substance abuse treatment program. Like Ms. H, psychotherapy can help them address these old childhood traumas that are having a negative impact on their lives as adults. The substance abuse may be what a psychologists would call "the presenting problem," and the childhood trauma would be labeled a "comorbid psychiatric disorder." It is possible to recover from both.