Sexual abuse is typically perpetrated in secrecy, and perpetrators pressure or even threaten their victims into remaining silent.

As a result, shame is a common consequence of child sexual abuse,1 and shame will often persist for many years after abuse has occurred.2 In fact, shame is one of the reasons that recovery can take such a long time.3 In contrast to guilt, which relates to specific events and actions, shame involves how a person views their entire self.4 Understanding the impact that shame has on varied and interconnected aspects of your life as a survivor can help you see that many of your experiences result from your abuse, not because you are weak or flawed.

01
SELF WORTH
People who were sexually abused often see themselves as fundamentally bad even though they are not responsible for what happened.5 The shame from sexual abuse leads people to describe themselves as damaged or unworthy.6 They feel a sense of worthlessness and a desire to hide or disappear.7 Sadly, the self-esteem issues brought on by shame can create a cycle: a person’s feelings of inferiority can lead to negative experiences that reinforce those feelings.8
02
EMOTIONAL HEALTH
Survivors of sexual abuse often struggle with their emotional health, and shame can make that struggle harder. People who conceal information because of shame can experience worse psychological symptoms than those that result from abuse alone.9 Shame contributes to the development of PTSD symptoms.10 More specifically, shame can lead to anger, sadness, anxiety, and depression.
03
PHYSICAL HEALTH
Shame can manifest itself through psychosomatic symptoms, which are “the expression of emotional pain [through]...bodily symptoms.”12 Researchers have found that sexual abuse in childhood is strongly associated with physical symptoms that don’t have a clear medical explanation,13 and shame plays a role in these symptoms.14 Some common symptoms that survivors may experience are chronic pelvic pain, irritable bowel syndrome, and fibromyalgia in the neck, shoulders, and back.15 Shame has also been associated with a weakened immune system.16 Unfortunately, shame can make it hard to get needed help because someone with unexplained physical symptoms is unlikely to disclose sexual abuse to a doctor even though the information could potentially be relevant.17
04
SEXUAL HEALTH
Survivors often subconsciously associate sexual acts with shame.18 For example, research has shown that some survivors experience shame during sexual arousal even when arousal is occurring in healthy situations.19 The problematic relationship survivors have with sexuality can manifest itself as both a lack of interest in and avoidance of sex or engaging in impulsive, risky sexual behavior.20 Also, survivors often battle body shame.21 Many struggle to feel like they are physically attractive.22
05
RELATIONSHIPS
Shame is “fueled by concerns about how one is perceived by others,”23 and that concern can make it difficult to establish healthy and fulfilling relationships. Shame makes people feel like they have to hide parts of themselves from others.24 Individuals avoid talking about their abuse and their pain.25 They want to disappear, conceal distressing information, and hide from others. This concealment and lack of communication can make it difficult to connect with others.26 Children and adolescents who experience shame might accept or even feel like they deserve being treated poorly by peers and dating partners,27 and those tendencies can persist into adulthood. Adults will often isolate themselves or can become overly submissive.28

If you’re experiencing shame, explore some of these ideas for ways to overcome it.


References:
1. Feiring, C., & Taska, L. S. (2005). The Persistence of Shame Following Sexual Abuse: A Longitudinal Look at Risk and Recovery. Child Maltreatment, 10(4), 337-349.
2. Deblinger, E., & Runyon, M. K. (2005). Understanding and Treating Feelings of Shame in Children Who Have Experienced Maltreatment. Child Maltreatment, 10(4), 364-376.
3. Feiring, C. (2005). Emotional Development, Shame, and Adaptation to Child Maltreatment. Child Maltreatment, 10(4), 307-310.
4. Pineles, S. L., Street, A. E., & Koenen, K. C. (2006). The Differential Relationships of Shame–Proneness and Guilt–Proneness to Psychological and Somatization Symptoms. Journal of Social and Clinical Psychology, 25(6), 688-704.
5. Nelson, S. (2002). Physical symptoms in sexually abused women: Somatization or undetected injury? Child Abuse Review, 11(1), 51-64.
6. Rellini, A. (2008). Review of the Empirical Evidence for a Theoretical Model to Understand the Sexual Problems of Women with a History of CSA. The Journal of Sexual Medicine, 5(1), 31-46.
7. Wenninger, K., & Heiman, J. R. (1998). Relating body image to psychological and sexual functioning in child sexual abuse survivors. Journal of Traumatic Stress, 11(3), 543-562.

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