Sexual abuse, PTSD and eating disorders: the things we don’t want to look at as parents

Trigger alert – this article contains disturbing thoughts for parents. We can’t ignore this important topic, which is highly correlated with eating disorders, but please use caution when reading. 

There are many times that a person develops an eating disorder with no history of trauma or abuse, but some statistics suggest that as many as 50% of us who are diagnosed with an eating disorder have experienced sexual abuse.

Finding out that our child has been sexually abused can be deeply traumatizing for us as parents. Many times we are unaware of the trauma our children have experienced, especially if it is sexual in nature. This is going to be hard – take a deep breath.

Sexual abuse is unwanted sexual activity, with perpetrators using force, making threats or taking advantage of victims not able to give consent. Most victims and perpetrators know each other. – Adapted from the Encyclopedia of Psychology

Sexual activity has a broad definition. For a child, it can include comments about their body, touching their body, showing them sexual images, masturbating in front of them, sexual touching, oral sex, and penetration.

If your child experienced sexual abuse, it is very possible that you had no idea. Many times the incidence of abuse and the reaction to the abuse are delayed by months, and even years. Sexual abuse is extremely confusing and shameful to a child, especially since the abuse is often perpetrated by someone they know – even a family member.

When children experience sexual abuse, they are impacted on a biological level. Sexual abuse is so egregious, that brain chemistry and neurochemistry actually change in response, and the person frequently develops Post Traumatic Stress Disorder (PTSD).

Because of the shame, many children block out sexual abuse from their working memory, making it even more difficult for a parent to recognize the symptoms. Here are some signs of PTSD due to sexual abuse:

  • Nightmares and insomnia
  • Avoiding certain people, places and things that may be associated with the abuse
  • Disengaging from people who may be associated with the abuse
  • Having little or no memory of the abuse
  • Feeling unable to discuss the abuse
  • Anxiety
  • Depression
  • Suicidal thoughts and attempts
  • Self-harm like nail biting, picking, cutting and burning
  • Eating disorders including anorexia, bulimia, and binge eating disorder
  • Risk-taking behaviors like fighting, shoplifting and sexual promiscuity
  • Drinking and drug use
  • Marked negative change in school performance
  • Headaches, stomach aches, nausea, vomiting and other pain symptoms

The development of an eating disorder in response to PTSD is seen as a coping or self-soothing mechanism. Starving, binging and purging are subconscious attempts to numb or control the emotional pain they are suffering. The important word here is ‘subconscious,’ since many don’t consciously remember the abuse and don’t know why they begin their eating disorder behavior.

One of the main symptoms observed in people who have PTSD is hyperarousal. This is “a state of increased psychological and physiological tension marked by such effects as reduced pain tolerance, anxiety, exaggeration of startle responses, insomnia, fatigue and accentuation of personality traits.” (Dorland’s Medical Dictionary) It has also been described as a chronic state of fight or flight.

According to the book A Bright Red Scream: Self-Mutilation and the Language of Pain, “People with PTSD try to compensate for this hyperarousal by shutting down and withdrawing from any kind of stimulation. They use dissociation and a range of mood-altering behaviors – cutting and burning, binging and purging, drinking and drugs, sex, and starvation – to numb out and regulate their emotions and keep the intrusive memories at bay.”

What a parent should do

If your child has an eating disorder, check with their therapist to ensure this difficult conversation is happening. This is not a conversation that should happen only once during the therapeutic experience – it may take time for sexual abuse to come to the forefront.

A trained therapist can support your child in acknowledging their pain in a manner that makes sense for them. It is a delicate process. You may not get information as to whether sexual abuse happened, but you do deserve affirmation that your child’s therapist is qualified to diagnose and treat PTSD.

If your child did experience sexual abuse, you may never learn the details. If the abuse qualifies as criminal, your child’s therapist will need to contact the authorities. If it falls in a gray area, your child’s therapist should work with you to set up boundaries and protections for your child so that they can avoid encountering the perpetrator again.

This is a process that should be intensively and explicitly discussed with your child’s therapist.

If you are concerned about this, and if this article made your “Spidey Sense” tingle, then please set an appointment with a qualified therapist who can help you work through your own concerns about your child’s past. This is serious business, and you need help processing even the possibility of sexual abuse committed against your child. Be gentle with yourself as you explore this area.

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