Mental Health Month “HIV/AIDS”

I decided to write about HIV/AIDS during Mental Health Month because whilst mental health and HIV/AIDS has a relationship, there are many other diseases and conditions with more of a relationship than HIV/AIDS and mental health. So more is talked about say, Alzheimer’s and mental health, Parkinson’s and mental health, menopause and mental health, etc.

As a neglected relationship I wanted to talk about the links with mental health and HIV/AIDS as much as anything, to be mindful of this fact; HIV/AIDS may be less of a world scourge than it was in the eighties and nineties but it has by no means gone. In fact, many who work in the field believe it is only a matter of time before the current cocktail that keeps HIV/AIDS as a manageable disease for the majority, will start to fail and require further research and medication. Additionally though we are on the cusp of a quasi-cure it would not in its current state, be do-able for the vast majority, most particularly, the poor. In addition, HIV/AIDS speaks to a larger issue, that of the continual zoonotic transmission of a disease from animals to humans (or equivalent).

Recent studies demonstrate, the rate by which potentially fatal pandemic diseases can be transferred interspecies, is far higher than previously thought. Researchers believe it is a matter of time before another HIV/AIDs style disease, will occur and spread. Whilst we may dismiss this as fear mongering, history shows us otherwise. Considering this and the history of HIV/AIDS the entire subject requires more in-depth analysis to ensure if this happens, all those infected are offered treatment rather than the select who can afford the Big Pharma monopoly prices.

If India had not stepped in, the ten million who died in Africa (and the number was in actuality far higher) would have continued to climb. If a Western country were to lose ten million to a disease, there is no way the monopoly of Big Pharma would have been permitted and as with the Anthrax scare the patent would have been lifted on the medication to ensure everyone had access to cheaper generic versions of the drug. India told this to the WHO years beforehand and offered to help those struggling countries like africa by supplying generic medication as less than one dollar a day, WHO and effectively, the Western world, ignored them and millions died.

Now the WHO and others are trying to force countries like India into not producing generic versions of existing medication in order to save lives. This at the behest of the already massively profiting pharmaceutical industries of the Western world. Profit it seems, literally comes before lives.

What does this have to do with mental health?

Having a disease like HIV/AIDS has a myriad of outcomes, not least a deleterious effect on our well-being and mental well being. Even if the disease is ‘managed’ the trauma of having a disease that is communicable, stigmatized and life-threatening, alongside the inevitable connection to sex, drugs, homosexuality and other stigmatized and judged things, causes a great deal of psychic stress.

When our bodies are unwell our minds are unwell.

Living with a disease like HIV/AIDS or hepatitis C can literally cause depression.

Surviving a disease like HIV/AIDS can cause similar issues known as ‘survivors guilt’ and the suicide rates both during the AIDS crisis AND afterward were extraordinarily high for this very reason.

Some people in power at the time felt that saving Africans was not a priority because quote; They would not know how to read the instructions on the medications, they would not take the medications properly, they would possibly cause the medication to work less effectively and even cause the virus to mutate and become resistant and put everyone else at risk’ so they chose to ignore the plight of Africa and other countries. It was essentially the worst kind of racist discrimination possible. On the other extreme, China did a disservice to their citizens by ignoring the problem saying they had no problem and thus, permitting no discussion or help.

Back to mental health. Imagine if you had HIV/AIDS today, would you feel ‘okay’ about it? Even if you had medication (with its side-effects) and you knew you may live a relatively normal life span? It would still affect you in so many ways, you would have to inform anyone you were intimate with, you would have to consider it when having children, you would have to let those you worked with and your insurance know. Even if you did not see it as a stigma, some people invariably would (because people love to judge) wouldn’t that cause at the very least, some anxiety and possibly other mental health issues?

A friend of mine contracted Hep C during college, he was deeply ashamed and despite therapy he ended up being celibate. That may be an extreme but it’s also one example of how illness, disease, viruses, and medical conditions can exacerbate mental health even when they don’t do so biologically like Parkinson’s does.

Many years ago after a sexual assault I was told my assaulter was HIV positive. I didn’t at that time have any idea of prophylactics for those exposed to HIV. Fortunately a professor of mine did and she told me where to go. I think to this day, if I had not met her, told her, and she had told me where to go, I may today be HIV positive. Maybe not a big deal if you are, but when you are not, a huge deal, which speaks to how people really feel about HIV/AIDS.

Taking the prophylactics which are basically the HIV/AIDS medication, for six weeks, demonstrated to me and gave me more empathy for, those who have to take them for the rest of their lives. They talk about how good they are at extending and maintaining life but they are rough on the body, and having to take quite a few every day, as well as the cost, is all round hard. I learned then, firstly never take your health for granted, secondly never judge someone else because you don’t know what they are going through and third, we in the Western world have an innate privilege that other countries do not have and we take it for granted.

The six-week supply of medication at the time cost around $3,000. Most of the world doesn’t earn that in a year.

This is going to happen again. And when it does, more will die and more will close their eyes to this because it’s not on their door step. We choose whom we empathize with and it’s almost a trend. If everyone else is donating we donate, if nobody cares, we don’t care, en mass this is our approach to charity and change.

HIV/AIDS hasn’t gone away. Other diseases will come that are possibly more devastating. It impacts entire generations, kills and destroys entire family trees, obliterates the ‘luxury’ of considering mental health fall out afterward because resources are so precious. Think now how many are dealing with mental health issues concerning the death of half of their families from HIV/AIDS and have no resources.

We see mental health treatment as a luxury because in many ways that’s what it is. And this is wrong. The domino effect of poor untreated mental health issues, causes loss of productivity and health, it is a vicious circle, if we ignore it, we do so with the knowledge ignoring it costs us more in the long run.

Stigma alone, social exclusion, judgement, blame, condemnation and fear, can strike illness in the heart of any sufferer. Suffering in silence, unable to share your diagnosis freely, even with the protection of the law, makes those with such diseases feel they are not the same as everyone else and in some ways that ‘secret’ they carry does set them apart. Imagine for a moment how that feels? Many of us cam emphasize somewhat, we may carry our own secrets, but that one is a pretty big secret and a heavy burden. We can help with that burden just by being good to those we meet, aware that we never know the extent of their burden.

When the next HIV/AIDS comes around, I hope everyone will stand up and demand that Big Pharma not prevent the treatment of all sufferers in all parts of the world. Your economic status or skin color do not reflect what your level of care should be. The only way this changes is if we, the people, change it by not ignoring what the inequality occurring in other parts of the world in part, due to our economic monopoly.

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Mental Health Month “All queered out”

The relationship between the LGBTQ community and Mental Health has long existed. Someone who believed same-sex relationships to be a sin, may point to the mental health ‘sickness’ of those who are attracted to partners of the same gender. This goes back to the seventies where mental health and being queer or transgender, was considered a mental defect/illness. It was not until the early seventies that the bible for Psychiatrists changed this diagnosis and it no longer was considered a mental illness.

During this time of stigma, those who admitted to being queer or transgender were often subjected to camps and programs that attempted to ‘cure’ them of their ‘proclivity’ of course they were unsuccessful but they did a great job of messing up generations of queers, so much so that many stayed in the closet, marrying and having children and never ever admitting who they really were.

Someone who is anti-gay may argue, that means they have a choice because they choose to stay in the closet and marry, they can be normal after all!

There is however, nothing normal about pretending to be someone you are not, and this definitely can be one reason LGBTQ people suffer from a higher than average degree of mental illness.

If it’s an argument of which came first, the chicken and the egg, then you can cross-compare to other studies looking at marginalized and condemned groups such as racial minorities, and see that levels of mental illness rise when bigotry and condemnation in the larger society are directed toward that group. No surprise, hate begets mental illness. It’s not all in your head!

How can hate cause someone to be mentally ill if mental illness is not a mailable and ‘chosen’ ailment? Hate cannot cause someone to get cancer, so how can we argue mental illness is as serious as cancer?

Hate can lead someone to drink too much, smoke too much, and that can cause cancer. It is called an indirect relationship. Cause and effect. The same is true of hate and the LGBTQ community, if you are condemned, judged, shamed, picked on, hated and treated badly day after day, that can literally drive you out of your mind. More commonly, a pre-existing tendency toward certain mental illnesses is exacerbated and tipped over the edge.

This does not mean, anyone ‘chooses’ to be mentally ill, but like anything in life, extreme stress CAN bring on symptoms. They have long known this with Schizophrenia, Bipolar and Borderline Personality Disorder and of course, PTSD has its roots in society as does anxiety. You cannot remove societal influence from the development of a mental illness yet it is as ‘real’ as any other disease in terms of true manifestation and side-effects.

Historically gay and minority populations experienced a high degree of stress and fear. They were having to hide who they were, meet in secret, they could be arrested because their emotions were illegal if expressed physically, and they often had other concerns such as low-income, poor access to care in the community, nobody to talk to honestly and unanswered questions about their own identity.

Our society is typically Heterosexist and Heterodominant because the vast majority of people in our society are heterosexual. It is one thing to show two women kissing, and have a bit of bisexual fun, quite another to be a committed full-time lesbian. Most people don’t relate to that, they may try to understand but that’s like a white person understanding the experiences of a black person, you can only go so far with that.

Thus, LGBTQ are misunderstood at best, and not understood at all at worst, with pastiche and parody being the status-quo. Historically this was even more so, as it was an illegal ‘act’ to be with someone of the same gender sexually (and everyone considered the deviancy of gay sex to be the key to being homosexual rather than thinking for a moment it could be about something other than sex).

Unfortunately a large portion of gay men were so promiscuous it did not help the ’cause’ because they really did live the life style that heterosexuals feared. I do condemn this in the sense that I see no good coming out of sleeping with twenty strangers a night, and whilst that may seem homophobic of me to say, having read the history of HIV and AIDS I see a causal history there as to why homosexual men became one of the earliest groups to be significantly infected by HIV/AIDS. This set the gay cause way back because straight people condemned all gays outright for the actions of the few, and believed HIV/AIDS to be a gay-plague, which of course it was not.

Reading the history of this time, I tried to better understand what would lead gay men to be that promiscuous, my first thought was, a lot of straight men would do the same thing given half the chance! My second thought was, it’s about reaction. Gays were subjected to such strict secrecy and condemnation they could not really be ‘out’ and when finally some cities were tolerant enough to be relatively out, certain populations ran with it. I understand the reaction/action/reaction cycle it exists in every subjugated population to some extent, and every new generation reacts to their parents, it’s a cycle of over-throwing the old for the new. But the level of promiscuity in cities like NYC and San Fransisco was a contributing factor as to why HIV/AIDS initially hit the homosexual male population so hard.

When we consider what a heterosexual who knows little about homosexuality must have thought upon hearing that some homosexual men with HIV/AIDS were sleeping with twenty plus partners a night, as well as doing drugs, it’s not hard to see why there was another wave of backlash against the gay community en mass.

That said, times have somewhat changed and whilst you can still find ‘bath houses’ and gay men (and some lesbians!) who wish to be as promiscuous as those early days, there is also a greater appreciation for actual relationships among the homosexual population. This should be emphasized more in our culture, as heterosexuals still believe homosexuality is about sex, and it is often a very small part of what goes into being a homosexual. The stereotypes are hurtful to the community as a whole, those include the idea that all lesbians are ugly, all queer men are paedophiles, all lesbians are men haters, all bisexuals are sex-addicts, all gay men are perverts.

Going back to mental health … when HIV/AIDS first hit, there were not enough resources to help the gay community, and there was therefore, even less help mentally. After the crisis began to die down and some treatments that worked began to help people live longer and HIV/AIDS was no longer a literal death-sentence a strange thing occurred…. there was a mass influx of extreme depression among the survivors of the ‘gay plague’ as it was known.

Survivor guilt and the depression that comes from severe illness and PTSD (seeing all your friends die) are HUGE factors in the development of mental illness. Some survivors actually deliberately stopped taking their HIV/AIDS medication and let themselves sicken and die because of not being able to stand surviving. They felt they didn’t deserve it. Why me and not my friends?

This was exacerbated by virtually NO resources for gay individuals who needed to talk about what they experienced, witnessed and felt. This still stands, in most cities throughout the US there are no specific mental health services for the homosexual and bisexual and transgender populations.

During my studies as a psychotherapist I sat in a large room with over a 1000 counselors on a briefing about ‘homosexuality and mental health’ during which everyone was told that to be homophobic or intolerant of homosexuality, was incompatible with being a mental health professional. Sounds good huh? Not so good. Of the 1000 there I would easily hazard a guess and say that a third, possibly half, were somewhat prejudiced, very ignorant and possibly homophobic. I say this after hearing them speak, the questions they asked, the people they were.

This is not condemning someone who is homophobic, any more than I would someone who is racist. It is your right. But it’s not legal and it’s not moral. So given this, those people have the difficulty of being legally required NOT to be what they actually privately are. Do you think many of them would admit this? Do you think they would stand up and say ‘I am against homosexual relationships’ and possibly lose their license? For those who are homophobic or anti-gay, you may be shaking your heads and saying ‘this is why it should not be legalized, you are forcing people to feel what they do not’ and I agree with the latter statement.

If you are homophobic you probably shouldn’t be a therapist with the exception of working in a religious community for like-minded people.

If that sounds extreme, well it is. Just as I would say if you are racist you should not work in a public setting but you would be fine in say, a community that supported your views and this cuts both ways (white and black).

LIkewise, if you are sexist, don’t work with the opposite gender.

I’ve been told that when you are a ‘ist’ you should work through your feelings and you should take clients who push your buttons. I don’t agree. Therapy is a fragile experience, and people pick up on intolerance. When I was training I saw and heard enough people to see, they KNOW when you are not comfortable with them. The same goes for ignorance, there is no place for ignorance and therapy when it comes to treatment. If you don’t understand it, refer, refer, refer. To someone who does.

The problem is funding, there are no funds for the queer community because it’s seen like Planned Parenthood as a problem more than anything else.

So if gays don’t have access to good mental health services (and other services) is it any wonder they have higher percentages of certain diseases and mental health issues?

The bottom line is; LGBTQ populations exhibit higher levels of anxiety, depression and alcohol/drug abuse than the standard population. This is not because they are all sex-addicted club fiends who pour drugs down their throats whilst sleeping with twenty partners a night. But the reality of this does lead ignorant people to label mental health as a weakness and point to this as an example. Some even go back to the idea that mental health is a perversion of nature, just as the pilgrims did when they put mentally ill people to death or locked them up.

It doesn’t take long to learn about a group of people you have nothing in common with and it can go a long way. Typically Native Americans ask that therapists working on reservations be of Native American heritage. Some say it should not matter who the helper is, it is more about their willingness to help.

I disagree. It does matter. Just as if you are black and you have been subject to racism you may wish to see another person of color, there’s nothing wrong with that, just as there is nothing wrong with being female and wanting a female gynecologist or therapist.

More gay people need to educate the majority about the specific issues relating to their population so those heterosexual therapists can actually be of some help to queer populations. Even more than that, those therapists who are anti-gay or prejudiced should recuse themselves. Yes – step away – don’t see homosexual patients – do them a favor!

Currently the accepted protocol is to be objective and even if ‘you are personally anti-gay’ you can be objectively helpful to a gay client. That’s ridiculous, no you cannot. I have a friend who is fairly anti-gay and works as a therapist and he is not ever going to be helpful to a gay client and can do more damage than good. Period. I have told him this but until the system changes, his boss and other leaders will insist that anyone, irrespective of their personal beliefs, treat gay clients.

Let’s change this…. and some other things and maybe the rates of mental illness will begin to decline in the LGBTQ population and with it, the high rates of suicide.

 

Mental Health Month”Grow up & forget about it!”

Do you know anyone who was sexually abused as a child? Were you? Was your daughter? Sister? Wife? Neighbor? Brother? Son?

Childhood sexual abuse and adult survivors of childhood sexual abuse (ASCSA) are in every society in every corner of our planet. It is often assumed children are resilient and can put up with a lot, and this is true, but childhood sexual abuse can destroy and does destroy so many parts of a child’s psyche we can honestly never know with any certainty how much was taken by the act of abuse.

What we do know is abuse, any kind of abuse, including sexual abuse, is going to have after effects that last long after the actual abuse ends. One of the ways this occurs is an unconscious attempt on the part of the child grown to adulthood (or near enough) in acting out the abuse in an attempt to understand it.

Does that seem crazy?

Very often organizations working with adult survivors noticed a pattern of repeat sexual and physical and mental abuse among populations who had endured these things. At first they believed a person who say, was raped was more likely to be raped a second time and this is borne out by statistics. But in addition to this increase likelihood of further victimization there was another pattern emerging; the unconscious re-enactment of aspects of the abuse by the survivor.

What that means in plain terms is, sometimes survivors will create situations similar to the abuse and actually reenact elements of the abuse, and go through those scenarios and possibly be re-victimized as a result. They will do this without being consciously aware of doing it.

Why would you ever want to do that?

It is thought this unconscious behavior is much like an unconscious wish to understand and reclaim what happened. Without intervention the individual is not aware they are doing it, and thus, when it happens is genuinely surprised (and re-traumatized) whereas when they are made aware this is a process of the mind trying to make sense of something that is hard if not impossible to make sense of, they can break the cycle.

Like many survivors who may turn to prostitution because of feelings of worthlessness and devalued degradation and shame, some will go in the opposite direction and have absolutely no sexual desire. These extremes are one form of ‘reacting’ to something the mind and spirit are trying to reconcile. Another way is the reenactment of the experience on some level. It has even been postulated that BDSM is one outlet for survivors to ‘act out’ their feelings and possibly reclaim their lost power.

Whether true or not, for others who have not had this experience, it may appear the individual is seeking to be abused on some level. It may even be an accusation thrown at the individual. Statements like; “You must want this / you keep putting yourself in these situations and letting it happen!” The individual will perceive this as being another condemning, blaming, shaming comment.

Abuse is hard to understand. I cannot understand why someone would sexually abuse a child, a woman, a man, an animal. I don’t think I could ever understand. So in absence of understanding, we sometimes go to great lengths to try to make sense of what happened to us.

I knew a woman who would drink a lot and go home with men and wait to see if they raped her. She was not aware she was doing this, until she really stopped the compulsion and thought about it. Then she realized she was seeing if she would be ‘betrayed’ again by a man who she had trusted and who had raped her when they had been drinking together. She had tried to talk to her friend who had raped her afterward about why he would have done this, he refused to say, and so she unconsciously put herself in similar situations to see if it would happen again and maybe understand it better. Of course when she realized what was happening she realized she did not want to be raped again! But until she came to that point she was unawares this was even happening.

Legally if she had been raped whilst drinking even if she consented to go home with someone, it would be rape if she did not give consent for sex and some would argue, if you are drunk you cannot give consent so with the exception of committed relationships where many times, partners will have sex when inebriated, the rule of thumb is, if you are not in a relationship and you or your partner are inebriated do not have sex with them because you cannot guarantee consent (unless it’s very obvious). Of course this is a difficult thing to gauge and it’s unrealistic to expect nobody to drink, so that’s where the legal system can get unstuck in issues of consent. However in most cases it is obvious for example if you are passed out drunk and someone has sex with you, that’s rape and you did not give consent, if you changed your mind and didn’t want to sleep with someone you withdraw your consent.

Therapy can be useful in working through trauma that involves enacting out parts of the abuse. Childhood survivors of sexual abuse go through triggering phases in their lives where it becomes challenging to deal with the history of their experiences. Typically these occur at puberty, during your first serious relationship, in pregnancy, during your child’s puberty and other occasions. It can be hard talking to family members about this, especially if the abuser was a family member. In a healthy marriage, talking about past sexual abuse histories helps you communicate what is and is not acceptable and what boundaries need to be respected, as well as bringing you closer.

Survivors of adult sexual abuse can have large issues with rage – anger – helplessness and anxiety.

Rage – anger at the perpetrator, at those who didn’t do enough to stop it, at oneself for being a victim, at people who trigger a reminder in any way.

Helplessness – feelings of impotence, uselessness, weakness, a feeling that nothing you do no matter how hard you try will change things or count.

Anxiety – fear, phobias, self-hate, secret-keeping, terror, flashbacks, nervousness, triggers, and general anxiety around anything related to or reminding of, the abuse.

Those as well as other symptoms can lead to severe mental health challenges, not least, depression and difficulty with trust and emotions. Unlike some who if raped may hopefully get some degree of immediate support, many times adult survivors of childhood sexual abuse, may never report what happened, may be disbelieved, may suppress it and keep quiet about it. Others may feel it was dismissed, forgotten about, considered unimportant and feel that people think they should ‘get over it’ by now. Those who are raped as adults and receive no support will probably also experience this isolation. That feeling can lead to mental illness if left to fester and remain unresolved. Rape Crisis Centers will see ANY child or adult of either gender who was raped or sexually abused in any way at any age at any time in their life. They have therapists who are trained in the legal ramifications, and also how to actually help those who have experienced this.

A fellow blogger reminded me to be mindful of male-rape and male sexual abuse and assault and how even if it does not happen with the same frequency it may suffer greater stigma because males are less likely to report any kind of sexual abuse, for similar reasons, but also because they are not as typical a victim and thus, they fear the condemnation of others who may think ‘you’re male, why were YOU raped? How could you have let that happen?’ As with women, and children, nobody LETS rape happen, they are victimized by a rapist and they survive that rape.

Men and boys of all ages can be raped by other men and boys. Men and boys can be raped by women, although this is the rarest form of rape and sexual abuse/assault it does and can happen. Typically the most common form of sexual abuse perpetrated by a woman toward a man is between a female relative (older) to a male relative (younger) when the power balance and physical strength is on the female’s side. The male relative may be told ‘that’s a fantasy come true’ when he tells his story of being raped by an older woman, but of course, for many young men this is no sexual fantasy, this is rape.

A man or boy can obtain an erection even against their will, because our bodies respond whether we emotionally wish them to or not, this is also true of women. A man or boy may be able to be touched to erection and then raped, and orgasm, and thus he may feel he was not raped even if he emotionally feels he was. A woman or girl can also experience this. The fear of ‘I came so I must have liked it’ is one big reason why males in particular do not talk about their sexual abuse. Another reason is, if a boy is raped by another boy, he feels people will think he is gay and whether he is or not, this can be a palpable fear in many social settings that perceive being gay negatively in some way.

For a boy who is not gay, being raped by a male, to the point of ejaculation is horrifying and leads them to have many internalized fears of ‘I must be gay / I must be twisted / I liked being raped’ instead of seeing that climaxing is no indicator of pleasure, it is a physical response to stimulation. Likewise, if raped by a member of the same-sex, the rape can be physically damaging, and emotionally scaring because that male may never have considered that they too could be raped. For girls and women we’ve always known it was a possibility, it doesn’t make it easier BY ANY MEANS but it’s a socially known phenomena, less for male-on-male-rape and yet, it has been used for years on the battlefield with both sexes.

Rape isn’t about sex it’s about domination, control, sadism, anger, violence.

Sometimes sexual pleasure is another reason that is gained by the rapist who inflicts pain, control, domination, fear, anger, violence. In other words, they get off on it. That’s the definition of a sadist and probably a sociopath (someone who has no empathy or regard for others). Equally narcissists can be deluded into thinking anything they do to anyone must be good because it feels good to them.

Those kinds of people capable of rape are our norm. But what about the good person who rapes? Is that possible?

Many times a best friend rapes their friend. In such incidences, everything you thought you knew flies out of the window. How could my best friend do this to me? What did I do to deserve this? You didn’t do anything. Sometimes people, even good people, do terrible things. We should not excuse a good person who does a terrible thing, because they committed an act that will stay with us forever. Oftentimes though, these are the very rapes that go unreported and can occur before adulthood.

Of course who wants to report rape when the system is broken? Ideally everyone should, that is the only way rapists are stopped. But even if you don’t, seeking therapy to work through the messed up feelings you will have afterward, as well as checking yourself physically and ensuring you are protected as much as possible from disease and injury is essential. This can and should include, an examination, evidence collected for should you proceed with a case (and you may not know if you want to at the time so get it taken so you have that choice) documentation of damage (for future reference in relation to your long-term health, blood tests for contracted sexual diseases and treatment if applicable including but not limited to, prophylactic treatment.

prophylactic treatment can include certain antibiotics that work to counter certain STD’s that are commonly transmitted. Others include The Morning After Pill which is not an abortion pill but a pill that prevents conception much like the regular pill but is taken once during the first 72 hours after a man has ejaculated inside you, to prevent unwanted pregnancy.

The least well-known prophylactic treatment is a HIV prophelactic. If you believe your rapist may have had HIV this is one measure to prevent contraction. You are given a large quantity of medication similar to the HIV treatment for up to six weeks typically a month, they have side-effects but they are reliable in preventing HIV transmission. Many people do not know about this and if it is applicable, it should be requested.

What about adults of childhood sexual assault? They are often raped in childhood, it is often a secret, as adults they may have scars and side-effects from this abuse including STD’s which further the shame and humiliation they feel. Seeing a good doctor who can go through your history and check on you regularly as well as prescribing appropriate medications can help though often the damage can be lasting and far-reaching which is why children abused in secret is so devastating as many are never treated until it’s too late.

With therapy it is never too late. I have seen people in their eighties who until that moment had never spoken about being abused as a child and at the termination of therapy they were glad they spoke out. It is never too late. Never.

But if you don’t get therapy for someone you love, it might lead to things you couldn’t imagine like them becoming the predator and abusing another child, as I saw many times happen, not because they were evil but because it’s a taught, learned maladaptive behavior that can be acted-out to the extent that the line between ‘abused’ and ‘abuser’ is blurred and finally, lost.

If you are friends with someone who has gone through something like this, be a friend to them and talk with them about it, don’t side-step around it, let them know you care and want to talk about it and encourage them to talk to a professional also.

Childhood sexual abuse survivors can be among the strongest most resilient souls you could ever meet, they are often the most inspirational and giving and helping. Nobody has to be destroyed by childhood sexual abuse, it is very rare that they are, but those who are, need the voice of us all, to prevent as much as we can, this quiet abuse that can be occurring right next door to us. We should all know the signs and symptoms of an abused child and not be afraid to check on a child we fear might be at risk of abuse.

That said, temper enthusiasm for helping with caution. Being brought up by a single father, many assumed I was at risk for being sexually abused by my father. He never did and never would, but I could see why they may have found it unusual for a small female child to be reared by their father. I was appreciative of their caution when I look back, but glad it didn’t cause further enquiry as that can be as damaging as doing nothing. It may be a fine balance but together, we can lower the number of children who are invisibly being abused in our society right now.