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Ask the Mental Health Expert Archives 2001-2004

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Aftermath of Child Molestation

Q. If someone was molested at a young age and continually tries to push away everyone who cares about her, is it possible that she will ever find a lasting and stable relationship? I'm very concerned about my sister... she says she is lonely, but it's like she creates her loneliness by pushing everyone away, including even her family.

A. The experience of sexual or physical abuse during childhood very often leaves lasting psychological scars, as I'm sure you know. But this doesn't mean that with time, effort, and probably long-term psychotherapy, someone who was molested can never find a "lasting and stable relationship". If we deal with the cold, hard statistics, we find that not everybody exposed to trauma develops clinical signs and symptoms of post-traumatic stress disorder.

According to the research of Dr. Naomi Breslau and colleagues, published in the March 1991 Archives of General Psychiatry, more than 75% of individuals exposed to typical traumatic events did not develop PTSD. (The rate of PTSD was 80% in women who reported rape, but that leaves 20% who did not develop PTSD). Breslau's group found that the risk of developing PTSD after severe trauma is increased by several factors: early separation from parents, neurotic traits, pre-existing anxiety or depression, and a family history of anxiety. So the risk of PTSD springing up is probably much greater when a traumatic event falls on fertile soil.

I don't know whether or not your sister suffers from symptoms of PTSD, but pushing everyone away could be consistent with that diagnosis. It might also signify another anxiety or a depressive disorder. If she is not already in psychotherapy, I would strongly suggest she consider this. Medication may also be helpful in dealing with PTSD symptoms (such as hyper-arousal, flashbacks, emotional numbing) as well as depression.

I also recommend the book, Coping With Trauma, by Jon Allen, for both traumatized individuals and their families. On a personal note, I have seen a number of patients with very traumatic early histories go on to find happiness with another person in a close and intimate relationship--but it isn't easy, and it certainly isn't without its rough spots.

March 2001

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