The prolonged and silent agony of sexual abuse

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Demonstrators hold up banners as they protest against gender based violence in Sandton, Johannesburg Friday, Sept. 13, 2019. The protesters are calling on President Cyril Ramaphosa to declare a state of emergency, a day after the country's latest crime statistics were released. (AP Photo)

The pain of sexual abuse lingers long after the initial trauma. Like a silent cancer, the memory of pain, eats away, at the victims brain. No pill can stop the nudging pain.

It manifests, frequently, as bouts of unexplained anger, suicidal depression and a range of somatic symptoms that is refractory to the best treatment that medical science can offer. The persistence of the emotional pain results in a number of failed relationships and broken marriages, adding to the victim’s pain.

In the thirty odd years that I have been counselling victims of sexual abuse, one thing that stood out was that the majority of the victims have been been females and almost all of them presented in their thirties and forties, even though the trauma took place whilst they were children.

Almost all of them never shared their pain with anyone, not even their own mothers fearing that they would not be believed or chastised for lying. Besides, why would these women share such devastating information to anyone and run the risk of it being used as a weapon against them by their nearest and dearest. Many were abused by older cousins, uncles and dads. Because of the family dynamics and socioeconomic challenges, the crimes were brushed under the carpet, and the victims had to suffer in silence. 

In many instances, mother and daughter bore the pain silently, resenting the presence of the perpetrator, who blithely carried on as if nothing had happened. One female in her forties, whom I treated for over ten years, plonked herself onto the chair, one afternoon, and told me that it was her dad’s funeral but she refused to attend it. He abused her when she was a child and she resented him ever since. She never mentioned this to anyone before. She felt she needed to speak to me because the trauma of her past was suddenly revived by the funeral. She needed the assurance that her anger was justified.

The only reason she spoke to me was because she finally plucked up the courage to trust me with this damming trauma that she had to carry along with her all her life. I could see the sense of relief as she unburdened her pain and I felt complimented that she could trusted with her pain. Who can blame her for not trusting anyone?

I saw her over fifteen years ago, but I still remember the consultation, because her traumatic experience left an indelible mark in my mind about the pain that she went through all her life. This was probably because she always presented herself with the most pleasant disposition whenever she consulted me. I could not imagine, what must have gone through her mind when she got married and had children.

Fortunately, unlike many other women, she has the most wonderful husband and loving children. Ever since that little session, she blossomed in her life and managed to overcome her pain and get on with her life. I have treated several other victims, and, my latest patient, a female in her thirties, was raped at the age of two in a shebeen, where her mother was drinking.

She presented with bizarre pains all over her body for the past month. I thought that most of her pain could be ascribed to her depression, after she lost her child about three months ago. It was after her third visit, that she casually blurted out to me, on the couch,  that she was abused at the age of two and several times later in an orphanage by older boys. Her mother was too steeped in alcohol to take care of her and her siblings, so she was exposed to the wolves.

What amazed me was that she could still remember being traumatised when she was just two years old. It was only when she was much older did she feel the mental impact of the trauma, which manifested as generalised and unremitting physical pains all over her body. After unleashing her mental pain, all her physical symptoms abated.

I have treated several women for severe depression, intractable headaches, strange outbursts of anger and bipolar depression. I suspect that many of these patients might have been abused in their early life but they have never been able to speak to anyone about it. It is a great pity that they don’t, because, the patients that have spoken to me have made tremendous strides in their life after sharing their pain with me.

Based on my experience, a vast number of women that have been sexually abused, suffer in silence. They suffer even after they report their perpetrator to the law because they have not dealt with the emotional and psychological pain. This aspect of the trauma, is rarely ever treated. The least we can do for these women is to create safe places, where they can be offered counseling in the most confidential manner apart from the numerous ongoing initiatives to teach boys and men to stop abusing females.

Everyone has a duty to protect females and children from abuse, not just the law and the government.

Dr Ellapen Rapiti is a family physician, specialising in child and mental health and addiction counselling.