Independent Nurse: Professional - Supporting victims of childhood sexual abuse.

Health professionals can help patients recover from psychosexual trauma, writes Graham Wilmer.

They call 'it' childhood sexual abuse; sometimes 'it' is even shortened to three little letters - 'CSA'. When you read a newspaper report about the conviction of a child abuser, there is often a quotation from the trial judge stating that 'the 'victim' will need counselling'.

So far, so good, except that it's not. The victim could be a child; it could be an adult; could be male; could be female, but regardless of what the judge has said, they will probably not receive anything like the counselling or support that they need, not just after the trial, but in the years that follow.

Unfortunately, the type of specialist support (such as complex psychotherapy) needed by victims of childhood sexual abuse, rape, incest or sexual abuse in later life is not available from most NHS trusts.

Then there is the added complexity of victims not actively seeking help, either through their own fear, or through lack of understanding of the root causes of their problems.

These are the 'victims' who have never been identified, but have lived with the impact of their abuse for years, coping; struggling; crying; drinking; failing; drinking some more; taking drugs; running away; self-harming; living dangerous, chaotic lives, silent, fearful and ashamed. For these 'victims' - and I am one of them - life can be a lonely and difficult experience.

Psychosexual trauma

What we are really talking about is psychosexual trauma. However, unlike the trauma of, say, a car crash, it isn't over in a flash. Trauma usually occurs over a prolonged period, and its impact lasts a lifetime.

During the period of the abuse itself, the traumatic images; emotions; sexual feelings; and other associated sensory signals, such as sound, taste …