Childhood sexual abuse and mental health: there are many more like Whitney

“Whitney”, the latest expose documentary about the life and career of Whitney Houston, has finally arrived at UK cinemas. Publicity for Kevin Macdonald’s film promised an investigative and intimate retrospective, featuring some rare never-been-seen performances as well as, it seems, some never-been-spoken discoveries about the star. One such discovery references that the singer was allegedly sexually abused as a child, and this has never been revealed or spoken about until now.

"Non-verbal communications, such as what is felt in the transference, often speak louder than words which are already difficult to express."

As a psychotherapist who specialises in working with trauma it would be all too easy to read the documentary reviews, piece together the tabloid stories and insightfully declare that “all the signs were there!” But back then as a childhood fan of Whitney and then latterly as someone who in a previous life worked in the entertainment business and was actually fortunate to have worked on productions which hosted the Houston and Warwick camp in the late 1990s – 2000s, I was none the wiser.

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Thinking back, I don’t ever recall hearing any rumours; it’s true that an artist’s PR machines can bury almost any unfavourable stories, but there’s always a rumour and according to Macdonald’s pre-publicity accounts the abuse was something which had been buried within the core of the family for many years. It was kept away from her (in the beginning) flawless career. Given the fundamental role that secrecy often plays in the 'success' of child abuse, the hidden or buried aspect of this particular narrative comes as no surprise.

In an industry which romanticises the conceptual tortured artist and perhaps in hindsight unconsciously disguises ill mental health as creative genius, there was no reason back then for me to think of Whitney as anything other than another industry casualty, who fuelled by drugs had burnt too bright, too fast and not, as a young woman who was unconsciously acting out her secret trauma. I would never have imagined that what we were watching in the media were the symptoms of the abuse and not the deep-rooted cause of her very public demise.

All too common

Childhood sexual abuse or CSA was formerly seldomly discussed or acknowledged. It has over the last several decades increasingly garnered attention both in the media and by professionals as being a “serious problem” and it is said to no longer be seen as a subject which is taboo; although the survivors and prevalence figures may suggest otherwise.

The prevalence of CSA is difficult to state accurately as it mostly goes unreported or undisclosed. However, despite the ambiguity around prevalence statistics various findings reveal that CSA affects a substantial percentage of the population (Brown and Tessier 2015).

CSA can be defined as any sexual contact with a child through the use of threat, force or deceit to secure a child’s participation or any sexual contact with a child who is incapable of giving consent by virtue of power differential, age or disability. Although both genders are vulnerable, girls are considered to be at greater risk, however the long term psychological and social impact on both are similarly deleterious.

Working at a small but overstretched and underfunded Women’s Psychotherapy service in North London, I would say that with very few exceptions all my cases feature various levels of Adult Sexual Violence and CSA in the narrative. Not entirely surprising as research shows that adult survivors of CSA have a considerably higher risk of developing long term mental health difficulties in contrast to the overall population.

Impact

Although each survivor’s experience is personal and unique, there is a commonality which binds them together and this is the profound short and long term mental, social and physical effects that CSA has on its survivors as well as the clinical presentation of fundamental core difficulties found within the varied symptomology and associated Mental Health Disorders.

These core difficulties include, cognitive distortions e.g. feeling responsible, self – blame, feelings of being dirty, spoiled or even cursed. Substance disorders such as drug and or alcohol dependency, eating disorders, inter relational problems, depression and anxiety, low self - esteem, problems with social adjustment and emotional functioning, trust and intimacy difficulties and symptomology which suggest PTSD or Complex PTSD.

Many years, even decades, after the abuse has ended survivors still seek to make sense of their experiences and the damaging psychological effects that just don’t seem to ease with the passing of time and this is what eventually leads them to seek therapy.

Healing process

When working with survivors of CSA it is essential first to provide clearly set out boundaries which create the therapeutic frame and provide feelings of safety and containment. Boundaries are broken psychologically and physically in cases of CSA and are therefore of great importance when working therapeutically.

Within the work itself I work together with survivors to help them to reflect upon how the abuse has been incorporated into their sense of self, sense of others and the world they live in. As the work progresses the survivor gradually makes links between past events and current difficulties which help them to process and give meaning to their psychological and emotional pain.

Empowerment is an important part of the work, I encourage survivors to find their voices and to speak what has been previously unspeakable. I never push for details of the abuse. When working with survivors of CSA it is important to avoid re traumatising the survivor by insisting on evidence. Non-verbal communications, such as what is felt in the transference, often speak louder than words which are already difficult to express.

It is important for survivors to express internalised rage, to mourn their loss of innocence, of childhood and self. Therapy often for many, also provides a chance to be heard for the first time. This is the opportunity for them to both reframe and reclaim their personal narrative.

The most important aspect of the healing process, I believe, is the therapeutic relationship in itself. Survivors of CSA can often develop fearful relating patterns; the relationship between therapist and survivor should provide a reparative experience of relationships. I believe that this is the path to resolving that which overwhelms and help move towards a space of healing and recovery.

There are and will be more like Whitney. Changing attitudes around stigma, shame and judgement as well as recognising the powerful impact that CSA has on its survivors helps to encourage open dialogue and critical thought. This in turn can help survivors to regain control, develop better coping mechanisms, agency and access to parts of the self which have been hidden. There are thousands of survivors who won’t have documentaries made about them, yet their stories must also be told and documented to help break the silence.