I did a thing..... I started a podcast. I'm going to share it here and see how it goes. I was working on YouTube videos, but find it's hard to take the time to make those, and a podcast is just a little easier to do these days. Listen here at -  Therapy Thoughts with Hanna

Preventing, Addressing, & Healing Child Sexual Abuse
 
I created this article and an accompanying video because there is very little comprehensive information available online in addressing Child Sexual Abuse.  I am creating this to help parents, caregivers, therapist, etc. who want to tackle this difficult topic.
 
Topics Addressed Below Include

• Where abuse takes place and who abuses
• Prevention
• Warning signs something happened
• The outcry
• The healing process

 
Where & With Whom Abuse Takes Place

• Overnight slumber parties
• Family, including extended family
• Childcare
• Church
• Any religious or spiritual institution (for example many types of yoga are implicated these days)
• Clubs (like scouts and sports clubs)
• Online grooming through games and social media
• Anyone the person might know that has access to them in their communities

 
Statistics tell us that 1 in 10 children will be abused by age 18.  This is a staggering number.
 
It is important to be aware that childhood sexual abuse happens to both boys and girls.
 
You are encouraged to look up grooming on places like the center for child protection and other sites.  Read their articles and blogs to understand in greater detail how gaining access to a child takes frequently takes place:  for example this article here
 
Prevention
 
The first important method of prevention is to help kids understand and be prepared for the risks.  Families can read books like, “I Said No!” and other age-appropriate books one can find at local bookstores and on amazon. Create a rule in your home of “no secrets, only surprises” and if anyone tells you to keep a secret it’s a sign to tell your mom/dad/caregiver as soon as it’s safe.  Help kids understand it’s tricky when someone tells them to keep a secret, but it’s not ok for a friend or adult to ask them to do so.  My kids will say things like “only surprises, no secrets”.
 
A very concerning trend is porn on phones/devices that is easily accessible for teens and kids.  Children and youth often do not know what to do with the graphic images, and there is a risk of acting them out.  For several parents and families I have encountered, this was a part of their story.  It’s important to keep an eye on social media and cell phone activity.  It’s also important to let children know if they ever see images on a phone or device and feel funny in their tummy, it’s ok to talk to mom/dad/caregivers about what they have seen.
 
It’s also important to prevent the cycles of abuse by breaking stigma and addressing child sexual abuse.  A lot of times child sexual abuse was never addressed or healed, and is passed on in the same scary secretive manner it occurred in.  It’s a coping mechanism for kids to act out what they have been through, so keeping an eye out for sexual acting out and asking about anything you notice with curiosity and compassion.  It’s important that we ask tough questions with children to make sure they are safe and keeping each other safe.  Many adults naturally shut down and go into denial in the face of these situations, making the toxic secrecy of this abuse that much more toxic.  Through education and helping professionals we can begin to heal this epidemic in our communities.
 
Warning signs something has happened
 
First, don’t assume it hasn’t happened or won’t happen to your family/child, even if you’re a police officer, counselor, social worker, community leader, teacher, well educated, etc.  Remember that child sexual abuse occurs with at least 1 in 10 children before age 18.  That means most of us know a family or child that has been impacted.
 
One of the first signs to notice is a child not wanting to go somewhere or with someone.  When children start showing symptoms and signs of resistance to going to family member’s homes, friend’s homes, neighbor’s homes, church gatherings, club gatherings, etc. caregivers need to listen to the resistance and begin to ask questions about safety.
 
Another symptom that something might be occurring is not eating or sleeping well, and/or having increased nightmares.  Sometimes wetting the bed, often well past potty-training years, can occur. Perhaps the child got out of bed at a sleepover and the abuse occurred, so they begin to fear getting out of bed to use the bathroom.  There can also be difficulty potty training in younger children.
 
Sometimes caregivers will notice a significant change in social behaviors such as suddenly getting shy and/or being overly clingy in ways they weren’t before.  There may be sudden difficulties or withdrawing in social situations.
 
Another sign might be playing out the abuse with dolls and/or other kids.  Inappropriate play, again, is a child’s way of trying to figure out what happened to them and why a play therapist is the best direction for getting help if concerned.  Children are not trying to be “bad” in play, they are trying to make sense of their world.
 
 
The Outcry
 
Sometimes the first thing to be revealed is the threat to keep the child silent and the rest will take time.  Let your child take that time. 
 
The child may need a ton of reassurance that if they tell the secret they were told to keep they won’t have to be around that person or place again.  There may be potentially strong fears if threats were involved to them or their family.
 
If your child is indicating something scary happened with a person or at a specific place, for young children, it may be easiest to ask them to show you what happened. They may act out the threat.  For example, they may show you how they were threatened by using a doll or by acting it out.  Remain as calm as possible, get support, and do your best to listen with reassuring care and reminding them that they are safe.
 
Children may have conflicting feelings around caring about the person that hurt them because they have been groomed.  This can be very hard for a parent/caregiver to witness but know that you will be working on it with professionals, and you do not have to correct the way it is coming out for the child.
 
Do your best to not ask a ton of questions or any guiding questions. Also, do your best to support them with what they are sharing.  The caregivers job at this time is to provide listening support and reassurance of safety. 
 
The very first thing to tell a child revealing sexual, or other abuse is, “this was not your fault”. This may seem obvious, but it has to be stated, and it needs to be stated again and again.  Children need to be told they did not do anything wrong.  Just like adults that are assaulted need to hear that they did not bring the situation on, children need to be reassured of this as well.
 
They need to be told they are loved, cared for, and safe.  They need to be told they were brave for telling. Sometimes, as they get older, they need to be reminded they are not broken, there is nothing wrong with them for what happened to them, and that they did amazing healing work as children/teens/adults. 
 
After the outcry notify police, the police will provide a case number and schedule a forensic interview at a child protection center.  Ask how to best prepare your child for the interview. Ask any questions you need about how the process will work.
 
More details may come out once the secret is shared.  You can look for a counselor for your child during this time, but sometimes starting that process is best right after the forensic interview, check with the play therapist or center that will conduct the interview.  Parents and caregivers will likely need support as well.
 
Sometimes victim’s compensation can help, and a social worker should be assigned from the forensic interview to help with that process.  It’s good for everyone to get lots of support.
 
Know that most of the time the people/places will deny that the child sexual abuse happened.  It can be very painful to have that kind of denial come from a neighbor, church, community center, family, etc. that you once knew and trusted.  Rarely have I heard of a family that has gone through this process and opened an investigation into the situation get restorative justice.  The other parents/family members/community members frequently deny and “protect” their accused child or adult.  Leave that process to the police and professionals.  Unfortunately, most of the time it becomes a child’s word against their perpetrator in the legal process. This does not mean the abuse didn’t happen, it’s just very hard to build evidence. You have to let go of the justice side, and focus on protection and healing of the trauma.
 
Sometimes the details coming out get messy, the child may defend the person, change their mind about what happened, play out the scenario in confusing ways, and act out what happened to try to figure it out.  You may need to supervise sibling play/friend play if very young and help a child know what to do with those thoughts or urges.  For example, helping them act it out on a stuffy, talk about it with their play therapist, or trusted parent/caregiver, etc. Also, if they are in play therapy and getting the help and support, they need, this can alleviate the compulsion to try to figure it out through play, and this concern often resolves.  For very young children there may be some questions about diapering by parents or other caregivers as they get a little older and they may need to know what was/is safe and what was/is unsafe.  It's important to let them ask questions and help children get clear about safe vs. unsafe people, situations, and actions.
 
It is normal for parents to feel guilty about not realizing sooner or noticing more signs.  This is a family trauma.  Just as the child needs to know this was not their fault, reminding yourself that as a parent of caregiver is also very important.  Forgiving yourself for what you did not know is some of the most important therapeutic work for a parent/caregiver.  The intensity of the pain from the outcry and abuse does fade with time, and healing is possible for the child, parents, and family. Also, it’s important to know that the healing may move at different rates as people work through the stages of grief.  One parent may stay stuck in denial, while the other parent is angry or deeply sad.  It is important to get individual, family, and play therapist on board as needed and as guided by mental health professionals.
 
The Healing Process
 
Certified registered play therapist are recommended for younger children.  You may want to interview a few while listening to your instincts.
 
Continue to work on empowering your child and providing education and guidance and reminding them it is not their fault.  There are some very helpful and awesome books available like A Terrible Thing Happened and Healing Days. I have used these books with teens/adults that did not address what happened until later in their teen years or adulthood.  Remind children that it is ok to talk to their trusted play therapist about anything they need to.
 
While it’s scary to wonder what impacts this might have on the family and your child, when working with good professionals you will all learn the healing lessons in this as well, how to reach for help when needed, who can be trusted, how to not keep toxic secrets, how to love each other through painful times in life, building resilience and developing instincts and intuition about who/how to trust and when to get help. 
 
A lot of kids just want to feel normal with their friends and in their life, and it’s important to help them restore this sense of normalcy.  It’s important to remind them they are safe, loved, and able to speak up when bad things happen and get the help they need.  It's important to keep reminding kids that they did not do anything wrong, and there is absolutely nothing wrong with them in having gone through this. There is plenty of good in this world and there are plenty of helpers.
 
Also, it’s normal for this to come up at different stages of life with new sets of questions.  This may come up again when the child hits puberty, as they become teenagers and young adults and begin to date, and when they learn it has happened to others.  It’s healthy to remind kids they can talk about it or get the help they need whenever it comes up.

Focus on the Basics
 
One of my favorite mentors in the counseling world shared with me that when life is overwhelming, it’s important to focus on the basics.  It’s ok to actually make this your sole focus sometimes.  Focus on getting enough sleep and rest, eating an adequate and healthy enough amount of food, and getting a little exercise.  This recommendation may or may not include focusing on how you will meal plan, on what time your bedtime needs to be, and how you will create a relaxing space to sleep. Focusing on basics could also include how to get in, at minimum, a 10-minute walk, even if just inside your house while watching a show.  
 
Getting in the Moment/Day
 
Grounding in the present can be very helpful.  Statement’s like these can help, “I have enough to eat today, myself/my family is safe and well today, I can take care of my needs today, etc.”  Finding gratitude in what we have today can bring tremendous comfort to many.  We know that all we really have is the present time in this day.  Take a minute to tell yourself, (for the past) “that already happened and it’s done, now I can focus on my needs for healing” or (for the future) “we aren’t there yet, I can think of that as I get closer”.  My mom used to have a great saying, “is it happening today, because if it’s not happening today, I don’t have to worry about it yet”.
 
Conscious Denial/Finding Joy in Memories and/or Joy in Future Hope
 
This might be one of the only times I recommend channeling human denial for helping with present day anxieties.  When things are very overwhelming, either remembering happy times that came before OR imagining what life will be like in a positive way on the other side of the current conditions can be helpful.  In studying the enneagram and working with people, we are oriented to time differently.  Some of us find comfort in the past, some find comfort in the future, and for some people the present is where it’s at.  Think about what works for you.  If pulling out an old photo album to remember a joyful time helps you then do that, get lost in the good memories.  If envisioning the good that can come out of present-day circumstances or a return to normal is helpful, then move into that daydreaming or envisioning.  The trick is to keep this tool hopeful and comforting.
 
Remembering What is in our Control and What is Not
 
It’s good to remind ourselves that things like a global pandemic are out of our control.  Other people’s reactions and responses are out of our control. What is in our control includes our responses and reactions.  Choosing the tools that work to help calm us and support us is something that is in our control.  It helps to sometimes state out loud to another person, or to ourselves, “that is out of my control”.  I sometimes make a list of what is in my control and what is outside of my control and start working on the things in my control.
 
Set Limits on Anxiety Stimulating Sources (news, situations, etc.)
 
I am a data driven person. I look at the data sometimes without much interpretation. For example, the news might be giving out scary information regarding the flu, yet the data shows statistically cases are decreasing.  There may be times the news is not saying much about the flu, but I want to make sure it’s not rampant, and so that if it is, I can protect myself as much as possible by avoiding crowded areas and taking other precautions.
 
It’s ok to say “this source will be my only source for today” or “I will only watch 2 hours of news today (which might be way too much for some people).  Listen to yourself and set your own appropriate limits for your well-being.  It’s ok to set concrete limits. Please be kind to yourself if you don’t follow them exactly. Like the saying in the recovery world goes, progress not perfection!
 
Also, going outside and watching the clouds or the breeze blow through the trees might help.  Changing the stimulus to soothing things in nature can definitely help.
 
Let Yourself Panic (for a little bit, with a ton of self-loving & self-compassionate thoughts)
 
One thing known is that when a panic attack reaches a certain point, we can’t stop it.  At that point we have to ride it out.  During a panic attack that is underway our bodies are responding to the threat.  What we control in that moment is what we say to ourselves.  I’m going to recommend some statements here.
 
“I am having a panic attack and I’ll be ok”.
“I’m going to be really kind to myself”.
“The reason I am afraid is _____, and I’m going to be compassionate towards that fear”
“Panic attacks only last on average 30 minutes, I’ll do _____ (deep breathing, listening to calming music, distracting myself with____, etc.) until it passes”.
“I know how to reach for the help I need, I’ll contact ________ to help me through this”.
 
We can turn the volume up on panic, or we can turn the volume down.  Below are examples of how to do this.
 
For example:
 
“My heart is racing, I’m definitely having a medical crisis” would turn the volume up from a 5 to at least a 7.
 
Vs.
 
“My heart is racing, I’m likely having a panic attack, this will last about 30 minutes, if my intuition tells me I need medical help, I’ll go ahead and call for medical help, meanwhile I’ll do some deep breathing and see if I pass through this in the next 30 minutes”.
 
Name Your Fears
 
Write down your fears and/or talk about your fears with a safe person.  I love the example on the show This is Us when Beth and Randall tell each other their worst fears, they state the worst-case scenarios out loud with each other.  Naming fears and talking about them helps them to lose their power and/or allows us to let in some compassion and support for them.
 
Noticing Hope
 
There are a lot of news sources and people that will emphasize the worst-case scenarios out there.  Make a concerted effort to look for people and new sources offering solutions and reassurance.  Sometimes it will be a mix.  Sometimes the facts are scary, but keep listening for the hopeful messages, too, and especially the ways to receive and give help.
 
Finding what works for you
 
Take some time to google search terms like “stopping a panic attack” or “managing anxiety”.  Look for meditations, yoga, guided relaxation techniques, helpful articles, apps on the phone, YouTube videos, and anything that helps you to manage your anxiety.  Try out the techniques that appeal to you, or list 2 to try this week.  I recommend the first one you focus on is tending to the basics.
 
I hope some, or all, of these tools can help you manage normal natural anxiety and overwhelm during this period of a global pandemic, or any overwhelmingly stressful time.  Feel free to share other techniques that work well for you, too.

Communication tips
 
One question that I get a lot as a counselor, is how to best communicate about hard subjects.  I hope this post will help.
 
What I typically tell clients is to move away from who is “right” and who is “wrong” and move more in the direction of expressing feelings, listening to the other person’s feelings, and negotiating needs attached to the feelings.  My favorite book on this subject is Nonviolent Communication by Rosenburg.  I truthfully tell my clients that if I could live my life according to the concepts in that book, I would have absolutely no problems with anyone.  However, I add, that I am far too human for that.  Still, when I want to get communication back on track, I rely on the methods I outline in this post.
 
I learned recently that Brene Brown, LCSW, uses the phrase below “the story I tell myself”.  I have a confession to make that I have not read many books (including hers) since having children. Though I just got audible, so I look forward to adding her books to my list.  I think so much good lingo has made it into the counseling world.  So, if you know resources of hers for communication in the way listed below, I’d love to learn about those, too.
 
Most people have heard of “I” statements.  Most people try to use them as a way to own our own thoughts instead of accusatory or judging “you” statements that frequently put people on the defensive.  Typically, the format is “when you______, I feel _______.”  While this is more useful than “you” statements, I have refined this into a formula I find works best, and provides room for even more healthy communication.
 
Communication Formula
 
I observe (notice) ________(describe the situation)_______________________
 
And I feel (FEELING WORD) _________(angry, sad, bewildered, hopeless, etc.)______________
 
The story I tell myself is __________(the story you tell yourself about what is happening, allowing room for the reality that your perspective may not be the full story)______________
 
What I wish for is _______(describe your wishes about the situation)______________
 
I’ll give an example of this in use:
 
(scenario) A boss becomes frustrated with an employee for not getting a job done the way they were hoping in the time frame they were hoping for.
 
B (Boss):  I don’t understand why when I assign projects to this team the job is never done like I ask, or on time! 
 
E (Employee):  I thought I was doing my best work, and I had some things come up that took precedent and thought you would understand and love the job I did!
 
Let’s explore unproductive inner beliefs that could develop around this:
 
B  My employees don’t respect me, they don’t like me or try to do a good job for me, I’m so done with this stuff!
 
E  No matter what I do my boss picks on me and can’t stand my work or our team, I’m so done with her micromanaging!
 
Now let’s use the formula to reframe it:
 
B I observe that I ask for a specific project to be done in a specific timeframe and that is rarely completed on time or in the way I ask for it.  I feel frustrated.  The story I tell myself is that I’m not respected in my position of leadership.  I wish that I could have something I ask for done when I ask for it and I’m not sure how to get that to happen.
 
E  I observe that you ask for projects to be done, but may not realize some of the other projects we are working on as a team can also require our focus, and that sometimes the timeframe seems too difficult to meet when we have other priorities that arise with those other projects.  I also observe that I try to do my best, but it seems to fall short of what you hope for.  I feel disheartened.  The story I tell myself is that maybe you have an issue with me or the team, and that it is too hard to live up to your expectations.  I wish that we could have more direct communication so that I’m even more clear about expectations and so that we can feel free to give feedback about the timeframe and work collaboratively around this.
 
Can you see where this could get worse in the first part, or where there is room for it to get better in the reframed model?  This model can be used in all relationships and conflict to work towards a more productive discussion where people can express and try to meet each other’s needs and wishes.
 
Caveat:  Sometimes there is a strong needs clash where it is unhealthy for one person to give into the needs of another. I frequently see this when family members have a strong sense of “blame” and the need is for the other person to “own all of the flaws and take all of the responsibility”.  This dynamic is often labeled scapegoating and it’s important for the person scapegoated to be able to successfully say, “no, I cannot meet that need or wish for you, even if I care about you”.  Healthy relationships sustain the ability for someone to say no, when it is unhealthy for them.  It’s good practice to really learn to listen to our own feelings and articulate those for ourselves and our wishes/needs attached to them, and sometimes those needs are for space or time to let emotions settle, or a need to say “no” to a dynamic.