Physical symptoms in sexually abused women: somatization or undetected injury?

Abstract

Medically unexplained physical symptoms and disorders in women sexually abused in childhood are widely interpreted as somatization-the expression of emotional pain and stress through bodily symptoms. However, the somatization theory is not based on detailed knowledge of the abusive incidents, and may underestimate the direct effects of violence and injury, repeated over years, to 'The direct effects of violence and injury, repeated over years' children's developing bodies. When adult survivors fully describe their childhood abuse, the extent of violence involved becomes clear. For example, their accounts of oral abuse invite us to reconsider how 'psychogenic' conditions like paradoxical vocal cord dysfunction or temporomandibular disorders may have come about. This also raises the important issue of whether paradoxical vocal chord dysfunction should be reclassed as an abnormal and suspicious sign in children. The paper outlines several forms of research which may elucidate further the role of physical damage and injury in adult survivors' physical disorders, including prospective studies; retrospective studies in collaboration with sexual abuse survivors; and comparative studies of international literature on the long-term physical health effects of torture and child marriage.

Mental health problems and medically unexplained physical symptoms in adult survivors of childhood sexual abuse: an integrative literature review

“…It was rare to examine case histories and/or medical records (Arnold et al . 1990) or to find case samples selected from identified survivors of CSA, for example from survivor support agencies or group therapy programmes (Nelson 2002, Larson et al . 2005).…”

“…1993, Morse et al . 1997, Nelson 2002, Warwick 2003). The paucity of such studies meant it was difficult to gain a detailed picture of how adult survivors themselves saw any interconnections among their own mental health, their somatic symptoms and abuse history.…”

“…Others have questioned somatization's assumed interconnection between mental and physical symptoms. Severity of oral sexual assault suffered by interviewees with throat, mouth and respiratory conditions (Nelson 2002) challenged assumptions that vocal cord dysfunction or temporomandibular disorders were of psychogenic origin. She suggested that sexual violence may generate independently both psychiatric and physical symptoms, just as a violent street rape may do, and more extreme symptoms may reflect more extreme violence.…”

‘I've Been Walking on Eggshells All My Life’: Fibromyalgia Patients' Narratives About Experienced Violence and Abuse

“…Moreover, individuals who have experienced sexual violence often suffer from gynaecological symptoms, vulvodynia, vaginismus and obscure pelvic pains. Problems in swallowing and other symptoms of the mouth and throat area have also been reported (Campbell, ; Laitinen, ; Nelson, ). Many symptoms may occur years after the violence occurred and present in the form of sleeping problems, fatigue, depression and stress symptoms, such as anxiety and flashbacks (Campbell, ).…”

A Person‐Centered Counseling Approach as a Primary Therapeutic Support for Women With a History of Childhood Sexual Abuse

“…This incongruence may emerge throughout these women's lives while they subconsciously wear a "mask" to avoid their true self because of the magnitude of hurt and pain within. In other words, the trauma experienced by these women contributes to increased levels of repression and dissociation, leaving them feeling less whole (Nelson, 2002). meeting these clients where they are in the therapeutic process is of paramount importance with regard to the healing and restoration of the self.…”