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15 January, 2012


For the most part, the hallucinations of sexual abuse survivors may be categorized as being simple; un-elaborate.  However, in some (thank heaven) rare cases, hallucinations in multiple modalities may combine in a perfect storm.  If you have not yet read through all the other posts, doing so will help you understand this one.

You will recall the shadowy figure that appears in the bedroom doorway, or at the foot of the bed.  In a perfect storm that figure may approach the bed.  The survivor may hear its footsteps and breathing.  As it bends closer she may smell the alcohol on its breath and feel the bed be depressed as it gets in with her.  I need not go further, but the hallucination may do so.

Perfect storms and other elaborations of otherwise simple hallucinations appear to be associated with particularly vicious and prolonged abuse, but they also tend to be associated with secondary substance abuse.

If you could visit any drug rehabilitation facility and ask the females who had been sexually abused as children to raise their hands, the count will be at least 90%. I suspect most of the rest, save a couple of percent, are either not telling the truth or have no conscious recall. The fact is that the social devastation wreaked by sexual abuse is tremendous, reaching into such far-flung areas of concern as substance abuse, prostitution, pornography, domestic violence, child abuse, marginal societal functioning, chronic health problems and multiple, associated mental health problems.

The latter have long distracted clinicians from the powerful intrapsychic symptoms described in these posts.  It’s easy (and common) to note such symptoms as depression, chronic anxiety, relationship problems, low self-esteem, drug abuse and the like.  Those presenting problems are often what bring the survivor into one treatment or another.  Working on those problems can help, but the gold is to be mined in helping the survivor link the more specific PTSD symptoms with their prior experiences.  The hallucinations of survivors often lead them to believe they are crazy (which is actually paradoxical testimony to the fact that they are not crazy).  Just the ability of the counselor to normalize the hallucinations by guiding the survivor to the recognition that they are expectable reactions to extraordinary trauma can provide great relief.

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