If a woman in your practice discloses a history of childhood sexual abuse, it may be difficult to know what to say. She may catch you "off guard" with a disclosure of abuse leaving you feeling unprepared to respond adequately. Remember that just a few simple sentences is often all it takes to make her feel validated and heard. Here are some ways that you could respond:
- "I am so sorry that you went through that experience. I am honoured that you felt you could tell me. You can be assured that the information you shared with me will be kept confidential."
- "It was very courageous for you to share your experience with me. It can be important for women to tell their care providers about childhood sexual abuse. I will make sure to take extra time when needed to explain or review information so you are making choices that are comfortable for you."
You may want to ask her whether or not she has had the chance to work with a sexual abuse counselor or therapist. She may have already had lots of assistance in working through her abuse and just wants to be honest with you about her past. Because there is such a strong link between childhood sexual abuse and such conditions as chronic fatigue, migraines, chronic pelvic pain and digestive disorders, it is absolutely beneficial in meeting her medical needs to elicit (in a respectful and sensitive manner) disclosures of past abuse.
Remember that the more you start screening for abuse histories, the more practice you will get at responding to abuse. Whatever you choose to say, ensure you are engaging with her by making eye contact and giving her your full attention. Survivors of childhood sexual abuse tend to be incredibly perceptive and are able to "read" people's body language very well. If you convey that you are in a rush or are disinterested, she is not likely to trust you again.
Please Remember...
- Sexual abuse is traumatizing regardless of the age of the victim
- Sexual Abuse is a violation of body, boundaries and of trust
- Feeling safe is an absolute requirement in any interaction she has with you given the boundary violations she has experienced.
- Make sure to be mentally prepared and have referrals ready should she request it.
From The Handbook on Sensitive Practice for
Health Professionals: Lessons from Women Survivors of Childhood Sexual Abuse
ISBN 0-662-29522-6, The National Clearinghouse on Family Violence
See also the section on Survivors of Childhood Sexual Abuse, including our suggestions on how to assist survivors of Childhood Sexual Abuse through the childbearing year.