**8. Intergenerational transmission of the trauma of sexual abuse and motherhood**

Johnson [62] claims that people who are victims of emotional, physical or sexual abuse are six times more likely to continue the abuse they have suffered. Other studies [63] have shown that half of the mothers whose children have been sexually abused have, themselves, been victims of sexual abuse. If the act of sexual abuse is not transmitted, this does not mean that the children of sexually abused parents will be safe from sexual abusers. Relational family therapy [16] discusses the unresolved effects of abuse, including disgust, shame and anger. These are vertically transmitted from the abused parent to the child through the mechanism of projec‐ tion-introjection identification. Even if this parent tries to warn the child about all the dangers of abuse [64], but is not in touch with the unprocessed effects and therefore does not know how to protect him/herself and set boundaries, it is much more likely that the child will become a victim of sexual abuse [16]. Miller suggests something similar in her *The Body Never Lies: The Lingering Effects of Hurtful Parenting* [65]. Here, she argues that childhood abuse is resolved in two ways: grown-ups who have been sexually abused as children transmit their unacknowl‐ edged emotions to their children or other people around them. Alternatively, the effects are suffered by the body of the abused person with psychosomatic or chronic diseases. In his study, Cross [55] reports that 34% of mothers whose children have been sexually abused have, themselves, been victims of sexual abuse. In their work, McCloskey and Bailey [66], state that it is three to four times more likely that a daughter of a mother who was a victim of sexual abuse would herself would be sexually abused, than in cases when mothers had no experience of sexual abuse. They believe that a common reason for the transmission of sexual abuse between generations is the preservation and continuation of contacts with the family members involved in the sexual abuse of the mother and then, also, the daughter. Other studies have shown that mothers of children who had been sexually abused like them exhibit a higher degree of stress and symptoms of post-traumatic stress disorder [67]. Additionally, they express fear that they will be bad mothers, directing hostility and frustrations towards their children [55]. Sexually abused mothers also show difficulties establishing a structure, express‐ ing affection and love for their children. They feel mixed emotions towards them and fear that their children will also become victims. This often results in them socially isolating their children, in order to protect them [55]. The results of a study by Hall, Sachs and Rayens [68] show that mothers with a history of sexual abuse use physical punishment on their children six times more often than mothers who have not been sexually abused. Cohen [69] stresses that, if they have not worked through the abuse, sexually abused mothers are less skilful and functional in the parental role.

abused mothers show significantly more trusting, deferring, relying and submitting behav‐ iours [59]. Grocke, Smith and Graham [60] have found that, compared to children of nonabused mothers, children of CSA survivors are more prone to interpreting ambiguous pictures of children and strangers as negative or frightening. They also believe that sexually abused mothers teach their children about the male and female sexual development and contracep‐ tion-related topics in more detail. Such mothers find this increased communication essential. This is because they presume that it will protect their children from a experiencing a similar sexual abuse. On the contrary, Douglas [61] reports that mothers with a history of sexual abuse are more anxious in child care, requiring intimate contact such as changing, bathing and putting to bed. Even though these activities, as such, are not "sexual", they may indicate that, because of the mother's unease, sexuality and intimacy will be taboo topics in the child's

Women who are aware of having been sexually abused may often fear that they will themselves **abuse** their child. The fact that the mother is afraid is a sort of safeguard and it is, therefore, quite unlikely that she would sexually abuse her child. However, there can be situations in which she feels aroused. For example, during the changing, bathing or breastfeeding of her child. Her body tells her that what is happening is not natural, that it is perverted. Particularly, this can happen if she, herself, has been sexually abused on the changing table. In this case, she may not even have the images in her explicit memory, that is, she cannot recall the event of the abuse. It suffices that her body remembers it, that the abuse is recorded in the organ memory - in implicit memory. If arousal or disgust occur, it is important that the mother controls herself, that she takes time to evaluate her feelings. In other words, it is necessary that she sets boundaries and becomes aware that it is her abuse reawakening; that her child deserves pure love. She has to feel able to withdraw, go to her partner and communicate these feelings if she is unable to process them herself. When this does not work, it is necessary that the mother seeks the help of a professional who will assist her in going through the emotions of abuse (disgust, shame, etc.) and help her work through them. It is not necessary for inappropriate touching to occur during the changing or bathing of the child, the atmosphere can already become terrifying and abusive when the mother feels aroused by the child's innocent and powerless body (just like someone who sexually abused her as a little girl was aroused by her as an innocent and powerless child). At the same time, the mother feels contempt for and disgust with herself for having these feelings. These feelings and real bodily sensations are unfair, both on the mother who experiences them and on the child who, through the projectionintrojection identification, senses and feels her distress or, even more, when the child drinks these feelings of abuse on her bosom [29]. In such an atmosphere, it is more likely that the unresolved feelings (perhaps even the action itself) will lead to an intergenerational transmis‐

sion of the trauma of sexual abuse, which we will discuss in the next section.

**8. Intergenerational transmission of the trauma of sexual abuse and**

Johnson [62] claims that people who are victims of emotional, physical or sexual abuse are six times more likely to continue the abuse they have suffered. Other studies [63] have shown that

growing up.

134 Sexology in Midwifery

**motherhood**

One of the responses to an unprocessed sexual abuse can also be seen in the mother's negative behaviour towards the child. For example, if the mother has been sexually abused as a little girl just as she started saying her first words, she may subconsciously feel an intense dislike and negative attitude towards her child when it starts to talk. She will not know what is going on but her body will testify to her distress. If she is able to take this distress seriously and allow herself to feel the girl inside her, then she will be able to accept her child. If not, this rejection and refusal of the child may intensify to a degree of neglect [30].

Some cases of unprocessed and repressed sexual abuse of a mother can come to light when, at a certain age, a child begins to frequently get ill or when various psychosomatic signs appear, sometimes also behavioural or learning problems. Usually the age at which certain symptoms emerge, (e.g., headaches, bedwetting, troubles sleeping etc.) coincides with the age at which the mother was sexually abused. With an ailing child, the mother may feel powerlessness, fear and even anger for having to keep going to the doctors. However, all of these feelings actually belong to her sexual abuse. Her child merely activates and reawakens them as they have not yet been processed. This is because she is not in contact with them. As a girl, when her body was exposed and unprotected, she felt fear and powerlessness. She had to suppress her anger at an injustice she suffered. When she senses the child's distress and sympathizes with it, she will help herself and contribute to the resolution of the feelings from her abuse. This will help not only her child, but also the little girl still living inside her who never really received any compassion, safety and support.

### **9. Conclusion**

The body never forgets sexual abuse. Even if the psyche pushes it to the subconscious because the pain is too great, the body will cry for help in every possible way (through psychosomatic troubles, health issues, addiction, workaholism, conflicts in a partner relationship, depres‐ sions, etc.). Years, even decades, can go by before the consequences of the abuse surface. If the abused woman functions normally, it may seem that she has no problems. However, one trigger, like pregnancy or childbirth, may suffice for sensations and feelings similar to the ones during the sexual abuse to start uncontrollably emerging. Most survivors do not even relate this to the original trauma, looking for the causes somewhere else completely. Yet, the problem is not solved until the trauma is. In the safe and trusting therapeutic environment, there is a way out of the vicious circle of distress and pain. However, it is a long process for which the abused needs a lot of strength, determination, resolution and encouragement, especially when the occasional crises occur. Clinical experiences have shown that, with an in-depth and successful therapy, an individual can live a very good and decent life. After successful therapy, they feel that they finally have "control" over the past - and not the other way round. At the same time, due to the distinction between the present (when something merely awakens) and the past (when something actually happened), such a person is much more relaxed as a parent. She can trust her intuition and body and feel her child as a mother. This means, of course, that she does everything to protect the child from experiencing a violence similar to the one she had. She emotionally equips the child so it is able to go out into the world. She ensures to sever the intergenerational transmission of the trauma of sexual abuse.

### **Author details**

Tanja Repič Slavič\* and Christian Gostečnik

\*Address all correspondence to: tanjarepic@gmail.com

Chair of Marital and Family Therapy, Department of Psychology and Sociology of Religion, Faculty of Theology, University of Ljubljana, Slovenia

### **References**

the mother was sexually abused. With an ailing child, the mother may feel powerlessness, fear and even anger for having to keep going to the doctors. However, all of these feelings actually belong to her sexual abuse. Her child merely activates and reawakens them as they have not yet been processed. This is because she is not in contact with them. As a girl, when her body was exposed and unprotected, she felt fear and powerlessness. She had to suppress her anger at an injustice she suffered. When she senses the child's distress and sympathizes with it, she will help herself and contribute to the resolution of the feelings from her abuse. This will help not only her child, but also the little girl still living inside her who never really received any

The body never forgets sexual abuse. Even if the psyche pushes it to the subconscious because the pain is too great, the body will cry for help in every possible way (through psychosomatic troubles, health issues, addiction, workaholism, conflicts in a partner relationship, depres‐ sions, etc.). Years, even decades, can go by before the consequences of the abuse surface. If the abused woman functions normally, it may seem that she has no problems. However, one trigger, like pregnancy or childbirth, may suffice for sensations and feelings similar to the ones during the sexual abuse to start uncontrollably emerging. Most survivors do not even relate this to the original trauma, looking for the causes somewhere else completely. Yet, the problem is not solved until the trauma is. In the safe and trusting therapeutic environment, there is a way out of the vicious circle of distress and pain. However, it is a long process for which the abused needs a lot of strength, determination, resolution and encouragement, especially when the occasional crises occur. Clinical experiences have shown that, with an in-depth and successful therapy, an individual can live a very good and decent life. After successful therapy, they feel that they finally have "control" over the past - and not the other way round. At the same time, due to the distinction between the present (when something merely awakens) and the past (when something actually happened), such a person is much more relaxed as a parent. She can trust her intuition and body and feel her child as a mother. This means, of course, that she does everything to protect the child from experiencing a violence similar to the one she had. She emotionally equips the child so it is able to go out into the world. She ensures to sever

Chair of Marital and Family Therapy, Department of Psychology and Sociology of Religion,

the intergenerational transmission of the trauma of sexual abuse.

and Christian Gostečnik

\*Address all correspondence to: tanjarepic@gmail.com

Faculty of Theology, University of Ljubljana, Slovenia

compassion, safety and support.

**9. Conclusion**

136 Sexology in Midwifery

**Author details**

Tanja Repič Slavič\*


[29] Repi T. *Nemi Kriki Spolne Zlorabe in Novo Upanje (The Silent Cry of Sexual Abuse and a New Hope*). Založba Mohorjeva Družba: Celje; 2008.

[15] Golding JM. 'Sexual Assault History and Physical Health in Randomly Selected Los

[16] Goste nik C. *Relacijska Družinska Terapija (Relational Family Therapy).* Ljubljana: Brat

[17] Brener ND, McMahon PM, Warren CW, Douglas KA. 'Forced Sexual Intercourse and Associated Health-risk Behaviors Among Female College Students in the United

[18] Briere J, Evans D, Runtz M, Wall T. 'Symptomatology in Men who were Molested as Children: A Comparison Study.' *American Journal of Orthopsychiatry* 1988:58(3) 457-61.

[19] Noll JG, Trickett PK, Putnam FW. 'A Prospective Investigation of the Impact of Childhood Sexual Abuse on the Development of Sexuality.' *Journal of Consulting and*

[20] Saewyc EM, Magee LL, Pettingall SE. 'Teenage Pregnancy and Associated Risk Be‐ havior Among Sexually Abused Adolescents.' *Perspectives on Sexual and Reproductive*

[21] Stock JL, Bell MA, Boyer DK, Connell FA. 'Adolescent Pregnancy and Sexual Risk-Taking Among Sexually Abused Girls.' *Family Planning Perspectives* 1997:29(5) 200-3.

[22] Seng JS, Oakley DJ, Sampselle CM, Killion C, Graham-Bermann S, Liberzon I. Post‐ traumatic stress disorder and pregnancy complications. Obstetrics & Gynecology

[23] Möhler E, Matheis V, Marysko M, Finke P, Kaufmann C, Cierpka M, Reck C, Resch F. 'Complications During Pregnancy, Peri- and Postnatal Period in a Sample of Women with a History of Child Abuse.' J*ournal of Psychosomatic Obstetrics Gynaecology*

[24] Grimstad H, Schei B. 'Pregnancy and Delivery for Women with a History of Child

[25] Spinelli MG. 'Interpersonal Psychotherapy for Depressed Antepartum Women: A Pi‐

[26] Goldschmidt L, Day NL, Richardson GA. 'Effects of Prenatal Marijuana Exposure on Child Behavior Problems at Age 10.' *Neurotoxicology and Teratology* 2000:22(3) 25-36.

[27] Waugh E, Bulik CM. 'Offspring of Women with Eating Disorders.' *International Jour‐*

[28] Neff K. PTSD: 'Survivors of Sexual Abuse and Pregnancy.' 2010. http://www.examin‐ er.com/article/ptsd-survivors-of-sexual-abuse-and-pregnancy (accessed June 15

Sexual Abuse.' *Child Abuse Neglect* 1999:23(1) 81-90.

*nal of Eating Disorders* 1999:25(2) 123-33.

lot Study.' *American Journal of Psychiatry* 1997:154(7) 1028-30.

States.' *Journal of Consulting and Clinical Psychology* 1999:67(2) 252-9.

Angeles Women.' *Health Psychology* 1994:13(2) 130-8.

Fran išek in Fran iškanski Družinski Inštitut; 2004.

*Clinical Psychology* 2003:71 575-86.

*Health* 2004: 36(3) 98-105.

2001:97(1) 17-22.

138 Sexology in Midwifery

2008:29(3) 193-8.

2014).


[58] Sroufe LA, Jacobvitz D, Mangelsdorf S, De Angelo E, Ward MJ. 'Generational Boun‐ dary Dissolution Between Mothers and their Preschool Children: A Relationship Sys‐ tems Approach.' *Child Development* 1985:56 317-325.

[44] Smith M. 'Childbirth in Women with a History of Sexual Abuse (I).' *Practising Mid‐*

[45] Courtois CA, Courtois-Riley C. 'Pregnancy and Childbirth as Triggers for Abuse

[46] Goste nik C. *Relacijska Paradigma in Travma (Relational Paradigm and Trauma).* Ljublja‐

[47] Tilley J. 'Sexual Assault and Flashbacks on the Labour Ward.' *Practising Midwife*

[48] Repi Slavi T, Goste nik C, Cvetek R. 'Trauma of Sexual abuse and the Family.' In: SPITERI, Ylenia (ed.), GALEA, Elizabeth M. (ed.). *Psychology of Neglect, (Psychology Research Progress)*. New York: Nova Science, cop.; 2012. p.29-46, Available from https://www.novapublishers.com/catalog/product\_info.php?products\_id=28684. (ac‐

[49] Washington Coalition of Sexual Assault Programs (WCSAP). *Pregnant and Parenting Survivors.* http://www.wcsap.org/pregnant-and-parenting-survivors. 2014 (accessed

[50] DiLillo D, Long PJ. 'Perceptions of Couple Functioning Among Female Survivors of

[51] Finkelhor D, Hotaling GT, Lewis IA, Smith C. 'Sexual Abuse in a National Survey of Adult Men and Women: Prevalence, Characteristics and Risk factors.' *Child Abuse &*

[52] DiLillo D, Damashek A. *Parenting Characteristics of Women Reporting a History of Child‐ hood Sexual Abuse.* University of Nebraska – Lincoln. Faculty Publications, Depart‐ ment of Psychology. http://digitalcommons.unl.edu/cgi/viewcontent.cgi?

[53] Ruscio AM. 'Predicting the Child-rearing Practices of Mothers Sexually Abused in

[54] Cole PM, Woolger C, Power TG, Smith KD. 'Parenting Difficulties Among Incest Sur‐

[55] Cross W. 'A Personal History of Childhood Sexual Abuse: Parenting Patterns and

[56] Zuravin S, McMillen C, DePanfilis D, Risley-Curtiss C. 'The Intergenerational Cycle of Maltreatment: Continuity Versus Discontinuity.' *Journal of Interpersonal Violence*

[57] Chase ND. *Burdened Children: Theory, Research, and Treatment of Parentification.* Thou‐

vivors of Father-daughter Incest.' *Child Abuse & Neglect* 1992:16 239-49.

Problems.' *Clinical Child Psychology and Psychiatry* 2001:6(4) 563-74.

Child Sexual Abuse.' *Journal of Child Sexual Abuse* 1999:7 59-76.

article=1106&context=psychfacpub: 2003 (accessed June 15 2014).

Childhood*.' Child Abuse & Neglect* 2001:25 369-387.

Memories: Implications for Care.' *Birth* 1992:19(4) 222-3.

na: Brat Fran išek in Fran iškanski Družinski Inštitut; 2009.

*wife* 1998:1(5) 20-3.

140 Sexology in Midwifery

2000:3(4) 18-20.

June 16 2014).

*Neglect* 1990:14 19-28.

1996:11 315-334.

sand Oaks, CA: Sage;1999.

cessed December 2 2012).


**Chapter 7**
