Sexual abuse can lead to a number of disorders. The most common are eating disorder, post-traumatic stress disorder, obsessive-compulsive disorder and loss of memories. The memory does not always remember well what really happened. There is some controversy whether memories of childhood abuse are accurate. Memories are never factual, but they are actively construed and reassimilated over time subject to childhood misattributions like – I caused it, I thought I was being killed, or all wanted is to be special. The memory is consolidated and there are some retrieval distortions, but it does not mean they were not abused.

What we have to take into consideration is that the distortions make abuse more injurious because of the child’s developmental limitations in information processing, resultant interpretation and attribution. It is the intensification, reconstruction and prolonged elaboration of memories and emotions that lead to post-traumatic stress disorder (PTSD) concerning memory in processing trauma resolution. There is a controversy among professionals about the need to know or not know? Children who have been exposed to inescapable stress through childhood are at risk when they become older to develop compulsion and reenactment of the trauma resulting in post-traumatic stress and dissociative symptoms.

Because sexual abuse is a violation of boundaries of the individual and of the body, it can lead to symptoms of self-injury of the body. One form of self-injury is eating disorder. I want to emphasize that all sexual abused people do not automatically develop eating disorder. Eating disorder is determined by a multitude of factors.

There are several syndromes associated with eating disorder some are directly or indirectly influenced by sexual trauma. Traumatized patients often discover especially when in therapy that they have forgotten details of their childhood and say, “I always knew that”. Why is it impossible to retrieve?

Sexual trauma is a syndrome of “knowing and not knowing” simultaneously. The resistance to knowing requires retrieval, reconstruction and integration of the memory that has been fragmented, distorted, dissociated and repressed.

Resistance to knowing is a characteristic of individual and society in general. For example, Freud did not want to recognize sexual abuse was an external factor conflict in hysteria.

In 1967 Freedman and Kaplan estimated sexual abuse to be one in 1,000. But in the 1980’s publications on sexual abuse found an incidence of 1 in 3 females and 1 in 7 males suffered from sexual abuse. In major cities there are as many as 2,000 to 3,000 new cases of incest each year that have been validated through the past decade.

The National Committee to Prevent Child Abuse reported that in 1993, that 2.9 million children were reported to protective services for child abuse, neglect or both. Of these 16,400 were for sexual abuse. If 2 million cases are substantiated as an incidence figure each year the prevalence of early trauma is between 60-90 million out of a total population of 225 million. Then the prevalence of adult survivors of severe abuse and neglect can be estimated to be 11 million. We have to ask, why is there such resistance to knowing and believing?

Janoff-Bulman wrote in 1985, whether we like it or not, each human being forms a theory of reality that brings order into what otherwise would be a chaotic world of experience. We need a theory to make sense of the world. At his time, there is an absence in the literature of recognition of the interconnections among sexual trauma dissociation and eating disorder. This is partially due to a blind spot in researches and clinicians ability to know. The critical question is – Why early trauma would influence eating behavior? One reason is that eating is often associated with family meals, nurturing and proof of the parent’s love for the child. So if the child is fed while abused, it creates a conflict that is confusing and very difficult to integrate. It is known that family meals, in destructive families can be seen like a ritual of terror with the father or mother controlling and violent over the child’s eating behavior. As the family dynamic is played out, it is associated with fear for the abused child.

There are other forms of sexual abuse. It is anything that has to do with violation of physical boundary and this can also manifest in eating disorder symptoms. Dissociation or split often prevent memoy of the actual event especially for young children and they are left with behavioral and somatic reenactments, which is a clue to the abuse. As children are not able to control what happened to their body, they react by being over controlling like throwing up compulsively or taking laxatives to purge the unwanted substances in their body. When sexual abuse occurs, the body and sex organs become the enemy in the mind of the abused child.

The survival strategy of children who must maintain the belief that adults are good and safe is that the body must be bad and therefore deserves to be punished. The bodies can then become a source of shame. Since eating influences body size, and in the case of females interferes with feminine development, the women reduces the probability of a man abusing her repeatedly and the incidents that he will have to deal with her bad sexual urges or incapacity to say no.

For other women, the body becomes the focus and the only reason a man would approach her. But, because she feels internally damaged, it leads her to focus on making the body more and more attractive and then it becomes an obsession. Alternatively, the only way to escape being alone is to make her body ugly and very fat so she will not attract men. Either way their internal schemes for safety are disrupted and their food can serve as a transitional object.

Parents and living objects are too scary, fasting and eating can be utilized to create mood alterations that can be numbing for the terrified person or alerting when the individual is too numb. It is also a way for the child to control the intake of their food while believing that they have control, no one can force them to eat. Eating disorder is very likely symptoms of early trauma.

Alice Miller said: “The truth about our childhood is stored up in our body and although we can suppress it we can never alter it. Our intellect can be deceived, our feelings manipulated, our perceptions confused and our body enriched with medication – but someday the body will present its bill, for it is as incorruptible as a child who still whole in spirit will accept no compromises or excuses and it will not stop tormenting us until we stop and face the truth.”

If the body is the temple of the soul, what are we to expect when the temple is violated or damaged with sexual abuse? The similarities seen in how sexually abused patients and those with eating disorder view and treat themselves and their bodies have led to a better understanding of the experience on non-integration of mind and body.