Mental Health Matters

A good friend of mine is the Executive Director of the Mental Health Association of the Abilene area. Back in November he asked me to consider writing a series of articles (one a month) for a local publication to inform the public on the possible effects sexual abuse can have on it's victims. Having worked for three years at the Regional Crime Victim Crisis Center, this subject is close to my heart. I thought I would begin posting these articles on this blog. This is my first article which was actually published in December.

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It seems the sexual abuse of children is an epidemic in our society. This evil respects no boundary of gender, race, ethnicity, or socioeconomic status. The Mental Health Association of Abilene recognizes that thousands of people in the Big Country have been impacted by this epidemic. Therefore, Executive Director, Kirk Hancock commissioned the penning of six articles over the course of six months for the purpose of educating the general public regarding the potential developmental impacts of sexual abuse on its’ victims.

When approaching the discussion of this subject, it is important to note that there are no standard or predictable outcomes and some seem to adjust better post-abuse than others. For the next five months, Mental Health Matters will have one article highlighting how specific dimensions of a person can be impacted by sexual abuse. These articles will take a “shot gun” approach to describing potential impacts. It should be noted that not all survivors of sexual abuse will experience all the effects discussed and the intensity with which others endure their respective impacts will differ. Therefore, it stands to reason that we first answer the question of what factors influence the intensity of the adverse developmental impacts on a child who has been sexually abused.

The duration and frequency of the abuse is one important component to consider. Some children experience the abuse on a daily, weekly, or monthly frequency for a duration of months or years. Others have endured less chronic or isolated instances of abuse. It is this latter group with the least amount of susceptibility to adverse consequences down the road.

Another consideration is the kind of abuse perpetrated. Those survivors with the most intense developmental impacts are those who sustained penetration orally, anally, or vaginally. The invasive nature of these acts adds to the already deep sense of violation both physically and psychologically. Sexual abuse can include less invasive, yet still horrific, forms such as manual stimulation and groping over the clothes.

The response of adults to the child's disclosure of the abuse is another vital piece to understanding the resilience of some abused children. Common mistakes parents and other significant adults make when a child musters the courage of disclosing the abuse are not believing the child, blaming the child, or defining the child by the abuse. The lack of support, blame and even punishment of the child can have just as devastating impacts as the actual abuse.

Other factors include the age and temperament of the child, the presence of violence or intimidation along with the sexual abuse, and the relationship of the abuser to the abused.

While there is nothing positive about an abusive situation, there can be a "best case" scenario. Bear in mind, even those who come from a "worst case" scenario who access quality professional help and have a solid social support system can not only survive, but thrive.

I've Got Issues...

I debated on what to title this posting. "Bathroom Issues" and "Urine for Quite a Story" were other possibilities. Alas, I just chose to own the issues.

You see, I do have issues that involve public restrooms and urine tests (not necessarily at the same time). When it comes to the former, I have what can only be characterized as "performance anxiety." I may have to really use the restroom, but just as someone else walks in prior to beginning the task, the urgency immediately leaves me for another 30 minutes. If a bathroom is crowded, I am much more comfortable in the stall rather than at the urinal and if someone is WAITING on me, that pressure makes my bladder pressure far less. I'm not sure where this originated in my psyche, but I'm sure part of the puzzle includes my grandmother's childhood warning that most adults in public restrooms are probably child predators. Only, she used much more colorful language and somehow associated child predators with gay men. A crowded public restroom provokes much more anxiety in me than a gay man does.

Now the "urine test" anxiety is easy to trace. As a preteen (approximately age 12) I was going to have minor surgery which required the "pre-op" blood and urine tests. However, I was only told about the blood test. When I was handed the cup and told to "fill 'er up" I kind of panicked because I didn't have to go. In fact, I had used the restroom just prior to the test so it could be hours! So, as it happens, I stayed in the restroom about 30 minutes. About 15 minutes into it, I started drinking out of the faucet with still no luck. When the urge eventually hit me and I returned the cup, the nurse proceeded to kid me about how long it took which only exacerbated my embarrassment. Since that time, I have tried to be aware of when a urine specimen would be needed and drink plenty of water prior to the appointment which usually solves any potential problems.

Since I'm not on probation, parole, or drug-abuse recovery, I don't really have to worry about frequent urine tests. However, I did recently choose to get new life insurance which required a blood test. I'm beginning to understand now, that it is usually understood that "blood test" is code or shorthand for "blood and urine test." For some reason, most people fail to tell you that little detail as was the case this last week. I was told to fast in the morning so I did. My in-laws were in town and as I was leaving my father-in-law made a comment about having to "fill up one of those little cups." I again panicked because the appointment was in 15 minutes and I had no possibility of filling up on water. So, I did what any rational adult would do... I obsessed over it the whole time. Then when I knew the time was drawing near for the cup, I told the nurse about my issues. She handed me a bottle of water. I drank it in record time but now not only did I not have any pressure on my bladder, I was FREEZING which further expands my bladder. After Laurie went through all her questions and blood drawing, I decided I could give the cup a try. I was in there for what seemed like 20 minutes with the faucet running and focusing on distracting thoughts (like counting tiles, multiplication tables by 5's) but there was no hope felt. I exited the bathroom with an empty cup and asked the nurse if there was any possibility of coming back. She was only going to be in the office for another hour but she agreed and even gave me the vials so I wouldn't have to transport a sloshing cup in my car.

When I left the nurses office and arrived at my own office, I immediately needed to fill up the cup. I did. I returned the vials and then proceeded to have to pee every 30 minutes for the next few hours.

I've got issues.