Childhood Sexual Abuse and Adult Sexual Problems: A New View of Assessment and Treatment

Abstract

The New View recognizes that people may be dissatisfied with any emotional, physical or relational aspect of sexual experience and thus invites men and women with abuse histories to discuss sexual issues that are distressing. There are numerous pathways by which child sexual abuse (CSA) can lead to sexual dissatisfaction in adulthood. In addition to those outlined by learning theory and trauma formulations, the New View adds several important and hitherto neglected paths: anxiety about being `normal' or living up to perceived cultural standards, power imbalance in the sexual relationship, stress (because of the consequences of low socioeconomic status), and limited access to both quality health care and sexual information. Assessment of both sexual difficulties and treatment must address these kinds of economic, social and relational factors. How the New View contributes to our ability to understand and treat the sexual concerns of men and women with histories of childhood sexual abuse will be presented in this article and illustrated with clinical case material.