Sexual Abuse and Body Image
DIANN M. ACKARD
Abuse experiences can have a number of negative effects on survivors' quality of life, including emotional distress, cognitive distortions, and psychopathology. Little is known about the specific impact of childhood sexual abuse (CSA) on the development and stability of a positive body image, although there is substantial evidence that CSA has both short- and long-term deleterious effects on self-esteem, a factor correlated with positive body image. In this chapter we review the definitions of and relationship between body image and CSA, common body image problems of survivors of CSA, and suggestions for clinical interventions. In particular, we focus on cognitive and experiential treatment of body image disturbance related to sexual abuse.
Body image is a mental representation of the body that includes perceptions of appearance, feelings and thoughts about the body, how it feels to be inside the body, and the body's functions and capabilities. New information is continually incorporated into one's body image. As the information is processed, body image changes. For example, running a half-marathon may enhance body image as the runner feels competent about what his or her body can do, whereas hearing a teasing or derogatory comment may be detrimental. Body image evaluation can span a wide range, including body satisfaction, dissatisfaction, and the distortion and disparagement evident in body dysmorphic disorder. The development of body image is a fluid process, much like growth and aging over the lifespan; one is frequently adjusting to major or minor changes.
Defining and assessing the impact of childhood sexual abuse is a complex task. Definitions of what constitutes childhood sexual abuse range