( Russell, 1995) because she can and does make this deal with the devils who divide her within herself.
Whatever the individual child's response to sexual abuse, the experience of exploitation and the social stigma attached to it make the developmental lessons of middle childhood difficult to learn. What good is self-regulation if the big and powerful people in one's life fail to regulate themselves? What happens when social comparisons reflect a shameful difference that she is too afraid or confused to reveal to others? Whether she becomes the silent, defiant, difficult child no one understands, the secretly self-blaming and guilt-ridden conformist seeking always to please, the precociously sexual little charmer on every uncle's knee, or one of the many variations on these themes, she is becoming a person at odds with her self.
Childhood sexual abuse produces a veritable lexicon of symptoms, conditions, and diagnoses. There are emotional consequences (e.g., depression, anxiety, anger, etc.), compulsive symptoms (e.g., eating disorders, substance abuse, etc.), behavioral problems (e.g., sexual dysfunctions, promiscuity, prostitution), and various cognitive disturbances (e.g., dissociation, memory lapses, depersonalization, borderline personality, etc.). Taken together, they cover most of the diagnostic categories defined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). Psychologists have sought to organize their understanding of the varied impacts of childhood sexual abuse in a number of ways, relying particularly on PTSD (Post-Traumatic Stress Disorder) models because they incorporate a number of different symptoms ( Briere & Elliot, 1994).
In this chapter, I have outlined a different, though not contradictory, developmental model that might also prove useful in understanding the varied and complex consequences of childhood sexual abuse. From a developmental perspective, the impacts of sexual abuse would vary not only by age, but by the different dimensions along which development can be observed. These dimensions include the physical, cognitive, social, emotional, contextual, and cultural factors that guide our understanding of who we are and where we belong in the world. To further complicate matters, these factors don't operate as distinct and separate influences, but intertwine in often unpredictable ways. That means that we cannot (and