Impact of Remembering Childhood Sexual Abuse on Addiction Recovery for Young Adult Lesbians

This article examines the impact of childhood sexual abuse on young adult lesbians' sexual identity and their recovery from chemical dependency. The authors recommend that counselors assess for sexual orientation (past and present), sexual abuse, and possible dual diagnosis. Implications for counselors are discussed. ********** Sexual assault, unfortunately, continues to occur in the United States for both men and women. Women are sexually assaulted more often than men, with an estimated 3% to 27% of women experiencing some form of sexual assault during their lifetime regardless of sexual orientation or identity (Eaton et al., 2008; Finkelhor, Hotaling, Lewis, & Smith, 1990; Kilpatrick, Saunders, & Smith, 2003; Patterson, 2009; Tjaden & Thoennes, 2006). Childhood sexual abuse (CSA) is not uncommon for women, including women who self-identify as lesbian. An estimated one in 16 children were victimized by sexual abuse during 2007 (Finkelhor, Turner, Ormrod, Hamby, & Kracke, 2009). Approximately 28% of lesbians report CSA (Descamps, Rothblum, Bradford, & Ryan, 2000), and approximately 11% of women report having sex with other women (Mosher, Chandra, & Jones, 2005). In their study, Saewyc, Bearinger, Blum, and Resnick (1999) found that bisexual and lesbian respondents (22%) were more likely to report a history of sexual abuse compared with their heterosexual counterparts (13% to 15%). Women who experience CSA or sexual abuse as adolescents often suppress the experience. Instead of acknowledging the abuse, they ignore it, hoping it will not affect the rest of their life; however, many find that this is an ineffective coping strategy (van der Kolk & Fisler, 1995). Unconsciously, the experience and the trauma associated with sexual abuse bleeds into other areas of the individual's life and can often manifest in many ways, ranging from mental health disorders, including substance abuse, to relationship issues throughout adolescence and, if untreated, into adulthood. In the United States, the prevalence of serious psychological distress (SPD) is roughly 10% of the adult population, with young adults representing the highest percentage rate at 18%. Approximately 13% of the female population has experienced SPD. Moreover, 22% of adults reporting SPD also reported substance dependence or abuse, whereas the rate among adults without SPD is 7.6% (Substance Abuse and Mental Health Services Administration [SAMHSA], 2009). Furthermore, 85% of adults between the ages of 18 and 25 years and 43% of adolescents between the ages of 12 and 17 years have reported using alcohol during their lifetime. In addition, approximately 7.7% of the total U.S. population and 5.1% of the female population will be diagnosed with alcohol dependence or abuse (age 12 years and older). Nearly 17% of young adults (between the ages of 18 and 25 years) will have received a diagnosis of alcohol abuse or dependence in the next 12 months. More specifically, approximately 12% of young adult women will receive an alcohol abuse or dependence diagnosis (SAMHSA, 2007). Surprisingly, approximately 54% of the population who need treatment do not receive treatment, and, of those who receive treatment, only 33% receive mental health treatment. Moreover, only 24% will receive substance abuse treatment, and only 10% will receive treatment for both mental illness and substance abuse simultaneously (SAMHSA, 2009). Furthermore, some therapists believe that sexual abuse that occurs in childhood or around puberty will manifest through a sexual orientation other than heterosexuality (i.e., homosexuality, bisexuality, or asexuality; Brannock & Chapman, 1997). This article examines (a) the impact of CSA on young adult lesbians' sexual identity, (b) their recovery from chemical dependency, and (c) the implications for counseling. IMPACT OF CSA ON YOUNG ADULT LESBIANS' SEXUAL IDENTITY The development of a sexual identity can begin early or later in life depending on an individual's experiences, place in the life span, and resources. …