Spotlighting sexual abuse: as allegations of past sex abuses continue to confront the Catholic Church, workers with histories of sex abuse may notice long-buried emotions beginning to resurface.

For much of the past year, Roman Catholic officials in the United States have faced heavy criticism for their handling of priests accused of sexually abusing young (mostly male) parishioners and especially for transferring accused priests to other parishes and allowing them to maintain their access to children. Certainly it would not be surprising if this criticism, combined with increased public awareness of the impact of sex abuse on children, triggers in some adults memories of past abuse they had forgotten. But neither would it be surprising if individuals who have always been aware of their personal history of sex abuse and have undergone treatment and lived normal lives suddenly find it more difficult to concentrate at work or sleep soundly at night. In fact, even for people who have been in treatment and are aware of their personal history of sexual abuse, the likelihood that the current publicity will have some impact on them is quite high.

Either way, the current spotlight on sex abuse in the church may be disquieting to some abuse survivors. The reactions they may experience can run the gamut, from a minor increase in anxiety to feeling overwhelmed, confused, and out of control. People who had forgotten the abuse might begin to have visual memories, feel physical sensations, or smell unusual odors, any or all of which might confuse or disturb them. At the other end of the spectrum, people who have undergone treatment and are very aware of the issues and symptoms they've been addressing may be able to handle new reactions more easily and better understand the link with their past sexual abuse.

Some people may even find the current publicity to be incredibly valuable and therapeutic. "Finally; things are being exposed," they may say to themselves. "Finally this is on the front page of the papers, and the world is recognizing the pain that I've endured." Others, however, may feel the issue is being shoved back in their faces again. "I thought I had dealt with this; I thought I was doing fine," they may say. "Now I'm having trouble sleeping again."

The bottom line is that there's not going to be one response. The symptoms, if any, that will be triggered by the church scandal will depend on the extent to which a given person has come to terms with his/her past abuse and recovered from it. However, even people who are aware of their abuse and have dealt with it to some degree might find that it is certainly not a benign experience to see television reports and read news articles day after day.

WATERSHED EVENT

Although the abuse allegations against Catholic clergy mostly involve sex with males, employee assistance professionals won't necessarily see more men experiencing reactions than women. The majority of sexual abuse survivors are women, so it is likely that many women will also be affected by the abuse allegations. But the church investigations probably will trigger more men to come forward for treatment than in the past, so employee assistance professionals should be prepared for an increase in male clients with histories of sexual abuse and trauma.

The crisis within the church may even prove to be a watershed event in the treatment of male sex abuse survivors, because increased awareness of this form of abuse should help improve access and treatment for men. Over the past two decades, women have gained real visibility in the fight against sex abuse, and it's been very helpful for them in becoming empowered and finding a voice. Now, with all these allegations arising, men are beginning to feel more comfortable and less isolated by their own abuse histories, making it easier for them to come forward.

Employee assistance professionals should be especially watchful for clients (both male and female) with combined histories of sexual abuse and substance addiction. Among individuals who present with substance abuse problems, a great many have histories of trauma, particularly in their childhood. Sexual abuse is frequently identified that way--people come in with substance abuse issues, and during their assessment a background of trauma is revealed.

But employee assistance professionals should not expect that substance abuse will necessarily be the lead issue for people contacting them at this time. Instead, EAPs will mostly see people who've been coping relatively well and maintaining their employment and who may now feel brave enough to tackle their sexual abuse issues head-on because they're recognizing that what happened to them has happened to many other people. But they may also see some people whose work performance is declining, who feel further alienated from their families and friends, and who may be using alcohol and/or other substances to comfort themselves.

Employee assistance professionals may also see workers whose abuse occurred at the hands of a family member and who still have contact with that family member (not an unusual scenario). As media coverage of the abuse allegations continues, the question of whether to confront the family member can become more pressing. People who were abused in familial circumstances may be saying to themselves, "Boy, I wish my abuser could be identified on the front page and have the whole country. pay attention. Here I am, straggling with it by myself, and my father who abused me all those years still lives around the corner and I have to see him regularly."

Abuse survivors should tread very lightly and consider the ramifications carefully before confronting the abuser and making things public within the family. It's not always a good idea to confront people, and timing is very important whenever it does take place. The issues of acknowledgement, validation, placing blame, and providing support--the same issues we see playing out in the current controversy involving church officials--are magnified within a family environment because of the nature of the relationships.

INDIVIDUAL RESOLUTION

The nature of a person's relationships with family members is an important mitigating factor in determining how badly s/he will suffer from abuse when it happens and how thoroughly and rapidly s/he will recover. Children who are abused yet have nurturing, non-abusive relationships with their parents and a very caring and loving family environment that encourages them to talk about what happened are going to be at much lower risk for long-term damaging effects than those who have no one in whom to confide. In some cases, the abuser is the only "caring" person in the child's life, which compounds the abuse because it occurs under the pretext of a "loving/caring" relationship. These victims will find it difficult to develop the trust in others that is central to the therapeutic work abuse survivors need to conduct in their recovery process.

There are many therapists who specialize in treating trauma and sexual abuse survivors, but EA professionals should not assume that a "trauma expert" is required to provide the type of care an abused employee may need. For instance, if an abuse survivor has managed quite well for many years but has experienced some minor symptom development in response to the recent media focus, s/he may be able to talk to someone for a few sessions, learn some relaxation techniques, improve sleep patterns, and perhaps return quite quickly to the prior level of functioning.

Typically, people who have not been terribly symptomatic just want to get back to feeling the way they felt before. For those who are more severely affected or want to take this opportunity to do additional therapeutic work, a trauma expert is the best choice.

Group therapy may or may not be helpful for sexual abuse survivors. As with other forms of therapy, timing is important. The type of group is also an important consideration: Some groups focus on symptom management, while others are insight- or process-oriented Once symptom management and skill building have been accomplished, employees may find it useful to talk about their abuse experience with other survivors.

Perhaps the most important function EAPs can play for workers who have been sexually abused and are now experiencing symptoms is to provide a safe, secure environment in which to begin to address these issues. Such workers will have the same concerns that all people feel initially when contacting an EAP: Is it going to be confidential? Will I be able to schedule appointments at times so I won't have to leave work and he noticed by my co-workers and supervisors? If the EAP can allay these fears and offer a welcoming environment, sexual abuse survivors will be able to take an important first step toward recovery.

Kevin Becker is former director of the Trauma Center in Boston, Mass., and a clinical psychologist who specializes in the impact of trauma and crisis on individuals and organizations.