Sexual Abuse

More Than What Happened - and More Treatable Than You Think

If You Need Support Right Now

Sexual abuse is real, and the impact is real - whether it happened to you last night, last year, or decades ago. You are not alone, and there are people trained specifically to help with this. The following resources are available 24 hours a day, free, and confidential:

• RAINN National Sexual Assault Hotline: 1-800-656-4673 (1-800-656-HOPE) | Online chat at rainn.org
• HAVEN (Oakland County’s sexual assault and domestic violence agency, serving Troy, including SANE forensic exam services): 24-hour Crisis and Support Line 248-334-1274 | Toll-free 1-877-922-1274 | haven-oakland.org
• Care House of Oakland County (Child Advocacy Center for child sexual abuse): 248-332-7173 | carehouse.org
• Michigan Children’s Protective Services (to report suspected child abuse): 1-855-444-3911
• National Domestic Violence Hotline (when sexual abuse occurs within an intimate or family relationship): 1-800-799-7233 | Text START to 88788
• 1in6 (free, confidential support for men and boys who have experienced sexual abuse or assault): 1in6.org
• 988 Suicide and Crisis Lifeline: Call or text 988

If you are in immediate physical danger, please call 911. If you have been recently assaulted, hotline advocates can help you think through your options - including medical care and forensic exam services - without telling you what to do. There is no wrong choice. Metro Detroit mental health crisis lines and walk-ins are also available if you need additional local support.

What This Page Is For

This page is for anyone whose life has been affected by sexual abuse - people who experienced it as children, as adolescents, or as adults; people who experienced it once or over years; people who experienced it from a stranger or from someone they knew, loved, or were related to; parents and caregivers of children who have been harmed; partners and supporters of survivors; and people who are not sure what to call what happened to them but know that something happened that they have been carrying alone. All of you are welcome here. All of you deserve support.

At Behavioral Medical Center in Troy, MI, we treat the psychological impact of sexual abuse as what it is: a serious clinical concern that responds well to thoughtful, evidence-based, trauma-informed care. Our licensed therapists work with children, adolescents, and adults across the full range of sexual abuse experiences, with treatment that is paced carefully, grounded in what is known to work, and built around the survivor’s own goals.

What Sexual Abuse Actually Is

Sexual abuse is any sexual contact, behavior, or exposure that occurs without freely given consent - and any sexual contact involving a child, who cannot consent. This includes rape and attempted rape, unwanted sexual touching, sexual contact obtained through pressure or threats, sexual contact when a person is intoxicated, asleep, or otherwise unable to consent, child sexual abuse and incest, sexual contact in significant power imbalances where genuine consent is not possible, intimate partner sexual violence, and non-consensual sharing of intimate images, among other forms.

It includes sexual abuse in any relationship - by strangers, acquaintances, dates, partners, spouses, family members, caregivers, religious leaders, coaches, teachers, employers, and others. It includes sexual abuse experienced by people of any gender, age, orientation, or background. It includes sexual abuse of men and boys, which is significantly more common and more underreported than public discussion suggests.

What separates sexual abuse from consensual sexual experience is not the specific act. It is whether the person freely consented, was able to consent, and was treated as someone whose body and autonomy mattered. The absence of “no” is not consent. Silence is not consent. Submission under threat or pressure is not consent. A child cannot consent to sexual contact with an adult. A person who is incapacitated cannot consent. None of these are gray areas, even when they are framed that way.

What Sexual Abuse Is Not

Sexual abuse is not the survivor’s fault. Not in any context. Not for any reason. Not because of what they were wearing, where they were, who they were with, what they had been drinking, what they did or did not say, or anything else. The responsibility lies entirely with the person who chose to commit it. Full stop.

Survivors often carry significant self-blame - “I should have fought harder,” “I should have known,” “I should not have been there.” This self-blame is one of the most common psychological consequences of sexual abuse, and one of the most important things therapy can address. Every response to sexual abuse is a survival response. Fighting is one. Freezing is one. Complying to stay safe is one. Dissociating is one. None of these are evidence of consent, and none of them are evidence of fault. It is also not the survivor’s fault if they did not disclose at the time, or for years, or ever. There are many real reasons survivors do not disclose, and the decision not to is what survival required at the time.

How the Impact Shows Up

The psychological impact of sexual abuse is significant, often persistent, and frequently misunderstood. It can show up immediately, weeks or months later, or years and decades after the fact - sometimes triggered by a life event that brings the material into a place where it can finally be felt.

Common ways the impact shows up clinically include:

• Symptoms of trauma and PTSD - flashbacks, intrusive memories, nightmares, intense reactions to reminders, hyperarousal
• Difficulty trusting others, including in relationships where trust has not been broken
• Difficulties with physical and sexual intimacy, including with safe partners
• A fraught or distressed relationship with your own body
• Persistent shame, guilt, or self-blame about what happened
• A sense of being damaged, broken, or fundamentally different from other people
• Anxiety, depression, panic attacks, and chronic worry about safety
• Sleep disturbances and difficulty feeling safe at night
• Chronic physical symptoms with no clear medical cause - pelvic pain, gastrointestinal issues, chronic pain, gynecological symptoms
• Substance use that developed as a way to cope
• Dissociation - feeling disconnected from your body, your surroundings, or your own experience
• Fragmented memory of the abuse, which is a normal trauma response and does not invalidate the experience
• Patterns of relational difficulty that repeat across different relationships
• Suicidal thoughts or self-harm, particularly in the absence of support
• Complicated, ambivalent feelings about the person who harmed you, especially when that person was loved or trusted
• For survivors of childhood sexual abuse, developmental impacts that have shaped identity, attachment, and self-concept across the lifespan

These responses are not signs of weakness. They are the predictable ways human beings respond to having their bodies, autonomy, and trust violated. They are also treatable.

Who We Work With

Our therapists work with the full range of presentations related to sexual abuse, including:

• Adult survivors of childhood sexual abuse - including abuse by family members, other adults in positions of trust, and others, often work that surfaces decades later
• Adults who have experienced sexual assault or rape - by strangers, acquaintances, dates, or others, recently or long ago
• Survivors of intimate partner sexual violence - sexual coercion, assault, or rape within marriages and partnerships, which is common and significantly underrecognized
• Survivors of institutional sexual abuse - within religious communities, schools, sports programs, the military, healthcare settings, and other institutional contexts
• Men and boys who have experienced sexual abuse or assault, including those who have never disclosed to anyone before
• Survivors of workplace sexual harassment and assault
• Children and adolescents who have experienced sexual abuse, in close coordination with Care House of Oakland County and other appropriate resources
• Parents and protective caregivers of children who have been harmed, including resources for parents of anxious children in the Detroit area
• Partners and supporters of survivors working out how to be helpful, including support through family counseling

On Disclosure and Your Right to Choose

A core principle of trauma-informed care is deep respect for the survivor’s right to make their own choices. Sexual abuse is, fundamentally, a violation of autonomy. Recovery is supported when autonomy is restored and honored at every step.

That means you choose what to talk about, when, and how. You choose what to disclose and to whom. You choose whether to pursue legal action, institutional accountability, or no external action at all. You choose whether to maintain or end relationships with people connected to what happened. You choose the pace, the focus, and the goals of your own care. Our role is to provide expert clinical support, share information about options, and walk alongside you as you make your own decisions. It is not to tell you what to do.

Therapy is a place where you can disclose without it triggering any external consequences for the person who harmed you, your family, or your relationships - unless you specifically want to take action and want help thinking through that. Some survivors use therapy to process what happened in private, without telling anyone else. Some use it to think through whether and how to disclose. Some use it alongside reporting or legal action. All are valid. If you’re weighing your options, learning about EMDR vs talk therapy for trauma may help you decide what kind of support feels right.

How We Treat This at BMC Troy

Treatment for the impact of sexual abuse at BMC Troy is individualized, clinically informed, and paced very carefully. There is no one-size-fits-all protocol. Pushing too hard, too fast, on sexual trauma material does real harm, and our therapists do not do it. We take the time to build the stability, safety, and resources that effective trauma work requires before moving into deeper processing.

Therapeutic approaches commonly used in this work include:

• Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) - an evidence-based approach particularly well-supported for children, adolescents, and adults
• Cognitive Processing Therapy (CPT) - focused on identifying and revising the abuse-related beliefs that maintain symptoms, including self-blame and damaged-self beliefs
• Prolonged Exposure Therapy - a structured, paced approach to processing traumatic memories, used when the person is ready
• EMDR-informed approaches - working with the way trauma is stored in the nervous system
• Internal Family Systems (IFS) - working with the internal parts that carry shame, fear, and the protective patterns built around the abuse
• Somatic and Body-Based Approaches - addressing the dissociation, hypervigilance, and complicated relationship with the body that sexual abuse often produces
• Phase-Based Treatment for Complex Trauma - stabilization, processing, and reintegration in sequence
• Coordination with Care House, advocates, medical providers, and legal resources, depending on the survivor’s needs and goals
• Coordination with medication management when medication is a helpful part of the plan

Your therapist will work with you to identify the approach - or combination of approaches - most likely to be effective for your particular situation. The work moves at the speed of safety, not the speed of urgency.

When to Seek Help

If you are wondering whether what happened to you warrants professional support, the answer is yes. There is no threshold of severity you need to meet. It does not matter how long ago it happened. It does not matter whether you told anyone at the time, or ever. It does not matter whether you have full memory of what happened or only fragments. It does not matter whether what happened “counts” by some external standard. If it has affected you, it is worth addressing.

You also do not need to be in crisis to reach out. Some of the most important work in this area happens long after the events themselves - in the years when the survivor has the safety, stability, and capacity to address what they could not address while they were still surviving it. If you are looking for a place to start, free mental health services are available in the Greater Detroit area for those who need them.

A Note on Confidentiality

Everything discussed in therapy sessions is confidential. Our therapists adhere strictly to HIPAA privacy standards, and nothing shared in session will be disclosed without your explicit written consent.

There are specific, limited exceptions we want you to know about up front. Under Michigan law, we are mandated reporters in cases of suspected current child abuse or neglect, suspected abuse of a vulnerable adult, and imminent threats of serious harm to self or others. The disclosure of your own historical abuse as a child does not, on its own, trigger reporting if there is no current child at risk. If there is current concern about a child or vulnerable adult, our reporting obligations apply, and your therapist will discuss this with you transparently before you share anything specific.

Both in-person and telehealth sessions are available for this work. We can discuss with you which format is most appropriate given your situation, including any privacy considerations around device use, internet history, or sessions taking place in a shared home.

Sexual abuse tries to convince you that what happened was somehow your fault, that no one will believe you, that the harm is yours to carry alone, and that nothing can really help. None of those things are true. What happened to you was not your fault, you are not alone, and the path to healing is real.

If you are in immediate danger, please call 911 or one of the hotlines listed at the top of this page. If you are ready to talk about clinical support for the impact this has had on your life, whether recently or long ago, call us at (248) 528-9000, Monday through Friday, 9am-5pm, to schedule a confidential assessment. There is a path forward, and there are people ready to walk it with you.