Sexual, emotional and violent abuse and trauma

The issues discussed in this chapter are problematic because abuse and violence have more serious and lasting consequences for those affected than in almost any other form of misfortune. Unlike war and catastrophes, which usually affect many other people and are to be dealt with emotionally as "fate" by those affected, abuse and violence above all entail the deep, almost non-erasable imprinting of a feeling of guilt and fear in the victim's psyche.

This means that until the end of successful therapy the victims feel responsible for what has happened, suffer deep feelings of shame and inferiority and are usually unable to talk about what they have experienced for many years. This applies equally to cases of sexual violence in young children (affecting both girls and boys), as well as forms of emotional assault or cases of singular sexual violence, such as rape committed mostly by familiar men, such as relatives, colleagues and often even partners or husbands.

Often the victims feel left alone in their search for understanding and healing. The victims' attempt to make themselves heard within the family often leads to highly destructive conflicts after which the victim is worse off than before.

Some forms of severe anxiety disorders, which also occasionally lead to treatment in psychiatric hospitals, have their origin in such traumas. Even within the scope of the public health care services, good and excellent treatment results can be achieved. Above all, it is important to overcome fear and shame, often combined with the fear of losing the support of the family, and to overcome the feeling of responsibility for what happened.

In any case, it is important for those affected not to give up hope of healing or improving despite all adversities. There are a lot of specialized psychotherapists and specialist clinics for the treatment of all forms of trauma.

These issues are also problematic in a societal sense, because the awareness of the scope of these crimes and the willingness of society to adequately prosecute and punish offenders as well as to offer the victims competent help and treatment options, still leaves much room for improvement.

As a result, victims are often left alone in their search for understanding and healing. Professional therapists are also often shy to devote themselves to these topics, feel overwhelmed and insufficiently trained. The victims' attempt to make themselves heard within the family often leads to very destructive conflicts after which the victim is worse off than before.

Some forms of severe anxiety disorders, which also occasionally lead to treatment in psychiatric hospitals, have their origin in such traumatizations.

In any case, it is important for those affected not to give up hope of healing or improvement despite all adversities. There are suitable therapists and clinics are also increasingly addressing this topic. Information can be obtained from the state chambers of psychotherapists, self-help groups and information services on the Internet.

Even within the scope of the public health care services, good and excellent treatment results can be achieved. Above all, it is important to overcome fear and shame, often combined with the fear of losing the support of the family, and to overcome the feeling of responsibility for what happened.

The severity of suffering is usually substantial, especially when the trauma begins early and lasts for a long time. A whole life can be shattered and the consequences for the development of personality are dramatic. Emotional consequences of violent trauma which only occured once, on the other hand, tend to heal well over a certain period of time, especially if they are treated in a timely manner. Individual levels of vulnerability of the affected person plays a major role too. No matter how serious the consequences of trauma are, little can be said about the healing powers of the individual. It is astonishing how well some people deal with fate that involves very cruel and/or tragic experiences. The course and prognosis is nevertheless very difficult to predict and depends on many factors.

Behavioural therapy, deep psychological therapy, analytical therapy (covered by health insurance); as well as all forms of humanistic psychotherapy such as Gestalt therapy and talk therapy, but also psychodrama or hypnotherapy (all not covered by health insurance).
In any case, a requirement for successful treatment is a particularly trustful relationship between patient and therapist as well as the therapist's experience with the topic. Of course, it is very important that the patient leaves the traumatizing environment. Social factors often play a major role and must be adequately addressed. Therefore, inpatient treatment in specialized clinics are often useful.

Depending on the severity of the disorder, treatment can take several years, sometimes spread over different phases, alternately in outpatient and inpatient therapy.

Health insurance companies, both private and statutory/public, usually cover the costs of treatment.