The Incest Survivors Aftereffect Checklist #ChildAbuse

1. Fear of being alone in the dark, of sleeping alone; night terrors, nightmares (especially of rape, pursuit, threat, entrapment, blood)

2. Swallowing and gagging sensitivity; repugnance to water on face when bathing or swimming (suffocation feelings)

3. Alienation from body—not at home in own body; failure to heed signals of body or take care of it; poor body image; manipulating body size to avoid sexual attention; compulsive cleanliness, incl. bathing in scalding water; or, total inattention to personal appearance or hygiene.

4. Gastrointestinal problems; GYN disorders (including spontaneous vaginal infections); vaginal/internal scarring; headaches; arthritis or joint pain; aversion to doctors (esp. gynecologists, dentists)

5. Wearing a lot of clothing, even in summer; baggy clothes; failure to remove clothing even when appropriate to do so (while swimming, bathing, sleeping); extreme requirement for privacy when using bathroom.

6. Eating disorders, drug/alcohol abuse (or total abstinence); other addictions; compulsive behaviors (including compulsive busyness)

7. Self-injury (cutting, burning, etc.) (physical pain is manageable) (this is an addictive pattern); self-destructiveness

8. Phobias, panic attacks

9. Need to be invisible, perfect, or perfectly bad

10. Suicidal thoughts, attempts, obsession (including "passive suicide")

11. Depression (sometimes paralyzing); seemingly baseless crying

12. Anger issues: inability to recognize, own or express anger; fear of actual or imagined rage; constant anger; intense hostility toward entire gender or ethnic group ("race") of the perpetrator

13. Dissociation ("splitting"), depersonalization; going into shock, shutdown in crisis (stressful situation always is crisis); psychic numbing; physical pain or numbness associated with particular memory, emotion (eg anger) or situation (eg sex)

14. Rigid control of thought process; extreme solemnity/humorlessness or extreme wit (often sharp)

15. Childhood hiding, hanging on, cowering in corners (security-seeking behaviors); adult nervousness over being watched or surprised; feeling watched; startle response; hypervigilance

16. Trust issues: inability to trust (trust is not safe); absolute trust that turns to rage when disappointed; trusting indiscriminately

17. High risk taking ("daring the fates"); inability to take risks

18. Boundary issues; control, power, territoriality issues; fear of losing control; obsessive/compulsive behaviors (attempts to control things that don't matter, just to control something!); power/sex confusion

19. Guilt/ shame/ low self-esteem/ feeling worthless/ high appreciation of small favors by others
The Incest Survivors Aftereffect Checklist Page 2

20. Pattern of being a victim (victimizing oneself after being victimized by others), especially sexually; no sense of own power or right to set limits or say "no;" pattern of relationships with much older persons (onset in adolescence); OR exaggerated sense of entitlement; revictimization by others (adult sexual violence, including sexual exploitation by bosses and "helping" professionals)

21. Feeling demand to "produce and be loved;" instinctively knowing and doing what the other person needs or wants; relationships mean big tradeoffs ("love" was taken, not given)

22. Abandonment issues; desire for relationships with no separateness; avoidance/fear of intimacy

23. Blocking out some period of early years (especially 1–12 but may continue into adulthood), or a specific person or place

24. Feeling of carrying an awful secret; urge to tell/ fear of its being revealed; certainty that no-one would listen. Being generally secretive. Feeling "marked" (the "scarlet letter")

25. Feeling crazy; feeling different; feeling oneself to be unreal and everyone else to be real, or vice versa; creating fantasy worlds, relationships, or identities (esp. for women: imagining/wishing self to be male, i.e. not a victim)

26. Denial: no awareness at all; repression of memories; pretending; minimizing ("it wasn't that bad"); having dreams or memories ("maybe it's my imagination") (these are actually flashbacks, which is how recall begins); strong, deep, "inappropriate" negative reactions to a person, place or event; "sensory flashes" (a light, a place, a physical feeling) without any sense of their meaning; remembering surroundings but not the event. Memory may start with the least threatening event or perpetrator. Actual details of abuse may never be fully remembered; however, much recovery is possible without complete recall. Your inner guide will release memories at the pace you can handle.

27. Sexual issues: sex feels "dirty"; aversion to being touched, especially in GYN exam; strong aversion to (or need for) particular sex acts; feeling betrayed by one's body; trouble integrating sexuality and emotionality; confusion or overlapping of affection/ sex/ dominance/ aggression/ violence; having to pursue power in sexual arena which is actually sexual acting out (self-abuse, manipulation [esp. women]; abuse of others [esp. men]); compulsively "seductive," or compulsively asexual; must be sexual aggressor, or cannot be; impersonal, "promiscuous" sex with strangers concurrent with inability to have sex in intimate relationship (conflict between sex and caring); prostitute, stripper, "sex symbol" (Marilyn Monroe), porn actress; sexual "acting out" to meet anger or revenge needs; sexual addiction; avoidance; shutdown; crying after orgasm; all pursuit feels like violation; sexualizing of all meaningful relationships; erotic response to abuse or anger, sexual fantasies of dominance/ real rape (results in guilt and confusion); teenage pregnancy.

28. Pattern of ambivalent or intensely conflictual relationships (in true intimacy, issues are more likely to surface; in problem relationships, focus can be shifted from real issue of incest). Note: Partner of survivor often suffers consequences of Post-Incest Syndrome also (especially sex and relationship issues).

29. Avoidance of mirrors (connected with invisibility, shame/self-esteem issues; distorted perceptions of face or body)

30. Desire to change one's name (to disassociate from the perpetrator or to take control through self-labeling)

31. Limited tolerance for happiness; active withdrawal from/ reluctance to trust happiness ("ice = thin")

32. Aversion to noise-making (including during sex, crying, laughing, or other body functions); verbal hypervigilance (careful monitoring of one's words); quiet-voiced, especially when needing to be heard

33. Stealing (adults); fire-starting (children)

34. Multiple Personality "disorder" (often hidden)

35. Food sensitivities/avoidance based on texture (mayonnaise) or appearance (hot dogs), which remind the survivor of abuse, or smell/sound which remind survivor of perpetrator; aversion to meat, red foods

36. Compulsive honesty or compulsive dishonesty (lying)

37. Hypervigilance regarding child abuse, or inability to see child abuse, or avoidance of any awareness or mention of child abuse; tendency to develop relationships with incest perpetrators

Note to therapists and others: Many of these "aftereffects" can be the consequence of other problems that occur in early life. There are, however, some items which nearly always indicate childhood sexual abuse, and when one experiences over 25 of the items on this checklist, incest should be strongly suspected.

by E. Sue Blume, CSW, Diplomate in Clinical Social Work, author of Secret Survivors This list is based on observation and interviews with incest survivors as well as work done by New York Women Against Rape.