Pathways to Understanding - How Adult Survivors of Child Sexual Abuse Came to Understand that they had been Sexually Abused.

While child sexual abuse is recognized as a global challenge in need of attention, all too often it takes years before sexual abuse is disclosed. We therefore need to understand more of the process leading to disclosure of child sexual abuse. The purpose of this study was to investigate how adult survivors of child sexual abuse came to understand that they had been sexually abused. We conducted semi-structured interviews with 8 women and 3 men (18-57 years old) and analyzed the interview transcripts using a hermeneutic-phenomenological approach to thematic analysis. Our analysis resulted in three main themes: The ambiguity of memory: "To remember the catastrophic"; The language of the body: "Let the body speak"; and Encountering an observant other: "The significance of being seen and recognized". The findings highlighted the complexity of the individual process of understanding that one has been sexually abused. The availability and intrusiveness of traumatic memories, bodily sensations and symptoms, and encounters with others proved to be contributing factors in the process. The findings give insights into why disclosure of sexual abuse can be difficult and have important implications for health professionals and policy makers working to help victims of child sexual abuse.