During the past two decades, all forms of child abuse, including sexual abuse and incest, have received wide recognition. As a result, many women who were sexually abused as a child has stepped forward to express their abuse experiences; thereby breaking the "conspiracy of silence." Incest is no longer in the closet, the family secrets, or the horror story that happened to someone else is now aired in the public arena.

It is conservative estimated that 40 percent of American women and 20 percent of men have experienced some form of childhood sexual trauma. Others studies suggested that as many as 180,000 women per million in the United States may have been incestuously abused before the age of 18; and as many as 45,000 per million may have been incestuously exploited by their own fathers. as survivors continue to come forward and disclose their incestuous experiences, these statistics, especially those for men, will increase steadily.

Incest and child sexual abuse has become so widespread that many mental health professionals are assessing it as a major social problem. The importance of real trauma to the development of psychopathology is increasingly recognized. The most damaging of actual trauma is incest; the sexual exploitation of a child by a family member who stands in a parental role, or in a relationship invested with significant intimacy and authority.

Childhood sexual abuse refers to any sexual activities between an adult and a child; it does not matter whether the activity involves actual contact or not. All sexual activity between an adult and a child is abusive because it is nonconsensual, even in cases where the child appears to be a willing or an eager participant. This type of sexual activity violates the child's life because children have neither the necessary experience nor the power that is required to give consent. Incest, on the other hand, refers to all sexual activity between family members whether abusive or non-abusive.

Incest survivors often experience problems with closeness and intimacy. Often sexual activity and sometimes non-sexual activity can produce feelings of anxiety, rage, anger or numbness. Survivors are often turned-off by sex, or they can be very promiscuous. Intimacy and close relationship with a parent, friend or even therapist, may evoke the feeling that sex will occur. Inappropriate desires for sex with people who hurt you are common among adult survivors of childhood incest, as is the expectation of being taken advantage of.

The feeling of absolute helplessness and hopelessness is often the most devastating factor in these young survivors of sexual abuse. When a child is violated by those deemed protectors, it destroys the belief that the world is safe, that things can be worked out, and that life is, indeed, manageable. For many survivors, the feeling of hopelessness and helplessness leads to unconsciously attempts to control everything and everyone in their immediate environment. Others may react by giving up control completely.

Finally, if you are a survivor or if you know someone who survived the trauma of incest or childhood sexual abuse; it is not too late to seek professional help and encourage them to do the same. Do not blame yourself. You have done no wrong; something bad was done to you, and you had no control nor the power to prevent it.

Dr. William Smith is a psychotherapist and personal consultant with over 30 years experience working with individuals and groups. He specializes in working with Adult Children of Alcoholic, Survivors of Incest, childhood sexual trauma, Rape survivors, and individuals experiencing symptoms of Depression, anxiety, and relationship concerns. Dr. Smith can be reached at insightconsultant.com or wspsych@msn.com