"If Only I Could Have Stopped It Reflections Af Adult Child Sexual Abuse Survivors On Their Responses During The Abuse

935485
research-article2020
JIVXXX10.1177/0886260520935485Journal of Interpersonal ViolenceKatz and Nicolet
Original Research
Journal of Interpersonal Violence
2022, Vol. 37(3-4) N P2076–NP2100
“If Only I Could Have © The Author(s) 2020
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DOI: 10.1177/0886260520935485
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Abuse Survivors on
Their Responses During
the Abuse
Carmit Katz1 and Racheli Nicolet1
Abstract
Child sexual abuse (CSA) has received much research attention in recent
years, leading to the considerable development of services provided
for children worldwide. The literature in the field of trauma studies
recognizes that responses to trauma are of central importance and
mainly discusses the fight-flight-freeze model of automatic responses
to traumatic events. For a variety of reasons, research on this specific
subject in the field of CSA is sparse. The current study was designed
to spotlight the way adults perceive their responses during incidents
of CSA. Semistructured interviews were carried out with 20 survivors
who described their responses. The results pointed to the irrelevance
of “fight or flight” responses in the context of CSA and emphasized
compliance, avoidance, and simply surviving the abuse. In addition, the
survivors shared the thoughts they had had during the abusive incidents.
Specifically, while they understood that what was being done to them
was wrong, they also realized that there was little they could do other
than try to survive. The survivors’ reflections on how their responses
to CSA affected their negative self-attributions and on the way they
1
Tel Aviv University, Ramat Aviv, Israel
Corresponding Author:
Carmit Katz, The Bob Shapell School of Social Work, Tel Aviv University, Ramat Aviv 69978,
Israel.
Email: drckatz@gmail.com
2Katz and Nicolet Journal of Interpersonal Violence 00(0)
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contend with difficult incidents in adulthood suggest the central role

played by CSA responses. The findings point to the multifaceted nature
of responses to CSA and to the urgent need to further examine them
by exploring other relevant contexts and perceptions to develop a
theoretical model that will address responses to child abuse and inform
both prevention and intervention efforts.
Keywords
child sexual abuse, response, trauma, fight-flight-freeze
Introduction
Trauma studies have long recognized that the way people respond to trauma
is of core importance to the long-term mental and physical ramifications of
the trauma (Krause et al., 2004; McEwen, 1998; O’Donovan et al., 2012;
Shalev et al., 2013), as well as for intervention (e.g., Foa & Kozak, 1986;
Levine & Frederick, 1997; Linehan, 2014). Surprisingly, however, in the spe-
cific area of child sexual abuse (CSA), victims’ responses have received con-
siderably less attention. The current study was designed to explore the ways
adult survivors of CSA describe their responses during incidents of abuse.
Retrospective accounts were chosen to examine the perceived impact of
response pattern on adulthood lives.
Responses to Trauma: The Fight-Flight-Freeze Model

Reactions to stress and trauma have been studied mainly in terms of the
physiological response of the autonomic nervous system. Cannon (1925)
was the first to describe the well-known concept of “fight or flight,”
referring to an instinctive attempt to eliminate or escape a threat.
Subsequently, an additional stress response related to fear was identified
in lab rats—the “freeze” response (R. J. Blanchard & Blanchard, 1969;
Campbell & Teghtsoonian, 1958; Gray, 1987; McClelland & Colman,
1967). When that response was further researched, a conceptual separa-
tion was suggested, between an initial freezing response, occurring when
a suspected threat needs to be assessed, and “tonic immobility” (TI) or
“fright” (Bracha et al., 2004). TI was described as lack of responsiveness
with a catatonic-like posture and suppression of vocal ability (Gallup,
1977), or as a state of suspended animation and paralysis (Scaer, 2007)
in situations of extreme fear, involving a sense of being unable to escape
(Abrams et al., 2009; Marx et al., 2008). The combined model was called
“fight-flight-freeze.”
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Responses to Trauma: Beyond the Fight-Flight-Freeze Model

Although the fight-flight-freeze model is often used as a theoretical frame-
work, it relies mainly on animal studies. A study that compared defensive
behavioral patterns of rodents to those of humans, using simulation scenarios,
showed other behaviors, such as risk assessment, screaming, or crying for help
(C. Blanchard et al., 2001). In a study on the responses of female crime vic-
tims, different behavioral patterns were discussed. For instance, “fight” behav-
ior was described as kicking, hitting, punching, or threatening the attacker, and
“freeze” behavior was described as keeping quiet, being motionless, or pass-
ing out. Additional behaviors, such as “doing exactly as you’re told,” trying to
reason with the perpetrator, and begging or pleading, were identified in another
study (Kaysen et al., 2005). The TI response came up in a study about women
who were victims of sexual assault; it was found to be common among this
population as well as to be correlated with fear (Bovin et al., 2008).
Recent studies have addressed additional responses to trauma. Taylor and
colleagues (2000) identified a response termed “tend-and-befriend”: A behav-
ior of affiliation under stress, deriving from humans’ innate social tendencies
that encourage them to engage in protecting others or in seeking social contact
in times of distress (Taylor, 2006). This response was assumed to be more
dominant in women, due to a suspected neuroendocrinal connection and cul-
tural inclination (Taylor et al., 2000). A study that used Q-sort methodology
indeed showed that women were more prone to exhibit tend-and-befriend
responses (Turton & Campbell, 2005). However, evidence of this kind of
response in men has also been reported: A study that explored male social
engagement behavior under laboratory-induced stress showed men’s use of
prosocial behaviors as stress-buffering strategies (Von Dawans et al., 2012).
A comprehensive model presented by Bovin and Marx (2011) suggests
that response to a traumatic stressor in humans comprises subjective emotion,
cognitions, and physiological reactions, all of which generate a behavior pat-
tern that is either passive or active. Examples of subjective emotions are fear,
anger, sadness, and disgust; a possible cognitive response is dissociation; and
physiological reactions may include increased heart rate, dizziness, and hot
flashes. The model also suggests that prior to a reaction a process of appraisal
takes place in which an evaluation of the environment and one’s available
resources is made (Lazarus & Folkman, 1984). This evaluation influences the
response an individual will exhibit.
Responses to Child Maltreatment

Empirical studies on children’s responses have been carried out mainly in
the area of bullying, employing qualitative interviews with children and
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adolescents (e.g., Evans et al., 2017). There were also several observa-
tional studies of children’s spontaneous reactions to peer-initiated conflict
(e.g., Baumgartner & Strayer, 2008). Studies on this topic have been car-
ried out among participants of a wide age range, from preschoolers as
young as age 3 to adolescents. Studies in the particular area of bullying
have pointed to several possible responses: counter-attack, flight, emo-
tional display, negotiating, and seeking help. In their meta-analysis regard-
ing the development of child and adolescent reactions to peer conflict,
Laursen and colleagues (2001) contrast three styles used for resolving
interpersonal disputes: coercion, negotiation, and disengagement.
In the specific area of child maltreatment (CM), a recent systematic lit-
erature review pointed to the lack of any conceptual framework of child
responses, highlighting the urgent need to advance the development of the
relevant theory (Katz et al., 2021). Finkelhor et al. (1995) examined chil-
dren’s behavior in situations of victimization using telephone interviews
with a nationally representative sample of 2,000 American youths aged
10–16 and their caretakers. In another study, a telephone survey was con-
ducted among 1,011 boys and girls of the same ages (Asdigian & Finkelhor,
1995). In both studies, the participants were questioned about how they
responded to the reported victimization. In both, the questions posed were
framed mostly as “yes/no” questions from a list of items referring to pos-
sible responses. The researchers used a scale of “preferred strategies” cre-
ated based on the four actions recommended by prevention education
programs: insisting on being left alone, screaming, threatening to tell, and
actually telling. The findings clearly showed that children who were
exposed to more comprehensive maltreatment prevention programs in their
schools utilized the four strategies more often.
Katz and Barnetz (2014) used the expression “behavior patterns,” put-
ting the focus on visible children’s responses to CM. The researchers’ cod-
ing of the children’s spontaneous responses to CM included “fight
behavior” and “flight behavior,” referring to the traditional meanings of
these responses. The researchers added “tend-and-befriend behavior” to
refer to behaviors meant to protect the children’s friends or siblings.
Finally, they identified in the children’s narratives an adaptive strategy
comprising the children’s attempts to survive the abuse by complying with
the perpetrator. For example, understanding that his or her father is about
to attack, a child uses the few seconds available to offer the father a belt to
be used instead of a knife. The findings indicated that although children
tried to employ both “fight” and “flight” in specific contexts, in response
to abuse by a parent most of them reported using the adaptive response of
surviving by complying with the perpetrator.
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DiPalma (1994) addressed several responses that emerged in retrospective

accounts of women who had experienced intrafamilial CSA. The women
indicated that the “fight” response was used rarely, and was mainly reported
by survivors of abuse perpetrated by a sibling or uncle, not by a father. The
women described the frequent use of pleading and praying to bring about the
end of the abuse. They also reported avoidance responses, for example wear-
ing multiple layers of clothing or arranging their bedroom in a way that
enabled their bed to be seen through the window. This response also included
attempts to reduce incident severity at those times when they were unsuccess-
ful in avoiding the incidents altogether, as by pretending to be asleep in the
hope that the perpetrator would simply lose interest.
The Current Study

The current study explored the way children respond to CSA through survi-
vors’ retrospective accounts. Twenty semistructured interviews with adult
survivors were conducted, focusing on their perceived responses to CSA and
reflections on how these responses affected their lives. The main research
questions were:
Research Question 1: How do adult survivors of CSA describe the

responses they had as children during the abusive incidents?
Research Question 2: What are their current perceptions of these
responses?
Research Question 3: How did these responses affect their adulthood?
The need to develop both a conceptual and an empirical framework of the

phenomenon provided the rationale for the qualitative approach used.
Method
Sample
The sample consisted of 20 Jewish Israelis (16 women) aged 24–53 who had
been sexually abused during childhood. The sample size was determined
based on inductive thematic saturation: Interviews were conducted until the
point at which no new data, themes, or codes emerged (Saunders et al., 2018).
Participants were recruited via social media platforms and were invited to
take part in face-to-face semistructured interviews at a place and time of their
choosing. In terms of educational attainment, the participants included col-
lege students (n = 6), holders of a BA (n = 4), holders of an MA degree and
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above (n = 7), and others (n = 3). In terms of marital status, participants

were married (n = 9), single (n = 8), and divorced/separated (n = 3). Twelve
had children. Most grew up in homes with both parents; two grew up in the
care of relatives; and one in foster care. No exclusion criteria were employed,
and no candidate refused to participate.
The participants’ age at the time of the first incident ranged from 4 to 17
years: more specifically, below 10 (n = 13) and 10–17 (n = 7). Occurrence
of abusive incidents was defined as either one-time (n = 4) or continuous/
repeated (n = 16). The duration of continuous abuse ranged from 1 week to
7 years. Perpetrator identity was: stranger (n = 3), neighbor (n = 2),
acquaintance (n = 3), educational instructor (n = 1), grandfather (n = 4),
father (n = 1), stepfather (n = 1), sibling (n = 2), extended family member
(n = 4). For one participant, there were two perpetrators in different inci-
dents. With regard to type of abuse, 3 participants described touching above
the clothing, and 17 described incidents that included touching beneath the
clothing or penetration. In eight cases, the abuse was disclosed during child-
hood, either by the participants themselves or by others in the nuclear family
who had witnessed the abuse.
Procedure
The interviews were conducted by postgraduate social workers experienced
in the field of trauma. A semistructured qualitative interview includes an out-
line of topics and questions reflecting the issue under study; the outline is
prepared by the researchers but does not require rigid adherence and does
allow for flexibility in terms of posing more detailed questions than the ones
initially drafted (Stuckey, 2013). In this way, in real time, the researchers can
delve into the topics that most naturally evolve in the actual presence of the
interviewee (Adhabi & Anozie, 2017; Stuckey, 2013). The entire research
team received intensive training and supervision by the first author, an expert
on CSA and qualitative research. Priority was given to creating dignified and
respectful interview conditions, including having the interviews conducted in
the participants’ homes or in another location of their choice. In addition, the
interviewers used open-ended questions that allowed the participants to share
their narratives freely and have them acknowledged. It was stressed to the
participants that their contribution to research was valued.
Lasting an average of 90 min, the interviews followed a guide that covered
several content categories, including perceptions concerning the sexual
abuse/acts (e.g., “Tell me your story”); their responses (“What was going on
with you during the time of the incident?”); and the disclosure process
(“Could you tell me who knows about what happened and the ways in which
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this information became known?”). All interviews were tape-recorded and

transcribed by the interviewers. For the purpose of presenting the data in the
current study, all interview transcripts were professionally translated from
Hebrew into English and double-checked by the authors.
Data Analysis
The data analysis was carried out according to several interrelated stages of
qualitative thematic analysis as defined by Braun and Clarke (2006). In the
first stage, the researchers become familiar with the data and identify initial
ideas. Accordingly, the researchers in the current study read the transcripts
several times, and an open coding that yielded initial categories was per-
formed. The cases were then broken down into small segments of text,
representing discrete units of meaning, and each was labeled according to
its content.
Following this stage, the codes were grouped together as initial themes.
Based on the authors’ reading and understanding, some of the themes were
removed or changed, and additional codes and categories were added. In
the third stage, the themes and subthemes were reviewed and classified in
accordance with their dimensions and properties (Strauss & Corbin, 1998).
In the fourth and final stage, themes were refined, named, and interrela-
tionships between them were suggested (Braun & Clarke, 2006). At this
stage, the authors referred back to the transcripts when necessary to
retrieve additional information needed to develop the categories (Maykut
& Morehouse, 1994).
Trustworthiness (Lincoln & Guba, 1985; Morse, 2015) was achieved
by member checking, peer debriefing, and audit trails. Member checking
was conducted during the data collection process, when participants were
asked to clarify, elaborate on, and give examples of their perceptions
(Morse, 2015). Peer debriefing took place throughout several stages of
the thematic data analysis process (Nowell et al., 2017) by having the two
authors analyze each interview at the weekly meetings they held through-
out the coding process, ensuring that the work was systematic and that the
coding system was uniform and accurate (Nowell et al., 2017). The audit
trail consisted of detailed documentation maintained throughout the
research, to show how the raw data were collected and analyzed. Excerpts
from the raw data were attached to all interpretations, and the peer-
debriefing process was documented in writing (Bowen, 2009). Finally,
the authors kept reflective journals to raise awareness of influences on
their interpretations and the relationship between those influences and the
topic at hand/participants (Jootun et al., 2009).
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Ethical Considerations
Given the study’s focus on highly sensitive issues, several steps were taken
to protect participants. Ethical approval was obtained from the Tel Aviv
University ethics committee, and all participants signed a consent form and
were told that they could stop the interview at any time. In addition, the
interviewers, who were supervised by the first author, created a respectful
environment for the participants. Finally, special attention was paid to issues
of confidentiality and dignity; all identifying details were removed from the
data, and pseudonyms were used throughout.
Results
A thorough thematic analysis was carried out on all 20 interviews, and the fol-
lowing themes were identified: (a) “Finding ways to make it easier”: participants’
behavioral responses to the abuse, (b) “I just knew it was wrong”: participants’
cognitive responses during the abusive incidents, (c) “If only I could have stopped
it”: participants’ reflections on their childhood responses to the abuse, and (d)
“I’m afraid of how I will react today”: participants’ reflections on the impact of
their childhood responses (to the abuse) on their responses to difficult situations
in adulthood.
“Finding Ways to Make It Easier”: Behavioral Responses to the

Abuse
The survivors’ narratives revealed several behavioral responses to the abu-
sive incidents. Note that all referred to several responses. The most common
was freezing or TI:
I froze to death . . . you could call it a corpse, a skeleton, not human, no blood,
no life . . . nothing, you are dead, you’re a corpse. There is nothing. (Abused by
a neighbor between the ages of 14 and18)
I froze, like I could not feel what was happening in the room, like I was a lump
of concrete, or something that is not alive, that’s just lying there. (Abused by an
uncle between the ages of 9 and16)
Three possible mechanisms for this freezing response were identified. The
first was the survivors’ perception that this response was involuntary and not
under their control:
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I don’t know if I understood in my brain, but I remember this freezing. I just

could not move, just could not move. (Abused once by a stranger)
I just froze, I didn’t understand what he was doing, I didn’t think about whether
it was good, bad, or wrong. I just didn’t do anything. (Abused once by a
stranger at age 6)
Some of the survivors described the freezing response as one that they had not
wanted: In other words, a response that was perceived by them at the time of
the abuse as a betrayal, performed by their bodies, and which ran contrary to
how they wished to respond, or how they thought it would be best to respond:
My body was just resisting me, really; like I understood that I should run but I
couldn’t. (Abused once by a stranger at the age of 9)
Several survivors described the freezing response as a means for them to

essentially “wait out the abuse”:
I froze to death. I mean I got totally paralyzed, like I let him do what he was
doing in order to get it over with. (Abused by a neighbor between the ages of
14 and 18)
Another behavioral response described by some of the survivors was

attempting to resist or fight the abuse, but not in a physical way. Rather, this
fight response was manifested in saying no to the perpetrator:
There was a lot of resistance . . . umm . . . Like, “I don’t want to . . . let me go

. . . stop.” (Abused by a neighbor between the ages of 14 and 18)
I think I told him: I want to get up, let me get up, let me get up. (Abused by a
stranger at age 12)
The survivors explained that physical resistance was irrelevant in their

situations, given the power imbalance between them and the perpetrators.
Although the survivors were only children at the time of the abuse, they
understood that if they tried to physically resist the situation would become
worse for them. They feared that resisting would offend the perpetrator and
would likely lead to even worse consequences for them:
He did not physically force it on me; it’s just that I knew I shouldn’t say no or
resist, I just understood it. (Abused by an uncle between the ages of 9 and 16)
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Understanding that they could not or should not resist, the children found
ways to resist that did not have the appearance of being acts of resistance:
I knew I couldn’t stop it, so I did not open my eyes, as though to say I did
not agree to what was happening. I tried to feel as little as I could from what
was happening. It was like, if I am closing my eyes, then I am not really
there, or it is not really happening. (Abused by an uncle between the ages of
9 and 16)
Another response that was identified by those who had survived mul-
tiple incidents of abuse was avoidance. As children, they knew that the
abuse was going to happen again, but tried to postpone it for as long as
possible:
I sat with the grownups; I wasn’t going to play. (Abused by a cousin at ages 6
and 7)
I tried to go with my mom wherever she went. (Abused by a cousin at ages 5

and 6)
Seeing that they would be unable either to resist or avoid the abuse, par-
ticipants who had survived multiple incidents explained how they had simply
“adapted” by finding ways to make the abusive acts less painful or to make
them end more quickly. One way was physical:
I contracted my muscles, because then I really had control over all of them,
I could isolate them and knew exactly what to contract . . . I thought and
said to myself, “Don’t stop contracting; don’t stop contracting; don’t let
go because then you’ll feel it more.” (Abused by a grandfather at ages
9 and 10)
I really tried going there with a bunch of coats on, and didn’t take them off . . .
When he touched me, I couldn’t feel a thing. (Abused by a grandfather at ages
11 and 12)
Another adaptive response described by the survivors—aimed at reducing

their physical pain—was to initiate certain acts or verbally support the
perpetrators:
I remember I asked to give him a blow job so that he wouldn’t penetrate me

. . . I was terrified and in pain and I didn’t know how to stop it so I thought
that at least this way it would be better or less painful. (Abused continuously
by peers)
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Journal of Interpersonal Violence 37(3-4)
She wanted me to do something and I remember I didn’t want to do it so I

encouraged her in what she was doing to me, hoping to postpone the next stage.
(Abused by a peer between the ages of 4 and 12)
Finally, the survivors described using compliance:
I was like a robot; did what he told me to do. He told me to sit so I did; he told
me to take off my shirt so I did. He told me to bend down so I did. (Abused by
a grandfather at age 9)
There is a girl sitting there like a robot, being told: Now do this, now do that,
now kiss me and all of these things. And this is what I needed to do so that it
would be over and he would be satisfied and go to sleep. (Abused by a
grandfather at ages 10 and 11)
In their interviews, in addition to describing their responses to the child-

hood abuse, all of the survivors talked about the struggles they had with
“holes in their memories.” Regardless of the type of abuse or perpetrator,
these holes served as a kind of torture for the survivors:
It upsets me that I don’t remember, because then there is always doubt regarding
whether it really happened. (Abused by a grandfather at ages 9 and 10)
This kind of dissociation was also a central feature of the abuse itself, in real
time:
I was disconnected from myself, from my body, like my soul was going away
and walking around. (Abused by a cousin at ages 5 and 6)
I was completely detached, not present in the situation. It’s like if you would
ask me what I’m thinking about when I’m doing the dishes. (Abused by a
It’s like a crazy dissociation. Like waking up from a dream . . . It’s exactly like
waking up from a dream. (Abused by a peer at age 6)
Some of the survivors described this dissociation as a process that they were
in some way aware of, and actively chose:
What I did physically was to just focus on the ceiling, the bed, the walls . . . I
used to look at the colors. I really remember the table and the drawers and the
piano and the window, details that were carved into my memory. (Abused by a
peer between the ages of 4 and 12)
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“I Just Knew It Was Wrong”: Cognitive Responses to the Abuse

All of the survivors, even when “freezing,” shared that, cognitively, they were
very active during the abusive incidents. Some of their thoughts were geared
toward reassuring themselves that eventually the abuse would be over:
Ok, it’s going to happen, now let’s just wait until it’s over . . . I know it is going
to happen now: It starts, it ends, and you will go back to your life, play with
your dolls, any minute now. (Abused by a grandfather at ages 9 and 10)
Some of the survivors shared that during the abusive incidents they tried to
focus on the “good” aspects, such as what they might get out of it:
I told myself: Suffer for 30 minutes and then you will get 300 shekels. I mean,
that was the negotiation I had with myself. (Abused by a neighbor between the
ages of 14 and 18)
I wanted him to buy me things. I loved animals. I wanted him to buy me fish.
(Abused by a father between the ages of 9 and 14)
In their interviews, the survivors said that as children, during the abuse,
they understood that what was happening to them was wrong:
I knew that it was wrong, that something really not good was happening here.
(Abused by a cousin at ages 6 and 7)
I understood even while it was happening that it was wrong, but that there was
nothing I could do about it. (Abused by an uncle between the ages of 9 and 16)
Nevertheless, even knowing that what was happening to them was wrong, the
survivors explained that they had other feelings as well; in many cases they felt
love toward the perpetrator, and acknowledged their dependency on him or her:
I thought he loved me. For me, that was love. (Abused by a cousin at ages 5 and 6)
I wanted to make my father feel good; I could make my father feel good.
(Abused between the ages of 9 and 14)
Because the perpetrator was often a significant figure in the victim’s life,
the child in some cases did not consider them as victim and perpetrator, but
rather as two participants with equal power:
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There was a time I didn’t look at it as something wrong; it was nice for me.
(Abused by a father between the ages of 9 and 14)
It was consensual . . . When I said no, he accepted it, he didn’t force it on me.
(Abused by a peer at age 9)
“If Only I Could Have Stopped It”: Reflections on Responses to

the Abuse
During the interviews, the interviewers invited the survivors to reflect on the
way they perceived in their adult lives the way that they had responded to the
abuse during their childhood. Some of them acknowledged that their
responses had simply been part of a survival mechanism. Elaborating on dis-
sociation, one of them shared:
If my brain hadn’t responded in this way, I could not have held on, I could not
have functioned. I now know that this was my way to survive. (Abused by a
One of the survivors who had responded in an “adaptive” fashion and who
had been active during the abusive incidents, said:
My being active and cooperating the way I did, it was because I didn’t have any
other option, and it’s ok because this was what saved me. Thanks to this, I am
alive. (Abused by a peer between the ages of 4 and 14)
However, this way of understanding their childhood selves reflects only a

small part of their overall feelings about what they had experienced and about
their role in it. Their narratives made very clear that they felt a great deal of
self-blame, guilt, and shame, as a result of the way they had responded or not
to the abuse. Also, they carried these kinds of negative attributions regardless
of the way in which they had responded. For instance, if their response had
been to freeze,
Oh my god, oh my god, why was I always freezing up? They say you should
fight back, and I just could not move. (Abused by a grandfather at ages 11
and 12)
Why didn’t I do anything? Why didn’t I move away from there? Why did I
walk with him? I was so ashamed. I remember feeling shame. (Abused by a
stranger at age 6)
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I was feeling that I was really weak, that I should have fought more and stopped
it. For a long time I was really ashamed that I allowed it to happen, in the way
I responded. (Abused by peers at age 17)
Why didn’t I run away and why didn’t I get up? I told myself that if I didn’t
know what to do to help myself, what could I expect my mother do to with this?
(Abused by a stranger at age 12)
These negative self-attributions were also evident when the survivors reported
having been compliant:
Because I didn’t fight and resist, I felt like I was actually encouraging him to
continue. (Abused by a grandfather at ages 10 and 11)
Not only did I not understand but I also cooperated and I felt guilty, and like I was
responsible . . . Have you read Lolita? So everything about her character being a
tease and a player and responsible. So this was how I felt for so many years. I
think even today I feel this way sometimes. (Abused by an instructor at age 10)
These negative self-attributions characterized not only their childhood but

also their adulthood as well. The most common self-attributions were self-
blame and shame:
Emotionally I am sure I was part of it. I should not have gone with him and I
should have told him to stop and I shouldn’t have talked to him. I blame myself
and I’m upset with myself for not doing everything I should have done. (Abused
by a grandfather at ages 10 and 11)
The self-blame and guilt that I feel is because of the fact that what happened
was as much my fault as it was his. I didn’t do anything that I should have done
to stop it. (Abused by an uncle between the ages of 9 and 16)
Furthermore, these negative self-attributions were exacerbated by responses

from the survivors’ social environment:
I walk around with very heavy feelings of blame and guilt and I feel like this is
part of what society communicates to us because of the stupid questions they
ask. Like they ask me, So why did you keep going to him? (Abused by a
neighbor between the ages of 14 and 18)
Finally, the survivors expressed how burdened they felt by these negative
self-attributions and how hard they tried to fight the self-blame and guilt, by
Katz and Nicolet
NP2090 15
explaining to themselves that they had only been children at the time of the
abuse. Nevertheless, these feelings of self-blame continued to be part of
their lives:
For many years I’ve been telling myself that I am the one to blame, because I
allowed it . . . A six-year-old girl, right? And I am in my 40s and this is still
what I am dealing with, and I’m still blaming myself for what happened . . . no
matter how wrong this is, it is just a fact in my life. (Abused by a cousin at
ages 6 and 7)
“I Am Afraid of How I Will React Today”: Survivors’ Reflections

on How Their Responses to the Abuse Affected Their
Responses to Difficulties in Adulthood
The survivors expressed that they did not trust themselves with difficult situ-
ations in adulthood, given the way they had contended with the abuse:
Even today I’m still afraid that if someone attacks me I won’t do anything; I
will freeze again and won’t actively protect myself. (Abused by peers at the
age of 17)
This is my most vivid memory, that I couldn’t move, and I’m afraid that if
something were to happen to me today I wouldn’t be able to move. (Abused by
a stranger at age 9)
The participants’ narratives revealed that this fear of reacting in adulthood

the way they had in childhood was grounded in reality:
I can see this pattern in my adulthood as well. When things are happening.
There is no more emotion; it’s like a guillotine, and I go into action . . . It’s like
I’m detaching away. (Abused by a grandfather ages 10 and 11)
It happens to me in life, I detach my body . . . umm, not my body, but I detach

my soul from my body. (Abused by a cousin at ages 5 and 6)
As is clear from the citations above, the survivors saw how their
responses to the abuse were still evident in their daily struggles and
stresses, especially in intimate and social relationships. In addition to a
dissociation response, they also responded in adulthood (as they did in
childhood) by being compliant and adjusting themselves to others’ expec-
tations of them:
16
NP2091
It really sucks because it becomes the automatic response of my brain; like, this
is the first thing that it does in order not to contend with difficult things.
(Abused by a grandfather at ages 9 and 10)
My relationships with men revolve around pleasing them . . . exactly like what
I did when I was a child. Just close your eyes, it will be over and you will
continue with your life . . . This is exactly how I was in the relationship with my
husband. (Abused by a grandfather at ages 9 and 10)
Discussion
The current study was designed to understand the way survivors of CSA
perceive and experience their responses to the abusive incidents they had
undergone as children, as well as the impact that these responses had on
their adulthood. The rationale for this study design, derived from trauma
studies, was that responses to traumatic incidents are of central impor-
tance to a victim’s survival process. Surprisingly, studies on responses to
CSA are sparse. The current study explored the perceptions of adult sur-
vivors, contributing to the development of a theoretical framework of
responses to CSA.
The survivors’ narratives point to a key conclusion: the irrelevancy of
fight-or-flight responses in the context of CSA. Despite the fact that such
responses have not been empirically reported in the area of CSA, the belief
that these are the “correct” or “appropriate” responses has affected the field
in two main ways. First, in prevention programs, children are still instructed
to fight or flee when they find themselves in situations of CSA (Daigneault
et al., 2012; Finkelhor, 2009; Morris et al., 2017). Second, in the forensic
context, the credibility of CSA survivors is still assessed based on fight-or-
flight responses: They are assumed to be more credible if they used such
responses (e.g., Katz et al., 2021; Suarez & Gallup, 1979). The current find-
ings add to the previous findings demonstrating that there is an urgent need
to revise our understanding of what actually happens in these situations so as
to improve our approaches in their aftermath.
The findings from the current study echo those of Katz and Barnetz (2014),
who stressed the irrelevancy of fight-or-flight responses in the context of CM
and pointed to other relevant responses. Previously, Finkelhor and colleagues
(1995) contributed to our understanding of the potential risks incurred by
children employing a fight response in such contexts. In their study, they
emphasized that a fight response might escalate the negative outcomes for the
children, including severe injuries. The narratives of the survivors who par-
ticipated in the current study support this finding.
Katz and Nicolet
NP2092 17
The survivors’ narratives in the current study pointed to responses that

were relevant for them. The first, repeated throughout the narratives, was
freezing. Only two studies have previously focused on freezing or TI in the
context of CSA (Heidt et al., 2005; Kalaf et al., 2017). Their authors used the
term “rape-induced paralysis,” which was coined in the 1970s (Burgess &
Holmstrom, 1976; Russell, 1974), and compared it with animals’ TI. The
participants’ responses to CM identified in these studies were as follows:
feeling frozen, being unable to move, feeling numb, feeling detached from
the self, feeling cold, uncontrollably shaking, being unable to call out, and
being afraid. The researchers assumed that the TI response was embedded in
the person’s being suddenly unable to resist or flee, and that the two condi-
tions inducing TI were overwhelming fear and inability to escape. Although
these researchers addressed TI as a strategy chosen when fight-or-flight was
impossible or failed, assumed (based on empirical studies with animals) that
TI was an adaptive response because the predator would lose interest and that
the individuals who adopted TI would be more likely to survive (Edeloar
et al., 2012). Heidt and colleagues (2005) found that more than 52% of their
participants reported TI in response to CSA. Kalaf and colleagues (2017)
reported that survivors of CSA were twice as high on TI indicators than were
people who had experienced other kinds of trauma (e.g., robbery).
In the current study, the survivors did not view the freezing response as
having been beneficial to them, as it had not helped them in any way.
However, the freezing response did have a different kind of impact—it fueled
their negative self-attributions. Heidt and colleagues (2005) reported that TI
was associated with greater psychological impairment. The researchers con-
cluded that this effect might have been the result of self-blame and guilt for
not having done more to fight off the abuse.
In addition to freezing and/or TI, the current study’s participants discussed
their experiences of dissociation and avoidance. These experiences and per-
ceptions echo a DiPalma (1994) study, which addressed several CSA
responses that emerged in retrospective accounts of women who had experi-
enced intrafamilial CSA. Both among participants in the current study, as
well as those in the DiPalma study, when the victims were unsuccessful in
avoiding the incidents altogether, they would, for example, pretend to be
asleep, hoping the perpetrator would simply lose interest.
It was clear from the participants’ narratives that although they tried to
employ an avoidance strategy, mostly this failed, and they ended up com-
plying or adapting. The compliance strategy was described previously by
DiPalma (1994), and the adaptive responses were described previously by
Katz and Barnetz (2014). The latter researchers identified in the children’s
narratives an adaptive strategy comprising the following components:
18
NP2093
acceptance of the maltreatment; need to calm the perpetrator and aim to at

least reduce the level of injury and pain; and providing the perpetrator with
abusive objects, or enacting behaviors that would ensure such a reduction.
The results of their study indicated that although children tried to employ
both “fight” and “flight” in specific contexts, most of the children who
were abused by a parental figure reported adaptive responses. Therefore,
although the literature mostly refers to passive strategies in cases where
experiencing the attack is inevitable (Schauer & Elbert, 2010), children
who experience CSA actually seem to respond actively in ways aimed at
mitigating the consequences of the attack, reflecting intentional survival-
promoting strategies.
Participants in the current study also talked about their thoughts during the
abusive incidents: Thoughts that reflected that while they understood that
what was happening to them was wrong, they also saw that the only thing
they could do was try to survive. The central issue of the power imbalance
between children and perpetrators was addressed by Caprioli and Crenshaw
(2017) who described the factors that create a culture of silence around CSA:
(a) “pre-selection” of potential victims more likely to remain silent, (b) the
imbalance of power inherent in the relationship, and (c) an internalized image
of the perpetrator who can exercise power over the survivor long after the
actual perpetrator has left or died. These factors came across loud and clear
in the survivors’ narratives and shaped their ability to respond to the CSA.
The survivors’ reflections on their CSA experiences contribute to our
understanding of the central role played by social norms and expectations.
Two of Finkelhor and colleagues’ studies (Asdigian & Finkelhor, 1995;
Finkelhor et al., 1995) provided a glimpse into these social expectations. The
survivors in the current study pointed in their narratives to the way these
social expectations affected their thoughts during the abuse and afterward,
greatly affecting the implications of these responses for their adult lives.
The survivors’ narratives point to two main life-long implications of their
responses to the CSA. The first was negative self-attributions in the form of
self-blame, guilt, and shame. On one hand, they understood there was noth-
ing they could have done as children in response to the abuse. On the other
hand, everything they had been taught previously, or asked subsequently
about their experiences, made clear to them that they had not met society’s
expectations, thereby exacerbating their negative self-attributions. In several
studies on the disclosure of child abuse (Alaggia et al., 2019; Collin-Vézina
et al., 2015; Lyon & Ahern, 2010; McElvaney et al., 2014), self-blame was
recognized as a definite barrier to the disclosure. However, the mechanism of
self-blame was not addressed and its possible relation to the responses of
children during abuse should be addressed in future studies.
Katz and Nicolet
NP2094 19
The concept of self-blame has been the focus of several studies in the area
of child abuse, especially in the clinical context. In general, self-blame is seen
as being part of normative development, even an important part in terms of
socialization (e.g., Dys & Malti, 2016; Talmon & Ginzburg, 2018). However,
children who are abused tend to develop self-blame following acts and inci-
dents over which they have no control (Briere & Runtz, 1993). In these cases,
self-blame does not derive from something that was the fault or mistake of
the child; as such, the child cannot learn from it or further develop as a result
of it. The literature, in this context, has addressed self-blame as a conse-
quence of abusive incidents and as something that has far-reaching effects on
the lives of children in both childhood and adulthood. For example,
Dorresteijn et al. (2019) demonstrated how childhood trauma is related to
adult symptoms of general anxiety, depression, and problems concerning
interpersonal sensitivity through the mediation of self-blame as a coping
strategy. Other findings have also demonstrated that self-blame is particularly
relevant for the onset of post-traumatic stress disorder following sexual
assault (Kline et al., 2018) and plays a significant role in other ramifications,
such as negative social reactions (Ullman & Filipas, 2005), revictimization
during adulthood (Filipas & Ullman, 2006), internalized stigma (Kennedy &
Prock, 2018), and psychopathology (Whiffen & MacIntosh, 2005).
Taken together, these findings imply that responses to childhood maltreat-
ment may have multifaceted, long-lasting sequelae, thus emphasizing the
necessity to further investigate these outcomes.
Limitations and Implications for Future Research and Practice

The current study has several limitations, the first of which was its small
sample size. Clearly, more studies must be carried out to further explore the
study’s research questions among additional survivors of child abuse, and of
various kinds of abuse—for instance, physical abuse. Moreover, there is an
urgent need to further explore various cultural contexts, as these contextual
domains (e.g., culture, religious affiliation, family structure) can greatly
affect responses to CSA. The narratives of other central figures (such as prac-
titioners who work with both children and adults in cases of CSA) should also
be studied and taken into account, as these could make a significant contribu-
tion to our understanding of the impact of CSA responses.
The current findings emphasize the central importance of responses to
childhood abuse (as experienced and remembered) and contribute to the
development of a conceptual framework. This theoretical framework should
inform practitioner training programs within the field of child abuse, as it will
be highly relevant in a number of contexts: clinical, forensic, and prevention
20
NP2095
efforts. Therapists and clinicians must be apprised of children’s actual—as

opposed to theoretical—responses/survival strategies. A clear understanding
of the motivations and the nature of these responses may assist both helping
professionals and clients in meaning-making, understanding and a reframing
of their responses (Figley & Kiser, 2013). As for the criminal justice system—
whose investigations of CSA incidents depend on an assumption of “fight” or
“flight” responses—an understanding of these alternative and unexpected
strategies is particularly crucial. It is likely that lack of knowledge on this front
is to the detriment of the children, whose experience of abuse may be doubted
because it does not align with outdated ideas on how one “should” respond.
Adapting prevention efforts in the CSA context is crucial and urgent in
light of the current study findings. It is evident that societal expectations,
internalized by children, to either fight or flee their abusers, only cause dam-
age and distress. Not only is the expectation of a fight–flight response irrel-
evant and unrealistic in this context, it may even further escalate an already
catastrophic situation for these children.
Declaration of Conflicting Interests

The author(s) declared no potential conflicts of interest with respect to the research,
authorship, and/or publication of this article.
Funding
The author(s) received no financial support for the research, authorship, and/or publi-
cation of this article.
ORCID iD
Carmit Katz https://orcid.org/0000-0001-6631-1141
References
Abrams, M., Nicholas Carleton, R., Taylor, S., & Asmundson, G. (2009). Human
tonic immobility: Measurement and correlates. Depression and Anxiety, 26(6),
550–556.
Adhabi, E., & Anozie, C. (2017). Literature review for the type of interview in quali-
tative research. International Journal of Education, 9(3), 86–97. https://doi.
org/10.5296/ije.v9i3.11483
Alaggia, R., Collin-Vézina, D., & Lateef, R. (2019). Facilitators and barriers to
child sexual abuse (CSA) disclosures: A research update (2000–2016). Trauma,
Violence, & Abuse, 20(2), 260–283. https://doi.org/10.1177/1524838017697312
Asdigian, N. L., & Finkelhor, D. (1995). What works for children in resisting assaults?
Journal of Interpersonal Violence, 10(4), 402–418.
Katz and Nicolet
NP2096 21
Baumgartner, E., & Strayer, F. F. (2008). Beyond flight or fight: Developmental

changes in young children’s coping with peer conflict. Acta Ethologica, 11(1),
16–25.
Blanchard, C., Hynd, A. L., Minke, K. L., Minemoto, T., & Blanchard, R. J. (2001).
Human defensive behaviors to threat scenarios show parallels to fear- and
anxiety-related defense patterns of non-human mammals. Neuroscience and
Biobehavioral Reviews, 25(7–8), 761–770.
Blanchard, R. J., & Blanchard, D. C. (1969). Crouching as an index of fear. Journal
of Comparative and Physiological Psychology, 67(3), 370–375.
Bovin, M., Jager-Hyman, S., Gold, S., Marx, B., & Sloan, D. (2008). Tonic immobil-
ity mediates the influence of peritraumatic fear and perceived inescapability on
posttraumatic stress symptom severity among sexual assault survivors. Journal
of Traumatic Stress, 21(4), 402–409.
Bovin, M., & Marx, B. (2011). The importance of the peritraumatic experience in
defining traumatic stress. Psychological Bulletin, 137(1), 47–67.
Bowen, G. (2009). Document analysis as a qualitative research method. Qualitative
Research Journal, 9, 27–40. https://doi.org/10.3316/QRJ0902027
Bracha, H. S., Ralston, T. C., Matsukawa, J. M., Williams, A. E., & Bracha, A. S.
(2004). Does fight or flight need updating? Psychosomatics, 45, 448–449.
Braun, V., & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative
Research in Psychology, 3(2), 77–101.
Briere, J., & Runtz, M. (1993). Childhood sexual abuse: Long-term sequelae and
implications for psychological assessment. Journal of Interpersonal Violence,
8(3), 312–330. https://doi.org/10.1177/088626093008003002
Burgess, A. W., & Holmstrom, L. L. (1976). Coping behavior of the rape victim.
American Journal of Psychiatry, 133(4), 413–418.
Campbell, B., & Teghtsoonian, R. (1958). Electrical and behavioral effects of differ-
ent types of shock stimuli on the rat. Journal of Comparative and Physiological
Psychology, 51(2), 185–192.
Cannon, W. B. (1925). Bodily changes in pain, hunger, fear and rage: An account of
recent researches into the function of emotional excitement. D. Appleton.
Caprioli, S., & Crenshaw, D. A. (2017). The culture of silencing child victims of
sexual abuse: Implications for child witnesses in court. Journal of Humanistic
Psychology, 57(2), 190–209. https://doi.org/10.1177/0022167815604442
Collin-Vézina, D., De La Sablonnière-Griffin, M., Palmer, A. M., & Milne, L. (2015).
A preliminary mapping of individual, relational, and social factors that impede
disclosure of childhood sexual abuse. Child Abuse & Neglect, 43, 123–134.
https://doi.org/10.1016/j.chiabu.2015.03.010
Daigneault, I., Hébert, M., McDuff, P., & Frappier, J.-Y. (2012). Evaluation of
a sexual abuse prevention workshop in a multicultural, impoverished urban
area. Journal of Child Sexual Abuse, 21(5), 521–542. https://doi.org/10.1080/
10538712.2012.703291
DiPalma, L. M. (1994). Patterns of coping and characteristics of high-functioning
incest survivors. Archives of Psychiatric Nursing, 8(2), 82–90.
22
NP2097
Dorresteijn, S., Gladwin, T. E., Eekhout, I., Vermetten, E., & Geuze, E. (2019).
Childhood trauma and the role of self-blame on psychological well-being after
deployment in male veterans. European Journal of Psychotraumatology, 10(1),
Article 1558705. https://doi.org/10.1080/20008198.2018.1558705
Dys, S. P., & Malti, T. (2016). It’s a two-way street: Automatic and controlled
processes in children’s emotional responses to moral transgressions. Journal
of Experimental Child Psychology, 152, 31–40. https://doi.org/10.1016/j.
jecp.2016.06.011
Edeloar, P., Serrano, D., Carrete, M., Blas, J., & Tella, J. L. (2012). Tonic immobility
is a measure of boldness toward predators: An application of Bayesian structural
equation modeling. Behavioral Ecology, 23, 619–626. https://pdfs.semantic-
scholar.org/1d4f/0cdc86116e2bb36607acff10600bf8bbf5c7.pdf
Evans, C. B., Cotter, K. L., & Smokowski, P. R. (2017). Giving victims of bullying a
voice: A qualitative study of post bullying reactions and coping strategies. Child
and Adolescent Social Work Journal, 34(6), 543–555.
Figley, C. R., & Kiser, L. J. (2013). Helping traumatized families (2nd ed.). Routledge.
Filipas, H., & Ullman, S. (2006). Child sexual abuse, coping responses, self-blame,
posttraumatic stress disorder, and adult sexual revictimization. Journal of
Interpersonal Violence, 21, 652–672. https://doi.org/10.1177/0886260506286879
Finkelhor, D. (2009). The prevention of childhood sexual abuse. Future of Children,
19(2), 169–194.
Finkelhor, D., Asdigian, N., & Dziuba-Leatherman, J. (1995). The effectiveness of
victimization prevention instruction: An evaluation of children’s responses to
actual threats and assaults. Child Abuse & Neglect, 19(2), 141–153.
Foa, E. B., & Kozak, M. J. (1986). Emotional processing of fear: Exposure to correc-
tive information. Psychological Bulletin, 99(1), 20–35.
Gallup, G. (1977). Tonic immobility: The role of fear and predation. The Psychological
Record, 27(Suppl. 1), 41–61.
Gray, J. (1987). The psychology of fear and stress (2nd ed.). Cambridge University
Press.
Heidt, J. M., Marx, B. P., & Forsyth, J. P. (2005). Tonic immobility and childhood
sexual abuse: A preliminary report evaluating the sequela of rape-induced paraly-
sis. Behavior Research and Therapy, 43, 1157–1171.
Jootun, D., Mcghee, G., & Marland, G. (2009). Reflexivity: Promoting rigour in
qualitative research. Nursing Standard, 23, 42–46. https://doi.org/10.7748/
ns2009.02.23.23.42.c6800
Kalaf, J., Coutinho, E. S. F., Vilete, L. M. P., Luz, M. P., Berger, W., Mendlowicz,
M., . . . Figueira, I. (2017). Sexual trauma is more strongly associated with tonic
immobility than other types of trauma—A population-based study. Journal of
Affective Disorders, 215, 71–76.
Katz, C., & Barnetz, Z. (2014). The behavior patterns of abused children as described
in their testimonies. Child Abuse & Neglect, 38(6), 1033–1040.
Katz, C., Tsur, N., Nicolet, R., Carmel, N., & Klebanov, B. (2021). Children’s
Responses to Maltreatment: Key Conclusions From a Systematic Literature
Katz and Nicolet
NP2098 23
Review. Trauma, Violence, & Abuse, 22 (5 ), 1155–1168. https://doi.org/10.

1177/1524838020908851
Kaysen, D., Morris, M., Rizvi, S., & Resick, P. (2005). Peritraumatic responses
and their relationship to perceptions of threat in female crime victims. Violence
Against Women, 11(12), 1515–1535.
Kennedy, A., & Prock, K. (2018). “I still feel like I am not normal”: A review of the
role of stigma and stigmatization among female survivors of child sexual abuse,
sexual assault, and intimate partner violence. Trauma, Violence, & Abuse, 19(5),
1–16. https://doi.org/10.1177/1524838016673601
Kline, N., Berke, D., Rhodes, C., Steenkamp, M., & Litz, B. (2018). Self-blame and
PTSD following sexual assault: A longitudinal analysis. Journal of Interpersonal
Violence. https://doi.org/10.1177/0886260518770652
Krause, N., Shaw, B. A., & Cairney, J. (2004). A descriptive epidemiology of life-
time trauma and the physical health status of older adults. Psychology and Aging,
19(4), 637–648.
Laursen, B., Finkelstein, B. D., & Betts, N. T. (2001). A developmental meta-analysis
of peer conflict resolution. Developmental Review, 21(4), 423–449.
Lazarus, R. S., & Folkman, S. (1984). Stress, appraisal, and coping. Springer.
Levine, P. A., & Frederick, A. (1997). Waking the tiger: Healing trauma: The innate
capacity to transform overwhelming experiences. North Atlantic Books.
Lincoln, Y. S., & Guba, E. G. (1985). Naturalistic Inquiry. SAGE.
Linehan, M. M. (2014). DBT? Skills training handouts and worksheets. Guilford.
Lyon, T. D., & Ahern, E. (2010). Disclosure of child sexual abuse. In J. E. B. Myers
(Ed.), The APSAC Handbook on Child Maltreatment (3rd ed., pp. 233-252).
Newbury Park, CA: Sage.
Marx, B. P., Forsyth, J. P., Gallup, G. G., Fusé, T., & Lexington, J. M. (2008). Tonic
immobility as an evolved predator defense: Implications for sexual assault survi-
vors. Clinical Psychology: Science and Practice, 15(1), 74–90.
Maykut, P., & Morehouse, R. (1994). Qualitative data analysis: Using the constant
comparative method. In P. Maykut & R. Morehouse (Eds.), Beginning qualitative
research: A philosophic and practical guide (pp. 126–149). Falmer Press.
McClelland, W., & Colman, J. (1967). Activity and different types of electric shock
stimuli. Psychonomic Science, 7(11), 391–392.
McElvaney, R., Greene, S., & Hogan, D. (2014). To tell or not to tell? Factors influencing
young people’s informal disclosures of child sexual abuse. Journal of Interpersonal
Violence, 29(5), 928–947. https://doi.org/10.1177/0886260513506281
McEwen, B. S. (1998). Stress, adaptation, and disease: Allostasis and allostatic load.
Annals of the New York Academy of Sciences, 840(1), 33–44.
Morris, M. C., Kouros, C. D., Janecek, K., Freeman, R., Mielock, A., & Garber,
J. (2017). Community-level moderators of a school-based childhood sexual
assault prevention program. Child Abuse & Neglect, 63, 295–306. https://doi.
org/10.1016/j.chiabu.2016.10.005
Morse, J. M. (2015). Analytic strategies and sample size. Qualitative Health Research,
25(10), 1317–1318. https://doi.org/10.1177/1049732315602867
24
NP2099
Nowell, L. S., Norris, J. M., White, D. E., & Moules, N. J. (2017). Thematic analysis:
Striving to meet the trustworthiness criteria. International Journal of Qualitative
Methods, 16(1), 1–13. https://doi.org/10.1177/1609406917733847
O’Donovan, A., Neylan, T. C., Metzler, T., & Cohen, B. E. (2012). Lifetime
exposure to traumatic psychological stress is associated with elevated inflam-
mation in the Heart and Soul Study. Brain, Behavior, and Immunity, 26(4),
642–649.
Russell, D. E. H. (1974). The politics of rape: The victim’s perspective. Stein & Day.
Saunders, B., Sim, J., Kingstone, T., Baker, S., Waterfield, J., Bartlam, B.,
Burroughs, H., & Jinks, C. (2018). Saturation in qualitative research: explor-
ing its conceptualization and operationalization. Quality & Quantity, 52(4),
1893–1907.
Scaer, R. C. (2007). The body bears the burden: Trauma, dissociation, and disease.
Haworth Medical Press.
Schauer, M., & Elbert, T. (2010). Dissociation following traumatic stress. Zeitschrift
für Psychologie, 218(2), 109–127. https://doi.org/10.1027/0044-3409/a000018
Shalev, A. Y., Yehuda, R., & McFarlane, A. C. (Eds.). (2013). International hand-
book of human response to trauma. Kluwer Academic/Plenum Press.
Strauss, A., & Corbin, J. (1998). Basics of qualitative research techniques. SAGE.
Stuckey, H. L. (2013). Three types of interviews: Qualitative research methods
in social health. Journal of Social Health and Diabetes, 1, 56–59. https://doi.
org/10.4103/2321-0656.115294
Suarez, S. D., & Gallup, G. G. (1979). Tonic immobility as a response to rape in
humans: A theoretical note. The Psychological Record, 29(3), 315–320.
Talmon, A., & Ginzburg, K. (2018). “Body self” in the shadow of childhood sexual
abuse: The long-term implications of sexual abuse for male and female adult
survivors. Child Abuse & Neglect, 76, 416–425.
Taylor, S. E. (2006). Tend and befriend: Biobehavioral bases of affiliation under
stress. Current Directions in Psychological Science, 15(6), 273–277.
Taylor, S. E., Klein, L. C., Lewis, B. P., Gruenewald, T. L., Gurung, R. A. R., &
Uptegraff, J. A. (2000). Biobehavioral responses to stress in females: Tend and
befriend, not fight or flight. Psychological Review, 107, 411–429.
Turton, S., & Campbell, C. (2005). Tend and befriend versus fight or flight: Gender
differences in behavioral response to stress among university students. Journal of
Applied Biobehavioral Research, 10(4), 209–232.
Ullman, S., & Filipas, H. (2005). Gender differences in social reactions to abuse dis-
closures, post-abuse coping, and PTSD of child sexual abuse survivors. Child
Abuse & Neglect, 29(7), 767–782. https://doi.org/10.1016/j.chiabu.2005.01.005
Von Dawans, B., Fischbacher, U., Kirschbaum, C., Fehr, E., & Heinrichs, M. (2012).
The social dimension of stress reactivity: Acute stress increases prosocial behav-
ior in humans. Psychological Science, 23(6), 651–660.
Whiffen, V. E., & MacIntosh, H. B. (2005). Mediators of the link between child-
hood sexual abuse and emotional distress: A critical review. Trauma, Violence,
& Abuse, 6(1), 24–39. https://doi.org/10.1177/1524838004272543
Katz and Nicolet
NP2100 25
Author Biographies
Carmit Katz is a senior faculty member at the Bob Shapell School of Social Work at
Tel Aviv University. In her research and practice, she focuses on child maltreatment
and deals with the issues of children involvement in legal process, family dynamic in
cases of child maltreatment, and prevention initiatives.
Racheli Nicolet is a senior social worker in the field of trauma and a research student
in the Bob Shapell School of Social Work at Tel Aviv University.

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935485

Carmit Katz1 and Racheli Nicolet1

contend with difficult incidents in adulthood suggest the central role

Responses to Trauma: The Fight-Flight-Freeze Model

Responses to Trauma: Beyond the Fight-Flight-Freeze Model

Responses to Child Maltreatment

DiPalma (1994) addressed several responses that emerged in retrospective

The Current Study

Research Question 1: How do adult survivors of CSA describe the

The need to develop both a conceptual and an empirical framework of the

above (n = 7), and others (n = 3). In terms of marital status, participants

this information became known?”). All interviews were tape-recorded and

“Finding Ways to Make It Easier”: Behavioral Responses to the

I don’t know if I understood in my brain, but I remember this freezing. I just

Several survivors described the freezing response as a means for them to

Another behavioral response described by some of the survivors was

There was a lot of resistance . . . umm . . . Like, “I don’t want to . . . let me go

The survivors explained that physical resistance was irrelevant in their

I tried to go with my mom wherever she went. (Abused by a cousin at ages 5

Another adaptive response described by the survivors—aimed at reducing

I remember I asked to give him a blow job so that he wouldn’t penetrate me

She wanted me to do something and I remember I didn’t want to do it so I

Finally, the survivors described using compliance:

In their interviews, in addition to describing their responses to the child-

“I Just Knew It Was Wrong”: Cognitive Responses to the Abuse

“If Only I Could Have Stopped It”: Reflections on Responses to

However, this way of understanding their childhood selves reflects only a

These negative self-attributions characterized not only their childhood but

Furthermore, these negative self-attributions were exacerbated by responses

“I Am Afraid of How I Will React Today”: Survivors’ Reflections

The participants’ narratives revealed that this fear of reacting in adulthood

It happens to me in life, I detach my body . . . umm, not my body, but I detach

The survivors’ narratives in the current study pointed to responses that

acceptance of the maltreatment; need to calm the perpetrator and aim to at

Limitations and Implications for Future Research and Practice

efforts. Therapists and clinicians must be apprised of children’s actual—as

Declaration of Conflicting Interests

Baumgartner, E., & Strayer, F. F. (2008). Beyond flight or fight: Developmental

Review. Trauma, Violence, & Abuse, 22 (5 ), 1155–1168. https://doi.org/10.

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