7 Signs You May Need Therapy for Childhood Sexual Abuse

7 Signs You Might Benefit From Therapy After Childhood Sexual Abuse

Experiencing childhood sexual abuse can leave deep emotional and psychological scars. For many survivors, the impact extends well into adulthood, even if the trauma occurred years or decades ago. Therapy for childhood trauma can be a powerful step toward healing, but how do you know when it might be time to seek help?

If you recognize yourself in any of these signs, it could be a sign that therapy might help.

1. Persistent Feelings of Shame or Guilt

One of the lingering effects of childhood sexual abuse is an internalized sense of blame. You may find yourself thinking, “It was my fault,” even if you logically know it wasn’t. These feelings of shame and guilt are common and valid, but they can become barriers to self-worth and healing. A trauma-informed therapist can help you gently unpack and reframe these beliefs.

2. Difficulty Trusting Others

If you find it challenging to open up to others or often expect betrayal, this may be a sign of unresolved trauma. Survivors often struggle with trust due to early experiences of boundary violation. Therapy can help rebuild your sense of safety in relationships by working through these trust-related patterns.

3.  Emotional Numbing or Disconnection

Do you sometimes feel detached from your emotions, or even from your body? Emotional numbing is a common coping mechanism among those who have experienced trauma. While it may have served as a survival strategy in childhood, it can limit your ability to fully experience life as an adult. Therapy can support reconnection and emotional processing in a safe, supportive environment.

4. Hypervigilance or Anxiety in Daily Life

Many survivors live in a state of constant alertness, even when there is no immediate threat. You might startle easily, avoid certain places or situations, or experience chronic anxiety. These are all signs of trauma that therapy can help address by regulating your nervous system and developing grounding techniques.

5. Struggles with Boundaries or People-Pleasing

If you find it hard to say no or often put others’ needs ahead of your own, this may stem from a disrupted sense of personal boundaries. Survivors of childhood sexual abuse are often conditioned to ignore their own comfort to avoid conflict or rejection. In counselling, you can learn how to set healthy boundaries and honour your own needs without guilt.

6. Recurring Flashbacks, Nightmares, or Intrusive Thoughts

Unprocessed trauma can resurface in the form of nightmares, flashbacks, or unwanted memories. These symptoms may be distressing and difficult to talk about, but they are treatable. Trauma therapy can help reduce their frequency and intensity through techniques like grounding, narrative processing, and somatic work.

7. You're Simply Tired of Carrying It Alone

You don’t need to wait for a “crisis” to begin therapy. Many survivors begin the process simply because they’re tired of feeling stuck or overwhelmed. If you’ve ever wondered whether your experiences “count” as trauma, or whether therapy is “worth it,” the answer is yes, you deserve support, compassion, and healing.

How Therapy Can Help

Therapy for childhood sexual abuse trauma isn’t about fixing you; it’s about giving you space to explore, feel, and begin to heal on your own terms. A trauma-informed approach can empower you to reclaim your voice and sense of self.

If you’re ready to take the first step, consider learning more about our Individual Counselling for CSA Survivors page for information about the services we offer. About the Author

Karen MacKeigan, RP (Qualifying), RSSW, is a trauma-informed Registered Psychotherapist (Qualifying) and Registered Social Service Worker based in Toronto. With over five years of experience supporting adult survivors of childhood sexual abuse through her work at The Gatehouse, Karen brings an empathetic, client-centered approach to psychotherapy. She draws from a variety of therapeutic modalities to create a warm, safe, and collaborative space where clients feel heard and supported. Karen holds a BA in Psychology, an MA in Counselling Psychology, and diplomas in both Early Childhood Education and Addiction and Mental Health.

Learn more about Karen