Survivors of CSA: Psychopathology, Emotional Regulation, and Disgust

Written by: Leah K., Practicum Student, The Gatehouse

Childhood sexual abuse (CSA) has the potential to disrupt the emotional development of the child during critical developmental periods, often resulting in adult survivors having difficulty regulating emotions and developing emotional attachments and relationships (Cortois & Ford, 2009; Coyle et al., 2014). Research has highlighted that CSA is a substantial risk for psychopathology, or in other words, mental or behavioral disorders (Molnar et al., 2001).  

In examining the relationship between emotions, associations, and traumatic and general distress systems of survivors of CSA, high levels of negative emotions were found (Coyle et al., 2014). Sadness, fear, low levels of happiness, and most notably very high reports of disgust were self-reported by survivors of CSA (Coyle et al., 2014).  

Disgust, the feeling of revulsion or strong disapproval, first evolved as a behavioral adaption for disease prevention by avoidance of pathogens in food. Disgust, however, as we know, is not limited to pathogen avoidance in food. A significant elicitor of disgust is illicit and immoral instances of sex and sexuality. The emotion of disgust concerning survivors of CSA have been neglected by academic literature until recently. Within the limited research, it is suggested that disgust may play an important role in suicide and parasuicide (Power & Dalgleish, 2008). The knowledge that survivors of CSA experience high levels of disgust compared to other groups has the potential to help guide healing and therapeutic practices to the needs of survivors of CSA. In recognizing the specific emotions implicated in psychopathology, treatment and therapies can be designed specifically for survivors of CSA.  

As discussed, the trauma that survivors of CSA experience often prevent the development of emotion regulation skills. Increased self-reports of negative emotions and under-developed emotional regulation skills suggest that psychological therapies for survivors of CSA ought to incorporate emotion regulation skills alongside addressing emotional change to tackle psychopathology (Coyle et al., 2014).  

Emotional regulation refers to the ability to control one’s emotions. This process takes time, and it is important to be patient and kind to yourself. By creating space and allowing yourself to pause, take a breath, and slow down the moment, one can slow down the moment between trigger and response (Klynn, 2021). An important skill is being aware of how you are feeling, and what your physical body is telling you, as this can help explain how you are feeling emotionally. By naming what you are feeling, one is better equipped to share with another individual what they are feeling (Klynn, 2021).      

 Instead of trying to stop emotions and feelings, it is important to recognize that your feelings are valid and that they will ebb and flow (Klynn, 2021). By engaging in positive self-talk, one can replace negative emotions with positive comments. Many strategies help build emotional regulation skills, some will work better for you than others. It is important to recognize that emotions are part of human nature, that they are valid, that your best is good enough, and that you are not your trauma (Klynn, 2021) 


Courtois C. A, Ford J. D. (2009). Treating complex traumatic stress disorders: An evidence-based guide New York, NY: Guilford Press 

Coyle, E., Karatzias, T., Summers, A., & Mick Power (2014) Emotions and emotion regulation in survivors of childhood sexual abuse: the importance of “disgust” in traumatic stress and psychopathology, European Journal of Psychotraumatology, 5:1, DOI: 10.3402/ejpt.v5.23306 

Klynn, B. (2021). Emotional regulation: Skills, exercises, and strategies. BetterUp.