I believe sex and gender identification are a significant factor in how individuals are affected. This stands to reason because for those who predominantly identify with more feminine energy, the abuse can feel more internalised not least because they are more easily physically overpowered, experienced more hormonal fluctuations of mood and are made to feel embarrassed or ashamed of this but also due to the nature of the sexual act for a woman. This can be partially attributed to the experience of being penetrated whether vaginally or anally. Being more feminine is often by its nature more commonly characterised by being the receiver while the more masculine energy is denoted by being the chaser/ hunter/provider archetype. This is relevant whether man, woman, transgender. What is partially most significant is whether the survivor feels and identifies more feminine than male. This is significant to mention therefore, because part of the sexual act for a woman is internal rather than external, as it is for a more masculine identifying man or woman.
Narcissistic abuse against a man or woman may include rape. Certainly boys and girls who have experienced childhood sexual abuse by a male family member that involved penetration may be more prone to attract narcissistic relationships as an adult. These may or may not be exclusively romantic in origin but may also manifest as particular communication signals/styles or needs that magnetise experiences and outcomes in life that afford them opportunities to gravitate towards friendships and work colleagues/superiors that repeats previous experiences. The potential for this to be more pronounced for those of us who identify more as feminine than masculine is heightened because the shame and guilt is more internalised, and therefore arguably greater. After all the sexual act happens within the body. I suspect this is more severe where actual ejaculation within the body has transpired. There is a sense of never feeling clean or being unable to rid oneself of the rapist. It may also lead to feelings of being the energetic equivalent of a stinking, rotting corpse which is how I felt for years after reaching adulthood and even having had children of my own. There may also be a more heightened sense of cognitive dissonance related to the inability to reconcile love and hate for the abuser where that abuser is in a position of authority and should therefore be trustworthy and safe. When the sexual act is internalised by a figure who should afford safety and nurture the negative response or reaction or trauma is heightened.
It is a well known cognitive reaction to an unbearable experience to normalise the trauma in order to cope with it. Therefore victims often reject interference from well meaning friends and family or even authorities and may even be their abuser’s staunchest advocate for a time especially if the abuser has asserted themself into the position of sole provider for their target/victim/survivor. This is a form of Stockholm syndrome. Although there have been incidences where boys have been recorded as having experienced this, it has been far more prevalent for females although incidents of women hostages are far greater than for men or at least they have been recorded as such. This does not take account of the fact that men are far more unlikely to admit abuse or seek help for it.
This being said, lets look at how n.a affects targets ranging from early signs to extreme latter stages of abuse.
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