Case Report: The resiliency journey of a Vietnamese female sexual abuse survivor: an exploration in life history

An overview of childhood sexual abuse

Child sexual abuse (CSA) is a traumatic experience that happens across countries, races, religions, classes, and cultures and has lifelong effects. CSA includes any interaction between a child and an adult (or another child) in which the child is used for the sexual stimulation of the perpetrator or an observer (Bolen & Gergely, 2014). CSA leaves serious consequences on the victim's mental health, which can have long-term effects without appropriate support and intervention strategies (Cashmore & Shackel, 2013; Hornor, 2010; Kendall-Tackett, 2012). There have been a lot of previous studies done to understand, support, and heal the survivors. These studies can be divided into three groups: (1) studies on the CSA's traumatic experience and causes (Blakemore et al., 2017; Murray et al., 2014; Stoltenborgh et al., 2011); (2) studies on CSA prevention (Barron & Topping, 2013; Rudolph & Zimmer-Gembeck, 2018; Rudolph et al., 2018); and (3) studies on support, intervention and healing the SAT (Adams et al., 2018; Sanjeevi et al., 2018). This research is the result of the efforts of various countries, communities, and societies working together to protect children's rights.

When studying the survivors' life experiences, it is essential to learn about the development of their social relationships after the abuse. Some of the negative long-term effects that CSA has on a child is the consequences and precariousness of the victim's communication abilities, interaction, and social connections when they become adults (O'Leary et al., 2010), go to work (Colarusso, 2010), get married (Fergusson et al., 2013) and even after having children (Mrazek & Kempe, 2014). It is also important when studying the essence of relationships to consider the cultural, religious, and social factors that influence the survivor’s life. Previous studies that have found differences across specific socio-cultural or religious groups regarding the impact of CSA or other early life trauma (Rosmarin et al., 2018; Santoro et al., 2016; Tishelman & Fontes, 2017; Wesley et al., 2017). This is a research direction that has garnered focus and is carried out in many countries in order to provide the most effective and appropriate solutions for survivors through consideration of religion and spirituality as a means of healing.

On the other hand, studies on the direction of mental health support and interventions for abused children always mention that a counselor, a clinician, or a social worker will be the one to conduct support and intervention for the victim (Dietz et al., 2012; Furniss, 2013). The issue of resilience, as well as the discovery of the link between the victim’s internal resources and CSA trauma, is promising aspect hat many researchers have addressed because of their potential and diversity. Resilience is the process of adapting well in the face of adversity, trauma, tragedy, threats or significant sources of stress (American Psychological Association, 2014). The resilience of CSA survivors has been covered in previous studies. Wilcox et al. (2004) found that ‘personal reliance’ is considered as it relates to empowering damaged young people to become healthy adults, who have gone from CSA’s victim to perpetrator. Williams and Nelson-Gardell (2012) emphasized the impact of environmental factors (school engagement, caregiver social support and education, hope and expectancy) on CSA trauma resilience in adolescents.

In Vietnam, research on CSA has been limited to presenting the situation (Linh, 2021; Tran, 2020), proposing solutions (Nguyen, 2018), practicing counseling, psychotherapy (Nguyen et al., 2016), and providing social support for victims (Dinh Vinh, 2020), there has been no longitudinal study in Vietnam addressing the long-term effects of CSA, or in-depth research on the psychological development, the essence of psychological phenomena in Vietnamese adults who were abused as children. Therefore, conducting a case study to understand the psychological transformation of Vietnamese CSA survivors in adulthood is urgent and a prerequisite for providing practical clinical evidence focusing on the post-intervention period in the group of survivors.

This article presents the case study of resiliency journey of an adult female survivor of CSA that occurred from the age of eight as a typical case of trauma recovery involving religious and educational factors. The study’s findings demonstrate a woman’s ability to overcome adversity, as well as her emotional resilience, within a modern understanding of Confucian philosophical doctrine and of education as a preventive factor.

The long-term effects of sexual abuse and mental support

Previous global studies all show that victims of CSA suffer long-term effects of psychiatric, psychological, and physical symptoms. CSA has been correlated with higher levels of depression, anxiety (Maniglio, 2010) guilt, shame (Dorahy & Clearwater, 2012), self-blame, coping and emotional regulation (Ullman et al., 2014), eating disorders, somatic concerns, anxiety, dissociative patterns, repression, denial, sexual problems, and relationship problems (Bentovim et al., 2018; Preti et al., 2006). In some cases, survivors experienced sexual dysfunction when they came into adolescence (Najman et al., 2005; Staples et al., 2012). A study done on the prevalence and predictors of sexual dysfunction in the US revealed that victims of CSA experience sexual problems more than the general population (Laumann, Piel, & Rosen, 1999). They found that male victims of CSA were more likely to experience erectile dysfunction, premature ejaculation, and low sexual desire, and they found that women were more likely to have arousal disorders (Laumann, Piel, & Rosen, 1999). These mental health issues are explored by psychologists and clinicians through empirical evidence. Also drawing on these long-term effects of CSA, many intervention strategies have been implemented, corresponding to different problems and individuals. Therefore, it is important to point out that each victim’s responses and experiences in CSA will not be the same. Although it is often viewed as a traumatic experience, there is no single symptom among all survivors, and clinicians need to focus on the individual needs.

In addition to psychotherapy and medical interventions, religion and spirituality are commonly regarded as important coping strategies by victims of CSA. Religion may contribute to greater resilience, attribution of meaning, and guidance as well as providing a social support network (Durà-Vilà et al., 2013). Although the spiritual impact of abuse can be devastating, some studies also document that spirituality can be a source of resiliency for many children and that those who can cope spiritually, also do a better job of coping emotionally and physically (Crisp, 2007). Religious and spiritual activities that are often performed by victims/survivors to recover from the trauma are: increasing the spiritual knowledge (e.g., religious education, Bible study), practicing spiritually (e.g., ritual, virtuous actions), consolidating the spiritual relationships (e.g., church involvement, holy matrimony), and experiencing spirituality and religion (e.g., meditation, prayer; see Pargament, 2013). Each of these activities is designed to sustain and strengthen the individual’s relationship with the Gods, Saints, Buddha or other supernatural forces. Religion and spirituality are confirmed as being supportive factor in recovering from sexual abuse. Sometimes, religion and spirituality become a part of the problem rather than a part of the solution for the CSA victims. This is clearly the case when it comes to clergy-perpetrated sexual abuse (Kenneth et al., 2008). Studies in this area are limited, but initial studies are consistent with these anecdotal comments: clergy-perpetrated sexual abuse is often associated with a conflicted or broken relationship with God, a loss of trust in religious institutions, and an impaired ability to develop spiritually (Easton et al., 2019; Fogler et al., 2008; Pargament et al., 2008). These signs of spiritual distress have been linked empirically to increases in anxiety and depression in CSA victims (e.g., Brady, 2008; Easton et al., 2019). However, when reviewing studies on the application of religion and spirituality as a form of mental support to sexual abuse survivors, there were only studies on Catholicism (Durà-Vilà et al., 2013), Christianity (Yan, 2001), Islam (Bhutto & Rind, 2019), and Buddhism (Sasson, 2014). The impact of other religions and belief systems has rarely been studied and deployed only at the level of common sense and indigenous knowledge.

The long-term effects of CSA analyzed above were confirmed to exist in Vietnamese adult survivors (Tran, 2020). Intervention strategies from psychologists, clinicians as well as support from social organizations have contributed to a positive effect in helping this group of survivors recover. At the same time, the application of spiritual and religious support strategies with the group of survivors was also carried out, focusing on Buddhism and Christianity – the two religions with the largest number of followers in Vietnam (Phan, 2011). However, a study on the psychological trauma of children and adolescents living in broken families by Nguyen (2019) reported that Confucianism and Confucian educational ideology in the family were the factors that aggravated the trauma of children being abused by their family members and were even a cause of suicide. When studying the psychological trauma of sexually abused children, Nguyen et al. (2016) also found that Confucian philosophical ideas of gender and the prejudice that stems from within the family is the main reason female victims are not protected and have no voice in the family.

Confucianism has had a profound impact on the culture and spiritual life of Vietnamese people (Vuong et al., 2018). The doctrine of Confucianism is divided into two parts: Lower (studying the social relationships) and upper (studying the operation of the universe and human beings). According to Yao and Yao (2000), in Confucianism, the five minimum moral qualities of a person are Benevolence (loving others), Propriety (showing respect and order in words and deeds), Righteousness (behaving morally), Wisdom (showing understanding and good judgement), and Trustworthiness (being reliable and honest). This doctrine is preached through forms of education, family activities, and social relationships (Vuong et al., 2018). In particular, over the past 1000 years, Confucian philosophy has become an educational viewpoint, a cultural feature, and an educational tradition of many Vietnamese families (Smith, 2021). In Confucianism, there is no need for formalities, religious rituals, prayers, or participation in religious activities to balance emotions, or talk and repent with God. It is paramount that you read, understand, and reflect on the teachings of Confucianism. To properly understand the authentic perception and successfully apply Confucian philosophy to life, one must learn the lower part first, then the upper part (O'Harrow, 2021). In the lower part, you have to learn from self-nurture (get to know yourself, isolate things to observe, find out the roots, train your will, get rid of sins, correct your mistakes, and find happiness), behave in accordance with the norms of the family and the country (appropriate social behavior) and with the world (contribute to society, find happiness in yourself and those around you). From these analyzes, combined with practical evidence on CSA trauma in Vietnam, it can be seen that the Confucian perspective is associated with the long-term effects of CSA as well as the resilience of this group of victims (Nguyen et al., 2016). Research on the resiliency process in survivors living in Confucian families, as well as the relationship between Confucianism and CSA, is urgently needed to serve as practical evidence to contribute to the case study or to consider as a model case in clinical psychotherapy and counseling.

Study purpose

This study is part of a longitudinal research project on mental support and intervention measures for female sexual abuse victims since 2016 in Vietnam (Nguyen et al., 2016). The purpose of the present study is to understand the lived experiences of a Confucian woman who had been sexually abused as a child by her brother and to understand her resiliency process throughout her childhood, adolescence, and adulthood.

With this goal, the researchers posed two research questions to explore:

Research team and reflexivity

The five researchers involved in this study with different tasks are presented in Table 1 (see Table 1).

The participant is currently an undergraduate. There was no prior relationship between the research team and the participants. When the recruitment information for research volunteers was announced to the classes through the lecturers, the participant actively contacted the research team with the desire to better understand her trauma and help disseminate the project’s values to other survivors. Before participating, the participant was given full information about this project, including the objectives, vision and ethical issues in personal information security and scientific publication.

Study design

As Creswell and Poth (2016) noted, qualitative research strategies are particularly appropriate to address the experience and perspectives of the participant. The method of investigating those realities and experiences is referred to as narrative research, a qualitative research method designed to capture the detailed stories or life experiences of an individual. With narrative research, we can learn about the survival and resiliency process of CSA victims throughout their psychological development. The three key elements of narrative theorizing: the sense-making function of narratives (focusing specifically on the role of time lapse between live devents and their narration), individuals’ efforts to attribute meaning to decisions and behaviors, and the place of individuals’ stories in a particular historical moment (Creswell & Poth, 2016). In focusing on the process of three key elements, the researchers documented the participant’s key milestones, thereby identifying key events and drivers that create, or promote the resilience.

The wider longitudinal research study, of which this study is a part, was conducted through 25 in-depth interviews between two researchers and the participant, each lasting between 45 to 60 minutes. The interview location was a psychological counseling office belonging to a key university in the south of Vietnam, which guaranteed a comfortable space and the confidentiality of the interviewee information.

This study belongs to the research project ‘Counseling for sexually abused children with artist playtherapy’ (Nguyen et al., 2016), which is funded by the Ministry of Education and Training of Vietnam, project number B2020.SPS.19 and supervised by the Department of Science and Technology Ethics committee of the Ho Chi Minh City University of Education (under the Ministry of Education and Training of Vietnam). This project aims to design and test the psychological interventions and support for sexually abused children. The data extraction used to conduct this study was approved by the Department of Science and Technology Ethics committee of the Ho Chi Minh City University of Education (Permit number: 1815/QD-BGDDT) and conducted in accordance with the Declaration of Helsinki. The participant was fully informed about the study process of the project, as well as the study conducted in this article prior to the interview.

Consent

Consent for participation in the research project was given by the participant in the interview recording and signed consent form. The name and personal information of the participant in this study were anonymized. The data used for publication was approved by the participant. The written informed consent from the participant is confirmed by her signature and the research team, under the supervision and guarantee of the Department of Science and Technology Ethics committee of the Ho Chi Minh City University of Education. Written informed consent for publication of the participant’s case details was obtained from the participant.

Participant

Once participants contacted the researchers to take part in the larger research project, a single participant from the group was purposively sampled for this case study based on the following criteria: 1. The participant must have experience of SAT. 2. Must be currently undergoing recovery (self-assessed and double-checked by the researchers). 3. Must follow the Confucian religion.

The criteria were assessed during the recruitment process through classroom discussions, where the participants voluntarily shared their experiences. CSA is a traumatic experience and not every survivor can overcome it and recover. Therefore, the researchers requested a private and confidential meeting with the selected participant to double-check that the participant was indeed willing to share the story. Screening criteria were discussed again privately with the participant, and further information on the research project was given. After the participant agreed to take part, the contact details were shared with the fifth researcher who contacted the participant officially. Confidentiality of the participant information was maintained through all stages of the recruitment and research phases.

The participant’s background was a Confucian woman (anonymous name L), who was 20 years old at the time the study took place, studying at university. L was the youngest daughter in a family of two siblings. Her brother was 12 years older than her. L’s parents were both office workers, they were often not at home or away on business trips. Her parents were always biased and give love to her brother. L was always ‘the last care’ for family members. L grew up and attended to school as normal as other girls her age. Since childhood, she has not had any medical problems. In terms of personality, L was introverted. She always felt inferior to her friends because she was not loved by her parents. In classroom, L only interacted a lot with her homeroom teacher because she was always fair and enthusiastically supported all students.

The participant's further information is presented in the form of biographical summaries, as well as key events in her life history. L has a history of being sexually abused by her brother between the ages of 8 and 16 years old. The types and frequency of abuse changed over time as long as her parents were away from home. For the first three years L was completely unaware that she was being abused. The brother would occasionally use erotic statements when talking with L and show L pictures of adult women wearing underwear or nude. L thought this was just normal communication and was amused when her brother introduced her to the development of the female body as an adult. From 12 to 15 years old, when L entered puberty with many drastic changes in the body, the brother approached L more, often sending messages via social media such as Facebook to confide in L. He often told L about his broken relationships to gain her trust and understanding. At first, her brother sometimes used some sensitive words when referring to the private area, but he gradually increased his erotic language, as well as sending L pictures and clips of sex as a way to educate her. From the age of 14, L started to feel uncomfortable when her brother kept texting her and sending her explicit pictures. L once told her parents, but they responded with silence and distrust. L was disappointed and lived a closed life. By the time L was 15, CSA cases were exposed and widely published in Vietnam, creating opportunities for many victims to speak up and ask for help from society. When her homeroom teacher taught a Civic Education lesson about the children’s rights and CSA, L realized that she had been abused for a long time. L quickly met with the teacher privately to share and get advice (for L, her homeroom teacher was an expert on children’s rights). With the support of her teacher, L decided to speak up and protest to her brother. L once again informed her parents about her brother’s sexual abuse. However, parents still did not believe her. They asserted that a Confucian family always lived in accordance with the rules and standards, sexual abuse was absolutely not happened. L was helpless and solved the problem by herself. L asked her brother to stop the abuse, or else she would report it to the police. This only deterred her brother for the first three months, however. After that, he became even more aggressive in stroking L, touching her sexually, making her feel very uncomfortable and “dirty”. When L was 16 years old, the abuse reached its climax. She was lured by her brother to drink alcohol and perform sexual acts, and was eventually raped by her brother. L fell into despair and depression and shared that she once attempted suicide after that terrible events three days but was discovered by her father, so it was not successful. By this time, the parents believed that what L shared was true because her brother confessed that he was ‘accidentally drunk and raped her’. They were shocked and took action to intervene with her brother. Although they did not report to the police, L's parents took L to live with her aunt in another city and she continued to attend high school. L had managed to cut off the source of her abuse from here. However, the period that followed was the most challenging as she tried her best to balance her emotions, resilience, and reintegration into daily life. Details of her resilience and how she coped with the SAT are presented in the findings and key events sections which follow.

Data collection and analysis

Given the scope of the current article, data collection was based on L’s CSA-related events since the age of 8. This life-history method, according to Goodson (2001), generates not only deeper knowledge about the individual but also about the social reality and family relationship that she has to act out and operate within. Data collected from the accounts reported by L are collectively known as ‘socially read biography’, which provides insight into her resilience process, and the socio-cultural context, and offers a significant source of information and knowledge about Confucian female CSA survivors. From the perspective of social transformation, the employment of the life history method in this study is in line with the social approach to narrative research which enables the survivor to express her voice and attitudes towards the CSA.

Further, in line with the life-history method, data were collected by in-depth, unstructured interviews (Goodson, 2001). Because CSA is a sensitive topic to discuss as well as to research, the interviews were face-to-face with just two people present in addition to the interviewee. Each interview lasted from 45 to 60 minutes (M = 54). During the first two sessions, the researchers established a relationship with L through open and friendly exchanges to create a safe, positive and comfortable atmosphere for L. When L felt ready to share her story, the researcher conducted 25 interviews. Parallel to each interview, the researcher observed in detail L's views, feelings, and behaviors, especially unconscious behaviors and body language expressions when retelling her story. L was interviewed with open-ended questions and was encouraged to answer and share her experiences as a victim and survivor of CSA. The interviews usually took place once a week on weekends (Saturday and Sunday). Interview questions focused on exploring life experiences, the resiliency process following the CSA's traumatic experience, and the impact of religion and education on the participant’s resiliency ability. Specifically:

The 25 interviews were conducted in Vietnamese for convenience and so that the participant felt most comfortable when sharing her experience. All the details in L's story quoted in this article were translated from Vietnamese into English by the author, who is fluent in both languages. Interview data was recorded (under the restricted conditions with the consent of the participant) and the research team confirmed not to use these for any personal interest. These recordings, after being processed, were stored in a secure data system set up by the Computer Science Center of the university where the participants are studying. During the interview process, the researcher systematized the events that occurred in the participant's story in chronological order, noting important events as well as keywords and sentences serving the data analysis. As data collection was underpinned by the method of life history, deliberate strategies were employed for data analysis of the participant’s narratives (Goodson, 2001). In other words, the stories told by L during the interview were interpreted to highlight the foci of the study.

The data analysis was based on transcriptions of in-depth life history interviews with detailed observations of the participant's behaviors, emotions, and perspectives. The story told by L was considered and analyzed in the broader context of mental health and social life in Vietnam rather than examined in isolation. The analysis process was interpreted independently by three researchers (the 1^st, 2^nd and 3^rd authors). After that, the three results are discussed in a group and supervised by the 4^th researcher to ensure non-disputes, reliability and semantic consistency. After the group discussion, the result was returned to a participant for comment and approved to be used in the findings section.

L’s sexual abuse traumatic experiences

L described various types of CSA trauma, involving violence, harassment (in person and online), coercion, intimidation, and mental/physical stress. The acts of sexual abuse mainly took place at L's family home, during periods of parental absence, or when L used online social networks. During the period of abuse before developing more resilience, L experienced a range of emotions and thoughts. The emotions and thoughts verbalized during L’s interview were summarized in Table 2 by the research team (see Table 2).

It can be seen that the feelings, thoughts, and responses (behavior), as well as the psychological trauma and forms of abuse, experienced by L during the period of abuse, are similar to those found in other CSA victims. However, when considering the long-term effects, there is a significant difference between L and other published cases. The next findings section presents L’s recovery process of struggle and resilience from the age of 16, when completely separated from the perpetrator and she is no longer being abused.

L’s struggle and resilience journey

Since moving to her aunt's house, L has not seen her brother. She also blocked him on Facebook and other social networking sites in order to completely cut contact. She only keeps in touch with her parents. However, the days following this transition were a challenging time for her. During one interview L recounted the first day of entering a new school:

In the first three months following the move, it was difficult for L to adjust to the new learning environment and make new friends. Her trust in society seemed to be falling apart. L withdraws and limits communication with friends:

Not only that, but L’s trust in her parents also broke down:

It can be seen that L suffered fierce internal struggle and torment related to her role in the family, her outlook on life, and the way she interacts and integrates socially. L commented:

In addition, L suffered a period of depression as a result of feeling trapped and unsupported:

L recalled the day she was most desperate, the day she attempted suicide, her father was able to intervene and tell L:

L’s father's words were from the Confucian philosophies. He wanted L to think about her suicide, which was not the best way to solve her problems. The training of will and knowledge is the way to help L overcome suffering. Her father’s teachings act as a resource to help L continue to live and explore this life. Her parents do not hate L but show their love skillfully. They wanted L to grow up through training in thought and action. The parents chose to separate L from the place that caused her suffering. Even so, they still protect L's brother to a certain extent. As for her brother, L cut off contact. Since then, L has always showed resistance and kept her distance from her brother, so he could not do anything to her. For L, this was the best solution at the time to balance her parents’ bias for her brother and her safety:

When describing how she overcame the fear, humiliation, torment, and pain caused by the CSA, L reports that she never forgets her father’ statement [a] and considers it as her life philosophy, helping herself to be motivated to learn and overcome her dark past. L said:

It is not easy for a survivor to make it through the CSA and related past experiences. The case of L is different. L recovered significantly in just one year. So, what happened during that period? L recalled and recounted that:

The influence of Confuncian philosophical educational factors, mostly passive education (integrated across subjects, taught throughout lessons and different blocks in the educational program) had created a solid psychological foundation for L to explore clearer the Confucian philosophy. Thanks to her father’s advice, her interpersonal relationships (L's teacher and new friends), combined with her reflection on life, L realized her resources and understood how to recover from the CSA: Self-nurture, the lessons of being and relationships.

L did not deny that CSA was a traumatic event, and faced it step by step:

Thus, one year after the end of the abuse, the pain and trauma still affect her. The appearance of intrusive memories and panic attacks sometimes recurred during the first year. L took care of herself by learning to adapt and change herself to overcome that pain. This was a great effort in her self-nurture journey because at this time, psychotherapy services in Vietnam were not popular. L continued to reflect on her father’s words, her former homeroom teacher's questions, and what she learned in the educational program she went through. This was her coping strategy: The last year of high school, when the pressure of studying and exams hit, was also the time when L was enlightened with many philosophies to overcome the painful past and work towards a good future. L stated:

L has determined her academic goals and future, thereby overcoming the darkness of her past. For L, the memory of being abused becomes a driving force that makes her constantly learn and strive to improve herself, protect herself, and help those around her to change their perception of the CSA. The following quotes from L clearly describes how she overcame darkness and became enlightened:

By studying Confucian philosophy, L strengthened her beliefs in herself. This philosophical contemplation created a tremendous change in her resilience. With this, L has accepted her past and overcome the darkness of her life. She was enlightened and had gained valuable religious experiences. Besides, there is also the participation of education as passive, long-term support. All form a solid and enlightening spiritual resource, leading L to find her rights and her self-esteem. Following high school, L's life was able to develop as she entered university. This was also the time when L realized her dreams and sublimated negative emotions into positive, meaningful experiences. L recounted how she felt on the first day she entered the university lecturing hall:

At this stage, when reiterating the issue of CSA, L was able to share very comfortably. With L, those experiences are valuable life experiences and a driving force for her development. L never forgot, nor let it affect her negatively. L got rid of sin and planned to make up for the time she has missed. L commented:

L's academic and life goals went quite smoothly, she achieved what she set out to do and became an advocate and volunteer to provide mental support for sexually abused children in remote areas – an area that is still heavily prejudiced in Vietnam. L obtained the first achievement in her self-nurture process and contemplation of Confucian philosophy. L accepted her CSA trauma, and strengthens her religious beliefs strongly in her continued study of Confucianism. The researcher met L again in the next interview session, where L shared that:

L continued to develop her exploration of Confucian philosophy after her self-nurture’s enlightenment. She increased social interaction (making friends and spreading positive values) and reconnected with her parents, as well as brother. A strong belief in fighting for feminism has motivated L to contribute towards her happiness. This is the continuing development in the lower part of Confucian philosophy. After the process of self-nurture is to nurture family relationships, participate in national activities and international cooperation. The event ‘L's brother's punishment’ was the consequence predicted by L's father when he shared with her about the law of cause and effect. It is the natural in Confucianism. This further strengthened L's belief in Confucianism. The remaining problem that made L wonder was how to change the family’s Confucian prejudice.

In the last conversation between the researcher and L, L shared a message that she wants to send to female survivors who are stuck, repressed, and resigned in Confucian prejudiced families:

L’s mental and spiritual resources: The passive effect of the education curriculum and the most authentic perception of Confucian philosophy

In L’s story, we discovered two factors influencing her resilience: the passive effect of the educational program, and Confucianism. These two factors create mental and spiritual resources that helped L to cope and gradually overcome the CSA trauma.

Previous studies have confirmed that religion can be a support or impediment to the resilience of sexual abuse victims (Durà-Vilà et al., 2013; Murray-Swank & Pargament, 2005). Our findings correspond with this view. Confucianism was both a barrier and spiritual support to the survivors. In L's case, during the period of abuse, Confucian philosophy was a constraint on her equal rights. She did not have a voice and couldn’t denounce her abuser. Previous studies on mental trauma and the mental health of Vietnamese children and adolescents also provides good evidence for this outdated prejudice (Nguyen et al., 2016; Nguyen, 2018). Vu argues that only once the outdated stereotypes of Confucianism have been phased out of Vietnamese families and society, can women truly have freedom (Vu, 2009). We argue, however, that L's story demonstrates how when the neutrality in Confucian philosophical doctrine is properly understood, it can form a great spiritual resource to help overcome the CSA trauma. The idea of neutrality was particularly significant for L: ‘Whoever you are, you will have these relationships and you have the things you need to achieve balance’ (Session 12, July 21^st, 2020). When survivors maintain a neutral attitude toward the perpetrator and CSA-related issues by being non-judgmental, non-retaliatory, and accepting that the trauma that has happened in their life; they will be strengthened in will and inner strength. When a survivor’s will and inner strength is strong enough that they can live independently they can transform the SAT into value. This is also a philosophy within the lower part of Confucianism. L had studied the Confucian doctrine from the beginning to enlighten and better understand the philosophy, as a foundation to overcoming CSA trauma.

In terms of the impact of education, Tho (2016) states that Vietnamese education is heavily influenced by Confucianism. Confucianism attaches great importance to learning and considers it to be the foundation of human development in society. The five Confucian minimum human moral qualities are still the leading educational maxims in Vietnam, especially in moral education (self-nurture) and students’ comprehensive personality development. The five basic qualities of Confucianism, and other valuable aspects derived from Vietnamese traditions are considered indispensable content in moral education and are integrated into all school subjects. Thus, with foundations in Confucian doctrine, the Vietnamese curriculum equips students with solid spiritual roots and moral values as resources for them to cope effectively with adversity. In L’s story, it is impossible not to consider her participation in the preventive educational program on life skills, especially the CSA prevention skills that have been promoted in Vietnam since the 2015-2016 academic year (Nguyen, 2018). CSA prevention skills that have been deployed in educational activities for Vietnamese students include: safe and unsafe touches, privacy protection, supportive relationships, safe social media usage, safe dating, and refusal skills (Nguyen, 2018; Linh, 2021; Tran, 2020). These are also the skills that L had learned since the 9th grade. Along with the skills education, the subject of Civic Education and Literature equipped L with core beliefs and values. In Civic Education, L was taught the five moral values (of Confucianism), but also equipped with legal knowledge on women’s and children’s rights. This knowledge system has similarities with Confucian doctrine when it comes to moral cultivation, law enforcement and social stabilization. Because of her interest in Confucianism, L instilled these values. In Literature, L was taught to love herself in the past, present and future. The life values that this subject brings to L are love, tolerance and forgiveness. L forgives her past, her brother’s crime, and resolves to live a fulfilling life. The comprehensive prevention skills, and education on moral values underpinning human potential, particularly the five basic qualities of Confucianism, have supported the formation of positive mental resources and supported abused victims to overcome trauma through the concept of neutrality.

L’ resiliency journey: The process of spiritual nurture towards the neutrality

The findings show that L's resiliency journey had stages, with the learning and improvement of life values learned in school and an authentic understanding of Confucian philosophy through different timelines. Her story started with curiosity around sex; to guilt and self-loathing; then acceptance and seeking out resources; finally, contemplation, enlightenment, and overcoming pain. In terms of long-term effects, L experienced torment, loss of faith in herself and her family, social isolation, depression, and even attempted suicide. This CSA traumatic experience, as well as expressions of long-term effects, is quite similar to that of survivors in other cultures (Hailes et al., 2019). According to Durà-Vilà et al. (2013), the psychological process that abused victims, specifically Catholic nuns go through to achieve recovery includes 8 stages: (1) Shock and distress; (2) Self-doubt; (3) Anger and mistrust; (4) Withdrawal and mediation; (5) Secrecy or disclosure; (6) Community acceptance; (7) Spiritual integration; (8) Posttraumatic growth. The nuns’ understanding of their abuse in the light of their religious beliefs enabled the trauma to be transformed into a potential catalyst for growth. Therefore, considering religious and spiritual aspects when supporting religious people with CSA trauma may allow religious narratives that incorporate the trauma to unfold. It is important for the believers to have an authentic perception of the religious philosophy and how to apply these philosophies in daily life.

Throughout her story, L discusses self-nurture and neutrality - two core principles of Confucian philosophy that any believer must understand and live by. These are also two factors that motivated L to learn about her trauma and overcome it. Initially, she could not accept the fact, but her interest in the authentic perception in Confucian philosophy prompted her to search for explanations. L learned how to analyze problems neutrally and applied this to her trauma. She was successful in transforming her crisis into a motivation for learning and was able to practice self-nurture with the core philosophical values of Confucianism. Some contents of the current Vietnamese educational program still maintain the Confucian philosophy, taking the cultivation of qualities as the main focus in the development of student's personality. This is an inheritance of Confucian philosophy in education and has created a powerful inner resource to help L overcome her trauma. L was able to turn the CSA trauma into a resource for her self-development, so that she could serve the community and help prevent future cases like hers.

From L’s story, we have proposed a model of CSA trauma resiliency detailed in seven stages (see Figure 1).

Figure 1. Flow diagram showing the stages of CSA trauma resilience in a Confucian woman.

Underlying data

Figshare: The resiliency journey of a Vietnamese female sexual abuse survivor: An exploration in life history. https://doi.org/10.6084/m9.figshare.15390255.v3 (Giang, 2021).

This project contains the following underlying data:

Extended data

This project contains the following extended data:

Data are available under the terms of the Creative Commons Zero “No rights reserved” data waiver (CC0 1.0 Public domain dedication).