Although I've treated adults with debilitating childhood physical and/or sexual abuse, and although some psychiatrists diagnose PTSD for every case of sexual abuse, I find it more accurate to restrict the PTSD designation to those whose lives were threatened. In some extreme childhood abuse cases, that was true. I've worked with patients who were threatened with guns, knives, and strangulation as children. The aggressor was often a parent, sibling, or older relative--and those terrifying threats had a lasting effect.
On occasion I've treated a woman or man for anxiety/panic attacks or obesity, and discovered they were physically and/or sexually abused as a child. Yet, they had no conscious memory of it. This type of repression is more common than people realize. The mind attempts to protect the individual from painful memories that it doesn't think could be accepted or handled.
A tell-tale sign exists when the patient reveals that her/his childhood memories have major gaps or blank periods. In extreme cases, they may remember very little of their childhood. Sometimes they have a feeling that "something happened," but not always. In less extreme cases, the patient remembers the beatings or sexual abuse.
However, even when remembered, it is rare for the child to report the abuse to a parent or school official. They just accept it, and try to move on with their lives. Unfortunately, these experiences usually have life-long negative effects unless treated. According to the CDC, approximately one in four girls, and one in 13 boys experience childhood sexual abuse.
Because so many victims never speak up, school counselors are taught that a girl's obesity could be a symptom of sexual abuse. From the point of view of the inner child, this makes perfect sense. Men are much less interested in an overweight girl or woman. Thus, it serves as a useful layer of protection. And, even though the threat and abuser may be long gone, the inner child maintains the extra pounds for decades--because in her world the threat is still very real!
While the healing process usually takes longer in cases of severe childhood physical and/or sexual abuse, life-changing improvements have been experienced by my hypnotherapy patients.