There is much that the SA survivor can do to manage stress. The second part of this section will focus on the physical management of stress. But before examining this, it is important to realize that the role of a psychotherapist can be extremely helpful. Some of you reading this have never told anyone about your abuse. If your abuse is minor and if you don’t suffer from any diseases linked to stress and if you don’t worry or get angry about your abuse history, then you may not need to go through psychotherapy for this. But, chances are good that the average SA survivor can benefit from the services of a psychologist, psychiatrist, or mental health worker. It is difficult to admit that you were abused, to summon the courage to deal with it, and to tell someone about this. If your finances are limited, call around to see if anyone will lower their fees or if there is a county or city based mental health program available at low cost. The nationwide list of centers on our website may not include your city; so do some research and you may find a center close to you. Some organizations provide group therapy, which has been shown by researchers to be extremely helpful in overcoming disease.

There are also several good books and websites that offer very beneficial help to SA survivors. One book, a classic in this field, is The Courage to Heal by Ellen Bass and Laura Davis. First printed in 1988, this book has been revised several times. Although the authors are not psychologists, they write from the heart and their advice, based on many workshops they have given, is practical.

Remember that your prior history of sexual abuse has already contributed to your stress level and this, combined with the stress in everyday life, may increase your risk for disease. If your body is prepared optimally and in excellent aerobic condition, distress will have a tough time causing disease.

Many SA survivors use obesity to protect themselves from further abuse. However, obesity is a risk factor for heart disease, diabetes, high blood pressure, stroke, and other afflictions. If you worry about still being molested, get a black belt in karate, carry mace, and go out in groups at night. The government offers guidelines (http://win.niddk.nih.gov/publications/understanding.htm) in defining obesity: most experts agree that men with more than 25 percent body fat and women with more than 30 percent body fat are obese. These numbers should not be confused with the body mass index (BMI). At this website, there is a weight chart you can consult to determine if you are overweight or obese.

If you are obese or very overweight and you have decided to lose weight, you should consult with a physician who is knowledgeable in this area. After doing that, use common sense regarding diet and exercise. Weight gain, though influenced somewhat through genetics, can be viewed simply as calories burned each day. If you consume more calories than you burn, you will gain weight and vice versa.

Fad diets appear generally about once or twice a year in the U.S. and are followed religiously by the populace, which may lose weight initially but then gain it back later. However, The 3-Hour Diet stands apart from the crowd and its program has stood the test of time. Author Jorge Cruise, a formerly overweight lad, formulated a common sense plan based on scientific research. His website, www.jorgecruise.com, lists his affiliations and accomplishments. His basic premise is that we eat portions of food that are too large, expand our stomachs, and gain weight. If the body becomes hungry, as it does a few hours after a meal, it begins to conserve fat and burn glycogen from muscle. This is the starvation mode. If a person eats five small meals a day, instead of three large ones, the body never gets hungry and continuously burns fat. In addition to this, small meals cause the stomach to shrink in size. This is what also happens after surgical stapling of the stomach. A smaller stomach cannot tolerate a normally large meal and will feel full after only a small one. By eating five small meals, you will lose weight. The Japanese, especially those who live in small fishing villages, usually eat until they are 80 percent full, following this same principle of eating small portions of food. This culture is known for its longevity.

Mr. Cruise’s book also offers suggestions on types of food. Avoiding foods with high fat contents (fried foods, French fries, fatty meats, most fast food, etc.) makes it easier to lose weight.

If you run a marathon, you will burn about 3,000 calories. But don’t worry; if you aren’t a marathon runner, there are other ways to exercise effectively. Swimming, walking, playing tennis, cycling, and other outdoor activities will burn calories. If you are obese and plan to begin an exercise program, check with your physician.

Kenneth Cooper, M.D. wrote the book, Aerobics, in 1968, which revolutionized the approach to physical exercise. For example, body builders may show off their gorgeous muscles on the beach, but their heart and lung capacity are nowhere near the levels of long distance runners or competitive swimmers. Dr. Cooper found that many of his patients responded so well that he devised a simple point system, which can be used by anyone beginning an aerobic exercise program. He has written several books since his original Aerobics, although copies of this classic are still available through book resellers on the Internet.

Some find it hard to give up certain foods, which have addictive powers. This includes the caffeine of coffee and sodas, sugar, and salt. While using a little of each of these every day will certainly not hurt, many people are slaves to these items. Ask yourself if you really need ten cups of coffee a day or ten candy bars, two Twinkies, and all that salt.

Smoking is a habit introduced to western society by the Native American Indians who have smoked for thousands of years. In their culture, smoking a pipe was often a religious or ceremonial ritual. In our culture, smoking cigarettes may relieve anxiety but it can often cause lung cancer, oral cancer, emphysema, or other disease. Some SA survivors smoke to get through the stress of life. The nicotine high is enough to energize them into feeling that they can cope with each day. However smoking comes with a price. To really understand what smoking can do to a person’s life, visit lung cancer patients in an oncologist’s office or volunteer at a local hospital.

Drinking alcohol dehydrates your system. Unfortunately we live in an age when the television bombards us with ads to drink beer and shows us that having a good time and drinking beer go hand in hand. And while there’s not much harm in a social drink or two, some individuals heavily abuse drinking alcohol, taking drugs, or using other forms of stimulants or relaxing agents so that their bodies become addicted and medically harmed. To test yourself, see if you can attend a social gathering (where alcohol is being served), have a good time, and not drink.

Many equate their self-image to their physical appearance. SA survivors may feel very guilty inside and, wanting to mask this, have a strong desire to maintain a very becoming external appearance. However, one’s self worth comes from within, despite all the claims from the beauty magazines that catch your eye at the checkout lines in the grocery store. Still, if you want to change your physical appearance, that is OK, as long as you realize that your beauty lies on the inside, not on the outside.

What can you do? Change your hairstyle? Have your dentist bleach your teeth or perform cosmetic dental treatment for a beautiful smile? There’s nothing quite as appealing as a healthy, vibrant white smile in making first impressions.

Does another aspect of your face bother you? Why not consult with a plastic surgeon and learn about your options? Even though the body is only our earthly clothing, there’s nothing wrong with looking nice. And, if it helps to raise your self-esteem, especially if you are a SA survivor whose self-image has been beaten down by the abuse, then it’s money well spent.