Most of the response messages here by nature tend to start with an "I'm sorry" or a "that's terrible" - but honestly the first thing I can think to say is that I admire you.
You, singular, not plural.
You describe having faced the trauma of your CSA, confronting and cowing your primary abuser, and successfully compartmentslizing it so you could live a good life around it. NOT blocking it out, NOT denial - actually getting treatment, getting support, getting at least some definitional measure of closure or justice. Very, very few of the guys here have done all of that. And I really admire the courage and effort that went into it. I admire winners.
The ASA seems to have ruined and undone all your hard work - I hope it doesn't offend to say that, but you've said about as much several times. And so it has dredged back up all the CSA, this time with extra filth like a tackily technicolorized or fake-3D reissue of an old movie where you already know the ending.
You can view this several different ways. How I urge you NOT to view this is as a cancer, thought to be in remission only to return and kill, irresistibly. It isn't irresistible. You did it before. There's a famous song from WW2 vintage - "We Did It Before And We Can Do It Again." Not that war is ever easy or safe, externally or internally. But - you did do it before. And if the kid who suffered all those vile tortures is still inside you, the young man who faced it, who rebuilt his life and stared down the perp, must be in there too. The self is a package deal, all history included.
You're not as strong as you used to be... at the moment... your spirit, your strength, have been... well... raped. It must seem impossible to even think of fighting. And that's horrible and I burn with hate for the sicko coward criminal pervert who attacked you at your weakest moments - because make no mistake he KNEW that you COULD fight him off and defend yourself under any normal circumstance. Adding insult to injury - he cheated. He CHEATED you of the opportunity for self-defense because he plainly knew you could take him. This is a common thread I see in many ASA stories, I dont know if I have the "standing" to say it, but it honestly means something to me - because the targeted men obviously ARE strong and masculine and can fend for themselves, and have to be poisoned like some medieval baron before the sneak-thief can dare to start ransacking.
The ASA is your real problem. You don't know how to fight it, it will surely take a different skill set than the CSA did - just as surely as someone who boxes his way to a great victory can still get his ass kicked by karate. Do whatever you can to protect yourself from the immediate poisons of the ASA. Don't hate yourself, don't give up. Stick with therapy and if it isn't working get another therapist. You've mentioned there being fairly few options where you live. As traumatic as the notion is, you might want to consider moving towards an area with better therapeutic options - even just a larger regional city. Or, somehow treat it as a weekly business trip. You have adult sons - they could perhaps defer some of the expenses. If you needed weekly flights to a cancer clinic for chemo, and needed their help to make that possible, don't you think they would?
Fight the ASA in any way you can, tooth and nail. Find or start a support group. Grab that baseball bat you sleep with and find some trees and shopping carts to annihilate. Do ANYTHING to get back to a semblance of your old self.
Because you did face down the CSA. You did. You, singular. And if you can somehow re-compartmentalize, re-envision, rebuild an adult life of self-sufficiency and strength... I believe you can put the CSA in its place again. I believe in you.
P.S. - I hope you don't find this too cheesy, but, I dunno, I just figured everybody needs a peptalk now and then:http://www.youtube.com/watch?v=vO0euzURgRI&feature=youtube_gdata_player