Pope Francis will be involved in all the sessions, for which nearly 200 bishops have come from around the world, including Chicago Cardinal Blase Cupich. The goal is to stop the crisis in the church. They'll hear firsthand from those whose lives were damaged by it.
RELATED: Roman Catholic Church leaders gather at Vatican for global meeting on clergy sex abuse
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"My whole life changed the day that that happened," said Larry Antonsen, abuse survivor.
Antonsen was abused by a priest on a church retreat when he was a sophomore in high school. Wednesday night he expects the nightmares to return, again.
"I still wake up literally every night," he said. "Not a night goes by where I don't wake up at least once with these memories coming back."
Every victim is a singular story, and collectively those stories are what the bishops traveling to Rome are being asked to take to heart.
"Your first reaction is outrage. Outrage at the hurt that's been visited on kids," said Cardinal Cupich.
And the anger goes deeper than that, to those who covered it up.
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"There were people who mishandled it in their communities, so that others could then go ahead and offend again," Cupich said.
The Rome summit is designed to change that; calling the top bishop leaders from all over the world in what truly amounts to a historic "come to Jesus" moment with their boss.
"This is the matter of the heart," Cupich said. "It's not a matter of enacting a law."
"The problem is that, historically, bishops are accountable to the Pope. They're not accountable to one another, nor are they accountable to, uh, the people," said Fr. Mark Francis, Catholic Theological Union President.
To fix that, Cardinal Cupich said the Pope wants bishops to know that when it comes to sex abuse, their jobs are on the line.
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"Bishops not only who misbehave themselves, but also mishandle these cases," Cupich sad. "They are liable to be removed from office."
Can they accomplish that in just a four day meeting? Even the Pope recently seemed to dampen expectations.
But survivors like Antonsen believe taking action is long overdue.
"Why shouldn't we have high expectations? We should have high expectations! If we want the church to change, we should have high expectations for them to do that," he said.
Cardinal Cupich, who is a leading organizer of the summit, insisted that clear global policies will be established with penalties spelled out for priests and bishops who abuse or mismanage cases. Catholics and non-Catholics will be watching carefully. Beyond any words, they want proof in action.