Improving health and wellbeing with adult survivors of child sexual abuse.
Yes, our RCbbc Blog has signed their Policy Statement & as such, we’ll be Sharing much of our parallel beliefs. Starting with the logo + goal.
Our goal is simple: we want to improve health and wellbeing outcomes for adult survivors of child sexual abuse.
At Visible, we are a catalyst for health and social care services system change across Leeds and beyond. We encourage, shape and instigate this change, using the experience of survivors to influence every aspect of the way we work.
After decades of denial and cover-up, adult survivors are coming forward, helped by radical new initiatives.
On 2 June, Noa Pothoven, 17, died at home in the Dutch city of Arnhem having refused all fluids and food. She had been sexually assaulted at the age of 11 and raped at 14, and suffered from anorexia and depression. She spoke of her “unbearable suffering” in the aftermath of the attacks – “I have not been alive for so long,” she wrote.
For survivors of childhood abuse, the potential long-term impact of their experiences is only beginning to be exposed; taboo, secrecy and shame still prevail. Yet, slowly, as inquiries are held and more cases come to court, greater numbers of adult survivors of childhood abuse are beginning to come forward. While some can cope well, for others lives and families are torn apart as the root causes remain hidden. Is society doing enough for adult survivors, who, too often, are overlooked, pathologised and criminalised?
Jimmy Savile, “eccentric and flamboyant”, garlanded with honours and awards, died in 2011 aged 84, never having paid for his crimes. A year after his death, he was revealed as a prolific and ruthless sexual predator throughout five decades. Concerns had been raised since the 1960s and suppressed. He had fame and power, so was free to abuse in plain sight.
Since then, a number of prolific offenders have appeared in court including Peter Ball, a bishop who was protected by the establishment, Barry Bennell, a football coach, and the pop singer Gary Glitter. In addition, groups of mainly Asian men, in cities including Rotherham, Nottingham and Oxford, have been given lengthy jail sentences for violently sexually exploiting vulnerable young girls, the victims treated by police and social workers as “child prostitutes”, their plight ignored.
In 2014 the government established the Independent Inquiry into Child Sexual Abuse (IICSA) to examine how institutions, including hospitals, care homes and boarding schools, have handled their duty of care to protect children. The inquiry has launched 14 investigations and has set up the Truth Project, “I Will Be Heard”. So far, more than 3,000 survivors of abuse have related their experiences at the hands of trusted adults, family members and in institutions.
Four years ago in Leeds, Savile’s birthplace, Tessa Denham, 58, a counsellor, coach and chief executive of the Women’s Counselling and Therapy Service, organised a workshop. Sixty colleagues from healthcare, the police, GPs, voluntary organisations and the city council attended. “The decades of denial and cover-up were beginning to crack,” Denham says. “That made me think, as a city, ‘What should we do? What do we need to do?’
“Abuse has shaped me. It still affects my daily life,” she says. “I was abused by my grandfather and my stepfather. Yet for years I’d tell everyone that I hadn’t been affected. It was only when I went for counselling in my 30s that I began to join up the dots of my own behaviour.
“I’m middle class, mouthy and I don’t lack confidence. Imagine what it must be like for someone who has none of those resources. Some survivors cope, others experience addiction, unemployment, prison, chaotic, shattered families, and still the secret is kept. That’s why we passionately believe it’s time to make a difference.”
The difference is a potentially groundbreaking holistic city-wide project called Visible, launched in Leeds on 10 June after two years of plannning. The aim is to proactively support adult survivors and open up a national conversation about the extent of need and why long-term government funding is essential.
The ambition is that projects like Visible are replicated across the country.
“It was as if we all gave a collective sigh of relief,” says Sinéad Cregan, Leeds adult services commissioner and chair of Visible. “Phew! At last we’re going to try and do something. More and more people at inquiries are talking for the first time. Yet, across the country, the response has not been good enough.”
What will Visible do in practice? Survivors say that many professionals don’t recognise trauma, and they don’t ask the right questions because they don’t know how to handle the response. Visible hopes to conduct research into what works best, increase public understanding, and train a range of professionals including police, magistrates, employers, commissioners, GPs, teachers and social workers to ask the right questions so that a range of appropriate help is offered. “We want to act as a catalyst.” Denham says. “When money is tight, there are no quick fixes but the door has begun to open.”
“Phil”, 52, is on Visible’s steering group. He waited 40 years before disclosing that as a boy he was abused by two men who threatened to harm his family if he told anyone. “It was when my son was the same age that I told my wife. I had a breakdown. I was worried the same thing would happen to him. I’d text him all the time.
“I waited 12 months before I got into the mental health system. I’ve self-harmed, I’ve tried to take my own life. I was interviewed by the police about Jimmy Savile because I worked with him as a hospital porter – and that’s when it got worse. I see the devil with the abusers’ face. I hear voices. In an ideal world, I’d like for people to speak out and be heard.”
In the survey, 90% said their intimate relationships were negatively affected, 89% said their mental health was negatively affected, 72% said that it had damaged their career, and 46% said it had a detrimental effect on their financial situation (because they often had to pay for therapeutic help they couldn’t access otherwise). Only 16% said the NHS mental health services met their need. “I am a survivor of childhood sexual abuse and the mental health system,” was one response.
“The spectre hanging over them infiltrates every aspect of life,” Sarah Champion, Labour MP and chair of the APPG said in the Commons. “A trigger can be anything – the same aftershave that their abuser was wearing or a feeling of being in an enclosed space. Unless we recognise that these people are victims of crime, they will not be able to lead their full lives and reach the potential that we all deserve to achieve.”
A 2015 survey of 400 adult survivors indicated that the abuse had begun, on average, at the age of seven and continued for long periods; 90% hadn’t seen their abuser brought to justice. The average wait before survivors tried to access services had been 20 years, and not even then had individuals disclosed abuse. For one in five who disclosed at the time, the abuse continued on average for a further six years.
Last year NHS England announced improved provision for victims of sexual abuse. The five-year strategy has an investment of £4m a year until 2020-21. “It’s welcome but it’s a drop in the ocean,” says Fay Maxted, chief executive of the Survivors Trust, which represents 130 organisations. “In real terms, funding has dropped significantly in the last 10 years.”
She is also concerned that the specialist trauma-trained organisations in the voluntary sector, which survivors frequently say they prefer to statutory services, won’t benefit from the funding controlled by GPs’ clinical commissioning groups. “The CCGs often have a lack of understanding of what survivors need.”
“Adult survivors don’t always present as the perfect victim,” explains Gabrielle Shaw, chief executive of the National Association for People Abused in Childhood (Napac). “We all need to understand better that the question isn’t, ‘what’s wrong with you?’ but ‘what happened to you?’”
Shaneen Mooney, 34, a housing officer, who runs her own essential oils company, Essential Flow, waited 16 years before disclosing. At the age of 14 she was groomed by a man in his 30s. “I thought it was romantic love. He ended the affair when I was 16. For years I didn’t value myself. I drank, I took drugs, I was unfaithful. I had a breakdown and dropped out of university and gradually began to realise that what had happened to me wasn’t right. It was rape.
“In 2014 I was given free counselling by a rape support charity. That’s no longer available. Then I waited a year for NHS counselling, which was hard. Gradually, I realised that the silence, keeping all the stuff inside me, was more damaging.”
Now happily married, Mooney says counselling has been invaluable. “I’m in a much better place. Victims don’t have to carry shame and believe there’s something wrong with them. Healing and wellbeing are possible. That’s why I share my truth in the hope that it will encourage others to break the taboo, speak out and get help. Life can change.”
In 2018, Napac, received 6,458 calls on its helpline but there were another 87,619 calls that couldn’t be taken because of lack of resources.
In Leeds, will Visible unleash a demand that similarly can’t be met? According to the IICSA, some 2 million people, are adult survivors of childhood sexual abuse, and 15% of girls and 5% of boys are predicted to experience sexual abuse before the age of 16. In Leeds those figures would translate to 50,000 adult survivors and more than 15,000 children and young people.
Visible was launched with a grant of £100,000 from Lloyds Bank Foundation. It has applied for further grants. Leeds city council faces a £100m funding gap by 2022. Will hopes be raised but not met?
“Health commissioners and government have to stump up the money,” Richard Barber of Leeds Survivor-Led Crisis Service says unequivocally. “Society has got its head stuck in the sand about the scale of child sexual abuse. As a result, survivors get demonised and traumatised over and over again.”
“Everybody knows somebody who is directly or indirectly affected,” points out Sharon Prince, consultant psychologist with Leeds and York Partnership NHS Foundation Trust, a part of Visible. “We have to change the response. That can range from family and friends listening and validating to more formal interventions. The first steps are for people to trust enough so they can disclose and be believed.”
Visible promotes “trauma-informed” support for survivors. It is based on building trust, collaboration and a survivor exercising choice. “It’s all about the quality of the relationship,” Prince says.
While funds for survivors are woefully inadequate, the Independent Inquiry into Child Sexual Abuse has spent an extraordinary £96m since 2014. It has recommended that support for adult survivors requires “urgent” attention. Money is promised in the forthcoming spending review. In addition, the parliamentary group wants the Home Office to commission research into the hidden economic and social cost of child sexual abuse, collect data on what is spent on therapeutic care, and research what support works best.
Dr Carol-Ann Hooper, Visible’s evaluator, says: “In the US, the term ‘parallel justice’ has been coined to argue for reparation for victims to take its place alongside the prosecution of offenders to enable survivors to heal and rebuild their lives. There is also a significant income-based justice gap. Those who can afford to pay for therapeutic help have options, those who can’t, may have none.”
“Helena”, 60, a former teacher, pays for trauma therapy. “Otherwise I’d have to wait several months and I can’t.” As a child, she and her friend, Janet, played in the street. A teenage girl invited them into her home. “We’d dress up in her clothes and stilettos,” Helena says. Play turned to abuse and both children had a bottle inserted in their vaginas. “I felt I’d done wrong. I did tell my parents three years later. They said, ‘We can’t do owt. It’s water under the bridge. The abuse made me wary of young women, mistrust everybody. I still find it very difficult to hug people. I became anorexic. I wanted to be unseen. Occasionally I’d mention what happened and people would say, ‘women don’t do that’.”
A few years ago, Helena went to an exhibition. “I’ve been lucky. There was an image called Release. I thought yes, you need to unburden, take away those heavy things on your shoulders. For years, I didn’t like clothes or dressing up, I didn’t like high heels. I never had friendships. But suddenly, I thought, yes, I can have friends. And I do. Abuse results in so many ripples over a lifetime. People don’t think to ask, ‘what are those ripples really about?’”
Visible already has plans to expand its work to include sporting bodies, churches, mosques, major corporations, magistrates and prisons. Leeds city council will also look at its own large workforce to assess the needs of potentially several hundred survivors. “We are also keen to collaborate with anyone in the UK,” Denham says. “We cannot afford to slip back.”
I was isolated and petrified
“I was abused until I was 11 by someone outside the family. When it was happening, it was horrible but I didn’t want to make a fuss” says Debbie, 43.
“By the time it stopped, I was isolated and petrified of everything. I’d hide in the cupboard if the phone rang. People would think I was rude. I just wanted to be invisible.
“I worked hard at university because I thought I was thick and horrible. I had a breakdown. I tried to commit suicide. I was in psychiatric hospital for four months. I became anorexic. At no point did anybody ask me why I hated myself. Why I was anorexic.”
At one point, Debbie weighed four stone and suffered multiple organ failure. “It took 10 years before I began psychotherapy and somebody finally asked me the right questions; otherwise my earlier medical records all say things like, ‘Deborah’s had a lot of input with little progress’.
“I’ve been diagnosed with OCD, personality disorder, complex PTSD.”
Unusually, Debbie received 12 years of support on the NHS, but then it stopped. Now she pays privately for psychotherapy. “I know things cognitively but I have no feeling. I’m not in touch with things emotionally. I’ve no attachment to anyone or anything.
“Six years ago, my mum asked if anyone had done anything to me. I don’t want my mum to know. I don’t want her to work out who it is. I don’t want him to say it didn’t happen. I want to feel safe and not want to be dead. I want to feel.”Topics
Good mental wellbeing — some people call it happiness — is about more than avoiding mental health problems. It means feeling good and functioning well. It can be helpful to maintain an awareness of your overall wellbeing. It can help you to identify the things that have an impact on how well you’re doing and give you more power in improving your functioning. The below wellbeing assessment is a tool to help you with this.
This wellbeing assessment uses the Warwick-Edinburgh Mental Well-being Scale (WEMWBS) to measure wellbeing. More about the WEMWBS is below.
To get a wellbeing score, read through the statements and click on the box that best describes your thoughts and feelings over the last two weeks, then click next to continue on through the 14 questions. You will receive information at the end that will provide an assessment of your current wellbeing.
The WEMWBS is an internationally validated assessment of well-being that utilises strength based language less likely to be triggering or distressing for those who have been traumatised.
By integrating and promoting use of the WEMWBS on the Living Well site, we are very much aware that childhood sexual abuse and sexual assault can profoundly impact on an individuals mental and physical well-being. We have included information on our website on some of the particular difficulties people who have been abused can face, as well as some ways of addressing these.
Our decision to foreground the well-being assessment is based on a knowledge that living a fulfilling, healthy, connected, active life is possible after sexual abuse and we do not wish to accept a lesser goal for all those whom we live and work with.
About the wellbeing scale
The WEMWBS questionnaire for measuring mental well-being was developed by researchers at Warwick and Edinburgh Universities (see Tennant R, Hiller L, Fishwick R, Platt P, Joseph S, Weich S, Parkinson J, Secker J, Stewart-Brown S (2007) The Warwick-Edinburgh Mental Well-being Scale (WEMWBS): development and UK validation, Health and Quality of Life Outcome; 5:63 doi:101186/1477-7252-5-63).
The Warwick-Edinburgh Mental Well-being Scale was funded by the Scottish Executive National Programme for improving mental health and well-being, commissioned by NHS Health Scotland, developed by the University of Warwick and the University of Edinburgh, and is jointly owned by NHS Health Scotland, the University of Warwick and the University of Edinburgh.
The WEMWBS is subject to copyright. We are grateful that we have received permission to use and make available the WEMWBS. Click here for more information about the WEMWBS.
Get the mobile version
The well-being assessment is one of the features available in the free Living Well Appfor iPhone and Android. Keep track of your well-being on the go.
For many survivors, counselling may be the first time they have ever disclosed the abuse. They may have been locked into silence for years or even decades. Telling the counsellor can bring tremendous relief. On the other hand, some survivors may have revealed the abuse previously, only to be met with disbelief or rejection. Being heard and believed for the first time is an immensely important experience.
Trust is a difficult issue for most survivors of abuse. They may find it impossible to trust anyone: anyone could be a potential abuser. Others, though, have a problem with trusting too easily. As children, they weren’t able to learn who to trust and who not to, so in adult life, they are not able to use their gut instinct to recognise situations that would make other people feel uncomfortable. This means they can find themselves getting into abusive relationships and dangerous situations.
Counsellors are trained to be trustworthy with respect to confidentiality, reliability and other boundary issues. Experiencing a trusting relationship with the counsellor allows the client to re-set their capacity to trust other human beings.
Childhood sexual abuse is traumatic in many different ways, and children often learn to protect themselves by splitting off their awareness of the abuse. This process is called dissociation, and it is almost like self-hypnosis.
A consequence of dissociation can be that adult survivors experience terrifying flashbacks of the abuse, which don’t feel like real memories. A trained counsellor can help the client to understand the process of dissociation, so that they are less frightened, and can begin to re-integrate their memories.
Many survivors have feelings of intense shame, which they carry with them all the time. Telling their story to a counsellor, who is always non-judgmental, allows them to see things from a different perspective. They may realise for the first time just how young and vulnerable they were when the abuse took place.
The counsellor will emphasise that a child is never to blame, no matter how persuasively the abuser tells them that they are. Hearing from an expert that their experience was typical can bring huge release from shame. Instead, feelings of anger and grief may surface, which the counsellor can help to deal with safely.
Counselling for sexual abuse
Counsellors who are trained and experienced in working with sexual abuse are used to hearing very shocking and upsetting accounts. For the client, being able to share details which once seemed unbearable for another person to hear can bring great comfort, and again can help to dissolve feelings of shame. Current issues, no matter how painful, can be brought up in a supportive, non-judgmental environment.
For the counsellor and client to work through the many issues arising from childhood sexual abuse can take a while, but eventually, the aim is that the client feels ready to move on, leaving counselling feeling more empowered and more free to live their life.
According to U.S. Department of Health and Human Services statistics for 2006, approximately 905,000 U.S. children were found to have been maltreated that year, with 16% of them reported as physically abused (the remainder having suffered sexual abuse or neglect.)1 In other studies, it’s been noted that approximately 14-43% of children have experienced at least one traumatic abusive event prior to adulthood.2 And according to The American Humane Association (AHA), an estimated 1,460 children died in 2005 of abuse and neglect.3
The AHA defines physical child abuse as “non-accidental trauma or physical injury caused by punching, beating, kicking, biting, burning or otherwise harming a child.”3 However, it can be challenging to draw the line between physical discipline and child abuse. When does corporal punishment cease to be a style of parenting and become an abusive behavior that is potentially traumatizing for its child victims in the long-term?
A recent episode of the popular television show Dr. Phil featured a woman whose extreme disciplinarian tactics later resulted in her arrest and prosecution for child abuse. A featured video showed her forcing her young adopted son to hold hot sauce in his mouth and take a cold shower as punishment for lying. Audience members were horrified—as was Dr. Phil—but the woman insisted that she couldn’t find a better way to control her child. Many child abusers are not aware when their behavior becomes harmful to a child or how to deal with their own overwhelm before they lose their tempers.
At its core, any type of abuse of children constitutes exploitation of the child’s dependence on and attachment to the parent.
Another therapeutic term that is used in conjunction with child abuse is “interpersonal victimization.” According to the book Childhood victimization: violence, crime, and abuse in the lives of young people by David Finkelhor, interpersonal victimization can be defined as “…harm that comes to individuals because other human[s] have behaved in ways that violate social norms.”5 This sets all forms of abuse apart from other types of trauma-causing-victimization like illness, accidents, and natural disasters.
Finkelhor goes on to explain: “Child victimizations do not fit neatly into conventional crime categories. While children suffer all the crimes that adults do, many of the violent and deviant behaviors engaged in by human[s] to harm children have ambiguous status as crimes. The physical abuse of children, although technically criminal, is not frequently prosecuted and is generally handled by social-control agencies other than the police and criminal courts. “5
What happens to abused children?
In some cases—depending on the number of reports made, the severity of the abuse, and the available community resources—children may be separated from their parents and grow up in group homes or foster care situations, where further abuse can happen either at the hands of other abused children who are simply perpetuating a familiar patterns or the foster parents themselves. In 2004, 517,000 children were living in foster homes, and in 2005, a fifth of reported child abuse victims were taken out of their homes after child maltreatment investigations.6 Sometimes, children do go back to their parents after being taken away, but these statistics are slim. It’s easy to imagine that foster care and group home situations, while they may ease the incidence of abuse in a child’s life, can lead to further types of alienation and trauma.
For children that have suffered from abuse, it can be complex getting to the root of childhood trauma in order to alleviate later symptoms as adults. The question is, how does child abuse turn into Post Traumatic Stress Disorder later in life? What are the circumstances that cause this to happen in some cases and not others?
Statistics show that females are much more likely than males to develop PTSD as a result of experiencing child abuse. Other factors that help determine whether a child victim will develop PTSD include:7
The degree of perceived personal threat.
The developmental state of the child: Some professionals surmise that younger children, because they are less likely to intellectually understand and interpret the effects of a traumatic situation, may be less at risk for long-term PTSD).
The relationship of the victim to the perpetrator.
The level of support the victim has in his day-to-day life as well as the response of the caregiver(s).
Guilt: A feeling of responsibility for the attack (“I deserve it”) is thought to exacerbate the changes of PTSD.
Resilience: the innate ability to cope of the individual.
The child’s short-term response to abuse: For instance, an elevated heart rate post-abuse has been documented as increasing the likelihood that the victim will be later suffer from PTSD.
Carolyn Knight wrote a book called Working With Adult Survivors of Childhood Trauma that states: “Trauma, by definition, is the result of exposure to an inescapably stressful event that overwhelms a person’s coping mechanisms.”6 She points out that an important aspect of an event (or pattern of events) is that it exceeds the victim’s ability to cope and is therefore overwhelming. A child should not have to cope with abuse, and when abuse occurs, a child is not equipped psychologically to process it. The adults in their lives are meant to be role models on how to regulate emotions and provide a safe environment.
According to the American Academy of Child & Adolescent Psychiatry, some of the particular symptoms of child PTSD include:8
Frequent memories and/or talk of the traumatic event(s)
Once a child has grown to be an adult, however, symptoms of PTSD can become more subtle as he or she learns how to cope with this in day-to-day life. The symptoms of PTSD can be quite general and can mimic other disorders: depression, anxiety, hypervigilance, problems with alcohol and drugs, sleep issues, and eating disorders are just a few. Many have problems in their relationships and trusting another person again. Many even end up in abusive relationships and find themselves re-enacting the past.
Community support is a vital tool in preventing child abuse and the PTSD that can result from it. If you suspect that you or a loved one is suffering from child abuse, please report it to your local Child Protection Services — or the police, if a child is in immediate danger. The longer that abuse continues, the higher the risk of causing severe symptoms.
If you or a loved one may be suffering from delayed effects of trauma due to childhood abuse, I encourage you to make a therapyappointment with someone who specializes in trauma and who can put you on a path of healing.
1 Child Maltreatment 2006. Washington DC: US Department of Health and Human Services Administration for Children and Families, Administration on Children Youth and Families Children’s Bureau; 2008. 1-194
Children who suffer trauma from abuse or violence early in life show biological signs of aging faster than children who have never experienced adversity, according to research published by the American Psychological Association. The study examined three different signs of biological aging—early puberty, cellular aging and changes in brain structure—and found that trauma exposure was associated with all three.
“Exposure to adversity in childhood is a powerful predictor of health outcomes later in life—not only mental health outcomes like depression and anxiety, but also physical health outcomes like cardiovascular disease, diabetes and cancer,” said Katie McLaughlin, Ph.D., an associate professor of psychology at Harvard University and senior author of the study published in the journal Psychological Bulletin. “Our study suggests that experiencing violence can make the body age more quickly at a biological level, which may help to explain that connection.”
Previous research found mixed evidence on whether childhood adversity is always linked to accelerated aging. However, those studies looked at many different types of adversity—abuse, neglect, poverty and more—and at several different measures of biological aging. To disentangle the results, McLaughlin and her colleagues decided to look separately at two categories of adversity: threat-related adversity, such as abuse and violence, and deprivation-related adversity, such as physical or emotional neglect or poverty.
The researchers performed a meta-analysis of almost 80 studies, with more than 116,000 total participants. They found that children who suffered threat-related trauma such as violence or abuse were more likely to enter puberty early and also showed signs of accelerated aging on a cellular level-including shortened telomeres, the protective caps at the ends of our strands of DNA that wear down as we age. However, children who experienced poverty or neglect did not show either of those signs of early aging.
In a second analysis, McLaughlin and her colleagues systematically reviewed 25 studies with more than 3,253 participants that examined how early-life adversity affects brain development. They found that adversity was associated with reduced cortical thickness—a sign of aging because the cortex thins as people age. However, different types of adversity were associated with cortical thinning in different parts of the brain. Trauma and violence were associated with thinning in the ventromedial prefrontal cortex, which is involved in social and emotional processing, while deprivation was more often associated with thinning in the frontoparietal, default mode and visual networks, which are involved in sensory and cognitive processing.
These types of accelerated aging might originally have descended from useful evolutionary adaptations, according to McLaughlin. In a violent and threat-filled environment, for example, reaching puberty earlier could make people more likely to be able to reproduce before they die. And faster development of brain regions that play a role in emotion processing could help children identify and respond to threats, keeping them safer in dangerous environments. But these once-useful adaptations may have grave health and mental health consequences in adulthood.
The new research underscores the need for early interventions to help avoid those consequences. All of the studies looked at accelerated aging in children and adolescents under age 18. “The fact that we see such consistent evidence for faster aging at such a young age suggests that the biological mechanisms that contribute to health disparities are set in motion very early in life. This means that efforts to prevent these health disparities must also begin during childhood,” McLaughlin said.
There are numerous evidence-based treatments that can improve mental health in children who have experienced trauma, McLaughlin said. “A critical next step is determining whether these psychosocial interventions might also be able to slow down this pattern of accelerated biological aging. If this is possible, we may be able to prevent many of the long-term health consequences of early-life adversity,” she says.
More information: “Biological Aging in Childhood and Adolescence Following Experiences of Threat and Deprivation: A Systematic Review and Meta-Analysis,” Psychological Bulletin (2020). DOI: 10.1037/bul0000270
There is an undeniable link between dissociative identity disorder (DID) and child abuse. Child abuse can lead to mental health problems that occur in childhood and can continue into adulthood. People often relate childhood abuse to depressive disorders, anxiety disorders, and posttraumatic stress disorder (PTSD), but dissociative identity disorder has the most significant connection to childhood abuse and neglect, so much so that the connection between DID and child abuse cannot be ignored.
What Is Child Abuse and Neglect, and Who Is at Risk?
Child abuse includes physical abuse, sexual abuse, emotional abuse, and/or neglect that results in the harm of a child. In a large majority of child abuse cases, a parent is the abuser. It is also important to note that women perpetrate child abuse more frequently than men, a reality that goes against common societal belief.
Child abuse knows no boundaries. It occurs in rich families and in poor, in families of all religious backgrounds, and in all different races. There is no “type” of child that will be abused, just as there is no one “type” of abuser.
The Relationship between Child Abuse, Neglect and Dissociative Identity Disorder
DID develops in response to severe, recurring trauma in childhood. Children are not fully equipped to cope with continued, severe instances of abuse, so they may develop dissociation as a survival skill, which can then develop into DID. It makes sense, then, that the rate of childhood abuse and neglect in people with DID is so high.
Preventing Child Abuse Can Prevent Dissociative Identity Disorder
There’s no telling how much of those 90% of DID cases could have been prevented had those children been protected from abuse. If we prevent child abuse, we can greatly reduce the number of cases of DID, and cases of other disorders with roots in childhood trauma.
Awareness and prevention is a universal effort. Mental health workers, teachers, and other professionals working with children need to be aware of the signs of abuse and neglect. We, as a society, need to educate our children about abuse and body safety and eliminate the shame abuse causes.
Most importantly, never deny a child or adult who says they have been abused. Most of the time, abusers are also very good actors, playing the part society wants to see on the outside, and changing their roles into abusers behind closed doors. During one of my psychiatric hospitalizations, I overheard a mental health aide say, “She said her mom abused her, but I don’t know; her mom seemed really nice and caring on the phone.”
That feeling of being invalidated hurts in a way that cannot be erased.
So many times in my life, people turned a blind eye to the abuse. As a child, I showed many of the classic signs of abuse, but those signs were ignored or rationalized by people on the outside. Here was a family that went to church every Sunday, sent their children to private school, and seemed put-together in public. Abuse doesn’t happen in families like that. Except it does. It happened to me; and it happens to countless others.
I’m managing my DID, but I wouldn’t wish it on anyone. I don’t want future generations to have to go through the same turmoil that I went through. Child abuse is preventable. DID can be, too.
Crystalie is the founder of PAFPAC, is a published author and the writer of Life Without Hurt. She has a BA in psychology and will soon have an MS in Experimental Psychology, with a focus on trauma. Crystalie manages life with PTSD, DID, major depression, and an eating disorder. You can find Crystalie on Facebook, Google+, and Twitter.
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It can be very disorienting to feel like you have done something, but you haven’t. It’s also disorienting to be someone who tries to be a nice person, but is constantly accused of being disingenuous. If you’re experiencing either of these feelings as a result of another person’s actions, it’s possible that you might be a victim of gaslighting.
Though many people have been introduced to the term gaslighting recently, it’s important to understand exactly where it came from. The term has a long and varied history in the public eye, but it mainly takes its name from the 1944 film Gaslight, in which a woman (Paula, portrayed by Ingrid Bergman) is psychologically manipulated by her husband to feel like she is insane when in reality she is perfectly fine.
Despite the fact that her mental state is perfectly fine, she still believes that she is going mad, a worry that gives her intense discomfort and produces legitimate feelings of madness.
It’s important to note that Paula eventually gets out of the relationship after realizing what is happening to her and learns to deal with manipulation, but the situation set a useful precedent for talking about psychological manipulation as it happens in society. Because of this, the term “gaslighting” reference’s the movie’s title as a way of describing the specific method of manipulation.
It might seem easy to understand manipulation as something that simply happened in a movie, but it can occur quite frequently in society. The most damaging thing about the practice is that many people who suffer from it don’t actually know that they’re being gaslit. Instead, they mistake their confusion for legitimate feelings against themselves, leading to lowered self worth and possible situations that make it more difficult to deal with gaslighting, such as Paula’s position in the aforementioned film.
This is why manipulation is important to understand and fight against when you notice that it is happening to you or somebody you know. More often than not, gaslighting occurs between two individuals who trust each other, with one subtly manipulating the other. Because it occurs often within intimate interpersonal relationships, manipulation can be incredibly difficult to spot.
Like with many other conditions, failing to notice manipulation early on can result in the condition getting worse, the victim becoming even more unaware, and potentially more damage in the long run.
To prepare yourself to deal with gaslighting before it’s too late, it’s essential to familiarize yourself with its symptoms. This is why we’re here to help—in this article, we’ll be taking a look at 10 Warning Signs of Gaslighting to Never Ignore.
Before we get into this article, we want to say that if you think that you might be experiencing symptoms of manipulation, it is important to get professional help from a psychologist or therapist. Medical professionals are the people who truly understand manipulation and how to deal with gaslighting, so please be careful and get help if you notice any of these 10 symptoms happening in your life.
#10. It’s Not All Negative
It’s easy to think that abuse and emotional manipulation is simply constant negativity and nothing else. However, abusers often mix in positive comments and what looks like love to make a victim believe that they actually do care about them. This type of hot/cold treatment is a cornerstone symptom of abuse.
Regardless of how it happens, it’s worth noting that positivity does not negate emotionally manipulative behavior and cannot be justified as love no matter how brief the negative behavior was.
#9. They Project Their Emotions
Many abusers often project their own problems onto their victims. For instance, if an abuser is having trouble managing money, they might criticize their partner’s financial situation more harshly than their own as a way of getting their partner to doubt their sense of reality.
#8. Confusion is Their Priority
Many abusers will start to gaslight victims by making them feel as though they are perpetually confused. It’s important to see these symptoms as they occur so you don’t fall prey to emotional abuse.
#7. They Get Others to Doubt You
Sometimes an abuser can manipulate the relationship a victim has to others by getting them to also be complicit in manipulating the victim. This is often without the others even knowing, getting them to admit to small personality traits and then blowing it up in the face of the victim.
For example, if an abuser wants a victim to think that they over-exaggerate everything, they might get a close mutual friend to admit that the victim blew one situation out of proportion. After this, they’ll present the findings to the victim in order to make them think they do blow things out of proportion.
#6. They Target Friends
A lot of the time, many people who are victims of gaslighting don’t realize it because they don’t have much contact with others who might be able to see the symptoms. This is often because the abuser makes the victim feel like they can’t trust their friends, resulting in them not socializing as much as they once did.
This can also be done by making their friends seem inauthentic or like liars themselves, causing the victim to believe the abuser and willingly limit their contact.
#5. Using Their Emotions
It’s no secret that being in a relationship involves both partners being able to listen to the other’s needs. However, abusers will often manipulate this relationship dynamic to make the other person do things they don’t want to do without evidence. Similar to what was previously mentioned regarding targeting friends and making the victim feel uncomfortable around those they used to socialize with, abusers can also cite their own personal feelings without providing evidence for something.
For example, if an abuser refuses to let their partner go see a friend on the basis that they hate them (or other aggressively negative feelings) without having any actual anecdotal evidence, that can be a form of gaslighting.
#4. Lying as a Precedent
When people lie, sometimes we have to think a bit to actually see through it clearly. This is why when somebody lies so blatantly, we take notice. Abusers manipulating victims will often take advantage of this dynamic, spewing blatant lies as a means of setting up a precedent.
By lying so directly, they will make the victim assume that everything they say from that point onward is a lie, something that makes manipulation a normal routine.
#3. Denying the Victim Agency
When we think of abusive behavior in relationships, we typically assume that it is something drastic, such as an abuser literally locking somebody into their apartment so they can’t go outside. However, there are more subtle ways this can occur through manipulation without the victim even noticing it, sometimes even being willingly complicit.
For example, if you’re in a relationship with somebody who continually questions your ability to not flirt with others while alone, they might be able to pressure you into feeling guilty for going outside or feeling that you can’t socialize without them by your side.
#2. Repetitive Nature of Symptoms
Many people falsely assume that they will be able to spot manipulation as soon as it begins happening, allowing them to quickly put a stop to the behavior. However, this couldn’t be further from the truth—gaslighting typically occurs over long periods of time, with the abuser slowly introducing more and more tactics into the victim’s everyday life until it has gotten too far to recognize it cleanly.
This is why it’s important to not take certain denials of agency lightly. If somebody is doing a similar action to deny your agency multiple times over, it could be an effect of how manipulation is now entering your relationship.
#1. Deny Something They Said
One of the most distressing symptoms of gaslighting is that the abuser might directly deny something they surely said previously. This is especially insidious as it pushes the victim to start to question their sense of reality.
When somebody says something didn’t happen that surely did happen, what does that mean for the rest of reality? Is it possible to even have an objective sense of reality when someone is lying so blatantly? This is why manipulation is such a harmful form of manipulation, as it can really get into somebody’s head and make them begin to question their entire life.
A way to prevent this can be to create objective proof of certain conversations so when they’re brought up again, you’re able to be sure that the abuser is definitely manipulating you.
Final Thoughts on Gaslighting
Gaslighting is an incredibly harmful form of emotional manipulation that is important to be aware of. By learning how to deal with gaslighting effectively, you can help yourself or your friends to catch the symptoms before it’s too late.
If you’ve noticed that you or somebody you know is experiencing symptoms of gaslighting, read the tips to this article and understand that speaking with a medical professional is the best way to deal with gaslighting!
KEYWORDS: childhood sexual abuse; emotional support; depression; parents; friends
Opening its Abstract with “The goals of this study were to evaluate the effects of emotional support from friends and parents at two time points (adolescence and adulthood) on adult depression in a nationally representative sample of survivors of childhood sexual abuse (CSA), and examine whether the associations were moderated by the identity of the perpetrator (parent/caregiver vs. not).” (Abstract 2012 p1)
Emotional Support and CSA
The Role of the Timing of Support – Does it Matter When?
Method | Data, Measures, Data Analysis
Results | Descriptive Statistics, Effects of Emotional Support on Adult Depression, Moderation by Perpetrator Identity (see NOTE)
NOTE: “There was, however, a statistically significant interaction between parental support in adulthood and perpetrator identity (p = .02). As shown in Table 4, among survivors of non-parent/caregiver abuse, high support from parents in adulthood reduced the odds of depression by 67% (p < .0001), and high support from friends in adulthood reduced the odds of depression by 42% (p = .02). Among survivors of parent/caregiver abuse, none of the emotional support variables were significantly associated with adult depression.”
Moderation by Gender | Discussion, Limitations, Conclusions
Acknowledgments | Footnotes | References
There was a significant change in Victims-Survivours + when they reached Adulthood, after non-parent/caregiver abuse. You can still get Counselling, without ‘Reporting an Incident’. These can give Surviving Victims of CSA greater confidence + strength in their lives. (see Results, Moderation by Perpetrator Identity (see NOTE above)