Violating children’s rights: The psychological impact of sexual abuse in childhood

Professor Jill Astbury MAPS, College of Arts, Victoria University

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All forms of child sexual abuse (CSA) are a profound violation of the human rights of children. CSA is a crime under Australian law and an extreme transgression of trust, duty of care and power by perpetrators. The rights violations that define CSA are critically connected to the deleterious behavioural and psychological health consequences that ensue. This article examines the long-term effects of CSA on mental health and the determinants of these outcomes, in order to identify opportunities to ameliorate the profound psychological impacts of CSA on the lives of many victims/survivors. The article is based on a literature review commissioned to inform the APS response to the Royal Commission into Institutional Responses to Child Sexual Abuse, which was established in 2013 by the Gillard Government.

Prevalence of child sexual abuse

Rates of CSA are difficult to gauge accurately given the clandestine, sensitive and criminal nature of the sexual abuse to which children are exposed. Perpetrators of CSA are often close to the victim, such as fathers, uncles, teachers, caregivers and other trusted members of the community (Finkelhor, Hammer & Sedlak, 2008). CSA often goes undisclosed and unreported to professionals or adults for many complex reasons, including fear of punishment and retaliation by the perpetrator, as well as the stigma and shame associated with this type of abuse (Priebe & Svedin, 2008).

A global meta-analysis of child sexual abuse prevalence figures found self-reported CSA ranged from 164-197 in every 1,000 girls and 66-88 per 1,000 boys (Stoltenborgh, van Ijzendoorn, Euser, & Bakermans-Kranenburg, 2011). In Australia, Fleming (1997) used a community sample of 710 women randomly selected from the Australian electoral roll and found that 20 per cent of the sample reported experiencing CSA involving contact. Another national survey involving both men and women (Najman, Dunne, Purdie, Boyle, & Coxeter, 2005) reported a higher prevalence of CSA, with more than one third of women and approximately one sixth of men reporting a history of CSA. A more recent study in Victoria (Moore et al., 2010) reported a prevalence rate of 17 per cent for any type of CSA for girls and seven per cent for boys when they took part in the study during adolescence. Both Australian studies involving community samples of women or girls and men or boys indicate that girls are two or more times more likely to experience CSA than boys.

Long-term mental health consequences

A significant body of research has demonstrated that the experience of CSA can exert long-lasting effects on brain development, psychological and social functioning, self-esteem, mental health, personality, sleep, health risk behaviours including substance use, self-harm and life expectancy. CSA often co-occurs with physical and emotional abuse and other negative and stressful childhood experiences that independently predict poor mental and physical health outcomes in adult life.

Nevertheless, the research literature indicates that when other predictors of poor adult mental health are statistically controlled, CSA remains a powerful determinant of psychological disorder in adult life (Kendler et al., 2000). Strong evidence from twin studies indicates that a causal relationship exists between CSA and subsequent mental disorders. Twin studies necessarily control for genetic and family environment factors and a number since 2000 have documented significant associations between CSA, depression, panic disorder, alcohol abuse/dependence, drug abuse/dependence, suicide attempts and completed suicides.

A systematic review and meta-analysis of studies published between 1980 and 2008 (Chen et al., 2010) found that a history of sexual abuse including child sexual abuse was related to significantly increased odds of a lifetime diagnosis of several different psychiatric disorders, including anxiety disorders, depression, eating disorders, posttraumatic stress disorder (PTSD), sleep disorders and suicide. A particularly strong link between CSA and subsequent PTSD has been found.

Although the diagnosis of PTSD may be appropriate for those who have been exposed to relatively circumscribed CSA, Herman (1992) argued more than two decades ago that this diagnosis does not adequately capture the psychological responses of people who are repeatedly traumatised over a long period of time, experience subsequent re-victimisation in adolescence or adult life and typically display multiple symptoms of psychological distress and high levels of psychiatric co-morbidity. For survivors of this kind of CSA, Herman (1992) proposed the expanded diagnostic concept of complex PTSD on the grounds that it was better able to accurately capture the complex psychological sequelae of prolonged, repeated trauma.

Risk of suicide: Australian research

Survivors of CSA face a significantly increased risk of suicide and a higher prevalence of suicide attempts and ideation. An Australian follow-up study (Plunkett et al., 2001) of young people who had experienced CSA compared with those who had not, reported that those with a CSA history had a suicide rate 10.7-13.0 times the national rate. Furthermore, 32 per cent of those sexually abused as children had attempted suicide and 43 per cent had thought about suicide. None of the non-abused participants had completed suicide.

A more recent Australian study confirms and extends this finding. Cutajar and colleagues (2010) conducted a cohort study of 2,759 victims of CSA by linking forensic records from the Victorian Institute of Forensic Medicine between 1964 and 1995 to coronial records up to 44 years later. They found that female sexual abuse victims had 40 times higher risk of suicide and 88 times higher risk of fatal overdose than the rates in the general population. Interestingly these rates were even higher than those for males, in contrast to the usual gender pattern for suicide. The respective rates for males were 14 times and 38 times higher than those in the general population.

Determinants of long-term mental health outcomes

While victims/survivors of CSA face greatly increased risks of poor mental health in adult life, a significant minority do not go on to develop psychological disorders (Saunders, Kilpatrick, Hanson, Resnick, & Walker, 1999). Broadly, two approaches to explaining this finding have informed research: differences in the nature of the abuse that has taken place; and post-abuse factors that positively mediate or intervene in the development of negative long-term mental health outcomes.

Nature of the sexual abuse

The likelihood of experiencing severe, negative mental health outcomes in adult life as the result of CSA is increased by several abuse-specific characteristics. Large scale epidemiological studies have consistently documented that forced penetrative sex, multiple perpetrators, abuse by a relative, and a long duration of CSA (e.g., more than a year) predict more severe psychiatric disturbance and a higher likelihood of being an in-patient in a psychiatric facility in adult life.

More than 20 years ago, Pribor and Dinwiddie (1992) investigated different types of CSA of increasing severity and found that incest victims had a significantly increased lifetime prevalence rate for seven psychological disorders including agoraphobia, alcohol abuse or dependence, depression, panic disorder, PTSD, simple phobia and social phobia. Bulik, Prescott and Kendler (2001) also confirmed that a higher risk for the development of psychiatric and substance use disorders was associated with certain characteristics of the abuse, including attempted or completed intercourse, the use of force or threats and abuse by a relative. More severe and chronic abuse which starts at an early age has also been reported to increase the risk of developing symptoms of dissociation.

Post-abuse mediating factors

Certain factors, both negative and positive, are likely to intervene after CSA has taken place and to mediate adult mental health outcomes.

  • Coping strategies
    Specific coping strategies used by survivors can positively or negatively predict long-term psychological outcomes. Overall, positive, constructive coping strategies such as expressing feelings and making efforts to improve the situation are associated with better adjustment (Runtz & Schallow, 1997; Tremblay, Hebert, & Piche, 1999), and negative coping strategies, including engaging in self-destructive or avoidant behaviours, with worse adjustment (Merrill, Thomsen, Sinclair, Gold, & Miller, 2001). However, the coping strategies used by survivors are contingent to some degree on the availability of social or material resources over which children have little or no control.

    In addition, the number of negative or maladaptive coping strategies used is predictive of the likelihood of sexual re-victimisation in adulthood (Filipas & Ullman, 2006). This strongly indicates that the link between CSA, negative coping strategies and adverse adult psychological outcomes is strengthened by sexual re-victimisation. Several studies have confirmed this relationship.
  • Re-victimisation
    CSA is associated with an increased risk of subsequent violent victimisation including intimate partner violence and sexual violence in adolescence and adulthood (see, for example, Classen, Palesh, & Aggarwal, 2005). Sexual re-victimisation involving rape or other types of sexual abuse/assault poses a potent risk for worse psychological health in adult life. A number of studies have confirmed that women who are sexually re-victimised compared with their non-revictimised counterparts have more severe symptoms of psychological distress in adulthood.
  • Social support and reaction to disclosure
    Historically, the role of social support and other societal and cultural factors in determining survivors’ responses to CSA has been under-explored in comparison with the heavy focus on the survivor’s role in responding to sexual trauma. Increased interest in the contribution of social support and other sociocultural factors has prompted increased investigation into the social contextual factors that can mediate adult outcomes following childhood violence, many of which are associated with the reactions to disclosure.

Delay in the disclosure of CSA is linked inevitably with other delays, all of which are harmful to the child. These include delay in putting in place adequate means to protect the child from further victimisation, delay in the child receiving meaningful assistance including necessary psychological and physical health care, and delay in redress and justice for the victim. Without disclosure, negative health outcomes are more likely to proliferate and compound. Conversely, disclosure within one month of sexual assault occurring is associated with a significantly lower risk of subsequent psychosocial difficulties in adult life including lower rates of PTSD and major depressive episodes (Ruggiero et al., 2004).

Yet experiences of disclosure are not uniform and whether they are positive or negative depends on the reactions of the person to whom the CSA is disclosed. Unfortunately, negative reactions to disclosure are common, constitute secondary traumatisation and are associated with poorer adult psychological outcomes (Ullman, 2007). Such reactions include not being believed, being blamed and judged, or punished and not supported, all of which can compound the impact of the original abuse and further increase the risk of psychological distress including increased symptoms of PTSD, particularly when the perpetrator is a relative.

Specific characteristics of disclosure appear to be protective against the development of psychiatric disorders. This finding highlights the importance of social support in concert with effective action by the person in whom the child confides. The degree to which someone is affected is likely to reflect various indicators of the severity of the abuse as well as countervailing protective factors such as the strength of family relationships and the survivor’s self-esteem. One such factor is a warm and supportive relationship with a non-offending parent, which is strongly associated with resilience following CSA and lower levels of abuse-related stress.

Implications for psychological training and practice

The research outlined above shows conclusively that CSA is associated with multiple adverse psychological outcomes, although such outcomes are not inevitable. The identified mediating or intervening factors that increase or decrease the risk of developing psychological disorders as a result of CSA have important implications for psychological training and for the practising psychologists who work with survivors of CSA.

Training on CSA

It is a matter of grave concern that the issue of CSA has been neglected in psychology training. When psychologists lack appropriate knowledge and skills to work with survivors they put both their clients and themselves at risk and can cause unintended harm. Training on CSA is urgently needed in psychology programs to disseminate evidence to students on the protean psychological consequences of CSA as well as the skills necessary to carry out the demanding mental and emotional work of treating survivors. Survivors can have chronic, complex problems in many areas of functioning and psychological disorders can overlap with physical health problems, including pain syndromes and high risk health behaviours such as alcohol, tobacco and drug use. Careful long-term psychological care is often necessary. As survivors may seek help from a range of psychologists, it is important that all psychologists are educated about the magnitude and psychological consequences of CSA.

Apart from acquiring more in-depth knowledge of the emotional effects of CSA and experience in trauma-related interventions, postgraduate courses should prepare practitioners for how exposure to their clients’ traumatic material can traumatise them as well. To remain psychologically healthy while working with survivors of CSA, psychologists need to be able to recognise symptoms of secondary traumatic stress and develop self-care strategies and support systems that will help them to manage the stress related to working with CSA survivors.

Most practising psychologists today who work with survivors have acquired their knowledge and skills ‘on the job’ post-graduation or as a result of their own initiative by attending workshops delivered by specialists in the field. An unknown number of registered psychologists may have no training on CSA and a more systematic continuing education program should be available and accessible so that all psychologists are equipped, at the very least, to ‘do no harm’ to the clients who have experienced CSA.

Implications for psychological practice

Knowing how to facilitate disclosure and take a comprehensive trauma history is an essential first step in developing a treatment plan for survivors of CSA. How a psychologist responds to a client’s disclosure will have an enormous impact on whether a survivor continues or abruptly terminates treatment. Any hint of disbelief, blame or judgment is likely to fracture the client’s fragile hope that she or he will be believed and that it is safe to undertake the painful task of working through the original abuse and its aftermath. If the response to a disclosure is negative it may be years before a survivor is willing to try again, and in the meantime the psychological burden of the abuse and its effects can proliferate. The effort to remain silent and keep the abuse hidden is extremely isolating and cuts off access to potential avenues of psychosocial support.

It would be a mistake for psychologists to assume, for example, that knowing about prolonged exposure therapy for the treatment of PTSD, would, by itself, be sufficient to offer effective treatment to survivors. Beyond the symptoms of traumatic stress associated with CSA, survivors often struggle with many other pressing concerns. These often relate to the deep betrayal of trust by the adult/s with a duty of care towards them as children. This betrayal can prompt persistent negative self-perceptions, difficulties in trusting others and their own judgement, and abiding feelings of shame and intrinsic ‘unloveability’ that contribute to insecure, unsatisfying relationships in adult life. These same issues can impinge on the client-psychologist interaction, making it challenging to establish a robust therapeutic alliance or maintain appropriate boundaries.

CSA does not result in a single disorder such as depression, treatable within the 10 sessions supported under the Better Access to Mental Health Care initiative. The chronicity and complexity of the disorders stemming from CSA require much longer term mental health care. The current system under Medicare is very poorly suited to meeting the mental health care needs of perhaps the most numerous and psychologically vulnerable group in society – CSA survivors.

Conclusion

The Royal Commission has provided a timely opportunity to closely examine the enduring, deleterious and multi-faceted impacts of CSA on survivors, how institutions in which abuse took place failed to intervene and the kind of assistance survivors believe will be most helpful in healing from their traumatic experiences. Psychology has much to contribute to this process and to ensure that the best available psychological evidence is put forward to address the profoundly disturbing phenomenon of child sexual abuse.

Clergy-perpetrated child sexual abuseIn contrast with the large evidence base amassed since the 1980s on the prevalence and health consequences of CSA occurring in the general community, minimal research was published before 2000 on CSA perpetrated by clergy or others working for institutions or organisations, and evidence remains limited in scope.There is an additional theological and spiritual dimension to clergy-perpetrated abuse that sets it apart other forms of CSA, including a spiritual and religious crisis during and after the abuse (Farrell & Taylor, 2000). CSA perpetrated by priests and other members of the clergy has been described as “a unique betrayal” (Guido, 2008) and the “ultimate deception” (Cook, 2005), and the implications of such abuse for victims are eloquently described by McMackin, Keane and Kline (2008):The sexual exploitation of a child by one who has been privileged, even anointed, as a representative of God is a sinister assault on that person’s psychosocial and spiritual well-being. The impact of such a violent betrayal is amplified when the perpetrator is sheltered and supported by a larger religious community. (p.198)Psychological consequences of clergy-perpetrated child sexual abuseClergy-perpetrated sexual abuse of children can catastrophically alter the trajectory of victims’ psychosocial, sexual and spiritual development (Fogler et al., 2008). In the US, investigation into the Catholic Church by the John Jay Research Team repeatedly identified certain psychological effects of clergy CSA in the personal testimony of survivors and family members. These included major symptoms of PTSD with co-occurring substance abuse, affective lability, relational conflicts, and a profound alteration in individual spirituality and religious practices associated with a deep sense of betrayal by the individual perpetrator and the church more broadly (John Jay College, 2004, 2006; McMackin et al., 2008).Some of these negative psychological outcomes are shared with survivors of CSA in the general population but those related to spirituality, religious practices and a sense of betrayal by the church alter the nature of the harm caused by clergy-perpetrated CSA. While a diagnosis of PTSD may be useful as a starting point in understanding and treating survivors of clergy CSA, Farrell and Taylor (2000) contend that “there are qualitative differences in [clergy-perpetrated CSA] symptomatology, which the PTSD diagnosis cannot explain” (p. 28). Such symptoms include self-blame, guilt, psychosexual disturbances, self-destructive behaviours, substance abuse, and re-victimisation. These symptoms are argued to emanate from the theological, spiritual and existential features of clergy CSA. For these reasons, Farrell and Taylor (2000) suggest that a diagnosis of complex PTSD (Herman, 1992) offers a better fit for the symptoms reported by survivors of clergy-perpetrated CSA.Preventing clergy-perpetrated child sexual abuseThe history of denial, cover up and delays in response to disclosures of clergy CSA by churches has been well documented, with their responses to perpetrators evidencing a failure to implement any effective preventative measures. To stop institutional CSA from occurring, it is critical to understand the situational indicators of such abuse so that the opportunities they afford to perpetrators to commit the crime of CSA can be identified.Parkinson and colleagues (2009) identified that having immediate and convenient access to minors were the defining characteristics that facilitated abuse. The evidence also suggests the need for parents and their children to be made much more aware of the grooming tactics used by clergy who perpetrate CSA. The John Jay College study (2006) identified the strategies that allowed the perpetrators to become close to the child they subsequently abused including being friendly with the victims’ families, giving gifts or other enticements such as taking them to sporting events or letting them drive cars, and spending a lot of time with victims.A recurrent theme in Australian victims’ accounts is how their parents’ religious beliefs and trust and reverence for members of the clergy meant that they could not conceive of the possibility that priests could sexually abuse their children and betray their own vows. Yet there is ample evidence that this trust was sadly misplaced and the same caution that would be applied to other members of society needs to be applied to the clergy.Finally, in tandem with a message from churches that there is zero tolerance for CSA, there needs to be a clear and trustworthy process in place, independent of the churches, that encourages children to disclose CSA safely and confidentially. Educational programs in all schools beginning in primary school might be one way of achieving this.Victims of clergy-perpetrated CSA need to be heard with respect and compassion, given meaningful assistance to meet their psychosocial needs, and provided with justice through those who perpetrated the abuse and those who covered it up being held fully accountable. Only then will it be possible for recovery from the immense trauma of clergy CSA and the rebuilding of shattered lives to truly begin.

The author can be contacted at Jill.Astbury@vu.edu.au

References

  • Parkinson, P., Oates, K. & Jayakody, A. (2009). Study of reported child sexual abuse in the Anglican Church. Submission to the Victorian Inquiry into the handling of child abuse by religious and other organisations.
  • Plunkett, A., O’Toole B., Swanston, H., Oates, R. K., Shrimpton, S. & Parkinson, P. (2001). Suicide risk following child sexual abuse. Ambulatory Paediatrics, 1 (5), 262-266.
  • Pribor, E. F. & Dinwiddie, S. H. (1992). Psychiatric correlates of incest in childhood. American Journal of Psychiatry, 149, 52-56.
  • Priebe, G. & Svedin, C. G. (2008). Child sexual abuse is largely hidden from the adult society: An epidemiological study of adolescents’ disclosures. Child Abuse and Neglect32(12), 1095-108.
  • Ruggiero, K. J., Smith, D. W., Hanson, A., Resnick, H. S., Saunders, B. E., Kilpatrick, D. G., Best, C. L. (2004). Is disclosure of childhood rape associated with mental health outcome? Results from the National Women’s Study. Child Maltreatment9, 62-77.
  • Runtz, M. G. & Schallow, J. R. (1997). Social support and coping strategies as mediators of adult adjustment following childhood maltreatment. Child Abuse and Neglect, 21(2), 211-226.
  • Saunders, B. E., Kilpatrick, D. G., Hanson, R. F., Resnick, H. S., & Walker, M. E. (1999). Prevalence, case characteristics, and long-term psychological correlates of child rape among women: A national survey. Child Maltreatment, 4,187-200.
  • Stoltenborgh, M., van Ijzendoorn, M.H., Euser, E. M. & Bakermans-Kranenburg, M. J. (2011). A Global Perspective on child sexual abuse: Meta-Analysis of prevalence around the world. Child Maltreatment16(2), 79-101.
  • Tremblay, C., Hebert, M. & Piche, C. (1999). Coping strategies and social support as mediators of consequences in child sexual abuse victims. Child Abuse and Neglect, 23, 929–945.
  • Ullman, S. E. (2007). Relationship to perpetrator, disclosure, social reactions, and PTSD symptoms in child sexual abuse survivors. Journal of Child Sexual Abuse, 16(1), 19-36.
  • Bulik, C. M., Prescott, C. A., & Kendler, K. S. (2001). Features of childhood sexual abuse and the development of psychiatric and substance use disorders. British Journal of Psychiatry179, 444-449.
  • Chen, L. P., Murad, M. H., Paras, M. L., Colberson, K. M., Sattler, A. L., et al. (2010). Sexual abuse and lifetime diagnosis of psychiatric disorders: systematic review and meta-analysis. Mayo Clinic Proceedings, 85(7), 618-629.
  • Classen, C. C., Palesh, O. G. & Aggarwal, R. (2005). Sexual revictimization: A review of the empirical literature. Trauma, Violence & Abuse, 6(2), 102–129.
  • Cook, L. J. (2005). The ultimate deception: Childhood sexual abuse in the church. Journal of Psychosocial Nursing and Mental Health Services. 43(10), 18-24.
  • Cutajar, M. C., Mullen, P. E., Ogloff, J. R. P., Thomas, S. D., Wells, D. L. & Spataro, J. (2010b). Suicide and fatal drug overdose in child sexual abuse victims: A historical cohort study. Medical Journal of Australia, 192(4), 184–187.
  • Farrell, D. P. & Taylor, M. (2000). Silenced by God: An examination of unique characteristics within sexual abuse by the clergy. Counselling Psychology Review, 15, 22-31.
  • Filipas, H. H. & Ullman, S. E. (2006). Child sexual abuse, coping responses, self-blame, PTSD, and adult sexual revictimization. Journal of Interpersonal Violence, 21, 652-672.
  • Finkelhor, D., Hammer, H. & Sedlak, A. J. (2008). Sexually Assaulted Children: National Estimates and Characteristics. National Incidence Studies of Missing, Abducted, Runaway, and Thrownaway Children (NISMART–2) Bulletin. US: Department of Justice.
  • Fleming, J. (1997). Prevalence of childhood sexual abuse in a community sample of Australian women. Medical Journal of Australia, 166, 65-68.
  • Fogler, J. M., Shipherd, J.C., Clarke, S., Jensen, J. & Rowe, E. (2008). The impact of clergy-perpetrated sexual abuse: the role of gender, development and posttraumatic stress. Journal of Child Sexual Abuse, 17(3-4), 329-358.
  • Guido, J. (2008). A unique betrayal: Clergy sexual abuse in the context of the Catholic religious tradition. Journal of Child Sexual abuse, 17(3-4), 255-269.
  • Herman, J. L. (1992). Complex PTSD: A syndrome in survivors of prolonged and repeated trauma. Journal of Traumatic Stress, 5 (3), 377-391.
  • John Jay College. (2004). The nature and scope of sexual abuse of minors by Catholic priests and deacons in the United States, 1950-2000. Washington, DC: United States Conference of Catholic Bishops.
  • John Jay College. (2006). The nature and scope of sexual abuse of minors by Catholic priests and deacons in the United States- supplementary data analysis. Washington, DC: United States Conference of Catholic Bishops.
  • Kendler, K. S., Bulik, C. M., Silberg, J., Hettema, J. M., Myers, J. & Prescott, C.A. (2000) Childhood sexual abuse and adult psychiatric and substance use disorders: An epidemiological and co twin control analysis. Archives of General Psychiatry, 57, 953 -959.
  • McMackin, R.A., Keane, T. M. & Kline, P.M. (2008). Introduction to special issue on betrayal and recovery: Understanding the trauma of child sexual abuse. Journal of Child Sexual Abuse, 17(3-4), 197-200.
  • Merrill, L. L., Thomsen, C. J., Sinclair, B. B., Gold, S. R. & Milner, J. S. (2001). Predicting the impact of child sexual abuse on women: The role of abuse severity, parental support and coping strategies. Journal of Consulting Clinical Psychology, 69(6), 992-1006.
  • Moore, E. E., Romaniuk, H., Olsson, C. A., Jayasinghe, Y., Carlin, J. B. & Patton, G. C. (2010). The prevalence of childhood sexual abuse and adolescent unwanted sexual contact among boys and girls living in Victoria, Australia. Child Abuse and Neglect, 34 (5), 379-385.
  • Najman, J. M., Dunne, M. P., Purdie, D. M., Boyle, F. M. & Coxeter, P. D. (2005). Sexual abuse in childhood and sexual dysfunction in adulthood: An Australian population based study. Archives of Sexual Behaviour, 34, 517-526.

Disclaimer: Published in InPsych on October 2013. The APS aims to ensure that information published in InPsych is current and accurate at the time of publication. Changes after publication may affect the accuracy of this information. Readers are responsible for ascertaining the currency and completeness of information they rely on, which is particularly important for government initiatives, legislation or best-practice principles which are open to amendment. The information provided in InPsych does not replace obtaining appropriate professional and/or legal advice.OCTOBER 2013 | ISSUE INDEXThe sexual abuse of children


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MILLIONAIRE CEO Who is Ghislaine Maxwell’s husband Scott Borgerson?

  • 15:48, 12 Dec 2020
  • Updated: 15:48, 12 Dec 2020

GHISALINE Maxwell won’t reveal who she is secretly married to, say American prosecutors.

Evidence, however, points to this secret husband being millionaire tech company CEO Scott Borgerson, 43, who has previously been linked to Maxwell and is now believed to be offering £19 million as part of a bail package for Ghislane.

Click here for the latest news on Ghislaine Maxwell

 Scott Borgerson, 43, is believed to be Ghislane Maxwell's secret husband
Scott Borgerson, 43, is believed to be Ghislane Maxwell’s secret husbandCredit: Medium

Who is Scott Borgerson?

Scott Borgerson is the 43-year-old CEO of CargoMetrics, born in 1976.

The company processes data-analytics for maritime trade and shipping.

He has most recently been valued at $100million (£76m).

Borgerson lives in a sprawling £2.3million ocean-front mansion in Massachusetts.null

 Borgerson is the multimillionaire CEO of a tech company
Borgerson is the multimillionaire CEO of a tech companyCredit: Vimeo/Arctic Circle Secretariat

Is Scott Borgerson Ghislaine Maxwell’s husband?

It’s thought that Borgerson is Maxwell’s secret husband, after her matrimonial status was revealed on Tuesday, July 14, as Manhattan prosecutors accused her of purposely hiding her wealth, reports the New York Post.

“The defendant also makes no mention whatsoever about the financial circumstances or assets of her spouse, whose identity she declined to provide to Pretrial Services,” Assistant US Attorney Alison Moe told Manhattan federal Judge Alison Nathan.

Borgerson is linked to the $1million New Hampshire mansion where Maxwell was snared by the FBI.

The court heard how Maxwell is claimed to have purchased her bolthole with an ex-military man named “Scott”.

Both “Scott” and Ghislaine – going by the name “Jen” – also used the same surname “Marshall”.

He has always denied their relationship, saying they are just old friends.

Ghislane Maxwell’s lawyers are now believed to be ready to propose a £22.5 million bail package, six months after she was detained as a potential flight risk ahead of her trial.

As much as £19 million of the bail will come from Scott Borgerson – which the couple would forfeit should Maxwell go on the run.

 Ghislaine Maxwell has denied involvement with Jeffrey Epstein's crimes
Ghislaine Maxwell has denied involvement with Jeffrey Epstein’s crimesCredit: Getty – Contributor

MailOnline reported back in August that Borgerson was the “boyfriend” of Ghislaine Maxwell – 14 years her junior.

It was alleged that Epstein’s ex had “stolen” the CEO from his ex-wife five years ago, in 2013.

The Mail claims that the pair met at an ocean preservation conference, with Borgerson’s devastated wife only uncovering the affair when she viewed a video of Borgerson and Maxwell “kissing and cuddling”.

They say that Maxwell had been living at Borgerson’s ocean-front pad, hiding out in the build-up to Epstein’s arrest.

Borgerson again denies this and says he doesn’t know where she lives.

Just days later she was pictured at a burger joint in the area.

An unnamed source said: “Scott left his wife for Ghislaine around five years ago. It’s just egregious what’s happened to Rebecca.

“Rebecca and Scott seemed like a really nice couple. But as time went on, he was very preoccupied and would be on his cell phone a lot, presumably on business calls. He was away a lot for work.”

 Epstein and Maxwell in New York City in 2005
Epstein and Maxwell in New York City in 2005Credit: Getty – Contributor

LATEST ON GHISLAINE

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Maxwell, Epstein & Clinton smile together in never-before-seen images

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Shock as NEW Epstein accuser, 34, emerges at Ghislaine court hearing

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Maxwell is victim of ‘Epstein effect’ but is NOT suicidal, lawyer says

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Ghislaine’s family launches WEBSITE to protest her innocence ahead of trial1 / 3

Who is Ghislaine Maxwell?

Ghislaine Maxwell was born in 1961, in Maisons Laffitte, France.

She is the youngest child of disgraced media tycoon and British publisher Robert Maxwell.

She moved to New York in 1991 after her father’s death and reportedly socialised with Ivana Trump.

In 1992 she had a romantic relationship with American financier Jeffrey Epstein and remained closely associated with him for decades afterwards.

On July 2, Maxwell was arrested by the FBI in Bedford, New Hampshire, on charges she conspired with Epstein to sexually abuse minors.

In December 2020, Ghislane Maxwell’s legal team sourced a New York house for her to live in if granted £22.5 million bail.

She will be with guards 24/7 to stop the risk of suicide.

The British socialite, 58, currently locked up on child grooming charges linked to Jeffrey Epstein, has asked a judge to free her on bond put up by friends and loved ones.https://imasdk.googleapis.com/js/core/bridge3.453.0_en.html#goog_1643457791Play VideoSarah Ransome said Ghislaine Maxwell bullied her until she begged Jefferey Epstein to leave ‘paedo island’ but the couple took her passport on The Prince and the Epstein Scandal

RETRIEVED https://www.thesun.co.uk/news/10474010/who-ghislaine-maxwell-boyfriend-scott-borgerson/

7 Gaslighting Phrases Malignant Narcissists, Sociopaths and Psychopaths Use To Silence You, Translated

Gaslighting is an insidious erosion of your sense of reality; it creates a mental fog of epic proportions in the twisted “funhouse” of smoke, mirrors, and distortions that is an abusive relationship. When a malignant narcissist gaslights you, they engage in crazymaking discussions and character assassinations where they challenge and invalidate your thoughts, emotions, perceptions, and sanity. Gaslighting enables narcissists, sociopaths, and psychopaths to exhaust you to the point where you are unable to fight back. Rather than finding ways to healthily detach from this toxic person, you are sabotaged in your efforts to find a sense of certainty and validation in what youve experienced.

The term “gaslighting” originated in Patrick Hamiltons 1938 play, Gas Light, where a manipulative husband drove his wife to insanity by causing her to question what she experienced. It was further popularized in the 1944 film adaptation, Gaslight, a psychological thriller about a man named Gregory Anton who murders a famous opera singer. He later marries her niece, Paula to convince her she is going crazy to the point of being institutionalized, with the agenda of stealing the rest of her family jewels. According to Dr. George Simon, victims of chronic gaslighting can suffer from a wide array of side effects, including flashbacks, heightened anxiety, intrusive thoughts, a low sense of self-worth, and mental confusion. In cases of severe manipulation and abuse, gaslighting can even lead to suicidal ideation, self-harm, and self-sabotage.

Gaslighting can take many forms from questioning the status of your mental health to outright challenging your lived experiences. The most dangerous culprits of gaslighting? Malignant narcissists, who, by default, use gaslighting as a strategy to undermine the perception of their victims in order to evade accountability for their abuse. These perpetrators can use gaslighting callously and sadistically because they lack the remorse, empathy, or conscience to have any limits when they terrorize you or covertly provoke you. Gaslighting by a malignant narcissist is covert murder with clean hands, allowing the perpetrator to get away with their mistreatment while depicting the victims as the abusers.

I’ve spoken to thousands of survivors of malignant narcissists who have shared their stories of gaslighting, and below I include the most commonly used phrases malignant narcissists, sociopaths,and psychopaths employ to terrorize and deplete you, translated into what they really mean.

These phrases, when chronically used in the context of an abusive relationship, serve to demean, belittle and distort the reality of abuse victims.

1. You’re crazy/you have mental health issues/you need help.

Translation:You’re not the pathological one here. You’rejust catching onto who I really am behind the mask and attempting to hold me accountable for my questionable behavior. I’d rather you question your own sanity so you believe that the problem is really you, rather than my own deceptiveness and manipulation. So long as you believe you’re the one who needs help, I’ll never have to take responsibility for changing my own disordered ways of thinking and behaving.

Malignant narcissists play the smirking doctors to their victims, treating them like unruly patients. Diagnosing their victims with mental health issues for having emotions is a way to pathologize their victims and undermine their credibility; this is even more effective when abusers are able to provoke reactions in their victims to convince society that they are the ones with mental health problems. According to the National Domestic Violence Hotline, some abusers will even actively drive their victims to the edge to concoct proof of their instability. The Hotline estimates that around 89% of their callers have experienced some form of mental health coercion and that 43% had experienced a substance abuse coercion from an abuser.

Most survivors who reported their abusive partners had actively contributed to mental health difficulties or their use of substances also said their partners threatened to use the difficulties or substance use against them with important authorities, such as legal or child custody professionals, to prevent them from obtaining custody or other things that they wanted or needed.The National Center on Domestic Violence and the Domestic Violence Hotline

2. You’re just insecure and jealous.

Translation:I enjoy planting seeds of insecurity and doubt in your mind about your attractiveness, competence, and personality. If you dare to question my numerous flirtations, affairs, and inappropriate interactions, I’ll be sure to put you back in your place in fear of losing me. The problem, as I’ll convince you, isn’t my deceptive behavior. It’syour inability to remain confident while I perpetually put you down, compare you in demeaning ways to others, and eventually cast you aside for the next best thing.

Manufacturing love triangles and harems are a narcissist’s forte. Robert Greene, author of The Art of Seduction, speaks about creating ”an aura of desirability” which stirs a frenzied sense of competition among potential suitors. In abuse survivor communities, this tactic is also known as triangulation. It grants malignant narcissists a depraved sense of power over their victims. They actively provoke jealousy in their intimate partners in order to control them and paint them as unhinged when they finally react. When a victim calls out a narcissist’s infidelity in any way, it is common for them to label the victims insecure, controlling, and jealous to avoid suspicion and to continue to reap the benefits of multiple sources of attention, praise, and ego strokes.

Remember: to someone who has something to hide, everything feels like an interrogation. Narcissists will often lash out in narcissistic rage, stonewalling, and excessive defensiveness when confronted with evidence of their betrayals. https://74478144733d8f22c65a31173c8b0af0.safeframe.googlesyndication.com/safeframe/1-0-38/html/container.html PSYCH CENTRAL NEWSLETTERGet our weekly newsletter

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3. You’re too sensitive/you’re overreacting.

Translation:It’s not that you’re too sensitive, but rather that I am insensitive, callous, and unempathic. I do not care about your emotions unless they serve me in some way. Your negative reactions provide me stimulation and pleasure, so please, do keep going. I enjoy putting you down for having legitimate reactions to my abuse.

According to Dr. Robin Stern, one of the effects of gaslighting include asking yourself Am I too sensitive? a dozen times a day. Claiming that victims are overreacting or oversensitive to emotional abuse is a popular way for malignant narcissists to override your certainty about the severity of the abuse you experienced.

Whether or not someone is a sensitive person is irrelevant when it comes to cases of psychological or physical violence. Abuse affects anyone and everyone of varying sensitivity levels, and its impact should not be taken lightly. A mark of a healthy partner is that they give you the space to feel your emotions and provide emotional validation, even if they do not agree with you. A malignant narcissist will excessively focus on your so-called sensitivity and consistently claim that you are overreacting rather than own their horrific actions when called out, regardless of how “sensitive” you may be.

4. It was just a joke. You have no sense of humor.

Translation: I love disguising my abusive behavior as just jokes. I like calling you names, putting you down, and then claiming you’re the one who lacks the sense of humor to appreciate my depraved “wit.” Making you feel defective allows me to say and do whatever I wish, all with a smile and a derisive laugh.

Disguising cruel remarks, off-color comments, and put-downs as “just jokes” is a popular verbal abuse tactic, according to Patricia Evans, author of The Verbally Abusive Relationship. This malicious tactic is very different from playful teasing which takes a certain amount of rapport, trust, and mutual enjoyment. When malignant narcissists dole out these unsettling “jokes,” they can engage in acts of name-calling, taunting, belittling and contempt while evading the responsibility of issuing an apology or owning their vicious verbal assaults. You are then gaslighted into believing that it is your inability to appreciate the “humor” behind their cruelty, rather than the reality of its abusive intentions.

“Just jokes” are also used to test boundaries early on in an abusive relationship; what you may have rationalized as a tone-deaf or off-color comment in the beginning can escalate into psychological violence quite quickly in the hands of a narcissist. If you find that you have a partner who laughs at you more than they laugh with you, run. It will not get better.

5. You need to let it go. Why are you bringing this up?

Translation: I haven’t given you enough time to even process the last heinous incident of abuse, but you need to let it go already so I can move forward with exploiting you without facing any consequences for my behavior. Let me love-bomb you into thinking that things will be different this time around. Don’t bring up my past patterns of abusive behavior, because you’ll then recognize that this is a cycle that will just continue.

In any abuse cycle, it’s common for an abuser to engage in a hot-and-cold cycle where they periodically throw in crumbs of affection to keep you hooked and to renew hope for a return to the honeymoon phase. This is a manipulation tactic known as intermittent reinforcement, and it’s common for an abuser to terrorize you, only to return the next day and act like nothing has happened. When you do recall any abusive incidents, an abuser will tell you to “let it go” so they can sustain the cycle.

This form of abuse amnesia adds onto your addictive bond to the abuser, also known as “trauma bonding.” According to Dr. Logan (2018), Trauma bonding is evidenced in any relationship which the connection defies logic and is very hard to break. The components necessary for a trauma bond to form are a power differential, intermittent good/bad treatment, and high arousal and bonding periods.https://74478144733d8f22c65a31173c8b0af0.safeframe.googlesyndication.com/safeframe/1-0-38/html/container.html

6. You’re the problem here, not me.

Translation: I am the problem here, but I’ll be damned if I let you know it! I’d rather subject you to personal attacks as you bend over backwards trying to hit constantly moving goalposts and arbitrary expectations of the way I think you should feel and behave. As you spend most of your time trying to fix your fabricated flaws while always coming up short of what I deem “worthy,” I can just sit back, relax, and continue to mistreat you the way I feel entitled to. You won’t have any energy left to call me out.

It’s common for abusive partners to engage in malignant projection – to even go as far as to call their victims the narcissists and abusers, and to dump their own malignant qualities and behaviors onto their victims. This is a way for them to gaslight their victims into believing that they are the ones at fault and that their reactions to the abuse, rather than the abuse itself, is the problem. According to Narcissistic Personality clinical expert Dr. Martinez-Lewi, these projections tend to be psychologically abusive. As she writes, “The narcissist is never wrong. He {or she} automatically blames others when anything goes awry. It is very stressful to be the recipient of narcissistic projections. The sheer force of the narcissists accusations and recriminations is stunning and disorienting.”

7. I never said or did that. You’re imagining things.

Translation:Making you question what I did or said allows me to cast doubt on your perceptions and memories of the abuse you’ve experienced. If I make you think that you’re imagining things, you’ll start to wonder if you’re going crazy, rather than pinpointing the evidence which proves I am an abuser.

In the movie Gaslight, Gregory causes his new wife to believe that her aunts house is haunted so she can be institutionalized. He does everything from rearranging items in the house, flickering gas lights on to making noises in the attic so she is no longer able to discern whether or not what she’s seeing is real. He isolates her so that she is unable to gain validation. After manufacturing these crazymaking scenarios, he then convinces her that these events are all a figment of her imagination.

Many victims of chronic gaslighting struggle with the cognitive dissonance which occurs when their abuser tells them that they never did or said something. Much like reasonable doubt can sway a jury, even the hint that something may not have happened after all can be powerful enough to override someone’s perceptions. Researchers Hasher, Goldstein and Toppino (1997) call this the “illusory truth effect” – they discovered that when falsehoods are repeated, they are more likely to be internalized as true simply due to the effects of repetition. That is why continual denial and minimization can be so effective in convincing victims of gaslighting that they are indeed imagining things or suffering from memory loss, rather than standing firm in their beliefs and experiences.

The Big Picture

In order to resist the effects of gaslighting, you must get in touch with your own reality and prevent yourself from getting entrapped into an endless loop of self-doubt. Learn to identify the red flags of malignant narcissists and their manipulation tactics so you can get out of disorienting, crazymaking conversations with malignant narcissists before they escalate into wild accusations, projections, blameshifting and put-downs which will only exacerbate your sense of confusion. Develop a sense of self-validation and self-trust so you can get in touch with how you really feel about the way someone is treating you, rather than getting stuck attempting to explain yourself to a manipulator with an agenda.

Getting space from your abuser is essential. Be sure to document events as they happened, rather than how your abuser tells you they happened. Save text messages, voicemails, e-mails, audio or video recordings (if permitted in your state laws) which can help you to remember the facts in times of mental fog, rather than subscribing to the distortions and delusions of the abuser.

Engage in extreme self-care by participating in mind-body healing modalities which target the physical as well as psychological symptoms of the abuse. Recovery is important to achieve mental clarity. Enlist the help of a third party, such as a trauma-informed therapist, and go through the incidents of abuse together to anchor yourself back to what you’ve experienced. Malignant narcissists might attempt to rewrite your reality, but you don’t have to accept their twisted narratives as truth.

References

Evans, P. (2010). The verbally abusive relationship: How to recognize it and how to respond. Avon, MA: Adams Media.

Greene, R. (2004).The art of seduction. Gardners Books.

Hasher, L., Goldstein, D., & Toppino, T. (1977). Frequency and the conference of referential validity.Journal of Verbal Learning and Verbal Behavior,16(1), 107-112. doi:10.1016/s0022-5371(77)80012-1

Martinez-Lewi, L. (2012, November 10). Narcissist’s Projections are Psychologically Abusive. Retrieved March 19, 2019, from http://thenarcissistinyourlife.com/narcissists-projections-are-psychologically-abusive/

Logan, M. H. (2018). Stockholm Syndrome: Held Hostage by the One You Love. Violence and Gender,5(2), 67-69. doi:10.1089/vio.2017.0076

Simon, G. (2018, May 11). Overcoming Gaslighting Effects. Retrieved March 19, 2019, from https://www.drgeorgesimon.com/overcoming-gaslighting-effects/

Stern, R., & Wolf, N. (2018). The gaslight effect: How to spot and survive the hidden manipulation others use to control your life. New York: Harmony Books.

Warshaw, C., Lyon, E., Bland, P. J., Phillips, H., & Hooper, M. (2014). Mental Health and Substance Use Coercion Surveys. Report from the National Center on Domestic Violence, Trauma & Mental Health and the National Domestic Violence Hotline.National Center on Domestic Violence, Trauma and Mental Health. Retrieved here. November 5, 2017.Psych Central does not review the content that appears in our blog network (blogs.psychcentral.com) prior to publication. All opinions expressed herein are exclusively those of the author alone, and do not reflect the views of the editorial staff or management of Psych Central. Published on PsychCentral.com. All rights reserved.


RETRIEVED https://psychcentral.com/blog/recovering-narcissist/2019/03/7-gaslighting-phrases-malignant-narcissists-sociopaths-and-psychopaths-use-translated#7.-I-never-said-or-did-that.-Youre-imagining-things

Recent reads …


Here’s just some of our highest viewed pieces:

learning-the-facts-is-the-first-step-to-preventing-child-sexual-abuse
FACT SHEET ON MEMORY: THE TRUTH OF MEMORY AND THE MEMORY OF TRUTH
ANTHONY KIM BRISBANE BUCHANAN – Sentence
Elite Sydney private schools face sexual abuse suits
Are You Overlooking or Rationalizing Abuse? That’s Denial!
Dubious BBC Staff

Misconceptions becoming weaponised

For many of the CSA Victim-Survivours and their families, the misconception of ‘justified manipulation’ is making a major part of the bigger picture. In experiences of multiple forms of “only our student/family has to deal with this”, the similar deny-deny-deny veil has been used repeatedly throughout the different institutions (i.e. churches, schools, clubs & teams) to use fake-news to hide the truths.

Ron Miller. (2016).

Catholic, other denominations (e.g. Anglican, Baptist, Presbetarian, Methodist), Private Schools (e.g. GPS: ACGS, BBC, BGS, GT, NC, TGS, TSS; ), lawyers, justice dept., police (state + federal), schools (Private – notably same-gender), journalism (online, paid and social) and other interested bodies have each increased their POV.

PRAYBOY satire of iconic Playboy media

While broad scale requests were sent to noted Private Schools (SEQ-GPS & NSW), Legal Bodies and Institutions already mentioned – there has (expectedly) been minimal feedback. Although there have been relevant leaps in Blog statistics, countries and articles – relevant ABC and SBS News contact has been included:

  • Perhaps they are too busy adjusting for these earlier exploits;
  • the hand of god has sent a messenger;
  • they each promise their sorrow, never to repeat it again (again);
Tassos Kouris (2008)

These ‘different pieces’ are being combined in RCbbc’s posts, to explain to readers that their repeated use + reuse is all too common. While reuse of positives may be understood for ‘competitive gain’, ‘academic prowess’ and ‘scientific understanding’, the often (silent 🤐 ) ‘negative gains’ are also swept-under-the-carpet:

  • As harmful as this may be to our individual children,
  • it’s also gravely hurtful – when taking a step back,
  • realise one action leads to another (influence),
  • tweeks-adaptions made to allow greater deception +
  • seeing at the big patterns forming.

Library Update!

We are pleased to add in ‘Darkness to Light’s “Child Sexual Abuse Statistics”, to our Library. Following is also a link to their website, celebrating 20 Years (2 decades) of preventing child sexual abuse. Please enjoy your viewing + post any of your comments/suggestions here …

20th Anniversary
Previous D2L logo (from CSA Statistics)

Covid-19: Are you concerned about wearing a mask?

Covid-19: Are you concerned about wearing a mask?

Covid-19: Are you concerned about wearing a mask?


— Read on royalcommbbc.blog/2020/09/05/covid-19-are-you-concerned-about-wearing-a-mask/

This is a very well-timed read, in this current COVID-19 age. Particularly those, whose health has been effected (e.g. CSA) may be extra vulnerable to the pandemic that’s already taking higher amounts of impacts. Although there will always be social disputes, COVID + CSA will never have a 😊 ending: 😳!

Similar + Different

Although this title may be recognised by some, as a recent inclusion in EC Curriculum in Qld (2008-12) – it intentionally parallels the controlling, executive set of rules of the church – while those following, ‘beneath’ practice these same “commandments” bound by emotions of ‘sin’ , ‘praise’ ‘righteousness’ and ‘faith’ (Old Testament, Knowing Jesus 2020), moving onto focus on motivation to “draw in the fishes, to feed 4,000 (then 5,000) men” (‘miracle’ story-analogy in the Bible’s Matthew 14:13-21, Mark 6:30-44, and Luke 9:10-17, John 6:1-15; practiced by Fundamentalist Churches, as “instruction from god”) (Knowing Jesus 2020). Differing denominations-sects of the Christian church interpret this common story extensively: from life-critical wars (modern tribal differences), global offences (WWII & Jewish Genocide), Court Offences (e.g. Buchanan Sentences and Lloyd Trials) and peaceful debates (politics, national-state & Vatican).

“The Feeding of the 5,000” painting attributed to Ambrosius Francken the Elder. Getty Images – SOURCED

4,444 victims was the extent of abuse by Catholic priests in the 2017 CARC (The Guardian, C. Kraus): Marist and Christian Brothers forming highest (20% & 22%). Through analytical review of ABC News’ 2019 article on the Catholic Church, it became evident that beyond the traits of “Celibacy, order and obedience” were reinterpreted by later religions. As many held to a goal of ‘being different & not copying’ the traditions of Catholicism, their reuse of “the religious order’s secretive, cloistered world” was commonly identified. Other examples include:

  • Although other churches have mostly broken away from Celibacy, each have created their own Order, with the element of Obedience practiced at varying levels;
  • Catholics continue to practice use of Roman terminology, yet few recognise the deceptions underlying this mistranslation;
  • Freemasonry in the Vatican – does the following sound familiar: “Masonry is not for everyone, just for the select few.” At the same time Masonry teaches it is the only true religion and that all other religions are but corrupted and perverted forms of Masonry. (2020).
George Pell (right) with now-disgraced priest Gerald Ridsdale in 1993. CREDIT:GEOFF AMPT (Browne 1993)

As complex as these examples may be, they were given to provide a small example of some popular influences practiced regularly. What began as just a ‘social influence’ 2,000 yrs ago, has grown into such impact that lives are lost, innocents are killed, with many other ‘breakaways’ following the original recipe. Unfortunately, Child-Sexual-Abuse remains a constant that’s still being addressed – despite the Royal Commissions, Inquiries, Summons and (empty) ‘Promises’ – CSA continues. Perhaps the means by which power is brought over vulnerable youth-disabled-elderly-indigenous-women-class-LGBITQ? One answer we all need is equality. Yes, Equality.

Catholic church told of 4,444 abuse claims in 35 years, says royal commission

REFERENCES