Losing a loved one is one of the most distressing and, unfortunately, common experiences people face. Most people experiencing normal grief and bereavement have a period of sorrow, numbness, and even guilt and anger. Gradually these feelings ease, and it’s possible to accept loss and move forward.
For some people, feelings of loss are debilitating and don’t improve even after time passes. This is known as complicated grief, sometimes called persistent complex bereavement disorder. In complicated grief, painful emotions are so long lasting and severe that you have trouble recovering from the loss and resuming your own life.
Different people follow different paths through the grieving experience. The order and timing of these phases may vary from person to person:
Accepting the reality of your loss
Allowing yourself to experience the pain of your loss
Adjusting to a new reality in which the deceased is no longer present
Having other relationships
These differences are normal. But if you’re unable to move through these stages more than a year after the death of a loved one, you may have complicated grief. If so, seek treatment. It can help you come to terms with your loss and reclaim a sense of acceptance and peace.
Symptoms
During the first few months after a loss, many signs and symptoms of normal grief are the same as those of complicated grief. However, while normal grief symptoms gradually start to fade over time, those of complicated grief linger or get worse. Complicated grief is like being in an ongoing, heightened state of mourning that keeps you from healing.
Signs and symptoms of complicated grief may include:
Intense sorrow, pain and rumination over the loss of your loved one
Focus on little else but your loved one’s death
Extreme focus on reminders of the loved one or excessive avoidance of reminders
Intense and persistent longing or pining for the deceased
Problems accepting the death
Numbness or detachment
Bitterness about your loss
Feeling that life holds no meaning or purpose
Lack of trust in others
Inability to enjoy life or think back on positive experiences with your loved one
Complicated grief also may be indicated if you continue to:
Have trouble carrying out normal routines
Isolate from others and withdraw from social activities
Experience depression, deep sadness, guilt or self-blame
Believe that you did something wrong or could have prevented the death
Feel life isn’t worth living without your loved one
Wish you had died along with your loved one
When to see a doctor
Contact your doctor or a mental health professional if you have intense grief and problems functioning that don’t improve at least one year after the passing of your loved one.
If you have thoughts of suicide
At times, people with complicated grief may consider suicide. If you’re thinking about suicide, talk to someone you trust. If you think you may act on suicidal feelings, call 000 or 112 (if calling from a Mobile Phone). Or call a suicide hotline number: In Australia, call 1800RESPECT (1800 737 732) to reach a trained Counsellor. For NRS Applications call 1800 555 677. Interpreter: 13 14 50
Causes
It’s not known what causes complicated grief. As with many mental health disorders, it may involve your environment, your personality, inherited traits and your body’s natural chemical makeup.
Risk factors
Complicated grief occurs more often in females and with older age. Factors that may increase the risk of developing complicated grief include:
An unexpected or violent death, such as death from a car accident, or the murder or suicide of a loved one
Death of a child
Close or dependent relationship to the deceased person
Social isolation or loss of a support system or friendships
Past history of depression, separation anxiety or post-traumatic stress disorder (PTSD)
Traumatic childhood experiences, such as abuse or neglect
Other major life stressors, such as major financial hardships
Complications
Complicated grief can affect you physically, mentally and socially. Without appropriate treatment, complications may include:
Depression
Suicidal thoughts or behaviors
Anxiety, including PTSD
Significant sleep disturbances
Increased risk of physical illness, such as heart disease, cancer or high blood pressure
Long-term difficulty with daily living, relationships or work activities
Alcohol, nicotine use or substance misuse
Prevention
It’s not clear how to prevent complicated grief. Getting counseling soon after a loss may help, especially for people at increased risk of developing complicated grief. In addition, caregivers providing end-of-life care for a loved one may benefit from counseling and support to help prepare for death and its emotional aftermath.
Talking. Talking about your grief and allowing yourself to cry also can help prevent you from getting stuck in your sadness. As painful as it is, trust that in most cases, your pain will start to lift if you allow yourself to feel it.
Support. Family members, friends, social support groups and your faith community are all good options to help you work through your grief. You may be able to find a support group focused on a particular type of loss, such as the death of a spouse or a child. Ask your doctor to recommend local resources.
Bereavement counseling. Through early counseling after a loss, you can explore emotions surrounding your loss and learn healthy coping skills. This may help prevent negative thoughts and beliefs from gaining such a strong hold that they’re difficult to overcome.
As the recent HBO documentary Leaving Neverlandso powerfully demonstrated, many adults have yet to tell anyone that they were sexually abused as a child—not their partners, not their friends, not their family members, not even their therapists. Many of us are familiar with the reasons why children do not come forward to report child sexual abuse, but many don’t understand why adults continue to carry this secret, sometimes to their graves. I have been counseling adult victims of child sexual abuse for the past 35 years. In this article, I’ll discuss many of the reasons why some adults continue to keep silent when it comes to being a victim of child sexual abuse.
Confusion
Many former victims of child sexual abuse are confused as to whether they were, in fact, sexually abused. This can be due to a lack of understanding as to what constitutes sexual abuse, because many people are misinformed as to what child sexual abuse actually is. For example, many people think of childhood sexual abuse as an adult having intercourse with a child—penetration of a penis inside a vagina or in the case of male on male sexual abuse, a male penetrating the child’s anus. But most childhood sexual abuse does not involve intercourse. Also, many people think of childhood sexual abuse as being an adult molesting a child. But childhood sexual abuse also includes an older child molesting a younger child. Child sexual abuse includes any contact between an adult and a child or an older child and a younger child for the purposes of sexual stimulation that results in sexual gratification for the older person. This can range from non-touching offenses, such as exhibitionism and showing child pornography, to fondling and oral sex, to penetration and child prostitution.
As the young men in Leaving Neverland explained, they did not realize that they had been sexually abused until they were in their thirties. Instead, they considered what allegedly occurred between themselves and Michael Jackson as a love affair in which they consented to all the activities that occurred. This kind of thinking is common for former victims of child sexual abuse. It wasn’t until one of the young men had a child of his own that he came to realize what had happened to him. When he thought of someone doing to his son what had been done to him, it suddenly dawned on him that he had been abused. “I’d kill anyone who did that to my son. Why didn’t I feel anything when I thought about what Michael did to me?” the young man shared. This lack of awareness and the inability to connect with and have empathy for themselves as a child is not uncommon in former victims of child sexual abuse.
Another issue that may add to the confusion is the issue of receiving pleasure. Although there is often physical pain involved with child sexual abuse, that isn’t always the case. For some victims, there is no physical pain at all. And victims have often reported experiencing some physical pleasure, even with the most violent and sadistic types of sexual abuse. This confuses victims, causing them to believe that perhaps they gave consent or may have even instigated the sexual involvement. The reasoning goes like this, “If my body responded (through a pleasurable sensation, an orgasm, an erection) it must mean that I wanted it.”
It is very important to understand that experiencing physical pleasure does not signify consent. Our bodies are created to respond to physical touch, no matter who is doing the touching. And many victims of abuse were so deprived of affection that they spontaneously accept and respond to any physical attention, no matter what its source.
Another reason why many question whether they were really abused is that they may not have a clear memory of what happened. They may have only vague memories or no memories at all, just a strong suspicion based on their feelings and perhaps their symptoms. It’s difficult to believe your feelings when you have no or very few actual memories. Some people will even doubt the memories they do have, fearing that “I’m just imagining” or “I’m making this up.”
One reason why someone may have no memories or vague memories is the common practice of victims to dissociate. Dissociation is a disconnection between a person’s thoughts, memories, feelings, and actions, and sense of who he or she is. This is a normal phenomenon that everyone has experienced. Examples of mild, normal dissociation include daydreaming, “highway hypnosis,” or getting lost in a book or movie, all of which involve losing touch with an awareness of one’s immediate surroundings.
During traumatic experiences such as crime, victimization, abuse, accidents, and other disasters, dissociation can help a person tolerate something that might otherwise be too difficult to bear. In situations like these, the person may dissociate the memory from the place, circumstances, and feelings caused by the overwhelming event, mentally escaping from the fear, pain, and horror of the event.
When faced with an overwhelming situation from which there is no physical escape, a child may learn to “go away” in her head. Children typically use this ability as a defense against physical and emotional pain or fear of that pain. For example, when a child is being sexually abused, in order to protect herself from the repeated invasion of her deepest inner self she may turn off the connection between her mind and her body creating the sensation of “leaving one’s body.” This common defense mechanism helps the victim to survive the assault by numbing herself or otherwise separating herself from the trauma occurring to the body. In this way, although the child’s body is being violated, the child does not have to actually “feel” what is happening to her. Many victims have described this situation as “being up on the ceiling, looking down on my own body” as the abuse occurred. It is as though the abuse is not happening to them as a person but just to their body.
While dissociation helps the victim to survive the violation, it can make it difficult to later remember the details of the experience. This can create problems when it comes to a victim coming to terms with whether or not they were actually abused. If you were not in your body when the abuse occurred, it will naturally affect your memory. You won’t “remember” the physical sensations of what the abuser did to your body or what you were made to do to the abuser’s body. This can cause you to doubt your memory and add to the tendency to deny what occurred.
Sometimes the reason victims don’t have clear memories of the abuse is that they were drugged or plied with alcohol by the abuser. It’s rather common for perpetrators to sedate their victims with alcohol or drugs as a way of gaining control over them and of ensuring that they will not tell anyone about the abuse. Victims who were sedated often describe their memories as “fuzzy” or have only short “snapshots” of memories that they may have a difficult time making sense of.
Denial
Some victims of child sexual abuse deny that they were abused, others deny that it caused them any harm, while still others deny that they need help. There are many reasons for denial. One of the most significant is that victims don’t want to face the pain, fear, and shame that comes with admitting that they were sexually abused.
Like dissociation, denial is a defense mechanism designed to prevent us from facing things that are too painful to face at the time. It can even allow us to block out or “forget” intense pain caused by emotional or physical trauma such as childhood sexual abuse. But denial can also prevent us from facing the truth and can continue way past the time when it served a positive function. This is what my former client Natasha shared with me: “I knew for a long time before admitting it in here that I was abused by my grandfather. But I just couldn’t face it. It was just too painful to admit to myself that someone I loved so much and someone who had been so kind to me could also do such vile things to me. And so I pretended it never happened.”
Another reason some people deny that they were sexually abused is that it forces them to admit that they became abusive themselves as a consequence of having been abused. If a former victim went on to abuse other children he may have an investment in believing that children are never really “forced or manipulated” into sex with an adult or older child. He may convince himself that children do so willingly and that they get pleasure from the abuse. This kind of denial often keeps former victims from admitting that they themselves were abused.article continues after advertisementnull
Fear
There are many legitimate reasons that former victims are afraid to tell someone they were sexually abused, even as adults. These include:
Their perpetrator threatened them. It is common for child molesters to threaten to kill their victims if they tell or to kill family members or pets. Even though being afraid of their perpetrator after becoming an adult may not make any logical sense, it is very common for former victims to continue to fear their abuser.
They are afraid they will not be believed. This fear is especially potent when a former victim has had the experience of not being believed in the past. And often, the belief that they will not be believed often comes from the perpetrator telling them things like, “No one will believe you if you do tell.”
They are afraid of the consequences once the secret is out. such as family disruption or violence. Some former victims fear that if they tell a family member about being abused, that person will become enraged and perhaps become violent toward the perpetrator.
Shame
Any time someone is victimized, he or she will feel shame because they feel helpless and this feeling of helplessness causes the victim to feel humiliated. There is also the shame that comes when a child’s body is invaded in such an intimate way by an adult. Add to this the shame associated with being involved with something that the child knows is taboo. Sometimes a child also feels shame when her body “betrays” her by responding to the touch of the perpetrator.
This overwhelming feeling of shame often causes a former victim to feel compelled to keep the secret of the abuse because he or she feels so bad, dirty, damaged, or corrupted. The feeling of shame can be one of the most powerful deterrents to a victim disclosing having been abused. This is what one former client shared with me about her shame about being abused: “I didn’t tell anyone when my drama teacher started abusing me because I felt so humiliated that I didn’t want anyone else to know about it. I felt disgusting, the lowest of the low. I guess most of all I felt so much shame about the things he did to me and made me do to him that I didn’t feel I deserved to be helped.”
Self-Blame
Self-blame is another major reason why victims keep their secret. Victims tend to blame themselves for the abuse they suffered, especially when it is a parent who sexually abused them. Children want to feel loved and accepted by their parents and because of this, they will make up all kinds of excuses for a parent’s behavior, even if that behavior is abusive. Most often children blame themselves for “causing” their parent to abuse them. Why? Because children naturally tend to be egocentric—that is, they assume that they themselves are the cause of everything. Needing to protect their attachment to their parents magnifies this tendency.
Perpetrators take advantage of a child’s tendency to blame themselves by telling the child it was their fault. They shouldn’t have sat in his lap the way they did. They shouldn’t have looked at him the way they did. They shouldn’t have dressed the way they did.
We as humans have a need to maintain a sense of control over our lives, even when we have lost control, as in the case of child sexual abuse. As a way of maintaining a false sense of control, many victims will blame themselves for their abuse. This occurs both in children at the time of their abuse as well as with adults who are still struggling with admitting they were abused in childhood. The unconscious reasoning goes like this: “If I continue to believe it was my own fault, that I brought this on myself, I can still be in control. I don’t have to face the feeling of helplessness and powerlessness that comes with being victimized. I can maintain my sense of dignity and avoid feeling humiliated.”
Sometimes victims blame themselves for the abuse because they hold the perpetrator in such high esteem. They couldn’t imagine that this respected person would do such a thing to them unless they had somehow encouraged it in some way. This was the situation with my former client Gabriel. Coming from a devout Catholic family, Gabriel became an altar boy when he was 9 years old. Like the rest of the parishioners, Gabriel adored the priest. That is why it was particularly shocking to Gabriel when one day the priest asked him to stay after mass and then sexually molested him.
Gabriel could not comprehend what the priest had done. He knew that what had happened was a sin and that priests were not supposed to be sexual. So in order to make sense of what had happened, he simply blamed himself. Somehow, he decided, he must have seduced the priest. He even believed that since he had begun to masturbate a few months earlier, the priest must have known about this and was punishing him or teaching him a lesson.
Finally, another reason victims tend to blame themselves is our culture’s tendency to blame the victim. “Victim” has become a dirty word in our culture, where victims are often blamed and even shamed. There are even spiritual beliefs that hold that if something bad happens to you it is because of your own negative thoughts or attitudes. Cultural influences like this serve to blame victims rather than encourage a self-compassionate acknowledgment of suffering. Former victims of sexual abuse as members of this culture accept this view, often without question.
A Need to Protect the Perpetrator
As evidenced by the behavior and thinking of the two young men in the Leaving Neverland documentary, some former victims still care about the perpetrator and want to protect him or her. In addition, as part of the grooming process, perpetrators work to separate the child or adolescent from their parents and their peers, typically fostering in the child a sense that he or she is special to the offender and giving a kind of attention or love to the child that he or she needs. Sometimes, the initial relationship of trust between a child and an adult or older child transforms so gradually into one of sexual exploitation that the child barely notices it. Between the time when the attention a child is receiving seems to be something positive in the child’s life and the moment when the sexual abuse begins, something significant has occurred. But the child may not be sure what it was and often remains confused about the person who has been significant to him but has now begun to abuse him. They can be plagued with questions such as: “Does he really love me?” and “Could I have caused these things to happen?”
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For many former victims, it is only after months or even years of therapybefore they develop enough trust in someone to tell their secret. Unfortunately, for various reasons, many former victims never make it to a therapist, even as adults.
If you are one of the many people who continue to carry the secret of childhood sexual abuse, it is vital that you break your silence. Even though it is difficult to reach the point where you can finally tell someone, this dark secret can make you sick, emotionally, psychologically, even physically. It can eat at you from inside, draining you of vital energy and good health.
The secret of child sexual abuse is especially shaming. It can make you feel like there is something seriously wrong with you; that you are inferior or worthless. You want to hide for fear of your secret being exposed. You don’t want to look other people in the eye for fear that they will discover who you really are and what you have done. You don’t want people to get too close for fear of them finding out your dark secret. And to make matters worse, carrying around this secret isolates you from other people. It makes you feel different from others. It makes you feel alone.
There is already a tremendous amount of darkness connected to child sexual abuse: the clandestine, sinister way it is accomplished, the manipulation and dishonesty surrounding it, the lies and deception used to keep it a secret, the darkness and pain surrounding the violation of a child’s most intimate parts of his or her body, and the violation of the child’s integrity. Keeping the abuse a secret adds darkness to an already dark and sinister act.
When you don’t share the secret of child sexual abuse, you don’t have the opportunity to receive the support, understanding, and healing that you so need and deserve. You continue to feel alone and to blame yourself. You continue to be overwhelmed with fear and shame.
I urge anyone who is still struggling because they can’t tell anyone about their victimization to seek counseling.
Our priority continues to be the processing of applications and delivering outcomes. We are doing everything possible to process applications and are working closely with participating institutions.
If you call the National Redress Scheme Information Phone Line (1800 737 377) from Australia (call charges may apply) or +61 6222 3455 from overseas you will be able to leave a voice mail message and we will return your call as soon as possible.
The Scheme continues to accept and process applications. If you need to lodge a document, provide identity documents or have any queries regarding the National Redress Scheme, please contact the National Redress Information Phone Line on 1800 737 377 from Australia (call charges may apply) or +61 6222 3455 from overseas and leave a message.
If you need immediate support, 24-hour telephone assistance is available through:
If you need assistance with your redress application you can contact a redress support service. A list of providers is available on this website. We are aware that many providers are operating in a different manner because of the impact of Coronavirus. In most circumstances they will be able to provide assistance over the phone.
If you need information about Coronavirus and what the government is doing visit www.health.gov.au or contact the Coronavirus Health Information Line on 1800 020 080. This line operates 24 hours a day, 7 days a week.
Through the Redress Scheme, those who have been sexually abused in Australian institutions now have the opportunity to obtain financial compensation, counselling and a personal apology for the horror they endured. But don’t for one minute think it will be an easy process.
On 14 September 2015 the Australian Royal Commission into Institutional Responses to Child Sexual Abuse released its Redress and Civil Litigation Report. After receiving submissions from more than 250 individuals and institutions, the 589-page report made 99 recommendations. There was an enormous financial cost to the Australian public for the Royal Commission so we should listen to what the Royal Commission had to say.
Here are some of the most significant recommendations regarding the Redress Scheme and what’s happened so far:
A national redress scheme for the estimated 60,000 likely claimants be established and commence accepting applications from survivors no later than 1 July 2017.
The Redress Scheme started on 1 July 2018, just a year late. While everyone can start the application process, my understanding is that some State legislation needs to catch up. Applications from Queensland, South Australia, Tasmania and Western Australia can be received but they can’t yet be assessed.
The major perpetrators of institutional child sexual abuse (the Catholic, Anglican and Uniting churches, Salvation Army, Scouts and YMCA) have agreed to join the scheme. However, the current lack of legislation in some States creates a loophole, so let’s hope those non-government institutions don’t use it to opt out.
The redress scheme to be independent of the offending institutions.
The applications for redress will be assessed by Independent Decision Makers, but we don’t know who they are. The Redress Scheme assures applicants that the Independent Decision Makers have no connection with participating institutions. Does this mean there will be no Catholic, Anglican or Uniting Church parishioners? No ex or current members of the Salvation Army, Scouts or the YMCA? How can the assessment process be transparent if the Independent Decision Makers are not named?
Appropriate redress for survivors would include a financial payment up to $200,000.
The payment through the National Redress Scheme has been reduced to a maximum of $150,000.
$150,000 is a paltry amount for the impact of child sexual abuse on your life. It would go nowhere near compensating MsForgotten Australianfor her lack of ability to sustain full-time employment throughout her life, without taking into account her suffering. The average redress payment is expected to be $76,000 and many will get less than that.
Applicants may receive a greater payout if they pursue compensation through the court process but the burden of proof will be greater in the court system than through the Redress Scheme. However, the burden of engaging in the court process is likely to be more adversarial and stressful than the Redress Scheme. It’s challenging for survivors to provide the detailed particulars (time, date, location etc) often required for the court process, particularly if the child sexual abuse occurred many years ago and occurred multiple times.
The Redress Scheme is of significant benefit for the perpetrating institutions as payouts are likely to be less than through the legal process, and they won’t be tied up and financing legal processes for years.
A person should be eligible to apply to a redress scheme for redress if he or she was sexually abused as a child in an institutional context and the sexual abuse occurred, or the first incidence of the sexual abuse occurred, before the cut-off date.
That is unless you’re in prison. If you are currently incarcerated you cant apply, you can do so when you’ve been released. If you’re out of gaol, but you’ve served more than a 5-year term then probably no redress for you, unless you are able to prove how rehabilitated you are.
Now I don’t want to get into an argument about prisoners getting money but here’s what infuriates me. The Royal Commission visited 60 prisons to take statements from prisoners who had been sexually abused in institutions. They did this because there is such a clear understanding that child sexual abuse derails peoples lives to such an extent they are over-represented in the prison system.
I provided counselling to prisoners who had attended private sessions with the Royal Commission. Their accounts of the sadistic child sexual abuse perpetrated against them were horrendous. For some, the Royal Commission was the first time they had disclosed the abuse and the process of disclosing was traumatic.
Of the, 6,875 survivors and/or their family and friends who attended private sessions between May 2013 and May 2017 to share their experiences of child sexual abuse in Australian institutions, 713 (10.4 per cent) were in prison at the time of their private session.
On average, survivors in prison were aged 11.3 years when they were first sexually abused in an institutional context, though many said they experienced physical and sexual abuse prior to this, often within the family. The majority were sexually abused on multiple occasions (86.7 per cent). Most said they were sexually abused by a single person (53.7 per cent), and almost three-quarters for a duration of one year or less (71.5 per cent).
Royal Commission into Institutional Child Sexual Abuse: Final Report – Private Sessions
So the Redress Scheme seems to be saying to prisoners “thanks for telling us what happened to you, we know that it stuffed your life up, but too bad, no Redress for you or your family”. Surely prisoners could apply and, if successful, any payout placed in trust.
Oh… and if you’re not an Australian citizen or permanent resident you also can’t apply. So too bad if you came to Australia, went to school here, got sexually abused as a child at school and then went home! No redress for you either.
A redress scheme should rely primarily on completion of a written application form.
Sounds easy, but filling out that 44-page document is complex. Some survivors believed that their statement to the Royal Commission would have been sufficient as an application. It’s agonising to document a detailed account of child sexual abuse and then send it off to be assessed, by an unknown party. Once again survivors are placed in the role of having to prove what happened to them.
There are supports available to help people with the application process. You can access them here:Redress Support Services. I would encourage anyone completing the application to be supported by family, friends and/or the support services offered.
Counselling and psychological care should be supported through redress in accordance with the following principles:
Counselling and psychological care should be available throughout a survivor’s life.
Counselling and psychological care should be available on an episodic basis.
Survivors should be allowed flexibility and choice in relation to counselling and psychological care.
There should be no fixed limits on the counselling and psychological care provided to a survivor.
Without limiting survivor choice, counselling and psychological care should be provided by practitioners with appropriate capabilities to work with clients with complex trauma.
Treating practitioners should be required to conduct ongoing assessment and review to ensure treatment is necessary and effective. If those who fund counselling and psychological care through redress have concerns about services provided by a particular practitioner, they should negotiate a process of external review with that practitioner and the survivor. Any process of assessment and review should be designed to ensure it causes no harm to the survivor.
Counselling and psychological care should be provided to a survivor’s family members if necessary for the survivor’s treatment.
New South Wales, Victoria and the Australian Capital Territory have free counselling services as part of the redress offer. Counselling services in Queensland, Tasmania, South Australia, the Northern Territory and Western Australia have not yet been finalised. Applicants living where States are not offering free counselling services will receive a payment of $5,000 to cover counselling. That’s about 25 sessions throughout a lifetime. That may not be sufficient to address complex trauma.
Some final thoughts….
We now have a situation where some child abuse survivors may feel abandoned by the Redress Scheme. If you were in an institution and were viciously beaten and neglected, but not sexually abused you are now “unlucky” because you can’t access the Redress Scheme. The Royal Commission didn’t just uncover child sexual abuse, it also uncovered systemic physical and emotional abuse and neglect in institutions and yet these non sexually abused survivors have no access to the Redress Scheme.
I’m not sure the Redress Scheme sets right that which is morally wrong.
What are your thoughts regarding the Redress Scheme?
