Despite Baptist churches (+7th Day Adventists & Jehovahâs Witnesses) being framed as though each individual location are âseperate entitiesâ, NRS acknowledgement under CARC conditions has included Institutions on a state-by-state level. As such, direct personal responses will be made on behalf of these state representatives. Under which these state bodies will be responsible for âcoercive control, indoctrinations & scapegoatingâ, in association with the âabuses & impactsâ (BraveHearts psychology, 2022).
As some of us have been taken through multiple âlevelsâ of CSA, this is where âComplex PTSD (Post traumatic stress disorder) also adds to the atypical occasions on NRS databases. Although I had previously suggested this in both my Private CARC Session and in my NRS Counselling, it wasnât until I started to share an âideas diagramâ with my psychologist, that another POV was made. It can be complex explaining, these complex settings, which are often covered by complex secrecy!
Professor Jill Astbury MAPS, College of Arts, Victoria University
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 survivorsâ responses to CSA has been under-explored in comparison with the heavy focus on the survivorâs 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 survivorâs 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 clientsâ 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 âon the jobâ 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 âdo no harmâ 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 clientâs 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 clientâs 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 âunloveabilityâ 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 â 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 âa unique betrayalâ (Guido, 2008) and the âultimate deceptionâ (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 personâs 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 victimsâ 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 âthere are qualitative differences in [clergy-perpetrated CSA] symptomatology, which the PTSD diagnosis cannot explainâ (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 victimsâ 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 victimsâ accounts is how their parentsâ 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.
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., OâToole 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 Neglect, 32(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 Womenâs Study. Child Maltreatment, 9, 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 Maltreatment, 16(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, 929â945.
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 Psychiatry, 179, 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), 102â129.
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), 184â187.
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 (NISMARTâ2) 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 INDEX
For many of the CSA Victim-Survivours and their families, the misconception of âjustified manipulationâ is making a major part of the bigger picture. In experiences of multiple forms of âonly our student/family has to deal with thisâ, 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 âdifferent piecesâ are being combined in RCbbcâs posts, to explain to readers that their repeated use + reuse is all too common. While reuse of positives may be understood for âcompetitive gainâ, âacademic prowessâ and âscientific understandingâ, the often (silent đ¤ ) ânegative gainsâ are also swept-under-the-carpet:
As harmful as this may be to our individual children,
itâs also gravely hurtful – when taking a step back,
realise one action leads to another (influence),
tweeks-adaptions made to allow greater deception +
Horrific memories, nightmares, and other forms of PTSD burden survivors of sexual abuse. Memories of violent sexual abuse become too painful to endure. The natural response of those overwhelmed by horrific memories is to bury the memories, cover them up, ignore them, push them away. Many try to flood the memories in drugs and alcohol to dampen the pain and anguish. These approaches attempt to keep out the harmful memories, but they canât be buried.
While we may not consciously remember the sexual abuse, the emotional memories are presentâalways. This gives rise to other emotional effects such as depression, low self-esteem, fear, anxiety, etc. Sometimes we are not aware of the impact of the unconscious memories. Sometimes we cannot get the emotional baggage out of our conscious, day to day, activities. Sometimes these memories can attack us in terrifying nightmares.
CHILDUSA points out that memories of violent sexual remain buried until the average age of 52! This delayed emergence of memory is especially true of those sexually attacked as children. My view is that memories of our abuse surface when we have the strength of character to face them. In my case, the most violent and horrific memories did not surface until I was 63.
I believe that the best path forward is to acknowledge the memory, incorporate them as part of who we are as a full person. It is an incredibly difficult process but a process that will eliminate the imprisonment of memories that controls our lives. It can be liberating.
Several elements ensure the success of the integration of harmful memories. It is a challenging journey, and gathering support is necessary. The first is to embrace those closest to you and seek their support, such as family or close friends. The second is to engage with a therapist who specializes in sexual trauma. The third is to participate in a support group through SNAP, a local rape crisis center, or find an agency of support.
I had great success with using the therapy practice of EMDR. (Wikipedia definition) It requires courage and strength. The benefit is that you bring include all your memories to become your true self, the good and bad.
I do not say that the burdens of PTSD and depression wonât disappear. But it does give us hope and the ability to thrive.
President, Survivors Network of those Abused by Priests, survivor, advocate, activist, volunteer, twin daughters, power yoga @SNAPnetwork #MeToo #ChurchToo
In an earlier post, I talked about child neglect (known as an “act of omission”). On the other end of the spectrum of child abuse is physical abuse, an act of commission.
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 horrifiedâas was Dr. Philâbut 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 casesâdepending on the number of reports made, the severity of the abuse, and the available community resourcesâchildren 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 â 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.
REFERENCES:
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
6 United States Department of Health and Human Services
7 “Child Abuse and Neglect, Posttraumatic Stress Disorder” by Angelo P Giardino, MD, PhD, Clinical Associate Professor, Department of Pediatrics, Baylor College of Medicine; Medical Director, Texas Children’s Health Plan, Incarticle continues after advertisementnull
Poverty in Chicago, IL (1974), Author/Source Danny Lyon for National Archive and Records Administration (NARA Record 1709309; NAID 555950), Original Source Environmental Protection Agency (PD as work product of federal govt.)
Speak up for those who cannot speak for themselves, for the rights of all who are destitute. Speak up and judge fairly; defend the rights of the poor and needyâ (Prov. 31: 8-9 NIV).
Poverty and abuse have much in common.
The traumatic and repetitive nature of child abuse, and the huge imbalance of power between adult and child, can leave profound psychological scars on victims â scars that may include PTSD, depression, and anxiety to name a few.
Often, victims are left with a fear of authority as adults. The impact of poverty is surprisingly similar.
Fear of Authority
Their hopes chronically dashed and their pleas for justice routinely ignored, the poor frequently assume further effort on their part will be futile.
People who have been repeatedly downtrodden â deprived of basic necessities, cheated of their rights by abusive landlords and the host of other scam artists who prey on the poor â will forget that they have a voice, and throw in the towel (already exhausted).
Angry and Overwhelmed
The thought of challenging a fraudulent real estate agent or employer can leave the poor feeling angry and overwhelmed. Why bother? Why risk failure and the associated pain?
That is one of the reasons getting the poor to vote is so difficult. They fail to recognize their potential power as a voting block. It is, also, one of the reasons the underprivileged sometimes explode in violence. Their patience at last at an end, they may see no other course open to them.
Of course, anger turned inward can become depression. That can manifest as apathy.
A Sense of Empowerment
Regaining control over their lives is essential for the poor. They deserve dignity and security.
Just as with the victims of abuse, if the poor can be convinced to risk confrontation in a judicial setting where their rights are protected, the act of standing up for themselves can help restore a sense of empowerment.
Success in any small degree (particularly when coupled with appropriate legal support and simple kindness) can help re-establish belief in a system from which the poor have felt excluded.
Whatever the outcome of litigation, the poor need no longer view themselves as voiceless children, forced once again to submit.
FOR MORE OF MY ARTICLES ON POVERTY, POLITICS, AND MATTERS OF CONSCIENCE CHECK OUT MY BLOG A LAWYERâS PRAYERS AT: http://www.alawyersprayers.com
