Sunday, January 30, 2011

On something unpleasant

Today I want to discuss something really unpleasant. I want to discuss it because I believe everyone, especially those who have children, have to at least intellectually contemplate this so they may never have to deal with this personally.

One of the most ignorant things I ever heard when I was a kid was a family friend of ours saying that a child from our neighbourhood had lied about being sexually abused. I guess what I found so ignorant about it was the spite (towards the child not the abuser) that she said it with. The story was that a child from our neighbourhood had confessed to her family that years before a male family friend/relative had sexually abused her. The abuser was well-known in the community as a “nice, normal guy”. He had many adult friends, one of which was this woman that said the child was lying, and there was nothing on the surface abnormal about him. The reason this woman said the child must have been lying was because she did not believe that the person named as the abuser looked like a “bad guy”, or that a child could hold a secret for that long, or that no child was “stupid” enough to allow sexual abuse to occur. Those ignorant things are what really stirred in me the need to better educate people on childhood sexual abuse. I can’t imagine anything more damaging than allowing people to believe that children are sexually abused because of the child’s own fault.

I wasn’t able to completely put my thoughts together on what exactly about childhood sexual abuse was not properly understood, and I guess I never should have expected to because the information was hard to come by and the topic is generally avoided. Then as a medical student some years ago when I was doing my mental health rotation, one of our supervisors suggested I read an article about the childhood sexual abuse accommodation syndrome. We were on a ward where the majority of patients were women with personality disorders, and almost invariably, a childhood history of sexual abuse so he thought it beneficial to understand a little of their background. The article was written in 1983 by Ronald Summit and I’ll briefly summarise what it talks about.

The childhood sexual abuse accommodation syndrome describes in a sort of timeline how the sexual abuse of children comes about and then the social and family-dynamic consequences of it. The process is generally broken down in five steps: 1) Secrecy, 2) Helplessness, 3) Entrapment and accommodation, 4) Delayed, conflicted and unconvincing disclosure, 5) Retraction.

1) Secrecy.
Who most commonly abuses children? Parents, stepparents, uncles, siblings, close family friends, teachers, religious ministers, etc. – essentially people in positions of trust to a family. Why they do it is a completely different discussion which I won’t go into here. The general belief is that it’s not a sexual-gratification motive, but rather one of establishing control. I believe it is probably both because generally these “nice people” who wouldn’t hurt a fly (hence their trusted roles in communities) have sexual feelings that for whatever reason are deflected onto children. Maybe they lack self-esteem in approaching other adults for sexual intimacy, maybe they see themselves as children themselves because of their own stunted emotional development, maybe they find the prepubescent physical characteristics of children more arousing than the adult physique, etc. Whatever the reason may be, the factor that unfortunately completes this equation to allow sexual abuse to happen is that children more than just been vulnerable, are also usually actively seeking of affection and from adults – and it is this that paedophiles take advantage of. The child is sworn to secrecy while the abuse goes on, and in return (at least initially) he receives very special and personal attention from their abuser. The secrecy of it all is perpetuated by the fact that the abuser either directly threatens harm to the child or family, or it is understood that if he/she discloses the abuse that he/she will generally face negative consequences of the likes of separating a family unit, admitting “wrong-doing”, facing shame in revealing the details of the abuse, etc.

2) Helplessness.
As a consequence of the sworn secrecy, the child is then locked into a helpless situation where he/she can’t tell anyone of the abuse and is also too physically and/or psychologically immature to fight off the abuser. A child may not like being hurt or sexually humiliated, but he also has a sense of not wanting to hurt the parent/friend/sibling, etc. that is abusing them. Children are way more self-sacrificial than we realize. On the other hand, it’s also possible the child is either precociously or physiologically passing through puberty where the sexual stimulation that the abuser procures for his advantage is also exciting to the child. This is an absolutely normal physical response, but one that the abuser will use to try to justify the abuse and may also extend the period of time the abuse occurs for. The child will eventually experience guilt but finds himself in a position where confessing the abuse also feels like admitting wrongdoing, and experiencing shame as a result of this. In this helpless situation the abuse is able to persist.

3) Entrapment and accommodation.
A person caught in a situation that they can’t physically escape from or stop, naturally develops psychological defences that allow them to distance themselves from the abuse. Children, even very young children, can learn to disassociate from unpleasant realities by psychologically separating their external/physical experience from their internal world. These defence mechanism are what allows the child to survive, but they often will then extend into other aspects of the child’s life, and will often stick with them through to adulthood. A child can eventually become an adult that is difficult to engage emotionally, that flees from emotionally-confronting situations like romantic relationships. Also, the abuse itself can become the punishment the child feels they deserve because they internalize their involvement in a “bad” situation as being a result of themselves being bad. People can go on for years perpetually recreating their childhoods in order to punish themselves, to attempt to “fix” a previous pattern (and inevitably instead repeating it), and also recreating the situations they know they can survive even though these situations were never pleasant. As an example of this, consider the fact that most people that were abused in childhood were often abused by more than one aggressor. Were they asking for it? No, of course not! But behaviourally they had come to know techniques (perhaps sexually-arousing techniques) that they had from personal experience known to please certain adults with paedophilic tendencies. We’ve all known of a precocious child and yet understood that they are a child and their behaviour was not something to take advantage of. Imagine a similar child who is only recreating what a previous abuser had “taught” them, and incidentally in their community encounters another abuser. A child may enter one after another child-abuser relationship. The child’s behaviour becomes both shaped by and perpetuates a life of abuse.

4) Delayed, conflicted and unconvincing disclosure.
Eventually a child, or more commonly an adult, will confess past sexual abuse. This is usually the first step in the healing process, which is why it is such a shame that most people don’t get past this step. The reason most people do eventually confess is not to seek punishment for the abuser but rather as a cathartic experience to free themselves from internal conflict. This is one thing that the adult parent or caretaker often misunderstands and for that reason many children are thought to be “making up stories” about a stepparent/sibling/teacher, etc. People also question the person’s confession because they don’t believe the abuser, such a trusted community member, would be capable of taking advantage of a child for sexual gratification; or they don’t understand why a child would delay this confession. This last reason is so hurtful because it is such a self-centered reason. The adult caretaker to whom the confession is made has certain concepts of themselves, as we all do. They believe themselves to be approachable, trustworthy, caring, protective of the child, and also with good judgement in the people they associate with and allow near their child. For this person to believe the child’s story is also to question their own integrity in their child-rearing abilities, to allow themselves to share in the blame. Of course, this is not the case! The true fact is that the abuser abuses the child AND the caretakers’ trust. A caretaker may seek to know exact details of acts committed and will interrogate the already ashamed and frightened child for this embarrassing information. The child, in turn, as a result of previous disassociation techniques that allowed them to survive the abuse, may not even be able to recall exact details, and so the child’s testimony is considered unreliable by questioning adults. In all, at a time of such crisis, blame is what is thrown around rather than proceeding from them on to soothe the child who is facing all sorts of new conflicts now too.

5) Retraction.
The family and/or the community is thrown into turmoil. People side with either the child or the abuser and seek to punish one or the other. Others disagree in the disclosure altogether because it may tarnish a respected member of society’s reputation. The child, as he has learnt before that he is ‘bad’ and brings about ‘bad’ things, believes the whole turmoil is his sole fault for disclosing what he could have continued to keep quite. As I mentioned before, children can be way more self-sacrificial than we realise, and as such a large proportion of the children who once admitted childhood sexual abuse, will then go on to retract their confession in order to return order, trust, and harmony to a family or community. It’s sad because the story people come to conclude is that there was a child who accused someone of sexually abusing them, but then he confessed he was lying about it all. That to me, is the sad thing about how misunderstood this issue is.

Thanks for reading. And, please, keep this in mind if you’re ever in a position to help a child or someone who has gone through this hell.

No comments:

Post a Comment