In

 The Problems With Emancipation

 The child welfare system is designed to take care of children up until they are 18 years old. In certain cases, they might even emancipate earlier. But what happens once they grow too old for the child welfare system?

The sad truth is that many grown-up foster children end up homeless and on the streets. The U.S. Department of Health and Human Services reports that up to 50% of former foster or probation youth end up homeless within the first year and a half of their emancipation. Foster children who also have disabilities (autism being a prevailing one) should, in theory, transfer from foster care or group homes into adult living facilities, but this does not always happen because of long waiting lists to get into such housing. They then have to find a way to survive on the street.

Even for a smart and capable former foster child, finding a job as an adult can be difficult without a proper formal education and college degree, which, unfortunately, is the case for many former foster children. A patient of mine, Amy (name changed), who was a former foster child, told me: “Something nobody mentions is that most kids, prior to emancipating from foster care and group homes, don’t graduate from school. Or, as in my case, truly the last formal schooling I had (apart from adult learning) was going to 6th grade. Neither in the foster home or group home was there much emphasis on school. Oh, technically, you are required to go, but often, kids don’t… is that their fault?”

Amy — who, regardless of being highly intelligent, pointed out that she was not given the resources she needed to get her degree while in the foster care system — eventually pursued her GED independently as an adult. She confided to me that she was never taught the importance of education or given the correct tools to help her study. Her foster parents and social workers were stuck at a base level of operation. She indicated: “I think these foster parents and group home counselors — whether earning hours or money — have a duty to get these kids educated. I mean, the odds are already stacked against them. Without an education, aren’t they just adding ammunition to what might already be a vulnerable state? Some of the smartest kids I have ever known were in the system, and sadly, like me, were never taught the value of education or quite simply how to study, and therefore, were given up on. While I did finally get my GED, it took me years to finally get up to a proper level of reading and writing. But let me tell you, I sure could have used the help in my earlier years.”

From the point of view of “the system,” there are a few things that make it hard to properly educate foster children:

• Their home lives are often inconsistent.
• They switch schools and teachers more often than most kids.
• The impact of potential trauma on their psyches can make learning more challenging than for other kids.

The Impact of Abuse and Trauma

Abuse and trauma often can have a negative impact on children. This cannot be overstated.  Whether a child experiences abuse at the hands of biological parents, the child welfare system, or simply of undergoing chronic change, long-term effects can (and often do) impact that child well into adulthood. Abuse can offer obvious repercussions in the form of broken bones and critical injuries. It can impact brain development and cause learning disabilities. And it can carry long-term affects well into adulthood. Childwelfare.gov has a laundry list of long-term consequences of child abuse and neglect based on studies that included 905,000 children reported abused in 2006 alone. Some of the more sobering consequences of child abuse include:

§       Physical health problems, including broad-spectrum issues that affect victims well into adulthood, like allergies, asthma, ulcers, arthritis, and high blood pressure

§       Emotional consequences: low self-esteem, depression, anxiety, panic attacks, suicidal tendencies, PTSD, trust issues, and attachment disorder

§       Mental health issues: a much higher risk for developing clinical psychiatric disorders

§       Detrimental behaviors: smoking, drinking, drug use, overeating, and sexual promiscuity

§       Social difficulty: a tendency toward antisocial traits and borderline personality disorders, even violent behavior

§       Juvenile delinquency

The remnants of an abusive childhood can impact an adult’s ability to function in school, work, relationships, and life in general. There is seemingly no boundary to the negative repercussions of having suffered an abusive childhood.

In my own work with adult survivors of abuse, I’ve seen examples of grown-up victims who:

• Lack motivation because they were conditioned to give up trying

§       Are so afraid of poverty and loss that they constantly overwork themselves to avoid the looming imaginary threat of homelessness

§       Subconsciously hold onto extra body weight out of a fear of not having enough to eat or to divert attention from the opposite sex

§       Were never properly taught about personal hygiene

§       Constantly re-enact their childhood relationships by remaining in abusive situations

§       Don’t feel close to anyone

§       Have extreme difficulty communicating with others

Sometimes, abuse and neglect of children can become a terrible cycle in which adults abused as children can become abusive with their own children. The negative impacts of child abuse can so grossly alter a person’s physical, psychological, and behavioral growth that it may perpetuates the cycle of child abuse and keep the foster care system “in business.”

In part one of this series, I introduced the paradox of the foster care system — a system that is designed to support abused and neglected children, but on the other hand may end up causing additional harm in some cases.

The “Safety” of Foster Care

Once placed in foster care, a child is not always guaranteed to be safe from abuse. In fact, Liftingtheveil.org cites a troubling statistic from one study, claiming that over 28% of children in state care are abused while in “the system.” However, former foster children I’ve worked with state that the incidents of in-foster-care abuse are much higher. Amy (name altered), an adult client who spent over seven years in the foster care system, told me that roughly nine out of ten fellow foster children she crossed paths with claimed that they had been abused by their foster parents.

She also expressed that foster children are often taught by their circumstances not to speak up and are conditioned to think abuse is “normal.” Additionally, Amy felt that it was not in their best interests to report abuse and risk being relocated, where they might be subject to yet more “unknown” abuse… and also have to endure another drastic change.  She explained, “A foster child is already taught that you don’t speak up. It’s dangerous. And don’t forget that mom/dad already gave you up, so best to shut your mouth, or you could end up moving again.”  While it seems like further studies of foster parent abuse are needed to gain more accurate statistics, the bottom line is that abuse happens too often.

In one recent (2010) and widely publicized case, an ex-foster child took his previous foster parent to court on sexual abuse charges and was awarded $30 million in damages. The abuse reportedly happened while he was in the California foster care system for five years in the ’90s. The accused foster parent had been allowed to foster multiple kids despite criminal records of abuse, drug use, and drunk driving incidents. He was eventually convicted of “nine counts of lewd or lascivious acts on a child by force, violence, duress, menace, and fear, and seven counts of lewd or lascivious acts on a child under 14.” He was given a 220-year prison sentence. The private foster family agency responsible for awarding this man’s foster license shouldered some of the blame for negligent vetting and monitoring of the home. (Source: http://en.wikipedia.org/wiki/Child_Protective_Services#cite_note-18)

 A Compromised System

During my own time working foster care agencies and in group homes, I often witnessed our agency staff become overwhelmed with the number of children they were required to monitor —not to mention the pressure of completing mountains of paperwork. The paperwork would often trump the actual visits in priority because it was required in order to keep the agency funded and our jobs intact. There seem to be incentives in place to keep children with foster families they are assigned to, which sometimes led to lenience when evaluating conditions. (Foster agencies receive money for each placement. If a child is removed from a placement, the agency can lose the commission. Although foster agencies and social workers usually have the child’s best interests at heart, these factors may contribute to a less than efficient system of properly monitoring foster homes.)

Many of the caseworkers (like myself) were fairly young, inexperienced recent graduates of psychology school putting in their time to accumulate enough hours to get their state licensing. Having little experience, we did not always know how to detect abuse or handle the enormous emotional volatility that is inherent in such a job. Other caseworkers were older adults with years of exposure to the failures of “the system” and defeatist attitudes that did not help them in their jobs. Ex-foster children I’ve spoken with reported jaded caseworkers who always seemed to “turn a blind eye,” never asking probing questions or visiting the sleeping areas of their charges.

Making things even trickier, there are statutes of limitations and other restrictions in place to prevent prosecution of perpetrators or state agencies too long after-the-fact. In Pennsylvania, for instance: “…the statute of limitations in most civil assault cases is two years from the date of the injury. If the injured victim is under the age of eighteen (18), the victim must file suit before they reach the age of twenty (20).” (According to the law firm Andreozzi & Associates, who specialize in foster care abuse claims.  However, there are sometimes ways around these restrictions. They say that “One exception to the statute of limitations for sexual abuse and molestation in Pennsylvania surrounds what is known as the common law ‘discovery rule.’ The application of this rule allows victims to file suit within two years of the time: (1) they discover the injury; and (2) they discover the source of the injury. However, it is important to note that Pennsylvania, unlike many other states, has rejected the repressed memory theory as a tool to apply the discovery rule.”

Group Homes

While issues with foster care placements in family homes are one thing, state-run group homes are a whole other matter. But, as you might expect, group homes are not always the safe havens that they should be either.

Within the group home system, children are moved around to facilities with varying levels of security and structure depending on their behavior and psychological/emotional growth. A change in level often means a child is immersed in yet another strange new environment. Each time a child is moved to another level, he or she gets new teachers, new therapists, new classmates, new roommates, and a new life. Foster children who have moved multiple times often develop detachment disorder: they become unable to attach to others as a defense mechanism. Sadly, this often results in a child who is not able to form normal long-lasting relationships that are crucial to success later in life.

The occurrence of child abuse in group homes is not uncommon either, even though staff there are trained and educated to help children. In the New York Times article “Learning to Cope With a Mind’s Taunting Voices,” Joe Holt describes a church-sponsored residential facility he grew up in called Childhaven, in Alabama:

“There were regular beatings, sometimes with a board, sometimes with a Ping-Pong paddle, sometimes with a razor strap,” Mr. Holt said. “You had to memorize a portion of the Bible, and if you didn’t, you’d get a beating. Once I got beaten so badly I thought I was going to pass out.”

According to the New York Times article, at least two staff members at Childhaven eventually pleaded guilty to child abuse, and the staff has “long since turned over,” but have other facilities like Childhaven instituted similar safeguards?

The Phenomenon of Emotional Detachment

Foster or group home children generally lack the childhood experiences that teach other children to trust authority figures.  What can seem like a lack of emotion or attachment ability in these kids may often be a veiled protection mechanism: they may remain reserved within relationships in order to protect themselves from further hurt. They might innately be aware of the sad truth that they are viewed by caseworkers and foster parents as potentially “troublesome,” and that — unlike most children — they must prove themselves to be trustworthy before they will be fully loved. This can seem like an overwhelming task for an already overly stressed child with compromised coping mechanisms. One former foster care client expressed: “What one has to consider is that foster kids are taught to not trust… so while it seems that we are detached, the truth is, often we know full well what is going on. But yes, we do have to protect ourselves, and hence, what seems like detachment to the clinical eye is simply what a “normal” individual would call “reserved.”

In Part 3 of this series, I’ll talk about the costs of a compromised system.

What causes parents to abuse their children?

As with all forms of abuse, one of the primary reasons an abuser becomes abusive is because he or she was once abused.  Adding to that, the stress and helplessness that can overcome a parent can contribute to abusive tendencies. A parent who is not getting enough time for adequate self-care, or has not been taught how to appropriately and consistently discipline a child, is at added risk for developing abusive tendencies. Substance abuse and addictions can be the root cause or simply exacerbate the problem.

Columbia University’s National Center on Addiction and Substance Abuse published a report in which substance abuse was cited as a factor in at least 70% of all reported cases of child maltreatment (in 2005). This report also concluded that adults with substance abuse problems are 2.7 times more likely to report abusive behavior toward their own children. ² (Assuming that there are probably an even higher incidence of those who abuse their children without reporting it.)

If you’re currently in a situation where you feel you may be abusing your own children, do something about it and call any abuse prevention hotline such as The Childhelp National Child Abuse Hotline at 1-800-4ACHILD.

¹ http://www.americanhumane.org/children/stop-child-abuse/fact-sheets/child-abuse-and-neglect-statistics.html

² http://www.americanhumane.org/children/stop-child-abuse/fact-sheets/child-abuse-and-neglect-statistics.html

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

How is child abuse defined?

The AHA defines child physical 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 (http://drphil.com/shows/show/1545/) featured a woman whose extreme disciplinarian tactics later resulted in her arrest and prosecution for child abuse. A featured video showed her forcing her young adopted son to hold hot sauce in his mouth and take a cold shower as punishment for lying. Audience members were horrified — as was Dr. Phil — but the woman insisted that she couldn’t find a better way to control her child. Many child abusers are not aware when their behavior becomes harmful to a child or how to deal with their own overwhelm before they lose their tempers.

At its core, any type of abuse of children constitutes exploitation of the child’s dependence on and attachment to the parent. Another therapeutic term that is used in conjunction with child abuse is “interpersonal victimization.” According to the book Childhood victimization: violence, crime, and abuse in the lives of young people by David Finkelhor, interpersonal victimization can be defined as “…harm that comes to individuals because other human[s] have behaved in ways that violate social norms.” ⁵This sets all forms of abuse apart from other types of trauma-causing-victimization like illness, accidents, and natural disasters.

Finkelhor goes on to explain: “Child victimizations do not fit neatly into conventional crime categories. While children suffer all the crimes that adults do, many of the violent and deviant behaviors engaged in by human[s] to harm children have ambiguous status as crimes. The physical abuse of children, although technically criminal, is not frequently prosecuted and is generally handled by social-control agencies other than the police and criminal courts. ” ⁵

What happens to abused children?

In some cases—depending on the number of reports made, the severity of the abuse, and the available community resources—children may be separated from their parents and grow up in group homes or foster care situations, where further abuse can happen either at the hands of other abused children who are simply perpetuating a familiar patterns or the foster parents themselves. In 2004, 517,000 children were living in foster homes, and in 2005, a fifth of reported child abuse victims were taken out of their homes after child maltreatment investigations. ⁶ Sometimes, children do go back to their parents after being taken away, but these statistics are slim. It’s easy to imagine that foster care and group home situations, while they may ease the incidence of abuse in a child’s life, can lead to further types of alienation and trauma.

How does child abuse turn into Post Traumatic Stress Disorder?

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: 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 and 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. (van der Kolk 1987, 25)” 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 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)
• Bad dreams
• Repeated physical or emotional symptoms whenever the child is confronted with the event
• Fear of dying
• Loss of interest in activities
• Regular physical complaints such as headaches or stomachaches
• Extreme emotional reactions
• Trouble sleeping
• Irritability, anger, violence
• Difficulty concentrating
• Constant or often clingy or whiny behavior and regression to a younger age
• Increased vigilance or alertness to their environment

Once a child has grown to be an adult, however, symptoms of PTSD can become more subtle as he or she learns how to cope with this in day-to-day life. The symptoms of PTSD can be quite general and can mimic other disorders: depression, anxiety, hypervigilance, problems with alcohol and drugs, sleep issues, and eating disorders are just a few. Many have problems in their relationships and trusting another person again. Many even end up in abusive relationships and find themselves re-enacting the past.

Community support is a vital tool in preventing child abuse and the PTSD that can result from it. If you suspect that you or a loved one is suffering from child abuse, please report it to your local Child Protection Services — or the police, if a child is in immediate danger. The longer that abuse continues, the higher the risk of causing severe symptoms.

For more information about actions to take if you suspect a case of child abuse, visit the Dreamcatchers website. [http://dreamcatchersforabusedchildren.com/abuse/report-abuse/?gclid=CI_Xlur5xqcCFQImbAodXEJAEQ]

If you or a loved one may be suffering from delayed effects of trauma due to childhood abuse, I encourage you to make a therapy appointment with someone who specializes in  trauma and who can put you on a path of healing.

Citations

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

²http://emedicine.medscape.com/article/916007-overview

³http://www.americanhumane.org/

⁴ http://www.americanhumane.org/children/stop-child-abuse/fact-sheets/child-abuse-and-neglect-statistics.html

⁵ http://www.americanhumane.org/children/stop-child-abuse/fact-sheets/child-abuse-and-neglect-statistics.html

⁶ http://books.google.com/books?hl=en&lr=&id=nXrCyT4J6o4C&oi=fnd&pg=PR13&dq=Childhood+victimization:+violence,+crime,+and+abuse+in+the+lives+of+young+people+By+David+Finkelhor&ots=cBmLbRNXBF&sig=1kSclkOp-PtXV9Pta9MqPYlRXHA#v=onepage&q&f=false

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, Inc on http://emedicine.medscape.com/article/916007-overview

⁸ http://www.aacap.org/

• Children in the U.S. were abused or neglected at the rate of 1.23%
• Out of that number, 64.2% experienced neglect
• 1,530 children died of abuse or neglect that year
• Roughly half the victims were of each sex, with only a slightly higher incidence of neglect victims being female¹

The National Child Abuse and Neglect Data System defines neglect as “a type of maltreatment that refers to the failure by the caregiver to provide needed, age-appropriate care although financially able to do so or offered financial or other means to do so.” (USDHHS, 2007)² Neglect is a unique type of trauma in that only children (and, in some cases, dependant adults) are susceptible to it. In order to experience neglect, a person must be reliant on others for their physical and emotional wellbeing. This vulnerability means that the child victims of neglect are disposed to experiencing related trauma (including PTSD) later in life.

Types of Child Neglect: ²

Physical Neglect — Children need the same basic necessities as everyone: food, clothing, shelter. However, they are reliant on others to provide these necessities. If a provider is not ensuring that their trustee is given these essentials, it is considered neglect. Physical neglect might mean that a parent is neglecting to provide adequately nutritious meals consistently, or it might mean that a parent has literally abandoned their child.

Educational neglect — Failure to provide a child with adequate education in the form of enrolling them in school or providing adequate home-schooling.

Emotional neglect — Consistently ignoring, rejecting, verbally abusing, teasing, withholding love, isolating, or terrorizing a child. Emotional neglect can also include subjecting a child to corruptive or exploitative situations (such as illegal drug use).

Medical neglect —American Humane.org cites Medical Neglect as “the failure to provide appropriate health care for a child (although financially able to do so), thus placing the child at risk of being seriously disabled or disfigured or dying.” Of all the types of neglect, this is the trickiest to diagnose because arguable religious or financial factors can play an adverse role in a child receiving appropriate medical care.

According to Child Welfare.gov, child neglect can lead to problems as an adult which include: ³

Physical consequences — such as failure of the brain to develop properly due to malnutrition and other medical issues; also, poor physical health in general which can lead to an array of problems later on

Psychological consequences — low self-esteem, problems maintaining healthy relationships, depression, PTSD, eating disorders, suicide attempts, cognitive/learning disabilities, social disabilities, and other issues

Behavioral consequences — juvenile delinquency, alcohol and drug abuse, criminal or abusive behavior

The dangers of neglect can be dire for a child’s healthy development. Without proper care, children are in danger of not developing properly due to malnutrition, physical injury, or illness. But the hidden danger of child neglect — the one that may not be apparent for many years but which can stick with a person for their lifetime – is the risk of Post Traumatic Stress Disorder that can affect them psychologically and emotionally in the long-term.

The psychological principle of attachment theory proposes that children become psychologically attached to their caregivers (and particularly their mothers) as infants in order to establish a vital sense of security. ⁴ In nature’s terms, keeping a child attached to the mother increases its chances of survival. So it stands to reason that being neglected is an affront to the “healthy, normal” sense of attachment that nature desires for children to have with their caregiver(s).

According to extensive research done by psychologist Mary Ainsworth in the 1970’s (published in her groundbreaking study Strange Situation), “What happens to children who do not form secure attachments? Research suggests that failure to form secure attachments early in life can have a negative impact on behavior in later childhood and throughout the[ir] life. Children diagnosed with oppositional-defiant disorder (ODD), conduct disorder (CD), or post-traumatic stress disorder (PTSD) frequently display attachment problems, possibly due to early abuse, neglect, or trauma.”⁴ In other words, children who experience neglect early in life may be at risk for a lifetime of trouble attaching properly in relationships.

Another reason that child neglect can lead to such a wide array of development and psychological problems is that children (particularly, infants) need a certain amount and type of input for their brain development to proceed normally through it’s various growth states. When deprived of appropriate input and stimulation, the brain may not develop normally, and this can affect brain functioning later on, which can affect an individual in many ways.

Not all children who experience neglect will experience long-term reactions. Factors determining whether the effects of abuse will be long-term include: ³

1.     The child’s age when the neglect occurred

2.     The type of neglect

3.     The frequency and duration

^CITATAIONS

¹ “Child Maltreatment 2006” released by the U.S. Department of Health & Human Services  — a 17th annual report of data collected via the National Child Abuse and Neglect Data System (NCANDS) http://www.acf.hhs.gov/programs/cb/pubs/cm06/cm06.pdf

² American Humane.org http://www.americanhumane.org/about-us/newsroom/fact-sheets/child-neglect.html

³ The Child Welfare Information Gateway http://www.childwelfare.gov/pubs/factsheets/long_term_consequences.cfm

⁴ http://psychology.about.com/od/loveandattraction/a/attachment01.htm

In this article we’ll focus on the contemporary Western attitude toward and definition of incest. According to Incest: The Nature and Origin of the Taboo, by Emile Durkheim (tr.1963), “The incest taboo is and has been one of the most common of all cultural taboos, both in current nations and many past societies.”

Incest is a type of sexual abuse that can (but does not always) include sexual intercourse, sexually inappropriate acts, or the abuse of power based on sexual activity between blood relatives.  The important thing to remember is that incest is a form of sexual abuse.  As a form of abuse, it is highly damaging to a child’s psyche and most often results in prolonged Post Traumatic Stress Disorder (PTSD).

Feminist.com says that “Incest and sexual abuse of children take many forms and may include sexually suggestive language; prolonged kissing, looking, and petting; vaginal and/or anal intercourse; and oral sex. Because sexual contact is often achieved without overt physical force, there may be no obvious signs of physical harm.”

Incest is a reprehensible form of abuse not just because it is cloaked in shame and stigma, but because this type of sexual abuse (like many other types of abuse, unfortunately) affects young victims by implicating and damaging their primary support system. This can be very confusing for children who have been taught to be wary of strangers, but to trust in family.  Because they are in the beginning stages of developing their value systems and trust models, the betrayal of incest can be utterly confusing, if not permanently damaging, to a child’s delicate psyche.

Statistics

The statistics on incest are extremely difficult to pinpoint because most cases of incest are never reported due to the intense level of shame associated with this type of sexual abuse. Aside from the misdirected shame that victims of incest often feel, there is increased pressure to keep it a secret because of fear of disrupting the family dynamic or experiencing blame or anger from other family members. However, it’s believed that the most common form of incest happens between older male relatives and younger females.

How incest PTSD manifests

PTSD as a result of incest can result in a variety of coping mechanisms including:

• Self-injury
• Substance abuse
• Eating disorders
• Issues with disassociation
• Promiscuity

How to handle a suspected case of incest

The most important thing to remember when dealing with those who have suffered incest (especially if the victim is yourself) is that shame and guilt, while a common response, is not an appropriate one. The biggest immediate help you can offer to a victim of incest is to listen with respect and compassion… and belief.  In other words, the first step is always to believe the victim.

RAINN (The Rape, Abuse and Incest National Network) has a protocol in terms of who a victim can feel safe reporting an incest situation to:

• A parent
• A teacher
• A school counselor
• A friend’s parent
• Your doctor
• Your minister (or pastor, priest, rabbi, imam, etc.)

To report suspected incest to authorities, call Child Protective Services (see this directory: http://www.rainn.org/public-policy/legal-resources/mandatory-reporting-database)

How to report child abuse and incest: http://www.americanhumane.org/about-us/newsroom/fact-sheets/reporting-child-abuse-neglect.html

Sexual abuse is a particularly sinister type of trauma because of the shame it instills in the victim. With childhood sexual abuse, victims are often too young to know how to express what is happening and seek out help. When not properly treated, this can result in a lifetime of PTSD, depression and anxiety.

The trauma that results from sexual abuse is a syndrome that affects not just the victim and their family, but all of our society. Because sexual abuse, molestation and rape are such shame-filled concepts, our culture tends to suppress information about them.

In the U.S (according to childtrauma.org), one out of three females and one out of five males have been victims of sexual abuse before the age of 18 years. And according to the American Academy of Experts in Traumatic Stress (AAETS), 30% of all male children are molested in some way, compared to 40% of females.

One of the most startling statistics unearthed during research into sexual abuse are that children are three times as likely to be victims of rape than adults. Stranger abuse constitutes by far the minority of cases. It is more likely for a child to experience sexual abuse at the hands of a family member or another supposedly trustworthy adult.

Sexual abuse is a truly democratic issue. It affects children and adults across ethnic, socioeconomic, educational, religious, and regional lines.

Exactly what constitutes “sexual abuse” when it comes to children?

The Incest Survivors Resource Network states that “the erotic use of a child, whether physically or emotionally, is sexual exploitation in the fullest meaning of the term, even if no bodily contact is ever made.” It’s important to notice this clause about “no sexual contact.” Often, victims of sexual abuse will try to downplay their experience by saying that it “wasn’t that bad.” It’s vital to recognize that abuse comes in many shapes, colors and sizes, and that all abuse is bad.

Outcomes of sexual abuse

The most common effect of sexual abuse is Post Traumatic Stress Disorder. Symptoms can extend far into adulthood and can include withdrawn behavior, reenactment of the traumatic event, avoidance of circumstances that remind one of the event, and physiological hyper-reactivity.

Another legacy of sexual abuse is that children abused at any early age often become hyper-sexualized or sexually reactive. Issues with promiscuity and poor self-esteem are unfortunately common reactions to early sexual abuse.

Substance abuse is a common outcome of sexual abuse. In fact, according to the AAETS, “specialists in the addiction field (alcohol, drugs, and eating disorders) estimate that up to 90 percent of their patients have a known history of some form of abuse.”

Specific symptoms of sexual abuse:
(citation, the American Academy of Experts in Traumatic Stress)

• Withdrawal and mistrust of adults
• Suicidality
• Difficulty relating to others except in sexual or seductive ways
• Unusual interest in or avoidance of all things sexual or physical
• Sleep problems, nightmares, fears of going to bed
• Frequent accidents or self-injurious behaviors
• Refusal to go to school, or to the doctor, or home
• Secretiveness or unusual aggressiveness
• Sexual components to drawings and games
• Neurotic reactions (obsessions, compulsiveness, phobias)
• Habit disorders (biting, rocking)
• Unusual sexual knowledge or behavior
• Prostitution
• Forcing sexual acts on other children
• Extreme fear of being touched
• Unwillingness to submit to physical examination

Studies have shown that children who experience sexual abuse tend to recover quicker and with better results if they have a supportive, caring adult (ideally a parent) consistently in their life.

Because most child sexual abusers were once abused themselves, it’s crucial for victims of sexual abuse to seek counseling and care so that they don’t end up repeating the pattern themselves.