Date added: 05/10/20

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This is a huge subject, and I am just going to make a few comments about my experience.  Though these experiences may to some extent seem random, I think they are also connected by a theme. My first experience of work with children who had suffered abuse and neglect was in 1985. I was shocked to see how their early lives had so terrorized and deprived them of the experiences essential for healthy development.

Because of abuse and neglect, a 12-year-old child might have the functioning level of an infant. He may not even have reached the level of emotional or neural integration normally achieved in the first 1 – 1.5 years.  These children’s development had literally been frozen. Their emotions were also highly dysregulated, and they can fall into an overwhelming panic or violent rage in an instant.  At the other extreme - still watchfulness, emotional detachment and withdrawal may be the predominant mode of functioning. One thing that surprised me at the time was the fact that children like this existed, as I had no idea. It was and still may be a human problem that is hidden away. I knew about various disabilities and their consequences, and there was plenty of media coverage – but nothing on these children traumatized by those who were supposed to protect them.

The single most significant predictor that an individual will end up in the mental health system is a history of childhood trauma, and the more severe and prolonged the trauma, the more severe are the psychological and physical health consequences. (Kezelman and Stavropoulos, 2012, p.x)

It has been said that the dynamics of abuse are secrecy and denial. Kezelman and Stavropoulos (2012) refer to the ‘culture of silence that continues to surround child abuse’. They explain why this may be so,

The many constraints which still militate against open discussion of child abuse compound recognition and addressing of violations the scale and magnitude of which, were they to be acknowledged and confronted, would both raise questions of complicity and comprise grounds for deep national shame. (p.39)

I recently read that it was published in the 1950s that one in a million women had probably experienced incest as a child. Apparently, the text where this was stated was still widely used in the training of psychiatrists in the 1980s.  Some researchers these days put the incidence of child abuse within families as closer to one in four. Why is there such a huge difference in 50 years?  Is child abuse on a huge increase or is it just being reported more or both?  We also know very well the historical controversies that have existed in the relational sciences, as to whether reports of child abuse by adults in treatment are real or phantasy.

Professor Middleton comments that `[i]t is hard to find a comparable example in society where something so damaging to so many could exist undisturbed for decades under the gaze of those professional bodies who would be assumed to have qualifications and motivations to bring clarity and to be at the forefront of addressing such a pervasive threat to the mental and physical health of fellow citizens’. (ibid p.38)

On the one hand, it seems that progress is made in the exposure of child abuse. But it doesn’t seem that it is becoming any less common. Some westernized countries may have been ahead in terms of surfacing the problem. I was in India 7-8 years ago and sexual abuse was just beginning to be talked about in the media. Since then there has also been a big movement to expose the violence towards women in India. I gave a talk to 100 or so social work students at an Indian University. During the talk, I referred to a child I worked with who had a severe panic attack when I made a simple request, like asking him to finish his breakfast. It turned out his mother had made a similar request and then hit him so hard on the head with a stick that he needed hospitalization. One of the students stood up and said she didn’t see why being hit caused the boy such problems in the future. She added ‘we’ve all had a good beating’ to which everyone laughed.

I explained that the beating, while some would argue is never good for a child, might also depend on the context to determine how much damage is done. For example, if the culture is one where hitting children is common, at least the child feels this is normal - my friends also get hit. Another factor might be whether the ‘disciplining’ action takes place in what is a generally loving family environment – where the parents are concerned for their child. Or is it part of a more neglectful environment? Are the parents’ actions more based on their own difficulties rather than the child’s needs? The severity is another factor – violence that requires medical treatment cannot be right under any circumstances. While physical discipline might be considered by some to be ok within a cultural context, I don’t think that anyone would argue that sexual abuse is.

Maybe because it simply isn’t ok – discussing sexual abuse tends to become difficult. Besides abhorrence towards the abuser, few other views are expressed. Sex offenders are routinely hated and despised. They are often portrayed as evil. I remember visiting a sex offender in prison. On the way to the prison, the taxi driver was keen to know why I was visiting. When I alluded to the reason, the conversation immediately ended. After the visit, I was wondering why the prisoner I visited came into the room, after the other prisoners. He sat on his own, wore a colored band and left before the others. I realized it was probably for his safety. Having anything to do with sex offenders or even children and young people who have been abused, can be uncomfortable and one’s motives might be questioned. This is highlighted by the difficulty that can be involved in having a conversation on the subject with someone who has been abused. Too much interest might be felt to be intrusive and voyeuristic. Too little might feel like turning a blind eye.

Recent sexual abuse scandals in the UK involving dead or elderly celebrities have caused outrage. Some of the most popular family entertainers, it turns out had been abusing children. The outrage has been towards the individual perpetrators, followed by the organizations that failed to be sufficiently protective or even colluded. It is as if the moral outrage about abuse can be vented towards these cases, but we can’t have a rational discussion about what is happening in our own neighborhoods. A few years ago, when I was opening a new children’s home in a residential neighborhood, we met each neighbor, so we could build a positive relationship. One neighbor could not let go of the question, ‘but have these children been sexually abused?’ He was fearful of this as if the neighborhood would be threatened and at-risk by having an abused child living among them.

In response, I focused on the fact that the children we were looking after, all had needs due to their difficult childhoods.  Our job was to meet those needs, so that they could develop and prosper. The neighbor kept persisting with his question.  In the end, I said that according to the statistics maybe 1 in 10 of the children in this neighborhood was abused. After that, he abruptly dropped the whole issue. 

Thinking about the conversations with the neighbor and taxi driver, I am struck by the fact that I just allowed the conversations to end. I could have asked them their views on what I had said. Maybe the underlying feelings, such as anxiety, fear and hostility led me to rather not talk and therefore collude in a small way. One of the inferences for anyone who is close to sexual abuse, whether personally or professionally, is that they may be complicit with the abuse. Therefore, anyone who talks about it, rather than to just utter disgust towards a perpetrator runs the risk of being judged similarly. It is common in working with traumatized children, to be treated as if one is an 'abuser'.

What I am suggesting with the examples above, is that the problem of abuse gets projected in an extreme way and this is part of the denial dynamic. I have come across worthy organizations who aim to tackle the problem of abuse by focusing on the pedophile, ‘lurking on the street corner’. The emphasis on stranger danger continues, though evidence suggests that the most likely threat to a child is someone close to them, especially a parent. We educate young children on how to avoid being lured by a stranger. Do we educate children on what to do if someone in the family is abusive? Maybe this reality just touches upon too many taboos and challenges the idealization of the family that is prevalent in many cultures.

The sociologist Frank Furedi (2013) wrote the book ‘Moral Crusades in an Age of Mistrust: The Jimmy Savile Scandal’, in response to the scandal of the deceased UK TV celebrity Jimmy Savile and the retrospective discovery of his serial abuse of children.

My understanding of Furedi’s argument is that the erosion of our trust in authorities leads to a high level of uncertainty, which makes us feel anxious.  We then project some of our anxiety onto children, who are increasingly perceived to be vulnerable and ‘at risk’. Interestingly, numerous countries have gone through the same process in the last few years. Erosion of trust; exposure of corrupt politicians, church, bankers, etc.; media exposure of scandal concerning child abuse; as the moral panic grows, ‘witch-hunts’ follow; discovery of institutional abuse; national outcry and government inquiry; followed by recommendations on how to better protect children.

These are necessary and appropriate concerns. However, as Furedi argues our difficulty in really thinking about rather than reacting to the issues involved, leads to some very unhelpful and destructive actions.  It also undermines the potential to make real progress. A slight illustration of a moral panic was when a pediatrician in Wales had bricks thrown through his living room window by angry neighbors.  Someone had referred to him as a pediatrician, which was mistaken to mean pedophile!

Wrongful arrests are on the more serious side of things. I know of one service for children that was closed, due to the wrongful accusation of a link with a pedophile ring. The sensationalized media headlines were followed by the withdrawal of children from the service. Two years later, after the service had closed, children unnecessarily removed, staff wrongly arrested, and careers ruined, the Judge concluded the trial by praising the work of the service.

How do we know when denial is appropriate and when it is a cover-up? Conspiracists might argue that Judges, Police, Politicians, Churches have a lot invested in supporting denial. This dilemma and lack of trust are exactly what Furedi suggests make this such an important and difficult problem.

Ultimately, what we want is no children suffering abuse and the potentially devastating consequences. How will this be achieved unless we become more able to have rational discussions about the problem? How do we become more capable to think about this difficult subject and what it means?

Furedi, F. (2013) Moral Crusades in an Age of Mistrust: The Jimmy Savile Scandal, Palgrave Macmillan 

Kezelman, C. and Dr. Stavropoulos, P. (2012) The Last Frontier: Practice Guidelines for Treatment of Complex Trauma and Trauma Informed Care and Service Delivery, Australia: Adults Surviving Child Abuse (ASCA), This document can be downloaded here, PDF -

Sean Ferrer, Director - Strategic Marketing, England
Patrick, you have written a highly thought-provoking, and courageous piece here. I use the word courageous, because the fashion these days is to portray all sex offenders as incarnate evil, so abhorrent that the mere mention of the label provokes a raft of negative commentary. The fact that you have not engaged in the standpoint is to be commended. 

Neither you, nor I, condone such offences, but I feel we both recognise that progress in our understanding of the phenomenon of sexual offences, especially against children, is continuously impeded when it is drowned out by a collective wail of disgust. Moreover, anyone who fails to express his or her disgust when exploring the topic risks being branded in some way complicit, or supportive of such damaging behaviour. 

Jonny Matthew, Consultant Social Worker and Criminologist, Wales
Good stuff, Patrick - very thought-provoking! Your comments about those who help being in some way viewed suspiciously, is very true. After many years of working with harmful sexual behaviour in teenagers, I've experienced this many times. Worse still, at times, I've colluded with this suspicion by moderating my comments in line with what I perceive to be the likely stance of skeptical others. I guess part of this is the desire to avoid "freaking out" the uninitiated! 

Sean's point about the prevalence of sexual interest in children is perhaps the next taboo for society to assimilate. The thorny issue of sex offenders as victims with reactive behaviours is another. Not that this is permissive or excusing in any way. Neither is it remotely suggesting that all victims do or may become perpetrators - that would be ridiculous. But we do have to face the fact that those who commit sexual crimes were very often victims themselves - meta-analytic research is really clear on this.


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