Understanding and Treating Sexual Abuse
Understanding and Treating Sexual Abuse
Since the 1 970s, many segments of society have demanded that steps be taken to reduce child sexual abuse. This outcry began in the mid-1970s when it became apparent that children who said they had been sexually abused were almost always telling the truth.
Sexual abuse is defined in the booklet Child Abuse—Helps for Ecclesiastical Leaders as “any sexually stimulating activity between a child and an adult or another child who is in a position of power, trust, or control” (p. 2).
Adults who describe the effect of being molested as children say that the form of sexual abuse makes little difference. Sexual fondling may be as traumatic as intercourse. The violation of the child’s trust affects her more than the actual nature of the abuse.
Relationship of Perpetrator to Victim
Forty-seven percent of the offenders come from the children’s own families or extended families. Another 40 percent, though not family members, are known by the children (Brown and Holder, 1980). Victims molested by non-family members are more likely to report the abuse than victims of incest. When abuse is perpetrated by family members, it may be years before the child or another family member is willing to report it.
Russell (Salter, 1988) studied a random sample of 930 adult women and found that 38 percent reported having been abused before age eighteen. Russell trained her interviewers extensively and had strict definitions about what constituted abuse. Hands-off offenses such as exhibitionism were excluded. Despite the narrowness of her definitions, Russell’s study, when compared with others, revealed the highest percentage of women who had been sexually abused.
Variances in studies show the difficulty of providing consistent statistics for the prevalence of sexual abuse among the general population. The more reliable studies do suggest, however, that sexual abuse may be the most underreported form of abuse.
Incidence among Church Members
In 1990, 1,872 children were reported to have been sexually abused in Utah (Division of Family Services Report, 1990). It is not known how many of these cases involved Latter-day Saints. There are no other reliable studies that reveal the prevalence of child abuse among members of the Church.
According to Feinauer (1988), the most devastating psychological effects occur when victims are abused by a trusted person who is known to them. Family relationship does not appear to be the determining factor in creating distress. The emotional bond the victim feels toward the perpetrator and the betrayal of trust appear to be the key factors.
Nevertheless, abuse within the family often results in the most severe effects. This is due to the longer duration and frequency of the abuse, the close relationship and greater age difference between the perpetrator and victim, the use of force, and the greater intrusiveness of the sexual activity (Russell, 1986). It is also due to the child’s dependence on, entrapment in, and loyalty to her family, which requires her to use strong defenses to cope (Courtois, 1988).
Because of the trauma associated with incest, the remaining portion of part 2 will describe the problems of incest survivors, although other victims of abuse may suffer in similar ways.
Long-term effects (two or more years following abuse) may include generalized anxiety; anxiety attacks; continued sleep disturbance and nightmares; fear of people, enclosed places, and the dark; anxiety about sexuality during adolescence; chronic depression with suicidal thoughts and attempts. Victims are much more likely than other people to consider or attempt suicide and to engage in self-mutilating or other types of sell-harmful behavior (Briere and Runtz, 1986).
Initially, abused children develop a negative view of themselves. Feelings of guilt, shame, and complicity are caused by the secrecy, entrapment, and betrayal by a trusted family member. Some children compensate by trying always to be good, hoping that their efforts will make the abuse stop. The shame is compounded if the child discloses the abuse and is blamed or disbelieved. She may feel increased isolation, worthlessness, and hopelessness. As she realizes that others have not had the same experiences, she may feel marked, disgusting, freakish, and unworthy of positive attention from others.
Initial physical effects may include aches and pains such as headaches or gastrointestinal and gemtourinary pains; physical signs of depression and anxiety such as lethargy, inability to concentrate,
Over the long term, victims may manifest self-hatred and self-disgust through physical problems. They may abuse or disregard their bodies. They may have chronic pain, infection, and phobias about genitourinary organs and their functioning. Victims may also have general physical problems such as anxiety, stress, obesity, or anorexia.
Initial effects on relationships include marked impairment in the victim’s ability to relate to and trust others; withdrawal even though the child is still needy and dependent. The needs of the child may be masked by her behavior. She may be very compliant or may act like a parent. She may appear mature beyond her years, taking care of everyone else in the family. But she does this because it is expected of her, it provides her with some power, it helps compensate for her feelings of badness, and it is a means of getting others to like her.
1. General difficulties in relationships. Fear, the inability to trust, and hostility lead to superficial relationships with both men and women.
3. Problems with parents, family members, and authority figures. The victim may feel hostility and rage toward family members or authority figures, or she may distance herself from the family to prevent continued abuse.
Chronic abuse may interfere with a child’s ability to learn. Victims may have difficulty learning, remembering, and concentrating, and they may have a shortened attention span.
Still others feel compelled to become super women. These are susceptible to burnout in their efforts to compensate for perceived personal deficiencies.
Incest often influences the way victims perceive the Church. Victims frequently distort and misconstrue religious concepts such as honesty, obedience, chastity, sin, punishment, worthiness, and repentance. When children learn that the abuse was wrong, they often feel confused and guilty. They conclude that they must be bad because they were part of it.
Incest victims tend to associate God with their earthly parents. They have difficulty understanding a loving, trustworthy Father in Heaven when they have an earthly parent who lies, manipulates, and sexually abuses them. Victims may also believe that their lot in life is to be abused. They may believe that their plight was chosen in the premortal world and that the Lord wanted them to be born into this family and have these experiences. Russell (1986) found that many victims of sexual abuse stopped believing in religious teachings.
Extensive treatment is frequently needed to unscramble the pathology associated with sexual abuse. Solving debilitating problems such as those described above often requires the combined efforts of qualified professionals and ecclesiastical leaders. The remaining portions of this module will describe assessment and treatment approaches.
Victims of sexual abuse need spiritual as well as professional help. Without spiritual help, victims may continue suffering through adulthood.
In families where incest occurs, nonoffending spouses and non-victim children often need spiritual as well as professional help.
“President Gordon B. Hinckley in counsel to priesthood holders states:
“‘Perhaps [child abuse) has always been with us but has not received the attention it presently receives. I am glad there is a huge and cry going up against this terrible evil, too much of which is found among our own’ (in Conference Report, Apr. 1985, p. 66; also Ensign, May 1985, p. 50).
“If any people ought to shun abusive activities and administer comfort and cures for such problems, it should be the Latter-day Saints. Church members should strive to exemplify Christlike attributes in all their relationships and avoid cruelty and other inappropriate behavior toward family members and others.
“A great privilege of mortal life is bringing children into the world. In this process, parents become co-creators with their Heavenly Father and are responsible to protect their children in every way. Children have a God-given tight to that protection and to complete security in their home. Parents should be willing to give their lives, if necessary, for the protection of their children.
“It is difficult to understand why any priesthood holder would abuse little children verbally, emotionally, or physically. When an adult member of the Church brings ugly, immoral involvements to innocent children, his priesthood leader needs to respond” (p. 1).
Ensure that victims correctly understand the Church’s position on abuse and the gospel principles
Historically, LDS Social Services has provided short-term therapy. However, long-term treatment is often necessary to resolve problems related to abuse. The needs of sexual abuse victims, perpetrators, and their family members are often extensive. As an LDS Social Services practitioner, you must necessarily limit your involvement in this problem area. Whenever possible, you should refer those affected by sexual abuse to therapists who specialize in such treatment. Provide therapy only in the circumstances outlined below or where local resources do not exist. The following guidelines will help you determine the extent to which you should become involved.
Accept only clients that can be treated adequately according to agency policy and within the time constraints of your agency. The efforts of LDS Social Services are usually best suited for (1) brief group therapy for adults molested as children, (2) victims with mild to moderate problems, (3) families with minor to moderate adjustment problems related to abuse, and (4) adolescent perpetrators who are not entrenched in abusive life-styles.
The ability to deal with transference and Children have a disposition to please adults. They countertransference. For example, it is common for a female who has been victimized by a male to perceive a male therapist in the same negative way that she perceives other males.
Children have a disposition to please adults. They may tell you what they think you want to hear rather than what really happened.
When child abuse is reported to public officials and ecclesiastical leaders, it is not always clear what actually happened. As a rule, children should be believed when they report abuse. Only a small percentage make up stories. Unfortunately, most victims are reluctant to share information because they are embarrassed or fear punishment. Many are coached to lie and are warned that telling what they know will destroy the family or cause the perpetrator to be thrown in prison. Others lack verbal skills to accurately describe the abuse.
Perpetrators typically deny or minimize accusations and often try to frighten victims into dropping charges. Adults sometimes wonder if accusations are contrived, exaggerated, or minimized. A thorough investigation by local authorities is needed to determine exactly what happened, not only to satisfy the demands of the law but also to help determine the victim’s need for treatment.
Sexual terminology and behavior that is unusual and inappropriate for the child’s age and background.
Sleep disturbances such as nightmares, phobias, or fear of being alone in the dark.
Changes in behavior and performance at school such as a short attention span, inability to concentrate, declining grades, poor study habits, unexplained absences, or tiredness for no apparent reason.
Histrionic attention-seeking, egocentricity, overdramatization, excitability, talkativeness, emotional lability,
Crying for no apparent reason.
Excessive watching of television.
Victims often feel estranged from God and long to be freed from shame, anger, guilt, and a sense of unworthin
Bishops can also help victims understand that they were not responsible for the abuse.
Focus on Multiple Family Problems
Incest frequently occurs in extremely dysfunctional families with many problems. Perpetrators lie about and minimize their sexual crimes and, in the process, model deceptive behaviors for other family members. Victims, spouses, and siblings soon learn that they, too, must deny, rationalize, and minimize problems to protect themselves as well as the perpetrator. Family members often live in fear, isolating themselves from the community to keep their secret from being discovered. Victims often use deceit and denial as coping strategies against the painful realities of abuse. Once these families are brought into treatment, their extremely pathological behavior can create chaos among the agencies and individuals who try to help them unless all those involved work in close harmony with one another.
Role reversals are common, with the victim daughter assuming many of the nurturing, caretaking responsibilities of the nonoffending mother.
Extreme family interdependency is shown in the conspiracy of silence surrounding abusive behavior.
Father-daughter incest is potentially the most damaging form of incest and is the kind most frequently prosecuted by the courts. The average victim is ten years old when her father begins his sexual advances (Giaretto, 1976, p. 2). Incestuous fathers are often anxious and insecure, and have less self-confidence than men in the general population (Rosenfeld, 1977). They frequently choose incest because they are unable to deal with adult women and establish ties with the outside community. In many cases, they have been raised in incestuous families and are victims themselves.
They often rationalize their incestuous behavior as fatherly affection or as a means of teaching children the facts of life.
Nonoffending parent” is a term used to describe the husband or wife of an incest perpetrator.~ In child sexual abuse literature, nonoffending parents have been described as passive-aggressive, helpless, rigid, overpowering, aloof, distancing, controlling, caring, castrating, or dehumanizing. Investigation has uncovered profiles of almost every type of personality (Brown and Tyson, 1978; Weiner, 1962). It is common for nonoffending parents to have been sexually abused as children and to be overtly or covertly aware that their children are being abused.
Nonoffending mothers often have low self-esteem and feelings of insecurity.
The nonoffending parent is often the object of the victim’s passive or focused rage. The child believes that the nonoffender knows she is being abused, even though this may not be the case. She feels that the nonoffending parent should do something about the abuse. She hopes the parent will protect her, divorce the offender, or at least make him stop the abusive behavior.
A child victim frequently believes the only person to whom she can express her anger is the nonoffending parent. This parent may love the victim but may struggle to understand and cope with the confusion, anger, and frustration of the victim, especially when the victim’s hostility is directed at her. When the victim is with the offender, she is often compliant and attentive and seems to prefer him over the nonoffending parent. This may confuse the nonoffending parent. The perpetrator often adds to the dilemma by persuading the victim to view the nonoffender as weak, deficient, or unable to parent.
If the nonoffending parent has lingering psychosomatic illnesses or is dependent on prescription drugs for such illnesses, the perpetrator may encourage her to remain isolated and to avoid her responsibilities so that he can have greater access to the victim.
When a nonoffending spouse is very dependent, her ability to acknowledge and expose the sexual abuse is greatly diminished. She realizes that disclosure creates the risk of extreme financial hardship for the family. She may choose not to report the abuse until she is employed and has enough money saved to escape with the children. Her self-esteem is often so low that she perceives herself as unemployable. She is frequently unskilled.
Some dependent nonoffenders reject evidence of the abuse, choose to believe the offender’s story of innocence, and psychologically abandon the victim while clinging to the perpetrator as the only hope for survival. Other family members may gather around the offender. Dissenters who sympathize with the victim are rejected. In this way, the perpetrator maintains control of the family and perpetuates their dependency.
When incest occurs, nonoffending parents usually feel guilty and angry about their poor choice of companions. Both they and their children fear the offender.
Henry Kempe (1977) discovered that people who are physically or mentally impaired have a 30 percent greater risk of being abused than those who are not. Disturbed, controlling adults often rationalize that these children do not have normal feelings or will not have normal relationships during their lifetimes. The victims often believe they are unworthy of relationships and do not allow closeness. A pattern often evolves in which they are continually victimized.
Forgetting is often perceived as a threat. If the victim were to allow herself to forget about the abuse, it could happen again.
Victims often respond to treatment in the same way they responded to the abuse. They wait to be told what to do instead of taking an active role in the therapy process. They have learned not to express feelings, hold opinions, or discuss choices. If they do not get better immediately, they may believe it is their fault. Consequently, therapy often seems to result in failure.
Begin the strengthening process by giving the child permission to accept and express feelings of anger and hurt. Incest victims, particularly, are afraid to accept or express their feelings. They often fear further rejection. They tend to blame themselves, thus inhibiting the healthy attitude that they have a right to be angry and feel hurt because their parent or parents have betrayed them (Porter, et al., 1984, p. 128).
Maxine Murdock stated: “Virtue is something that cannot be taken away from anyone; it can only be given up voluntarily. If for example, a person is robbed, does that make him a robber or a thief? Or if someone takes your life, are you therefore guilty of murder? Certainly not. And of course the same is true of rape: the guilt lies with the perpetrator, not the victim.”
6Murdock, Maxine, “When It Happens to One Among Us,” Ensign, October 1981 (emphasis added).