INTRODUCTION
"Thousands of South African children are living in a Dickensian world where they are exposed to abuse on a scale that experts now believe affects one in every three. And those are only the cases that are reported." [Personality, August 6, 1990]. What exactly is this horror that is sweeping our land? Generally speaking, child abuse occurs when a person causes harm which is not accidental to the child, that impairs or endangers a child's physical or emotional development.
1. THE TYPES OF ABUSE
A. PHYSICAL
This occurs when children receive broken limbs, bruises, burns, bites, cuts or similar injuries due to violent actions of adults. These actions may be the result of commission or omission. At times the injuries may also be the result of excessive discipline. When a parent views a child's behaviour as bad and lashes out in a moment of uncontrolled anger, physical abuse results.
B. EMOTIONAL
Emotional abuse includes both active behaviour towards the child or withdrawal of interaction with the child. It involves excessive or unreasonable parental demands that place expectations on a child that are beyond their capability. Examples include constant criticism, belittling, and persistent teasing. When parents fail to provide the necessary nurture for a child's physical and emotional development this is also referred to as emotional abuse. Emotional abuse involves acts of omission, ie. ignoring or passively rejecting a child, and a lack of physical contact with the child; and acts of commission such as constant yelling, demeaning remarks, threatening, terrorising and bizarre or unusual punishment. It is the underlying factor in most cases of child abuse.
C. NEGLECT
Child neglect is the continued failure to provide children with the basic necessities of life - food, clothing, shelter, emotional security, medical and dental care and adequate supervision. Neglect is more what a parent does not do [omission], than what they do [commission]. It is not an isolated incident but rather a situation where parents are unwilling or unable to provide the level of care that is essential for the child's physical, intellectual or emotional development. Neglect is a failure to meet the needs of the child!
D. SEXUAL
Sexual abuse includes a broad range of sexually-orientated activities which involve the child, ranging from sexual exposure and fondling to anal or vaginal penetration, ie. activities that expose children to sexual stimulation inappropriate to their age, psychological development, and role in the family.
When such activities occur between family members, the term Incest or Intrafamilial child sexual abuse is used. This can include any adult who plays the role of a family member in the life of the child, ie. Blood-relatives and Step-parents or Surrogate parent figures are included.
Child sexual abuse which is perpetrated by someone outside of the family - a babysitter, family friend, teacher or unknown molester, is known as Extra-familial child sexual abuse.
The word "Survivor" is an apt description for those who live with an abusive past. Like survivors of other life changing traumas they carry scars inflicted on them by the actions of other people for the rest of their lives.
A. DENIAL
Many abuse victims attempt to deny their past experiences, as denial helps to block out unpleasant or painful memories. It is simply too difficult to admit that a parent or respected adult did such a terrible thing.
B. MINIMISING
Victims may respond by saying to themselves, "It wasn't all that bad." This helps to lessen the feelings of guilt that they are carrying.
C. RATIONALISATION
Victims often rationalise the abuse by making excuses for the abuser. Alibis such as, "He really did care for me," "He and mom didn't get along very well" or "It was my fault that it happened" are thin but consciously adequate excuses for inexcusable behaviour.
D. BLOCKING OUT
With the help of "selective memories," victims block out memories of the abuse and the abusive relationship because of painful feelings associated with it.
A. PHYSICAL PROBLEMS
The internalisation of the abuse experiences may result in physical problems. They range from feeding and sleeping disturbances in infants and toddlers to bed-wetting in young school-age children, and such gynaecological disturbances as painful menstrual periods or the absence of periods in adolescent girls.
Vulvar lacerations, and abrasions in the genital region, and, occasionally, venereal or other sexually transmitted diseases result from sexual contact. In adolescence, abuse may result in pregnancy, leading to either childbirth or abortion, both highly traumatic for a teenage girl. Many survivors suffer psychosomatic disorders such as migraines, stomach and skin problems, and disabling aches and pains.
B. EMOTIONAL PROBLEMS
[a] Guilt - This is the most common effect of child sexual abuse. The source of this guilt varies. Some feel guilty about an ingrained defect in themselves that elicits sexual abuse. They conclude they are evil and have done something to deserve the abuse. Guilt is reinforced when counsellors ask questions that suggest that the child invited the sexual attention of the adult.
Adult perpetrators commonly attribute the blame for abuse to the victim - and, unfortunately, the child usually believes them. One of the immediate goals in counselling is to help the child realise they were not responsible for the abuse so they can begin unloading their guilt and feelings of responsibility.
Guilt may arise from the "complicity problem." Since sexual stimulation is pleasurable, survivors very often feel guilty not just about being involved in the sexual activity but about their pleasure in it.
If the child who is abused takes the place of a legitimate sexual partner (ie. her own mother), guilt may arise from having taken another woman's partner.
Survivors often feel guilty about how they could have let the whole thing continue without telling someone. They have been locked into a kind of conspiracy against society, urged, threatened or perhaps bribed into silence.
This guilt carried by the survivor is partly an imparted guilt, laid on the abuse victim by another person's wrongdoing. No child has sufficient understanding to be sexually responsible. The craving for love and attention that renders a child vulnerable is the natural response of a child to trusted adults in their life. The abuse of that trust is the responsibility of the adult who initiates sexual activity. The unequal distribution of power between abuser and abused throws the weight of responsibility on the adult involved.
[b] Shame - With the overwhelming guilt come a feeling of shame. This sense of shame seems to be rooted in the experience of being physically overpowered and coerced into activities which are often revolting to the child. The sense of shame is experienced not just because of the abuse, but because they let it continue for so long without saying anything.
[c] Low Self-Worth - a demonstration of low self-esteem and a crippling loss of self-worth is seen. This may in turn lead to a learned "victim mentality" where the victim ceases trying to get away or gain relief. When victims learn that they are powerless they may stop struggling and become passive.
[d] Anger and Hatred, Leading to Depression and Despair - Feeling defrauded, an intense anger burns in the survivors as they realise the extent to which they have been violated, exploited, and betrayed. This anger is often turned inwards causing depression, despair, and suicidal thoughts or actions. It may erupt in irrational fury directed towards parents or other close people. This anger and hatred uses up the energy survivors need to get on with their lives. A helplessness some feel is thought to stem from anger turned inward.
[e] Fearfulness and Anxiety - Once that sense of trust is betrayed survivors experience fearfulness and anxiety. It may erupt at particular moments in relationships, shadowing some of the most joyous events and stages of life. A special fear of intimacy, of letting anyone close, is very common. This will inhibit friendships, fragment marriage and even result in over-protective parenting. Most disturbing is the way in which it impedes faith, making the spiritual pilgrimage of the abused survivor especially difficult.
Victims may have received threats of harm to themselves or to loves ones, or they may have been subjected to actual physical or sexual violence - so they consequently feel unsafe in unfamiliar situations, afraid of new people.
[f] A "Tough Skin" - The experience so hardenes the individual that there is a consequent inability to admit or even perceive their feelings.
The damage done by an abuser reaches beyond the inner emotional life of the survivor, like a dark shadow it affects behaviour patterns and relationships.
Survivors need to understand why they feel and act the way they do and why they have difficulty in establishing and maintaining relationships.
The damage experienced by the abused may stem from the following factors:-
[a] Betrayed Trust - Since the abuser is most often a loved or trusted person in the child's life, a deep sense of betrayal pervades the child's view of life. Poor basic trust is most common in survivors.
[b] Interrupted Sexual Development - This naturally affects relationships as the child is prematurely forced into stimulation for which they are wholly unprepared. The abused is unprepared for a sudden leap in sexual development.
[c] Confused Roles - The victim may be forced into a premature adult role as lover-wife-partner. Caregivers on whom the child depends exploit the child's vulnerability and relate to the child in roles which are confusing and/or terrifying to the child.
[d] Lost Childhood - The experience of a pre-sexual personhood has been lost leaving the victim without an opportunity to develop resources to deal with adult life.
The specific behavioural problems that result from sexual abuse are:-
[a] Negative/self destructive patterns of behaviour - victims of child sexual abuse respond with negative and self-destructive behaviour patterns. They may seek escape through substance abuse or run away from home.
[b] Sexual promiscuity - This is common in survivors and is usually a cry for love and affection.
[c] Aggressiveness or total passivity - Either extreme is detected.
These behavioural patterns complicate the problems of low self-esteem, guilt and a lack of control over life. The pieces of their lives become, not only jumbled, but twisted and scarred.
The distorted relationships of a childhood marred by abuse cast their long shadow across adult relationships in many areas.
[a] Marriage - The betrayal of trust in childhood leaves the survivor battling to enter into an intimate marriage. Either aversion or addiction to sex causes problems in marriage adjustment. If flashback memories occur in intercourse, endless conflict and pain is experienced. A "repetition compulsion" may cause women to chooses an abusive husband. A lack of self-worth may mean that the abuse survivor has an excessive need of affirmation from others, but because of all the negative words flung at them during the abuse, they discount words of encouragement or praise. Hammered by self-doubt they are unable to believe that people really like them.
[b] Parenting - The survivor has to fight two extreme tendencies: repeating abusive patterns of behaviour, and reacting by over-protectiveness. Parents who were abused are often suspicious of adults who relate to their children.
[c] Lesbianism/Homosexuality - For some women, the strong mistrust of men may lead them into lesbianism. A relationship with another woman may feel like a safer kind of relationship. Women who are abused by a women may feel repulsed by or afraid of being alone with women. This affects their relationship with their mother as well as their friends. For boys abused by men there could be a tendency to adopt a homosexual life-style or a withdrawn life-style.
The abused person develops many problems in their spiritual life, including:-
[a] Difficulty trusting in God - The abused person has been betrayed and the ability to trust is therefore harmed. Having been abandoned in their time of need they have felt completely alone in their pain. This confusion of feeling has set up a barrier between them and God. There is a struggle with doubt that makes the victim question whether they can ever hope hope again or trust God to protect them. The inability to forgive: the abuser, self or God also causes a barrier to growth in their spiritual life.
[b] Distorted Identity in Christ - The result of abuse includes the confusion of the identity of the victim. The girl feels intruded upon, disrespected, used, unclean, robbed and manipulated, with the result that her glory, dignity and worth are severely damaged. One's self-image has a direct bearing on one's image in Christ. That same feeling of worthlessness is carried over into their relationship with God and they doubt that they can be accepted by Him.
[c] Directing Anger at God - The victim may respond by saying, "Where was God anyway? I don't even believe that there is a God anymore! Why did He have to make my daddy the way he is?" This anger may even be extended to include all christians who were friends before the abuse.
The need for ministry to youth who are abused cannot be overlooked. As the incidence of abuse rises the youth leader will increasingly be confronted by the young person seeking counselling for a recent or early childhood abuse situation. The way to minister effectively to the abused is to:-
A. PROVIDE SECURITY
The victim of abuse has experienced a severe break in trust, especially where the abuser was a relative or family member. They need to feel safe and know that they can talk to you. Find a regular time to talk, listen and celebrate together with the survivor of the abuse.
B. PROVIDE AFFIRMATION
Sexually abused youth have a poor self-concept and are riddled with guilt. They are desperate to be accepted. Accepting the abused as they are without showing signs of judgement will convey a sense of unconditional acceptance.
C. PROVIDE BELONGING
Just as they need to be accepted they need to feel a sense of belonging to a group or individuals. Provide a safe support group that will accept them just the way they are. The support group should be a place where they are able to get help and encouragement from others who have had similar experiences.
D. PROVIDE INTIMACY
While the leader must be careful about touch which may cause a flashback, they should share something about themselves, develop little "in" jokes and make use of eye contact. This will help the abused back on the road to relational integration again.
E. PROVIDE FRIENDSHIP
Find time to hang out just as friends without mentioning the subject of abuse. Take the person out to a neutral territory that will cause new experiences to take the place of the old experiences.
For a full and complete recovery the abused should experience the following:-
A. CLAIM THE PAST
The survivor needs to come to the place where they can put words to their past by verbalising it to another person. This helps the person to claim their past as their own. As humans, in a sense, we are the sum total of past experiences. When we cut ourselves off from our past, we cut ourselves off from our own identities. The whole and healthy person is the one who is able to embrace both the past and the future. Many abused survivors have repressed distressing memories for so long that they have memory gaps in their personal histories. A lot of courage and counselling help is needed for them to be able to say, "This is what happened to me. This is also part of my life."
It is essential for survivors to speak about their past because,
a. It helps them accept their past as a fact
b. There is a catharsis, a purging of painful memories in the telling
As the survivor begins to reveal the past they will often express intense anger towards the abuser. They should be encouraged to embrace the anger and not try to deny it. Do not allow the anger to become suppressed into the subconscious as it will manifest in depression or uncontrollable outbursts.
Anger directed against God should not be met with a rebuke by the counsellor. God is great enough to bear anger. He can absorb its full impact. It is best to spend their anger against Him until, in the quiet, he lets them feel the pulse of his own broken heart.
Once the survivor realises that anger is legitimate, and even healthy, once they have turned it upward, instead of outward towards others or inward onto themselves, they will find themselves freed from its control.
While the survivor cannot change the past, and though their past may have been under the control of someone else, their future is theirs. They can determine to prevent their past from controlling their future. Help the survivor to dare to trust God for a different kind of future. Lead them in a prayer expressing trust and confidence in the God of new beginnings [Isaiah 43:18,19].
B. GIVE FORGIVENESS
The first step in forgiveness is directed towards the survivor themselves. The realisation that they were not to blame for the abuse experience is an essential step in helping them to unload their tremendous guilt and feelings of responsibility.
Forgiveness is not excusing what has happened, but operated in clear knowledge that we have been hurt and sinned against. It's a choice that we have to make throughout our life. Every time we choose to forgive we make a choice for forgiveness. Until we forgive people they have the power to go on ruining our life, but when we forgive, their power over our life is destroyed.
When we offer forgiveness, we do several things:-
[a] We Transfer the case to a higher court - A good definition of forgiveness is "to give up all claim to punish or to exact penalty for an offence." We must stop demanding an accounting from the person who wronged us. Survivors who harbour a secret desire to murder their abusers do more damage to themselves than to the abuser. In forgiving the abused acknowledges the wrong done to them, while they commit the person to a higher judge.
[b] We let go of our resentment - The second aspect of forgiveness is to give up resentment, to stop being angry with the abuser. The word forgive comes from an ancient word that means, "to give away."
[c] We become willing to bear the pain of another's sin against us - The will is the part of us that needs to become active here. A willingness to accept the pain of the offender and release the offender is costly. Just as Christ is willing to bear the pain of every sinful act we have committed, he asks us to be willing to do the same for others.
[d] We wait for God to work an act of release within - Forgiveness is only complete when something supernatural occurs. As God fills the survivor with His redemptive love they are truly able to forgive their abuser. He fills the abused with His compassion and release flows.
Forgiveness helps us to embrace and be free of our past and it opens us up fully to the forgiveness God extends to us.
C. DETERMINE TO RECOVER
The stage must be reached where the abused makes the conscious decision to become well again. It is the stage of turning to God as the Divine Therapist and asking for healing. The assurance of the possibility of total renewal by God was spelt out by Paul in 1 Cor 6:9-11. He mentions a list of morally perverted individuals and says, "such were some of you, but you were washed, you were sanctified, you were justified in the name of the Lord Jesus Christ and in the Spirit of God." No one is beyond the circle of God's healing power.
For the abused the road to healing comes through the renewal of the mind. This takes place through the memorisation and meditation of scripture and the application of their truths to life and through a fresh commitment to prayer
D. LEARN SELF-ACCEPTANCE
The need to forgive self is part of the healing process. Just as the abuser has been forgiven the abused must come to the place where genuine self- forgiveness becomes a reality. Often forgiveness needs to be given for actions that were never one's own fault. Then forgiveness must be levelled against those actions which were one's own fault: ie. hatred, resentment, bitterness; possibly a sinful life-style or a vindictive "taking it out" on others.
Rebuilding a self-image involves a journey of learning to:-
* Refuse the effects of the past
* Nurture/parent oneself into the present
* Achieve in ways that will provide esteem milestones into the future
Recovery from abuse can be viewed as a process with four overlapping stages:-
A. THE IMPACT STAGE
The initial stage lasts for a few hours to several days and is characterised by shock, disbelief, anxiety, and fear. The victim is confused about whether to report the abuse and there is a fear that the abuse will recur. At this stage the youth leader should give support, guidance as decisions are made, or assist the victim in receiving medical care and safety. Often this assistance is not given because the abused is too afraid to report the incident.
B. THE DENIAL STAGE
In order to cope with the stress, the survivor tries to push aside the trauma of abuse and return to a pre-crisis stage of functioning. Victims need to feel secure, organised and in control. On the outside it may appear that the person is healed, but the hurt remains and much ministry is needed.
C. THE PROCESS STAGE
This stage begins when the feelings of assault can no long be suppressed. Often an event or emotional distress will trigger the old feelings and the victim is flooded with anxiety, depression and a preoccupation with the event. The survivor needs to talk, express feelings, struggle with guilt and feel the support of the youth leader. The survivor needs to be in touch with a support group where mutual help can be shared.
D. THE INTEGRATION STAGE
The final stage comes when the individual begins to no longer feel controlled or dominated by the effects of the abuse. They are still viewed as painful events in the past, but the individual has grown to a higher maturity and is able to move on with their life.