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Child Sexual Abuse

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Foundation Child Sexual Abuse is a non profit organization working as speciaL consultative status with United Nations.

 

(1) Child Sexual Abuse

The scope of the problem of child sexual abuse within our society is an epidemic of such vast proportions that virtually all children are at risk of abuse. Children are abused by loved ones, friends, family friends, those in whom they place their trust, and those bound to care for them. They are abused by those they hardly know and even those they do not know. Children of all ages are at risk and vulnerable to sexual abuse, whether in their homes, their community, or even over the Internet. Society’s response to this tragedy has been to develop programs that identify, assess, and treat the victims, treat or punish the offenders, and teach young children how to deflect approaches.

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(2) Child Sexual Abuse

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Child sexual abuse is a social construction. It is surely a reality-a tragic reality-but the definition and scope of child sexual abuse, and its conceptualization, are socially constructed phenomena. As such, to understand child sexual abuse and society’s response to it, the socio-cultural context within which it is defined and conceptualized must also be understood. These texts are therefore not only concerned with what we know about child sexual abuse, but also with how we frame what we know about child sexual abuse. While the empirical knowledge base largely frames what we know about child sexual abuse, how we conceptualize and make inferences from this knowledge base are impacted critically by the theories that guide our thinking.

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(3) Child Sexual Abuse

Child Sexual Abuse

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THE EARLY PERIOD: FREUD’S THEORY OF SEDUCTION

It was into this socio-cultural environment that Freud moved. In 1885, while finishing his medical studies, he made a several-month study trip to Paris where he worked under Charcot, whom he admired. Masson, an expert on Freud, shows that during Freud’s stay in Paris, he was not only exposed through Charcot’s and Tardieu’s writings to the reality and frequency of child sexual abuse, but also probably witnessed autopsies on some of its young victims. Freud also had in his possession the major French books on sexual violence against children and was familiar with the writings of Fournier, Bourdin, and Brouardel.

From Paris, Freud returned to Vienna, where he established his medical practice specializing in nervous disorders. Here he introduced a type of therapy that relied on the patient talking while the physician listened. This free association method of treatment allowed his patients to explore hidden emotions in an atmosphere free of judgment and censure and opened for him a view into underlying issues of psychopathology. The most important turning point in Freud’s career was when he began to understand the force called the unconscious, and he explored this realm not only in his patients, but also through his own self-analysis.

This discovery set the stage for his work on child sexual abuse. By 1896, Freud had formalized his theory on the etiology of hysteria, which he presented to his colleagues in a group of three papers entitled, “The Aetiology of Hysteria”. In these papers he presented a sample of 18 patients, labeled hysterical, who he concluded had been victims of childhood sexual assault by various caregivers. In these three papers he further suggested that the abuse itself was responsible for the victims’ significant psychopathology (neuroses).

These papers, however, offered contradictory information concerning the identify of the perpetrators. He variously implicated teachers and female caretakers (but not mothers), and same-age, opposite-sex children such as brothers. Only later, in his private letters to Wilhelm Fliess, his good friend, did he suggest that fathers were most often the offenders.

Rejection of the Theory of Seduction

Freud’s colleagues, including Charcot, who “found it preposterous that parents would molest their own children”, frankly rejected his theory, a rejection that continued as long as Freud embraced his seduction theory. As Masson states, “In accepting the reality of seduction, in believing his patients, Freud was at odds with the entire climate of German medical thinking”. It is perhaps not surprising then, that by 1897 Freud had repudiated his own observations. In his now famous letter, he announced to Fliess, "I no longer believe in my neurotica.” Freud now believed that most, but not all, of the assaults he reported had never occurred. He instead suggested that the young child, needing to release sexual tensions, wished for the sexual attention from her father. He believed that these tensions were universal and unfolded in developmental stages.

Having replaced his theory having a universal external etiology with a theory having a universal internal etiology, Freud then advanced his theory of the Oedipus complex, which became a "universal and intrapsychic rather than environmental hazard for emotional health.” According to the Oedipus complex, the female child initially takes her mother as her love object. When the child sees the male genitalia, however, she immediately recognizes it as superior and consequently falls victim to penis envy. Her father now becomes her new love object. It is during this stage, Freud hypothesized, that girls create incestuous fantasies of themselves with their fathers. Freud therefore came to believe that reported cases of incest were simply wishful fantasies for the love object. As Hare-Mustin states, "patients are made ill by their fantasies, not by what happens to them".

Rationale for Freud’s Reversal

What could have caused Freud’s complete reversal of thought in such a short time? As the impact of Freud’s reversal has become recognized, different authors have forwarded rationales. This literature, however, often reflects the ideological background of the writer, with psychoanalytically trained professionals sometimes being more muted in their opinions and feminist writers being more provocative. Nonetheless, at least five rationales for his reversal have been forwarded.

The Effect of Professional Censure

When Freud first forwarded his seduction theory, he was young in his career, and the opinion of his colleagues probably mattered greatly. His theory of seduction was considered unpopular at the least and, more likely, outrageous. Perhaps an analogy of the pressure Freud might have felt to rescind his theory can be educed from the current environment. Even today, in an age far more enlightened than the one in which Freud lived, the backlash against a full knowledge of child sexual abuse is great. Professionals have been attacked, sometimes with serious repercussions. These attacks have occurred even though the scope of child sexual abuse is undeniable. Freud, however, was one of the few professionals of his era suggesting that “hysteria” was a result of actual incidents of sexual abuse. Because Freud’s young professional reputation appeared to be at stake, he may have felt extreme pressure to rescind his theory.

Freud’s Unresolved Issues

Another rationale for Freud’s renunciation of his seduction theory was forwarded by Westerlund. After analyzing Freud's letters and other historical writings, she suggested that Freud, after recognizing the existence of certain hysterical features in his brother and several sisters, was on the verge of discovering that his father might have sexually abused one or more of them. In the same letter to Fliess in which he recanted his theory, Freud stated, “In all cases, the father, not excluding my own, had to be accused of being perverse".

How can this statement be interpreted? Westerlund interprets it to mean that Freud’s father may have been guilty of incest. The context, within which this letter was written, however, must be considered. Freud had recently presented a theory in which most or all hysteria was reported to result from a childhood history of sexual abuse. It is especially obvious today that current symptomatology is not always the result of child sexual abuse. Perhaps because he had developed a theory of hysteria based only upon a history of child sexual abuse, Freud found himself in the awkward position of having to defend the position that all individuals with hysterical features were previously sexually abused. As Armstrong puts it, “Incest was the (sole) cause of female neurosis, thus female ‘neurotics’ must have experienced incest’. Unable to reconcile this apparent conflict, Freud may instead have had impetus to abandon his theory.

It was also during this time that Freud experienced overly affectionate feelings towards his daughter and reported a dream to Fliess in which these feelings occurred. While Westerlund states that these were incestuous feelings, Freud suggested that as they were in a dream, they were symbolic of his need to suggest that the father was responsible for neurosis. There is some question whether Freud’s "shocking" behavior towards his niece was also perhaps erotic in nature. Westerlund cites Jones, Freud’s biographer, as stating that it is likely that the cruel behavior with which Freud and his nephew treated his niece had some likely erotic component.

These three experiences, while equivocal, lend weight to Westerlund’s argument that by endorsing a theory in which hysterical symptoms resulted from sexual abuse experiences, Freud may have come dangerously close to acknowledging a side of himself and his father with which he was most uncomfortable. Freud may have had significant personal issues with his original theory because of his own father’s possible perpetration, his brother’s and sisters’ neurotic symptomatology, or his own possible erotic feelings. Westerlund hypothesizes that only by creating the Oedipus complex was Freud able to resolve the very personal nature of his original seduction theory.

Universality of Abuse

Another factor that may have contributed to Freud’s renunciation of the seduction theory becomes apparent in one of his letters to Fliess, in which Freud struggles to accept that fathers-and not just a few-could commit acts of incest. As he stated, “The astonishing thing [was] that in every case blame was laid on perverse acts by the father ... though it was hardly credible that perverted acts against children were so general.” As will be discussed later, Olafson, Corwin, and Summit suggest that the knowledge of the scope of the problem of child sexual abuse is so overwhelming that it is human nature, and the nature of society as a whole, to deny its existence or prevalence.

Theory of Periodicity

One of the more entertaining, although probably no less factual, rationales for Freud’s renunciation pertains to a series of events involving Freud, one of his good friends, and one of his patients. While the following is not so much a rationale for rejecting his theory of seduction, it does give an interesting view of the process by which this reversal may have occurred. The following is a brief summary from Masson’s book on Freud’s renunciation of the seduction theory.

In the early years of his professional life, Freud worked with a patient, Emma Eckstein, who had been sexually abused as a child by her father. This trauma, Freud argued, was responsible for her hysteria. At the time, Freud was good friends with Wilhelm Fliess, a physician who was advancing a theory, perhaps not unusual for its time, that the nose was the center of sexual feelings and that an operation on the nose could correct sexual dysfunction, especially the desire to masturbate. Evidently, Ms. Eckstein may have had this desire, although it is not certain. Regardless, Fliess wanted to operate, and Freud consented.

Fliess had never performed this operation before and apparently made serious mistakes. After Ms. Eckstein had a severe and life-threatening hemorrhage, another physician reoperated on her nose and found that Fliess had inadvertently left a piece of gauze in her nose, causing the subsequent infection and hemorrhage. In Freud's first letter to Fliess after this second operation, Freud was obviously concerned about the error, but already appeared to be rationalizing it. In this letter, Freud said that Fliess had done the best he could and that it was an unfortunate accident. Although Freud expressed concern for his patient, he was "inconsolable" about Fliess' part in the affair.

This incident markedly strained the relationship of the two men. Freud seemed to need to reconcile this experience so that the operation, and his approval of it, could be justified. The more letters that were written between the two, the softer the recriminations became.

Finally the men, relying on another of Fliess' theories-the theory of periodicity-began to alter the reality of the operation. This theory states that the numbers 28 (the female period) and 23 (the male period) are critical numbers and that all events in a person's life are determined by these numbers. Within 15 months of the operation, Freud and Fliess had begun to dismiss Fliess' culpability for the operation. Instead, they now believed that Ms. Eckstein would have bled anyway, as the operation fell on a critical date.

Nine months later, Freud dismissed the event further by stating that the bleeding was a result of Ms. Eckstein's “wish to have Freud by her side” and “her own perverse imagination”. As Freud stated in his letter to Fliess, “As far as the blood is concerned, you are completely without blame!". Freud now had reason to state that hysteria was not caused by real events, but by fantasized events. Perhaps it was a small step, then, to state not only that Ms. Eckstein’s abuse was an incestuous fantasy, but that all female children have incestuous fantasies. As Masson states: From 1894 through 1897, no subjects so preoccupied Freud as the reality of seduction and the fate of Emma Eckstein. The two topics seemed bound together. It is, in my opinion, no coincidence that once Freud had determined that Emma Eckstein’s hemorrhages were hysterical, the result of sexual fantasies, he was free to abandon the seduction hypothesis.

Psychoanalytic Perspective

All viewpoints discussed to this point are antagonistic to Freud’s renunciation. Other viewpoints in the professional literature, mostly by psychoanalysts, are more sympathetic to Freud’s renunciation. These viewpoints provide a balance to the literature presented thus far. Both Powell and Boer and Tabin, among others, take issue with the previous viewpoints, suggesting instead that Freud had important reasons for abandoning his seduction theory. Tabin first points out that only two of the 18 cases upon which the original seduction theory was based could be corroborated.

The patients’ disclosures themselves were often not willingly forthcoming, and Powell and Boer even suggest that the abuse memories were confabulations brought on by Freud’s use of strongly suggestible statements. As Tabin states, “His patients were not pleading from the couch that he accept their accounts of abuse in childhood. Furthermore, none of his cases showed any benefit from his interpretation that he could not otherwise explain in conventional terms. Indeed, these patients all fled from treatment”. As reported in a letter to Fliess in 1897, Freud returned from vacation only to discover that he had no patients, after which he felt resigned to surrender “his dream that his theory would win him eternal fame”.

The second major point of Tabin is that Freud continued throughout his lifetime to be aware not only of the childhood histories of sexual abuse in certain of his patients, but also its consequences. Thus, while he continued to attach greatest meaning to intrapsychic phenomena, he did not ignore the actual events.

Different authors have presented rationales for Freud’s renunciation of his theory of seduction. One very possible rationale is that Freud advanced this theory in an era that was not amenable to its acceptance. Because of the response of his colleagues and the newness of his practice, he may have felt great pressure to rescind the theory. To accept the theory may also have meant his acceptance of his own father’s “perverted” acts and that he would have to look closer at his own possible sexual feelings towards his daughter and niece.

Finally, to admit that so many of his hysterical patients were also victims of child sexual abuse would force him to accept a far greater prevalence of child sexual abuse than was comfortable. The actual rationales for Freud’s renunciation must be left for historians to decide. Awesome societal forces framed the environment in which Freud repudiated his theory. Given the socio-cultural environment in which Freud lived, the far easier path was to renounce his theory of seduction and to embrace a theory that his colleagues and society could tolerate.

It is interesting to speculate how the professional response to child sexual abuse in the following decades might have differed had Freud strongly held to his original position. Perhaps the best way to frame what might have been is as a paradigm shift. Kuhn conceptualizes paradigm shifts as scientific revolutions initiated by the introduction of a theory that does not just rework what is already known, but requires a complete reconstruction and re-evaluation of prior knowledge.

Because new paradigms confront the established paradigm, however, they are not readily accepted into the developing knowledge base. Indeed, many scientists who have introduced these paradigm shifts have been censured, and future generations have been left to resurrect their work.

Surely, with Freud’s developing reputation, had he held to his theory of seduction, he might have initiated a scientific revolution of sorts in the understanding and conceptualization of child sexual abuse. Because of the societal forces already in place, however, even had Freud defended his theory of seduction, it might have been rejected by his colleagues for some time to come. Yet Freud did not choose this path, but instead bowed to pressure. By renouncing the seduction theory, he rationalized the perverted acts away, and they disappeared into thin air as the overactive imagination of a young child whose incestuous wish is played out through an incestuous fantasy.

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(4) Child Sexual Abuse

Child Sexual Abuse Uncovered and Investigated (Video)

How to Protect Your Child from Sexual Abuse

WHAT IS CHILD SEXUAL ABUSE?

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The Effect of Freud’s Renunciation

The renunciation of Freud’s seduction theory and later, the forwarding of the Oedipus complex, profoundly affected the mental health profession. Psychoanalytic theory became the foundation for psychiatry for many years to come, with the Oedipus complex being the core of that theory. To use psychoanalytic theory, however, Freud’s original theory of seduction had to be renounced. As Anna Freud wrote, "Keeping the seduction theory would mean to abandon the Oedipus complex, and with it the whole importance of phantasy life, conscious or unconscious phantasy. In fact, I think there would have been no psychoanalysis afterwards". The development of the knowledge base on child sexual abuse was thus effectively suppressed.

To accept psychoanalytic theory, however, was to negate the client’s reality and to place the clinician in the role of expert. These experts, then, were thought to know more than the clients themselves about their clients’ reality. Patients who disagreed with their clinicians’ interpretations that their sexual abuse was simply a fantasy were said to be experiencing resistance. Even when clinicians acknowledged the sexual abuse, victims were often blamed for seducing their fathers so that they might fulfill their incestuous fantasies.

This emphasis on intrapsychic versus extrapsychic phenomena in the etiology of the victim’s psychopathology also influenced the continued blaming of victims, effectively silencing them. As Rush states: Any attempt on the part of the child or her family to expose the violator also exposes her own alleged innate sexual motives and shames her more than the offender; concealment is the only recourse. The dilemma of the sexual abuse of children has provided a system of foolproof emotional blackmail: if the victim incriminates the abuser, she incriminates herself: Finally, by blaming the victim, the social environment could then be held blameless. Westerlund states: When Freud relegated women's reports of sexual abuse by their fathers to fantasy, he.. .claimed a biological determinant rather than a sociocultural determinant for female neurosis.

The incestuous wish for the father was to be seen as inherent in the daughter's nature, the result of her physical decadency and intrinsic biological inferiority. Seduction fantasies were inevitable, they were representations of the innate female need to compensate themselves for their lack of a penis ....Freud was seduced into and seduced others into protecting the sexual offender and thus betrayed the sexual victim.

Freud advanced his original seduction theory after discovering that many of his “hysterical” female clients were reporting histories of incestuous abuse. He was then confronted with the knowledge that many fathers, possibly even his own, sexually abused their daughters. Given the opportunity to publicly identify this behavior in some fathers, he reneged, choosing instead to define "normal" behavior as girls having precocious sexual wishes that had to be fulfilled through vivid fantasy lives.

He thus effectively colluded with a society that wished to deny the existence of child sexual abuse, while modeling a pattern of removing blame from the offender and placing it on the victim.

"With Freud's retraction of the seduction theory, he left behind at once the simple explanation for the trauma, his endorsement of the intrinsic strengths of the post-traumatic patient, and his intrepid strategies for undoing the traumatic effects“. Possibly in no other clinical population has one person had such a significant and detrimental effect on the outcome of so many. With his reversal of the seduction theory, he colluded with a society not willing to know the truth.

THE MIDDLE PERIOD: 1900 THROUGH 1970

Most of Freud’s many followers continued to embrace the Oedipus complex and its rationale for reports of child sexual abuse. Of note, however, two of the most distinguished of his followers, Carl Jung and Otto Rank, either broke with Freud or denounced his seduction theory. Interestingly, both men, as children, had probably been sexually abused. Goldwert suggests that their sexual abuse may have been one reason they came to resist Freud's emphasis on sexuality and the Oedipus complex.

Then in 1932,  Ferenczi, one of Freud's most cherished colleagues, presented a paper even over the objections of Freud that suggested that children were being sexually abused (Summit). In his "Confusion of Tongues Between Adults and the Child," Ferenczi addressed not only the sexual abuse, but also the denial of this abuse by the adult world. Shortly thereafter, Freud and the professional community denounced Ferenczi for attempting to revive interest in the importance of childhood sexual assault and after Ferenczi’s death, with Freud’s agreement, the publication was suppressed. Although he may have been an early proponent of child sexual abuse victims, Ferenczi also had his own significant problems. Tabin suggests that these problems included “sexual play with his own medical patients” and “exchang[ing] kisses with his patients as a part of their treatment”, although these incidents may have occurred earlier in his career. The confusing information again suggests that the exact historical events are unclear and are open to the interpretation of the presenter. Although Masson convincingly argues that Ferenczi was attempting to revive interest in child sexual abuse, even over the objections of Freud and other psychoanalysts, other viewpoints do exist.

For the next 30 years, hardly a word in the psychiatric community was said about sexual abuse. Typical of the few writings of this period were two studies by Bender, who recognized that the incest had occurred, but placed the blame for the abuse on the seductive nature of the daughter. For example, in 1937, Bender and Blau wrote that they frequently considered “the possibility that the child might have been the actual seducer rather than the one innocently seduced”. Even 15 years later, Bender and Grugett concluded that "it was highly probable that the child had used his charm in the role of the seducer".

The next major event occurred in the 1950s when Kinsey, Pomeroy, Martin, and Gebhard published a survey reporting that 24% of the 4,441 female participants were, as children, sexually abused by adult men. Even though the large majority of these victims reported being frightened by this experience, Kinsey et al. stated instead, in a famous quote, “It is difficult to understand why a child, except for its cultural conditioning, should be disturbed at having its genitalia touched, or disturbed at seeing the genitalia of other persons, or disturbed at even more specific sexual contacts”. They suggested instead that the children were disturbed more by the reactions of the adults who discovered the contact than by the contact itself. Kinsey et al. were concerned, however, about the offenders who were often imprisoned for “accidental exposure of the genitalia while intoxicated, for nude swimming, and for the bestowal of ‘grandfatherly affection”’. Between 1940 and 1965, three other nonrandom surveys reported that between 17% and 28% of respondents were sexually abused as children.

Even after these surveys were published, however, the scope of the problem of child sexual abuse, although more clearly defined, was largely ignored by both the professional and lay communities. This era was thus largely marked by the suppression and distortion of information concerning the scope of child sexual abuse.

1970s and 1980s

While no clear line divides this earlier era of suppression and distortion from the modern era in which the scope of child sexual abuse was acknowledged, it probably occurred sometime in the 1970s. During this period, several key events occurred. The C. Henry Kempe National Center for the Prevention and Treatment of Child Abuse and Neglect opened, the National Center on Child Abuse and Neglect (NCCAN) was established, and NCCAN funded the first comprehensive study on the incidence of child abuse and neglect (NIS-1). Then in 1978, Russell conducted the first random community prevalence survey, consisting of a sample of 930 adult women in the San Francisco area and found that 38% of the respondents had experienced childhood contact sexual abuse. Because of the methodological rigor of her study (Bolen & Scannapieco), it was difficult to discount, even though it did generate considerable controversy. By the early 1980s, studies of child sexual abuse were beginning to proliferate, and the knowledge base began to develop rapidly.

What could account for this sudden interest in child sexual abuse? First may have been the impact of the Vietnam War and the political and social environment of the late 1960s and 1970s. This was a period of profound social consciousness-raising as society "grappled with the moral dilemmas posed by the Vietnam War" and all it represented (Vander Mey & Neff. No longer was the status quo taken for granted, but it was often the impetus for controversy and rebellion. Social consciousness-raising and revolution in thought were rampant. Within this socio-cultural context, it was probably far more difficult to suppress the “discovery” of child sexual abuse.

Another important factor was the developing feminist movement, which brought with it a heightened sensitivity to issues of females. Florence Rush’s book, The Best Kept Secret, was published in 1980, followed in 1981 by Judith Herman’s classic study on father-daughter incest. These and other feminist writings suggested that child sexual abuse was symptomatic and a direct derivative of living in a patriarchal society. Sexual abuse was conceptualized as a symptom of a greater problem-a male sense of entitlement to use females and children for sexual enjoyment (Herman). Sexual abuse of children and rape of females were thus conceptualized similarly. Consequently, while others were attempting to understand why child sexual abuse was so prevalent, feminists were instead attempting to understand why more children were not sexually abused. As Herman stated in a later feminist analysis of sexual assault, if, as many feminists argue, the social definition of sexuality involves the erotization of male dominance and female submission, then the use of coercive means to achieve sexual conquest may represent a crude exaggeration of prevailing norms, but not a departure from them....The unanswered question posed by feminists is not why some men rape, but why most men do not.

By the end of the 1980s, the scope of the problem of child sexual abuse was more clearly defined. Several random community surveys (Russell & Wyatt) and even a national prevalence survey (Timnick) had now been conducted. While prevalence rates for child sexual abuse differed based upon the studies’ methodologies, one fact was certain: Child sexual abuse, both for male and female children, was a substantial problem.

This knowledge brought with it a significant professional response, and numerous treatment centers were established for child and adult victims. Clinicians became sensitive to preventing what they termed “system-induced trauma” to victims (Conte). Child sexual abuse also came to be viewed as a multidisciplinary problem. Treatment, evaluation, and assessment protocol were developed, and the response to child sexual abuse across all mental health professions burgeoned. While professionals were now trying to respond to the scope of the problem of child sexual abuse, however, empirical knowledge lagged. Studies in the 1980s were largely descriptive, answering broad questions about who and how bad. They were not yet sophisticated enough to answer questions about better treatment or assessment protocol. This lack of an empirical base for clinical protocols thus set the stage for the 1990s.

1990s

The climate of the 1990s can be framed by a single word-backlash. This backlash started as a series of controversies over the developing knowledge base, with two areas receiving particular attention. The first issue was whether females were being under identified as offenders. The second issue was whether mothers involved in custody or divorce disputes were falsely and maliciously charging their ex-partners with sexually abusing their child. Shortly, however, controversies began erupting concerning the techniques used by clinicians. In probably the first major attack, clinicians were accused of leading young children to make false charges of ritual abuse. In the 1990s these attacks on clinicians gained in momentum and became more generalized so that clinicians working with both children and adults were now involved. Clinicians working with children were accused of using aggressive, suggestive, and leading techniques that placed the veracity of the child’s disclosure into jeopardy. Clinicians working with adult clients were accused of leading their clients to falsely disclose histories of childhood sexual abuse. Regretfully, many of these attacks were hostile and even vicious.

While much has been written concerning this backlash, it is beyond the scope of this book to review this substantial literature. More salient to this book is the need to frame the backlash within the ideology of the 1980s and 1990s and to understand why the environment of the 1990s was ripe for a backlash.

The first reason that the climate was ripe for a backlash is the state of empirical research in the 1980s. In relation to the needs of clinicians and others directly involved in the assessment and identification of victims, the empirical knowledge base for child sexual abuse was clearly inadequate. The development of a knowledge base is complex, with the beginning phase marked by descriptive and exploratory research. Only then does research move to answering questions framed in a more sophisticated manner. Research in child sexual abuse is so new that there simply has not been enough time to develop an empirical base with sufficient breadth and depth.

This problem has been inevitable given the short history of the empirical base. Because of the seriousness of the issue of child sexual abuse, however, clinicians were forced to make clinical judgments beyond the limits of the empirical research base available. Inevitably, these judgments were questioned. One reason for the backlash, therefore, is to ask the important question: What is the basis for clinical judgments? Regretfully, however, this discussion has often been pointed and personal.

A second reason for the backlash was explored by Olafson, Corwin, and Summit. It is their thesis that a cycle of discovery and suppression of child sexual abuse over time exists. In their view, the knowledge of child sexual abuse is so overwhelming that it must be denied. They state: If we were really to take into account the role sexual coercion and violence play in shaping human culture and personal identity, fundamental structures of thought could well be shaken and changed. Such great shifts in world view unsettle even those whose privileges and self-images are not directly threatened by them (Kuhn). Indeed, information about the prevalence and impact of sexual abuse may constitute unwelcome news on all shades of the political spectrum ....The full realization that child sexual victimization is as common and as noxious as current research suggests would necessitate costly efforts to protect children from sexual assault.

It remains to be seen whether the current backlash will succeed in resuppressing awareness of sexual abuse ....If this occurs, it will not happen because child sexual abuse is peripheral to major social interests, but because it is so central that as a society we choose to reject our knowledge of it rather than make the changes in our thinking, our institutions, and our daily lives that sustained awareness of child sexual victimization demands.

A final reason for this backlash is similar, but framed within a feminist perspective. As Olafson et al. state, “It can be argued that the intensity of the current debate is fueled by the defense of gender and professional privilege and hierarchy”. This quote speaks to one of the foremost statistics of child sexual abuse-that approximately 95% of offenders are male, whereas approximately 70% of victims are female. Further, with 30% to 40% of all girls being sexually abused prior to their 18th birthday (Bolen & Scannapieco), “common sense would suggest that some comparable percentage of the male population has been doing the victimizing” (Herman). While Herman’s statement may be somewhat of an exaggeration, as most offenders abuse multiple children, it is probable that a significant minority of men within society has committed, or are at risk to commit, sexual abuse.

To internalize this knowledge is paramount to a social revolution. One of the hallmarks of patriarchy is that it is founded upon the premise of the benevolent male taking care of the less-positioned female. History, however, suggests that the image of the benevolent patriarch is a myth. Instead, the prevalence of child sexual abuse suggests that the more likely reality may be one of male entitlement, male domination, and male subjugation of females and children. To truly understand the scope of child sexual abuse thus brings with it a responsibility to advocate, not only for the safety of children, but for the reform of basic tenets that undergird modern society and that may foster child sexual abuse-something the privileged majority do not willingly seek, as their power base would be disrupted. Instead, it becomes critical that the scope of the problem of child sexual abuse be suppressed.

In this context, the current backlash is about a far greater controversy than simply whether children and adults create or are implanted with false memories, whether leading questions influence victims, whether dissociative disorders can be induced, and all the other issues that have come to the fore in recent years. These controversies are better flamed as screen issues for a far greater and underlying issue-that of the basic structure and privilege of members within society

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(5) Child Sexual Abuse

Child Sexual Abuse Statistics

Child Sexual Abuse

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Looking Forward

 Where will we be in 10 years? This is a difficult question for even those with crystal balls. What can be considered, however, is social forces that may shape the future agenda for child sexual abuse research, treatment, and policy decisions.

Perhaps the most important issue is the current environment of conservatism. This environment and its concomitant political agenda have already radically affected issues of children. While great gains for children’s rights were made between 1960 and 1990, the country (USA) is experiencing a current reversal of these rights. As legitimised in the current welfare “reform” act, the federal government no longer views children as having innate rights to be fed, sheltered, and clothed.

Guardians and more specifically, single mothers, are punished as well. Some of the most marginalised members of society are thus in grave danger of being complete without resources. This environment of conservatism bodes poorly for the rights of children not to be sexually abused. If, as feminists contend, child sexual abuse is related to the abuse of power, then depowering the powerless and empowering the powerful may serve to tip the scales in favour of greater access to the sexual violation of children. When children are abused, the current conservative environment may also make it more difficult for the victims to be heard and especially, to be believed. There is also grave concern that punishing the guardians of these children will increase the children’s risk of abuse. Single mothers on welfare are now required to return to work, although the so-called welfare reform laws often exclude the resources these women need to find employment sufficient to afford safe child care.

Although findings remain inconsistent, some community prevalence surveys suggest that children are at greater risk of abuse when their mothers work than when they do not, and this relationship is especially apparent for children living only with females. It may be that these findings reflect an issue of supervision as children lose the protective influence of their mothers and sometimes, safe alternative caretakers. If inadequate supervision is the issue, then the recent passage of the child welfare reform bill, which forces single mothers back into the work force without providing adequate funding for safe child care, may have ominous implications for the risk of their children to be sexually abused.

The current environment of political conservatism and the “reform” laws may thus have dire consequences for the protection of children. While the intended effects of these supposed reforms are chilling, the unintended effects may be even greater. In a climate that strengthens the disparity of power between adults and children, males and females, and whites and persons of colour, the obvious losers are the less powerful. Whether this environment will contribute to an increased rate of sexual abuse of children remains to be seen. The possibility, however, cannot be discounted.

Theories of Child Sexual Abuse: A Historical and Sociocultural Perspective

As discussed before, the theoretical base of knowledge for child sexual abuse began with Freud’s seduction theory. After realising that most of his hysterical clients were also victims of child sexual abuse, Freud forwarded a theory of seduction in which he posited an etiological link between child sexual abuse and later hysterical symptoms. This theory was met with rejection and scorn from the professional community, and he renounced the theory only a short time later. The import of this renunciation was so profound that little work to advance the knowledge base of child sexual abuse was done for many years to come. Even so, certain lines of thought, influenced by Freud’s psychoanalytic theory, permeated the writings during this time. It is therefore not surprising that these writings, when they admitted to the occurrence of the sexual abuse, typically removed blame from the offender and placed fault for the sexual assault onto the victim, almost always assumed to be the daughter.

The first formal theory of child sexual abuse, appearing in the professional literature in the 1960s and 1970s, may be family systems theory. This theory, which derived from general systems theory, posited a systemic approach to father-daughter incest. All members of the family, including the mother and victim, were hypothesised not only to be responsible for the initiation of the incest but also to collude in its maintenance. Like the earlier writings, family systems theory (a) applied primarily to father-daughter incest and (b) continued to remove blame from the offender.

Since the mid-1970s, several more sophisticated theories of child sexual abuse have been developed. Those that attempt to clarify why certain individuals might abuse a child include sociobiological theories, feminist theory, attachment theory, and behavioural theories, including conditioning theory and social learning theory. The primary theory that focuses on why certain children are at greater risk of abuse is the feminist theory.

The following text briefly discusses the historical development of theories of child sexual abuse. Because the matter of culpability is central to this development, it is used to organise these next sections. Freud’s theory was amply discussed before. Therefore, these texts start with the era following Freud.

Theories of Culpability

Seduction by the Daughter

 As discussed in the previous texts, certain important writers following Freud continued to acknowledge that child sexual abuse did occur. A few early studies also acknowledged its occurrence but often rationalised that the daughter had seduced her father. The import of Freud’s Oedipus complex in these early studies is obvious. After rejecting his childhood seduction theory, Freud posited an internal aetiology for child sexual abuse. As such, a victim reporting an abuse incident was said to be confusing the abuse memory with her fantasised desire as a child for her unavailable love object-the father. If abuse clearly did occur, it was, therefore, logical to place the blame on the daughter, who was said to be acting out her desire for her unavailable love object.

The offender was then conceptualised as falling within the seducer’s spell. When placed within the perspective of Freud’s influence, it is perhaps easier to understand why many writings of this early period blamed the victim. Regretfully, however, this trend of blaming the victim continued into more recent literature, and examples were fairly frequent even in literature published in the 1980s. For example, a study published in 1980 divided victims of incest into two groups-participant victims (those who had in some way encouraged the initiation or continuation of the sexual relationship) and accidental victims (those who had not done so). One of the discriminating features of the groups was whether abuse had occurred more than once. If it had, the victim was assumed to have participated because she must have encouraged or initiated the abuse. The researchers commented on the "clearly seductive style" of one participant victim, a six-year-old girl who had been forced to masturbate her father since she was two years of age.

In 1982, Yates also concluded that "the majority of youngsters have become not only victims but participants". These children purportedly did not report the abuse because of the "gratification that the incest provides". In his case study of an 18-month-old toddler who had been sexually abused since birth, Yates reported that the child’s foster mother "could not lie down on the bed when he was awake, as he would crawl on top of her and attempt to burrow under her clothes". If a woman visited, he would "sit on her lap, wrap his arms around her neck, and deliver sensuous kisses. Then he would attempt to open her blouse or lift her skirt”.

He went on to state that "eroticized preschool children... [are] readily orgasmic and also maintain a high level of arousal without orgasm". Other permutations to the theory of seduction by the daughter are also found in the literature. For example, because not all girls were molested, Karl Abraham, an early follower of Freud, suggested that there must be something intrinsically wrong with those who were. On the other hand, Cohen suggested that the daughter initiated and participated in the incestuous relationship to keep the family together. The incipient guilt from having her incestuous fantasy realised, Cohen suggested, then enabled the daughter to recognise her responsibility for the abuse. Other historical literature suggested instead that the daughter was “seeking oral gratification from the father as a result of rejection by the mother".

Occasional literature published in the 1990s also alludes to the daughter’s culpability. For example, Lacey found that 18 of 112 female bulimic patients asked about a history of either incestuous abuse or incestuous fantasies reported experiencing incestuous feelings or fantasies and, “for two, the fantasies were in part acted out”. The researchers suggested that “the relationship [between incestuous fantasies and actual abuse] can become blurred to the point of being indistinguishable, particularly if the patient has incorporated such thoughts into neurotic conflict”. Another article published by Larson in 1993 presented a case study of an adolescent female abused by her father. This adolescent, “through continual reflection and discussion of the therapeutic relationship dynamics...was increasingly able to see the active role she’d played in her own incest”.

Even though the professional literature has fewer examples of blaming the victim, some professionals continue to consider the victim partially culpable for the abuse. Many different studies have now assessed how professionals assign culpability for child sexual abuse. It is perhaps not surprising that early studies found that professionals attributed a substantial portion of the responsibility for the abuse to the victims themselves. For example, in an early survey, Galdston found that 52% of surveyed psychiatrists believed that daughters usually contributed to the incest. Studies published in the 1980s continued this pattern. In one of these studies, 35% of law enforcement officers and 69% of child protective service workers considered teenage victims to be as guilty as the abusive

father. Eisenberg, Owens and Dewey also found that just more than half of medical personnel attached some blame to the victim. In other studies in which attribution of blame was measured on a scale from 1 (no blame) to 5 (high blame), the mean score for victim culpability ranged from 1.83 to 2.65.

Even studies published in the 1990s, however, continue to find that 12% to 45% of professionals attribute some responsibility to the victim. One of these studies concluded that mental health professionals do not blame victims. Yet, while the allocation of blame to the victim was low (below 30%), 37% of male respondents and 24% of female respondents did allocate some blame to the victim. Another study published in 1993 found that, on a scale of 0 (no responsibility) to 5 (very responsible), attribution of blame to the victim ranged from .12 to .25 for “resisting” victims and from .67 to 1.65 for “encouraging” victims (p. 64). Finally, Johnson et al. found that approximately half of the teachers and social workers queried said that there was some likelihood that an impetus for the abuse was the daughter’s seductive behaviour. This literature, therefore, suggests that professionals still do not, as a whole, endorse the opinion of child sexual abuse experts-that the victim is never to blame. That any blame is assigned to the victim by professionals working with child sexual abuse victims has far-reaching implications.

The mere existence of a victim blame factor, however slight, reflects an apparent belief that incest victims may in some way be responsible for their own assault, and that children ... may be held less than fully innocent in their actions in sexual matters when approached by adults who are most often family members, relatives, or people they know well and trust. Although the professional literature appears to be responding by reducing the number of published papers that suggest victim culpability, it is of concern that professional attribution of blame continues to some degree. While professionals may assign only a small amount of the blame to victims, some are too much.

 

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