1. Do you think there is as much of a problem with child maltreatment in the U.S. as there is in Romania? Why or why not?
2. Why do you think adults tend to not believe children when it comes to this issue? What are some ways that we as a society can work on in regards to believing children?
3. What are some ways in which school systems/friends could help or reach out to those who have been sexually abused?
4. What are potential ways that Miami could help college students impacted by maltreatment?
5. Did this article change or alter your previous perceptions on child sexual abuse? If yes, in what way?
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Contemporary Readings in Law and Social Justice
Volume 5(2), 2013, pp. 499–510, ISSN 1948-9137
PSYCHOLOGICAL ASPECTS OF CHILD SEXUAL ABUSE
MIHAELA RUS
psiholog_m@yahoo.com
Ovidius University, Constanţa
ALINA BUZARNA-TIHENEA GĂLBEAZĂ
alina_buzarna84@yahoo.com
Ovidius University, Constanţa
ABSTRACT. According to statistics, about 90% of people were emotionally abused
in childhood, but many do not realize, deny or, worse, abuse their own children or
others, considering that their treatment of childhood was “natural and normal.”
Emotional abuse is a form of aggression, but the law can not penalize it. Most
parents believe that child abuse means physical or sexual violence and / or child
neglect. But they do not know that they can hurt the child simply by their excessive
attitude. The emotional abuse is any behavior that is intended to control, subjugate,
submit other beings through fear, intimidation, humiliation, blaming, and “growing”
guilt, coercion, manipulation, invalidation etc. The consequences of emotional abuse
are multiple, varied, extremely serious; they leave marks for life, affecting child
development at various levels – emotionally, intellectually and even physically.
Moreover, it will affect the future adult’s social and professional life, relationships
and physical and mental health, to a greater or lesser extent, depending on the type
of the emotional abuse, and on its frequency and intensity.
Keywords: behavior, emotional abuse, violence, control, sexual abuse
1. Introduction
Abuse means the use of force in order to try to dominate a child, to compel
him/her to do dangerous things that he/she does not want to do, expose
him/her to hazardous situations or to situations perceived by him/her as
dangerous. Any action that causes injury or psycho-emotional disorders is
an abuse.
The abuse can be of several types:
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Physical abuse – involves the use of physical force against children and
subjecting them to hard work that exceed their capabilities, actions that
result in damage of their body integrity.
Emotional abuse – is the inappropriate behavior of adults towards
children, behavior that adversely affects a child’s personality in
development. Child rejection, forced isolation, terrorization, ignoration,
humiliation and corruption are manifestations of child abuse.
Sexual abuse – consists in exposing the child to watching pornography,
seduction (advances, caresses and promises) or involvement in sexual acts
of any kind.
Economic abuse – implies attracting, persuading or forcing the child to
do income generating activities, the adults close to the child at least partially
or indirectly benefiting from this revenue. The economic abuse leads to
removing the child from school, thus depriving him of the chance to access
superior social and cultural levels.
Neglection – is the adult’s inability or refusal to appropriately
communicate with the child, and the limited access to education.
The term “sexual abuse” refers to the sexual exploitation of a child
whose age does not allow him/her to understand the nature of the contact
and to adequately resist it. This sexual exploitation may be done by a child’s
friend whom he/she is psychologically dependent on.
The sexual abuse can have different aspects:
– sexual evocation (phones, exhibitionism, pornography, the sexual
content of the adult’s language etc.)
– sexual stimulation (erotic contact, masturbation, incomplete genital
contact, forced participation in the sexuality of a couple etc.)
– making sex (rape or attempted rape).
1.2 Issues of Abuse
a) Children may be abused since very young.
Children may be abused from a very early age. They are often seduced
by games in a sexual- abusive situation. The abuser often establishes
positive relationships with both parents and the child.
The child is encouraged or forced to engage in the abusive relationship.
This is achieved through rewards and / or threats. The sexual activity is
presented as something special, and the child should be considered lucky
because he/she has “a chance” to participate in it. The child is unable to
understand what is happening. Just when he/she is told that “the game is
secret” he/she begins to understand that something is wrong.
The child’s role in this game varies. He/she may be required to actively
participate in the game or be passive, as if “he/she would sleep”.
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b) The agressors are rarely violent
Sexual abuse within the family or within the family network is rarely
violent. Pattersen (1990) emphasizes that pedophile people are seldom
violent; on the contrary, they appear to be sensual and protective. However,
the abuse is emotionally traumatic, because the child’s silence is often
ensured by corruption, and, at the same time, the child is made to feel guilty
and responsible for what happens. The abuse may also be violent or become
violent if the game evolves in intromission. The abuser often develops a
behavioral model of restraint. The abuse may continue until the child is able
to escape from that relationship or until someone realizes what is happening
and puts an end to the situation. A confused and fearful aspect of sexual
abuse is represented by the secret that the child must keep and by the feeling
of complicity that dominates him/her.
c) The abuse associated with other types of maltreatment
The sexual abuse is often associated with other types of abuse described
above. A child who has been sexually abused within his/her own family
might also have been exposed to other types of maltreatment. All these
have, of course, a number of common features. However, the action for
sexual abuse is different from the activity of other types of maltreatment,
because, in this case, we do not deal only with serious criminal behavior,
but also with a taboo behavior. This case will be treated both from the point
of view of the child’s welfare and as a court case.
d) Child sex tourism
At the seminar “Abuse and violence against children”, held in Brasov,
in March 2000, which was attended by prosecutors, policemen,
representatives of the civil society and of specialized institutions in
Romania and Italy, it has been shown that the violence against minors is a
global phenomenon.
The Italian experts and the representatives of the civil society have
acknowledged that Italy is the leading country which exports sex tourists to
Romania. Sex tourism refers to those individuals, especially pedophiles,
who came from Italy to Romania just to have sex. There are some travel
agencies that, for a certain price, can provide these individuals pictures of
the children available. They do not necessarily want to come to Romania;
they can also go to Latin America, Thailand and Taiwan.
Because social and legal penalties for sexual abuse are severe and
because there are no signs of sexual abuse that can be easily noticed by
others, just as with physical abuse, many abused people refuse reporting
such cases. The uncovered abuses are more numerous than those reported.
This is also true for child sex tourism.
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e) The incest – a special form of abuse
Most authors agree regarding the existence of traits that can be
frequently and regularly seen in the “incestuous” family:
– The same drama is repeated over several generations.
– There is a significant family dysfunction.
– The child is not recognized as a subject.
The incest often begins within an atmosphere of seduction quickly
accompanied by constraints and threats.
The father: if the father’s personality often reveals some psycho-
pathological traits (perversity, psychopathy, mental deficiency, alcoholism),
most often these traits are not evident. Numerous surveys have shown the
existence of emotional immaturity, of a past marked by emotional
deficiencies and separation. Prohibitions are wrongly internalized. The
emotional relationships are experienced as an extreme dependence. The
guilt related to the incestuous act is rarely felt, the father even asserting his
right of possession or initiation duty.
Some authors have described two types of incestuous fathers:
– One who is experiencing his perversion in a depressed manner: child
among children, he pities himself, he cries in jail, he transforms his
daughter into the mother he wanted to have (passive-dependent).
– One who justifies his sexual possession attitude towards children by
theoretical arguments. He often has a dictatorial behavior (active-
dependent).
The mother: her past is often “haunted” by sexual abuse or violence.
Depressive traits are common. Paradoxical attitudes are not rare: she
delegates childcare to the father; she lets children sleep with their father
and, under various pretexts, she sleeps in another room. Usually, the
mother’s unconscious complicity is present: she “does not want to know
anything” and she passively (or a perversely?) accommodates herself to the
situation.
The couple and the family: many families are characterized by social
isolation, by the scarcity of social relations. The mother’s absence due to
work during the night, illness or divorce can promote the transition to an
incestuous act which, until then, remained in a latent state. There are
frequent misunderstandings and difficulties in the couple’s sexuality. Some
authors have noted that, sometimes, sexual abuse seems to have the function
to avoid the sexual conflict in the parental couple and, some other times, it
limits the conjugal conflict and prevents family breakup. For other authors,
the couple’s relationship is based on the “violent husband – female subject”
dependency. Witin this couple, the main links seem to be dominated by
complicity and by the pleasure of absolute control. The couple’s sexuality is
low or even nonexistent.
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Incestuous relationships – in 30-40% of cases, we are speaking of
father-daughter incestuous relationships (and, in as many cases, according
to other case studies, of grandfather – granddaughter incest). Most occur
when the victim is aged between 6 and 12 years.
f) Conflicts in dysfunctional families
In all families there are conflicts and differences. In functional families,
members learn to adjust to the differences, to live conflicts and to express
their strong feelings (anger, for example) without this having negative
consequences and harm the sustainability of relationships. Most people who
lived in dysfunctional families, such as those where there has been sexual
abuse, had the opportunity to learn such things.
Conflicts are inevitable, especially when we do not have the same
opinion on several issues or when we feel threatened, ignored, rejected.
1.3 Causes of Abuse
At a structural level, there can not be described a particular psycho-
pathological organization of the victim. Thre has been already indicated the
frequency of the depressive features, where the feelings of guilt, shame,
self-devaluation dominate. Disturbances in the organization of narcissism
(self-love) are common; they are marked by a very intense sense of
humiliation, a lack of self-esteem which explains, in part, subsequent
pathological behaviors in adolescence and adulthood. For some authors
(Stoller), pathological behaviors in adulthood, especially some perverse
behavior, would be an attempt to escape the feeling of humiliation suffered
in childhood.
The main causes of sexual abuse are poverty, illiteracy, exploitation
and vulnerability, violence, education, alcohol, drugs and mental illness.
These data reflect the relationship between social problems and the problem
of the increased number of sexual abuse cases.
1.4. Defense Mechanisms
Incest victims continue, in adulthood, to resort to various survival
techniques that they were using during childhood in order to deal with
abuse. For example, it is known that many cases of personality duplication
are caused by a serious physical or sexual abuse. By dissociating his/her
personality, a child can endure the terror of being raped, persecuted.
Personality disintegration is probably one of the most radical defense
mechanisms used by the incest victims. As it is known, such behavior is
likely to be highly disruptive in adulthood. There are other numerous
defense mechanisms against abuse that, without being radical, can,
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however, create difficulties to their adult survivors. We speak here of
refusing to sleep in darkness, addiction, etc. For some time, the defense
mechanism played a useful role but now, in adulthood, it may prevent the
survivor to take his/her life into his/her own hands.
2. Clinical and Behavioral Manifestations
Physical attacks can be seen especially in the first 24-48 hours following the
sexual abuse: bruises, swelling, bleeding, even severe genital lesions,
genitourinary infections and sexually transmitted diseases. If physical
examination is required (forensic finding or care), it must be done in an
appropriate psychological context, with the previous preparation of the
child. In any case, this should not represent a further intrusion, a kind of
medical “rape”, worsening the already suffered trauma. On a forensic plan,
it is important to sample the elements that may help identify the agressor.
Psychological symptoms are frequent and show the suffered mental
trauma. They are different depending on the uniqueness of the event or on
its repetition.
There can be direct signs of distress: different somatic complaints,
fatigue; food disorder, with a sudden onset of: anorexia, vomiting, refusal to
feed; common sleep disorders: fear of sleep, bedtime rituals, nightmares,
repeated nighttime awakenings or night terror; affective disorders: apathy,
feeling confused, disinterest for games, sad face, bouts of tears, depression;
adjustment disorders: sudden school difficulties, isolation, escape, refusal to
stay at home or elsewhere with an adult. There are also situations when the
school is seen as a means to escape the traumatic family situation.
Other behaviors can be considered as indirect witnesses of the
traumatic sexual experiences experienced by the child (especially when it is
repeated): unexpected and prolonged masturbation, inappropriate sexual
conduct with an open curiosity, language that uses adult sex words; sexual
games with dolls or children. All these behaviors do not necessarily testify a
sexual abuse but their sudden appearance without a particular event to
explain them, an evocative family situation, can guide the clinician towards
this possibility.
The situations that can detect sexual abuse are varied. Children can
often be very “direct” in expressing their memories related to certain
intimate problems. Also, some younger children may confess their sexual
experiences while playing, by sketching them verbally and / or by means of
gestures (MacFarlane, 1986). A boy, for example, might require the
kindergarten teacher to play with him in the same way “his daddy” does and
if the child were asked to show how his daddy played with him, he should
be able to demonstrate. But, generally, adults do not believe what the child
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says or they feel better if they talked about something else. A child who is
not believed might try the next time not to directly confess his problems,
making, however, further attempts to do it indirectly (Lindblad, 1989).
Older children sometimes talk to other children of the same age who, in
turn, might tell it to adults. However, usually, the child keeps the secret of
those stories, and denies them if asked directly.
The child who is aware of the “danger” and of the fact that he/she must
not talk about it, and who has been probably threatened or “double-
crossed”, may protest against the event of a visit to his father living
elsewhere, during the weekend, doing so without giving any explanation.
However, he/she might say: “Dad likes to play silly games – I do not want to
visit him”. Then, the child stops breathing for several seconds while the
adult decides whether he/she really needs to ask questions about the child’s
statement or whether “it is better to leave things as they are because,
anyway, the child said some weird things.”
The secrecy that reigns over the abusive relationship and the child’s
vulnerability force him/her to be silent and allow the recurrence of the abuse
for many years. The abuse takes place only when the child is alone with the
abuser and the event can not be shared with anyone else. The “secret” is
ensured by threats and corruption. “If you tell anyone what happened, I’ll
go to jail”, “If you’ll tell your mother, she will always hate you”. As time
passes, the child feels increasingly guilty and he/she will use more and more
energy to cover the facts to which he/she was drawn.
2.1 Consequences
The children who were exposed to the sexual abuse from a small age will
have an early sexualized behavior. They will approach other people in a
way similar to the one learned from the abuser. They may have a form of
pseudo-mature flirtation behavior. Kari Killén quotes the words of a
pediatrician whom he consulted in connection to a child who presented such
deviant behavior: “it is hard to judge someone’s feelings in such a situation.
She acts like a bitch. I reacted in the same way in which I respond to a bad
woman.” The girl was four years old.
These children are often reluctant to have contact with other children of
their age. They are afraid that someone “could see.” They isolate
themselves and perceive themselves as different from other children. This
difference can be seen in the sense of “worse,” “blackguard” or “more
adult,” secretly. Their ability to concentrate weakens and their school results
deteriorate rapidly. They often try to avoid gym classes and undressing in
the presence of other children and going to shower, “as others might notice
it”. For the same reasons, they will try to avoid the school doctor. At the
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same time, they will struggle to avoid routine medical checks; they will
often contact the nurse for various stomach pains, headaches, leg pain and
other somatic problems.
Serious sleep disorders, phobias and nightmares with sexual content
may also be signs that a child has been sexually abused. Hysterical seizures
accompanied by screaming, tremors or fainting may also occur. It is also
encountered a form of pseudoepilepsy (Putnam, 1985; Finkelhor, 1986;
Conte, Berliner, 1988) and appetite disorders (Oppenheimer et al. 1985;
Sloan, Leichner, 1986).
During adolescence, the frequency of suicidal thoughts, threats and
attempts will increase. Unable to escape the abuse, they will act as abuse
disclosure consequences could be worse than exposing the abuse. Thus,
suicide can be seen as the only way out from an irresolvable dilemma: to
tell or not to tell.
There are described different types of self-destructive behavior
(Shapiro, 1987). Drug abuse since the early teens can somehow ease their
pain. Prostitution might be another destructive, but logical way to escape,
from a certain point of view (they learned it at home). These children are
not able to focus on learning something at school and they will not be
adequately prepared to compete on the labor market.
It can be said that it is more difficult to obtain a proof related to sexual
abuse than to physical abuse. Exceptions are cases of sexually transmitted
diseases and pregnancy cases. Sometimes, certain physical changes can be
demonstrated, such as the dilatation of the anus, some traces around other
body openings, pelvis, thighs and breasts. There are other somatic
symptoms that may be inconclusively related to sexual abuse; for example
chronic urinary tract and vaginal infections. Bleeding and itching of the
genital and anal areas, chronic constipation, irregular and delayed
menstruation can also be correlated with sexual abuse. Psychosomatic
disorders, such as stomach pain and pelvic pain may also occur. Other
children may have difficulty even to walk or sit.
Some children may be particularly concerned about sexual games and
show detailed knowledge about adult sexuality. They are very active and
take the initiative in sexual games with other children at kindergarten, for
instance. Many of them regress and come to behave in ways characteristic
of an earlier stage of development: for example, urinary incontinence, baby
language. This identification dilemma appears in sexual abuse because
regression is frequently met in children undergoing various types of stress,
including family crises or nursery influence.
When a child shows several of these symptoms at the same time, the
adult should take them into consideration, as sexual abuse might be a
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possible explanation. This hypothesis should be included in making the
differential diagnosis.
Sexuality rules change very quickly. Pornographic films and literature
for / with children are easily available. Other cultural changes also occur,
including the increase in the number of divorces that result in an increased
number of stepfather families, where incest taboos are supposed to be lower
compared to families with biological parents.
Although there are some studies showing that child sexual abuse does
not leave marks on his/her personality over time, however, most of them
also stress that it undoubtedly affects the normal evolution of the victim,
namely:
• the abused children suffer from anxiety and depression more
frequently than other children;
• they show a very low level of self-esteem regarding sexual behavior
(i.e., they are dissatisfied after sex or they are often in embarrassing sexual
situations);
• for male victims abused by men, the probability to become
homosexuals increases 4 times.
The consequences of child sexual abuse can be classified into:
a) physical (venereal disease, serious injury), psychological (from
phobias and nightmares to suicidal tendencies) and social (difficult
interpersonal relationships, delinquency, prostitution);
b) short-term and long-term (considered “delayed psychological
bombs”, including chronic depression, self-destructive tendencies, function-
ing difficulties in marital-parental roles).
In women, four core symptoms of childhood sexual psychotrauma
occur:
1) oppressive, obsessive memories, often accompanied by nightmares
related to the abuse, which causes them fear before bedtime;
2) very pronounced self-underestimation;
3) distrust of men, and sometimes of women;
4) sexual indifference, vaginismus and frigidity.
Such women can not defend themselves, give in easily, and become
victims of insistent demands. Showing multiple symptoms (depression,
anxiety, alcohol and drug abuse, difficult interpersonal relationships), they
can get the attention of psychiatrists. From the perspective of some
specialists, eating disorders, such as anorexia and bulimia, are often linked
to childhood sexual trauma.
Obsessions (obsessive thoughts, clear visions or outbursts of memories,
nightmares), repressions (denial and emotional numbness), combined with
guilt, fear and anger, are key features of PTSD. Posttraumatic stress
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disorder traits can also be found in cases of rape, which may lead to feelings
of humiliation, increased vulnerability and the fragility of personal identity.
The goal of the treatment of women with symptoms of childhood
sexual trauma consists in finding the abuse and in the victim’s subsequent
ability to share both her past and present experiences, in connection with the
incident, including the hatred felt for the rapist and the grief caused by the
fact that once her mother was unable to protect her from evil. The victim
must transfer the responsibility for what happened on the adult who
committed the abuse, thus freeing herself.
3. The Sexual Abuse in Romania – Statistics and Causes
The number of sexual offenses against children has doubled during 1998-
2000; 90% of street children prostitute, and, in most orphanages, they were
mistreated in one way or another.
According to a study made by the government agency for child
protection together with “Save the Children” and UNICEF Romania
organizations, the number of child abuse cases has increased in recent years,
such situations being encountered both in the family and in the institutions
for the protection of minors.
The study refers to all forms of child abuse (emotional, physical or
sexual) and to the methods of their exploitation (prostitution, sex tourism
and others). The number of the sexual offenses against children has doubled
during 1998-2000, compared to previous years; a quarter of the victims
were children aged under 14 years. Also, in what concerns children and
their families, nearly 90% were at least once subjected to emotional abuse,
while three quarters suffered from physical abuse.
The same study reveals that the majority of street children prostitute in
order to survive, but over 90% of them refuse to talk about the abuses to
which they are subjected. Around 10% of the girls living on the street
prostitute from a very young age, i.e. nine or ten years old. Pedophilia is
increasingly common among street children, with a trend of development
and organization. Many of them – especially boys – are the victims of their
friends on the street or of the persons who recruit them in order to put them
in connection with some clients. The authors of the study argue that, in
Bucharest, there are around 40-50 adult clients, mostly foreigners who came
to Romania under the pretext of business or tourism. They own several
apartments in the capital, where they bring the children (most aged between
8 and 15 years), and they film or photograph them while having sex with
them.
The study also revealed the existence, in care institutions, of all forms
of abuse against children, either by older colleagues or by the staff within
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the centers. Thus, nearly half of the 3,000 respondents (institutionalized
children) confirmed the practice of beating penalties, but admitted that it has
been less applied in the past two or three years. More than a third of the
juveniles from care centers said they know about other children forced to
participate in sexual practices, but few admitted that they were subjected to
such abuse or that it happened in their institution.
In Romania, the explanations of the context in which abuse and neglect
occur are:
1. The punitive education mentality, lack of empathy for the child, for
his/her needs and aspirations. “You have to be strict with child,” “The child
should be accustomed to the hardships of life,” “Beating comes from
Heaven,” “Children must obey” are just some of the Romanian educational
patterns.
2. The existence of taboos, false modesty and sense of helplessness that
explain community indifference and non-intervention in cases of abuse.
3. The lack of an effective child protection – medical, educational,
social and legal services have limited and reduced resources. These
deficiencies are accompanied by the inadequate mentality of those working
in this field.
4. The lack of the necessary legislation. The issue of child abuse is
weakly, vaguely and incompletely mentioned in the national legislation.
There has not been developed a domestic legal system that strengthens and
supports the enforcement of the international law in the field, to which
Romania adhered. For example, the emotional abuse is not provided in the
Romanian legislation.
4. Conclusion
In Romania, child abuse/neglect is common. Abuse and neglect are seen as
something quite normal in many families and in child care institutions.
According to a national study conducted by the National Authority for
Child Protection and Adoption, on a sample of 1555 households that
included at least a minor in the family and 1259 children between 13-14
years, 9.1% of the children surveyed said that they underwent a type of
sexual abuse. Most children, i.e. 5,7%, said that their own drunk parents
forced them to do different indecent actions, and 2.2% said that they were
forced to caress their erogenous body parts. The majority of the abused
children is from Moldova, Oltenia and Crisana Maramures and is part of
large and poor families, with a fairly low level of education.
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