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Ethical Boundaries: Treating Childhood Sexual Trauma
Childhood Sexual Trauma continuing education psychology CEUs

Section 18
Misconceptions about the Molestations of Children

CEU Question 18 | CEU Answer Booklet | Table of Contents | Child Abuse
Counselor CEUs, Social Worker CEUs, Psychologist CEs, MFT CEUs

Sexual assaults on children are definitely not rare phenomena. According to Finkeihor (1979, 1982, 1987) and Fritz, Stoll, and Wagner (1981), in the general population one may find that between 15% and 45% of women and between 3% and 9% of men have been sexually traumatized as children. And while reports of physical abuse of children increased by 16% nationwide from 1983 to 1984, during the same period reports of sexual abuse increased by 59% (Garcia, 1986). Moreover, it is conservatively estimated that only one out of five cases of child molestation is ever reported to the police. Considering this extremely low rate of reporting, it is clearly a mistake to presume that actual occurrences are infrequent. Before the clinical aspects of the sexual traumatization of children are discussed in this book, it may be helpful to review some of the causes of this misconception.

For the most part, adults tend to have a mental "set," in which children are seen as requiring careful supervision and disdpline: children are viewed as being "naughty" or unreliable. Many adults believe that they need to be on guard against children's fibs, exaggerations, and "tall tales." In many instances, even if a child has reported being sexually assaulted by an adult, the child is considered to be lying until it is proven that he or she is telling the truth. We consider it to be ironic that in the justice system, one of whose concerns is the protection of children, an adult is innocent until proven guilty, but a child's word against an adult is immediately greeted with skepticism. Also worth noting is that the preponderance of professional literature on the subject of childhood sexual trauma, before 1970, was focused above all on the issue of whether the child was lying or telling the truth, as opposed to the emotional implications of the experience on the child.

In our experience (supported by others, e.g., Finkeihor & Browne, 1985; Geiser, 1979; Green, 1986; Hilberman, 1976; Peters, 1973), the child in a majority of cases is telling the truth. When assessing the veracity of a child's allegations, we prefer to begin with the assumption that what is said is true until it is proven otherwise in the course of a thorough evaluation (Geiser, 1979). By doing so, one may set in motion a process that will make certain that the child is protected from any possible future abuse.

Another unfortunate source of misconceptions concerning sexual assault against children can be found in the writings of Sigmund Freud. Because he was unable to come to terms with the knowledge that some of his adult patients had been victims of incest, Freud changed certain case studies to portray incest fantasies as opposed to actual incest (Peters, 1973). Why did Freud do that? Peters surmised that Freud already had endured enough professional criticism because of his theories of infantile sexuality, and was unwilling to endure the additional censure that would result in his revealing that a significant number of his patients (for the most part, members of prominent Viennese families) were in fact the victims of incest. In addition, Peters hypothesized that Freud himself, the father of daughters, could not personally cope with revelations of this sort. Unfortunately, few clinicians have thought to question these clinical falsehoods. Hence, this errant point of view may have permitted them to avoid dealing with a particularly painful and shocking aspect of human behavior, by relegating it to the fantasy life of simple children. Despite the current recognition that these Freudian signposts were false, there is still considerable reluctance in the clinical profession to become involved in this issue.*

Another consideration, related to the one discussed above, is that a majority of the adults who sexually abuse children are known by the child's family or are related to the family itself (DeFrancis, 1969; Finkeihor & Browne, 1985). So the child may be reporting assault by a family friend, a member of the community who is known to the family, or a family member. Some parents are simply not prepared to face the family disruption or social pressure that giving credence to such a report may bring. Unfortunately, many parents simply refuse to believe that a family member or the nice man who lives down the street could have done such a thing, because of the popularly held notion that child molesters are either hostile old men, members of another race, or people who are obviously deranged. In point of fact, the person who molests children is very different from those people. A majority of child molesters are of the same race as the child and are apparently sane men in their late twenties or early thirties (Groth & Birnbaum, 1978).

The Los Angeles Police Department has compiled a profile of men who molest young boys. The man is usually married, with children of his own, middle class, and a college graduate. In many cases, he has a fairly active sex life with his wife. In general, he does not have good interpersonal relationships, but he is often perceived by those who know him as a respectable citizen. This proffle is a far cry from the stereotypical "dirty old man who gives out candy in the playground"; in fact, few children are sexually assaulted by elderly people.

Because most children who are sexually traumatized are victims of people they know and trust, most assaults occur within the child's natural environment. Many pedophiles seek jobs or volunteer positions in places that are frequented by children and that parents think of as safe: e.g., schools, recreation centers, day care centers, nursery schools, the Boy Scouts, Big Brothers, or Big Sisters (Geiser, 1979, p. 93). Because of phenomena such as these, the therapist should consider the child's story to be true until he or she is absolutely sure that the story is false. In our experience, when it comes to reporting sexual assaults, children can usually be counted on to tell the truth more often than adults.*

Another facet of this dilemma that may serve to confuse matters and influence adults to disbelieve or blame the child is that in many cases of sexual assault against young children, no extreme physical force is involved. If force is used on a child, it is usually in the form of a verbal threat or coercion (DeFrancis, 1969; Finkeihor & Browne, 1985; Groth & Birnbaum, 1978; Schultz, 1975; Sgroi, 1978). The child is most often lured into the situation in some way. Logically, one can see that adults who intend to molest young children do not have to use much physical force: because the molesters are bigger, they can overpower their victims easily. And, realizing that most child molesters are known and trusted by the child, one can see that no force is required in many cases involving children. Because of the notoriety given to child murders and other violent crimes against children, people hold the fixed belief that sexual assaults against children are violent. Hence, when a child tells an adult that he or she has been sexually assaulted, the parent may misconstrue the missing evidence of physical force as evidence of compliance on the child's part; or, he or she may look upon the child's story as untrue. We have observed that people tend to be relatively more sympathetic toward victims of sexual assault who have been physically injured (whether children or adults) because they can focus their attention upon the victim's physical injuries. In that way, they may avoid dealing with the sometimes shocking sexual aspects of the assault, as well as with the victim's often more profound "invisible psychological wounds" (Everstine & Everstine, 1983, pp. 163, 164).

Finally, there may be aspects of a child's behavior that will cause adults to doubt the reality of the child's story. Some molested children have a considerably flattened affect, which adults tend to misinterpret as being blasé about (or undisturbed by) the event (Burgess & Hoimstrom, 1974; Everstine & Everstine, 1983; Green, 1986; Peters, 1973; Sgroi, 1978). The flat affect of these children is actually indicative of childhood depression, shock, or fear, as opposed to indifference or calm. The child's superficial lack of emotion may even lead adults to believe that he or she was unaffected by the assault. It could also lead a clinician to believe that the child is emotionally unaffected by the event, or to doubt that the supposed event occurred because the child is so calm. Instead what may be occurring is that the child is depressed and not capable of expressing himself or herself, or the child may be too afraid or ashamed to express inner feelings to an adult. This phenomenon was described aptly by Sgroi (1978):

Children can exhibit the entire gamut of behaviors in response to a sexual assault, ranging from the negative to the positive. Unsophisticated observers may note calm and unconcerned behavior or outright denial of the situation or positive response by the child to the suspected perpetrator (all these behaviors have frequently been observed in child victims where sexual assault has been proved) and mistakenly conclude that no sexual assault could have occurred because of the child's reaction. It is essential that helping professionals who come in contact with these children be knowledgeable about the wide range of possible reactions that may be exhibited. (p. 135)

Some children may appear emotionally bland or neutral, while others may exhibit positive feelings or even affection toward those who have sexually traumatized them. By contrast, some children may exhibit intense negative feelings toward the perpetrators; still others react to sexual traumatization by any one of a wide range of somatic reactions- sleep and eating disturbances, bedwetting, or phobic reactions. Because of these complicating factors, there may follow a period of several weeks or months-requiring considerable support-before the child may reveal his or her true feelings about the incident and the assaulter.

Behavior that can lead to the most tragic misunderstanding is that of the (so-called) seductive child. Too often, adults accept the protestations of the child molester that he or she was seduced by a sexually aggressive child. It is our experience, as well as that of others (e.g., Geiser, 1979; Green, 1986; Meiselman, 1978; Porter, Blick, & Sgroi, 1982), that such excuses are rarely, if ever, true. Emotionally needy or neglected children (as many child victims of sexual assault are) may try to please an adult by responding to the adult's overt or covert sexual demands. Children are rarely sexual in front of, or toward, adults-unless they have been previously traumatized sexually by an adult. Many children are sexual with other children in an exploratory fashion, usually out of the sight of adults. However, even if a child were to be sexually aggressive with an adult, most persons would agree that responsibility for self-control and appropriate behavior should rest with the adult.

Children are essentially polymorphous in their sexual orientation. As Schultz (1975) has pointed out, children may be sexually curious but they are curious in a childish manner, i.e., relative to their development stage. When a child's curiosity results in adult, genital sex, the child may become terrified or feel betrayed or confused, because he or she has no way to resolve or release the overstimulation that occurs. What may have begun as curiosity or an attempt to gain an adult's affection and attention often results in a nightmare from which one cannot awaken.

It should be noted that overt sexual behavior on the part of a child is quite frequently a cry for help. In other words, it may be a way of trying to tell the adults around the child what has happened. A traumatized child may act out sexually with other children, may perform autoerotic acts in public, or may behave in a primitively seductive way toward adults. These actions are often an indicator of prior sexual trauma, and one should take care to avoid reacting intemperately to the overt sexuality of the child's behavior, no matter how shocking it may be. The child may be testing an adult, by this means, to see if the adult is going to abuse him or her sexually, just as someone else has done in the past. The child may be portraying, in a pathetic dramatization, what is impossible to say. (The subject of sexual acting out as a cry for help is discussed in detail in Chapter 3.)

Many factors have interacted to cause misperceptions concerning the problem of sexual abuse of children. Clinicians are beginning to realize that the abuse of children is an enormous problem for our society and that there are literally thousands of young victims in need of the care and protection of adults. Moreover, there are other thousands of "silent victims" (Hilberman, 1976; Nelson, 1982), namely those children who were disbelieved or who could not even tell an adult about the abuse that they suffered in childhood, and who have grown into adulthood with the emotional wounds of these assaults.
- Sullivan-Everstine, Diana, & Louis Everstine, Sexual Trauma in Children and Adolescents: Dynamics and Treatment, Brunner/Mazel Publishers, Inc.: New York, 1989.
The article above contains foundational information. Articles below contain optional updates.

Personal Reflection Exercise #4
The preceding section contained information about misconceptions about the molestation of children. Write three case study examples regarding how you might use the content of this section in your practice.

Online Continuing Education QUESTION 18
Why did Freud change certain case studies to portray incest fantasies as opposed to actual incest? Record the letter of the correct answer the CEU Answer Booklet.

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