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survivors eventually disclose the abuse to people that they trust including relatives,
close friends, family, physicians, and therapists. "Breaking the Silence"
refers to broader disclosure, encompassing complaints to professional bodies,
lawsuits, and public statements, as mentioned earlier -- anything that alerts
the professions and the public to the common occurrence and tragic consequences
of abuse by health professionals.
mentioned earlier, breaking the silence is made difficult by a number of factors,
including survivors' feelings, community attitudes and lack of support, the self-protective
stance of the health professions, and the idiosyncrasies of the legal system.
Ethics - 4 Patterns of "Victim Thinking"
Helping Mary through Breaking the Silence
"If you haven't spent adequate time dealing with the trauma and are trying to suppress or minimize what happened to you, then you are spending your energy fighting yourself. If this is the case, it is no wonder that you are exhausted and have little energy for other people. Most of your energy goes to keeping the trauma in denial or repression and managing your symptoms, so they don't get out of control and cause an economic or emotional disaster. Essentially, you are spending your time and strength trying to pretend the trauma never happened, or trying to convince yourself that it wasn't that important and, of course, you can handle it (and the emotions and issues that it raised) all by yourself."
Ethics - Allow a Perpetrator to Resume Practice?
Pope draws attention to a case where a psychiatrist was prohibited from treating females, and stresses that such interventions "do little to address the underlying failures of self management that characterize patient-clinician sexual contact. He feels there is a failure to focus on the development of a therapeutic alliance essential for treatment to proceed... Pope states a concern that a clinician who cannot be considered competent to treat women should be considered competent to treat men."
Pope feels licensing boards need a great deal of education to make them aware that sexual abuse of clients, like other varieties of sexual assault, is not just about sex. Other dimensions such as the balance of power differential between mental health professional and client; the mystique and special entitlement accorded to health professionals; the breach of trust and fiduciary duty; the lack of caring, empathy, and concern; as well as other personality and situational factors, are all involved. I feel if mental health professionals who sexually abuse clients are allowed to return to practice, they should have a lengthy period of monitoring and supervision as there is little evidence that rehabilitation plans are effective, and literature indicates the recidivism rate is high.
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