She was sexually abused
She was a well-behaved girl. She was doing well in school. At age 11, her mother migrated to work in New York. She was left with her stepfather. He abused her for years. She failed her GSAT. She became very aggressive and promiscuous.
When she told her mother about the abuse, her mother told her to keep quiet and not to bring shame on her family. Her stepfather threatened to kill her if she said anything to anyone. She started to cut herself repeatedly, which made her feel better. She attempted suicide several times. She became pregnant for an older man at age 15. She ran away from home at age 16.
This story highlights some of the issues faced by children who are sexually abused.
1 The abuser is often known. In many instances the abuser is a family member - father, stepfather, uncle, brother, cousin or family friend.
2 Abused children are often silenced. The abusers often threaten to kill them and sometimes family members silence the children because they fear embarrassment, especially if the family is seen as a model in the community or prominent in the church. Unemployment among women is high in Jamaica and many women are dependent economically on the abuser; taking action would mean the loss of financial support. The children are silenced, the mother silently bears the pain and fails to protect her child.
3 Children who are abused end up with deep psychological scars. Most persons who were abused as children never get over it and end up with major psychological problems as adults.
4 Shame, guilt and self-blame. Children who are abused may end up blaming themselves. Sometimes they may be blamed by others such as teachers, police and caregivers. Girls are sometimes told that they are too precocious or were dressed inappropriately. Often the child who is abused is left to suffer alone; he/she feels dirty and contaminated and may have no one to talk to.
5 Depression is common. Victims of abuse develop depression at an early age and may end up being depressed for the rest of their lives. They may also develop post-traumatic stress disorder.
6 Deliberate self-harm. Many persons who engage in deliberate self harm such as 'cutting' or repeated suicide gestures have a history of sexual abuse in childhood. Deliberate self-harm is often a cry for help in someone who is suffering from psychological pain.
7 Problems with relationships. Many persons who were abused have difficulty forming trusting relationships. Some may, in fact, end up in abusive relationship as this is the only pattern of relationship they can exist in. Some persons who were abused have problems with intimacy and sex, as they have not dealt with the problems associated with the abuse.
8 Personality problems. A lot of sexually abused persons develop fragmented personalities. They may display changes in personality when they remember the abuse or undergo stress, as this is the way they cope with the abuse.
9 Deal with abuse in the family. Do not cover it up. Do not blame the child. Reassure the child who is abused that it was not his/her fault and that, in fact, he/she was violated by an adult who betrayed his/her trust. Remind children also that the adults in their lives failed to protect them.
10 Therapy is important. Children who are sexually abused need therapy. This should be done by someone who is trained. Adults who survive sexual abuse also need therapy.
Dr Wendel Abel is a consultant psychiatrist and head, Section of Psychiatry, Department of Community Health and Psychiatry, University of the West Indies; email: firstname.lastname@example.org.