A Guide To Failing Sexually Abused Children

Hazel Aged 9
Me, aged 9. I’d already been a victim of sexual abuse for 7 years when this photograph was taken.

 

CW: Child Sexual Abuse, Rape, Incompetence
Help:  https://www.rapecrisishelp.ie/find-a-service/
https://www.samaritans.org/ireland/how-we-can-help/contact-samaritan/
https://www.mentalhealthireland.ie/need-help-now/

Yesterday, Sarah McInerney wrote a piece in The Times about my late friend, Shane Griffin, and how he was let down by a number of systems in Ireland: The Eastern Health Board, the HSE, TUSLA, and the judiciary, to name a few.

It was a lovely tribute to a lovely man and it mentioned how the abuse children suffer is compounded by the neglect they (we) are then subjected to by the very institutions that are supposed to mind them (us). The problem I have with the piece is not the piece itself,  but the fact that it tells us nothing new, and it amounts to nothing more than a bit of hand-wringing, and an invitation (which was taken up by many on Twitter) to have a big, online, hand-wringing fest.

We have known for years that children who are sexually abused in Ireland have their abuse compounded by the further abuse and neglect of those who are supposed to help us. The Journal has been reporting on this for years – just have a look at this and this and this and this and this  : All pieces giving details about children who were sexually abused, and how their suffering was compounded by government agencies, individual social workers, doctors, psychologists etc. who did nothing and who were promoted for their lack of action. Our government, our government agencies, and individual social workersdoctors, psychologists, psychiatrists, and others who work for those agencies are complicit in the abuse, neglect and suicides of people in this country. No one is held accountable, and victims struggle to survive in a country that doesn’t support us.

For example, if (God forbid) your ten-year-old child were sexually assaulted and you went to get help for them. This is what would happen:

  1. You would phone somewhere like CARI, St. Clare’s Unit, or St. Louise’s Unit, or your local social worker, begging for help.
  2. You would not receive help.
  3. The service / social worker you contacted would, in turn, contact TUSLA and report the information. (Note: If this isn’t done online – bearing in mind that only 20% of HSE workers have access to the Internet – the documents will be returned. Estimates vary on how long this will take.)
  4. TUSLA would put your child on a waiting list to be assessed. This waiting list is currently years long.
  5. A social worker from TUSLA would interview your child and decide whether or not they were lying about the abuse. They call this determining whether or not the allegations are ‘founded’ or ‘unfounded’. (More about this below).
  6. If they decide that your child is not a liar, your child will be referred to CARI to be put on their waiting list for help.
  7. If you wanted to access services through the HSE, you would have to involve the Gardaí, as well. St. Clare’s and St. Louise’s Units will not put you on their waiting lists unless you have done so.

Don’t forget that, for the years you’re waiting for help, you’ll have been dealing with a child whose mental health is suffering, you’ll have been grappling with your own pain and feelings of guilt, fear, and your mental health will also be suffering. Your child may be suicidal. Your child may be self-harming. Your other children, and your partner / spouse will also be suffering in a similar way.

If the abuse was perpetrated by a member of your family, the mental anguish will be compounded. There will be no help or support for your abused child, you, or your family members unless you know how to find a competent therapist and pay for therapy yourself.  Good luck with that.

Founded / Unfounded

Whether or not your child gets help depends on whether or not a social worker in TUSLA says they’re allowed to access this help (such as it is). How do they do this? Well, the truth is that nobody knows. Social Workers in Ireland receive no training in how to determine the veracity of a claim of abuse. Nor or they trained in how to treat abuse victims or victims of trauma. (That is changing, however, as Dr Joe Mooney has just introduced a module in UCD for those studying there.)

I’m not being at all flippant when I say that they may as well just flip a coin to decide whether or not a child’s allegations are taken seriously. If you think I’m joking, have a look at the PQs (Parliamentary Questions) 445 – 447 asked by Róisín Shorthall at the end of 2018 and the Minister’s response.

Just today (January 13th, 2020), I got word from a friend – I’ll call her Anna, though that’s not her real name – who contacted TUSLA in 2010 to report abuse she had suffered when she was a child. Make no mistake, this is a brave thing to do. Anna was raped 3-4 times a week, from the age of 14 until she was 17. She is aware that she is not the only person this rapist raped. One other woman has had conversations with Anna about being raped by this man, too, but she’s afraid to go to the Gardaí. Of course, he’s an upstanding member of his local community in Wicklow, so when he was asked – more than eight years after the abuse was reported – if the allegations were untrue, he denied it.

And that was that.

Anna’s mental and physical health are suffering because of the damage this man did to her, which has been compounded by services which are supposed to put ‘Children First’. Anna no longer lives in Ireland because she can’t bear to live in a country that cares so little for raped children. I cannot say I blame her.

Getting Personal

I’m not going to pretend to be objective. I’m not going to pretend this isn’t personal. Because it is personal. I am one of the children who was let down by the system. I have encountered nothing but obstacles from every institution, service and individual – with the notable exception of one social worker who alerted me to the fact that a file on me existed. This she did, almost as an aside at the end of a conversation in 2010. It took me two years of constant requests before I was given access to my (heavily redacted) files.

This letter refers to a case conference that took place in November 1988. I was, at this time, 15 years and two months old.

Case Conference Nov 1988 croppedI think it’s worth noting that I never, ever met a single one of the people present at that ‘case conference’ – except for Imelda Ryan.

This is borne out, in part by this (heavily redacted) letter from Rosemary Cooke, who was at the meeting referred to in the correspondence above:

I Have Never Had Contact With Hazel

At the same time, she declares herself the key worker in my ‘case’.

I remain the key worker

And, as you can see from the top line, she asserts that there is ‘little social work intervention possible.’ This woman is still in practice, by the way, and has added the role of ‘Mediator’ to her suite of offerings.

It would actually be funny, if it weren’t so serious.

Let me draw your attention to lines 21, 22, 23, and 24 of the first document. Please bear in mind that everyone at that meeting knew I had been sexually abused by my elder brothers, and was being sexually abused by my father. It was further accepted that the younger children in the house were also at risk of being / were being abused.

But, as you can also see, my mammy didn’t want my daddy to leave the house. So no one interfered. Fifteen-year-old me is referred to as being ‘very disturbed’, ‘not liking my father’ and wanting him ‘out of the house’. It is absurd that this is even noteworthy – or that it is noteworthy, but no further explanation is required. ‘Dr’ Ryan suspects this is a plot on my part. Imagine being 15 and wanting a rapist out of your family home in order to protect yourself and the other children in the family! Clearly quite the little plotter. I was the only person prepared to do anything to address the situation. That should not have been my job. Please also note that I am vilified for disclosing that I was suicidal (line 24). Please also note that, even though the Gardaí were referred to – though I still have no idea how they were expected to ‘control the family’ – they were never contacted by anyone about this abuse until I knocked into my local station when I was 18.

But let me go back to the ‘psychiatrist’ involved – the woman who was supposed to have my welfare at heart. Bear in mind, I was between the ages of 14 and 16 when I was attending St Louise’s Unit. Bear in mind that it was confirmed I was being sexually abused (or, in today’s parlance, my allegations were ‘founded’) . Yet, here is a sample of things that she said about this very scared, very vulnerable teenager:

‘Hazel is “seeking attention”, and has on more than one occasion, cut her wrists’. (Letter dated (05.12.1989). Could you imagine the audacity of a suicidal teenager trying to kill herself. Clearly, still plotting!

Perhaps even more disturbing, however is this gem:

Actually, it's called rape

I’m particularly disturbed by the use of the term ‘sexual intercourse’. Even in the 1980s, ‘sexual intercourse’ with a child was called rape. I would expect a professional, in a letter to other professionals, to use correct terminology. Maybe I expect too much.

I have reams of documents recovered from the HSE and St. Louise’s Unit, but I won’t bore you by reproducing them all here – I think you get the gist.

Of course, I am the first to admit that I am no spring chicken and these documents date from the late 1980s and early 1990s. BUT the system is still the same – actually, you could even argue that it’s a bit worse because ‘self-referrals’ like mine was, are no longer accepted by these units. Imelda Ryan was the director of this unit until a few years ago (2016 if my memory serves me correctly) when she retired. The culture that she inculcated is still very much alive and well in the Unit. In fact, this disdain for victims is evident in almost every single service that is meant to care for us.

The problem is the system, and the culture that supports it. It would not be easy to overhaul the system: There would be huge resistance, and we’d have to change the culture in which we live and operate. But that’s not really the Irish way, is it? We’ll continue, instead, to wring our hands with bone-crunching intensity and cry at the funerals of our friends. Friends whose deaths were entirely preventable if only we had competent people in positions of power. Or even people who cared.

Safety Device

SAfety Device

(Content Warning: References to Child Sexual Abuse, link to graphic piece on the effects of Child Sexual Abuse)

It’s been an interesting few weeks. As some of you may know, there is a Fear Nua* in my life and I’m enjoying all sorts of things that, for many people are ‘normal’ but for me are beyond any experiences I’ve had to date. It’s all good, though. It’s all good.

I’m not about to gush about him, because he is a far more private person than I am – and I respect that – but also because so much of what’s going on is private and personal to us and to the third entity that is our relationship.

I will, however, say this much: I’ve been learning an awful lot from him. One of the biggest lessons I’m learning is my own value, my own right to be, and my own right to be who I am. I’ve also been crying a lot more than usual, but they have been happy, and / or healing tears. Like last week, when I suddenly had a thought that had my eyes leaking; I’d resigned myself, years ago, to the thought that I would die without ever knowing the love of a good man, without ever knowing what it would it be like to be in a relationship with a man that wasn’t abusive. I really believed that I would die without being in a relationship where I was valued for who I am – or that I would ever be with a man who enjoyed being with me, rather than one who merely wanted to possess me, and crush me. Now, I know that’s not true. And, oh! The joy of that. The absolute fascination with being with someone who values my ideas, my opinions, my thoughts, my mere presence is something I know I can’t adequately explain.

A few days after we met, he mentioned, in the course of conversation, that he had been researching how to be with a woman who had trauma as a result of child sexual abuse. He wanted to know how best to react, how best to treat me, taking my history into account. Reader, you could have knocked me down with a feather. Never, ever, ever, has a man I’ve been with, or even a man I’ve been married to, shown the slightest bit of interest in finding out how they could make being in a relationship easier for me. I knew, then and there, that he was A Keeper.

Then, yesterday, he presented me with the bracelet you see pictured above. It’s a safety device, and I’ll explain why.  Having already read this piece, he was anxious to work with me to ameliorate the effects any way he could. We were making progress, but then he had an idea. He reminds me that I have chosen him. That I choose him, repeatedly, every day, every hour, every moment that we are together. That I could choose to walk away, but I am choosing to stay because I am choosing him. As he is, likewise, choosing me. He needs me to feel safe. To know that I am safe with him, everywhere, all the time, no matter what. He would prefer if I stayed present when we’re together, because he is no threat to me, and I need to know that, and be able to remember that, and remind myself of that any time I feel I need to.

This bracelet serves that purpose: by simply seeing it, I am reminded of him, reminded that I am always safe with him. Touching it has the same effect, and – if I move my wrist slightly – the tags you can see chime gently, providing an aural reminder.  As my friend Jane Mulcahy noted, tweeted to me ‘It’s v lovely & delicate, H. Like affection, intimacy & trust.’  I think she put it perfectly. This piece of jewellery has the added bonus of being beautiful. A bit like himself, really.


*In Irish,
Fear Nua (pronounced Farr Nooa) means ‘New Man’.

 

 

Breastfeeding After CSA

Breastfeeding Awareness Month 2018

The first week of August was World Breastfeeding Awareness Month, but in the US, the United States Breastfeeding Committee has declared the whole month of August Breastfeeding Awareness Month. In honour of that (not in the least because I didn’t blog about the issue during the first seven days of August!), I wanted to share a few thoughts on breastfeeding after child sexual abuse (CSA).

While so many of us want to breastfeed, and spend our pregnancies imagining doing just that – and, indeed, preparing for it, it’s not always that easy. Aside, altogether, from the issues and difficulties that many women without a history of CSA encounter, there are additional difficulties that may manifest if the new mum such a history.  I’ve enumerated a few of them here:

  • If our breasts were a focal point of our abuse, we may be reluctant to offer, or share them, with anyone else – even our own babies. The physical contact may be just too much.
  • Dissociation is something I’ve discussed on this blog before – it’s often a huge part of our experiences when we are being abused. Dissociation, sadly, can also be part of our experiences when we’re breastfeeding – which can effect the mother-child bonding that is a much-mentioned positive element of breastfeeding. This, in turn, can lead to further shame and guilt around our bodies.
  • There are three kinds of touch that can be difficult for a woman with a history of CSA: self-touch, touch of another, and medical touch. Breastfeeding is, often, comprised of all three: The touch of the mother’s own hand on her breast – before, during, and after, a feed; the touch of the baby on the mother’s breasts; the manipulation of the mother’s breasts in order to assist with a latch etc.
  • Bodily fluids – even her own breastmilk – may be disgusting to the new mother who associates such fluids with abuse.
  • The shame that CSA visits on a woman, on her body, on her sense of self, can be mirrored in the shame that attaches to ‘bodies on display’ in many parts of the world. Then, there is the fact that  many societies visit shame on women who breastfeed in public, so this adds to the difficulty.
  • The mouth of her child on her breast can be triggering for the new mother with a history of CSA. It may remind her too much of her abuser/s slobbering all over her breasts.
  • If her birth didn’t go how she planned, the new mother may well have the old tape of ‘I can’t do anything right’ playing in her head. This may mean that she is convinced she can’t breastfeed her baby, either – so she may not even try.
  • If breastfeeding is difficult – or impossible – for the survivor of CSA, it can add to her feelings of guilt, and of the fact that her body is ‘failing’ her.

It’s not all bad, though. For many women with a history of CSA, managing to breastfeed successfully can be an hugely healing experience for women. It is a(nother) example of her body ‘behaving’ properly; of her body doing what it’s supposed to do.

If you are supporting a new mother who has a history of CSA, there are things you can do to help:

  • Reassure her that her choices are valid.
  • Reassure her that she is not being judged.
  • Reassure her that there are myriad other ways to love her baby.
  • If she really wants to breastfeed, discuss using a pump and expressing milk for her baby to exclusively feed breastmilk to her child.
  • Help her to see her milk as a ‘good’ / ‘useful’ fluid.
  • Remind her that she birthed beautifully, and that she can breastfeed beautifully, too – with help and support.
  • Encourage her to attend La Leche League, or Cuidiú meetings while she’s still pregnant.

The transition to motherhood is a monumental one for every woman, but it can be harder for those of us with a history of CSA. Ditto breastfeeding. Being sensitive to the possibilities can make the experience so much easier, and empowering, for these women.

CSA Disclosures In Pregnancy: Why Women Don’t Tell

Zipped Mouth

With more than 25% of women reporting that they have been sexually assaulted, every midwife and birthworker will encounter a survivor of child sexual abuse (CSA) several times in her / his career.

Not everyone who has been abused will disclose to their midwife. Given that, I advise midwives, and other HCPs to treat all women as survivors until, and unless, they are told otherwise.  There are a number of reasons why a woman might be fearful of disclosing to her midwife: Depending on where she is in her recovery, the woman may feel guilty about the  abuse – victim-blaming is so common in society that it’s not unusual for a woman to feel this way. Often, we feel that we need to protect people from our reality, and don’t want to upset or shock our lovely midwives. There is also the additional concern that we will be labelled as ‘difficult’ or ‘needy’ or ‘defective’.

A survivor can also feel that her trauma will be minimised, misunderstood, or ignored. She may also worry that she will be told it ‘makes no difference’ or ‘it’s not relevant’. This is particularly likely if she has had these reactions on previous occasions when she has disclosed.

 

Pregnant women may also worry that their history of child sexual abuse will be recorded on their charts, viewed by many other people and discussed without her knowledge or permission. These days, with a mandatory reporting obligation on caregivers, women may be concerned that their abuse will be ‘broadcast’ and that they will be called upon to revisit it with other agencies. The stress of this may be something they don’t want to think about – especially not while they are pregnant.

Sometimes, a pregnancy might feel like the first time that a woman’s body has done something ‘right’ or ‘normal’, and the woman may be striving really hard to be treated as ‘normal’ throughout her pregnancy. There is always a possibility, too, that the woman may not have disclosed to her partner that she has a history of CSA. She may also be afraid of bringing up the emotional pain and stress of her abuse by mentioning it to her midwife.

 

Women may already have experienced reactions that left a lot to be desired with regard to the amount of empathy they were met with. Whether or not her midwife will be empathetic or knowledgeable is hard to tell on first meeting her. It can feel like a huge emotional risk for a pregnant woman to disclose her history of child sexual abuse to a stranger, even if that stranger is a medical professional. If a woman doesn’t get a sense that her information would be treated sensitively, indeed, that she wouldn’t be treated sensitively upon disclosure, she may feel safer keeping that information to herself.

 

(If you are a midwife or birthworker interested in learning more about how to support women who have been sexually abused, check out the details of this course, which will be available in May:  http://bit.ly/2E9Be9p).

 

Forgiveness (Part 2)

forgiveness-332x263

Last month, I wrote the first part of this ‘series’ in Forgiveness. If you’re interested, you can read that entry here.

I wrote about what I think forgiveness isn’t. I ended the piece talking about peace – and how those of use who have been hurt (and are generally called upon to forgive) need, and deserve peace.

Here’s what I have learnt about forgiveness in recent months, though – bearing in mind that I have researched this from an academic point of view, as well as engaging with people who work in law enforcement, and others who are dedicated to reform, here and abroad.

My ‘aha’ moment around forgiveness, though, came when I was talking to a financial coach, Karen McAllister.  Funny how the answers you’re looking for don’t necessarily come from the source you might expect them to. Anyway, talking to Karen about forgiveness, I realised that my version of forgiveness was not about exonerating the transgressor, but about reclaiming the power that I was settling on them. 

Let me unpack that, and explain what I mean. At this juncture, I’m going to go backwards for a little bit, and look at the etymology of the word ‘forgive’. To forgive means to grant a pardon, and a pardon is to ‘pass over an offence without punishment’. ‘Pardon’ has its roots in two Latin words: ‘Per’ (which means ‘forward’ or ‘hence’) and ‘Donare’ (which means ‘give as a gift’).  To forgive, then, is ‘the granting of the gift of, henceforth, not punishing an offence’. Forgiving, then, in the traditional sense, the way I wrote about it last month, essentially gives the forgiven a free pass, while not doing an awful lot for the forgivee.  To me, that reinforces something else I mentioned last month; that the only person we need to forgive, in that sense, is ourselves.

To come back, now,  to the idea of forgiveness as a reclamation of power, I think that is the manifestation of forgiveness of the self.  The person who has damaged you, who has trespassed against you, is not given a free pass, but you reclaim the  power that they have stolen from you.

Perhaps the easiest way to do that is to use a real-life example. My eldest brother, Nigel Talbot, sexually abused me for most of my childhood. He is not remorseful, and though he has said ‘sorry’ in person, he has continued to abuse me in other ways, and he has also continued to abuse other women – sexually, emotionally, and financially.  My forgiveness took the form of a letter to him. Initially, I was going to send it to him, but – thinking about it – I realised that, to do so, would still be giving him power. I would still be expressing a desire for him to do something / to be something that he could choose not to be. What I need to do, for myself, is to call back that energy that he holds while I don’t forgive. The forgiveness is about me, not about him.

In any event, I know that if I did send a letter to him, his wife would keep it from him.

If you would like to read that letter, you can do so here.

This was the first of many such letters I’m writing, and with the penning of every one, I am feeling stronger, and more self-reclaimed. It’s definitely something I’d recommend, and if you do it, too, I’d love to know if it works for you.

 

 

                                                                                                           

 

 

 


 

 

Twelve Tips For Maternity Care for Survivors of Sexual Abuse / Assault

Pregnant Belly

About a month ago, I posted on Twitter using the ‘Me Too’ and ‘Maternity Care’ hashtags. Quite a few people got in touch to say that they found the advice I offered useful. A number of women contacted me privately to say that they found my tweets validating and reassuring. A few fathers also sent me messages to let me know that they witnessed the mothers of their children experiencing issues around their treatment and they realised, having read my tweets, that these reactions and issues were directly related to the abuse they had suffered as children.

In the hopes that these words will reach – and help – more people, I’m posting them here, as well.

  1. Sexual abuse is endemic. Treat ALL women as survivors until they tell you otherwise. Err on the side of caution.
  2. Continuity of care is best for women in order to build trust. We are extra vulnerable when pregnant, birthing, and in the peri-natal period.
  3. Before labour, ask if we have special requests for during labour – places not to touch, words not to use, etc.
  4. Call us by our names. Not ‘Love’ or ‘Sweetheart’. Abusers rarely use our names. Don’t diminish our personhood.
  5. Never, ever use the phrase ‘good girl’. We’re not girls. We’re women. Most of us were abused by people who used the phrase ‘good girl’ while they were abusing us.
  6. Don’t use nursery / childish language around us. That can be triggering.
  7. Don’t tell us to do something, eg ‘pop up on the bed’. Ask if we’d like to – explain why.
  8. Accept ‘no’ as an answer – don’t try and cajole or persuade us to turn our ‘no’ to a ‘yes’.
  9. Never tell us you’re going to do something. Ask permission. Our bodies belong to us, even when we’re birthing.
  10. Never perform a VE unless it’s necessary (hint: it’s *never* necessary.
  11. Be aware that our physiological responses may be different. EG we often pause dilation at about 4cms. Don’t rush with interventions because we are taking ‘too long’. Trust us. Trust our bodies.
  12. After birth, breastfeeding – no matter how much we want to – may be extremely triggering. Have compassion.

I offer workshops based on trauma-informed care to birth workers, based on my own experiences, and my academic research, (and the fact that I was Ireland’s first practicing doula!). If you’d like details, please get in touch.