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ss triple helix - autumn 2003,  Child Abuse

Child Abuse

The long term effects of child abuse on mental health, social behaviour and relationships stem from a loss of trust, hope and self esteem in the developing child. Traditional theories of why child abuse occurs include considerations of parental personality, lifestyle and behaviour and also socio-economic stress; but often fail in acknowledging the role of individual responsibility and choice. Proper spiritual development is dependent on a modelling by parents of God's character and a truly Christian approach to child abuse involves making ourselves vulnerable enough to suffer with the abused and feel their pain. Only in this way can lost hope, faith and love be fully restored.

We all, to some extent, carry responsibility for abuse, writes Peter Sidebotham

If there were first century child protection registers, Jesus should have been on one. Two thousand years ago, a baby was born to an unmarried teenage mother, which in his culture carried far more stigma than it does today. As American author Philip Yancey puts it, 'In the modern United States, where each year a million teenage girls get pregnant out of wedlock, Mary's predicament has undoubtedly lost some of its force, but in a closely knit Jewish community in the first century, the news an angel brought could not have been entirely welcome.

The law regarded a betrothed woman who became pregnant as an adulteress, subject to death by stoning.'[1] Jesus was born, far from home, the illegitimate baby of a teenage Mum, cut off from family and community support, with bizarre beliefs about herself and her baby, a sure sign of underlying mental illness.

However there is a far more profound reason why I believe Jesus might have been placed on a child protection register. To understand that we must first explore a bit about child abuse - what it means and why it happens.

The impact of child abuse

Figure 1 - A pyramid of abuse

figure

Child abuse can be thought of in terms of a pyramid (figure 1). It is often the extreme end of child abuse that people think about: the severe and persistent maltreatment of children with malicious intent. The immediate effects of such abuse are clearly horrific, whether it is one of the 1-2 babies who die each week, or the much greater number who are left disabled or even just physically hurt at the time. However, the lower levels are of equal concern. These levels make up the bulk of those children seen every day by professionals working in child welfare. At these lower levels the thresholds are not easily defined. When does a casual attitude become neglectful or parental discipline become abusive?

Anyone working within the caring professions will be familiar with the long-term effects of maltreatment, particularly the emotional maltreatment that accompanies all abuse. These long-term effects seem to be found just as much at the middle levels of the pyramid as they are at the extreme end of the spectrum and they form what is perhaps the most concerning aspect of abuse. Many of the long-term effects are well documented, including effects on mental health, social behaviour and relationships; and impacts on child behaviour and development.[2,3,4,5] These effects can be viewed as stemming from three basic impacts on the developing child: a loss of trust, a loss of hope and a loss of self esteem (figure 2).

Figure 2 - The effects of abuse

figure

Child development

As the child moves from a position of vulnerability to maturity, he or she grows and develops in many different ways. An integral part of that, and overlapping with the other aspects, is the child's spiritual development. We can view our spiritual development as covering three areas: an awareness of ourselves, an awareness of others and an awareness of God.

Probably the greatest influence on a child's spiritual development will be what they see of God in their parents. Most children will learn that their parents are there, even when they can't see them; that their parents love them, care for them and are interested in them. In that sense, spiritual development is not a matter of doctrine, or even of morals, but a modelling by parents of God's character. Child abuse, most of which we know to be committed by parents, flies in the face of this crucial aspect of a child's development.

In 1 Corinthians 13, Paul highlights the three pillars of faith, hope and love, the greatest of these being love. These three can be applied to our understanding of spiritual development, and to the impact of child abuse:

Child abuse destroys faith

I saw Abbie, aged two in the emergency department. She was covered in injuries including over 30 burns from a cigarette lighter. The excuse from the parents was that it happened in play. In Matthew 7: 9-11 Jesus asks, 'Which of you, if his son asks for bread, will give him a stone? Or if he asks for a fish will give him a snake?' He continues, 'If you then, though you are evil, know how to give good gifts to your children, how much more will your Father in heaven give good gifts to those who ask him?' This rings true for most of us, but not for the abused child. As Francis Bridger puts it, 'A child who does not learn how to trust adults now will have difficulty trusting anybody at more than a superficial level later on. This extends to trust in God.'[6]

Child abuse destroys hope

Emma, a 16 year old came with her mother to my clinic. Her stepfather had sexually abused her three years previously. Since then she had become isolated and shy. She had effectively dropped out of school and found it difficult to relate to her friends. In an attempt to overcome this shyness, she had taken to binge drinking to made it easier to cope in social situations. I asked Emma what she wanted to do with her life. Hesitatingly she said she had wanted to be a lifeguard, but she knew that she never could, as it would take too much to change. Emma had lost hope and this had led to the feeling that she could not control her future.

Child abuse destroys love

As a paediatric registrar I saw three year-old Kirsty. She had presented with a minor injury that in itself was not worrying. However, she sat in the A&E cubicle, watching me warily with that aura of 'frozen watchfulness'. What hit me were four words in biro on her arm: 'I'm a little bitch'. This to me sums up the most devastating aspect of child abuse: children grow up feeling unloved and unvalued. The Bible is full of illustrations and references to God's love for his people. But children who have been brought up to believe they are worthless and unlovable, who have never known what it is to be loved and valued, will struggle to believe in such a loving God.

Why do people abuse children?

Early understanding of child abuse tended to fall within two theories: the psychodynamic and the sociological. Psychodynamic theories saw abusers as somehow different from 'normal' parents: mad, sad or bad. Sociological theories, saw abusers as normal people in extreme circumstances: that stress, especially financial stress tipped them over the edge.

Neither theory is adequate. Most parents I deal with in cases of suspected abuse are normal parents, not much different from me. Since becoming a parent, I am even more aware of this. There were times when I have felt like shaking our babies when they would not stop crying. I have sometimes gone further than I feel happy with in my discipline, too, or spoken harshly and regretted it.

As for sociological theories, it's true that there are social gradients in abuse.[7,8] However, having worked both in the UK and internationally in areas of poverty and deprivation, I am convinced that this isn't the full answer. Most poor people do not abuse their children. Moving beyond this, most researchers and practitioners now work within the ecological theories of Bronfenbrenner.[9,10] This structure informs the assessment framework within which UK child protection work is based.[11] This ecological framework can be portrayed as a series of concentric circles (figure 3). The child is located within the nucleus of his or her family and home: the microsystem. This in turn is located within a wider exosystem of the neighbourhood and social environment, which in turn is dependent on the wider cultural values and beliefs of the particular society: the macrosystem. Into all this, the parents bring their own background experiences, each of which will have its own concentric circles. The important thing to recognise here is that this is not a static system, but is moulded and shaped by the actions of all the players.

Figure 3 - An ecological model of abuse

figure

Thus we can recognise the importance of parental personality, lifestyle and behaviour, but also the contribution of socio-economic stresses and the child's own developmental needs. And perhaps most importantly, the impact of our society on parenting, and the stresses that brings. If you consider child abuse in this light, it is impossible to avoid the conclusion that we all, to some extent, carry responsibility for abuse. By creating and maintaining our cultural values of consumerism, achievement and individualisation, we all carry some responsibility towards those children who are harmed when parenting can't withstand the pressures that imposes.[12]

Individual responsibility

Where all models of child abuse break down, though, is their failure to acknowledge individual responsibility and choice. We all have a choice about how we behave. And we cannot deny that responsibility. If we look at the tragic death of Victoria Climbie,[13] it was Koaou and Manning who were ultimately responsible. Similarly, in Abbie's case her father who was responsible for her cigarette lighter burns. David Southall and colleagues have hinted at this.[14] Whilst at one level, society must take the blame, at the other extreme, where there is deliberate, malicious abuse; the individual perpetrator is responsible and must be dealt with through the criminal justice systems.

Southall's model doesn't go far enough, however, in that at all levels the individual must carry some responsibility and at all levels, society, and therefore you and I must carry responsibility as well. Lord Laming was right in pointing out that the system failed Victoria Climbie. Yet it was not just failure to identify and prevent the abuse. The interplay of structures and inequalities led to a family in the Ivory Coast giving up their daughter to a relative stranger in hope of a better future. We are all guilty.

Evil

Cases such as Abbie above, or Victoria Climbie highlight the evil nature of child abuse. At its most extreme, it is malicious and cruel. It targets the weakest at the point where they are most vulnerable. Above all, it portrays the exact opposite of all I believe about God.

  • Where God has a particular concern for the vulnerable, abuse targets them
  • Whilst God is loving and kind, abuse is malicious and cruel
  • While God wants peace and goodness, abuse brings pain and fear
  • Abuse robs people of the full life that God intended
  • And as we've already shown, child abuse destroys faith, hope and love, three bedrocks of God's character and dealings with mankind.
  • God values each individual but abuse says 'you're worthless'
This evil extends beyond the abused, to ruin the life of the abuser.

God to the rescue

In understanding abuse, we have to acknowledge that we live in a fallen world where evil is at work destroying people's lives, and where we all must share the guilt and responsibility for the suffering around us. Within this, child abuse epitomises that evil and suffering and the guilt of each one of us. We all need forgiveness, healing and rescuing, and we all need hope, faith and love restored. For some mysterious reason that I don't really understand, God chose to tackle this evil and suffering not by erasing it or imposing his love and goodness, but through incarnation, by identifying with it. This may have something to do with the nature of the evil and suffering that lies at the heart of abuse and forms the real problem.

If we believe in an all-powerful God, we must believe that he could deal with suffering and put a stop to pain. But the root of suffering demands something more profound than miraculous erasing. In choosing to love us, God relinquished some of that power, for love makes us vulnerable.

Jesus did not deal with suffering from a distance, but by coming close enough to be touched by it, to feel the pain. John Ortberg has expressed it powerfully: 'In a contagious world, we learn to keep our distance. If we get too close to those who are suffering we might get infected by their pain. It may not be convenient or comfortable. But only when you get close enough to catch their hurt will they be close enough to catch your love.'[15] That is what Jesus did, getting close to those who were suffering, the abused, outcast and vulnerable, and bringing with him acceptance, restoration and hope.

If Jesus was born today, he might not be placed on a child protection register, but I believe he would somehow suffer with the abused and feel their pain, for it is only in that way that they can regain the love that has been taken from them. That same challenge should extend to us. In the words of Bridger, 'it will be a gospel of cuddles and softly spoken words. These are the seeds out of which, by the grace of God, fuller faith may develop.'[16]

References
  1. Yancey P. The Jesus I never knew. 1995 Marshall Pickering, p29
  2. Aber JL, Allen JP, Carlson V, Cicchetti D. The effects of maltreatment on development during early childhood: recent studies and their theoretical, clinical, and policy implications. In D Cicchetti and V Carlson (Eds) Child maltreatment: theory and research on the causes and consequences of child abuse and neglect. 1989 CUP
  3. Bifulco A, Moran A. Wednesday's child: research into women's experience of neglect and abuse in childhood, and adult depression. 1998:Routledge
  4. Cicchetti D, Rizley R. Developmental perspectives on etiology, intergenerational transmission and sequelae of child maltreatment. New directions in Child Development 1981; 11:31-56
  5. Oates K, Peacock A, Forrest D. the development of abused children. Developmental Medicine & Child Neurology 1984;26:649-656
  6. Bridger F. Children finding faith. 1988: SU p13
  7. Pelton L. The myth of classlessness. In Pelton L (Ed.) The social context of child abuse & Neglect NY: 1981 Human Sciences Press. pp 23-38
  8. Spencer N. Poverty and child health. Abingdon : 2000 Radcliffe Medical Press
  9. Bronfenbrenner U. The ecology of human development. Cambridge: 1979 Harvard University Press
  10. Belsky J. Child maltreatment: an ecological integration. American Psychologist 1980; 35:320-335
  11. Department of Health Framework for the assessment of children in need and their families. London: 2000) The Stationery Office. www.dh.gov.uk/PublicationsAndStatistics/
  12. Sidebotham P. Culture, stress and the parent-child relationship: a qualitative study of parents' perceptions of parenting. Child: Care, Health & Development 2001;27: 469-485
  13. Laming. The Victoria Climbie Inquiry. London: 2003 HMSO (www.victoria-climbie-inquiry.org.uk)
  14. Southall DP, Samuels MP, Golden MH Classification of child abuse by motive and degree rather than type of injury. Archives of Disease in Childhood. 2003;88: 101-104.
  15. Ortberg J. Love beyond Reason. Zondervan: 1998 Grand Rapids, Michigan p56
  16. Bridger p26
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