Walks and Thoughts

of Michael Simes

An old Man's Tale:



West Vale

Clay House


Cragg Vale



Pecket Well

Luddenden Dean

Jerusalem Farm

Catherine Slack

Stone Chair

It's Just Like Home:

Hong Kong





Marlborough Sounds


Milford Sound



Blue Mountains

Northern Beaches


A City Of Revolution:




Notre Dame

The Adult Legacy Of Childhood Sexual Abuse

Individual Therapy With Adult Mental Health

Referrals Where CSA Is The Key Factor

Dick Agass And Mike Simes

Although it cannot be proved that childhood sexual abuse invariably does long-term damage, there seems little doubt that in the overwhelming majority of cases that come to light the abuse is 'developmentally toxic' (Summit, 1988) and poses a significant threat to mental and/or physical health (Browne and Finkelhor, 1986; Bagley and Rams ay, 1986). Research also confirms the common-sense assumption that the worse the abuse (i.e. the more prolonged, penetrative or violent it is) the greater the harm (Herman et al, 1986; Jehu, 1989; Hall and Lloyd, 1989). Another key factor here is the particular stage of psychic and cognitive development the victim has reached at the time of the abuse (Osborn, 1990). Although the physical damage can be severe the most persistent wounds are usually the emotional and psychological ones (Hobbs and Wynne, 1989). The real crime of sexual abuse is 'the abuse of the mind and self (Bollas, 1989). At the heart of this process lie an abuse of power and a complete betrayal of basic trust. Children are hurt most when the damage is inflicted by someone to whom they look for love and protection. In this sense it may be more damaging for a child to have something good which is then spoiled or taken away (like Helen) than to have an experience which is consistently bad (Steele, 1986). The crucial factor here is the closeness of the relationship rather than whether or not it is a blood-tie: 'It is the relationship, not the biology, that is betrayed' (Gelinas, 1981). The mind-blowing, space-invading nature of the abusive act, accompanied by the inevitable injunction to secrecy, results in a profound disturbance of the child's inner sense of self. If the abuser claims to be bestowing a 'special' relationship, and if the victim is aware of enjoying at least some of his attention, then notions of 'good' and 'bad' are totally confounded to produce an appalling psychic dilemma (Herman and Hirschman, 1981; Gardner, 1990). The victim is split - internally from her own bodily and emotional experience, and externally from her family and the outside world (Summit, 1983; Vizard, 1988; Kraemer, 1988). Consequently she becomes more and more isolated: her perceptions can no longer be validated and she comes to doubt her own experience of reality (Bowlby, 1988; Schatzow and Hennan, 1989). From a psychodynamic viewpoint, Miller (1985) argues that to be exploited in this way by a loved one produces 'an interlinking of love and hate' which remains unresolved because anger cannot be expressed towards the abuser for fear of losing him. (Helen is recognisable here.) Personality development inevitably suffers, and subsequent relationships are characterised by the same love-hate ambivalence, without the person really understanding why. It is hardly surprising that abuse victims are chronically confused. Gelinas (1983) claims that a complaint of 'confusion' in someone who is not psychotic is 'the single best indicator of an undisclosed incest victim'. This was strikingly true of both Helen and Christopher. Helen spent most of her life in a state of deep confusion until therapy gradually helped her to clear the fog, and Christopher's confused state was the initial reason for his admission to hospital.

The family backgrounds of both Helen and Christopher share many of the features commonly reported in abusing families. (We realise that the following discussion takes no account of cultural and ethnic variations - see, for example, Mtezuka, 1990.) Such families are frequently marked by parental discord and a failure of parental care. One striking correspondence in Helen's case lies in what Herman and Hirschman (1981) call 'the almost uniform estrangement of mother and daughter', an estrangement which normally predates the actual abuse. This brings home the fact that sexual abuse is rarely a factor on its own: rather it tends to occur within the context of more general abuse and neglect (Bagley and Ramsay, 1986; Bifuloo et al, 1991). This in turn derives from a transgenerational pattern characterised by the parents' own unmet needs. Relationships are often skewed in such families so that a special burden falls on the only or oldest daughter to act as 'little mother' (Goodman and Nowak-Scibelli, 1985). Admittedly this occurs in 'normal' families too, and may be viewed as 'part of a girl's socialisation into feminine gender role' (Ash, 1984). Nevertheless the 'parentification' of abuse victims ensures that their own developmental needs take extra low priority within the family. A combination of blurred intrafamilial boundaries (Furniss, 1983) and an excessively rigid external boundary means that family pathology may be sealed off from outside influence for many years. Social isolation is a common feature of such families (Jehu, 1988). Indeed, the inoest family functions as a sort of closed system' which permits little inflow of fresh energy or information from the outside Alexander, 1985). Many adult survivors remain captive to the closed system of abuse long after they have physically separated from their family of origin.