A Narrative approach to sexual abuse in children

Trauma Conference

29 August 2012

The narrative metaphor

Narrative therapy is based on the notion that we tell stories in order to make meaning of our lives. Narrative therapy engages clients in the telling of the stories of their lives in order to find meaning which enables them to take action in their lives. The meanings that we make determine the steps that are able to take. E.g. if a child believes that she is to blame for the sexual abuse that happened to her, she will be inclined to experience shame and will therefor keep the abuse a secret.

Life is multi-storied not single-storied

Our lives are multi-storied. There is no single story that is the truth about our lives. As we live our lives we are constantly making up stories about our lives. Unfortunately children are often known and understood by the dominant negative stories of their lives which are often associated with the pain and the effects of abuse/trauma that they have been subjected to.

These kinds of expressions trap children into negative identity conclusions about themselves. They leave little room for children to become anything different from these dominant understandings about their lives. Many children start behaving in ways that confirm these negative identity conclusions about them.

However in NT we believe that, no matter what a child has been through there will always be aspects of his or her life experience that contradict the dominant story of pain, hopelessness, and worthlessness. Regardless of the hardships that a child has been through, there are always treasures to be found in his or her life. As therapists we need to engage in a kind of treasure hunt that helps children to be in touch with their lives’ treasures. By finding the traces of the treasures we can help develop them in order to assist the child to move towards a more preferred life understanding and identity.

Single-story telling is re-traumatising to children who have experienced abuse

If children are only asked to re-tell the stories of the trauma that they had been subjected to this can actually re-traumatise them, making them increasingly vulnerable. If they have to repeatedly talk about the particularities of the abuse, this evokes fear and makes them relive the experience of the abuse in ways that are not helpful to them.

In narrative therapy we as therapists practice “double-listening” skills. These are the skills of seeking two stories. We honour and listen to the story of trauma and to the concerns of the child, but we take care not to get stuck in the dominant story being presented. Rather, we listen carefully for thin traces of stories of hope. We listen for the subordinate story lines, those stories that are often neglected in the face of the dominant story of trauma.

People always respond to the traumas that they are subjected to

No-one is a passive recipient of trauma. People are always responding, whether they are children or adults. They respond to prevent the trauma, to try to minimise/modify its effects, or to try to make it stop, or to try to protect others and so on. Often these responses are overlooked or disqualified so that people are often not familiar with their own responses, leading to feelings of hopelessness and an overriding sense of victimhood. We listen carefully to stories that children tell about their response to the trauma that they had been subjected to.

In order to illicit the response-stories we might ask questions about the following (Ncube 2010:5):

  • What helped them survive the incident of abuse
  • The steps they have been taking to recover
  • The skills and knowledges that they have been putting to use during the difficult times
  • The history of the skills and knowledges about survival that they have been using
  • Who or what these skills and knowledges are linked to
  • The values, hopes, and dreams that are being expressed through the steps that they have taken to survive the abuse.

The development of these alternative story-lines offers children a new perspective about their lives and a hope to become the person they desire to be. Alternative story lines can create islands of safety and enable psychological and emotional safety. Once these islands of safety have been created it becomes possible for the child to speak about experiences of abuse without being re-traumatised and without being defined by the trauma associated with the abuse.

Responses to trauma have a foundation

Children’s responses to trauma have a foundation. It is based on what the child gives value to – this might be a dream, a hope or a vision of what life could be about. E.g. a child may decide to be silent about abuse by a family member because he or she gives value to family, to peace, relationships etc. Children’s responses to trauma are based on what the child intends for their lives. They involve skills and knowledges that children have about life, which need to be acknowledged and honoured so that they continue to put them to good use on their journey through life.

Working with the effects of the abuse

Brainstorm: The possible effects of the abuse. (Fear, shame, depression etc) Sometimes these effects of the abuse alert adults that there had been abuse. We then need to work at minimizing these effects. They become the focus of our conversations. In narrative therapy we use a linguistic practice called “externalizing conversations” where we give the problem/effect a name e.g. The Fear. We then investigate The Fear, how it operates, when it is most inclined to show up, what supports it and also what undermines it.

Challenging children to re-claim their lives from the effects of the abuse

The effects of the abuse might throw a big shadow over the lives of children so that they start very limited and limiting lives. Example of the girls who said that they no longer enjoyed dancing, netball and combing their hair. Fear to walk to certain places – had to give up activities. Make plans about safety and doing things that will support them. Is this fair? The boys took so much from you, is this fair that they have also taken your dancing, your joy in being pretty and playing netball. No. Stand up to that and take it back! In therapy we make plans to support the child in taking back the territories of their lives that they want to re-claim. Sometimes it involves planning safety measures or small steps to gain confidence or the company and support of peers or family members in order to strengthen them to take those steps. Conversations about what life was like before the abuse and what it was that they used to find enjoyable are helpful.

Accountability and the therapeutic practice

In any therapeutic relationship there exists a power-difference between therapist and client with therapists being in the more powerful position. In a therapeutic relationship between an adult and child this power imbalance is even bigger. We are accountable to our clients for the effect of our engagement with them.

Accountability is promoted through (Joy 1999:153):

  1. Consulting with non-offending parents of care-givers prior to meetings involving the child. This enables initial feelings of grief, guilt or disbelief that are common following disclosure, to be addressed without imposing these adult emotions and experienced on the child.
  2. Honour children by taking seriously that which they select to focus on during the therapeutic conversations. EG child who wanted help with the Maths teacher who was rude and abusive.
  3. Addressing the effects of the abuse on the child in the context of the child’s experience. This includes the effects of: the abusive events, responses and reaction of family members and other people interventions by investigative agencies expectations regarding school performance
  4. Developing means that make manageable for children the complex task of deconstructing the politics of abuse. This enables children to discover the answers to some of the most pressing concerns that children express:

Am I to blame?

Did I deserve it?

Was it something about me?

Why didn’t I tell?

  1. Striving to achieve a balance in the sessions where we acknowledge the seriousness of what had occurred and the resulting horror and confusion experienced by children while at the same time constantly working to create meetings that are wrapped in positive energy.

The politics of adult-child relations and the politics of sexual abuse

Abuse is about the imbalance of power in relationships. The more powerful take advantage of and exploit the less powerful, privileging their own needs and feelings over those of others. In the work with children who have experienced sexual abuse, the more powerful, privileged adult is positioned as being fully responsible for the abusive behaviour. One of the most important factors in understanding the politics of child sexual abuse is recognising that it is a deliberate, planned action. The abusing person coerces the child by either the application of trickery that masks the real nature of what is intended, or by instilling intense fear as to the consequences of refusing to co-operate.

When children bring their stories to the counselling meeting, it is not simply stories of sexual abuse they bring, but sexual abuse in the context of being a child in a society which routinely elevates adult rights, feelings and convenience over the needs of children. We are challenged to understand the meanings that children make of their lives in their own terms – rather than adult terms.

The voicing of sexual abuse

As with all experiences of trauma healing begins with speaking or voicing the story of trauma. For many children and young people this is almost impossible.

In all sexual abuse situations, it is fear that maintains secrecy. Disclosure elicits fears of humiliating embarrassment, of being disbelieved, considered responsible, or being rejected by those they are dependent upon and love. The child may fear for the hurt a disclosure would cause to others, particularly the person abusing them, if he/she is a family member. For some children the fear is about their own safety, or the safety of other family members.

Attending to the most pressing concerns of children

Is it my fault, am I to blame? (Joy 1999: 158-160)

Draw up a comparative list between the 9 year old (age of victim when abuse started) and the grandfather who was 63 when abuse started.

Nine year olds                                                   Grandfather

Clever, but not like adults Intelligent man
School gr 4 Job as manager for 30 year
Not very old, don’t know about a lot of things Aged 63 when first abused Elizabeth
9 years of learning right and wrong 54 more years of learning right and wrong
Think adults are always right He had more learning about right and wrong
Are afraid of some adults He is strict and people take notice and do what he tells them to do
Much smaller He is big and weighs a lot
Not believed as much He is seen as important by other adults

Following the list up with questions:

Whose idea was it to do those abusive things?

Who thought up these ideas?

Who decided when the abuse would happen?

Who decided what would happen?

Who decided where it would happen?

Who said not to tell?

When you think of all of this, who do you think is the one responsible for the abuse?

Conflict of love and hate (Joy 1999: 160)

Draw a pie chart with positive and negative parts in relation to the offender. Follow this up with questions about the behaviours that the offender (ie her father) engaged in that were hurtful and repulsive rather than about him as a person. This will enable the client to take up a clear position in relation to the abusive behaviour.

Taking responsibility for the family disruption following disclosure: “If I hadn’t told, none of this would be happening” (Joy 1999:164-167)

Make a detailed recording of the story following the disclosure. Then ask about the events leading up to the disclosure. Record both these stories.

  • My cousin did sexual abuse
  • I was very scared and confused
  • He threatened me and made me keep it secret
  • He kept pestering me more and more
  • I felt trapped by him
  • Most times I just couldn’t stop him
  • I wanted to tell but I was afraid
  • I started to hate myself
  • I became more and more afraid of him
  • He hurt me so bad that I told my best friend
  • He took me to our teacher and we told him
  • Our teacher told the police

DISCLOSURE

  • Everyone had to talk to the police
  • Everyone is scared what will happen
  • My uncle came over and yelled at Dad
  • He called me a liar
  • He said the family is ruined because of it
  • People are crying all the time and yelling at one another
  • The police said my cousin might go to jail
  • If he does he it might kill him
  • Some of the family won’t talk to us
  • Mum and Dad can’t take it much longer

Instruction: Rub out every item listed there that would not be there if his cousin did not abuse him. Only one left was: My cousin did sexual abuse.

Identity is socially constructed

Children who experienced sexual abuse often becomes isolated as a result of the secret that they carry, the thin and negative identity conclusions they have about themselves and the fear that cut them off from others. We want to reconnect them with their communities of concern and care. We can do this within the therapeutic conversations by re-membering the people that love them back into their lives through telling stories of love and kindness. We can write letters to reconnect the children with their communities of care. We may also invite them into conversations and have them witness the lives and stories of our clients. Support groups are really useful in this regard.

We do not consult with children in isolation – there is space for individual work and consultations with children on their own, but we ALWAYS involve people from the child’s life eg family members, people from school. WHY? Because the meanings that children make of their experiences and their options for living the lives that they prefer to live are directly linked to responses of the people around them to the abuse. The 60 min of safety that we are able to offer is just NOT enough in terms of the child’s life lived in a bigger society. Give examples.

Raising awareness and making our society a safer place for children

Children are encouraged to report sexual abuse, but often they have to continue living in a dangerous and abusive environment. This leads me to the question: “What are we offering these children?” Sixty minutes of counselling in a safe environment once a week just does not seem adequate – in fact it feels a bit like putting plasters on a seriously ill body.

I started wondering whether individual counselling might not be supporting the belief that the “problem” in sexual abuse resides within the victim, thereby exonerating the community from responsibly for their abuse. If we, as counsellors, do not address the factors in society that keep the problem of sexual abuse of children alive we are, in a way, contributing to the problem. By treating the problem of sexual abuse as confidential matter that stays within the walls of our consultation rooms we support the culture of silence which is regarded as one of main factors that feed the problem – making it easier for perpetrators to offend and harder for victims to speak out and seek help, keeping alive the helplessness, myths, stigma’s and denial surrounding the problem in society. In this way we also leave cultural beliefs, practices and structures that inform and support sexual violence unchallenged.

Narrative Therapists are aware of the effects of dominant cultural beliefs which assist us in contextualizing the sexual abuse of children:

We hold the view that we live in a society grounded in, and shaped by, patriarchal ideology, and our social, political and cultural analysis occurs within the context of this ideology. Society encourages patriarchal attitudes and actions. Society condones men having power over women and children. This encourages the subordinate status of women in society and in the family. (Esler & Waldegrave 1990: 134)

 Abuse happens in a context where there is an imbalance of power in relationships.

Child sexual abuse consists of a set of subjugating practices or techniques of power perpetrated against the most vulnerable, dependent and impressionable members of our society. It involves the whole spectrum of dominant power/knowledge from brute force and inscription on the body to the most subtle and difficult to detect forms of manipulation. (Linnel & Cora in Joy 1999:149)

By asking detailed questions about the difference in power between the victim and perpetrator and the strategies of abuse of power employed by the perpetrator feelings of guilt, shame and culpability are challenged.

We attend to the short and long term effects of the abuse (Durrant & Kowalski 1990:72). By unpacking and challenging the dominant cultural beliefs that surround sexuality in a patriarchal culture we seek to undermine dangerous and damaging practices and beliefs e.g. “bad girls get raped”; “you were looking for it with the seductive clothes that you were wearing”.

Narrative Therapists work with the understanding that identity is socially constructed in interaction with people. Therefor practices that connects and re-connects clients with communities of care form a very important part of the work, especially when working with sexual abuse which is so often surrounded by secrecy and isolation from others (White 1997; 2007). In an approach to therapy which de-centres the therapist we always work towards finding other people in the lives of our clients who can join us in standing with our client (White 2007).

We know that our efforts to undermine the cultural assumptions and practices responsible for the victim’s experiences of shame, guilt and fear is often a thin voice against everyday experiences from powerful, strong voices in their own communities. We are also painfully aware that the fears which our clients express are often very, very realistic. Nobuntu has often remarked about the loss of a spirit of Ubuntu in the townships. We share a dream that people would join hands to take responsibility for problems affecting the community. In the following Case Study we will illustrate how Narrative Therapy created opportunities for transformative work in the wider community.

 Conclusion

I support an approach to counselling and therapy which will voice the suffering of victims of sexual abuse in the bigger community. As counsellors we dare not carry the stories of oppression and abuse with us without taking a stand against the injustices supported by our culture. In this regard we take an activist stance. We agree with Weingarten (2000) that “matters of life and death are too hard, too onerous, and too painful to ‘do’ alone.” I have many stories of how the joining of hands and voices can ripple out in transformative ways (Morkel 2011a & b).

References:

Esler, I & Waldegrave, J 1990. Sexual Abuse: Two women’s different ways of working with the same problem and from the same perspective in Durrant M & White C (eds) Ideas for therapy with sexual abuse. Dulwich Centre Publications, Adelaide South- Australia (133-158)

Durrant, M & Kowalski, K 1990, Overcoming the effects of sexual abuse: Developing a self-perception of competence in Durrant M & White C (eds) Ideas for therapy with sexual abuse. Dulwich Centre Publications, Adelaide Australia.

Joy, Maxine 1999. Shame on who? Consulting with children who have experienced sexual abuse in Morgan, A (ed). Once upon a time….Narrative therapy with children and their families Dulwich Centre Publications, Adelaide, South Australia. (145- 172)

Ncube, Ncazelo 2010. The Journey of Healing: Using narrative therapy and map-making to respond to child abuse in South Africa in The International Journal of Narrative Therapy and Community Work 2010:1 (3-12)

White, M 2006a. Children, trauma and subordinate storyline development. In Denborough, D (ed). Trauma: Narrative responses to traumatic experiences. Dulwich Centre Publications, Adelaide, Australia (143-165)

White, M 2006b. Working with people who are suffering the consequences of multiple trauma: A narrative perspective. In Denborough, D (ed). Trauma: Narrative responses to traumatic experiences. Dulwich Centre Publications, Adelaide, Australia (25-85).