CHILDHOOD ABUSE AND TRAUMATISATION

1. CHILDHOOD ABUSE AND TRAUMATISATION Borbála Tóth, József Horváth Budapest, Hungary Private Practice INTRODUCTION TO THE PROBLEM CASE REVIEWS: If we look back in the history of mankind, examples, both in the times of the Old Testament and in the stories of mythology, prove that the problem of incest is as old as mankind itself. The Christian and the Islamic religion register specific restraints concerning incest in the Bible and the Koran. It is a social consensus that we treat incest as a taboo, or it is legally accepted, as in the Egyptian culture, where they tried to keep the supernatural origins of ”the royal blood” untouched by the help of sibling-marriage. (Bischof, 2002). The well-known figure of Oedipus from the Greek mythology is a dominant capstone of Psychoanalysis. (Dethlefsen, 1990) We cannot approach our topic without him. The discovery of the Oedipus complex is an important fruit of Freud’s self-analysis in the summer and autumn of 1897. We must admit that through the elaboration on the Oedipus Complex, it becomes clear and evident why the prohibition of incest and the requirement of exogamy is so important: These determine the humans as social beings, determine their existence and their socialisation as well. This idea of Freud parallels Lévi-Strauss’ point of view who wrote that culture came to existence through the prohibition of incest. Freud analyses the different measures of precaution to prevent incest relationship in the life of historical peoples through various examples in his book titled Totem and Taboo, concerning mother-in-law and son-in-law, father and daughter, brother and sister relationships. (Freud, 1913). In our poster, we place the phenomenon of sexual abuse into focus, as we see it as more and more frequent and affecting all social classes. We make our presentation on the basis of our own Mental Hygienic – Psychotherapeutic –, Clinical Psychology and Psychiatric experiences. We did not have specific consultation hours for the mentioned subject. Signs of traumatisation emerged during the therapeutic process in all of the following cases. Three cases will be mentioned, without claiming to carry out a deep analysis, focusing on the abuse and the traumatisation. 1ST CASE: The young woman, aged 24 came to the therapy as a result of conversion symptoms complaining of a strong headache, ”pain around her heart”, numbness in the legs, feeling dizzy and she had already tried suicide. She was treated in the psychiatric department three times as a result of the symptoms detailed above. The first interview was ballad-like, broken. After the first couple of sentences she revealed that when she was 3 years old, her mother sent her to a foster home with her siblings. The two older ones were taken out a little later, but she stayed there with her younger brother. She did not know her father, according to her recital, he was always drunk and got frozen (died) in a pool of water. The patient was 10 years old when her step-father raped her, and after the first coitus, she got admitted to the Child Department of the regional hospital, unconscious. Her step-father abused her older sister as well, her older sister ”gave him up” to the police. After this legal proceedings were started against him. Her step-father jumped into a well instead of bearing responsibility. In this case it is easy to discover the transgenerational patterns. Her mother was 23 when she sent her to the foster home, the same age as herself when she started to suffer from the symptoms. Her son was 3 years old when the patient became ill, her child was the same age as her, when she got to the foster home. This is a case of timed crisis, where the age of the child, and the age of the mother activated her traumatic experiences, which generated not only emotional storms, but serious somatic symptoms as well, and contributed to the blockage of the development of the personality. Supposedly, it was the atmosphere of the therapy that served as a catalyst for the emergence of the patient’s long suppressed secret. An individual supportive therapy was given to the patient, and the family underwent a family therapy, this way helping the patient improve her identity as a mother. (B.Tóth-J. Horváth, 1996.p.187-190.) 2ND CASE The patient, a fine artist woman, aged 40, came to supportive therapy because of her present familial status and self-evaluating problems. Her introduction gained a special emphasis for me, she wore a pastel scarf and Eastern style silk trousers. Her whole appearance, and her ”weightless” introduction was surrounded by mystery. This appearance meant to me that she tried to gloss over her problems. The secret was present during the first meeting as well, but it was revealed only later during the therapeutic process. In further therapeutic sessions, the patient showed a conventional appearance. The question of ”why now” concerning her coming to the therapy can be answered from the following biographical context: The patient is divorced, at the time of the therapy she has two children, a 10-year-old girl and a 12-year-old boy. Earlier, she lived abroad with her husband, the children were also born there. They moved back to Hungary 3 years before the time of the therapy. The patient was 10 years old when her mother died of leukemia. They did not speak about her mother’s death and the circumstances of her illness in the family. Her father was also a fine artist, he was out a lot, usually he went home late. The patient lived in the same room as her brother, who was 5 years older than her, till she was 14. She still considers her relationship with her brother an important one, and calls him the ”apple of her eye”. This way the girl in prepuberty and the boy in puberty, in the lack of parents, found the intimacy and happiness in each other. This event seriously influenced the patient’s difficulties with choosing a partner, and the consolidation of her relationships. The time of presenting for therapy is not accidental. Her daughter is 10 years old now, the same age as she was when she ”fell in love with her brother”. During the therapy, we processed the relationships with the family members, identified the patterns of the past, reassessed her feeling of intimacy towards her brother, talked about the maternal role and the regulation of the boundaries between the siblings. There is a positive turn in the effects of the therapy: the patient realises that though self realisation is important, it cannot take priority over the moral responsibilities of the role of a mother. The genogram of the family was the catalyst of the therapeutic process, which meant a clearly perspicuous map for the patient to reveal the secrets and the obstructions in her family. DEFINITIONS Defining the incest-relationship:according to Hirsch, there is an anthropological, a criminal and a psychological definition. The criterion of the psychological approach is that this relationship occurs between strong and weak, exploiter and exploited, in most of the cases between parents or adult relatives and children. There is always latent or open aggression in the story, in the background of which there is a characteristic family dynamics working. In many cases, the abusers try to disclaim responsibility by claiming that there was no direct sexual intercourse. We must emphasise it as a criterion of the definition of incest that if the adult uses the contact with the child for the satisfaction of his/her own erotic desires, this event postulates a taboo. The prohibition of incest concerns stepfathers and stepmothers as well. We stress one criterion of De Jong’s (In: Hirsch, 1990. p.164.) 4 criteria for sexual exploitation: the age difference between the abuser and the abused is at least 5 years. On the basis of this point we can make a difference between the source of mutual sexual experience in childhood and the real incest relationship. 3RD CASE: After clinical examination a 13-year-old adolescent boy came to the psychotherapy session, with serious gastroenerological symptoms, as a result of the suggestion of the specialist, as he was vomiting, having a headache and feeling dizzy. His adapting disorder at school and his uneven scholastic record were the attendant symptoms. The child was born in Rumania, Transylvania. He was 2 years old when his parents divorced, her mother came to Hungary to work. The child remained with the father, without proper care. Later he only spent the summer vacations at his father’s. He has two siblings: a ”Rumanian” girl, he says, and a boy in Hungary. He defines his existence in Hungary as being a ”Transylvanian and foreigner”. It must be emphasised from the exploration that he had a foreskin operation (circum cision) when he was 3 years old. He started school in Hungary. He was continuously assaulted at school, he had to change schools, this is his third school at present. Before the therapy, the child took a projective and an achievement test. The results of projective tests show signs implying mystery and insecure, ambiguous future. Concluding from the tests, the therapist poses a statement: you have a secret. The answer is: how did you know? After all these, he reveals that when he was 3 years old, after his foreskin operation, the older boys abused him, lacking parental control. He was 8 years old when, during his summer vacation at his father’s, pornographic pictures were shown to him. This time he started to ”approach” his ”Rumanian” sister. He is crying while telling all these. When the child is tumbling ”between two homes”, the feeling of being a foreigner and being excluded is activated again in his new schools, and the boy becomes a victim again. It is not an accident that these somatic symptoms, indicating a serious blockage, emerge in the beginning of adolescence, at the time of the evolution of sexual roles. After the emergence of the traumatic experience, and the involvement of the mother in the therapy, the boy’s condition became better, his symptoms ceased to exist. During the therapy, we tried to solve the problem of his socialisation at school as well. SUMMARY: THE RESPONSIBILITY OF THE MEDIA: • In all the three cases we meet an early childhood and childhood incest and abuse determining the whole • life and conduct of the individual. • Our choice of the three cases above was not an accident: these people did not come to us for a specific • help because of their traumatisation, but came because of having somatic and psychiatric symptoms and • diagnosis. • It must be emphasised that the symptoms showed the depth of the trauma in a symbolic language, and • how the patient was unable to struggle with his/her own problem. • All the three cases were loaded with secrets. • It is also a common characteristic that the early experiences with praecox influenced the process of the • harmonious development of the personality severely. • The traumatic event emerged during the therapeutic process, this way determining the aim and the • direction of the therapy. • In all of the three cases, children of split up families appeared in the role of the victim. None of the patients • gained affirmation from the father, moreover, the father appeared in their lives as a significant other, as a • physical and emotional lack or vacuum, this way making the finding of a partner and the establishment of • a relationship with men much more difficult. In the case of the 13-year-old boy, the identification with the • role of a man was aggravated. In the case of the women, the mother was not present physically (because • of death), or if she was present, she was unable to show proper emotional support and strengthen the • female identity in her daughter. • The specialty of the case of the 40-year-old artist is that she interpreted her incest with her brother as an • egosynton, however, this meant significant self-evaluating problems in her adult life, and the questioning of • her own values and sexuality. • Finally, our cases can be characterised by the criteria of post-traumatic stress disorders summarised • by Judith Hermann, according to which these cases can be characterised by the questioning of the basic • relationships, the psychological vulnerability of the personality and the constraint for repetition, in which • the person lives through the self-destructive process again and again. Concerning many cases that are shown to the public through the media, discretion is severely hurt, specifically when the victim is shown on the front page of magazines. Internet pages are full of pathological incest-taboo cases, videos, which can cause ”infection”. This information transmitting can serve as an appeal for the act to individuals with pathological desires. The media contributed to the world wide spread of child pornography to a great extent, which can become a new taboo problem of postmodern times. We must think about the Internet as a modern Tree of Knowledge, from which we can gain good and bad fruit as well. THE PSYCHODYNAMIC BACKGROUND OF THE INCEST FAMILIES In an analytic approach, the interpretation of the problem of incest is a transgenerational narcissistic deficit. Unsatisfied narcissistic needs in early childhood create a pathological claim in adulthood, which is, in a paradoxical way, passed on to the victim. The adult uses the child as an intimacy-substitute. From the aspect of System Theory, we must emphasise that the other parent does not want to know about this abnormal relationship, it is the other parent’s blind spot. According to our clinical experiences, the proof of the intimacy substitute is that the child that used to sleep alone sleeps with the parent, specifically in the case of divorced parents, primarily mothers. They refer to the child’s fear at night. We meet this phenomenon through the somatic and psychosomatic symptoms of these children. BIBLIOGRAPHY: Bischof, Norbert (1985): Das Reatsel Ödipus. Die biologischen Wurzeln des Urkonflikts von Intimitaet und Autonomie. Piper Verlag GmbH, München. Brooks, B. (1985): Sexually abused children and identity development. American Juournal of Psychotherapy 39, 401-410. (In: Christopher Bagley and Wilfreda E. Thorston (eds.): Understanding and Preventing Child Sexual Abuse, 1996). Cyr, Mireille et al. (2002): Intrafamilial sexual abuse: brother-sister incest does not differ from father-daughter and stepfather-stepdaughter incest. Child Abuse and neglect 26, 957-973. Dethlefsen, Thorwald, (1990): Ödipus der Raetsellösen. Bertelsmann. Freud, S, (1913): Totem und tabu. Göncöl Kiadó, Budapest. Herman, Judith (2003): Trauma and Recorvery; Trauma és gyógyulás - az erőszak hatása a családon belüli bántalmazástól a politikai terrorig. Háttér Kiadó -Kávé Kiadó-Nane Egyesület, Budapest. Hirsch, Mathias (1990): Realer inzest Psychodynamik des sexuelle Missbrauchs in der Familie. Springer-Verlag Berlin Heidelberg. Jones, Elsa (1991): Working with Adult Survivors of Child Sexual Abuse. Karnac Books, London New York. Tóth, Borbála – Horváth, József (1996): Palócföldi Párhuzamok. Pszichoterápia V. évfolyam 3. szám 187-190.o. Tóth, Borbála (1999): A szexuális zaklatás mint a fiatalok bántalmazásának egyik formája. Pszichoterápia VIII. évfolyam 1. szám 35-42.o. Tóth, Borbála (2006): Családfánk-sorsunk rejtett mintázata. Kairosz Kiadó, Budapest Translated by Mónika Dénes Painting:Orazio Fidani: (1606-1656) Lot and his daughters, Museum of Fine Arts, Budapest www.tothborbala.hu