Overview
According to the NSPCC, child abuse (CA) takes many forms, ranging from emotional, sexual, physical abuse, grooming and stalking. It can happen in-person and happens increasingly online (NSPCC, 2021.) It also includes a lack of love, attention or care – this form of abuse is called neglect. It can be inflicted by any adult, but also from other children or peers. CA can be over a period of time, ranging from a minute to a lifetime, but even a one-off action that causes deliberate harm is abuse. In UK statistics, a victim must be under 16 to classify as CA.
CA is still a widespread problem. Statistics from various sources attest to this fact. The Crime Survey for England and Wales estimates that 1 in 5 adults aged 18 – 74 in England and Wales experienced some form of abuse before being 16 years old, approximately 8.5 million people. This includes 3.1 million people who experienced sexual abuse before being 16; this includes both adult and child perpetrators (Elkin, 2020.) According to the Office for National Statistics, in the year from March 2018 to March 2019, ~227,500 cases of CA offences were recorded by the police. Only 1 in 25 (4%) of these recorded offences resulted in a charge or summons. However, approximately 4 out of 5 (79%) of those charged or summoned to court were successfully convicted by the Crown Prosecution Service.
Ghislane Maxwell on trial.
(The Times, n.d.)
The effects of CA are often very deep and long lasting. In her eye-opening literature review, Kendall-Tackett (2002) points out victims of CA as adults are more likely than control populations to:
Abuse alcohol and drugs (Felitti et al., 2001.)
Become morbidly obese (Felitti et al., 2001.)
Engage in high-risk sexual behaviour: this includes underage sex, teen pregnancy, multiple partners and unprotected sex (Fergusson et al., 1997.) Interestingly, this behaviour particularly correlates with victims of sexual abuse.
Reject friendly behaviour and overtures i.e., overestimate how dangerous other people are (Gauthier et al., 1996.)
Suffer from clinical depression and post-traumatic stress disorder (Gladstone et al., 1999.)
Most strikingly, victims of CA are 4 times more likely to experience abuse as an adult. Over half of adults (52%) who experienced abuse before being 16 also experienced domestic abuse later in life, compared with just 13% of those who did not experience abuse before being 16 (Elkin, 2020.)
Another reason CA can linger for a long time is it tends to be subtle and hidden from view. Victims often do not fully realise what is happening for a long time before anything is done. A particularly dramatic example of this is the Rochdale child sex abuse ring (Carter, 2012.) Victims were often bribed, coerced and gaslighted into staying quiet about their treatment e.g., what they were experiencing was normal behaviour between men and ‘women.’ It is much harder to escape from an abusive scenario than is often assumed.
Power imbalances can be more subtle than assumed. In the Rochdale sex abuse ring, 'soft power' was used to coerce victims into staying quiet.
(BBC, 2017.)
Life is often fraught with difficulty, strife and setbacks, especially for a CA victim. This is why resilience is so crucial to wellbeing. But what is resilience? Is it inherent or can it be learned? And how could we foster resilience in CA victims?
Literature Review
Resilience is not easy to define or explain, because there are many factors that contribute to or undermine a person’s resilience. We will deconstruct what resilience is, how it can be fostered and how it can help people, specifically CA victims.
What is resilience?
Resilience was a term originally used in epidemiology; it describes what factors help people live with and recover from diseases. The term was first used in psychology by researcher Emmy Werner in 1971. She conducted a 40 yearlong cohort study on impoverished children from Kauai, Hawaii. Her participants were from an economically poor part of Hawaii, and many of them had experienced an unfortunate family life. Their parents were drug abusers, alcoholic, unemployed and/or mentally ill, or a combination of these (Werner et al., 1971.) Out of this sample of children, 2/3 exhibited ‘destructive’ behaviour in their adolescence and early adulthood, including drug abuse, alcoholism, unemployment and out-of-wedlock children. However, 1/3 of the sample did not exhibit any of this behaviour. Werner dubbed this sub-sample ‘resilient.’ People in this sub-sample were less swayed by their circumstances and embodied traits that allowed them to better adapt and live more successfully than their peers.
According to the American Psychological Association, resilience is the process of successfully adapting to difficult and challenging life experiences, through mental, emotional and behavioural flexibility as well as adjusting to external and internal demands (APA, 2022.) Another terse definition of resilience is the ability to positively adapt to a stressful or adverse situation (Hopf, 2010.) Note that it is the ability to adapt, not to be immune to or insensitive to adversity. In a nutshell, it seems resilience is the ability to bounce back, no matter what a person experiences (in this case CA.)
Resilience is not developed by avoiding life's problems: it is developed by accepting and adapting to them.
(Friedrich, 1818)
How can resilience be fostered?
The literature on what constitutes resilience is wide-ranging, vast and insightful. However, some traits seem to be particularly helpful to victims of CA. This is based on two comprehensive literature reviews that point to many different methods of fostering resilience in CA victims (Domhardt et al., 2014; Sanjeevi et al., 2018.) See below for ideas researchers posit:
Reappraisal
It seems Marcus Aurelius, the Roman emperor and philosopher was right when he said, “Our lives are what our thoughts make it.” (Aurelius, 2022) Himelein & McElrath (1996) found that ‘reappraisal’ i.e., re-wording one’s experience, had a significant impact. Positive reframing was another helpful method of cognitive therapy. Another significant cognitive shift that helped child sex abuse (CSA) victims was refusing to dwell upon the abuse they experienced. The researchers also emphasised the importance of disclosing and discussing the abuse with others, a factor that will be touched upon later.
Knowing thyself
Himelein and McElrath also emphasised the importance of developing emotional intelligence i.e., to become more in touch with what one feels, how to react to it and how to manage intense emotions, even use them towards one’s goals. They dubbed it ‘becoming more strategic’ towards oneself.
Future-orientation instead of past-orientation
(Edmond et al., 2006) found orienting a CA victim’s away from past events and towards the future, no matter how frightening it could be, was a helpful coping strategy. They argued this was because it increased the patient’s internal locus of control, a concept that has lots of literature explaining its importance.
An internal locus of control
This is a prevalent concept in psychology. Put simply, a person who has an external locus of control believes external forces shape their circumstances; someone with an internal locus of control believes they are in control, and that they shape their own circumstances. Researchers found a strong correlation between a CA victim’s locus of control and their resilience to negative mental health outcomes in adulthood that are associated with CA (Valentine & Feinauer, 1993; Walsh et al., 2007.) It is worth noting that there is a lack of comprehensive, broad-based literature reviews on what personality traits are conducive to developing an internal locus of control over a more external one. Even if researchers do not fully understand how locus of control develops in an individual, they do know it fosters resilience in CA victims.
(Verywell Mind, 2021)
Blaming the culprit, not yourself
Adapting one’s mindset over time throughout adulthood helps too. (Feinauer & Stuart, 1996; Valentine & Feinauer, 1993) showed that more resilient adults learned to shift blame from themselves to their abusers over time. They argued this was a sign of healthy adaptation. This is in contrast with CA victims who remain attached to trauma-based emotions and thoughts, including self-blame, self-stigmatisation, betrayal, and powerlessness. These traits negatively correlated with resilience (Breno & Galupo, 2007.)
There is some tension between blaming the culprit and developing an internal locus of control. After all, what can you do if your suffering is not your fault? Is blaming someone else going to make things better? Valentine & Feinauer (1993) noted that shifting blame onto the perpetrator’s shoulders takes a weight off the CA victim’s shoulders. It is also worth remembering that developing an internal locus of control is more about adaptability than fortune. Fortune can change at any time, but adaptability is a trait that stays. To paraphrase Darwin, it is not the strongest of the species that survives, nor the most intelligent; it is the one that is most adaptable to change.
Religion, faith, and by extension culture
A cross-sectional showed that teenage girls who were more religious/spiritual were better able to cope with their abuse than their non-religious peers. The researchers dubbed religiousity and spirituality as ‘protective’ factors against CSA (Chandy et al., 1996a; Chandy, Blum, & Resnick, 1996b). Tarakeshwar’s et al. (2006) research model included religiosity as a dimension of their resiliency model. They found religiosity was a factor in promoting resilience in adults who experienced CSA and had tested HIV positive. In Sanjeevi’s et al. (2018) literature review which includes this study, they argue that this finding is particularly striking because it demonstrated just how powerful social support can be. They stated that social support is by far the best supported protective factor for CA victims. It is not too much of a stretch to argue that someone who genuinely believes in a higher power has a wider support network than a non-believer. Whether God, angels, demons, spirits, nirvana, etc. exist or not is not relevant. What is relevant is the effect a person’s belief has, as Tarakeshwar’s et al. empirical study shows.
Perhaps it is easier to accept suffering when there is more to life than meets the eye...
Family
CA victims who are fortunate enough to have at least one nurturing parent exhibit far more resilience than CA victims who lack a parental figure. Support from a father seems to particularly help pre-pubescent, female CSA victims (Daignault & Hebert, 2009.) In adolescents, parental support from a mother, father or both parents fosters better mental health outcomes (Feiring et al., 1998; Spaccarelli & Kim, 1995.) Blood relations are not the only source of support though: a protective factor for CA is to have a caregiver in one’s life. This effect is particularly pronounced amongst teenagers (Rosenthal et al., 2003; Williams & Nelson-Gardell, 2012.)
Parental figures are not the only family members who matter. Support from siblings, spouses and extended family all appear to have a noticeable impact (Banyard & Williams, 2007; Banyard, Williams, & Siegel, 2002.) Interestingly, adult CA victims who behave paternally towards their own children seem to cope better with their past than adult CA victims who do not have children (Katerndahl et al., 2005.) This is counterevidence against the prevailing finding that CA victims who have children often abuse them (Price-Robertson, 2012.) More research is needed to find out exactly how, when and why some adult CA victims behave paternally, yet others abusively.
Good schools
If a CA victim attends a school with good people, it can be a lifeline. It seems that school can be a regular escape for CA victims. After all, most abuse takes place privately behind closed doors, in contrast with school which is a more public environment. As mentioned in the ‘reappraisal’ section, talking to others about CA is enormously beneficial to a victim (Himelein & McElrath, 1996.) Being an active member of a school community correlated with more resilient outcomes in teenagers (Pharris, Resnick, & Blum, 1997.) The researchers implicitly argued that being an active member of a school community can make a CA victim’s life fuller, thereby make the victim’s abuse feel smaller. Williams & Nelson-Gardell (2012) showed that being academically engaged at school fostered more resilient outcomes in CA victims than academically disengaged CA victims. Furthermore, doing well at school/college/university seems to foster more resilience in adult CA victims than adult victims who did not graduate from their education (Hyman & Williams, 2001.) An educational environment can also be useful because there are ‘alternative’ parent figures. Female CA victims who found teachers, caretakers and support workers who showed a caring attitude towards them became more resilient than they were before attending school (Chandy et al., 1996.)
Friends, peers and community
CA victims can also make friends at school. Some victims find it easier to confide with a peer than an adult. Those who choose to confide with peers demonstrate more resilience than those who do not (Edmond et al., 2006.) The quality of a victim’s friendships matter too. Interpersonal trust, assessed by the Children’s Attributions and Perceptions Scale (Mannarino, Cohen and Berman, 1994), was a protective factor against developing psychopathologies later in life (Daigneault et al., 2007.) Interestingly, adolescents with tribal leaders seemed to be more resilient than their abused peers (Pharris et al., 1997.) This finding ties in very nicely with the religious and cultural factors mentioned earlier. It is also an eye-opening discovery since most modern Western cultures lack small-scale, tribal structures. To summarise the above 3 sections, it seems the more people a CA victim comes across, the more likely they are to find someone who can help.
A friend in need is a friend indeed.
(Afremov, n.d.)
With all these different findings in mind, how could this information help foster resilience in a CA victim?
Advice for Intervention
It is critical to keep in mind that the factors mentioned in the literature review and in this section overlap and intermingle with one another. For example, religion often has a social aspect to it, which intermingles with social support structures, schools, community and cultural factors. Another example is by focusing on cognitive factors, such as reappraisal, future-orientation, meditation etc., then opening up to others becomes more likely, which is a social factor since the victim is interacting with others (Verni, 2015.) In other words, if a victim focuses on developing one aspect of their life, then it becomes more likely that other positive factors will influence their recovery too. We recommend a multi-faceted intervention for CA victims, with a focus on making the victim more resilient and more self-reliant over time.
Psychotherapy, particularly Cognitive Behavioural Therapy (CBT)
CBT can be very helpful for CA victims. CBT’s problem-addressing and problem-solving nature could help a victim come to terms with their abuse directly. Since CBT also focuses on using techniques to manage thoughts and behaviours (and by doing so emotions,) it promotes resilience and self-reliance. Some of the techniques that research points to as being particularly helpful include reappraisal, bridge statements, meditation, future-orientation and developing an internal locus of control (Valentine & Feinauer, 1993; Edmond et al., 2006; Walsh et al., 2007.) Therapy should ideally focus on the client’s needs and experiences, which is why we are not against other forms of psychotherapy. However, one should be careful that other supplementary therapies do not interfere with one another, or with CBT.
Talk to someone, anyone, whoever will listen
Talking to someone earnestly and being listened to makes a big difference neurologically (Peters, 2020.) It does not even matter much who a victim talks to, whether they are a licenced psychotherapist, a school janitor or a distant friend. It is breaking one’s silence and being heard that matters, which is why we encourage:
Strengthening ties with others
Research points to how critical others are in fostering resilience in CA victims. We recommend strengthening ties with anybody who does not contribute to the abuse. This could range from siblings, extended family, neighbours, friends, classmates, teachers, school staff, clergy or tribal leaders (Banyard & Williams, 2007; Banyard, Williams, & Siegel, 2002; Daigneault et al., 2007; Pharris et al., 1997.) The more social ties a victim has, the more options they will have to reveal, offload and process their abuse.
Becoming part of any community
We would also encourage a CA victim to become part of communities in their life, wherever appropriate. There is a large social aspect to recovery and resilience. Interacting with local neighbours, residents, participating in cultural activities and observations where relevant e.g., celebrating Easter (Tarakeshwar et al., 2006.) Joining clubs that interest the victim are shown to be beneficial too (Pharris et al., 1997.) We would also include school and religiosity as beneficial community-based factors (Pharris, Resnick, & Blum, 1997; Chandy et al., 1996a; Chandy, Blum, & Resnick, 1996b.)
Knowing how to spot the signs
We advocate for people to be educated on signs of abuse in children. Abuse is often subtle, behind closed doors and not all that easy to spot. We think this could be integrated into current education curriculums, part of psychology courses or part of wellbeing education. Sometimes, asking someone if they are okay at the right time can save their life. It is particularly important to enlighten school workers on signs of neglect or abuse in children and teenagers. A good school environment can be a life raft for CA victims (Pharris, Resnick, & Blum, 1997; Williams & Nelson-Gardell, 2012.)
One subtle sign of abuse is when a child is excessively private about their family life.
(Dali, 1925)
Knowing thyself
Introspection, observing yourself, becoming mindful and being in touch with yourself is useful for a CA victim. Our prior interventions of psychotherapy and high-quality social relationships will help with this journey. It helps the victim learn more from their past, use this knowledge to their advantage, as well as shifting the onus onto the perpetrator’s shoulders, thereby lifting the weight off the victim’s shoulders (Feinauer & Stuart, 1996; Valentine & Feinauer, 1993; Breno & Galupo, 2007.)
We also advocate that anybody, CA victim or not, learns to become more aware of themselves. Understanding what makes you tick can make it easier and quicker to notice when abuse is happening, whether you are experiencing, inflicting or observing it. Preventing abuse from ever happening in the first place by watching yourself carefully seems to be a good idea. Prevention is often the best cure.
Brief Resilience Scale (BRS) measurements
Last but not least, we would recommend using BRS to monitor a CA victim’s progress (or lack thereof.) Smith’s et al. (2008) scale would be particularly suitable for use with young people. Since the BRS is short and brief, it would likely not daunt or bore a young victim too much. It could also help therapists, caregivers, parents etc. monitor the victim’s progress. Also, since the BRS has scientific weight behind it, this information could also feed into psychometric research on CA (Windle et al., 2011; Amat et al., 2014.)
We hope this report provides you with some ideas.
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