Child Survivors and Perpetrators of Sexual Abuse: Treatment Innovations

195 Pages·1995·10.14 MB·English

by  Michael G. Hunter

Child

Survivors

and

Perpetrators

of

Sexual

Abuse
This book is dedicated to my Grandma, Pauline LaFollette, and
the first Dr. Hunter, William Frank, for showing me that authors
are everyday people and to Norma Hunter forensuring that Ihad
a childhood filled with books.
Child

Survivors

and

Perpetrators

of

Sexual

Abuse

Treatment Innovations

Mic Hunter

EDITOR
SAGE Publications
InternationalE ducational and Professional Publisher
Thousand Oaks London New Delhi
Copyright 0 1995 by Sage Publications, Inc.
All rights reserved. No part of this book may be reproduced or utilized in any
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For information address:
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Printed in the United States of America
Library of Congress Cataloging-in-Publication Data
Main entry under title:
Child survivors and perpetrators of sexual abuse :Treatment
innovations I edited by Mic Hunter.
p. cm.
Includes bibliographical references and index.
ISBN 0-8039-7194-X (acid-free paper).-ISBN 0-8039-7 195-8 (pbk:
acid-free paper)
1. Sexually abused children-Mental health-Congresses.
2. Sexually abused children-Rehabilitation-Congresses. 3. Teenage
sex offenders-Mental health-Congresses. 4. Teenage sex offenders-
Rehabilitation-Congresses. 5. Child sexual abuse-Treatment-
Congresses. I. Hunter, Mic.
RJ507.S49C48 1995
6 18 .92’ 85836-dc20 94-42211
This book is printed on acid-free paper.
95 96 97 98 99 10 9 8 7 6 5 4 3 2
Sage Production Editor: Tricia K. Bennett
Contents

Foreword vii
Part One:Child Survivors
1. Managing Disorders of Self-Regulation
in Sexually Abused Boys 3
WilliamN. Friedrich
2. Inpatient Treatment of Adolescent
Survivors of Sexual Abuse 24
Sally Cantor
3. Ritual Abuse: Traumas and Treatment 50
Gayle M. Stroh
Part Two:Child Perpetrators
4.Sexually Aggressive Children
andSocietal Response 79
Hendrika B. Cantwell
5. When the Offender Is a Child: Identifying and
Responding to Juvenile Sexual Abuse Offenders 108
Jacqueline Jackson Kikuchi
6. Monster Therapy: The Use of a Metaphor in
Psychotherapy With Abuse Reactive Children 125
Sandra Ballester and Frederique Pierre
7. Parallel Treatment of Parents of

Abuse Reactive Children 147

Diane R. Griggs and Amzond Boldi

References 166

Index 174

About the Editor 180

About the Contributors 182
Foreword
There is no more valuable resource to a society than
children. Yet even the most conservative estimates sug-
gest that the sexual abuse of children is all too common in the United
States. As you read these words, there is a debate raging in both
professional and public publications as to the validity of memories
related to childhood sexual abuse. No doubt the debate will continue
for years, even as children continue to be abused. Regardless of one's
beliefs concerning the formation and recall of memories, there are
several points on which most people can agree: There are children and
adolescents who have been sexually maltreated, these children ought
to receive treatment, and such treatment ought to be provided in an
effective and efficient manner. As you will see, the contributors to this
volume are dedicated to providing such treatment.
Although sexual abuse of children has existed since time immemo-
rial, the serious study of the incidence and impact of such behavior has
a very short history. Only 40 years ago, Weinberg's (1955)book, Incest
Behavior, reported that incest took place in no more than one or two
families per million. Unfortunately, we now know that sexual abuse is
all too widespread. As we have opened our eyes to the suffering that
results from sexual abuse, our simplistic views of what constitutes
maltreatment and who perpetrates these acts have been shattered. We
now know that much sexual abuse takes place in the home, that both
men and women abuse children, and that children abuse other children.
Just when we think that we have seen all there is to see, we gain a new,
painful awareness.
vii
viii Child Abuse Survivors and Perpetrators
This book will challenge many readers’ concepts of the labels ”vic-
tim” and “perpetrator.” In doing so, it will cause discomfort, perhaps
even anger. However, I believe that it will also lead to increased com-
passion for those who have responded to their own abusive pasts by
repeating the pattern. Whenever I think about the labels ”perpetrator”
and “sex offender,” I am reminded of a story told to me by a wise old
man. He said that he had been present at a war crimes trial. A Jewish
man who had been held in a death camp was led into the room to testify
against a Nazi guard charged with killing the Jew’s family and forcing
him to put their still-warm bodies in the ovens to be burned. As the
Jew’s and Nazi’s eyes met for the first time since the horrifying event,
the Jewish man fell to the floor, thrashing and crying. The judge called
for arecess sothat the witness could compose himself prior to testifying.
When the court was reseated, the prosecuting attorney spoke gently to
the witness: ”I’m sure this is very difficult for you. I imagine that you
were overcome with hatred when you saw this monster before you,“
pointing at the accused Nazi. ”No,” responded the witness, ”I expected
to see a monster and to be filled with hatred. Instead I saw a man, just
another person. And I was overwhelmed with the knowledge that if
another human could do what he did,that I too could be capable of such
acts, and it was more than I could stand to know about myself.”
Part One, Child Survivors, begins with William Friedrich’s chapter on
the difficult but vital task of facilitating emotional regulation and
impulse control inchildren who have been sexually abused. He not only
provides a sound theoretical base for his treatment, but also provides
the reader with practical treatment recommendations.
Unfortunately, not all those who experience sexual abuse have the
opportunity to obtain treatment while they are children. Many do not
become identified until they reach adolescence. Sally Cantor contrib-
utes a chapter on the specialized treatment of adolescents within the
hospital setting. She provides the criteria for determining when inpatient
treatment is appropriate and includes assessment techruques. She details
the treatment process using her patients’ own words to provide exam-
ples of the concepts she is explaining.
The final chapter in this part is contributed by Gayle Stroh. She
focuses on what may be the most horrifying type of sexual maltreat-
ment: ritual abuse. Because she is dealing with a controversial and
emotionally charged topic, she easily could have overwhelmed the
reader with graphic details. However, she is able to present her views
with a detachment that makes the information very assessable to the
Foreword ix
reader, so that the valuable concepts are clear and are not overshad-
owed by the tragic histories of her patients.
Perhaps the most controversial topic within the field of sexual abuse
is sexually aggressive children. Are they to be viewed as offenders or
as victims? How they are labeled will affect how they are treated.
Hendrika Cantwell opens Part Two, ChiZd Perpetrators, by providing a
cultural background for addressing this difficult issue. She invites the
reader to look at our society and its impact on children, rather than
merely focusing on the inappropriate behavior of the children.
Following Dr. Cantwell's overview, Jacqueline Jackson Kikuchi pro-
vides a model for identifying sexually aggressive children. She tackles
the difficult task of defining the differences between normal child and
adolescent sexual behaviors and behavior that ought to be considered
abusive. She does so in a manner that is free of moralizing, a trap that
befalls many authors who attempt this same task.
Once sexually aggressive children have been identified, how are they
to be treated? Sandra Ballester and Frederique Pierre provide a treat-
ment model for working with such youngsters. Their "monster" meta-
phor provides their young patients with a way to assume responsibility
for their emotions and behaviors without also assuming the shame of a
negative label.
The final chapter is provided by their colleagues, Diane Griggs and
Armond Boldi, who describe a model for working with the parents of
these children. Their program shows how the concepts described by Dr.
Cantwell in her opening chapter can be put into practice to provide
effective treatment.
I have been quite impressed by the knowledge and skills of these
contributors. I am most grateful to them for their efforts in creating this
book, as well as their attempts to heal the wounded young people that
surround them. I know you will find what they have written useful in
your clinical work.
Mic Hunter
St. Paul, Minnesota