Wednesday, February 16, 2011

New Memoir on Healing from Abuse

"People don’t make up things like that for fun."

That’s what Jane’s therapist tells her when Jane reports fragmentary memories from her childhood that hint at sexual abuse. A busy, successful scientist, Jane at first fights the implications, but finally has to admit that something indeed happened. With help from a gifted therapist as well as creative arts, Jane taps into her own aliveness and reconciles with both her parents’ love and their betrayal.

This deeply personal memoir, The River of Forgetting, invites the reader behind the closed doors of the therapist’s office and into the author’s journal and her very body. Jane’s tender story shows how we can use the challenges of painful childhood traumas to transform our lives.

A powerful and sensitive portrayal, full of insight into Jane’s own confusion as well as her family’s bewildering dynamics. The writing is by turns lyrical and gut-wrenching, angry and tender. This inspiring, important book shows that healing and joy are possible after childhood abuse.
—Marilyn Van Derbur, author of the bestselling Miss America By Day

A brave and inspirational book. Jane Rowan has made an important contribution to our understanding of child sexual abuse and healing, affirming that we can transform trauma into lives filled with peace and joy.
—Ellen Bass, co-author of bestseller The Courage to Heal

With astonishing bravery and eloquent voice, Jane Rowan explores what it is to be haunted by memories of childhood abuse so long and so deeply buried that you must fight to believe them true. Her work honors scars long hidden and offers hope for healing. Her book is a gift that dares to render clarity from childhood chaos.
—Martin Moran, author of The Tricky Part
Order The River of Forgetting through the website or Amazon (Kindle available).

Monday, April 20, 2009

Child Abuse and Neglect

Child Abuse and Neglect


Child Abuse

In the USA, an estimated 906,000 children are victims of abuse & neglect every year, making child abuse as common as it is shocking. Whether the abuse is physical, emotional, sexual, or neglect, the scars can be deep and long-lasting, often leading to future child abuse. You can learn the signs and symptoms of child abuse and help break the cycle, finding out where to get help for the children and their caregivers.

Facts about child abuse and neglect How could anyone abuse a defenseless child? Most of us can’t imagine what would make an adult abuse a child. The worse the behavior is, the more unimaginable it seems. Yet sadly, child abuse is much more common then you might think. Child abuse cuts across social classes and all ethnicities. And the abuse overwhelmingly is at the hands of those who are supposed to be protecting the child- the parents.

What is child abuse?

Child abuse happens in many different ways, but the result is the same- serious physical or emotional harm. Physical or sexual abuse may be the most striking types of abuse, since they often unfortunately leave physical evidence behind. However, emotional abuse and neglect are serious types of child abuse that are often more subtle and difficult to spot. Child neglect is the most common type of child abuse.

How can child abuse happen?

There are many complicated factors that lead to child abuse. Risk factors for child abuse include:

  • History of child abuse. Unfortunately, the patterns we learn in childhood are often what we use as parents. Without treatment and insight, sadly, the cycle of child abuse often continues.
  • Stress and lack of support. Parenting can be a very time intensive, difficult job. Parents caring for children without support from family, friends or the community can be under a lot of stress. Teen parents often struggle with the maturity and patience needed to be a parent. Caring for a child with a disability, special needs or difficult behaviors is also a challenge. Caregivers who are under financial or relationship stress are at risk as well.
  • Alcohol or drug abuse. Alcohol and drug abuse lead to serious lapses in judgment. They can interfere with impulse control making emotional and physical abuse more likely. Due to impairment caused by being intoxicated, alcohol and drug abuse frequently lead to child neglect
  • Domestic violence. Witnessing domestic violence in the home, as well as the chaos and instability that is the result, is emotional abuse to a child. Frequently domestic violence will escalate to physical violence against the child as well.

The lasting effects of child abuse

All types of child abuse and neglect leave lasting scars. Some of these scars might be physical, but emotional scarring has long lasting effects throughout life, damaging a child’s sense of self and ability to have healthy relationships.

You can make a difference

One of the most painful effects of child abuse is its tendency to repeat itself. One of every three abused or neglected children will grow up to become an abusive parent. You may be reluctant to interfere in someone’s family, but you can make a huge difference in a child’s life if you do. The earlier abused children get help, the greater chance they have to heal from their abuse and not perpetuate the cycle.

Physical child abuse: Warning signs and how to help

Many physically abusive parents and caregivers insist that their actions are simply forms of discipline, ways to make children learn to behave. But there’s a big difference between giving an unmanageable child a swat on the backside and twisting the child’s arm until it breaks. Physical abuse can include striking a child with the hand, fist, or foot or with an object, burning, shaking, pushing, or throwing a child; pinching or biting the child, pulling a child by the hair or cutting off a child’s air. Another form of child abuse involving babies is shaken baby syndrome, in which a frustrated caregiver shakes a baby roughly to make the baby stop crying, causing brain damage that often leads to severe neurological problems and even death.

Warning signs of physical abuse

Physical signs. Sometimes physical abuse has clear warning signs, such as unexplained bruises, welts, or cuts. While all children will take a tumble now and then, look for age-inappropriate injuries, injuries that appear to have a pattern such as marks from a hand or belt, or a pattern of severe injuries.

Behavioral signs. Other times, signs of physical abuse may be more subtle. The child may be fearful, shy away from touch or appear to be afraid to go home. A child’s clothing may be inappropriate for the weather, such as heavy, long sleeved pants and shirts on hot days.

Caregiver signs. Physically abusive caregivers may display anger management issues and excessive need for control. Their explanation of the injury might not ring true, or may be different from an older child’s description of the injury.

Emotional child abuse

“Sticks and stones may break my bones but words will never hurt me”. This old saying could not be farther from the truth. Emotional child abuse may seem invisible. However, because emotional child abuse involves behavior that interferes with a child’s mental health or social development, the effects can be extremely damaging and may even leave deeper lifelong psychological scars than physical abuse.

Emotional child abuse takes many forms, in words and in actions.

Words. Examples of how words can hurt include constant belittling, shaming, and humiliating a child, calling names and making negative comparisons to others, or constantly telling a child he or she is “no good," "worthless," "bad," or "a mistake." How the words are spoken can be terrifying to a child as well, such as yelling, threatening, or bullying.

Actions. Basic food and shelter may be provided, but withholding love and affection can have devastating effects on a child. Examples include ignoring or rejecting a child, giving him or her the silent treatment. Another strong component of emotional abuse is exposing the child to inappropriate situations or behavior. Especially damaging is witnessing acts that cause a feeling of helplessness and horror, such as in domestic violence or watching another sibling or pet be abused.

Signs of emotional child abuse

Behavioral signs. Since emotional child abuse does not leave concrete marks, the effects may be harder to detect. Is the child excessively shy, fearful or afraid of doing something wrong? Behavioral extremes may also be a clue. A child may be constantly trying to parent other children for example, or on the opposite side exhibit antisocial behavior such as uncontrolled aggression. Look for inappropriate age behaviors as well, such as an older child exhibiting behaviors more commonly found in younger children.

Caregiver signs. Does a caregiver seem unusually harsh and critical of a child, belittling and shaming him or her in front of others? Has the caregiver shown anger or issues with control in other areas? A caregiver may also seem strangely unconcerned with a child’s welfare or performance. Keep in mind that there might not be immediate caregiver signs. Tragically, many emotionally abusive caregivers can present a kind outside face to the world, making the abuse of the child all the more confusing and scary.

Sexual child abuse

Sexual abuse, defined as any sexual act between an adult and a child, has components of both physical and emotional abuse. Sexual abuse can be physical, such as inappropriate fondling, touching and actual sexual penetration. It can also be emotionally abusive, as in cases where a child is forced to undress or exposing a child to adult sexuality. Aside from the physical damage that sexual abuse can cause, the emotional component is powerful and far reaching. The layer of shame that accompanies sexual abuse makes the behavior doubly traumatizing. While news stories of sexual predators are scary, what is even more frightening is that the adult who sexually abuses a child or adolescent is usually someone the child knows and is supposed to trust: a relative, childcare provider, family friend, neighbor, teacher, coach, or clergy member. Children may worry that others won’t believe them and will be angry with them if they tell. They may believe that the abuse is their fault, and the shame is devastating and can cause lifelong effects.

Signs of sexual child abuse

  • Behavioral signs. Does the child display knowledge or interest in sexual acts inappropriate to his or her age, or even seductive behavior? A child might appear to avoid another person, or display unusual behavior- either being very aggressive or very passive. Older children might resort to destructive behaviors to take away the pain, such as alcohol or drug abuse, self-mutilation, or suicide attempts.
  • Physical signs. A child may have trouble sitting or standing, or have stained, bloody or torn underclothes. Swelling, bruises, or bleeding in the genital area is a red flag. An STD or pregnancy, especially under the age of 14, is a strong cause of concern.
  • Caregiver signs. The caregiver may seem to be unusually controlling and protective of the child, limiting contact with other children and adults. Again, as with other types of abuse, sometimes the caregiver does not give outward signs of concern. This does not mean the child is lying or exaggerating.

Child neglect

Child neglect is the most frequent form of child abuse. Neglect is a pattern of failing to provide for a child's basic needs, endangering a child’s physical and psychological well-being. Child neglect is not always deliberate. Sometimes, a caregiver becomes physically or mentally unable to care for a child, such as in untreated depression or anxiety. Other times, alcohol or drug abuse may seriously impair judgment and the ability to keep a child safe. The end result, however, is a child who is not getting their physical and/or emotional needs met.

Warning signs of child neglect

  • Physical signs. A child may consistently be dressed inappropriately for the weather, or have ill-fitting, dirty clothes and shoes. They might appear to have consistently bad hygiene, like appearing very dirty, matted and unwashed hair, or noticeable body odor. Another warning sign is untreated illnesses and physical injuries.
  • Behavioral signs. Does the child seem to be unsupervised? Schoolchildren may be frequently late or tardy. The child might show troublesome, disruptive behavior or be withdrawn and passive.
  • Caregiver signs. Does the caregiver have problems with drugs or alcohol? While most of us have a little clutter in the home, is the caregiver’s home filthy and unsanitary? Is there adequate food in the house? A caregiver might also show reckless disregard for the child’s safety, letting older children play unsupervised or leaving a baby unattended. A caregiver might refuse or delay necessary health care for the child.

What to do if a child reports abuse

You may feel overwhelmed and confused if a child begins talking to you about abuse. It is a difficult subject and hard to accept, and you might not know what to say. The best help you can provide is calm, unconditional support and reassurance. Let your actions speak for you if you are having trouble finding the words. Remember that it is a tremendous act of courage for children to come forward about abuse. They might have been told specifically not to tell, and may even feel that the abuse is normal. They might feel they are to blame for the abuse. The child is looking to you to provide support and help- don’t let him or her down.

Avoid denial and remain calm. A common reaction to news as unpleasant and shocking as child abuse is denial. However, if you display denial to a child, or show shock or disgust at what they are saying, the child may be afraid to continue and will shut down. As hard as it may be, remain as calm and reassuring as you can.

Don’t interrogate. Let the child explain to you in his/her own words what happened, but don’t interrogate the child or ask leading questions. This may confuse and fluster the child and make it harder for them to continue their story.

Reassure the child that they did nothing wrong. It takes a lot for a child to come forward about abuse. Reassure him or her that you take what is said seriously, and that it is not the child’s fault.

Reporting child abuse and neglect

Reporting child abuse seems so official. Many people are reluctant to get involved in other families’ lives. However, by reporting, you can make a tremendous difference in the life of a child and the child’s family, especially if you help stop the abuse early. Early identification and treatment can help mitigate the long-term effects of abuse. If the abuse is stopped and the child receives competent treatment, the abused child can begin to regain a sense of self-confidence and trust. Some parents may also benefit from support, parent training and anger management.

Reporting child abuse: Myths and Facts

  • I don’t want to interfere in some one else’s family. The effects of child abuse are lifelong, affecting future relationships, self esteem, and sadly putting even more children at risk of abuse as the cycle continues. Help break the cycle of child abuse.
  • What if I break up someone’s home? The priority in child protective services is keeping children in the home. A child abuse report does not mean a child is automatically removed from the home - unless the child is clearly in danger. Support such as parenting classes, anger management or other resources may be offered first to parents if safe for the child.
  • They will know it was me who called. Reporting is anonymousIn most states, you do not have to give your name when you report child abuse. The child abuser cannot find out who made the report of child abuse.
  • It won’t make a difference what I have to say. If you have a gut feeling that something is wrong, it is better to be safe than sorry. Even if you don’t see the whole picture, others may have noticed as well, and a pattern can help identify child abuse that might have otherwise slipped through the cracks.

Child Abuse Hotlines: Where to call to get help or report abuse

Child abuse prevention

Reducing the incidence of child abuse is a matter of intervention and education.


In some cases, as in cases of extreme cruelty, sexual abuse, and severe alcohol and drug abuse, children are safer away from the caregiver. Not all abusive parents intend harm to their children, however. Some parents need help to realize that they are hurting their children, and can work on their problems. Some examples include:

  • Domestic violence. A mother might be trying to do her best to protect her children from an abusive husband, not realizing that the children are being emotionally abused even if they are not physically abused. Helping a mother leave an abusive relationship and getting supportive counseling can help stop these children from being abused.
  • Alcohol and drug abuse. Alcohol and drug abusers may be so focused on their addiction that they are hurting their children without realizing it. Getting appropriate help and support for alcohol and drug abuse can help parents focus back on their children.
  • Untreated mental illness. A depressed mother might not be able to respond to her own needs much less her children’s. A caregiver suffering from emotional trauma may be distant and withdrawn from her children, or quick to anger without understanding why. Treatment for the caregiver means better care for the children.

In some cases, you might be able to provide support for parents/caregivers who need help yourself. What if a parent or caregiver comes to you? The key is not to be self-righteous or judgmental, which can alienate caregivers, but offer support and concrete offers of help, such as helping them connect with community resources. If you feel that your safety or the safety of the child would be threatened if you try to intervene, leave it to the professionals. You may be able to provide more support later after the initial professional intervention.


Some caregivers have not learned the skills necessary for good parenting. Teen parents, for example, might have unrealistic expectations about how much care babies need or why toddlers can be so prone to tantrums. Other times, previous societal and cultural expectations of good child raising may not be considered so today. In previous generations and in many cultures, for example, strict physical discipline was considered to be essential in teaching a child to behave. Education can greatly help caregivers who need information on raising children. Parenting classes can not only be effective for teen parents, but for parents who themselves were abused and need to learn new parenting patterns. Education on managing stress and building healthier relationships also helps caregivers.

Children need education as well to help protect against abuse. They need to know that abuse is never their fault and is never “OK”. Teaching a child about inappropriate touch and that they should never keep secrets that make them uncomfortable can help prevent sexual abuse.

For caregivers

Do you see yourself in some of these descriptions, painful as it may be? Do you feel angry and frustrated and don’t know where to turn? Caring for children can be very difficult. Don’t go it alone. Ask for help if you need it. If you don’t have a friend or family to turn to, call the child abuse hotline, 1-800-4-A-CHILD, yourself. The hotline is also designed to get you support and find resources in the community that can help you.

Related links for child abuse and neglect

General information about child abuse and neglect

Child Abuse Learning Center – The nonprofit that runs the National Abuse Hotline® has a multipage site offering statistics and succinct lists and descriptions of different types of child abuse and their signs and effects, as well as strategies for prevention. (Childhelp)

Child Abuse and Neglect – This site, from a bureau of the U.S. Department of Health and Human Services, provides links to basic information about child abuse and neglect and to many other sites and publications that provide more detailed information and help. (Child Welfare Information Gateway)

Warning signs of child abuse

Recognizing Child Abuse: What Parents Should Know (PDF) – Lists signs and symptoms of child abuse in children and in their parents. Covering physical abuse, emotional maltreatment, neglect, and sexual abuse, this outline is useful for teachers, family friends, and relatives. (Prevent Child Abuse America)

Physical and Behavioral Indicators of Abuse – Clearly laid out in chart form, detailed lists of child abuse and neglect symptoms in several different areas. (The National Children’s Advocacy Center)

Child Abuse - Signs and symptoms – Detailed lists from a British nonprofit, plus insight on listening to children who may be abused and helplines for reporting abuse. Also available in a PDF brochure. (Kidscape)

Physical child abuse

Physical Child Abuse – Reviews the definition of physical abuse and signs of abuse, including shaken baby syndrome (Child Welfare Information Gateway)

Shaken Baby Syndrome – Clear, comprehensive description of what SBS is, how it causes brain damage and death, its signs and symptoms, and strategies for soothing a baby before the caregiver’s frustration mounts. (KidsHealth)

Sexual child abuse

Prevent Child Sexual Abuse: Facts About Those Who Might Commit It (PDF) – Offers warning signs of sexual abuse in children and in their adult abusers, along with tips on how to prevent and stop it. (Stop It Now!)

Understanding Child Sexual Abuse – A clear, objective explanation of the effects of child sexual abuse, the chances of recovery, and strategies for prevention. (American Psychological Association)

Sexual Abuse – Good brief description of what constitutes child sexual abuse, how to spot it, and what to do if your child tells you about it. (American Academy of Pediatrics)

A Parent's Guide to Internet Safety – Scroll down to the subhead “What Are Signs That Your Child Might Be At Risk On-line?” for ways to recognize possible child abuse, particularly sexual abuse, on the Internet and what to do to prevent and resolve it. (Federal Bureau of Investigation)

Emotional child abuse

Emotional Child Abuse – Reviews the definition of emotional abuse and signs of abuse (Child Welfare Information Gateway)

Emotional abuse – See the “Answers to common questions” on this British site for good advice about recognizing and responding to emotional child abuse. (National Society for the Prevention of Cruelty to Children)

Fact Sheet: Emotional child abuse (Prevent Child Abuse America)

Child neglect

Child Neglect: Definition and Scope of Neglect – Article on what constitutes child neglect, how it affects children, what causes it, and how the community can intervene. (Child Welfare Information Gateway)

Neglect – Succinct lists of physical and behavioral indicators suggesting that a child is being neglected. (Coalition for Children)

Effects of child abuse

Long-term Consequences of Child Abuse and Neglect – This government-sponsored site offers details on the physical, psychological, behavioral, and societal effects of child abuse. (Child Welfare Information Gateway)

Reporting and stopping child abuse

Toll-Free Crisis Hotline Numbers (Child Welfare Information Gateway)

Talking about abuse Discusses what to do if either a child or a caregiver approaches you about abuse. (NSPCC)

Reporting Child Abuse – Guidance on how to find out what your responsibilities are and where to get more information. (Darkness to Light)

Preventing child abuse

Talking to a child about abuse Helps parents teach children how to protect themselves against abuse, including learning about touch, and that they should never keep secrets. (Childhelp)

Talking to kids about child sexual abuse Discusses concrete tips on how to protect children against abuse, including talking to family members and avoiding tricks. (Stop it Now)

Prevention Tips for Parents – This page carries links to PDF articles and fact sheets that together provide a good overview of how to protect children from abuse. (Prevent Child Abuse America)

How to Stop Child Abuse in a Public Place – Tips for how to respond when you see someone mistreating a child. (Child Abuse Network)

You Have the Power to Prevent Child Abuse and Neglect- Discusses ways to prevent abuse both by education and by strengthening community ties. (Child Welfare Information Gateway)

Joanna Saisan, MSW, Ellen Jaffe-Gill, M.A., and Jeanne Segal, Ph.D., contributed to this article. Last modified in October 08.