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Now! NEWS

Spring 2004, Vol. 12, No. 1

The Mind, the Body, and Child Sexual Abuse

The following article by Dr. James Mercy is an invited commentary. Dr. Mercy is Associate Director for Science at the Division of Violence Prevention, U.S. Centers for Disease Control and Prevention. He also serves on the Board of Directors of Stop It Now!.

I’ve always been interested in the profound and mysterious ways that the body and the mind are connected. It seems like we are constantly discovering new ways our emotions and feelings relate to our physical body. Yet even with all we know, I think our culture has a tendency to discount, and even disbelieve, that the ways we’ve learned to think and feel have dramatic implications for our behavior and health. At the same time, the potential influence of genetic and other biological factors seems to be much more readily accepted and influential in terms of how we invest limited resources for treatment and prevention of many different health problems. These observations lead me to wonder if our societal complacency towards the problem of child sexual abuse may be, in part, rooted in our skepticism towards mind-body connections. In the absence of severe physical injury or disease, do we, as a society, subconsciously believe that the consequences of child sexual abuse for its victims can’t really be that bad?

I’m trained as a scientist to be skeptical and to be, at least theoretically, objective. But even a scientific skeptic can’t ignore the accumulating evidence documenting a link between child sexual abuse, the emotions and cognitions of its victims, and their physical health. We are learning that because survivors of sexual abuse often develop depression and anxiety in their lifetimes, and, in turn, risky behaviors or conditions such as smoking, substance abuse, promiscuity, and obesity, they may ultimately also be at greater risk for serious illnesses such as cancer, heart disease, and HIV. The injuries caused by child sexual abuse, therefore, unfold throughout one’s life and may have a substantial impact on, not just the quality of life, but also life expectancy.

We’ve also learned that adult survivors of child sexual abuse use health services far more often than those who have not been abused and that they often present with complaints (e.g., chronic pain and headaches) that are among those most frequently encountered by primary care physicians. I cannot help but wonder: If one out of every five women and one out of every seven men has been sexually abused, what might the full impact of child sexual abuse be on our health care system and on the chronic and infectious diseases that most profoundly affect the health of our nation?

The scientific skeptic in me acknowledges that the evidence concerning these associations is far from complete and, therefore, we need more research. But my heart tells me that we also need to do a better job of forthrightly and clearly communicating how child sexual abuse affects its victims and what it may be costing each and every one of us. My heart and mind also tell me that preventing child sexual abuse is vital. Reaching people before they abuse and before they are abused is one of, if not the most important way, to stop the damaging and costly effects of child sexual abuse. Programs like Stop It Now! and others that focus on prevention must continue to press for change until child sexual abuse is eradicated.

From Questions to Answers

In 1992, when Stop It Now! was founded, we felt strongly that increasing public awareness about sexual abuse was not enough, by itself, to radically change behaviors. Popular strategies such as “Just Say No” oversimplified a complex and emotional family issue, and we set out to broaden the field of prevention to include a public health campaign focused on adults.

Our first goal was to assess what the public understood about child sexual abuse and use that information to look at the barriers to and incentives for preventative action. At that time, no one else in the country had studied the public’s knowledge or awareness of child sexual abuse. Using the tools of public health, experts from around the country helped us design the first telephone survey of the public’s knowledge, attitudes, and beliefs (KAB) surrounding child sexual abuse for our pilot program in Vermont. Then, over the next seven years, our sponsoring agencies in Philadelphia, Minnesota, and Georgia, repeated the survey to collect data in each of those locations and nationally. The results, which are summarized below, were surprisingly consistent with the original findings from Vermont. This data is the foundation from which all of our program work is built.

AWARENESS Over 95 percent of respondents said “Yes” when asked: “Are you familiar with the term child sexual abuse?” We also found that a majority of respondents knew that abusers lived in their communities. However, when asked if they saw child sexual abuse as a problem, there seemed to be significant variations, with a high of 89 percent in Georgia and a low of 49 percent nationally.

TALKING ABOUT CHILD SEXUAL ABUSE Most respondents (>85 percent) were willing to offer some explanation of child sexual abuse. Unfortunately, for many, their explanation was: “Child sexual abuse is the sexual abuse of children.” Even when prompted, they were not able or not willing to give a more detailed explanation such as “touching the private parts of a child.” In our national survey, only 38 percent of respondents demonstrated that they could talk about the issue. In our pilot areas, the number of respondents who could explicitly talk about it was over 60 percent.

IDENTIFYING WARNING SIGNS Over three-quarters of respondents were able to identify at least one warning sign of sexual abuse in a child. This is a tribute to the work of prevention experts who have worked for decades to educate the public about child sexual abuse. However, this number dropped to less than half when respondents were asked for a warning sign or characteristic of someone who has been (or is) an abuser.

KNOWING WHAT TO DO We asked respondents what they would do if they knew someone was sexually abusing a child. In these cases, at least three-quarters of the respondents knew to report the sexual abuse. A significant percentage said they would either talk with the individual or refer him/her to an appropriate agency. We also asked what they would do if they were faced with a situation where they knew someone might be sexually abusing a child, but were not sure. In this case, a third of respondents said they would report the situation. One quarter said they would talk directly to the individual or offer a referral. One quarter said they would not know what to do.
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The results of these surveys are the basis of the program work at Stop It Now!. Because people do not know the warning signs for perpetration, our programs emphasize teaching these signs. Because adults do not know what to do or what to say to other adults about child sexual abuse, our programs and materials offer skill building in these areas. For example, our training materials help adults learn to use explicit language and proper names of body parts when describing sexual abuse. Furthermore, our helpline continues to encourage families to educate themselves, ask questions, create a family safety plan, and especially, to stay involved when they are concerned about a situation but have no evidence or information to report to authorities.

Results from these surveys in Philadelphia, Minnesota and Georgia can be found on our website www.stopitnow.org.

by Joan Tabachnick

For Development News, Tune Into WJBH

WJBH is Stop It Now! shorthand for We’re Just Brainstorming Here. We turn it on whenever we need an altered mode of thinking and communicating to solve really big problems. The quiet hum of WJBH in the background helps us suspend the usual judgement and analysis that brings static to our everyday thinking. We turn up the volume on novel thinking and let our ideas blast.

At the beginning of 2003, The Board of Directors tuned into WJBH to see if they could help us to solve the fundraising dilemma faced by so many non profits in these years of shrinking individual and public support. In the spirit of brainstorming, they generated a number of ideas that had never been considered before. One of them lit a fire under a Board Member who said, “I’ll donate $1,000 to get that idea started.” The result is the Angel Ad, which ran in The Atlantic Monthly in December 2003, and netted us many inquiries and some donors. Other national magazines are currently considering placing it as well.

The Angel Ad was the collaboration of Board Members William Ferguson, Bob Mazer and Linda Bowen, with help from Development Consultant, Holly Martineau. Copy was donated by Sujeong Shin; Doreen St. John created the graphic: and Sue Laks of Harmelin Media in Bala Cynwyd, Pennsylvania executed the pro bono placement. From start to finish, this ad shows that WJBH is the place to listen for successful ideas.

Helpline

A Look Back at Helpline Calls 2003

The Stop It Now! helpline received a total of 666 calls in 2003. Seventy-seven percent of the calls were from friends and family members concerned about behaviors of a loved one, 16 percent were from individuals and professionals looking for information, and 7 percent were from adults concerned about their own thoughts, feelings or acting-out behaviors .

Callers to the Stop It Now! helpline speak to us confidentially. The following are composite stories using callers’ own words:

“I am a survivor of incest and am getting therapy for that, but now I have to deal with the other side of the issue: the fantasies, interests, and responses to possible abusing behaviors. I haven’t offended, nor do I plan to, but these feelings are so disturbing, I know I need help.”
—Adult concerned about his own thoughts and feelings*