Child's Play, The Citizen, April 2009

"Abuse" Isn't Always Traumatic

Gregory K. Moffatt, Ph.D.

During a recent interview, a reporter asked me how children respond to abuse. She had no idea what a complicated question she was asking. For more than twenty years I've worked with children who have been sexually abused and during those years I've seen almost everything. Responses include depression, post-traumatic stress, neurosis, hypervigilance, and hypersexuality.

I've worked sexual abuse cases where the victims have ranged in age from as old as fifteen or sixteen to as young as six months. Perpetrators have been brothers, fathers, stepfathers, step-siblings, mothers, aunts, uncles, babysitters, scout leaders, coaches, pastors, and strangers. The length of abuse has ranged from an isolated, one-time event to ritual, weekly molestation and rape. These events have involved everything from mild touching over clothing to invasive rape with objects that would only fit in the places they were inserted if the tissue were forced, torn, and abraded. Many of these children were deeply scarred, both emotionally and physically, by their abuse and the event will be with them the rest of their lives.

But believe it or not, some children are molested and don't even know it. For these children, the response to their abuse was nothing. They had no response because they didn't know they had been abused.

Children have minimal concept of personal space or modesty. People touch children all the time. Molestation could easily meet the legal definition in our state and yet not be invasive or painful and it may not even register as something unusual to the child. If the child is very young (preschool or younger), if the molestation is not forced, invasive, or painful, and if the molestation doesn't involve removal of clothing, the child may easily be unaware that the "law" has been broken or that a violation has occurred.

Odd as it sounds, this is sometimes even true for adults. Some adults, usually males, have a sexual fetish called frotteurism in which they become aroused by sexually touching unsuspecting victims. This usually happens in elevators or crowded areas where it isn't unusual for one person to bump up against another. These "victims" leave the elevator not even knowing that they have been "molested." No therapy is needed because no trauma has occurred.

For this reason, therapy is not always necessary with children who have been abused. In fact, bringing the otherwise innocuous event to the child's awareness could do more harm than good. Imagine, for example, that you were the victim of frotteurism. You would have an emotional response to the event only when you were informed it happened. Otherwise, almost by definition of the fetish, you couldn't be worried about it.

If the child is unaware of the abuse, if there are no symptoms of trauma (i.e. sleep disruption, dietary disruption, emotionalism that is abnormal for the child, hypersexualism) and the child has not expressed any desire to talk about it or asked questions, then it very well may be that the child is fine.

Children need to be aware of their body parts and they need to be aware of who has the right to touch them and who doesn't, but creating trauma where none existed before would be irresponsible. Many times over the years when frightened parents called me to let me know their child had been molested, they were surprised (and maybe relieved) to hear that therapy wasn't necessary.

There are certainly situations where intervention may be necessary. If the child is aware of the molestation, if the molestation was invasive, forced, or painful - if the perpetrator made threats, if some of the symptoms listed above are present, or if the child expresses concern, fear, guilt, frustration, or anger over the event, therapy is likely necessary. Fortunately, not every legal case of molestation is a life-long trauma.

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