A female friend of mine remained silent for many years about the sexual violence she (and, unbeknown to her, her brother) had suffered as a child whilst in the care of a female relative. She had tried confiding once in a counsellor but the response from the counsellor had been dismissive, refusing to countenance any notion that a woman could be a perpetrator or indeed that a woman would inflict sexual violence on another female. This was more than a decade ago. One would hope now, following the recent high profile case in which a Plymouth nursery worker was jailed for sexually abusing children in her care, we are in fact more prepared to think the unthinkable.
Being prepared to think the unthinkable is imperative when it comes to acts of sexual violence. Sexual violence takes many forms; knows no gender, cultural or class boundaries; and sadly is far more extensive than many of us would want to believe.
A report in the Guardian newspaper (January 6, 2010) suggested that a decade ago, the UK had nearly 80 rape crisis centres, but now only 39 are still operating and offering specialist support services to women who have survived sexual violence. My fear is, that faced with ever more difficult financial constraints within health and social care, the issue of sexual violence will become even more sidelined.
Not surprisingly, the thought of sexual violence is too difficult for many people to contemplate as it breaks so many taboos. Sexual violence breaches boundaries of trust; can happen within family and ‘caring’ relationships or within other power relationships; and is frequently associated with the most degrading, dehumanising and violent sexual acts. As such there can be a tendency to want to ignore it or take refuge in self deception and collude with unrealistic and stereotypical views of perpetrators. Evidence suggests that most sexual violence is perpetrated by men but we should never allow ourselves to fall into the trap of stereotyping those who abuse, ignoring the possibility that the perpetrator may be female – as was the case with my friend.
As a social worker I was constantly astounded by people’s rigid perceptions of perpetrators and their belief that perpetrators are easily identifiable. I know from experience how difficult it is to convince a jury that the handsome softly spoken and charming man before them is indeed capable of sexual violence. As well as disbelief in the systemic failings of services, maybe one of the other reasons that the public responds so negatively towards social workers is that they genuinely believe it is easy to identify a perpetrator and cannot understand why social workers fail so regularly, in their eyes, to do so. I have yet to meet a perpetrator who perfectly fits the stereotype so often portrayed in the media. Perpetrators are not always withdrawn, socially inept, lonely, unattractive men, inhabiting the shadows and unable to maintain consenting adult relationships.
The writer Carol Ann Lee has recently written a biography about the infamous child killer Myra Hindley, entitled ‘One of Your Own’ – the title is taken from a comment made by the incarcerated Hindley: “Infamous – I have become disowned – but I am one of your own.”
Lee compares Hindley to those who were willing and able to commit atrocities during the Holocaust, yet still able to conduct loving and caring family relationships and remain respected members of their communities. Likewise, Hindley was able to compartmentalise her life; capable of acts of kindness to other children in her neighbourhood. Hindley, it is claimed, was an adoring aunt to her niece yet still able to commit shocking acts of violence against other children. Acknowledging that perpetrators are all too frequently outwardly respectable, harmless, loving and caring members of society challenges our human desire to make sense of the world and to have some control over it. Seeing perpetrators as outsiders rather than ‘one of our own’ may be more comforting but ultimately it is based on a false premise. It is an act of self deception and a dangerous one.
The Vatican’s Secretary of State, Cardinal Tarcisio Bertone, has recently outraged many by suggesting that the Catholic Church’s sexual abuse crisis was linked to homosexuality (Guardian, April 14, 2010). Scapegoating an already stigmatised group is far easier than confronting a system and structure that has allowed individuals to abuse positions of power and authority over the disempowered young. A cynical statement designed to locate abuse within another community and allow the rest of society and its institutions to go about its business with a clear conscience.
Having to accept that sexual abuse is perpetrated by the charming, the attractive, the caring father, mother, uncle, aunt, friend, neighbour, teacher or priest is just too challenging and unsettling to contemplate – in spite of most evidence pointing to the fact that sexual violence is more often than not perpetrated by someone known to the victim, and generally someone in a position of power (SAVI Report, 2002).
The incidence of officially recorded sexual violence in the UK is in itself staggering, and yet much more of it remains unreported. Figures highlighted in a government report, ‘Together we can end violence against women and girls: A strategy’ (Home Office, 2009), suggest that 3.7 million women in England and Wales have been sexually assaulted at some point since the age of 16. In any week 10,000 women are assaulted and 2,000 women raped. Thirty four percent of rapes are committed against children under 16 years of age.
The human and financial costs of sexual violence are immense. A child who has been sexually assaulted, for instance, is at greater risk of sexual assault as an adult (Finkelhor and Yllo, 1985). Studies have also demonstrated a long term association between child sex abuse in both male and female survivors and subsequent mental health difficulties, with 1 in 4 people who access mental health services having been abused (Spataro and Mullen – British Journal of Psychiatry (2004) 184:416-421).
Home Office research published in 2005 has attempted to estimate the financial costs of sexual violence. Estimates indicate that each adult rape costs over £75,000 in emotional and physical input – the cost to health services and the criminal justice system and lost output due to the long term issues faced by the victims. The overall cost, in 2003/2004 was estimated to be 8.5 million pounds, (Home Office, 2005).
This March saw the publication of the ‘Report from the sexual violence against women sub-group’ which highlighted the role of the NHS in supporting women and children who are victims of sexual violence. Among many things, the report calls for better prevention strategies to combat sexual violence – such as support for good parenting and early treatment of childhood mental health problems.
Recognising the vast under-reporting of sexual violence, the report calls for more initiatives to raise awareness among the general public and more specifically among health professionals.
Furthermore, the report draws attention to the fact that women survivors of sexual violence may experience ‘retraumatisation’ in response to treatment and care from health providers which unintentionally may trigger or reawaken previous experiences of abuse. It suggests that health staff need to be more aware of the impact that intimate treatment such as dentistry or maternity care may have on these women.
The report acknowledges, too, that such awareness-raising along with training is necessary for health staff in order that they can challenge their own feelings of reluctance in dealing with such a sensitive area of work. Staff may feel uncomfortable because of a lack of knowledge, a lack of confidence in how to respond appropriately within time constraints, or uncertainty about outward referral pathways. Furthermore, it is recognised that health staff may have their own unresolved issues around their personal experiences which prevent them from dealing effectively with patients who have been sexually abused.
Issues of sexual violence need to be discussed more openly, but in a culture that remains reluctant to even openly discuss healthy sexual relationships, there is still a long way to go. Greater awareness is needed among health and social care staff of the indicators of sexual violence and the appropriate responses.
Such developments are long overdue but the sub-group’s report goes some way in beginning to look at initiatives for tackling these challenging issues.
The long term human costs of sexual violence are well documented and in these financially constrained times we need to make the arguments about the economic benefits of improved prevention, detection and treatment of sexual violence.
Sadly, sexual violence is nothing new, but it is time that we took a more informed approach in dealing with its causes and consequences; moving away from inaccurate stereotypes of perpetrators, ignoring the indicators and disregarding the extent to which it occurs.
On a broader level we need to emphasise the importance of a well informed population of young and old people, able to talk more openly about consensual sex as well as abusive sexual experiences. If we fail to provide people with the appropriate language with which ‘victims’ can describe the abuse; neglect to create the environments in which people can be heard; ignore the need to equip people with the knowledge to identify when abuse is occurring, on either a personal level or otherwise; and do not respond sensitively and appropriately when sexual violence is disclosed, then it will continue to go unnoticed and under-reported. Furthermore, without more dialogue and greater awareness, we can never hope to better understand and challenge the circumstances in which abuse occurs; break patterns of dysfunctional behaviour and ultimately reduce the incidence.
Perpetrators are not outside of families and society, they are in families and society – ‘one of your own’ – and we have to begin to deal with this fact whether we like it or not.