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Section 7 (Web #21)
Severity of psychological abuse
Instances of psychological abuse were rated in terms of overall severity using the same 4-point scale used for the majority of the CECA scales (i.e., 1, marked; 2, moderate; 3, some/mild, or 4, little/none). The overall severity was influenced by the number of subcategories of psychological abuse rated but equally by the intensity and frequency of single forms of such abuse. Judgments were made by considering a number of features of the abuse in the child's particular context, consistent with predefined rating criteria. As with other CECA scales, severity ratings reflected the potential for long-term psychological and emotional damage rather than actual damage to the subject, and raters were always blind to the psychiatric outcome of the subject or his or her reported reactions to the abuse.
The following are examples of overall severity of psychological abuse determined from the cases examined and typical of those used as rating benchmarks.
Marked psychological abuse. "I went through a phase of having a bag by my bed at night because quite often Dad would come home late at night and order us all out of the house. My mother had to take us children out, whatever the time or weather, to go and stay with friends. There was no warning, you never knew when it would happen" (subcategory of "deprivation of basic needs"). "Also, I had asthma as a child and I used to keep my tablets and my inhaler and a few personal bits and pieces with me just in case I needed them at night. One night when Dad came in drunk, he came into my room and woke me up and threatened to take my medication away. He said that nothing would give him more pleasure than to take my tablets away and watch me die slowly" (subcategory of "extreme rejection").
Moderate psychological abuse. The girl was brought up by her aunt after being separated from her parents at age 5. Her aunt was cold and critical throughout the relationship. When the girl went on a school trip lasting a few days, her aunt offered to look after her pet dog, to feed and walk the dog, usually the girl's responsibility. The girl describes her return from the trip: "I went on a school trip, I was about 9. My aunt picked me up from the school at the end of the trip. She handed me the dog's collar and lead and said, "You won't be needing these any more. The dog's dead. I had it put down." "It was the first thing she said as I got off the school bus." No explanation was given of this action. The dog had been perfectly healthy, and there were no practical reasons for disposing of it. There was no prior discussion of the aunt's decision (subcategory of "deprivation of valued object").
Mild psychological abuse. The woman reported that as a child she had a kidney complaint, which was never diagnosed or treated, and as a result had poor bladder control. She used to wet the bed at night and wet her knickers regularly by day. "I was still wetting at the age of 7 or 8, and at primary school. At home we didn't have a washing machine. Washing was a problem--there were no radiators or drying facilities. I can remember mother saying to me once: "If you wet your knickers again, I'm going to rub them in your face," and I came home from school with wet knickers and so she did" (subcategory of "humiliation").
On the basis of examples such as those just given, careful scrutiny of 300 cases of childhood experience, and following the definitions in the psychological abuse literature, the following subcategories of psychological abuse were derived to help in the identification and scoring of the severity of the experience.
Humiliation/degradation. The key feature of this category is those actions or comments that degrade and humiliate the child and have the potential for invoking shame. The rating is based on the likelihood of shame being induced in most children subjected to such treatment rather than the actual degree of shame reported. Public viewing of such humiliation would add to the severity. (See the example of bedwetting under mild abuse.)
Terrorizing. This involves attempts to invoke extreme fear or dread in the child in a calculated way, excluding physical attacks. This includes, for example, deliberately playing on a fear that the child is known to have, such as forcing the child to sweep insects out of the basement when the child is known to be terrified of insects. As with the humiliation category, the rating is based on the likely response by the child in such a situation, rather than the actual response invoked.
Cognitive disorientation. This type of abuse includes a number of techniques aimed at confusing and disorienting the child in terms of ( 1) his or her belief in the evidence of his or her senses (e.g., repeatedly telling the child she had misunderstood a command, which had in fact been correctly followed), ( 2) memory (e.g., enforcing a belief that the could not recall valued experiences in the past) or ( 3) sense of identity (e.g., convincing the child that a biological parent was not the child's parent or that a separated parent was dead). In extreme instances, strategies akin to brain washing are utilized. One woman described her stepfather's behavior: "I was on house duty, where everything had to be scrubbed and then when you'd finished, you had to start it all again. And it was like mental torture ... 'Hang the washing out,' and you'd put it out and then he'd say, 'No, I didn't want it out, I wanted it in,' and you'd go and bring it all back in and he'd put it on the table and say, 'I thought I'd told you to hang that washing out.' ... He was making you feel as though you'd misunderstood the first command or you'd done the opposite to what he'd asked. Until you wondered if you were going mad."
Deprivation of basic needs. This involves depriving the child of basic needs such as light, sleep, food, or the company of others. This type of abuse is closely related to neglect, but it may be distinguished from the latter by the way in which the resource is controlled and rationed by the parent/perpetrator. This is not typically present in neglect, where depriving a child is often a by-product of mismanagement and poor coping. In the following example, the child was deprived of social contact with her siblings. The woman talks about when her father remarried when she was 6: "I wasn't allowed to speak to my half-siblings. It was sort of like "us" (me and my sister) and "them" (my stepmother's children). My stepmother always favored her own children. She wouldn't feed me like her own children. It was different when my father was at home. Then I was allowed to sit and eat at the table with the others. When he wasn't there, I used to have to stand in the corner when they ate."
Deprivation of valued objects. This form of abuse involves depriving the child of a specific object that the he or she values or treasures. This may be an inanimate object, such as a toy or precious memento, or it may be animate, as with a pet, but it may also occasionally extend to significant others to whom the child is forbidden to talk (such as separated parents or relatives). It may also be more abstract in terms of a valued aim or achievement (e.g., taking up educational or sports opportunities). Frequently the object is the only source of comfort available to the child, for example, a toy or a special present, and it is typically removed or destroyed in a deliberate, calculating fashion to maximize distress and disappointment. (See the example of the pet being destroyed under moderate abuse).
Extreme rejection. This involves peaks of rejection that indicate abandonment or wishing the child was dead. Examples include locking the child out of the house when he or she is distressed or hurt for a long period of time, or abandoning a young child in an unfamiliar place, then returning some time later without explanation. The example of the wish for the child's death when undergoing an asthma attack described earlier would also fit this criterion.
Inflicting marked distress or discomfort. Although distress and discomfort are features accompanying most types of abuse, notably physical and sexual abuse, particular elements distinct from these are required for psychological abuse. One is force feeding, not only at mealtime but also with noxious substances such as shoe polish or feces. Vomiting often ensues, and physical pain, discomfort, or revulsion are involved. One woman related: "If I didn't want to eat what she'd cooked, I'd have my nose held to force me to eat. If she didn't manage to get it all into me, it would be presented cold at a later meal, then again at another. Eventually the food made me vomit."
Emotional blackmail. The key feature of this category of abuse is the use of serious threats to close others to ensure control and compliance. Emotional blackmail may also include threats to reveal stigmatizing information about the child or family, which will have negative consequences for the child. This form of psychological abuse often accompanies sexual abuse in order to induce compliance by threats to harm others (e.g., siblings) or to tell others of the child's "guilt." (See the example of telling others the child was a liar to prepare for possible disclosure of sexual abuse.)
Corruption/exploitation. This type of abuse involves forcing the child to take part in (usually) illicit activities such as stealing or drug taking. For example, one 10-year-old child was repeatedly given amphetamine by her mother and told it was sherbet. Incidents of exploitative sexual activity are also included in this category, for example, taking pornographic photographs of the child for distribution, or involvement in pedophile groups. The latter would rate on both sexual and psychological abuse. Thus child prostitution and ritualized sexual abuse would also be rated as both sexual and psychological abuse.
The last two categories indicate how psychological abuse can integrally co-occur with other abuse such as sexual abuse. An abuse "complex" was rated only when psychological abuse formed an integral part of the same incident with either physical or sexual abuse. For example, a 14-year-old girl was punished by her father for a minor infraction by pulling down her underwear and belting her on her bare bottom in front of her family and relatives. Here the psychological abuse subcategory of humiliation was rated in addition to physical abuse. Abuse complexes were distinguished from pure forms of psychological abuse, where sexual or physical abuse did not form part of the same incident as the psychological abuse example. However, it was also possible for the perpetrator of pure psychological abuse to be engaging in other forms of abuse or neglect on separate occasions with the same victim. For example, if the 14-year-old girl was hit by her father on other occasions with no publicly humiliating element, then she would rate as having recurrent physical abuse in addition to the specific psychological/physical abuse complex just described.
Similarly, psychological abuse could be a complex with sexual abuse. One woman described sexual abuse from her father: "It was full intercourse. And if I refused, I would get a hiding [beating] from him. If, for instance, if I bunked off [skipped] school and he found out, he would threaten to tell my mother--and I was more frightened of my mother funny enough--but if I let him screw me, he wouldn't say nothing about the school thing. He always said that if I got pregnant, I must say that it was my boyfriend who did it. He also made me out to be a liar ....It was like preparing in case I ever did say anything [about the abuse]."
Psychological abuse accompanying sexual abuse usually related to compliance or secrecy, such as campaigns of terrorizing the child or threatening the safety of close others to increase compliance and prevent the child from disclosing. Elements intrinsic to the sexual abuse, such as the betrayal of trust by a perpetrator who is a close other and the inappropriateness of the sexual behavior, were reflected purely in the severity rating of the sexual abuse. Helplessness on the part of one parent in relation to any abuse from the other parent (e.g., "bystander apathy") did not in itself qualify as psychological abuse. Greater collusion or participation in tormenting the child was required in order to rate psychological abuse; only the figure active in the abuse rated as the perpetrator. For example, a mother who did nothing to stop sexual abuse of her child by the father was not rated as perpetrating psychological abuse, although her behavior was considered an indicator of neglect.
- Moran, P., Bifulco, A., Ball, C., Jacobs, C., & Benaim, K. (2002). Exploring psychological abuse in childhood: developing a new interview scale. Bulletin of the Menninger Clinic, 66(3).
"Personal Reflection" Journaling Activity #7
The preceding section contained information regarding psychological abuse in childhood. Write three case study examples regarding how you might use the content of this section of the Manual in your practice. Affix extra paper for your Journaling entries to the end of this Manual.
What three techniques are included in the cognitive disorientation type of abuse?
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