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Saturday, September 14, 2013

Richard Dawkins just has it wrong

Speaking in an interview with Times magazine, author Richard Dawkins stated:

‘Just as we don’t look back at the 18th and 19th centuries and condemn people for racism in the same way as we would condemn a modern person for racism, I look back a few decades to my childhood and see things like caning, like mild paedophilia, and can’t find it in me to condemn it by the same standards as I or anyone would today.’

At one level, it is perhaps easy to see the merits in Dawkins argument - times change and so do standards of what is and is not acceptable. Yet, he suggests that what took place 50 or 60 years ago represented such a different standard that sexual and physical abuse should be seen as indicative of the times.

Richard Dawkins


The Sovereign Independent goes on:

In a new autobiography Professor Dawkins told how a master at his Salisbury prep school had pulled him on to his knee and put his hand inside his shorts’, adding that other boys had been molested by the same teacher.
While he said that he had found the episode ‘extremely disagreeable’ he wrote: ‘I don’t think he did any of us any lasting damage.’

Those of us who work in and around child protection have worked with enough parents from that age to know that they live with the haunting memories of the abuse from those times. In my view, Dawkins minimizes the impact but also creates a patina of acceptance for what took place. Consider the following:


  • In Mount Cashel orphanage in St. John's, Newfoundland where state wards were routinely physically and sexually abused by the Christian Brother's of Ireland. This occurred through the 1950's;
  • How about the literally hundreds of victims of Jimmy Savile in the UK;
  • In Canada, there were several churches involved in the residential schools where Aboriginal children were stripped of their identity and dignity through neglect, physical and sexual abuse;
These are but three high profile cases amongst thousands that could be added to the list. But most importantly, Dawkins fails to see that what he is describing is the abuse of power by a teacher who is engaged in grooming a child towards greater sexual involvement. In his case, it may have stopped for any number of reasons. One can almost be certain that the teacher he speaks of has other victims, some of whom would have been less fortunate than Dawkins.

The clinical research tells us that those who use their position of authority to take sexual advantage of a minor, typically have several victims. In order to help reduce this type of sexual abuse, we need to educate children about both protecting themselves and being open about advances that may occur. As a society, we also must respond to those who do offend. Seeing it as Dawkins describes it is dangerous as it dismisses the importance of the offence.

Dawkins says that he got over it - maybe he had a good support network; had resiliency; had a way to compartmentalize the event - but for millions of others, these sorts of events have created life long damage that has impacted their lives in multiple ways.

In essence, he has become the apologist for the abusers. That is the most dangerous aspect of his thinking.

Coincidentally, some rather poignant research was published in Frontiers in Psychaitry:

Child sexual abuse (CSA) occurs frequently in society to children aged between 2 and 17. It is significantly more common in girls than boys, with the peak age for CSA occurring when girls are aged 13–17. Many children experience multiple episodes of CSA, as well as having high rates of other victimizations (such as physical assaults). One of the problems for current research in CSA is different definitions of what this means, and no recent review has clearly differentiated more severe forms of CSA, and how commonly this is disclosed. In general we suggest there are four types of behavior that should be included as CSA, namely (1) non-contact, (2) genital touching, (3) attempted vaginal and anal penetrative acts, and (4) vaginal and anal penetrative acts. Evidence suggests that CSA involving types (2), (3), and (4) is more likely to have significant long-term outcomes, and thus can be considered has having higher-impact. From the research to date approximately 15% of girls aged 2–17 experience higher-impact CSA (with most studies suggesting that between 12 and 18% of girls experience higher-impact CSA). Approximately 6% of boys experience higher-impact CSA (with most studies suggesting that between 5 and 8% experience higher-impact CSA). The data also suggests that in over 95% of cases the CSA is never disclosed to authorities. Thus, CSA is frequent but often not identified, and occurs “below the surface” in the vast majority of higher-impact cases. 

This research emphasizes the long term impact of sexual abuse in most cases.

Reference for research

Martin, E.K. & Silverstone, P.h. (2013). How much child sexual abuse is "below the surface" and can we help adults identify it early? Frontiers in Psychiatry. published online at http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3711274/

 

Wednesday, September 4, 2013

Are we making progress with sexual abusers of children?

There is likely no topic that can stir a highly charged debate like the one around sexual abusers of children. I am careful to not use the word pedophile as the broad descriptor as they are a subset of the sexual abusers of children. A pedophile has a sexual orientation to children whereas not all sexual abusers have that.

None the less, there is a major abhorrence of sexual abusers in our society. There is a strong sentiment against them that might be summed up as, "Throw them in jail and toss the key away." The research, however, offers a somewhat different view.


There is not doubt that sexual abuse is prevalent. It is estimated that up to 20% of women and around 8% of men report that they have been abused prior to age 18. There are some highly visible examples such as with the Catholic Church, Jerry Sandusky, the former UPenn coach, the Boy Scouts of America, Jimmy Savile in the UK, all coming to mind.

As well, the long term consequences of sexual abuse are significant in both physical and mental health. Some victims of sexual abuse will also go on to become perpetrators.

With all that in mind, I was fascinated to see research published by Langstrom et al., in The British Medical Journal. It looked at the data on preventing sexual abusers of children from reoffending. Overall, they did not find that there was significant research to conclude that many interventions have an evidence base to support that they are effective. There is simply a significant need for well designed research to help answer the question. This was a rather disappointing conclusion.

There were a few points in the article that merit specific mention:

1. The observed rate of re-offence for sexual abusers of children is low. One study with a sample size of 9,603 found only 12.7% re-offended after 5 years. Yearly hazard rates are less than 3%;
2. Treating all sex offenders alike is dangerous. By low risk offenders with high risk offenders we create a significant concern of increasing the risk level of the low risk offender - a contamination effect;
3. Even keeping low risk offenders in long term therapy may increase their risk;
4. The Risk, Needs and Responsivity principle is important - offenders should be matched with treatment that matches their level of risk; the specific treatment needs of the client and their responsivity to intervention.

To be as effective as we can be with sexual abusers of children, we need to understand more, but also be sure to apply what we do know. Policy should be driven by the research. There is no taking away the pain of sexual abuse. Effective intervention with offenders is one of the tools we need. We have yet to develop effective prevention tools that reduce the frequency of sexual abuse. As the authors note, rates of abuse have not differed substantially in recent decades (although regional variations exist).

Reference:

Langstrom, N., Enebrink, P., Laure, E., Lindblom, J., Werko, S. & Hanson, K. (2013). Preventing sexual abusers of children from reoffending: Systemic review of medical and psychological interventions. The British Medical Journal, 347, f4630.  http://doi.org/10.1136/bmj.f4630