Stockholm clinic specializes in treating sexually abused boys
The child, the conditions of its existence, and society's treatment of the child are dependent upon what the child means to us. When children are regarded as refuse, they are abused. -- Karl Eric Knuttson, Prof. of Anthropology, Stockholm University
STOCKHOLM (JP): It is misleading to think that sexual abuse against children happens only outside the home. And it is equally naive to think that only girls become victims of sexual abuse or that only adults commit the violation.
Radda Barnen (Swedish Save the Children), which has been involved in the struggle against sexual abuse of children since the late 1970s, opened a boys' clinic in 1990 to treat sexually abused boys.
At that time there was a specialist clinic for sexually abused children in Stockholm. But almost all the children were girls, who were treated by female therapists.
"As a result of a survey conducted by the Stockholm Department of Social Services, we knew that a large portion of sexually abused children are boys. That is why we decided to focus our efforts on them," said Borje Svensson, a social worker and psychotherapist who has been working at the clinic since the start.
Svensson has also co-authored a book, Boys -- Sexual abuse and treatment, with psychologist Anders Nyman who also works at the clinic.
The book is a summary of five years of work at the Boys' Clinic. During that time over a hundred boys were treated and it was discovered that nearly half of the cases occurred at home and approximately a quarter of the boys who came to the clinic were sexually abused by their biological fathers.
"In many cases the sexual molestation is only part of the sadistic, tyrannical and capricious control these fathers exercise in their homes," write Nyman and Svensson.
Why are these fathers driven to torment their children?
Stoller R. in his book The Erotic Form of Hatred defines perversion as "the erotic form of hatred". Perversion is a fantasy that is acted out, a sexual deviation whose foundation is hostility. By hostility, Stoller means a state in which someone wants to harm another person.
The grief denied by an adult who was sexually abused as a child breeds this kind of perversion.
Because it is with his son that a father can identify most strongly, it is on him the repressed emotions are projected. The father unloads his feelings of self-loathing and powerlessness onto the child. When the father physically abuses and sexually violates his child, he is striking against the repressed image of his own victimization, according to Nyman and Svensson.
Bad mothers
Nyman and Svensson also discovered that cases of sexual abuse by mothers continue for long periods, and usually start early in a child's life.
Such mothers are clearly mentally disturbed.
"It was like I was two different people. Sometimes I just lost control. I knew it was wrong, but I couldn't stop myself."
That was how Martin's mother expressed how it felt. She sexually abused her son for six years. During the first three years of Martin's life, he lived at home with his mother and father. His mother acted out her mentally sick impulses with the boy. She sexualized her care of him, stroked his penis and encouraged him to stroke her genitals. She masturbated the baby and tried to perform intercourse with him. She smeared him with urine and feces, which she allowed to dry. She isolated him from other children. During these three years, Martin was constantly harnessed to his pram or his push-chair when he was outdoors. He could scarcely walk and couldn't speak at all.
Nyman and Svensson say sexual abuse by women is easier to conceal than sexual abuse by men. Women's sexual abuse of boys can be masked by physical and emotional care of the child. It can often be difficult to draw the line between normal motherly physical care and intimacy, and more sexualized fondling.
For some children, write Nyman and Svensson, the sick world inside the home becomes normal, while the healthy world outside the home has become abnormal.
Children who have been victims of sexual abuse by their mothers are confused and disoriented. Once they have gained a little perspective on the abuse, they ask, "Why did she do it?"
But this question is rarely put to the abuser. Loyalty and the child's yearning for a normal mother remain strong, even after the child has been moved to a safe environment.
"Confronting the mother with this central question can mean being rejected," according to Nyman and Svensson.
Sibling incest
Sadly, sexual molestation within the family is not limited to parents. The offender may also be an older brother or sister.
"Grief and neglect are among the causes of sexual abuse by children towards younger children," Svensson told a group of journalists who visited his clinic during the first World Congress Against Commercial Sexual Exploitation of Children last month.
"Children do abnormal things when they don't live in a normal situation," he explained.
From their experience at the clinic, Nyman and Svensson identity two types of sexuality between siblings: symbiotic and sadistic.
"We choose to define symbiotic sexuality as abuse here as well, since in our experience it is usually a highly traumatic experience for both parties, even if there is no real aggressor but only two victims," write Nyman and Svensson.
In symbiotic sexuality, siblings turn to each other for comfort, and this can develop into sexuality. It's because children have a need for protection, warmth and physical contact. Children enjoy caressing. There are no inborn taboos to what parts of a child's body we are permitted to touch.
"The only thing the child perceives is that a touch feels different on different places on the body: it tickles, feels warm, is more intense, or less intense," write Nyman and Svensson.
In sibling incest, children live in an environment where sexual and physical boundaries are constantly overstepped, which contribute towards the sexualization of their needs for closeness and physical contact. They develop an emotional dependence on each other in lieu of a natural relationship with an adult, according to Nyman and Svensson.
While both parties are victims in a symbiotic sexuality, there is an identified offender and a helpless victim in sadistic abuse.
Max, 14, subjected his brother Robert, 8, to experiments that gradually became sexual in nature. Their parents were both highly educated, held high positions and worked a great deal.
Max was the brother for whom the parents had the highest expectations. Yet at the same time, he was the one who found it most difficult to live up to them. When he failed to make the grade, he was sometime subject to corporal punishment by his father.
Max became detached from his own emotions. Everything that had to do with feelings, impulses and drives was viewed by him as chaotic, abhorrent and unacceptable -- something he couldn't cope with.
The abusing of Robert can be seen as an attempt to compensate for the powerlessness he experienced in his relationship with his father and the bullying he was subjected to in school. At the same time he used his little brother as a kind of emotional "dustbin" for his fantasies, his impulses and his forbidden emotional life.
At first Max found it difficult to remember anything about the abuse. Moreover, he claimed that Robert was complicit in the behavior and even almost an instigator of it.
But what Max did with Robert was not a manifestation of normal curiosity or the urge to experiment.
"In our opinion, Max was at risk of repeating the abuse on others. It was important to draw attention to this, since he exhibits such a complete abuser personality," explain Nyman and Svensson.
In siblings' cases, the clinic videotapes interviews of both victim and perpetrator and confronts the latter with the victim's story.
"If he can accept responsibility it is likely that he will not repeat the offense," Svensson said.
Unforgettable
In most cases, a child victim simply cannot forget the trauma of his abuse.
Bertil, 45, was only eight years old when his father began to abuse him. As is common in cases where it is the biological parents who are the perpetrators, Bertil has a split image of his father. On the one hand, he was the person Bertil still looked up to, on the other hand he was an evil and terrifying devil who could make him rigid with fright and turn him into a stick.
He never told his mother of what happened.
Bertil stopped trusting men, and believed women couldn't handle hearing difficult things. He had never had sexual relations with either men or women. Bertil withdrew from human intimacy and didn't trust other people.
However, if the perpetrator is a complete stranger, usually the victim is not traumatized.
"If the child comes from a happy family, he will not be traumatized. But if he comes from an unhappy family, he will blame himself," said Svensson.
Treatment
The length and success of the treatment of sexually abused children depends on their age. Boys aged between seven and eight years old are usually very sensitive because they have come to believe that adults like them conditionally.
"For example, by touching their penis. So they touch the penis to be liked," said Svensson.
Treatment at the clinic covers four important points: describing the abuse, expressing feelings, saying no, setting boundaries, and acceptance.
Describing the abuse is a way of "making reality real".
"For some boys, language is the best way, describing in words the abusive acts to which they have been subjected. Others prefer to show in play what they have experienced, especially the younger children who have not yet started school. For yet others, the best means of expression is drawing or using dolls to show what happened. Some boys find it next to impossible to describe the abuse by any means," said Svensson.
Expressing feelings is one of the cornerstones of all therapy.
At the Boys' Clinic, there is a room which allows the visiting boys to express their inner lives in a safe environment. There is a variety of materials to help children express their feelings, such as boxing gloves, swords and clubs to hit mattresses with, to help them act out feelings of anger.
The clinic has carefully selected small stuffed animals which the smaller children can use when playing and telling stories as symbols of good and evil, danger and safety, fear and courage, trust and distrust.
It also has large stuffed animals, a family of life-sized bears, a life-sized Saint Bernard dog, and a snake as well as a large boa constrictor. Besides acting as symbols, the big animals are more physically challenging than the small ones.
One thing common to all the boys who have visited the clinic is that they have been invaded physically and/or emotionally in one way of another. Anyone who has had his spatial, somatic and emotional territory violated in this manner is at risk himself of violating other people's boundaries. They need help identifying and expressing emotions that have to do with wanting and not wanting, saying yes and saying no, putting oneself in other people's shoes, private areas and boundaries on the body and in life.
"We mark boundaries in the room with the big rubber band. We can create areas, countries, for different emotions and activities which we can move between, explore and play around. We have also learned that many of these boys lack knowledge about their own body and its functions. We sometimes get questions concerning elementary sexual knowledge: 'What's the white slimy cream that comes out of my big brother's penis?' or 'Why do penises get straight?'" write Nyman and Svensson.
Finally, these children must also learn to get on with their lives, to avoid getting bogged down in the "victim" persona, to reconcile themselves to what has happened and put it behind them, to give up the idea that the past can be remade or denied and to accept the fact that complete justice can never be obtained.
"It is not certain that sexually abused children will ever be able to accept and become reconciled to their fate. Many will probably carry their rage, their fear and above all their shame within them for a long time to come," Nyman and Svensson warn.