Looking into the darkness.

Part of my training to be a counsellor has included role play. This may not be a surprise to many, however this has been role play with a specific aim. We were asked to honestly reflect on what type of client we would find most challenging, with reference to abuse.

Pause for a moment and consider, you belong to one of the helping professions, who would you least like to have opposite you? Who would challenge you the most to be supportive and non judgemental? Who would you struggle to reach emphatically? In a counselling context who would you shy away from creating the intimacy with that  the therapeutic bond demands?

This is more than an academic exercise if approached with total honesty and authenticity. Several of my classmates have realised they need to return to personal therapy themselves. Being asked to look at your darkest fears, and then bring them out into the daylight, work with them, whilst being filmed and given feedback, is I think, the hardest thing many of us have had to do.

On reflection I realised I would struggle with a woman who was abusing a child, particularly sexually. I am a mother, a rather lax feminist (I like heels too much I am afraid). I understand, and accept, ideas around how patriarchy oppresses women, intergenerational theories of abuse, and how abusers are often simply transmitting their own trauma. Even with this intellectual understanding I knew that, in my heart, I would find it hard to work with such a client.

Such an admission is hard, especially when one is supposed to be trained in understanding abuse, its causes and its repercussions. (I explore some theories of the causes of abuse here). However the alternative is I believe, to only have the theories, and refuse to look at the darkness. This line of thought was prompted by a series of tweets last night, by @itsmotherswork, a stranger, who like so many strangers on twitter, I find educates and enlightens me.

They were talking about a serious case review into the death of Child K in Southampton, a series of failures, and the lessons all who come into contact with the vulnerable can take from those failures. What is consistent throughout the report is that professionals were willing to see the mother (Miss L) as a victim of domestic abuse, and offer appropriate support, but unwilling, or perhaps unable, to see the child as a victim of it;s own abuse, separate from that perpetrated on its mother.

These two quotes perhaps make clear what I mean.

Content note for child abuse in the following quotes.

3 The most significant contact with the hospital was the occasion when, in September 2008 at just over four years old, Child K was brought to A&E with Injuries to the penis and a ‘mild abrasion to right forehead, slight laceration, abrasion on right upper lip, some blood in left nostril and finger tip bruises to right thigh’. He presented as very upset and staff found it difficult to engage with him. His mother behaved inappropriately towards him, shouting and handling him roughly, so that staff had to intervene to stop her. The child gave what appeared to be rehearsed responses when asked how the injuries were caused, saying for example that he had “walked into a door”. Staff had explicit concerns that he may have suffered inflicted injuries.

The existence of any injury to the penis of a young child should be a red flag to those with a safe guarding responsibility, since it is highly unlikely to be accidental. Alongside the other injuries described it would seem a clear case that needed strong, and speedy action. Compare the response to this, when the mother was treated in hospital a year later.

7.5.7 A year later in September 2011 Ms L herself was treated in hospital as a result of injuries caused, she said, in an assault on her by Mr X. She had been punched to the face, neck and body as a result of a dispute about a computer game. Hospital staff made appropriate referrals to police, CSC and to the IDVA who was already involved following previous domestic abuse.

This ties in with one of the conclusions of the Serious Case review.

8.3.6 Some professionals over-identified with Ms L, regarding her only as a victim. In fact we know now that she was repeatedly dishonest, not just with professionals but even to the extent to which she concealed the truth about Child K’s paternity. There was a continuing failure to explore the extent to which she not only neglected and failed to protect Child K, but also may have been a perpetrator of the violence he suffered. The fact that she was a victim clouded professional judgment and obscured the need systematically to explore the relationships within the family.

And, further on where it says;

8.7.11 There is no evidence that the agencies gave priority to the needs of Child K and his siblings in this way. Instead professionals focused largely on Ms L, who was seen solely as a victim who was telling the truth about the dynamics of her relationships. This raises issues about the thoroughness of MARAC arrangements and there is a recommendation that this be considered further.

Looking into the darkness is hard. Providing support for an abused woman, who is an archetype rather than a real person is so much easier. To see the person across from us as a victim so often means to see them as good. In much the same way as some will talk about the deserving poor, so often those in the helping professions have constructed the idea of the deserving victim. It comes about, partially, because this way they do not have to deal with the more morally complex idea that someone can be a victim and an abuser. However if we look at the intergenerational transmission of abuse, which has a lot of good evidence to support it, so many of those we term abusive are also victims.

I cannot, and would not, like to suggest how other professions should improve their training. Nor would I like to dismiss the huge impacts cuts to services have had on areas such as social work and accident and emergency. However something all of us can do is take time to reflect on the darkness we do not wish to acknowledge. In this case signs of physical and sexual abuse were ignored whilst an adult victim of domestic violence was offered support. Was this perhaps because those who came into contact with the family could more easily handle the concept of Miss L as a loving, abused, mother, than as an abuser and a victim?

 Link to the serious case review, content note for graphic descriptions of child abuse and domestic violence

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