Abuse is an age-old phenomenon.
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Through stories, we realise that children have always been victims of ill-treatment in all sorts of ways. For a long time they were objects, exchange goods, production agents, and were hardly taken into consideration. If, in ancient times, a father had a right of life or death over his newborn, in the middle Ages the child was perceived as a human being fundamentally endowed with mischief or evil, raising suspicion. In the nineteenth century, the child was still subject to educational dictatorship if not put to work at a young age.
However, at the end of the 19th century, the concept of abuse began to appear in legal texts. In , the International Convention on the Rights of the Child recognised the child as an object and subject of the law. In recent times, the child seems to have been better recognised and protected, even if abuse still exists and some still hesitate to believe this. Adult movements have and are being set up so that children are better respected in terms of their basic needs, which are divided along four axes.
The primary needs concern physical well-being in its various forms diet, physical care, emotional warmth, etc. The second axis deals with security, in its material and emotional aspects; dimensions of stability, regularity, and coherence are included. The third following point is about boundaries: it is essential that the child meet adults who, in a firm and affectionate way, articulate and enforce a line of demarcation between sociability and egocentrism, demonstrating the importance of containing the more serious of our personal impulses and our most unacceptable desires.
Finally, the fourth axis is spiritual: the child, in order to build himself up, to gradually form his identity, wants to be valued, encouraged, and recognised as being kind, to be listened to, to share thoughts with adults. It is through the demonstration of all of these in the socio-familial environment that this goal can be realised. As a result, the child will gradually establish his singular and unique place in a community, becoming a person with a solid and secure base, and a well-developed sense of self-esteem. Parents, the main figures of attachment and education, are therefore expected to exist in the manner of one of the various forms of parenthood.
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This helps the child, among other things, to progress towards a personal ideal, even if, like the end of the rainbow, it grows further away as the pursuer moves towards it. Situations of psychological neglect and abuse highlight shortcomings in these basic needs. In addition to negligence, several categories of abuse are schematically defined according to its physical, sexual or psychological nature, as well as stating whether it takes place in the family circle or outside it. It is important to recognise that this differentiation is confronted by complex clinical realities, usually incorporating several forms of inadequacy and failure with respect to behaviour towards the minor.
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For the International Convention on the Rights of the Child excerpt from Article 19, , mistreatment includes any form of violence or brutality, whether physical, mental or sexual, neglect, or any form of exploitation. In , the WHO adopted the following definition:. As we observe, there are nuances depending on the sources and authors. According to our experience, and following the work of Haesevoets, we consider mistreatment any attitude that does not take into account the satisfaction of the needs of a child and thus constitutes an important obstacle to his or her development [3,4].
Abusive behaviour can be intentional, or the result of negligence or social failures. Abuse covers different meanings and includes a wide variety of semantic ranges: martyred children, beaten, in mortal danger, suffering gross negligence, belonging to a family at risk, shaken babies, cases of torture, confinement or institutional violence, child slaves, sold or for sale, child victims of abandonment, infanticide, street children, child victims of paedophilia, prostitution and child pornography, child victims of excessively rigid education, children living in perverse relations with adults, victims of abuse of power, sexual assault, trauma, or chronic child abuse.
Moreover, and certainly in our time, it is necessary to acknowledge a degree of cultural difference; for example, Kazat mothers in Central Asia and Yakuts in Siberia masturbate their young child to appease them, this approach being quite accepted in their community. The response would be rather different in Europe. As for incest, many authors propose various definitions, from the broadest to the most specific.
Thus, Kempe and Kempe, in , consider that it is the involvement of dependent children and adolescents, immature in their development, in sexual activities of which they do not fully understand the meaning, thus violating taboos about family roles . For Strauss and Manciaux, in , incest is the participation of a child or adolescent in sexual activities that he or she is unable to understand or that he undergoes under duress, or sexual activities that transgress the social taboos that exist in almost all societies .
In , Furniss and his colleagues argued that incest is any form of child abuse by any adult parenting in the family context . Authority and power can constrain the child to sexual submission . Hayez and de Becker, in , consider incest to be a sexual relationship that brings into contact people between whom marriage, or sexual union in general, is legally impeded by kinship which also includes siblings. Such a relationship can be formed between a minor and a relative or similar figure . In , out of fourteen SOS-Enfants Teams in the French-speaking part of the country, three, ours being one of them, are currently integrated into general hospitals.
A SOS-Enfants Team, created to help and care, is a group of specialised professionals, recognised and subsidised by the State to fight against all forms of abuse. It collaborates regularly with other structures, including public social services, and reports situations to the judicial authorities where it deems this appropriate. The explicit agreement of a young person of more than fourteen years is required.
The aim is the establishment of an assistance program adapted to the difficulties stated above. The SAJ can also perform a third-party role in families encountering difficult and isolating situations by mediating during confrontational exchanges between members. In the case that there is no collaboration from the family and the SAJ considers the child in danger, the body will inform prosecution services and the judicial protection process can then start. The latter can impose any measures, unlike the SAJ, which must negotiate any actions to be implemented .
In short, it carries out a complete psycho-medico-social assessment of any child referred to them, along with his relatives, before proposing pedagogical, social, and therapeutic support. Each situation encountered is singular, marked by the various negative effects of the tragedy of abuse. Here we recount three that, without being paradigmatic, illustrate our point. The objective is not to analyse the different aspects of care but to pinpoint some elements to support the theme of the article. Mehdi is eight years old when the school doctor requests our intervention following the discovery of multiple bruises on his body.
During the examination, the child confides that both his father and his mother hit him regularly with a belt. After establishing an evaluation framework with parental consent, we will have the opportunity to meet Mehdi alone and with his family. He understands that he can be boisterous, silly, and tell lies. Mehdi sees himself as a scapegoat in his family.
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While his parents cannot deny hitting their son, they believe it is educational, and respects family traditions, especially as the child is difficult. For his part, Mehdi, while he understands and excuses the parental actions, suffers and considers himself a victim of injustice. Through his words, we can see that he is serving as a projection surface for the frustrations and dissatisfaction of adults.
With each parent we will carefully approach the issues of authority and law, while respecting their rites, tradition, and religion.
A Belgian program to fight child maltreatment: The “SOS children” teams
The therapeutic goal is to model family relationships, through clearly defining roles and avoiding the use of violence. Low-key subsequent support work, including providing help to the parents, will allow, after six months, the establishment of positive interactional patterns. One day, however, Mehdi, relying on the framework of the clinical intervention, threatens his parents by saying that he will go to the police if they reprimand him harshly or if they do not give him what he wants. In his own way, the child is trying to take power, therefore no longer respecting parental authority.
A crisis re-emerges, aggravated by a risk of dysfunction and maltreatment. In order to avoid harmful acting out, personal and group development sometimes requires sustained support from clinicians over time. Felix is sixteen when we meet him for the first time, he is accompanied by his mother. She requires an assessment because one of her friends has accused Felix of sexually touching her six year-old daughter. The events reportedly took place during a holiday with several families. The sexual assault was allegedly repeated at night during the same holiday. The mother is turning to professionals to try to understand, not knowing who to believe, her son or her friend, the mother of the potential victim.
The teenager denies the facts as a whole, claiming that this is an act of revenge against him engineered by the older sister of the so-called victim. Different meetings are then proposed, individually and as a family. By family meetings, we mean meetings between Felix and his mother since he is an only child and he has never known his father. We also learn that the mother is in a homosexual relationship, information that will also be revealed to Felix by our team during the follow-up.
Felix is a young man who is uncomfortable with himself, willingly isolating himself in his room, immersed in his music and screens. He says that he is hurt by these accusations that harm his reputation. During individual meetings, Felix, relying on the relationship of trust with the clinician, gradually evokes his fears, his doubts, but also his attraction to girls of his age.