A welcoming place for survivors and their loved ones. AGENDA

» Welcome - Introductions » What is Child ? » Understanding the Effects of Abuse » How to Support a Survivor » The Stages of Healing from CSA » Prevention » What to do in case of disclosure » Community Resources » Questions » Training Evaluation Group Agreements

» Take Care of Yourself » Confidentiality » Listen Respectfully » Honor Time Limits » Respect Differences » Keep an Open Mind

Child Sexual Abuse Training Trauma Stress Complicity Identity Shame Trust

Safety Community Survivors Healing Center Our Services:

» Intensive Therapy Groups » Information and Referrals » Outreach and Education » Prevention Training » Caring for Kids Event » Speaker Panels » Volunteer Opportunities

Child Sexual Abuse Training Why we offer group therapy:

Community is the antidote to shame (Gordon Wheeler)

Compassion is the antidote to shame (Brene Brown)

Shame Exercise CHILD SEXUAL ABUSE STATISTICS

»1/5 girls and 1/7 boys are sexually assaulted before they turn 18 (ACE Study) »Children ages 7-9 are the most commonly molested »Foster youth are 10 times more likely to be sexually abused (Darkness to Light) »Children unaware about child molesters are most vulnerable of all

Child Sexual Abuse Training CHILD SEXUAL ABUSE STATISTICS

» Only 3/10 are reported to the police (FBI)

» Youth are 2.5 times more likely to be raped than adults (Darkness to Light)

» Youth are victims of in 66% of the cases reported to police

» 75% of victims are photographed while living at home; parents are most often involved in creating child porn

» Many people live with the shame of sexual assault for their entire lives if they don’t get support What is Child Sexual Abuse? Child Sexual Abuse

FBI Definition of was changed from The carnal knowledge of a female forcibly and against her will to Any penetration without consent in 2012. Child sexual abuse includes a wide range of sexual behaviors that take place between: a child and an older person (adult) or between two children. CSA occurs when full consent of involved parties is not possible due to differences in size, power, age, developmental level, or authority.

» Molestation » Oral Copulation » Rape » Sodomy » Penetration » Commercial Sexual Exploitation of Children

Child Sexual Abuse Training Child Sexual Abuse

» Photographing the child for sexual purposes » Showing the child pornographic materials » Sexualized talk with the child » Exposing genital areas to the child for sexual gratification » "Peeping" in on child while dressing, showering, using the restroom » Masturbating in front of the child » Making the child engage in: • oral sex • vaginal or anal intercourse • • sexual activities with animals

Child Sexual Abuse Training Adverse Childhood Experience (ACE Study)

» What’s an Ace Study? » Collaboration between Kaiser San Diego and Center for Disease Control (CDC) » 17,000 participants

Child Sexual Abuse Training How this is Illustrated...

Childhood sexual abuse chronic depression morbid obesity diabetes hypertension hyperlipidemia coronary artery disease muscular degeneration psoriasis death

Child Sexual Abuse Training Depression:

Most say depression is a disease. Many say depression is genetic. Some say it is due to a chemical imbalance.

What if depression were not a disease, but a normal response to abnormal life experiences? Felitti

Child Sexual Abuse Training Major Findings: 2 out of 3 had at least one ACE 11% had five or more ACEs

People with 4 Ace’s or more were: » 7 times more likely to be alcoholics, » 10 times more likely to have used street drugs, » 12 times more likely to attempt suicide, » 6 times more likely to be raped » 4 times more likely to suffer from chronic depression » have health problems (heart disease, obesity),

Child Sexual Abuse Training At risk populations

» 59% of females in prison were sexually abused » 95% of sex workers » 60% of teen mothers » 43% of adolescent runaways » 53% of reported substance abusers » 60-80% of individuals in substance abuse facilities

Survivors of childhood sexual abuse make up a large proportion of certain at-risk populations Myths and Facts About Child Sexual Abuse

» CSA is more common in Cities than rural areas » Only adults perform CSA » Children “ask” for these actions by being “seductive” or by “consenting” Myths to the perpetrator » Child sexual abuse is rare and only involves girls » Child sexual abusers are all homosexual

» Abuse is seldom a one time incident. Incidents often repeat over periods of time. » Abusers come from all income, education, and intelligence levels » In 90% of child sexual abuse cases, the child knows and trusts the Facts person who commits the abuse » Children rarely fabricate stories, they do not have the explicit sexual knowledge to enable them to talk about sex unless they have experienced it.

Child Sexual Abuse Training We often think abusers look like this When instead the picture looks more like this Who abuses? •Abusers actually tend to be members of the family or someone with strong social ties to the family •Tend to be young, almost half were between 20 and 40 Who is abused? : »15-28% are abused by a parent or step parent »52% are sexually abused by fathers only mothers only a family member other relatives mothers acting with another person »40% are sexually abused by day care providers other older, more powerful children Effects of Child Sexual Abuse Key Terms and Effects:

Stress: non-specific response of the body to any demand that overwhelms resources – positive and negative stressors – getting married, changing jobs, sex etc… Stress produces the activation of the sympathetic nervous system

Trauma: threat to one’s life or bodily integrity, hyper-arousal of the ANS, not all traumatic events lead to trauma.

Traumatic Stress: a normal reaction of the mind and body to an overwhelming event that threatens life and/or limb: your own, someone close to you, or that you witness. Someone with traumatic stress may be reacting to recent events, or event from childhood

Post-traumatic Stress: traumatic stress that has not been processed by the body

Child Sexual Abuse Training Fight, Flight, Freeze, or Freak

During a traumatic event, the brain tells the nervous system to prepare the body for a defensive action, such as fight or flight.

If those actions are not possible, the brain tells the nervous system to freeze/freak.

These changes are normal responses to an abnormal event. After the event is over, the nervous system will usually return these body systems to a normal level of functioning within a few hours, days or weeks.

Child Sexual Abuse Training Post Traumatic Stress Disorder

ICD-10 definition: After a trauma. The person has each of the following key symptoms for over a month, and they result in decreased ability to function (e.g., work, social life): intrusion (e.g., flashbacks, nightmares) ; avoidance (e.g., not wanting to talk about it or remember); arousal (e.g., insomnia, anger); negative thoughts/ mood of self or society.

Simple PTSD: Results from a single event in adulthood (DSM-IV symptoms)

Complex PTSD: Results from multiple traumas, the projection of past experiences into the future, typically in childhood (broad symptoms, including personality problems.)

About PTSD: Trauma survivors often blame themselves for what is happening to them. Negative self talk precedes self harm behaviors.

Child Sexual Abuse Training POST TRAUMATIC STRESS DISORDER

The ICD–10 definition states that PTSD may develop after ‘a stressful event or situation... of an exceptionally threatening or catastrophic nature, which is likely to cause pervasive distress in almost anyone’ (World Health Organization, 1992: p. 147) Post Traumatic Stress Disorder

: Rates

» About 1/3 of people exposed to trauma develop PTSD. Men have higher rates of trauma, but women have more childhood trauma, and are more likely than men to develop PTSD if exposed to trauma. » 10% for women. 5% for men (Lifetime, US.) » Treatment: If untreated, PTSD can last for decades, if treated, people do recover. » Most effective treatments: cognitive behavioral (i.e., coping skills training) and exposure (tell trauma story).

Child Sexual Abuse Training Effects of Child Sexual Abuse

» Low self-esteem » Early » Depression » Prostitution » Anxiety » Drug and alcohol abuse » Isolation » Self-harm behaviors » Regressive behaviors (cutting, burning) » Dissociation » Eating disorders » Nightmares » Abstinence of sex » Flashbacks » Interpersonal difficulties » Difficulty concentrating (trouble at work or home…) » Feeling unsafe » Running Away » Promiscuity

Child Sexual Abuse Training Effects of CSA Under the Age of 6

» Headaches »Distress at removal of diapers » Stomachaches »Disclosure of CSA » Irritation of genitals »Sexually acting out » Bruises and/or sores »Lack of emotions/numbing » Persistent masturbation »Bed wetting » Eating/sleeping »STIs disorders »Crying » Defecation

Child Sexual Abuse Training Ages 6-9

» Isolation » Problems obeying » Fear » Poor school performance » Sexually inappropriate behavior » Lying to hide CSA » Sexually acting out » CSA disclosure » Numbing

Child Sexual Abuse Training Ages 9-13 Ages 13-18

» Truancy » Self-destructive behavior » Running away » Delinquency » Low self-esteem » Prostitution » Drug/alcohol use » Pregnancy » Avoidance of physical/ » STIs emotional intimacy » Avoidance of the opposite sex

Child Sexual Abuse Training • 1. Recognize the signs

• The signs of abuse aren’t always obvious, and learning the warning signs of child sexual abuse could be life saving. You might notice behavioral or physical changes that could signal a child is being abused. Some of these warning signs include:

• Behavioral signs: Shrinking away from or seeming threatened by physical contact, regressive behaviors like thumb sucking, changing hygiene routines such as refusing to bathe or bathing excessively, age-inappropriate sexual behaviors, sleep disturbances, or nightmares

• Verbal cues: Using words or phrases that are “too adult” for their age, unexplained silence, or suddenly being less talkative

• Physical signs: Only 2% of children exhibit physical signs. • Bruising or swelling near the genital area, blood on sheets or undergarments, or broken bones DID YOU KNOW THAT…

• Children ages 7-9 are the most commonly molested.

• Few children will disclose sexual abuse while it is happening

• Most children will not show signs that they are being molested

• Children who are not educated about child molesters are the most vulnerable of all

• More trauma results when children are not believed or supported when they tell

• Children process trauma differently Society and child sexual abuse - Link between domestic violence and political violence – - Judith Herman in Trauma and Recovery 1992 History:

»War tactic that has infiltrated the domestic sphere »In 1920’s Freud published paper on prevalence of sexual abuse in his clients. He was forced as Jew in Nazi Vienna to Retract paper and invented theory on Oedipal and Electra complex »In the 1950’s the APA wrote that strengthens character (The Body Keeps the Score Bessel van Der Kolk 2013)

Child Sexual Abuse Training - Fast forward 50 years… -

» Ellen Bass and Amy Pine led writing workshops » Several participants disclosed child sexual abuse » Founded SHC as a resource for people to heal » 1988 by Ellen Bass and Laura Davis » 2005 ACE findings » 2016 Spotlight (on the church sex abuse scandal) won the Oscars and Vice-President Biden spoke to create unified response

Child Sexual Abuse Training OFFENDER RED FLAGS

• Purchasing children special gifts for no reason • Wanting to take children on outings that include being alone with them • Making sexual comments / act “flirty’ around children or teens • Don’t allow children privacy. (Ex: Walking in on them while dressing or using the restroom) • Act jealous about other relationships • Volunteer with youth groups, but do not have children in those groups • Seem preoccupied with child sexual development • Engaged in repeated physical contact with children. claiming the touching was “accidental” Prevention

» Trust your instincts » Identify your abusers so they are not left alone with a child » Intervene or report it to CPS when when you suspect child sexual abuse » Minimize high risk situations » Teach consent (that they have a say over who and how their body’s are touched) » Teach children accurate names of body parts » Teach them about body safety and the difference between okay and not okay » Empower kids to say “no” when it is not okay to touch them » Teach them to take care of their private parts so they do not have to rely on others » Educate children as to what’s a good and a bad secret » Avoid focusing on “stranger danger” with children, often children are abused by people they know » Listen to your child and pay attention » Increase your child’s self-esteem Increasing Self-Esteem

Recognizing low self-esteem » Rigid defenses » Submit » Withdraw

Building self-esteem: “I am lovable and capable” » Build child’s intrinsic sense of self worth » Build confidence in your child’s abilities » Make sure your expectations don’t clash with that child’s ability » Practice non-judgment » Active listening » Exercise, Self-Defense Classes

Child Sexual Abuse Training Talking to Your Children

» Give them situations and solutions in a non-threatening environment where they are more likely to open up to you » Teach your child to say no, and good touch, bad touch, and secret touch » Rehearse the phrases your child would actually use, let your child name people they would go to if they didn’t feel comfortable with an interaction » Sports and other physical activities increase a child’s sense of their body and their power » Play the “what if” game » Use storytelling » Avoid judgment and blame and be patient

Child Sexual Abuse Training Talking to Older Children

» Make sure your teen understands you » Respect him or her » Listen to them more instead of just “talking at them” » Let them know you will be available to talk at any time, and you will remain calm and practice remaining clam when they actually come to you » Let them know they will not be in trouble if they were experimenting with drugs or alcohol when the sexual assault occurred.

Child Sexual Abuse Training Continuum of Sexual Activity

Mutual sexual exploration consensual and joyful for everyone involved

Persuasion of reluctant partner

Exploitation of one partner

Coercion

Sexual harassment

Sexual assault

Child Sexual Abuse Training WHY DON’T CHILDREN TELL US ABOUT ABUSE?

• REMEMBER , an offender is usually someone the child and family are close to, likes and maybe depends on.

• Some children are afraid they won’t be believed

• Children believe that someone will get in trouble or that their family will break up.

• The more incidents, the less likely a child will disclose.

• Even though what happened to them was not their fault, they still feel like it In Case of Disclosure:

» “I believe you” » “It was not your fault” » Validate the information » Listen » “I will always love you” (depending on the situation) » If a minor, report the abuse immediately to CPS or the police

Child Sexual Abuse Training • Before you report

• Tell the child that you’re going to talk to someone who can help. Be clear that you are not asking their permission.

• The child may not want you to report and may be frightened, especially if the perpetrator has threatened them or their loved ones. Remember that by reporting, you are involving authorities who will be able to keep the child safe.

• Ensure that the child is in a safe place. If you have concerns over the child’s safety, be sure to discuss them explicitly with authorities when you make the report. If you fear that the perpetrator will cause further harm to the child upon learning about the investigation, clearly communicate this to authorities. Supporting Survivors

Trauma Therapy »Developing support and coping strategies »Develop a concrete safety plan »Recognizing and naming the symptoms »Develop trusting relationships »Mobilizing social network

Control of body: getting enough sleep, exercise, food, regulation of symptoms and understanding self- harm behavior Safety of environment: safe place to live, plan to protect, transportation, financial resources

Child Sexual Abuse Training How to Recognize Overwhelm

» Eyes become glazed over » Unable to look at you » Pale face » Short, quick breathing » Dilated pupils

Child Sexual Abuse Training Healing is: ❖ Listening to my intuition, my “inner knowing” and acting accordingly. ❖ Not second guessing myself. ❖ Having energy to take care of my home and life stuff. ❖ When I can help others and still have time and energy for my needs. ❖ Looking at the past with compassion and gentleness. ❖ Not having flashbacks or memories. ❖ Not having flashbacks or memories (control my life). ❖ When memories are there but not in charge

Child Sexual Abuse Training Healing is: ❖ Acknowledging the past, accepting the future and living in the moment. ❖ Connecting to people. ❖ Embracing fun and pleasure without guilt or fear. ❖ Not isolating from people. ❖ Living in the present. ❖ Finding support, and learning how not to be so alone. ❖ Building trust on yourself. ❖ An uncharted journey.

Child Sexual Abuse Training Foundations of Trust 1. Create Safety 2. Ask “what happened” – not “what’s wrong with you” 3. Set healthy boundaries (I get to say No when I don’t feel like it and you get to say No when you don’t feel like it) 4. Be accountable, be true to your word 5. Identify and build on current resources 6. Regard defenses as resources 7. Be open minded/Don’t judge 8. Make the most generous assumption about someone’s intention 9. Be prepared to just listen

Child Sexual Abuse Training It is possible to move away from a vast, unbearable pain by delving into it deeper and deeper […]. You can look at all the parts of a terrible thing until you can see that they are assemblies of smaller parts, all of which you can name and some of which you can heal or alter, and finally the terror that seemed unbearable becomes manageable. Barbara Kingsolver

Child Sexual Abuse Training Resources

Child Protective Services 454-4222 Monterey Rape Crisis Center 375-4357 Parent Center 426-7322 / 724-2879 Family Services 423-9444 National Child Abuse Hotline 1-800-422-4453 Survivors Healing Center 423-7601 Survivors of Incest Anonymous 410-893-3322 Youth Services 728-2226 Victim Services 454-2010 / 763-8166 Women’s Crisis Support Crisis Line 888-900-4232

Child Sexual Abuse Training In Closing...

» Closing Statements - Is there any Information you want to share with the group regarding this training? Any comments in general?

» Any Questions?

» Evaluations

Thank you! A Welcoming Place for Survivors of Child Sexual Abuse and Their Supporters

104 Walnut Avenue Suite 201 Santa Cruz, CA 95060

Phone: (831) 423-7601 Email: [email protected] Good Books to Read on this Topic: » Ellen Bass and Laura Davis: The Courage to Heal » Judith Herman: Trauma and Recovery » Bessel Van Der Kolk: The Body Keeps the Score » Babette Rotschild: The Body Remembers » Peter Levine: Waking the Tiger » Karen Adams and Jennifer Fay: No more secrets: Protecting your child from child sexual assault » Eliana Gil: Helping Abused and Traumatized Children » Eliana Gil: Someone in my Family has Molested Children » Karen Johnson: The Trouble With Secrets » Staci Haynes: The Survivors Guide to Sex

Some Good TED Talks on this Topic: » Brenee Brown TED Talk – Vulnerability » Tony Porter TED Talk – A call to men » Jaffa TedX Ted Talk: Why I Stopped Watching Porn