OPEN HEARTS & OPEN MINDS A toolkit of sensitive practice for professionals working with survivors of institutional childhood abuse Jeff Moore, Christine Thornton, Mary Hughes and Eugene Waters OPEN HEARTS & OPEN MINDS A toolkit of sensitive practice for professionals working with survivors of institutional childhood abuse Jeff Moore, Christine Thornton, Mary Hughes and Eugene Waters
CONTENTS
• Acknowledgements 4 • Contributors 5 • Foreword by Mary Higgins, CEO, Cara Nua 6 1 Introduction: how to use the toolkit 7 2 Institutional childhood abuse in Ireland: an overview 11 3 Experiences in care: what childhood in an institution was like 23 4 The impact of institutional childhood abuse: statistical information 31 5 Developing sensitive practice 36 6 Dealing with disclosures: a guide for the practitioner 46 7 Self-care: a necessity for the practitioner 53 8 Enhancing resilience 62 9 Further reading on sensitive practice 68 • End notes 69
Published by icap (Immigrant Counselling & Psychotherapy) and London Irish Centre, 2014. © icap 2014, all rights reserved. icap is a registered charity no. 1079353 and a company limited by guarantee no. 3917115. Registered address: 96 Moray Road, Finsbury Park, London N4 3LA.
2 Acknowledgements
ACKNOWLEDGEMENTS
The authors gratefully acknowledge the financial support of the Saint Stephens Green Trust. Starting in 2011, SSGT funded the development and delivery of training for practitioners and volunteers working with survivors of institutional childhood abuse (ICA). This toolkit came from the research and consultation which underpinned the training. We also acknowledge the continued funding of the Irish Department of Education, the Irish Health Service Executive and the Department of Foreign Affairs Emigrant Support Programme in Dublin. QUICK LINKS We acknowledge the expertise and skills of the practitioners who gave their time MAIN so willingly and contributed enormously to the project. In particular we would like CONTENTS to thank Marie Aubertin, Simon McCarthy, Jennie McShannon, Phyllis Morgan, Sally CHAPTER 1 Mulready, Geraldine Reidy, Dr. Mary Tilki, Francis Whelan and Helen White. CHAPTER 2
We would like to thank several authors whose research inspired the project: Professor CHAPTER 3 Alan Carr, of University College Dublin, for kindly agreeing for his report to be disseminated CHAPTER 4 during the training sessions and throughout this toolkit; Schachter, Stalker, Teram, Lasiuk CHAPTER 5 and Danilkewich whose work with survivors of sexual abuse was inspiring and greatly influenced this toolkit; Paddy Doyle for kindly allowing the re-production of a timeline CHAPTER 6 illustrating the history of institutional abuse in Ireland. We also acknowledge the wide range CHAPTER 7 of authors involved in the Commission to Inquire into Child Abuse. The CICA was the CHAPTER 8 primary reference for this project and remains the most important text on ICA in Ireland. CHAPTER 9
Above all, we would like to thank the survivors who took part in the project, and to END NOTES acknowledge their generosity and courage. We sincerely hope that your involvement will lead to survivors of ICA receiving more sensitive and appropriate engagement from community organisations and public bodies. We felt privileged that you trusted us with your experiences of engaging with information and advice service providers, and were moved and inspired by the strength and resilience you have shown throughout life.
A physician once asked Elie Wiesel, “How does one treat survivors of the Holocaust?” Wiesel replied, “Listen to them, listen very carefully. They have more to teach you, than you do them.”
Open Hearts & Open Minds: A toolkit of sensitive practice for practitioners working with survivors of institutional childhood abuse 3 Contributors
CONTRIBUTORS
Jeff Moore Jeff Moore is currently the Jigsaw Programme Coordinator at Headstrong - The National Centre for Youth Mental Health. Jeff was previously Director of Welfare for the London Irish Centre where he managed the largest welfare services for Irish people outside of Ireland, including information and advice services for emigrant survivors of institutional abuse. Jeff’s recent research includes a needs analysis of the Irish community in London QUICK (2012) and an impact assessment of the Benefit Reform Act on the Irish community LINKS in London (2013). Jeff holds an MA in Community Development from Goldsmiths, MAIN (University of London) and is working towards a PhD with Dublin City University. CONTENTS CHAPTER 1
Christine Thornton CHAPTER 2 Christine Thornton is Clinical Director of Immigrant Counselling and Psychotherapy CHAPTER 3 (icap), and an organisational consultant in private practice. icap is the leading voluntary organisation offering culturally sensitive psychotherapy and counselling to Irish people in CHAPTER 4 the UK. In 2012, an independent study found icap particularly effective in working with CHAPTER 5 people who normally find it hard to access and sustain psychotherapy and in particular CHAPTER 6 survivors of institutional abuse. Christine holds an MSc in Psychology as well as clinical qualifications, and has had a professional interest for many years in the interplay of CHAPTER 7 professional and personal life in the caring professions. Her latest book, Group and Team CHAPTER 8 Coaching [Routledge, 2010] has been translated into both European and Asian languages. CHAPTER 9
END Mary Hughes NOTES Mary Hughes is qualified as a psychoanalytic psychotherapist, registered with UKCP, a counsellor and a teacher, and for 12 years worked as a psychotherapist at icap. She has been involved in psychotherapy, training and teaching for over 40 years, in the NHS, the Voluntary Sector and in private practice. Mary has many years of experience in working with people from the black, ethnic minority and LGBT communities in a variety of settings including Community Education, Social Services, UCL Student Counselling Service, AGIP (The Association for Group and Individual Psychotherapy) and University College Hospital London.
Eugene Waters Eugene is the County Childcare Manager for Wicklow in Ireland, responsible for overseeing the quality of care to pre-school children in the county through delivery of training and support, such as the roll-out of universal child protection training within the sector. Previously, Eugene spent seven years working in London, in the areas of community development, financial inclusion and adult education. Eugene holds a BA in Human Development from St. Patrick’s College (Dublin City University) and an MRes in European Public Policy (Birkbeck, University of London) and has published in the areas of local governance, community development and migration.
Open Hearts & Open Minds: A toolkit of sensitive practice for practitioners working with survivors of institutional childhood abuse 4 Foreword
FOREWORD Mary Higgins, CEO, Caranua*
Open Hearts & Open Minds makes an important contribution to QUICK highlighting the experience of people who as children experienced LINKS abuse in institutions in Ireland and to help practitioners who come MAIN CONTENTS into contact with them as adults, to recognise their needs and to respond to them in ways that are sensitive and positive. CHAPTER 1 CHAPTER 2 The Commission to Inquire into Child Abuse was established to hear CHAPTER 3 evidence from people who had spent time in institutions as children. It concluded that neglect, together with emotional, sexual and physical abuse, CHAPTER 4 was both systemic and endemic in those institutions. The effects of this CHAPTER 5 regime on those who experienced it have been both devastating and long CHAPTER 6 lasting, manifesting in many physical, psychological and social ways. CHAPTER 7 Understanding the causes of presenting needs and difficulties is crucial to CHAPTER 8 effective diagnosis and intervention but the connection to institutional abuse CHAPTER 9 is not well made by mainstream practitioners. Survivors have reported END that they do not feel that their early experience is well understood NOTES and as a result are not confident in revealing information about those experiences. This situation compounds the sense of shame and secrecy that is felt by so many survivors, and leaves their needs unmet.
I believe that Open Hearts & Open Minds can help to address this situation by filling the gaps in information and knowledge and offering tools to practitioners in addressing the needs of survivors effectively, while at the same time helping them to listen and learn from them about their strength, resilience and capacity to recover.
* Caranua is an independent Irish State Body set up to help people who, as children, experienced abuse in Institutions in Ireland and have received settlements, Redress Board or Court awards.
Open Hearts & Open Minds: A toolkit of sensitive practice for practitioners working with survivors of institutional childhood abuse 5 QUICK LINKS MAIN INTRODUCTION CONTENTS
HOW TO USE THE TOOLKIT CHAPTER 1
CHAPTER 2 In this chapter we look at: CHAPTER 3
Who and what is the toolkit for? 8 CHAPTER 4 Background to the research and education project 8 CHAPTER 5 CHAPTER 6 Developing sensitive practice 9 CHAPTER 7 Self-care 9 CHAPTER 8 Using the toolkit 10 CHAPTER 9 The limits of use of the toolkit 10 END NOTES
Open Hearts & Open Minds: A toolkit of sensitive practice for practitioners working with survivors of institutional childhood abuse 6 1 Introduction: how to use the toolkiit
WHO AND WHAT IS THE TOOLKIT FOR?
This toolkit aims to help professionals and volunteers who provide services to work more effectively and safely with Irish emigrant survivors of institutional childhood abuse (hereafter abbreviated to ICA). Recent studies have shown that survivors of ICA feel their experiences are not understood by professionals such as GPs.1 With this in mind, we aim to provide information and guidance from a range of primary and secondary sources, to help professionals understand the needs of survivors of ICA and work with them in a sensitive QUICK and effective way. The toolkit was originally developed for advice and information workers, LINKS but we have found that a wide range of professionals and volunteers have found it useful. MAIN CONTENTS
In the course of our conversations with frontline workers in culturally sensitive Irish agencies CHAPTER CONTENTS in the UK, such as advice workers, caseworkers, housing workers, and volunteers, it became clear that survivors often choose to disclose to workers in these agencies. This is testament CHAPTER 1 to the sensitivity and effectiveness of workers in these agencies and highlights the value of CHAPTER 2 culturally sensitive approaches. However, workers also told us that they were worried about their CHAPTER 3 ability to respond to these disclosures sensitively. Some workers talked about feeling personal responsibility and giving clients a lot of time and energy without considering their own well- CHAPTER 4 being. In some cases, we heard from workers who simply shut down survivors who began to CHAPTER 5 disclose ICA, for fear that they did not have the skill set to deal with it safely and effectively. CHAPTER 6
There are numerous reason that people choose to disclose childhood maltreatment. Survivors generally CHAPTER 7 disclose to individuals with whom they feel close, those with whom they experience confidentiality CHAPTER 8 2 and trust, and persons that they feel “should” know about important life events. Furthermore, the CHAPTER 9 way this disclosure is managed can have a significant effect on the well-being of the survivor. With END this in mind, the toolkit provides information and resources to help practitioners and volunteers NOTES work through how to best respond to disclosures and for their on-going work with survivors of ICA.
Finally, a common theme throughout the toolkit is the strengths and resilience of survivors of ICA. Despite experiencing horrifying childhood abuse, many of survivors have gone on to live full and meaningful lives. This is what the psychologist Ann Masten calls the “ordinary magic” of resilience.3 The impact of trauma in enduring psychological problems must be worked through with suitably qualified professionals, but exploring the strengths, resilience and protective factors of vulnerable individuals is the domain of all helping professionals and volunteers. Rather than thinking of survivors of ICA as “damaged” or “vulnerable” we encourage practitioners to think of the extraordinary courage and strengths of this group.
BACKGROUND TO THE RESEARCH AND EDUCATION PROJECT
From 2001 and until 2013, the Irish government has funded a number of dedicated services for survivors of ICA, such as accredited advice and information services at the London Irish Centre (LIC). ICAP continues to receive funding to provide funding for counselling and
Open Hearts & Open Minds: A toolkit of sensitive practice for practitioners working with survivors of institutional childhood abuse 7 1 Introduction: how to use the toolkiit
therapy. Targeted services have provided crucial support and improved the quality of life of thousands of survivors. Many have developed unique, sensitive and effective ways of working with survivors. The project draws on the experiences and expertise of front-line workers in these services to inform the practice of other professionals working with survivors of ICA.
The project is indebted to the work of a team of researchers in Canada who developed a set of principles for sensitive practice for professionals working with survivors of sexual abuse.4 The current project set out to develop similar principles for professionals and volunteers working with survivors of ICA and those whose childhoods were spent in institutions. QUICK LINKS MAIN The main source of information for the project was the Commission to Inquire into Child CONTENTS
Abuse (2009) (CICA, as we will refer to it hereafter). In order to provide contextualised CHAPTER data, we also conducted interviews with 22 emigrant survivors of ICA, and with professionals CONTENTS with a long history of working with survivors. The tools developed as a result of these CHAPTER 1 interviews are presented in Chapter 7 (page 53). Drawing on the information provided by CHAPTER 2 survivors, that chapter also gives examples of what survivors deem to be bad practice. CHAPTER 3
CHAPTER 4
DEVELOPING SENSITIVE PRACTICE CHAPTER 5
CHAPTER 6 In the focus groups, many survivors felt that workers, even in culturally sensitive organisations, did not understand the severity and complexity of the impact of institutional upbringing. Many CHAPTER 7 survivors felt that workers were shocked/ reluctant to talk about issues surrounding institutional CHAPTER 8 abuse; for some clients this led to disengagement. With this in mind, this toolkit provides chapters CHAPTER 9 on the history of institutional abuse (page 11), individual experiences of institutional abuse (page 23) END and information about its effects – Chapters 2 (page 11), 3 (page 23) and 4 (page 31). The toolkit NOTES also provides guidance on the practice of experienced professionals, in allied professions, and survivors’ feedback on how to manage disclosures sensitively and effectively – Chapter 6 (page 46).
SELF-CARE FOR PROFESSIONALS
The toolkit aims to promote awareness about the potential personal impacts of working with individuals who have experienced trauma. In researching this project, the authors were frequently deeply moved and inspired by the resilience shown by so many survivors who participated in the project; yet experienced professionals highlighted that working with survivors can be distressing and traumatising for even the most proficient. The toolkit offers strategies to help workers manage their own well-being when working with survivors of institutional abuse Chapter 7 (page 53).
“It takes people time to know how to deal with this level of horrific abuse that you’re going to hear about and just on a daily basis seeing and talking to damaged people in front of your eyes. Knowing that okay you can help them so much but you have to know where the boundaries are and not let yourself get too much drawn in.” Outreach Worker, SSGT Project
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USING THE TOOLKIT
The toolkit is not prescriptive about what constitutes good and appropriate practice in all cases. It aims to provide people working in the ‘helping professions’ with useful information on survivors’ experiences of institutional upbringing and what they perceive as good and sensitive practice. We hope that this will provide ‘food for thought’ for professionals to decide what is appropriate in their own setting. We provide several examples from survivors’ own experiences of working with professionals and volunteers, and recommend QUICK that readers interpret how these examples might apply to their own work. LINKS MAIN CONTENTS
CHAPTER THE LIMITS OF USE OF THE TOOLKIT CONTENTS
CHAPTER 1 The toolkit should not be seen as a licence to work independently with survivors of ICA. It is important that you understand the statutory regulations in relation to CHAPTER 2 reporting abuse, Equally, it is vital that staff recognise the limits of their professional CHAPTER 3 capabilities and look to work in partnership with professionals and survivor led CHAPTER 4 organisations. If you are concerned about a client’s well-being, it is vital that you make contact with a qualified mental health professional, for example through icap. CHAPTER 5
CHAPTER 6 Although this toolkit references international studies on institutional abuse, the focus CHAPTER 7 is overwhelmingly on Irish survivors of institutional abuse: all the participants and practitioners interviewed were Irish. Although we hope that the toolkit may be useful CHAPTER 8 to a wider audience of people working with those who were abused in childhood, our CHAPTER 9 findings may not necessarily be wholly applicable to other groups or contexts. END NOTES
Open Hearts & Open Minds: A toolkit of sensitive practice for practitioners working with survivors of institutional childhood abuse 9 QUICK LINKS MAIN INSTITUTIONAL CONTENTS CHILDHOOD ABUSE CHAPTER 1 IN IRELAND CHAPTER 2 AN OVERVIEW CHAPTER 3 CHAPTER 4
CHAPTER 5 This chapter gives an overview of the history of institutional childhood abuse (ICA) in Ireland and, like all remaining chapters, is accompanied CHAPTER 6
by some questions for reflection. Even reading about the scale of this CHAPTER 7 abuse may be upsetting: we recommend that you arrange to read it and CHAPTER 8 discuss the questions with one or more colleagues to ‘debrief’. CHAPTER 9 The brief history of institutional abuse in Ireland was reproduced with END the permission of the CICA. The full version is available at: NOTES http://www.childabusecommission.com/rpt/pdfs/CICA-VOL1-02.PDF
The section outlining the media and government responses comes from Colm Kenny’s article: Significant Television: Journalism, Sex Abuse and the Catholic Church in Ireland. http://dit.ie/icr/media/diticr/documents/5%20 Kenny%20ICR%2011.pdf Again, full permission to reproduce was obtained.
Finally, the timeline of abuse is reproduce and updated with the permission of Paddy Doyle http://www.paddydoyle.com/a-history-of-neglect
What is institutional childhood abuse? 12 Definitions of abuse 12 A brief history of institutional care in Ireland 13 Timeline of events relating to institutional care in Ireland 15 Institutional abuse and the media 18 Reports and commissions by government and religious orders 19 Questions for reflection and discussion 22
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WHAT IS INSTITUTIONAL CHILDHOOD ABUSE?
Over the past decade, in Ireland and further afield there have been disclosures of systematic abuse of children of all ages who have resided in institutions run by the State and Religious Orders, that were charged principally with their protection (CICA, 2009; Australian Parliament, 2004; Scottish Government, 2011). When child abuse, of any nature, occurs in these settings it is described as institutional childhood abuse (ICA), differentiated from familial and stranger abuse because it is perpetrated by those who: “may be employed in a QUICK paid or voluntary capacity; in the public, voluntary or private sector; in a residential or non- LINKS 5 residential setting; and may work either directly with children or be in an ancillary role”. MAIN CONTENTS
Institutional abuse is more complex than commonly understood forms of abuse, such CHAPTER CONTENTS as sexual, financial, physical or emotional. Like those types of abuse, institutional abuse concerns the misuse of power. Additionally, ICA may also be perpetrated by peers CHAPTER 1 within institutions. Research shows that ICA goes beyond sexual and physical abuse CHAPTER 2 and reports show that neglect and emotional abuse are significant aspects of ICA.6 CHAPTER 3
“Sometimes when I’ve talked to people and they have this thing that everyone CHAPTER 4
that was in these homes was sexually abused. I say it’s not true, I said there was CHAPTER 5 physical and mental abuse which is nearly as bad at times.” Survivor, SSGT Project CHAPTER 6
There is no recognised definition for institutional abuse and the Irish State in its CHAPTER 7 response to the disclosure of abuse at industrial schools and reformatories did not CHAPTER 8 include a formal definition of what institutional abuse is. One useful definition is given by Gill who states that institutional abuse is “perpetrated not by any single person CHAPTER 9 or programme, but by the immense and complicated child care system, stretched END NOTES beyond its limits and incapable of guaranteeing safety to all children in care”.7
The term ‘institution’ was defined by the CICA as: “A school, an industrial school, a reformatory school, an orphanage, a hospital, a children’s home and any other place where children are cared for other than as members of their families.” (CICA)
DEFINITIONS OF ABUSE
The CICA in Ireland was required to hear the evidence of witnesses who wished to report four types of abuse as defined by the Acts. The definitions changed in the 2005 Act and the changes made by the 2005 Act are shown in the box on page 13:
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Physical abuse The wilful, reckless or negligent infliction of physical injury on, or failure to prevent such injury to, the child. Sexual abuse The use of the child by a person for sexual arousal or sexual gratification of that person or another person. Neglect QUICK Failure to care for the child which results, or could reasonably be expected to LINKS result, in serious impairment of the physical or mental health or development MAIN CONTENTS of the child or serious adverse effects on his or her behaviour or welfare. CHAPTER Emotional abuse CONTENTS Any other act or omission towards the child which results, or could reasonably be CHAPTER 1 expected to result, in serious impairment of the physical or mental health or development CHAPTER 2 of the child or serious adverse effects on his or her behaviour or welfare. CHAPTER 3
CHAPTER 4
A BRIEF HISTORY OF INSTITUTIONAL CHAPTER 5 CARE IN IRELAND CHAPTER 6
CHAPTER 7 The Relief of the Poor Act of 1598 provided for the appointment in every parish of ‘overseers of the poor’ with duties of ‘setting to work the children of all such whose parents shall not CHAPTER 8 be thought able to keep and maintain their children’. However, by the late eighteenth and CHAPTER 9 early nineteenth centuries, in both Ireland and Britain, the rapid growth of populations END meant that the parish ceased to be a viable unit for the administration of relief. Destitute NOTES children roamed the countryside or streets, foraging for food and pilfering for a livelihood.
On an official level, the response to this substantial social problem was the Poor Relief (Ireland) Act, 1838. This established a system of workhouses throughout the country, under the central authority of the Irish Poor Law Commissioners. By 1853, 77,000 children below 15 years of age (one third of them orphans), which was 6.5% of all children that age or under, were living in workhouses, while an unknown number of ‘street urchins’ were still living wild in the towns (CICA, 2009).
However, neither workhouses nor voluntary efforts were equal to the scale of the problem, and it came to be accepted that something more was required. In the first half of the nineteenth century in Britain and in Ireland, there were several commissions and committees to investigate both the broad subject of poverty and the particular needs of poor children. The industrial school system was proposed as a solution. This idea was based on a Continental model and by the 1850s Germany, Switzerland and Scandinavia had nearly a hundred institutions for criminal and destitute juveniles, whose achievements were well known in Ireland and Britain. The thrust of the education provided in these schools, some of which were called ‘Farm Schools’, was in favour of practical training, which would equip the children for employment, rather than academic
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learning. From the mid-19th century a huge network of institutions was developed in Ireland to care for children whose parents were deemed unable to look after them. These institutions were managed by religious orders and were largely state funded. Shortly after independence in 1921, this care system was put under the control of the Department of Education.
The three main categories of institutions were: Orphanages These were for children from more prosperous backgrounds who were in need of state care. QUICK LINKS Reformatory schools MAIN These were established in the mid-19th century and housed children convicted of criminal offences. CONTENTS Industrial schools CHAPTER CONTENTS The main reasons for children being committed by courts to industrial schools were non-attendance at school, conviction of criminal offences and, in the majority of cases, CHAPTER 1 for what was called lack of proper guardianship. This was often termed ‘neediness’. CHAPTER 2
There are varying estimates of the number of children who were effectively CHAPTER 3 incarcerated in Irish industrial and reformatory schools. CHAPTER 4
CHAPTER 5 According to Raftery and O’Sullivan (1999), 150,000 children (mainly female) were placed in industrial schools between 1869 and 1969 and 15,000 children (mainly male) between 1858 and CHAPTER 6 1969. 8 Irish government figures state that, ‘approximately 29,500 people, born since 1930, were CHAPTER 7 committed by the courts to industrial and reform schools. At its peak at the turn of the [20th] CHAPTER 8 century, this system contained a massive seventy one schools ... Up until the 1950s they contained over 6,000 children at any one time.’ (Dail Debates, 1 October 2003). The CICA estimates CHAPTER 9 that, during the period 1936–70, ‘a total of 170,000 children and young persons (involving about END NOTES 1.2 per cent of the child population) entered the gates of the 50 or so industrial schools’.
In 1990’s a series of television programmes documented the systemic abuse of children in Ireland’s Roman Catholic-run childcare system, primarily in the Reformatory and Industrial Schools, leading to an apology by the then Taoiseach, Bertie Ahern on 11 May 1999.
“On behalf of the State and all citizens of the State, the Government wishes to make a sincere and long overdue apology to the victims of childhood abuse for our collective failure to intervene, to detect their pain, to come to their rescue … ‘All children need love, care and security.’ Too many of our children were denied this love, care and security. Abuse ruined their childhoods and has been an ever present part of their adult lives, reminding them of a time when they were helpless. I want to say to them that we believe that they were gravely wronged, and that we must do all we can now to overcome the lasting effects of their ordeals.” Bertie Ahern, Former Taoiseach, 1999
Mr Ahern went on to outline a number of measures, including the setting up of a Commission to Inquire into Childhood Abuse. Other measures included the establishment of a national counselling service for victims of childhood abuse, and the amendment of the Statute of Limitations, to enable victims of childhood sexual abuse to make claims for compensation in certain circumstances.
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On 19 February 2013, Taoiseach Enda Kelly made an historic apology to the women who had been locked away in the Magdalene laundries and who were excluded from the earlier provisions:
“I, as Taoiseach, on behalf of this State, the Government and our citizens, deeply regret and apologise unreservedly to all those women for the hurt that was done to them, for any stigma they suffered as a result of the time they spent in the Magdalene laundry.” Taoiseach, Enda Kenny, 2013
Speaking in the debate on the McAleese report, which has reviewed the state’s involvement QUICK in the laundries, he added that the women deserved more than a formal apology and LINKS announced the appointment of Judge John Quirke to head a three-month review which MAIN CONTENTS will make recommendations about compensation, including ‘payments and other supports, CHAPTER including medical cards, psychological and counselling services and other welfare needs’. CONTENTS
CHAPTER 1 TIMELINE OF EVENTS RELATING TO CHAPTER 2 INSTITUTIONAL CARE IN IRELAND CHAPTER 3 CHAPTER 4
1868 The Industrial Schools Act. Industrial schools were established CHAPTER 5 to care for “neglected, orphaned and abandoned children.” They CHAPTER 6 were run by religious orders and funded by the public. CHAPTER 7 1900 Peak of industrial schools with 8,000 children in 71 schools. CHAPTER 8
1908 The Children Act defined reformatories as responsible for feeding, CHAPTER 9 clothing, housing and teaching young offenders and instigated annual END visits by an Inspector of Reformatory and Industrial Schools. NOTES
1924 The new State’s Department of Education noted that there were more children in industrial schools in the Irish Free State than in all of the United Kingdom.
1929 The Children Act allowed destitute children to be sent to industrial schools, even if they hadn’t committed a crime.
1933 The Commission of Inquiry Into Widows’ and Orphans’ Pensions found only 350 of the children in industrial schools were orphans (5.3 % of the total)
1933 Industrial schools were abolished in the UK, but not in Ireland.
1934 The Cussen Report, which investigated industrial schools, had reservations about the large number of children in care, the inadequate nature of their education, lack of local support and the stigma attached to the schools, but concluded that “schools should remain under the management of the religious orders”.
1945 Secretary to the Department of Education wrote to the Secretary of the Dept. of Finance to denounce the “grave situation which has arisen regarding the feeding and clothing of children in industrial schools” due to “parsimony and criminal negligence”.
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1945 Funding to industrial schools tripled.
1946 Rules governing industrial schools were updated and funding increased.
1946 Community pressure in Limerick led by Councillor Martin McGuire, on the Dept. of Ed forces the release of Gerard Fogarty, 14, from Glin Industrial School after he was flogged naked and immersed in salt water for trying to escape to his mother. A call for public inquiry into industrial schools was rejected by Minister of Education. Thomas Derrig because “it would serve no useful purpose”. QUICK LINKS 1946 Fr. Flanagan, famous founder of Boystown schools for orphans and delinquents in the MAIN CONTENTS US, visits Irish industrial schools. He describes them as “a national disgrace,” leading to a CHAPTER public debate in the Daíl and media. State and Church pressure forces him to leave Ireland. CONTENTS
1947 Three-year-old Michael McQualter scalded to death in a hot CHAPTER 1 bath in Kyran’s Industrial School. Inquiry found school to be “criminally CHAPTER 2 negligent,” but the case was not pursued by the Dept. of Education. CHAPTER 3
1951 State Inspector denounced conditions of industrial schools and care of children. CHAPTER 4
1952 State funding to industrial schools increased. CHAPTER 5 CHAPTER 6 1955 Secretary of the Department of Education visited Daingean Industrial School, Offaly, and found that “the cows are better fed than the boys.” Nothing was done for another 16 years. CHAPTER 7
CHAPTER 8 1957 Marlborough House building was condemned by the Dept. of Works as “a grave risk of loss of life.” No alterations were made, and it continued unchanged for 15 years. CHAPTER 9
END 1962 Fr. Moore, Chaplain at Artane Industrial School, complained about the abuse received NOTES by the boys in the school. The State dismissed his allegations as an exaggeration.
1963 The Bundoran Incident. Eight girls trying to escape from St. Martha’s Industrial School had their heads shaved. It became a scandal when it was front- page news in a British tabloid with photos and headline, “Orphanage Horror”. A Department of Education official visited the Mother Superior of the school to tell her “The Department was unlikely to do anything of a disciplinary nature”.
1967 Department of Health visit Ferryhouse Industrial School, Clonmel to investigate the death of a child from meningitis. They described conditions as “a social malaise” and recommended the closure of the school.
1969 Under 2,000 children were in 29 schools. Artane Industrial School was closed.
1970 The Kennedy Report recommended closure of industrial schools, as Justice Kennedy was “appalled” by the “Dickensian and deplorable state” of industrial schools.
1972 Marlborough House, Dublin closed down.
1984 Payment-per-head funding for children in care in Ireland was abolished.
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1984 Department of Health introduced fostering for children in care.
1989 The Children Act gave health boards powers to care for children.
1989 The God Squad by Paddy Doyle published.
1991 The Child Care Act gave powers to health boards to care for children who were ill-treated, neglected or sexually abused. QUICK 1996 The Madonna House Report detailed continuing physical and sexual abuse of LINKS children in State and Church care. The report was suppressed by the government. MAIN CONTENTS 1997 Dear Daughter was broadcast on RTE. Christine Buckley’s description of her CHAPTER abuse while under care in Goldenbridge sparks public debate on industrial schools. CONTENTS
CHAPTER 1 1998 The Christian Brothers in Ireland make a public apology to those who were physically or sexually abused in their care. CHAPTER 2
CHAPTER 3 1999 States of Fear by Mary Raftery and Eoin O’Sullivan was broadcast on RTE in April and May, renewing debate on industrial schools CHAPTER 4
CHAPTER 5 1999 Suffer the Little Children by Mary Raftery and Eoin O’Sullivan published CHAPTER 6 1999 Freedom of Angels by Bernadette Fahy published CHAPTER 7
1999 An Taoiseach Bertie Ahern apologised on behalf of the government CHAPTER 8 to the victims of child abuse in industrial schools, acknowledging the responsibility of the Irish State in providing services for children. CHAPTER 9 END NOTES 2000 The Commission to Inquire into Child Abuse is established to investigate the extent and effects of abuse on children from 1936 onwards
2000 Focus Ireland publication, Left Out On their Own, reported serious deficiencies in residential care. They found 75% of those leaving Health Board Care experience homelessness within the first two years of leaving.
2001 Catholic Church agreed to pay over £100 million into a special State fund for victims of abuse. In return, the State arranged that people seeking compensation from the Residential Institutions Redress Board are barred from suing the Church directly. Only victims of sexual, not physical, abuse are eligible for compensation.
2002 The Redress Board was set up under the Residential Institutions Redress Act, 2002 to make fair and reasonable awards to persons who, as children, were abused while resident in industrial schools, reformatories and other institutions subject to state regulation or inspection.
2005 The Commission to Inquire into Child Abuse (amendment act).
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2009 The Commission to Inquire into Child Abuse releases the “Ryan Report”. A 2600 page report which drew on testimony from thousands of former inmates and officials from more than 250 church-run institution
2011 The Residential Institutes Redress Board Closes
2012 The Residential Institutes Statutory Fund Act is published The board for the Residential Statutory Fund is established 2013 QUICK LINKS MAIN INSTITUTIONAL ABUSE AND THE MEDIA CONTENTS CHAPTER CONTENTS In the 1990s, a series of television programs publicised allegations of systemic abuse in CHAPTER 1 Ireland’s Roman Catholic-run childcare system, primarily in the Reformatory and Industrial Schools. The abuse occurred primarily between the 1930s and 1970s. These documentaries CHAPTER 2 included “Dear Daughter”, “Washing Away the Stain” and “Witness: Sex in a Cold Climate CHAPTER 3 and Sinners”. These programs interviewed adult victims of abuse who provided “testimony CHAPTER 4 of their experiences, they documented Church and State collusion in the operation of these institutions, and they underscored the climate of secrecy and denial that permeated the church CHAPTER 5 response when faced with controversial accusations.” In 1999, a documentary film series CHAPTER 6 titled “States of Fear” which detailed abuse suffered by Irish children between the 1930s and CHAPTER 7 1970s in the state childcare system, primarily in the Reformatory and Industrial Schools. The Irish Times writer, Greer, wrote in 1994 that “The collective impact of the media exposure CHAPTER 8 of these cases was to increase social awareness and to transform sex crime, and child abuse CHAPTER 9 in particular, from an issue of private to public concern. The subsequent impact on levels of END press attention to sex crimes was enormous”. For more on the role of the Irish media in NOTES raising awareness of institutional abuse see research by Colum Kenny and Donnelly & Inglis.9
“One of the first things I did was read up on the subject, like Suffer the Little Children from Mary Raftery and Eoin O’Sullivan. I watched States of Fear and read about the Redress Board and the Commission to Enquire into Childhood Abuse - all these sort of subjects - and found out more about the experiences of survivors. That’s the first thing I’d recommend for anyone who wants to work with survivors to understand that it’s a very specific experience.” Outreach Worker, SSGT Project
Open Hearts & Open Minds: A toolkit of sensitive practice for practitioners working with survivors of institutional childhood abuse 17 2 Institutional childhood abuse in Ireland: an overview
REPORTS AND COMMISSIONS BY GOVERNMENT AND RELIGIOUS ORDERS
The Cussen Report (1936) The Cussen Report was the first comprehensive assessment of the industrial school and reformatory system. It surveyed conditions in 54 institutions, all managed by Roman Catholic religious orders or parish priests, and was dissatisfied with aspects of the education and training of the residents, as well as with the appropriateness of such places for disabled QUICK LINKS children (who were found in these homes in large numbers) and the stigma attached to such MAIN institutions. However, the Report’s conclusion largely supported the continuation of the CONTENTS system. In 1938, the responsible arm of government, the Department of Education, appointed CHAPTER Dr Anna McCabe to be responsible for general and medical inspection. She first reported in CONTENTS 1939. Although she did not always endorse allegations of abuse, Dr McCabe began a campaign CHAPTER 1 to address what she described as the appalling and Dickensian conditions she found. CHAPTER 2
The Kennedy Report (1970) CHAPTER 3 In 1967, the Department of Education established the Kennedy Committee which was CHAPTER 4 charged with visiting all of the 34 remaining reformatory and industrial schools. The Committee reported in 1970 in detailed and scathing terms, which were described by CHAPTER 5 Tom Boland (Director of Strategic and Legal Services in the Department of Education CHAPTER 6
and Science during the formative period of the Commission) as having confirmed the CHAPTER 7 ‘folk memory’ that ‘the institutions were desperate places’ (Boland 2004). The Kennedy Commission questioned the ethos of caring for children in large institutions and noted CHAPTER 8 the state’s ‘totally inadequate financial provision’ for the running of the schools (Kennedy CHAPTER 9
Report 1970: para 5.8). The Report also pointed out deficiencies in planning, training, END and inspection and made important recommendations regarding present and future child NOTES care in Ireland. These included the abolition of the existing residential care system and it named several institutions for immediate closure. The process of closing down the reformatories and industrial schools, which was already underway (by 1969 just 31 schools were left), accelerated following the publication of the Report. These closures did not, however, signal any dramatic improvement in state provision of child care in Ireland.
The Commission to Inquire into Child Abuse (1999) The mid to late 1990s was a time of increasing public consciousness of the impact of the institutional regimes upon thousands of Irish children and families. In March 1998, the Irish government first began to discuss formally the need for an official response to the problem of institutional child abuse. In April 1999, an official working group on the subject proposed to the government a comprehensive package of measures. These measures included an Inquiry, the provision of a national counselling service and amendment to limitation legislation in respect of sexual abuse claims. Available along with the national counselling service for survivors would be family-tracing assistance through Barnardo’s and a scheme of educational grants for those who had been deprived of educational opportunity.
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A Commission to Inquire into Child Abuse Act (‘the Act’) became law on 26 April 2000 and the Commission was established on 23 May 2000. The functions of the Commission were outlined in the Act as follows: • To provide for persons who suffered abuse in childhood in institutions an opportunity to recount the abuse and make submissions • To conduct an inquiry into the abuse of children in institutions and to ascertain why it occurred and who was responsible QUICK • To publish a report setting out its findings and recommendations including LINKS in particular recommendations on the steps which should be taken to MAIN CONTENTS deal with the continuing effects of abuse and to protect children in similar CHAPTER situations from abuse at the present time and in the future. CONTENTS
The Commission was to be comprised of two committees: the Confidential Committee CHAPTER 1 and the Investigation Committee. These would be entirely separate in composition, each CHAPTER 2 with its own Chairperson. A complainant could only appear before one or the other of the committees, although there was some provision for changing from one to the other CHAPTER 3 (s 19). The Commission defined ‘complainant’ as the person alleging that he or she was CHAPTER 4 abused. Respondents could be either an individual, a management body (usually religious CHAPTER 5 organisations) or a regulatory body (a governmental body). The Confidential Committee would have a predominantly therapeutic function, as a forum where survivors of abuse CHAPTER 6 who did not wish to have that abuse inquired into by the Investigation Committee could CHAPTER 7 tell of their experiences in a sympathetic and private environment. The Confidential CHAPTER 8 Committee would make a general report to the Commission based upon its findings. CHAPTER 9
The Residential Institutions Redress Act (2002) END The State initially envisaged a compensation scheme which would follow-on from NOTES the work of the Commission to Inquire into Child Abuse. That is, the Commission’s Investigation Committee would determine issues of fact concerning allegations of abuse, and a Compensation Board would decide the level of damages. During the early stages of the Commission, it became clear that the Investigation Committee would not be able to function unless the scheme of compensation was initiated. The Government decided that it would proceed with the establishment of the Redress Board in advance of completion of the work of the Commission. The Bill was signed into law by the President on 10 April 10 2002 and is now the Residential Institutions Redress Act 2002. The Redress Board was set up under the Residential Institutions Redress Act, 2002 to make fair and reasonable awards to persons who, as children, were abused while resident in industrial schools, reformatories and other institutions subject to state regulation or inspection. Between 2002 and 2012 the board proceeded close to 15,210 applications.
Open Hearts & Open Minds: A toolkit of sensitive practice for practitioners working with survivors of institutional childhood abuse 19 2 Institutional childhood abuse in Ireland: an overview
The Commission to Inquire into Child Abuse (Amendment) Act (2005) The “Commission to Inquire into Child Abuse (Amendment) Act 2005” gave effect to the recommendations of the report of the Government of the “Review Group on the Commission to Inquire into Child Abuse” and the report and subsequent recommendations of Mr. Justice Ryan, on the workings of the Commission. The new provisions allowed for extension of the Commission’s functions, by including a duty on the Commission to inquire into the manner in which children were placed in institutions and the circumstances in which they continued to be resident there. The Act also removed the obligation on the Investigation QUICK Committee to hear all complainants and gave it discretion as to which witnesses it considered LINKS should be called to a full hearing, to ensure that the inquiry’s functions are fulfilled. MAIN CONTENTS
CHAPTER The Ferns Report (2005) CONTENTS The Inquiry was set up by the Government of Ireland to identify complaints and allegations CHAPTER 1 made against clergy of the Diocese of Ferns prior to April 2002, and to report upon the response of Church and Civil Authorities. The Inquiry did not concern itself with CHAPTER 2
the truth or otherwise of the complaints and allegations made, but entirely with the CHAPTER 3 response to those allegations. The Inquiry recorded its revulsion at the extent, severity CHAPTER 4 and duration of the child sexual abuse allegedly perpetrated on children by priests acting under the aegis of the Diocese of Ferns. The investigation was established in the wake CHAPTER 5
of the broadcast of a BBC Television documentary Suing the Pope, which highlighted CHAPTER 6 the case of Fr Seán Fortune, one of the most notorious clerical sexual offenders. CHAPTER 7 The Ferns Report was presented to the Irish government on 25 October 2005 and CHAPTER 8 released the following day. It identified more than 100 allegations of child sexual abuse made between 1962 and 2002 against twenty-one priests operating under the aegis of the CHAPTER 9 Diocese of Ferns. Eleven of these individuals were alive in 2002. The nature of the response END NOTES by the Church authorities in the Diocese of Ferns to allegations of child sexual abuse by priests operating under the aegis of the diocese had varied over the forty years to 2002.
Commission of Investigation, Dublin Archdiocese (2009) The Dublin Archdiocese Commission of Investigation was established to report on the handling by Church and State authorities of a representative sample of allegations and suspicions of child sexual abuse against clerics operating under the aegis of the Archdiocese of Dublin over the period 1975 to 2004. It was released in 2009, a few months after the report of the Commission to Inquire into Child Abuse. The Commission of Investigation was headed by Judge Yvonne Murphy, starting in 2006. The original brief was to report in 18 months, but such was the volume of evidence and allegations concerning the abusive behaviour of a sample batch of just 46 priests that time extensions had to be allowed.
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The Residential Institutions Statutory Fund Act 2012 The Residential Institutions Statutory Fund (RISF) was officially established on March 25th 2013, and is now known as ‘Cara Nua’. It will oversee the use of the cash contributions of up to €110 million pledged by the religious congregations to support the needs of some 15,000 survivors of residential institutional child abuse. The legislation from the act indicates that support will be available for survivors and this will include a range of approved services, including health and personal social services, education and housing services. By autumn 2013 €60m had been received from the congregations. QUICK LINKS Minister for Education and Skills, Ruairi Quinn said, “The establishment of the MAIN Residential Institutions Statutory Fund Board represents a critically important step CONTENTS
in responding to the needs of those who were subjected to horrendous abuse while CHAPTER children in residential institutions. I greatly appreciate the fact that the members have CONTENTS agreed to contribute to the work of the Board and I wish them well in their work. CHAPTER 1
While the tasks facing the Fund are significant, I am confident that it will make a CHAPTER 2 meaningful contribution to the wellbeing of the survivors of institutional abuse”.10 CHAPTER 3
CHAPTER 4
CHAPTER 5 QUESTIONS FOR REFLECTION AND DISCUSSION CHAPTER 6 • How does institutional abuse differ from sexual abuse or CHAPTER 7 abuse which occurs within a family setting? • How is this difference important when you are working with clients? CHAPTER 8 • What feelings do the government and religious responses to the abuse bring up for you? CHAPTER 9 • How might these feelings affect your work with clients? END NOTES • Apart from abuse itself, what other information might clients disclose that indicates institutional upbringing? There is more information about this in Chapter 6 (page 52).
Open Hearts & Open Minds: A toolkit of sensitive practice for practitioners working with survivors of institutional childhood abuse 21 QUICK LINKS MAIN EXPERIENCES IN CARE CONTENTS
WHAT CHILDHOOD IN AN INSTITUTION WAS LIKE CHAPTER 1
CHAPTER 2 This chapter explores: CHAPTER 3
What were the experiences of children in the institutions? 24 CHAPTER 4 Why did individual children enter care? 24 CHAPTER 5 CHAPTER 6 The extent of abuse 25 CHAPTER 7 What forms of abuse did individuals experience? 25 CHAPTER 8 Questions for reflection and discussion 30 CHAPTER 9
END NOTES
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WHAT WERE THE EXPERIENCES OF CHILDREN IN THE INSTITUTIONS?
Using statistical and first-hand accounts from the CICA,11 this chapter gives an outline of the experiences of institutional upbringing during the period 1939-1970. ICA is not homogeneous and survivors experienced significantly different childhoods. Nevertheless, as the research tells us, there are some common treads to these experiences. Neglect, abuse and abandonment were often at the heart of it. The chapter aims to give a broad contextual QUICK picture of the main reported reasons why children ended up in care and to familiarise the LINKS reader with the types of abuse often encountered by children during their time in care. MAIN CONTENTS In our experience, the more practitioners can understand the experience that was ICA, CHAPTER the more sensitive and empathetic they will be when working with survivors of ICA. CONTENTS
CHAPTER 1 WHY DID INDIVIDUAL CHILDREN ENTER CARE? CHAPTER 2 CHAPTER 3 Although the balance varied from decade to decade, the majority of children were CHAPTER 4 committed to industrial schools and reformatories because they were deemed to be ‘needy’. Although it is certainly true that many children who entered care were needy in CHAPTER 5 the sense of being impoverished, it is important to consider the wider societal context CHAPTER 6 and primary reasons why most children entering care. As Rafferty and O’Sullivan note: CHAPTER 7
“Approximately eighty per cent of all children committed, and over ninety per CHAPTER 8
cent of girls, came under the category ‘lack of proper guardianship’. In practice, CHAPTER 9 this was a catch-all heading, which included children of unmarried mothers not END eligible for adoption, children who had lost one or both parents, those whose NOTES parents were incapacitated through illness, or whose families were unable to look after them due to poverty. Homeless children came within this category, as did those whose families had been broken up because of desertion or the imprisonment of one parent. However, in all these cases, the language and procedure of the courts was to place the onus of guilt on the child, and the State, rather than attempting to address the poverty that existed in these families, chose instead to fund religious orders to effectively incarcerate these children.”12
Almost three-quarters of witnesses (72%) who participated in the CICA were admitted directly from the family unit, with the remainder entering from mother and baby homes (12%), various forms of foster care (7%), or children’s homes (5%). The remaining 4% of witnesses were unable to determine how they came to end up in institutional care.13
Alcohol abuse, poverty, unemployment, family violence and lack of care and control at home were the most common reasons given by witnesses as the cause for their admission into care, with 30% of those interviewed citing the above reasons as contributory factors to their admission. Almost as many witnesses (29%) identified being admitted to into care as a consequence of being a non-marital child. 14% of the survivors interviewed were admitted into care due to a conviction for a criminal offence, the majority of which consisted of petty
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theft of clothes, food and money. Only 8% of those interviewed were admitted to care due to abandonment by a parent and in many of these instances it was the father that left, usually to seek work in the UK or USA. Poor health and substance misuse, highly prevalent during the period described, were often cited as contributory factors also, as one witness explained:
“Mum had TB, my father couldn’t look after us ... he was an alcoholic ... I have no recollection because I was only 18 months ... (old) ... going there ... All my Mam’s family had died of TB, she was the only one that survived, basically she was on her own. I saw my father once, I remember him coming QUICK up one Christmas. I didn’t know I had brothers until ... (later years) ...”14 LINKS MAIN CONTENTS
CHAPTER THE EXTENT OF ABUSE CONTENTS
“All participants had experienced multiple forms of CHAPTER 1 abuse and neglect.” Fitzpatrick et al 2010: 394 CHAPTER 2
CHAPTER 3 Whatever the circumstances cited for admission into institutional upbringing, over 90% of all respondents to the CICA experienced a combination of physical neglect, physical abuse, CHAPTER 4 emotional neglect and emotional abuse. More than four in every ten witnesses interviewed CHAPTER 5 testified to being sexually abused, in many cases severely, repeatedly and in a systematic fashion. CHAPTER 6 Volume 3 of CICA (2009) provides statistical and qualitative data of survivors' testimony given by witnesses to the Confidential Committee, regarding the nature and scale of CHAPTER 7 child abuse in Irish institutional care up to 1989. There were 857 reports of child abuse, CHAPTER 8 involving 474 males and 383 female survivors, given to the Confidential Committee. It CHAPTER 9 exposes a catalogue of physical, emotional and sexual abuse, in tandem with neglect that END cannot be explained by unique historical or cultural circumstances (Ferriter, 2006). NOTES
WHAT FORMS OF ABUSE DID INDIVIDUALS EXPERIENCE?
Here we give an overview of the types of abuse and neglect experienced by those who submitted testimony to the Commission to Inquire into Child Abuse. The examples are by no means exhaustive and are intended only to brief the reader in preparation for dealing with a survivor of ICA in a sensitive and empathetic manner. Further advice is outlined in {chapter 6 and later chapters. The 4 main types of abuse found within the Commission to Inquire into Child Abuse can be broadly defined as: Physical abuse, emotional abuse, sexual abuse and neglect.
Neglect CICA categorised neglect under a series of headings: diet, hygiene, health care, education and a lack of supervision. Forty-six percent of witnesses complained of being constantly hungry or ‘starving’. Some male witnesses reported having to survive on a diet of ‘unsweetened sludge’ made up of bread dipped in dripping and shell cocoa. Some female witnesses told a similar story of hunger: “if you saw anybody eating anything you just went up and grabbed it, we were always
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hungry”. Amongst the female witnesses, twenty-two reported eating grass, leaves and berries and twenty-six remembered lack of drinking water and having to drink water from the toilets.
Prior to the 1970s basic sanitary standards were very poor. Life in care for children was defined by almost military levels of routine, with play a periphery feature and education subjugated to hard, mainly unpaid, manual work, one of the over-riding features of life in care during this period. For females, this often included time working in the laundry; ironing, washing, sewing as well as being charged with looking after young babies, often totally unprepared and unsupervised as these examples illustrate: QUICK LINKS MAIN “Witnesses reported having to wash, starch and iron nuns’ habits, clerical CONTENTS vestments and altar linen, sheets, shirts and table linen. The work in the CHAPTER washrooms and laundries was described as laborious, without the aid of CONTENTS
washing machines or other equipment in the period prior to the 1960s. CHAPTER 1 Witnesses recalled standing on boxes as small children to reach into laundry CHAPTER 2 troughs and washing nun’s sanitary cloths in cold water with bare hands.”15 CHAPTER 3 “I distinctly remember the babies would be on potties for a long time and sometimes the older children would lift them up and with a cloth push this CHAPTER 4 thing ... (rectal prolapse) ... I didn’t know what was going on at the time.”16 CHAPTER 5
The types of work expected from boys included: “weaving, shoemaking, CHAPTER 6 tailoring, and carpentry workshops, kitchens, staff residences, farmyards, fields CHAPTER 7 17 and bogs, as well as day labouring for local farmers and businesses.” CHAPTER 8
Emotional abuse CHAPTER 9 END The CICA documented survivors' testimony of emotional abuse with regards to: deprivation of NOTES family contact; personal identity; secure relationships; affection; approval; and a lack of protection.
“Witnesses reported a daily existence in the Schools that was dominated by fear, humiliation, loneliness, and the absence of affection. Fear was strongly associated with the daily threat of being physically and otherwise abused and seeing co-residents being abused. Constant apprehension about the next abuse to which they would be subjected was also a feature.” CICA, 2009
The state of constant fear was a source of enormous emotional distress for children in care, many of whom reported being in an unrelenting state of fear at being singled out for physical or sexual abuse. Such was the extent of this fear that survivors often referred to it as ‘mental torture’ and describe it in equal terms with that of physical abuse:
“You were in constant fear; you were terrified all the time. There would be a sudden explosion of punishment as the poor souls were thrashed or whacked. In class I would be so fearful I would be shaking as the Brother passed, who might hit you for no reason.” CICA, 7.229
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This fear of physical violence was not unfounded as this account by one male witness graphically illustrates:
“The man doesn’t deserve to be called Brother. I was only 5 feet away the day it happened…If he walked in everyone was on edge ... I’m not sure why but this evening he Br ... X ... walked straight down the passage way and he dragged ... (named co-resident) ... out of his chair ... crying ... and he gave him an unmerciful beating, an unmerciful beating. I’m telling ye he did not stop with that leather strap … I’m telling ye, you wouldn’t beat an animal QUICK the way he beat ... named co-resident ... To this day it haunts me, the whole LINKS MAIN place was full and he was left lying. Br ... X ... cleared the place out … That CONTENTS was the last time, the very last time, I seen ... named co-resident ... I think CHAPTER it was 3 days afterwards I heard he was dead ... It has haunted me.”18 CONTENTS
CHAPTER 1 Even if the threatened violence did not materialise, many witnesses report feeling immense guilt at the subsequent sense of relief they felt, as one male witness explains: CHAPTER 2
CHAPTER 3 “Even when I was in the dormitory you used to hear the frock, the thing they ... (Brothers) ... used to wear. I’d hear them walking down and you’d be CHAPTER 4 hoping they would not stop at you. I remember in the bed praying to God CHAPTER 5 they would take somebody else instead of you, and then would say “thanks CHAPTER 6 God for saving me”. You’d feel guilty about that ... The screams of the fellas being abused, everyone could hear it ... I was actually terrified.”19 CHAPTER 7 CHAPTER 8 Bed wetting was a common occurrence, which was punished severely. The constant state of starvation of the children was also manipulated to form a source of emotional as well as CHAPTER 9 physical abuse: “There would only be a few pieces of food and you wanted to make sure END NOTES that you got a bit. He’d ... (lay ancillary worker) ... call you up and then when you were half way up he’d say ‘false alarm’ and you’d have to go back with nothing.” (CICA, 7.227).
Fear, humiliation, loneliness, and the absence of affection were the hallmarks of many of the witnesses’ experiences in care and in many ways was every bit as damaging as the physical and sexual abuse, as one witness described: “The emotional abuse was worse than the physical abuse and its effects have stuck since then”.20 This form of emotional abuse often had life- long affects on survivors of abuse, long after they had been discharged from institutional care: “The worst thing was the emotional removal of self: it still has a huge effect on my life.”21
Physical abuse A defining feature of institutional upbringing was the rigid control by means of severe corporal punishment. A climate of fear, created by pervasive, excessive and arbitrary punishment, permeated most of the institutions and all those run for boys. Children lived with the daily terror of not knowing where the next beating was coming from. Seeing or hearing other children being beaten was a frightening experience that stayed with many all their lives.
The CICA found a complex picture of physical abuse. There were 474 reports of physical abuse involving 26 Schools given in evidence by 403 male (98%), some of whom were admitted to more
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than one School. While many witnesses reported that the abuse was pervasive, they particularly wished to report extraordinary incidents from their experience. Other witnesses reported multiple episodes of physical abuse. Witnesses reported being physically abused by religious and lay staff and others including: visiting clergy, members of the general public and men in work and holiday placements. Witnesses also reported being physically abused by co-residents.
“I had a hiding in the boot room, you had to take your shirt off, you were completely naked and he ... (Br X) ... beat me with a strap and a hurley stick on the behind and the legs and that.” QUICK LINKS “I was beaten up quite a few times for not making the bed right, I had to go to MAIN the boot room. We used have long night shirts then you know, he ... (Br X) ... CONTENTS dragged it off me, naked and whop, he knocked hell out of me, he knocked the CHAPTER CONTENTS shit out of me ... he hit with a leather strap with coins in it. One Brother ... he used a tyre he did, a bicycle tyre, it used to wrap around your arm. That was CHAPTER 1
for wiping my nose in my sleeve, he didn’t like that, it “wasn’t a nice thing”. CHAPTER 2
“Some of the Brothers had different leathers, I know because I made them CHAPTER 3 when I was 14, in the boot room, some of them had little tiny leads in them, CHAPTER 4 some had coins, some were straight. They weren’t soft, they were hard.” CHAPTER 5
Sexual abuse CHAPTER 6 CICA (2009) defines child sexual abuse as: CHAPTER 7
“The use by a person for sexual arousal or sexual CHAPTER 8 gratification of that person or another person.” CHAPTER 9
Of the 274 reports of sexual abuse submitted by female witnesses to the Confidential Committee END NOTES of CICA (2009), almost 2 in every 5 witnesses (38%) had been fondled inappropriately, 1 in 5 had experienced enforced nakedness/voyeurism (19%), whilst 1 in 10 reports were of vaginal rape. Female witnesses reported being stripped naked (often by nuns) and beaten, sometimes in the view of male lay workers or priests. Female witnesses reported being abused by a wide range of people; grounds staff, lay care workers, teachers, clergy, nuns and the general public.
The testimony received by survivors as part of CICA included sexual abuse ranging from ‘contact’ sexual abuse encompassing rape and associated physical violence to ‘non-contact’ abuse such as enforced nakedness or voyeurism. The scale and extent of sexual abuse reported to the Commission to Inquire into Child Abuse included:
“Inspection of genitalia, kissing, fondling of genitalia, forced masturbation of, and by, an abuser, digital penetration, penetration by objects, oral and anal rape and attempted rape, by individuals and groups. Witnesses also reported several forms of non-contact sexual abuse including detailed interrogation about sexual activity, indecent exposure, inappropriate sexual talk, voyeurism, and forced public nudity.”22
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Sexual abuse came from a disarming array of sources, with witnesses testifying to abuse by members of the clergy, lay workers and also from other children in care. In a hierarchy of fear, abuse was cascaded from one level to the next, with no one immune to its effects in one form or another.
“There was things ... (sexual abuse) ... going on, between the lads, and I was absorbed into it. The way we behaved with one another, it was all based on fear. The physical violence ... it was the way the whole thing was held together. ... You had the strongest to the weakest boys, the strongest can pick on anybody, the QUICK strongest do it to the weakest boys and the darkness is handed out back along.”23 LINKS MAIN CONTENTS Perpetrators of abuse went to great lengths to stop the boys from reporting the CHAPTER abuse, with threats of violence and psychological manipulation a common feature of CONTENTS the abuse. Even if a child had the courage to report an incident of abuse it was rarely CHAPTER 1 acted upon and in many cases resulted in a physical punishment and more severe treatment going forward. Not knowing who was safe to turn to left many of the CHAPTER 2 witnesses feeling totally isolated, as this story from one male witness illustrates: CHAPTER 3
“One Brother kept watch while the other abused me ... (sexually) ... then CHAPTER 4 they changed over. Every time it ended with a severe beating. When I told the CHAPTER 5 priest in Confession, he called me a liar. I never spoke about it again.”24 CHAPTER 6
“I ... used to go out to the garden, there was this man in the fields there CHAPTER 7 ... (lay ancillary worker) ... He’d say “howya” ... I said “hello” but I CHAPTER 8 didn’t have anything to do with him. He brought me into a room, it was kinda like a little house and locked the door and ... he raped me, he just CHAPTER 9 took everything off me and he kept saying, “you tell them and I’ll kill END NOTES you”, I was only about 14. I felt dirty and to this day I feel dirty.”25
The threat of violence to siblings of the abused was a common psychological weapon used to deter reporting the abuse. Many witnesses recalled reporting abuse to other clergy or lay staff to no avail:
“When I told nuns about being molested by ambulance driver, I was stripped naked and whipped by four nuns to ‘get the devil out of you’.”26 “I told another girl ... (about sexual abuse) ... she told the nuns, 4 of them beat me, they said I had to go to Confession. I had to say it so loud so that she would hear me confess my sin, then she knew that I had confessed and they ... (four nuns) ... said a chant over me. They decided a time and place to beat the devil out of you, they didn’t do it straight away, they made you wait. I always remember her saying ... ‘you’re a filthy Communist’.”27
The Commission to Inquire into Child abuse: www.childabusecommission.com/rpt/pdfs
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QUESTIONS FOR REFLECTION AND DISCUSSION • What reactions did you have to the accounts of abuse and neglect outlined in this chapter? • What, in your opinion, is an appropriate reaction to this information? • How might your personal feelings about ICA influence your work with survivors? • How could you monitor your own responses to ensure as good an experience as possible for the person disclosing? • What safeguards could you put in place for yourself, to make QUICK your reactions to disclosures of ICA appropriate? LINKS MAIN CONTENTS
CHAPTER CONTENTS
CHAPTER 1
CHAPTER 2
CHAPTER 3
CHAPTER 4
CHAPTER 5
CHAPTER 6
CHAPTER 7
CHAPTER 8
CHAPTER 9
END NOTES
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CHAPTER 5 This chapter provides a short review of some of the available research on the psychological impact of ICA. Although there is an increasing body of research on CHAPTER 6
childhood maltreatment, ICA remains an under-researched area. However, two CHAPTER 7 seminal studies, Carr et al., (2009)11 and Wolfe et al., (2006), have been conducted CHAPTER 8 in this area and we urged readers to take the time to read these.28 As noted in both studies, the samples are not representative, and although the data paints a CHAPTER 9
useful picture of the current needs of survivors of ICA, it is important to remember END that survivors may, and will, present with varying levels of need and resilience. As NOTES with all research it is important to be mindful about how it can be translated into practice. Although practitioners may use this data to better understand the potential presenting needs of survivors, it remains vital that those working with survivors work in a person-centre way and consider the individualised needs of their clients.
This chapter includes statistical data about:
The known effects of institutional childhood abuse 32 Long-term effects of institutional childhood abuse (Table 1) 32 Commonly reported symptoms and emotional reactions to abuse (Table 2) 33 Rates of life problems of all 247 participants (Table 3) 33 Rates of current psychological disorders among survivors of institutional living (Table 4) 34 Questions for reflection and discussion 35
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THE KNOWN EFFECTS OF INSTITUTIONAL CHILDHOOD ABUSE
In the short-term, ICA has profound effects on cognitive and social development of survivors. Wolfe et al. (2006) found that 88% of a group of 76 Canadian adult survivors of institutional abuse, at some point in their lives, suffered from a psychological disorder.29 Post-Traumatic Stress Disorder (PTSD) and other anxiety disorders, depression and alcohol abuse were the most common disorders. Initial studies on the long-term effects institution upbringing has shown that QUICK compared with children reared in families, those reared in institutions had poorer adjustment. LINKS MAIN CONTENTS
TABLE 1 Long-term effects of institutional childhood abuse CHAPTER (taken from Wolfe et al, 2006) CONTENTS
• Personality disorder CHAPTER 1
• Criminality (especially in men) CHAPTER 2 • Marked marital problems CHAPTER 3 • Multiple broken co-habitations CHAPTER 4 • Teenage pregnancy (in women) CHAPTER 5 • Having one’s children taken into care (for women). CHAPTER 6
In 2009, Carr et al., examined the psychological adjustment of adult survivors of institutional CHAPTER 7 30 abuse in Ireland. 247 adult survivors of institutional abuse in industrial and reformatory CHAPTER 8 schools recruited through CICA were interviewed. The study found 25% had passed the CHAPTER 9 Primary Certificate Examination, 6.1% had passed the Intermediate Certificate Examination END and only 5.3% had passed the Leaving Certificate Examination (Carr, et. al., 2009). Participants NOTES were predominantly of lower socio-economic status (SES) with 24% unemployed; 15.4% unskilled manual workers; 28% semiskilled manual workers; and 12% skilled manual worker. Only 3.2% were non-manual workers. Only 3.65% were in lower professional and managerial posts, and only 0.4% had higher professional or managerial appointments. 34% of participants were retired. With respect to the stability of long-term romantic or marital relationships, 34.6% of the 217 participants who had long term relationships were still in these relationships. 36.4% reported that they had been in one long-term relationship that had ended.
Carr et al, found that all participants had experienced one or more significant life problems with mental health problems, unemployment and substance use being the most common. More than four fifths of participants had an insecure adult attachment style, indicative of having problems making and maintaining satisfying relationships.
Open Hearts & Open Minds: A toolkit of sensitive practice for practitioners working with survivors of institutional childhood abuse 31 4 The impact of institutional childhood abuse: statistical information
TABLE 2 Commonly reported symptoms and emotional reactions to abuse (Wolfe et al, 2001)31
• Alcohol abuse • Intimacy problems • Behavioural problems • Lack of self-identity • Confusion about sexuality • Memories/flashbacks • Criminal behaviour • Poor self-esteem QUICK • Degradation • Robbed of Innocence LINKS • Drug abuse (marijuana, LSD) • School dropout MAIN CONTENTS • Employment difficulties • Self blame CHAPTER • Feeling empty inside • Self doubt CONTENTS • Guilt • Sexual problems CHAPTER 1
• Homelessness • Shame CHAPTER 2
• Inability to trust • Stigmatisation – homosexuality label CHAPTER 3
• Interpersonal relationship problems • Trouble with parents, boy/girlfriends, CHAPTER 4 husband/wife CHAPTER 5
CHAPTER 6
TABLE 3 Rates of life problems of all 247 participants CHAPTER 7 32 (CICA) CHAPTER 8
CHAPTER 9 80% END 70% NOTES 60% 50% 40% 30% 20% 10% 0%
Self harm
Homelessness Violent crime Unemployment Frequent illness Substance misuse Non-violent crime
Mental health problems Frequent hospitalisation Anger control with children Incarceration for violent crime
Incarceration for non-violent crime Anger control in intimate relationships Institutionalisation for mental health issues
Open Hearts & Open Minds: A toolkit of sensitive practice for practitioners working with survivors of institutional childhood abuse 32 4 The impact of institutional childhood abuse: statistical information
About four fifths of participants at some point in their life had had a psychological disorder including anxiety, mood, substance use and personality disorders. The overall rates of psychological disorders among survivors of institutional living, for most disorders, were double those found in other community populations in Europe and North America (2009).
TABLE 4 Rates of current psychological disorders among survivors of institutional living compared with rates in QUICK normal community samples in Europe and the USA LINKS (CICA)33 MAIN CONTENTS
CHAPTER CONTENTS 50% CICA 45% CHAPTER 1 Europe 40% CHAPTER 2 USA 35% CHAPTER 3 30% CHAPTER 4 25% 20% CHAPTER 5
15% CHAPTER 6 10% CHAPTER 7 5% CHAPTER 8 0% Anxiety Mood Personality Alcohol or disorders disorders disorders substance CHAPTER 9 misuse END disorder NOTES
When this abuse occurs within a residential childcare setting, there are particular aspects which cause acute problems for survivors, and which have direct implications for the development of resilience. These are discussed at length by Wolfe et al (2003), who referred to them as “dimensions of harm”: betrayal and diminished trust; shame, guilt and humiliation; fear of or disrespect for authority; avoidance of reminders; and injury and vicarious trauma.34
“Even somebody who appears outwardly to have come – I won’t say survived but who has come through it and done something with their lives. Even that person – even if I wanted to describe myself as that sort of person – still within me there are certain things in my life that will happen, little incidents that people might do without realising and it will traumatise me like that.” Survivor, SSGT Projects
Carr’s and Wolfe’s studies show that although the majority of survivors of ICA show signs of psychological maladaptation, this is not true of all survivors of ICA. In Wolfe’s study, 12% were “resilient and showed good adaptation, despite institutional abuse”. In an Irish context, similar findings have emerged.35 Flanagan et al., (2009) found that of
Open Hearts & Open Minds: A toolkit of sensitive practice for practitioners working with survivors of institutional childhood abuse 33 4 The impact of institutional childhood abuse: statistical information
a group of 247 Irish survivors of institutional abuse, 45 survivors display the common disorders previously discussed.36 According to Flanagan, the “resilient group was older and of higher socioeconomic status; had suffered less sexual and emotional abuse; experienced less traumatisation and re-enactment of institutional abuse; had fewer trauma symptoms and life problems; had a higher quality of life and global functioning; engaged in less avoidant coping and more resilient survivors had a secure attachment style”.37
Institutional child sexual abuse and suicidal behaviour: Outcomes of a literature review, consultation meetings and a qualitative study: www.nosp.ie/institutional_07.pdf QUICK LINKS MAIN CONTENTS
CHAPTER QUESTIONS FOR REFLECTION AND DISCUSSION CONTENTS
• How can this data be used in your work with survivors? CHAPTER 1
• How should it not be used? CHAPTER 2 • Does the data reflect your experiences of working with survivors? CHAPTER 3 • Having read through Carr et al. and Wolfe et al., do you have CHAPTER 4 further thoughts about how to use this data? CHAPTER 5
CHAPTER 6
CHAPTER 7
CHAPTER 8
CHAPTER 9
END NOTES
Open Hearts & Open Minds: A toolkit of sensitive practice for practitioners working with survivors of institutional childhood abuse 34 QUICK LINKS MAIN DEVELOPING CONTENTS SENSITIVE PRACTICE CHAPTER 1 CHAPTER 2
This chapter sets out some principles which form a framework for CHAPTER 3 developing sensitive practice. It is based on research with a sample CHAPTER 4 of emigrant survivors of ICA about their experiences seeking professional help. From the research these themes emerged: CHAPTER 5 CHAPTER 6 Introduction 37 CHAPTER 7 Taking time 37 CHAPTER 8 Building rapport 38 CHAPTER 9
Sharing control 40 END NOTES Respecting boundaries, including privacy and confidentiality 40 Demonstrating understanding of institutional abuse 42 Understanding the complex traumatic effects of institutional abuse 42 Sensitivity about literacy and educational attainment 43 Sensitivity to identity loss 44 Moving on and building resilience 45 Questions for reflection and discussion 45
Open Hearts & Open Minds: A toolkit of sensitive practice for practitioners working with survivors of institutional childhood abuse 35 5 Developing sensitive practice
INTRODUCTION
When the project team first looked at how to develop training for practitioners working with survivors of ICA, we found a lack of previous research on what survivors perceived as good and sensitive practice. We decided to conduct focus groups with a small cohort of emigrant survivors with a view to developing principles of sensitive practice, building on a previous study (Schachter et al. 2009). In total 22 survivors of ICA were interviewed, all Irish and living in the London, and all but 2 female; we learned about what survivors found distressing or QUICK disturbing, what led to disengagement, and what was good and sensitive practice. A further LINKS 7 professionals with experience of working with survivors of ICA were interviewed, with a MAIN view to understanding how experienced practitioners worked with survivors in a sensitive CONTENTS and effective manner. All the quotes in the chapter are from participants in the study. CHAPTER CONTENTS
This chapter sets out our findings, highlighting what survivors of ICA and practitioners CHAPTER 1 deem important in creating, or failing to create, a sensitive and positive environment. CHAPTER 2 The headings in the chapter are the main themes that emerged. The themes related to CHAPTER 3 relational and informational topics. The relational themes can be summarised under the over-arching principles of taking time, building rapport, sharing control and respecting CHAPTER 4 boundaries. The informational aspects include demonstrating understanding of ICA, CHAPTER 5 understanding the complex traumatic effects of ICA, sensitivity about literacy and CHAPTER 6 educational attainment, and sensitivity to identity loss. A final theme was the importance of having a focus on moving on, the positive achievements and resilience of survivors. CHAPTER 7 CHAPTER 8
CHAPTER 9
TAKING TIME END NOTES All participants in the current study highlighted the importance of taking time; it was most evident theme in the data analysis. Participants talked about the importance of providing plenty of time to enable the survivor to think about the proposed course of action, to go slowly and to allow time for a break if necessary.
“I need time and space. I can't do it in one day. Because don't forget it's our whole life and it's been traumatic, especially for a lot of the men, it's purely traumatic.” Survivor of ICA
People who were robbed of their time in childhood have greater need of time now. Taking time not only allows the survivor to ‘catch up with themselves’, prevailing over the temporal dissonance that is a central feature of post-traumatic stress reaction (Greenberg, 2003) but also allows the professional ‘time to think’, which reduces simple ‘unthinking’ errors which can occur when working with survivors of childhood trauma. Both survivors and experienced practitioners felt that expecting survivors of ICA to disclose sensitive personal information in a 30 minute session was insensitive and unrealistic. However, as with all issues surrounding disclosure, the management of time can be complex; for example, the ‘door handle disclosure’, made when the client has come to the end of their time, creates a conflict for the professional between organizational pressures and the client’s individual needs; for the client, it can make an experience of rejection more likely.
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“Sometimes they just open up with so much anger and hatred of the place (Institution). You just have to sit with them and listen ... you have to make sure you are in a position to give them time.” Specialist Outreach Worker
In their work with survivors CSA Schachter et al. (2009) found that health care practitioners tend to be problem oriented and tend to respond to disclosures as a problem that requires immediate action or resolution. The current study found that practitioners with little experience of working with survivors of ICA, often take this approach. Survivors involved in the current project explained that although it was important to listen and QUICK accept the information, often they did not expect an immediate action or outcome, and LINKS MAIN that it was often preferable to identify a later time for discussion about actions. CONTENTS
CHAPTER We found that ‘taking time’ has several elements. The effective professional who receives CONTENTS a disclosure of historic childhood abuse must listen carefully and non-judgementally, feeling CHAPTER 1 the power of what is communicated. Even listening to such revelations is difficult and may ‘beggar belief’, but it is crucial that the survivor feels believed and respected in what CHAPTER 2 they are saying. It is often important to acknowledge how wrong it was that the person CHAPTER 3 experienced these things as a child, and to find an appropriate way to express empathy. CHAPTER 4
“You want to come and for someone to be able to understand you and to listen CHAPTER 5
to you ... you'd want someone you can identify with, someone that you could CHAPTER 6 say what it was like and someone who listens and believes.” Survivor of ICA CHAPTER 7
‘Taking time’ also has a structural element. Workers can more easily give survivors CHAPTER 8 the time and attention they need if there is recognition in organisational policy that CHAPTER 9 some clients need more time. For the specialist workers, flexibility is built into END the role. However in a more highly structured role such as advice giving or health NOTES care, the system needs to build in capacity for flexibility where possible.
BUILDING RAPPORT
Survivors and practitioners involved in the study consistently mentioned the importance of building a relationship before moving on to achieve goals. Although building rapport is an important element of all professional relationships, the literature shows that it is an absolutely essential element of effective practice when working with adult survivors of childhood maltreatment (Kendall, 2011). Good rapport not only increases individuals’ sense of safety, but also facilitates clear communication and engenders cooperation. For example, in their discussion of relationship-centred disclosure, Teram et al., (1999) found that disclosures of CSA are often initiated by adult survivors after a trusting relationship has been established, allowing for enhanced understanding of a client’s needs. The case study here is a composite illustration, and does not reflect the experience of any particular participant in the research. It illustrates some of the practical issues relating to the development of rapport in non-clinical services.
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MARY Mary had been in and out of the advice service for years. She was homeless and had many health problems, and various advice workers had tried to help her, but nothing had ever really got off the ground. The centre had a ‘no appointment’ policy which meant that Mary saw a different worker each time, and she would always give up and stop coming before any results could be achieved. One day Roisin, who had recently started work in the centre, saw Mary, and spoke to her gently. Mary began to weep as she spoke of her early life in a ‘home’ and her sense that she belonged nowhere, that no one wanted her. Roisin, spoke to her line- QUICK manager who authorised a fixed appointment, and an appointment was made for the next day. LINKS Mary returned, they spoke again of past difficulties, and Roisin asked Mary what she would MAIN CONTENTS really like. The centre manager had observed the interaction and agreed that Roisin could CHAPTER become Mary’s ‘case worker’. Over the next few months as they worked together, Mary CONTENTS came to live in a warden-assisted home, and at last accessed health care she had needed for CHAPTER 1 years. The centre reviewed its policies and devised criteria that allowed vulnerable clients to be ‘exceptions’ to the ‘no appointments’ rule and to be allocated their own case worker. CHAPTER 2 CHAPTER 3
Sometimes there are ‘shortcuts’ to achieving rapport. One of the consistent findings of CHAPTER 4 Fonagy et al., (2012) was that clients valued the Irishness of their therapist, even, in one CHAPTER 5 case, where the therapist was not in fact Irish. To feel accepted, understood without too much explanation, is a central part of rapport (Thornton & Corbett, forthcoming). CHAPTER 6 This also seems to chime with the frequently expressed view of participants that CHAPTER 7 survivors of ICA were often more comfortable disclosing ICA to their peers. CHAPTER 8
“You don't have to tell them your whole life story. You can just CHAPTER 9
say I've been to the schools or whatever. But they instantly END will open up and I think they feel safer.” Survivor of ICA NOTES
One of the lasting legacies of childhood abuse is a sense of shame and worthlessness (Wolfe et al., 2006). Professionals seeking to establish rapport must keep this in mind and be at pains to avoid behaviour which gives the appearance of rejecting or dismissing the survivor. However unintentional, it may stir profoundly painful and disturbing feelings. Put simply, it is important to be particularly courteous and attentive. Critically it is important to avoid the insensitivity described by a survivor here:
“I would feel that an inexperienced worker might say to a survivor, oh that place is where you were sexually abused? You think, does the person need to hear something like that?” Survivor of ICA
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SHARING CONTROL
“You want them to talk with you and to you. It's this thing – we grew up with people talking at us day and night, told what to do, bossed about, beaten about. You don't want that now because it's humdrummed into you and it reminds you of the childhood where it was – we were all spoken at. Do this, do that …" Survivor of ICA
The concluding section of the Commission to Inquire into Child Abuse (2009) found that schools QUICK were run in a severe, regimented manner that imposed unreasonable and oppressive discipline LINKS MAIN on children. As with other forms of abuse, a central aspect of institutional abuse is the loss of CONTENTS control and the powerlessness survivors felt. All survivors who participated in the current study CHAPTER commented on the importance of a non-authoritarian approach. Experienced practitioners CONTENTS were particularly aware of the need for a non-authoritarian power-sharing relationship. Most CHAPTER 1 participants talked about the importance of giving survivors of ICA as much control as possible. CHAPTER 2
“The bureaucracy and the authority - I can’t stand it. As children it was just CHAPTER 3 beaten into us. The first thing you thought of, when I get out of here is - nobody CHAPTER 4 will ever do that to me again. Nobody is going to tell me what to do.” Survivor of ICA CHAPTER 5
Even in a highly structured engagement like psychotherapy, a measure of flexibility is helpful CHAPTER 6 to survivors who find it impossible to fit into a system, even a benign one. For example, therapy is normally offered in a weekly 50-minute session. For some survivors, to attend CHAPTER 7 a session at a fixed time and stay for the full 50 minutes is an achievement to be carefully CHAPTER 8 worked towards with the therapist. Phone contact instead, or shorter sessions, are not CHAPTER 9 uncommon at the start, as the trusting relationship is built. Many survivors need to experience END a practitioner’s willingness to engage with them as an individual, not as a ‘client’ to be slotted NOTES into a system. This approach, which sees normal therapeutic boundaries as a developmental target, is part of what underpins success in working with survivors and others who cannot tolerate authority because of their early experience of severely abusive authority.
RESPECTING BOUNDARIES, INCLUDING PRIVACY AND CONFIDENTIALITY
“When he had to go see a psychiatrist, it was a male psychiatrist. So he couldn't have been in the room on his own with that male psychiatrist - he would have freaked out completely. He couldn't be because he was sexually abused by men.” Specialist Outreach Worker
A core skill required by social and community workers is the capacity to relate to others and their problems (O’Leary et al., 2012). It is the foundation of successful working relationships. However, it is a skill that involves walking a fine line, remaining conscious of their professional responsibility, to focus on the client’s needs within the relationship and respect the boundary that the client needs to feel safe; while also respecting their own needs and boundaries. Boundary issues occur when workers face possible conflicts
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of interest, for instance in dual or multiple relationships (Reamer, 2003). Dual or multiple relationships occur when professionals engage with clients or colleagues in more than one relationship, whether social, sexual, religious, or business (St. Germaine, 1993, 1996).
If multiple relationships arise with a client, it is always important to know ‘what hat you have on’ and to make it explicit, since the power imbalance tends to make multiple relationships more confusing and problematic for the client than for the professional. These issues also arise for therapists and counsellors, but these ethical issues are a major focus of training and on-going supervision, universally accepted as a central component of effective QUICK LINKS practice. Advice, housing and social workers, health professionals and others face similar MAIN dilemmas, but often without this underpinning support of regular reflective space. CONTENTS
CHAPTER Many participants in the current study disclosed concerns about the possibility of physical contact, CONTENTS and how distressing this would be for a survivor of ICA and, in particular, those who experienced CHAPTER 1 CSA. All practitioners in the study were aware of the possible implications of any form of physical CHAPTER 2 contact, such as proffering a handshake or sitting too close to a survivor. Reamer (2003) highlights that social and community workers should not engage in physical contact with clients when there CHAPTER 3 is a possibility of psychological harm to the client. Evidence indicates that as many as 50% of Irish CHAPTER 4 survivors of ICA, particularly male survivors, experienced sexual abuse whilst in institutional CHAPTER 5 care (Carr et al., CICA) and, it is, therefore, essential that workers consider the potential psychological impact of even minor physical contact. However as in all else, it is important to be CHAPTER 6 led by the client. If the client puts out her or his hand to the practitioner, a rigid refusal to shake CHAPTER 7 will likely be experienced as a rejection, which can also damage or even destroy the relationship. CHAPTER 8
Most participants highlighted the importance of boundaries of confidentiality. Although CHAPTER 9 guidelines for confidentiality and data protection form the bedrock of any well run service END NOTES for vulnerable people, particular care is needed with survivors of ICA. Disclosure of even the most basic information could have an enormous impact on a survivor’s life and their friends’ and families’ and it is vital that workers can explain clearly how data is managed. Survivors gave examples of receiving letters or voice messages which included words such as “survivor” and “Institutional abuse”. In each case, the client had not disclosed the full details of their childhood to their friends and family and disclosure would have had an enormous impact on their lives. The interview data indicated that survivors need service providers to be explicit about issues such as data protection. Providers need to be clear and open about policy and procedures and communicate these in a way that is suitable to the needs of survivors of ICA.
“A lot of women have said – that if their husband – especially if they're married to an Irishman – they've said to me, he would divorce me in he knew about my childhood.” Survivor of ICA
“I told not one person in my working world I am what they call today a survivor.” Survivor, SSGT Project
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DEMONSTRATING AN UNDERSTANDING OF INSTITUTIONAL ABUSE
“They make assumptions. I mean, the usual assumptions are like not really understanding the depth of it ... just how comprehensive the malnutrition, not being clothed properly, being cold, being in fear, the abuse.” Survivor of ICA
In keeping with previous research (Higgins, 2010), the majority of survivors involved in the current study felt that helping professionals, and the general public, do not understand what institutional QUICK LINKS abuse entailed. Participants explained that this often meant disclosures were met with shock MAIN or disbelief. For many, this type of reaction was a significant barrier to future help seeking. CONTENTS
CHAPTER “What you have to remember is you've got to look at that person that CONTENTS
you're speaking to and how they're going to react. If they're going to CHAPTER 1 be oh, mouth open in shock, you won't speak to them.” Survivor of ICA CHAPTER 2
Research into other areas of childhood maltreatment shows that survivors report more negative CHAPTER 3 experiences in health care settings when providers appear to lack knowledge, understanding CHAPTER 4 of, or sensitivity to CSA and its effects. In their 1999 study, Teram et al. found that survivors may be hesitant to mention a history of CSA because of experiences of feeling rejected in CHAPTER 5 the past, which also was reported to worsen symptoms. Survivors reported being labelled as CHAPTER 6 difficult patients by health care providers because of reactions and relational struggles related CHAPTER 7 to CSA and the distress caused when professional demonstrated a lack of understanding (Schachter et al., 1999). In the current study, survivors explained that they would often prefer CHAPTER 8 to disclose the abuse to other survivors, but if that was not possible they wanted to speak with CHAPTER 9 individuals who understood their upbringing and were not shocked by their experiences. END NOTES
UNDERSTANDING THE COMPLEX TRAUMATIC EFFECTS
“The pain may not be physical, it could be mental. Like things like listening to children crying and going to sleep at night. I had that for years. Because my job was to get up at night with some of the other girls and push them out of the bed and make them sit on the toilet so they didn't wet the bed. But you didn't get your sleep. You had to get up the next morning. They used to cry, lingering cry, you know a really sad cry. I made sure my children never had that when they were growing up.” Survivor of ICA
Institutional abuse is typically an on-going exploitation of power and breach of trust; it may involve physical, sexual, or emotional abuse (Wolfe, Jaffe, Jette, & Poisson, 2003). Survivors who participated in the current study felt that the on-going nature of the abuse and neglect was a defining characteristic of institutional upbringing. In contrast to singular traumatic events, prolonged, repeated trauma can occur only where the victim is in a state of captivity, unable to flee, and under the control of the perpetrator (Herman, 2006). Although not formally recognized in diagnostic systems, the concept of complex post−traumatic stress (C-PTSD)
Open Hearts & Open Minds: A toolkit of sensitive practice for practitioners working with survivors of institutional childhood abuse 41 5 Developing sensitive practice
has been suggested independently by many major contributors to the field (Herman, 2006). Herman identifies three broad areas of disturbance which transcend simple PTSD; “The first is symptomatic: the symptom picture in survivors of prolonged trauma often appears to be more complex, diffuse, and tenacious than in simple PTSD. The second is the development of characteristic personality changes, including difficulties with identity and in relating. The third area involves the survivor's vulnerability to repeated harm, both self−inflicted and at the hands of others” (1992, p.379). Failure to recognize these symptoms as the predictable consequence of prolonged, repeated trauma can contribute to the misunderstanding of survivors. QUICK “Even somebody who appears outwardly to have come through – I won't say LINKS MAIN survived but who has come through it and done something with their lives. Even CONTENTS that person – even if I wanted to describe myself as that sort of person – still CHAPTER within me there are certain things in my life that will happen, little incidents that CONTENTS
people might do without realising and it will traumatise me like that.” Survivor of ICA CHAPTER 1
Although participants highlighted the heterogeneity of outcomes for survivors, the majority CHAPTER 2 also pointed to significant long term effects. Practitioners and survivors spoke about the CHAPTER 3 importance of understanding trauma reactions in the help seeking setting, such as triggers CHAPTER 4 and trauma reactions. A trigger is a reminder of past traumatizing events, which may be quite “ordinary” – for example, the gender of a person in authority can be a powerful trigger that CHAPTER 5 leaves some survivors feeling vulnerable and unsafe (Havig, 2009). Participants in the current CHAPTER 6 study spoke about flashbacks triggered by children crying, the layout of a professionals CHAPTER 7 office and the clothing worn by professionals (such as a round collar reminiscent of a priests collar). Professionals working with survivors of ICA should be aware of the potential for re- CHAPTER 8 traumatisation in community settings, especially in clerical organisations, and work to minimise CHAPTER 9 the more obvious environmental factors which can trigger a post-traumatic stress reaction. END NOTES
SENSITIVITY ABOUT LITERACY AND EDUCATIONAL ATTAINMENT
“I think it's other things are things like assuming people can read and write, not being aware that they wouldn't have understood. It's kind of just awareness really.” Survivor of ICA
The evidence shows the state of terror in which many children lived left them with lifelong challenges in learning. According to the CICA, 70% of witnesses reported receiving no second-level education and, while some witnesses heard by the committee reported having successful careers in business and professional fields, the majority reported being in manual and unskilled work their entire working lives (2009). Participants in the present study emphasised the heterogeneous nature of survivors in terms of achievement. Nevertheless, they also stressed how important it is that the practitioner understands the vulnerabilities and under-developed skills of some survivors of ICA, such as poor literacy, numeracy and communication skills and how this may affect tasks such as form fill and appointment making.
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Examples were given of how some practitioners give simple unobtrusive offers of help – ‘would you prefer to fill the form in yourself, or shall I write down what you say?’ – which can help relieve the shame and tension of the person who has never been taught to write.
SENSITIVITY TO IDENTITY LOSS
“It is definitely a thing of identity. People not having birth certs, passports and things and actually some didn't even know their true identity.” Survivor of ICA QUICK LINKS Record keeping in institutional care in Ireland was virtually non-existent (CICA, 2009). Upon MAIN CONTENTS discharge many survivors were unable to find any record of their parents or family; others CHAPTER were unable to find records of the circumstance surrounding their entry into institutional care. CONTENTS Sibling relationships were strongly discouraged, with siblings either being kept apart or placed CHAPTER 1 in different institutions. Children who went in as babies could be in the same industrial school as a sibling but completely unaware of it. They could leave the institution either believing they CHAPTER 2 had no brothers or sisters, or not understanding what it meant to have a brother or sister. CHAPTER 3
CHAPTER 4 “Then I have a sister who I can't find. She was a year older than me and I'm still trying to trace her, they can't find her. The records in CHAPTER 5
Ireland, ... they've all said oh no, they can't find her.” Survivor of ICA CHAPTER 6
Participants told us about survivors who were still searching for family and personal records. All CHAPTER 7 participants in the current study spoke about how distressing it was to have to explain the lack CHAPTER 8 of knowledge of family background and/or records to professionals. Participants told of health CHAPTER 9 professional asking for information about family health history or community workers seeking END information for benefit or housing applications. Explaining educational history was also cited as NOTES a distressing experience in community settings. Although such questions may be unavoidable, it is important that practitioners are aware of the potentially traumatic effect on survivors.
“I went into this place in Dublin to ask about the job situation. These two girls kept asking me about my family. I didn't want to go into it, but they kept asking about it. I found it very upsetting and went home to rang me friend immediately, I was angry and upset. It's just that I found it very insensitive when they kind of repeated themselves.” Survivor of ICA
This kind of insensitive repetition can easily be avoided with the awareness that for some people, this ‘normal’ information is not known. Once we have this awareness, we can enquire gently whether the person would have the kind of information we need: ‘would you know whether there is any history of that in your family?’ The questions may still need to be asked, but can be asked in a more sensitive way.
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MOVING ON AND BUILDING RESILIENCE
Much of the focus in the trauma literature, as in service delivery, has been on the challenges and difficulties that result from exposure to trauma. There is limited research on how survivors of ICA cope or recover from institutional upbringing and/or abuse. Some participants however showed an awareness of the current focus on weaknesses and expressed a desire for professionals to look beyond the institutionalised abuse. QUICK “I think the whole thing is about moving on and giving LINKS people tools to move on.” Survivor, SSGT Project MAIN CONTENTS “We've moved on. I've never considered myself a survivor. Survivor of what? CHAPTER This is the big question to me because every one of us, regardless who we are, CONTENTS we are all the survivors of something or other in life.” Survivor, SSGT Project CHAPTER 1
This is a clear steer from some survivors that they are looking for services that not only CHAPTER 2 address problems but also support the survivor’s own resilience and capacity to live a life not CHAPTER 3 defined by past abuse. This is important information for those who design and deliver services to survivors. We have therefore included some material about resilience in the chapter about CHAPTER 4 self-care (page 53), and a further chapter summarising some research on resilience (page 62). CHAPTER 5
CHAPTER 6 “Yes, this is very important to try to move on and keep up with changes in the world.” Survivor, SSGT Project CHAPTER 7
CHAPTER 8
CHAPTER 9
QUESTIONS FOR REFLECTION AND DISCUSSION END • Which of the principles described above make most sense to you? Why? NOTES • Are there any principles you disagree with? Why? • Did the experiences and principles described in the chapter explain any of your own past experiences with survivor clients? • Did you learn anything new from the chapter? What? • What is one thing you could do differently to improve your work with survivor clients?
Open Hearts & Open Minds: A toolkit of sensitive practice for practitioners working with survivors of institutional childhood abuse 44 QUICK LINKS MAIN DEALING WITH CONTENTS DISCLOSURES CHAPTER 1 A GUIDE FOR THE PRACTITIONER CHAPTER 2 CHAPTER 3
This chapter offers guidelines for dealing with disclosures based on feedback CHAPTER 4
from experienced practitioners and survivors. The chapter discusses: CHAPTER 5
Guidelines for dealing with disclosures 47 CHAPTER 6 CHAPTER 7 Challenge of disclosure for survivors 48 CHAPTER 8 Door handle disclosures 49 CHAPTER 9 How the person feels after telling you 49 END Why do people disclose? 49 NOTES What if the person keeps telling you about the trauma 50 Who may disclose abuse? 50 Feelings after someone’s disclosure 51 Importance of debriefing 51 Questions for reflection and discussion 52
Open Hearts & Open Minds: A toolkit of sensitive practice for practitioners working with survivors of institutional childhood abuse 45 6 Dealing with disclosures
GUIDELINES FOR DEALING WITH DISCLOSURES
Dealing with disclosures of abuse can be challenging even for trained therapists, yet many other professionals will receive disclosures in the course of their work. Where the abuse has been severe and prolonged, as is often the case with people abused while in institutional care, it is possible for the disclosure to be distressing and harmful to both people. But there are some simple tools that can be used to respond when a client tells us about childhood abuse, which can minimise harm and make the experience, although distressing and painful, a positive step for the client. It is always, also, QUICK a developmental opportunity for the professional to learn to cope with a challenging situation. LINKS MAIN Respect CONTENTS The core principle is to demonstrate respect for the person who has been CHAPTER CONTENTS abused. This includes taking seriously and acknowledging what they have said, and respecting also the emotional impact of their saying it, for them and for you. CHAPTER 1 CHAPTER 2
Allow time CHAPTER 3 It is important that you both have time to digest the importance of what has been said. Even if it is very close to the end of the time you have [more about this shortly], put other issues to one CHAPTER 4 side for a moment, slow things down and acknowledge what has been said to you. The form of CHAPTER 5 words is best if it is your own, how you would naturally speak, but here are some possibilities: CHAPTER 6
CHAPTER 7 • That is something very important that you have just told me CHAPTER 8 • I am honoured that you have shared that with me; it must have been hard CHAPTER 9 • What a terrible time that must have been; you must be END a strong person to have survived that. NOTES
What you will actually say in the moment is very individual, depending on who you are, who they are, and the relationship between the two of you. It is important, and difficult, to stay aware of how you feel about what they have said. It will not usually be appropriate to say everything you feel. Expressing the wrongness of what was done, your admiration, your respect and empathy may all be helpful; but you may also feel angry, overwhelmed or deeply distressed, and whether and how you express these feelings requires thought and care.
Express something of your feelings, but do not enact them Your feelings on hearing the disclosure may be very strong. It may be appropriate to acknowledge the feeling, but it is not usually helpful to express it in a strong way. Put simply, it is better to speak of being angry than to get angry, which could be frightening or confusing for the person. Your role is to witness the wrongness of what was done to them, while remaining calm. Slowing things down is important, so that both you and the person can take things in.
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So for instance, if you are feeling angry, it may be more helpful to say something like:
• It makes me feel angry that happened to you. • How did you feel about that? • That must have been so terrible; it is hard even to take in. • That is so wrong. You deserved better. Can we just stop a moment? • It is usually not helpful to express strong distress or feeling overwhelmed, because it puts QUICK a burden on the person making the disclosure. You may be able to say something like: LINKS • What happened was so enormous, it is hard to take it in MAIN CONTENTS • That would be upsetting for anyone CHAPTER • No child should have had to deal with that. CONTENTS
CHAPTER 1 It is usually not helpful to express strong distress or feeling overwhelmed, because it puts CHAPTER 2 a burden on the person making the disclosure. You may be able to say something like: CHAPTER 3
• What happened was so enormous, it is hard to take it in CHAPTER 4 • That would be upsetting for anyone CHAPTER 5 • No child should have had to deal with that. CHAPTER 6
CHAPTER 7
Giving control to the client CHAPTER 8 In all our interactions it is important to give the person as much control as possible – institutional abuse is about being in the power of the abuser over long periods, experiencing CHAPTER 9 helplessness and terror. Take a stance of being 'alongside' the person, a helper evaluating END NOTES the options, rather than being the 'expert' or in control. For example, describe the options, the pros and cons, and leave the choice to the person, even if there is one option which seems ‘obviously’ best to you. You cannot make assumptions about what is desirable, since the person may have been left with fears or troubles you are unaware of. For instance, what looks to you like a very nice home in the country may remind them of the isolation and fear they felt in an abusive home which was also ‘in the country’. A small city flat may feel much safer. Make time to explore the options thoroughly, including their feelings.
CHALLENGE OF DISCLOSURE FOR SURVIVORS
“Just being there was the worst thing and the humiliation especially.”38
Shame is a core feature of abuse. Abused people often feel ashamed and responsible for what has been done to them. Many people abused in childhood do not tell even their partners or closest friends in adult life about these experiences. This may be particularly true for people who have been abused within an institution, where there was usually so little positive experience to let the child know that s/he was a good person, worthy of care. The emotional harm done through persistent belittling and negating of the child's person can have a more insidious, pervasive effect than even sexual or physical abuse.
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This means that respect for the person disclosing the abuse is absolutely central to responding appropriately. A person abused in childhood will be highly sensitive to any signals that we are not really listening or not taking seriously what they say; if a client leaves the session with this kind of feeling, even if in fact we were simply distracted or busy, there will be damage to them, and to the relationship. In some cases, they may not come back.
DOOR HANDLE DISCLOSURES QUICK LINKS When a client makes a major disclosure right at the end of a session, it is an expression of MAIN their fear and a test of your trustworthiness, and your response will often determine whether CONTENTS or not they come back. It is crucial to acknowledge the weight of what has been said and the CHAPTER fact that you have heard it and still wish to work with them. You might say something like: CONTENTS CHAPTER 1
• That is very important, what you have just told me CHAPTER 2
• I wish we had more time to talk about that CHAPTER 3
• We will need to think about that together going forward. CHAPTER 4
CHAPTER 5 After the disclosure make sure to mention the next appointment, even if it has already been CHAPTER 6 discussed, so that they know they are welcome to come back. If you have some flexibility to bring that appointment forward, you could ask them if they would like you to do so. CHAPTER 7
CHAPTER 8 HOW THE PERSON FEELS AFTER TELLING YOU CHAPTER 9 END NOTES After making a disclosure of abuse, the person may well have a feeling of being exposed, with feelings of shame and even self-hatred. Your response to the disclosure is critical in minimising these feelings. Warmth and respect need to be conveyed, and it may be helpful to ask the person how they feel about having told you, so that they can tell you their feelings. Hopefully they may gather from your respectful interest that you do not reject them because they have had these experiences.
WHY DO PEOPLE DISCLOSE?
People disclose trauma because they are still in its grip; a part of them is still in shock. Trauma has a ‘half-life’, an enduring impact on the inner world of the traumatised person. There may be a compulsion to revisit in memory the events that were so terrible, so overwhelming, that they couldn’t be taken in emotionally at the time they happened. This is true of all trauma, car crashes for instance, as well as abuse. Traumatic experiences – which feel like experiences our emotions cannot catch up to, so that we feel shocked and unable to feel – will re-surface until the emotions the person truly felt at the time can be expressed – ‘catch up’. This is difficult work, even in therapy, and there is a real risk of re-traumatisation.
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WHAT IF THE PERSON KEEPS TELLING YOU ABOUT THE TRAUMA?
If the person seems inclined to go over and over the details of the trauma in subsequent meetings, try to recall them to the present moment. Make it clear that you are attending to them and are thinking about what is best for them.
• Going over this seems so upsetting. Shall we stop and take a few deep breaths to feel calmer? QUICK LINKS • Talking about the past seems to be very distressing for you. Shall we take a moment? MAIN • What do you think we should focus on today – talking about those times, or... CONTENTS CHAPTER CONTENTS The feeling of the person who is ‘caught’ in retelling the story of their abuse, is often a feeling CHAPTER 1 of not being in control, so anything you can do to return control to them is helpful. Sometimes simply attending to their needs and offering some space to think may help. You could suggest that CHAPTER 2 you both take a few deep breaths for calm. Offering some sense-experience, such as a hot cup CHAPTER 3 of tea or better yet, strongly scented herb or spice tea, can help bring the person back to the CHAPTER 4 present. Other things with strong scents, such as rescue remedy or smelling salts can be effective. CHAPTER 5
Do not touch the person without invitation. What you intend as a reassuring squeeze CHAPTER 6
of the hand or pat on the arm, may be experienced as frightening and threatening. CHAPTER 7
CHAPTER 8 If the person seems to want to keep re-telling you the story, it is OK to state your own limits: CHAPTER 9
END • These things that happened to you were so wrong, and I don’t feel qualified to help you with that. NOTES • I really feel for you, though that may not help you. My job here is to help you with ... how can we best manage that? • I know some people who can help you with the feelings, might you be interested in talking to someone? • These terrible experiences have really stayed with you. I do not know how to help you with that. I wonder whether you have thought of talking to someone who really knows how to help you?
WHO MAY DISCLOSE ABUSE?
There are some indicators which suggest that a person may have been abused in early life. Paying attention to these can help you prepare yourself for disclosure and also pay attention to making disclosure less frightening for the client. Of course some people who exhibit these characteristics may not have experienced abuse; it is always dangerous to make assumptions.
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Possible indicators of abuse • Stronger than usual anxiety • Obsessive safety routines • Difficulties with authority • Difficulties relating to others • Stronger than usual anger • Gaps in information/ vagueness about life • Self-neglect story or details like family medical history • Obsessive cleanliness QUICK LINKS There is a common thread here. In childhood everyone needs someone ‘bigger, stronger, wiser and MAIN kind’ to look after them. Where this has been missing, it leaves us with many difficulties in forming CONTENTS and maintaining relationships, and often with little knowledge of how to look after ourselves. CHAPTER CONTENTS
CHAPTER 1
FEELINGS AFTER SOMEONE’S DISCLOSURE CHAPTER 2
CHAPTER 3 You may feel a number of things: angry, overwhelmed, frightened, disgusted, dirtied. The feelings you have may also reflect some of the feelings the person has about themselves CHAPTER 4 as a result of their experiences, communicated to you non-verbally. Bear in mind too that CHAPTER 5 there may be a time lag in feeling these things, as the traumatic nature of the experience CHAPTER 6 means that it cannot be taken in all at once. For example, you may find yourself becoming inappropriately angry, without understanding why, several hours later, perhaps at home. CHAPTER 7
CHAPTER 8 It is important to accept that hearing disclosures is hard work, with an impact on you and CHAPTER 9 your colleagues. Because of this impact, everyone doing this work needs regular opportunities END to debrief and reflect with others. This is sometimes done through ‘supervision’. It helps the NOTES feelings to be expressed and best practice in serving the clients to be worked out together.
IMPORTANCE OF DEBRIEFING
It is vital that you have an opportunity to debrief, and the opportunity for reflection with colleagues is one of the most useful tools you can have, both to feel more on top of things, and to share ideas about how best to help people making disclosures. You can take steps to organise this kind of conversation with colleagues who do similar work. If your service doesn’t offer some kind of supervision or debrief, you could speak to your manager about starting something. It is essential in preventing burnout and preserving good organisational health.
The overwhelming nature of survivor experience can 'get into' professionals so that they develop various dysfunctional psychological mechanisms to cope. For example, some people will feel overburdened and will talk about workload while assiduously avoiding any new work; this is often accompanied by a resentful attitude to managers who are seen as 'having it easier'. Or, more worryingly, we can start to have favoured, 'deserving' clients whom we attend to at the expense of other, 'non-deserving', clients. Debriefing, dialogue and reflection within the organisation about this challenging work is the most effective way to avoid these and many other difficulties.
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In the next section we discuss further how to look after yourself and maintain resilience.
QUESTIONS FOR REFLECTION AND DISCUSSION • What are the most important things when hearing a disclosure of ICA? • What feelings do I have during and after a disclosure of ICA? • What responses from me have seemed to help clients? QUICK • What responses from me have seemed to distress or distance clients? LINKS • What opportunities do I have/ could I create to debrief MAIN CONTENTS with colleagues and learn from each other? CHAPTER CONTENTS
CHAPTER 1
CHAPTER 2
CHAPTER 3
CHAPTER 4
CHAPTER 5
CHAPTER 6
CHAPTER 7
CHAPTER 8
CHAPTER 9
END NOTES
Open Hearts & Open Minds: A toolkit of sensitive practice for practitioners working with survivors of institutional childhood abuse 51 QUICK LINKS MAIN SELF-CARE CONTENTS
A NECESSITY FOR THE PRACTITIONER CHAPTER 1
CHAPTER 2 This chapter includes: CHAPTER 3
Why is self-care important? 54 CHAPTER 4 Trauma 54 CHAPTER 5 CHAPTER 6 What happens to a person in trauma? 54 CHAPTER 7 What does this mean for workers? 55 CHAPTER 8 What are the obstacles to self-care? 55 CHAPTER 9 Vicarious trauma 56 END Debriefing and reflection 57 NOTES What is ‘self-care’? 57 Self-care at work: recovery time and the link between mind and body 57 Some instant techniques for self-care at work 58 Developing habits of self-care 59 Building resilience 60 The American Psychological Association – 10 ways to build resiliance (Table 5) 60 Questions for reflection and discussion 61
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WHY IS SELF-CARE IMPORTANT?
““Caregivers working with victims of violence carry a high risk of suffering from burnout and vicarious trauma unless preventive factors are considered...” Christian Pross, 2006
Dr Pross was writing about the impact on workers of hearing accounts of torture and abuse. The first ‘preventive factor’ that he names in minimising this impact is ‘self-care’. We approach this topic first through thinking briefly about trauma, and its short and QUICK long term effects on our capacity for relating to ourselves and others. We then move to LINKS MAIN practical steps to help ourselves cope and recuperate after disclosures of trauma. CONTENTS
CHAPTER CONTENTS
TRAUMA CHAPTER 1
CHAPTER 2 In the immediate experience of a traumatic event our ability to think about what is happening to us is shut down or suspended because, at the oldest and deepest level of our physical being, CHAPTER 3 we ‘know’ that we must act to avoid and/or counter the danger to our survival. This is called CHAPTER 4 the ‘fight/flight’ response and is common to all living things. But there is a third possibility. If at CHAPTER 5 the time of the threat neither of these options is possible, for example, because we are small and helpless and there is no one to help; if there is no one to protect and care for us at a time CHAPTER 6 when we are too small to care for ourselves, we will attempt to survive by ‘freezing’. Emotionally CHAPTER 7 speaking we are 'stuck' in the traumatic moment and doomed to relive it until it can be processed. CHAPTER 8
Past trauma can be processed through new relationships, but when it is severe the person’s CHAPTER 9 experience of trauma may disrupt any new relationships s/he attempts. In this case there is no END NOTES substitute for skilled and painstaking psychotherapy with a therapist who thoroughly understands the process. On page 68 we give information about how to refer a survivor for psychotherapy. Other professionals can however help by understanding what is happening for the traumatised person, and responding in ways that will help them stay in control and reduce re-traumatisation.
WHAT HAPPENS TO A PERSON IN TRAUMA?
Some traumatic experience is a normal part of life. If things are OK for us when we first encounter trauma, that is, if we have someone who takes care of us, we begin to develop the capacity to care for ourselves, and then the capacity to care for others. We become able to recover the ability to think after a trauma, and to recover; so we develop the capacity to manage stress and trauma. This is called resilience.
If this does not happen for us, because there was no one who had the capacity to take care of us emotionally as well as physically, we are left with a legacy of lacking this resilience. If there was originally no one there on whom we could rely for help, care and love, we will continue, at a deep physical and emotional level, to fight, fly or freeze. This limits, distorts or even destroys our ability to be resilient and leads, for example, to Post Traumatic
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Stress Disorder (PTSD). Even when we survive a later danger or traumatic experience, we are left without a means to recover, to ‘process’ the experience afterwards.
Learning to manage trauma to some degree is an inevitable, even necessary, part of being alive; however the profound and on-going nature of the traumatic abuse experienced by children in institutional care in Ireland has had grave consequences that we are only just beginning to understand.
So in summary, even if the trauma happened in a time long past, it can be very much alive in QUICK LINKS the present and can make it difficult for us to relate to and trust ourselves and other people MAIN in the present. This can destroy our capacity to be creative and have hope for the future. CONTENTS
CHAPTER CONTENTS WHAT DOES THIS MEAN FOR WORKERS? CHAPTER 1 CHAPTER 2 For workers whose clients have experienced trauma, self-care is very important, CHAPTER 3 because without it there is the danger that history will repeat itself in the relationships between workers and clients. This is called re-traumatisation (for the client) and vicarious CHAPTER 4 traumatisation (for the worker), and is a real risk. It happens through unconscious CHAPTER 5 processes of which neither person is aware, until it is too late; the best intentions will CHAPTER 6 not prevent it, only thoughtfulness in managing the relationship skilfully and respectfully, and consistent self-care so that we are in the best possible shape for our work. CHAPTER 7
CHAPTER 8 Anyone working with survivors needs to be able to: CHAPTER 9
END • Understand and acknowledge our own experiences of trauma and level of resilience NOTES • Acknowledge our limitations (including recognising differences and similarities) • Be mindful of and work within our personal boundaries • Acknowledge the need for self-care • Actually care for ourselves.
WHAT ARE THE OBSTACLES TO SELF-CARE?
One of the primary obstacles to on-going self-care is a loss of resilience or diminished resilience.
For each of us, the ability to be resilient can vary considerably during life, and that loss or diminishment of resilience can come about in various ways. So, for example, if we have been ill, or recently bereaved, it may be difficult to tolerate another person’s feelings of anxiety or grief, when normally we could empathise.
So too, if we are going through a time of feeling frustrated, unsupported and unappreciated, it may lead to feelings of inadequacy that can make a client’s needs seem
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overwhelming, un-meetable demands; if this goes on it can cycle into further feelings of inadequacy and self–blame. These experiences of loss of resilience would normally be temporary, and when the worker receives support and has time to recover, the feelings will diminish or disappear and resilience will return. This will be true even if not all the client’s needs are met as well as the worker and the client had hoped.
A more fundamental threat to a capacity for self-care and resilience is 'carer’s syndrome'. This is the belief that we need to prove how worthwhile we are by caring for others, rooted in an underlying belief that in ourselves we are not worth caring about. Although we may not think QUICK LINKS of ourselves in this way, there is an element of this feeling in most if not all 'caring professionals'. MAIN The belief may not always be obvious but can lead to, for example, difficulty in maintaining CONTENTS necessary boundaries; repeatedly overworking to point of exhaustion or illness; or feelings of CHAPTER guilt and responsibility such that enjoying life outside of work becomes almost impossible. CONTENTS CHAPTER 1
CHAPTER 2 VICARIOUS TRAUMA CHAPTER 3
'No man is an island', and no woman either. Vicarious trauma comes about, paradoxically, because CHAPTER 4 of our human need for relationship and our capacity for compassion. Our ability to ‘resonate’ CHAPTER 5 with another’s traumatic experience is part of our deep physical (brain) and emotional make- CHAPTER 6 up, now being mapped in the physical brain by neuroscientists. This aspect of our humanness can lead us to participate in terrible group fear, hatred or violence; thankfully it is also the CHAPTER 7 part that allows us to share in each other’s joy, excitement or communal healing grief. CHAPTER 8
CHAPTER 9 When we are faced with someone who is traumatised, even if that person does not immediately END tell us about their experience, the part of us that is sensitive to danger becomes alert and ready NOTES to fight or flee. In other words we begin to experience our own deep physical and emotional response to threat. The more unexpected the ‘sharing’, the higher is likely to be our level of response. Also the less the client has been able to ‘process’ their experiences, and the more 'raw' and immediate what they express, the greater the impact on us. In such a case we often need more time to recover ourselves, and then activate our internal carer and so offer an empathetic and thoughtful service to the client. In these circumstances it is important to slow things down and acknowledge what is happening emotionally between the worker and the client.
Because we are human and each have some experience of trauma, our capacity for caring for others in this way has limits. If we are repeatedly exposed to these vicariously traumatising revelations without processing our experiences emotionally, problems will arise. We risk becoming systematically traumatised ourselves, which apart from the heavy personal cost will render us unable to function for the client or meet our own needs for self-care. If we do not attend to this situation, it can lead to long term damage to our resilience, health issues, and perhaps an inability to continue in the job. This brings with it the loss of skilled and experienced people and much good work.
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DEBRIEFING AND REFLECTION
In the previous chapter we explained that using supervision, or some other regular opportunity to debrief and reflect with colleagues, is the single most important step you can take in self-care. Organisations whose workers regularly hear disclosures of abuse and trauma have a duty of care to make sure these opportunities are available, and used.
QUICK WHAT IS ‘SELF-CARE’? LINKS MAIN CONTENTS Self-care has two aspects, and doing either one helps you do the other. CHAPTER CONTENTS The first is to genuinely and consciously believe that you are someone who is worthy of care. CHAPTER 1 This may not always be as easy as it sounds. Many people in the caring professions have some part of themselves that faces some of the obstacles mentioned above. Make sure that you debrief CHAPTER 2 thoroughly after distressing revelations from clients, and consciously seek help from others. CHAPTER 3
CHAPTER 4 The second aspect is to take steps to care for yourself; even in the middle of very busy and demanding work that is based in caring about and for other people. CHAPTER 5
CHAPTER 6 Self-care can be thought of as treating yourself in ways that help you maintain your CHAPTER 7 resilience in the face of the inevitable demands of life, including traumas both past and present. Further, self-care can enable you to appreciate the good things in CHAPTER 8 your life and even help you to greater contentment – to be glad to be you. This CHAPTER 9 in turn helps you to help others, including your clients and colleagues. END NOTES
SELF-CARE AT WORK: RECOVERY TIME AND THE LINK BETWEEN MIND AND BODY
When our work involves emotional strain, it is important to have simple, quick ways of recovering our equilibrium at least a little before we go on. The principle is that following a shock or stress such as disclosure, we need a little recovery time. There is an automatic physiological component to this, known as the fight/flight response:
The fight/flight response 1. Speeds up breathing 2. Releases adrenalin into the bloodstream, which 3. Increases heart rate 4. Pumps blood to muscles and essential organs 5. Shuts down the digestive system 6. Thickens blood so it will clot if you are cut.
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Contrast this with what happens in our bodies when they have recovered the relaxed (normal) state:
Normal (relaxed) state 1. Breathing becomes deep and slow 2. Heart rate decreases 3. Blood flow to extremities increases 4. Pumps blood to muscles and essential organs QUICK 5. Muscles relax/ return to their normal, resting, state LINKS 6. Hormonal equilibrium is established, and MAIN CONTENTS 7. Overall metabolism is slowed. CHAPTER CONTENTS
If you can summon one characteristic of this relaxed state, you break the stress ‘chain’ and CHAPTER 1 the rest of the characteristics follow. Relaxing the body is therefore an important technique CHAPTER 2 for recovering from stressful moments at work, and the easiest aspect of the ‘relaxed’ CHAPTER 3 physiology to influence, is our breathing. Taking a few deep breaths really does help. Sometimes you can do little about the demands made on you. But you can develop the CHAPTER 4 habit of taking immediate action to reduce your stress, before, during and after stressful CHAPTER 5 events. These practices release some tension and restore perspective in the moment. CHAPTER 6
CHAPTER 7
SOME INSTANT TECHNIQUES FOR CHAPTER 8
SELF-CARE AT WORK CHAPTER 9
END Here are some instant approaches to reducing stress: NOTES
Instant stress reduction • Take some deep breaths and slow down your breathing. • Don't blame yourself for being stressed. Accept it. • Stretch. If you work at a computer, your shoulders need regular stretching. • Check your posture – gently straighten your back, drop your shoulders, uncross your limbs. Allow the tension to flow out of your hands, neck and face. • Make yourself more comfortable. • Unfocus and relax your eyes, taking in a wide field of vision. • Look at the most pleasant sight in your environment. Focus on it. • Soften the muscles of your face; smile.
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If you can, take a few minutes:
Taking five • Cut out unnecessary movement or speech for a while. • Take a micro-break. Stop, close your eyes and focus on your body, allowing it to relax; let go for one minute, concentrating only on body sensations. Then re- open your eyes and re-assess your priorities before beginning work again. QUICK • Become an observer rather than a participator for a while LINKS • See the positive or funny side of what is happening MAIN • Ask yourself, `How much will this matter in 12 months' time?' CONTENTS CHAPTER • Risk saying what you feel or need, to someone you can trust CONTENTS
• If possible, leave the building alone for a short walk, preferably in a green space. CHAPTER 1
CHAPTER 2 DEVELOPING HABITS OF SELF-CARE CHAPTER 3 CHAPTER 4
The last section was concerned with instant responses to stress. But we CHAPTER 5 also need to take a larger view of our lives. For each person self-care means something different, but will usually include the following elements: CHAPTER 6 CHAPTER 7
• Paying attention to your own emotional health, for example, noticing if CHAPTER 8
you begin to feel ‘down’ or angry or ‘burdened’ often. When you do, it is CHAPTER 9 then important to speak to someone you trust about these feelings. END • Paying attention to your physical health, for example, eating enjoyable and NOTES nourishing food, getting enough sleep, and at least some exercise. • Making sure that you have enough time to have a private life and relationships that are not to do with work. That may include family, a partner, friends and/or pets with whom you spend time without having to think or talk about work. • Allowing yourself to ‘not do’ for a while; to relax, to sleep, to rest, lie on the sofa • Having interests or pastimes that you enjoy and are not directly connected to what you do at work, such as reading, film, singing, gardening, bird watching, sport, learning a language, cooking, playing games, dancing or walking.
It can be helpful if these are completely different from your work, for example, if you spend a lot of time listening to other people, go somewhere quiet and be alone for a while; or go dancing where the music is so loud that no one can hear anyone else speak. It may also be helpful if some [not all!] these things are a challenge, skills you need to learn or improve.
The point is to have parts of your life that remind you that you are more than you- at-work, and that nurturing other aspects of yourself is good and right. This gentler way of living is self-reinforcing; as we practise self-care it becomes habitual, automatic, involving less effort. It becomes easier to care for ourselves the more we do it.
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BUILDING RESILIENCE
Table 5 (below) provides a useful framework to help build resilience at an individual level. It was developed by the American Psychological Association to understand resilience and the factors that affect how people deal with hardship. Much of this work focuses on developing and using a personal strategy for enhancing resilience.39 You will notice several connections and overlaps with self-care. QUICK LINKS TABLE 5 The American Psychological Association 40 MAIN – 10 ways to build resilience CONTENTS
1. Making connections CHAPTER CONTENTS 2. Avoid seeing crises as insurmountable problems 3. Accept that change is a part of living CHAPTER 1 4. Move toward your goals CHAPTER 2 5. Take decisive actions CHAPTER 3
6. Look for opportunities for self-discovery CHAPTER 4
7. Nurture a positive view of yourself CHAPTER 5 8. Keep things in perspective CHAPTER 6 9. Maintain a hopeful outlook CHAPTER 7 10. Take care of yourself. CHAPTER 8
Make connections CHAPTER 9 Good relationships with close family members, friends or others are important. END NOTES Accepting help and support from those who care about you and will listen to you strengthens resilience. Some people find that being active in civic groups, faith- based organizations, or other local groups provides social support and can help with reclaiming hope. Assisting others in their time of need also can benefit the helper.
Avoid seeing crises as insurmountable problems You can't change the fact that highly stressful events happen, but you can change how you interpret and respond to these events. Try looking beyond the present to how future circumstances may be a little better. Note any subtle ways in which you might already feel somewhat better as you deal with difficult situations.
Accept that change is a part of living Certain goals may no longer be attainable as a result of adverse situations. Accepting circumstances that cannot be changed can help you focus on circumstances that you can alter.
Move toward your goals. Develop some realistic goals Do something regularly – even if it seems like a small accomplishment – that enables you to move toward your goals. Instead of focusing on tasks that seem unachievable, ask yourself, "What's one thing I know I can accomplish today that helps me move in the direction I want to go?"
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Take decisive actions Act on adverse situations as much as you can. Take decisive actions, rather than detaching completely from problems and stresses and wishing they would just go away.
Look for opportunities for self-discovery People often learn something about themselves and may find that they have grown in some respect as a result of their struggle with loss. Many people who have experienced tragedies and hardship have reported better relationships, greater sense of strength even while feeling vulnerable, QUICK increased sense of self-worth, a more developed spirituality and heightened appreciation for life. LINKS MAIN Nurture a positive view of yourself CONTENTS Developing confidence in your ability to solve problems and trusting your instincts helps build resilience. CHAPTER CONTENTS Keep things in perspective CHAPTER 1 Even when facing very painful events, try to consider the stressful situation in a broader CHAPTER 2 context and keep a long-term perspective. Avoid blowing the event out of proportion. CHAPTER 3 Maintain a hopeful outlook CHAPTER 4 An optimistic outlook enables you to expect that good things will happen in your CHAPTER 5 life. Try visualizing what you want, rather than worrying about what you fear. CHAPTER 6
Take care of yourself CHAPTER 7 Pay attention to your own needs and feelings. Engage in activities that you enjoy CHAPTER 8 and find relaxing. Exercise regularly. Taking care of yourself helps to keep your CHAPTER 9 mind and body primed to deal with situations that require resilience. END NOTES
QUESTIONS FOR REFLECTION AND DISCUSSION • What parts of this section have you found most relevant to you? • What have you learned about how you react to stress? • What one action could you take, to care for yourself a little better while you are at work? • What one action would give you a more satisfying work/life harmony? • How could you build your resilience?
Open Hearts & Open Minds: A toolkit of sensitive practice for practitioners working with survivors of institutional childhood abuse 60 QUICK LINKS MAIN ENHANCING RESILIENCE CONTENTS
CHAPTER 1 This chapter outlines: CHAPTER 2
What is resilience? 63 CHAPTER 3 Seven tensions (Table 6) 64 CHAPTER 4 Resilience and survivors of ICA 64 CHAPTER 5 Factors that helped participants most in facing life challenges (Table 7) 65 CHAPTER 6 Additional ways of strengthening resilience 66 CHAPTER 7 CHAPTER 8 Further reading 67 CHAPTER 9 Questions for reflection and discussion 67 END NOTES
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WHAT IS RESILIENCE?
“I think the whole thing is about moving on and giving people tools to move on.” Survivor, SSGT Project
As we mentioned in the last chapter, resilience is how people resist, cope or recover after experiencing adversity. Today, resilience is seen as a dynamic process and not an innate internal trait. It is increasingly considered when examining how individuals negotiate or recover from experiences like ICA. Despite the experience of institutional QUICK upbringing, some of the survivors we spoke to led high functioning lives. The study LINKS MAIN of resilience can help us understand what internal and external factors support CONTENTS survivors to resist the maladaptive outcomes usually associated with ICA. CHAPTER CONTENTS
Early research on resilience focused on the identification of particular qualities and personality CHAPTER 1 traits, such as hardiness and self-efficacy, which help people to overcome adversity (Cicchetti CHAPTER 2 & Garmezy, 1993). Recently research has focused on the process by which the qualities of resilience are acquired over time and on the natural fluctuations that occur across the life CHAPTER 3 span. Although, there is no universally accepted scientific definition of resilience (Wald, CHAPTER 4 2008), there are several existing definitions that share in common a number of features all CHAPTER 5 associating resilience with human strengths, some type of disruption and growth, adaptive coping, and positive outcomes following exposure to adversity (e.g., Bonanno, 2004; CHAPTER 6
Connor et al., 2003; Friborg et al., 2003; 2005; Matsen et al., 1999; Richardson, 2002). CHAPTER 7
CHAPTER 8 In her recent review of 2979 potentially relevant studies Windle defined resilience as: CHAPTER 9
END “The process of effectively negotiating, adapting to, or managing significant sources NOTES of stress or trauma. Assets and resources within the individual, their life and environment facilitate the capacity for adaptation or bouncing back in the face of adversity. Across the life course, experiences of resilience will vary.”41
In defining resilience Ungar has said that:
“In the context of exposure to significant adversity, resilience is both the capacity of individuals to navigate their way to the psychological, social, cultural, and physical resources that sustain their well-being, and their capacity individually and collectively to negotiate for these resources to be provided and experienced in culturally meaningful ways.”42
The promotive factors that can help individuals avoid the negative effects are called either assets or resources. According to Zimmerman, assets are the positive factors that reside within the individual, such as competence, coping skills, and self-efficacy. Resources are also positive factors that people overcome risk, but they are external to the individual. Resources include family support, mentoring, or community organizations that promote positive development.
Open Hearts & Open Minds: A toolkit of sensitive practice for practitioners working with survivors of institutional childhood abuse 62 8 Enhancing resiliance
Early resilience investigators often noted a common list of resources and associated with resilience in their studies of diverse children and situations. Over the decades, this list of widely observed promotive or protective factors in the individual, their relationships, and their cultures or communities, have developed. In a study of over 1500 individuals in 11 countries on five continents, generic and culturally specific aspects to resilience were outlined.43
TABLE 6 Seven tensions (Ungar, 2006) QUICK 1. Access to material Availability of financial, educational, medical and LINKS resources employment assistance and/or opportunities, as MAIN well as access to food, clothing and shelter CONTENTS CHAPTER 2. Access to supportive Relationships with significant others, peers and CONTENTS relationships adults within one’s family and community CHAPTER 1 3. Development of a Desirable sense of one’s self as having a personal and CHAPTER 2 desirable personal identity collective sense of purpose, ability for self-appraisal of strengths and weaknesses, aspirations, beliefs and CHAPTER 3
values, including spiritual and religious identification CHAPTER 4
4. Experiences of Experiences of caring for one’s self and others, the CHAPTER 5 power and control ability to effect change in one’s social and physical environment in order to access health resources CHAPTER 6 5. Adherence to Adherence to, or knowledge of, one’s local and/ CHAPTER 7 cultural traditions or global cultural practices, values and beliefs CHAPTER 8
6. Experiences of Experiences related to finding a meaningful role in one’s CHAPTER 9
social justice community that brings with it acceptance and social equality END NOTES 7. Experiences of a sense Balancing one’s personal interests with a sense of of cohesion with others responsibility to the greater good; feeling a part of something larger than one’s self socially and spiritually
Table taken from www.ncbi.nlm.nih.gov/pmc/articles/PMC2277285 with permission.
RESILIENCE AND SURVIVORS OF ICA
In this toolkit we have detailed some of the horrific neglect and abuse experienced by survivors of ICA. We can feel overwhelmed by the magnitude of these life experiences; it may seem difficult to see beyond these terrible childhood events. Some experienced mental health professionals can safely and effectively help survivors work through their childhood trauma. However, for most helping professionals exploring childhood trauma is beyond their capacity and scope of practice and in some cases may put both the client and worker at risk. Resilience and a strengths-based approach is a useful and effective responses to this challenge.
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In one of the few studies completed to date, Flanagan et al., examined the profile of a group of resilient Irish survivors of ICA.44 She found that resilient survivors engaged in less avoidant coping, had a secure adult attachment style and that the quality of romantic relationships in adult life may in part account for resilience. In a similar study, Rodin and Stewart found resilience was found to be highly evident in elderly survivors of childhood maltreatment.44 They found active engagement in relationships and in valued activities to be the most often mentioned contributors to resilience in these older survivors of childhood maltreatment.
In Carr et al., study of Irish survivors of ICA, participants’ self-reliance, optimism, work and QUICK LINKS skills collectively were the most frequently reported sources of personal strength (59.3%) MAIN and factors that helped participants face life challenges (58%).46 Their relationships with their CONTENTS partners and/or family were the most commonly cited things that meant most to participants CHAPTER in their lives (70.2%). This was also the second most common source of strength (16.19%) CONTENTS along with their relationship with God or a spiritual force (16.19%). Their relationship with CHAPTER 1 their partners and/or family was also the second most common factor that helped them CHAPTER 2 face life challenges (25.5%). Relationship with God or a spiritual force and relationship with a friend including other survivors were cited by less than 11% of participants as factors CHAPTER 3 that helped them face life challenges and things that meant most to them in their lives. CHAPTER 4
CHAPTER 5
CHAPTER 6 TABLE 7 Factors that helped participants most in facing life challenges (CICA)47 CHAPTER 7
CHAPTER 8
CHAPTER 9 70% Series 1 60% END NOTES 50% 40% 30% 20% 10% 0% Self reliance, Relationship Relationship Relationship my optimism, with my with God with a friend, my work and current or other including my skills partner spiritual other and family force survivors
These findings have some useful applications in our work with survivors of ICA. In the simplest sense, they help us move away from focusing on childhood abuse and trauma. Although we know that context or environmental factors play a role in the development of resilience, this framework encourages workers to work with clients to explore their individual strengths, relationship, coping strategies and social supports.
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The studies above provide valuable insights into some of the factors which have help some survivors cope. It should be noted that these factors do not exist in isolation and workers should attend to the individual person, to draw to their attention and promote the strengths and resources they already have and can develop, which support and help them. More and more we see that resilience is culturally specific. For example, unpopular behaviour that resists harm may be a pathway to resilience surviving from a time when it was necessary; this is how a therapist would understand it. Understanding such strategies as “hidden resilience”48 may help us to greater empathy and effectiveness as workers. We may be able then to help the person make links or identify strategies that are more likely to be effective now. QUICK LINKS MAIN In the previous chapter on self-care we included some material about building personal CONTENTS resilience. This material is as applicable to survivors as it is to workers, although CHAPTER of course the choice to use any of the strategies is ultimately a personal one. If we CONTENTS are using positive strategies to build our own resilience, we are more likely to be CHAPTER 1 able to assist survivors we work with to attend to and build their resilience. CHAPTER 2
CHAPTER 3 ADDITIONAL WAYS OF STRENGTHENING RESILIENCE CHAPTER 4 CHAPTER 5 We can also attend to the organisational and societal factors which will build rather than diminish CHAPTER 6 resilience. At an organisational level, we should review working environment, such as offices and waiting rooms, and the competencies of our staff teams. In reviewing interventions with CHAPTER 7 survivors of ICA in Canada, Wolfe et al., suggested that “education and training needs to be CHAPTER 8 directed at institutions themselves (e.g., staff, volunteers, board members), as well as community CHAPTER 9 professionals that provide services to survivors...the majority of victims describe the legacy of END their abuse being compounded by lack of intervention and prevention programs, despite their NOTES efforts to break the silence. Survivors need to see an open and genuine effort by the institution that goes beyond superficial reactions to disclosures as if they are isolated incidents.”49
The culture of organisations should also be considered. In Irish communities, until recently disclosures of abuse within clerical institutions was ignored, denied, or minimised. It was not unusual for survivors of ICA to be shunned or disbelieved. In our work with survivors, participants told us how important it was that workers accept and honour their stories of suffering. It is essential that organisations take an open, honest and responsive position to disclosures and on-going work with survivors of ICA. Encouraging survivors to use services and community organisations in a collaborative or independent manner is vital and was a key recommendation of all survivors involved in this project.
Survivors of ICA have exposed social problems that have long been ignored. Their courage has forced society to face painful realities about trusted community leaders, established organizations, and institutions. At a societal level, in Ireland and the UK, the common understanding of ICA is derived from high profile media reports of investigations and commissions, with chronic abuse and neglect the common narrative. Rarely is the extraordinary courage, strength and determination in the face of adversity discussed. Each survivor has their own story and these stories are rooted in survival despite adversity, the likes of which the rest of society cannot begin to imagine. Through
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this project, survivors have told us “moving on” is important and must be at the heart of progress. Although professionals have a role to play, communities and survivors themselves must be empowered to recognise and celebrate the ordinary magic demonstrated by survivors every day.50
FURTHER READING
Uncertain Legacies: Resilience and institutional child abuse – a literature review QUICK www.scotland.gov.uk/Publications/2012/06/5914/downloads LINKS MAIN Protective Factors and the Development of Resilience: CONTENTS www.ncbi.nlm.nih.gov/pmc/articles/PMC2683035 CHAPTER CONTENTS The resilience doughnut: CHAPTER 1 www.theresiliencedoughnut.com.au/details.php?p_id=25 CHAPTER 2
CHAPTER 3 Strengths-Based Social Work Assessment: Transforming the dominant paradigm: www2.sunysuffolk.edu/bybeem/SS30/Strengths%20based%20social%20work%20assessment.pdf CHAPTER 4
CHAPTER 5
CHAPTER 6
QUESTIONS FOR REFLECTION AND DISCUSSION CHAPTER 7
• How do you currently consider and promote the resilience of clients seeking help? CHAPTER 8 • How does this relate to you building your own resilience? CHAPTER 9 • Are you aware of any protective factors which might benefit survivors you work with? END • Are there any steps your organisation could take better to promote resilience? NOTES • Can you think of any community wide interventions which would benefit survivors of ICA?
Open Hearts & Open Minds: A toolkit of sensitive practice for practitioners working with survivors of institutional childhood abuse 66 QUICK LINKS MAIN FURTHER READING ON CONTENTS
CHAPTER SENSITIVE PRACTICE CONTENTS
CHAPTER 1
CHAPTER 2
CHAPTER 3
CHAPTER 4
CHAPTER 5
CHAPTER 6
CHAPTER 7
CHAPTER 8
CHAPTER 9
END NOTES
icap 0207 272 7906 [email protected] www.icap.org.uk
Open Hearts & Open Minds: A toolkit of sensitive practice for practitioners working with survivors of institutional childhood abuse 67 9 Further reading on sensitive practice
Arnesman, E. O’Riordan, M. (2007). Institutional child sexual of Resilience: A Critical Evaluation and Guidelines abuse and suicidal behaviour: Outcomes of a literature review, for Future Work. Child Dev, 71(3):543-562 consultation meetings and a qualitative study. National Suicide Masten, A. S. (2009). "Ordinary Magic: Lessons Research Foundation, National Office of Suicide Prevention: Dublin. from research on resilience in human development" Brennan, C. (2007). Facing what cannot be changed: The (PDF).Education Canada 49 (3): 28–32. Irish experience of confronting institutional child abuse. O’ Toole, F. (2009, May 21). The savage reality of Journal of Social Welfare & Family Law, 29, 3–4, 245–263. our darkest days. The Irish Times, p. 1. Carr et al., (2010). “Profiles of Irish survivors of Radke-Yarrow M, Sherman T. Hard growing: Children who institutional abuse with different adult attachment styles”. survive. In: Rolf J, Masten A, Cicchetti D, Nuechterlein Attachment & Human Development 11 (2): 183. K, Weintraub S, editors. Risk and protective factors Carr, A., Dooley, B., Fitzpatrick, M, Flanagan, E., Flanagan- in the development of psychopathology. Cambridge QUICK Howard, R., Tierney, K., White, M., Daly, M. & Egan, J. University Press; New York: 1990. pp. 97–119. LINKS (2010). Adult adjustment of survivors of institutional child Raftery M., O Sullivan E. (1999) Suffer the little children: the abuse in Ireland. Child Abuse and Neglect, 34, 477-489. inside story of Ireland’s industrial schools. Dublin. New Island MAIN CONTENTS Commission of Inquiry into the Reformatory and Rossetti, S. J. (1995). The impact of child sexual abuse Industrial School System (1970) Report on attitudes toward God and the Catholic Church. CHAPTER 1 Commission to Inquire into Child Abuse. (2009). Commission to Child Abuse and Neglect, 19, 1469-1481 Inquire into Child Abuse Report. Dublin, Ireland: Stationery Office. Rutter M. Psychosocial resilience and protective mechanisms. CHAPTER 2 Delaney, L., Fernihough, L., & Smith P. J. (2013). Exporting the In: Rolf J, Masten AS, Cicchetti D, Nuechterlein KH, Weintraub poor health: The Irish in England. Demography, 50(6), 2013-2035. S, editors. Risk and protective factors in the development of CHAPTER 3 Ferguson, H. (2007). Abused and looked after children psychopathology. Cambridge; New York: 1990. pp. 181–214. CHAPTER 4 as moral dirt? Journal of Social Policy, 36(1), 123–39. Rutter M. Psychosocial resilience and protective mechanisms. Fitzpatrick, M., Carr, A., Dooley, B., Flanagan-Howard, R., Flanagan, In: Rolf J, Masten AS, Cicchetti D, Nuechterlein KH, Weintraub CHAPTER 5 E., Shevlin, K., Tierney, K., White, M., Daly, M. & Egan J. (2010). S, editors. Risk and protective factors in the development Profiles of adult survivors of severe sexual, physical and emotional of psychopathology. Ca Tilki M. (2003) ‘A study of the CHAPTER 6 institutional abuse in Ireland. Child Abuse Review, 19, 387-404. Health of the Irish-born people in London : The relevance Fonagy, P., Jennings-Hobbs, R., & Speed, M. (2012). of social and socio-economic factors, health beliefs and CHAPTER 7 Coming Home to Ourselves. London: icap. behaviour’. Unpublished PhD Thesis, Middlesex University. CHAPTER 8 Gaffney M. (2001) Culturally sensitive care for older Irish people. Tilki M. (2006) ‘The social contexts of drinking among Irish men in London’. Drugs: Education, Prevention and Policy, 13, (3) 247-261 Report commissioned by Haringey Irish Community Care CHAPTER 9 Gaffney M. (2002) Mental Health Needs of older Irish people in Tilki, M., et al., (2009) The Forgotten Irish, Social Policy Research Centre, Middlesex University.http://eprints. END Camden and Islington. Research commissioned by the London NOTES Irish Centre and funded by Camden and Islington Action Zone. mdx.ac.uk/6350/1/Tilki-Forgotten_Irish.pdf Goffman E. Asylums: Essays on the Social Situation of Tilki, M., Ryan, L., D’Angelo A., & Sales R. (2009). The Mental Patients and Other Inmates. Doubleday, 1961. Forgotten Irish; a report of a research project commissioned by the Ireland Fund of Great Britain. Retrieved from Goffman, E. (1961). Asylums: Essays on the social situation of https://eprints.mdx.ac.uk/6350/1/Tilki-Forgotten_Irish. mental patients and other inmates. New York: Doubleday Anchor. pdfmbridge; New York: 1990. pp. 181–214. Groome, D. (2011). The church abuse scandal: Were Ungar, M.; Brown, M.; Liebenberg, L.; Othman, R.; Kwong, W.M.; crimes against humanity committed? Retrieved Armstrong, M.; Gilgun, J. (2007). "Unique pathways to resilience from http://elibrary.law.psu.edu/fac_works/6 across cultures". Adolescence 42 (166): 287–310.PMID 17849937 Hickman M., Walter B. (1997) Discrimination and the Irish Werner EE, Bierman JM, French FE. The children of Kauai community in Britain. London. Commission for Racial Equality. Honolulu. University of Hawaii Press; Hawaii: 1971. Higgins, M. (2010). Developing a profile of survivors of abuse in Werner EE. Overcoming the odds. Journal of Developmental Irish religious institutions. Retrieved from http://www.ssgt.ie/files/ and Behavioral Pediatrics. 1994;2:131–136. [PubMed] developing_a_socio_economic_profile_of_survivors_o.pdf Werner EE. Resilience in development. Current Directions Kennedy, M. (2000). Christianity and child sexual abuse: The in Psychological Science. 1995;3:81–85. Wolfe, D. A., survivors voice leading to change. Child Abuse Review, 9, 124-141. Francis, K. J., & Straatman, A. L. (2006). Child abuse in Masten A, Best K, Garmezy N. Resilience and development: religiously-affiliated institutions: Long-term impact on men’s Contributions from the study of children who overcome mental health. Child Abuse & Neglect, 30, 205–212. adversity. Development and Psychopathology. 1990;2:425–444. Wolfe, D. A., Jaffe, P. G., Jett´e, J. L., & Poisson, S. E. (2003). Masten A, Coatsworth JD, Neemann J, Gest S, The impact of child abuse in community institutions and Tellegen A, Garmezy N. The structure and coherence organizations: Advancing professional and scientific understanding. of competence from childhood through adolescence. Clinical Psychology: Science and Practice, 10, 179–191. Child Development. 1995;66:1635–1659. [PubMed] Wolfe, D. A., Jaffe, P. G., Jette, J. L., & Poisson, S. E. (2001). Mahood, L., & Littlewood B. (1994). The vicious girl Child abuse in community institutions and organisations: and the street-corner boy: Sexuality and the gendered Improving public and professional understanding. (Law delinquent in the Scottish child-saving movement, 1850- Commission of Canada), York: Anchor/Doubleday. 1940. Journal of the History of Sexuality, 4, 549-78. Luthar S, Cicchetti D, Becker B. (2000). The Construct
Open Hearts & Open Minds: A toolkit of sensitive practice for practitioners working with survivors of institutional childhood abuse 68 End notes
END NOTES
1. http://www.ssgt.ie/files/developing_a_socio_economic_profile_of_survivors_o.pdf 2. http://scholarworks.gsu.edu/cgi/viewcontent.cgi?article=1006&context=psych_diss 3. http://www.bccf.ca/sites/default/files/Ordinary_Magic.pdf 4. http://www.integration.samhsa.gov/clinical-practice/handbook-sensitivve-practices4healthcare.pdf 5. http://bjsw.oxfordjournals.org/content/30/6/795.short 6. See Wolfe, 2006, CICA, 2009, Carr, 2009) 7. http://www.tandfonline.com/doi/abs/10.1300/J024v04n01_03#.UcANlfmkr4A 8. http://www.amazon.com/Suffer-Little-Children-Irelands-Industrial/dp/0826414478 QUICK 9. http://dit.ie/icr/media/diticr/documents/5%20Kenny%20ICR%2011.pdf & LINKS http://www.tandfonline.com/doi/pdf/10.1080/13537900903416788 MAIN 10. http://www.education.ie/en/Press-Events/Press-Releases/2013-Press-Releases/PR13%20-03-22.html CONTENTS 11. http://www.childabusecommission.com/rpt/pdfs/ CHAPTER 1 12. http://www.amazon.com/Suffer-Little-Children-Irelands-Industrial/dp/0826414478 13. http://www.childabusecommission.com/rpt/pdfs/CICA-VOL3-04.pdf CHAPTER 2 14. http://www.childabusecommission.com/rpt/03-04.php 15. http://www.childabusecommission.com/rpt/03-08.php CHAPTER 3 16. http://www.childabusecommission.com/rpt/03-08.php CHAPTER 4 17. http://www.childabusecommission.com/rpt/03-06.php 18. http://www.childabusecommission.com/rpt/03-07.php CHAPTER 5 19. http://www.childabusecommission.com/rpt/03-07.php 20. http://www.childabusecommission.com/rpt/05-03A.php CHAPTER 6 21. http://www.childabusecommission.com/rpt/05-03A.php CHAPTER 7 22. http://www.childabusecommission.com/rpt/03-07.php 23. http://www.childabusecommission.com/rpt/03-07.php CHAPTER 8 24. http://www.childabusecommission.com/rpt/03-07.php 25. http://www.childabusecommission.com/rpt/03-09.php CHAPTER 9 26. http://www.childabusecommission.com/rpt/05-03A.php 27. http://www.childabusecommission.com/rpt/03-09.php 28. http://www.childabusecommission.com/rpt/pdfs/CICA-VOL5-03.pdf & http://www.learningtoendabuse.ca/sites/default/files/child%20abuse%20religious%20institutions.pdf 29. http://www.ncbi.nlm.nih.gov/pubmed/16464495 30. http://www.childabusecommission.com/rpt/pdfs/CICA-VOL5-03.pdf 31. http://www.lfcc.on.ca/institutional.pdf 32. http://www.childabusecommission.com/rpt/pdfs/CICA-VOL5-05.pdf 33. http://www.childabusecommission.com/rpt/pdfs/CICA-VOL5-05.pdf 34. http://onlinelibrary.wiley.com/doi/10.1093/clipsy.bpg021/abstract 35. http://www.ncbi.nlm.nih.gov/pubmed/16464495 36. http://www.acco.be/download/nl/39109674/file/journal_2-3-2009_-_profiles_of_resilient_survivors_-_2.pdf 37. http://www.acco.be/download/nl/39109674/file/journal_2-3-2009_-_profiles_of_resilient_survivors_-_2.pdf 38. http://www.childabusecommission.com/rpt/05-03A.php 39. http://www.apa.org/helpcenter/road-resilience.aspx# 40. http://www.apa.org/helpcenter/road-resilience.aspx 41. http://journals.cambridge.org/action/displayAbstract?fromPage=online&aid=8111915 42. http://www.springer.com/social+sciences/book/978-1-4614-0585-6 43. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2277285/ 44. http://www.acco.be/download/nl/39109674/file/journal_2-3-2009_-_profiles_of_resilient_survivors_-_2.pdf 45. http://sgo.sagepub.com/content/2/2/2158244012450293.full 46. http://www.childabusecommission.com/rpt/pdfs/ 47. http://www.childabusecommission.com/rpt/pdfs/CICA-VOL5-05.pdf 48. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2277285/ 49. http://www.lfcc.on.ca/institutional.pdf 50. http://www.cea-ace.ca/sites/default/files/EdCan-2009-v49-n3-Masten.pdf
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