Tardy redress would hurt victims more

The testimony given to the royal commission sitting in Ballarat provides further insight into the unconscionable human cost of child sexual abuse. The inquiry has revealed that 12 boys have died, allegedly by suicide from a single class of 33 at St Alipius school and 40 suicides related to child sexual assault have occurred within the Ballarat community. This community has been crushed to its core.

Silenced survivors have shown courage coming forward. … To not promptly address their needs would not only be soul-destroying but also life-threatening.

One after another, victims are continuing to come forward courageously breaking their silence. It has been asserted that there were schools in which no child was safe, with periods during which every teacher was an alleged sex offender.

With no safe place or person to tell, these children lived in constant fear of the next assault, powerless and helpless, as those charged with their care abused their power and betrayed them time and again. The possibility of “fight or flight”, a normal physiological response to danger was not available. Where was their community of nurture, care and compassion? And why did no one intervene to protect them?

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These survivors, now men, have related heartbreaking stories of lives ruined by disability, welfare dependency, mental illness, substance abuse and relationship breakdown. Many of those who have not paid the ultimate price are living a life sentence imposed by the predatory behaviour of paedophile priests and sealed by a system which protected its own at all costs.

The leadership of the Catholic Church in particular, is now under intense scrutiny. The Royal Commission into Institutional Responses to Child Sexual Abuse is prising open a previously secretive and closed network. The silence is being shattered.

Throughout the royal commission we have seen a series of entrenched systems previously accountable only to their own internal intransigence publicly examined and we as a community have been shocked. That so many once revered systems could so conspire to betray their charges, not once but repeatedly, over decades and across leadership structures, is not acceptable.

The royal commission will release its interim recommendations around redress and civil litigation at the end of June. The recommendations will lay the foundations for a fair and just response for victims, including those now providing testimony in Ballarat. Adults Surviving Child Abuse (ASCA) calls on state and federal governments in Australia to respond proactively. They must immediately move to put in place frameworks and structures to implement the recommendations.

Silenced survivors have shown courage coming forward. They have trusted the commission and its processes as well as the governments that have supported it. To not promptly address their needs would not only be soul-destroying but also life-threatening.

When the recommendations are released, the immediate response should provide optimal possibilities for survivors to access much-needed support and redress. For many it will be too little; let’s not make it too late for all.

It is time for institutions to be brought to justice and held accountable. It is also time for true leadership, the sort of leadership seen within the commission, and it needs to come not just from all of the institutions paraded before the commission, but also from governments across Australia.

Dr Cathy Kezelman is the president of Adults Surviving Child Abuse (ASCA)

Help and support for adult survivors of childhood trauma and abuse is available from the ASCA professional support line on 1300 657 380, 9am- 5pm Monday-Sunday.

Read more: http://www.smh.com.au/comment/tardy-redress-would-hurt-sex-abuse-victims-further-20150521-gh6hex.html#ixzz3vdhh4mUz
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Abuse on the radar

CHILD abuse and other forms of child maltreatment are common and destructive.

The ongoing proceedings of the Royal Commission into Institutional Responses to Child Sexual Abuse along with the national family violence agenda, are spearheading change in our awareness and attitudes to this trauma.

Trauma is an experience of real or perceived threat arising from single or repeated adverse event/s. Such trauma generally involves abuse of power, betrayal of trust, fear and a sense of helplessness and confusion.

When trauma is interpersonal it is especially damaging. When it is repeated and extreme, occurs over a long time, and is perpetrated in childhood by the very people charged with a child’s care, it is called complex trauma.

It is important to differentiate complex trauma from “single incident” trauma, where the latter describes one-off events in adulthood such as a physical or sexual assault, or a natural disaster such as flood or fire.

Complex trauma requires different treatment responses.

Many survivors of complex trauma show remarkable resilience and manage well. However, many are left struggling day to day with their emotions, relationships and sense of who they are and where they fit in the world.

According to the ACE study in the US (the largest longitudinal study of adverse childhood experiences ever undertaken), such events are “vastly more common than recognized or acknowledged”. They powerfully impact the mental and physical health and wellbeing of individuals “a half-century later” and, without intervention, they cause “long-term disease, disability, chronic social problems and early death”.

This is because strategies adopted to cope with overwhelming childhood experiences, such as smoking, substance abuse, overeating and physical inactivity, become risk factors for physical health problems later on.

In February of this year, the national organisation, Adults Surviving Child Abuse (ASCA), released an economic report — The cost of unresolved childhood trauma and abuse in adults in Australia — which outlined the urgent need for informed responses to unresolved childhood trauma that is highly prevalent in the general population.

The groundbreaking report builds on ASCA’s 2012 “Practice guidelines for treatment of complex trauma and trauma informed care and service delivery”, which set the standards for clinical and service practice.

Research findings from both reports confirm that people who have experienced even extreme early life trauma can recover.

So what is the role of doctors in helping to improve the lives of Australians directly affected by childhood trauma? What can practitioners do to identify those impacted and provide them with the tools, resources and referral pathways they need to find a path to health and wellbeing?

The prevalence of complex trauma, particularly from childhood, is such that, every day, doctors are seeing a high number of patients who have diverse and sometimes medically unexplained symptoms or comorbid diagnoses.

Many of our most challenging health problems are the result of compensatory behaviours such as smoking, overeating, and alcohol and drug abuse. While damaging to health in the longer term, such behaviours often provide immediate partial relief from emotional problems caused by traumatic childhood experiences.

It is important for all practitioners to be aware that past and/or present trauma may underlie some diverse presentations of their patients and be alert to its effects, in the knowledge that trauma becomes compounded over time and its impacts become cumulative.

Primary care practitioners are in a unique position to help patients feel safe and build the trusting environment that can enable disclosure. The response to any disclosure of overwhelming experiences — both in childhood and in adulthood — is critical.

This means that when engaging with all patients, it is important to keep the issue of trauma on the radar. It is also important to practise from a trauma-informed perspective that incorporates the core principles of safety, trustworthiness, choice, collaboration and empowerment.

While direct screening for trauma requires specialist training, all patients benefit from trauma-informed physicians who are aware of the impacts of trauma, and of the resources, tools and referral pathways, which optimise safety and the possibilities for recovery.

Help and support is available from the ASCA professional support line on 1300 657 380, 9 am – 5 pm Monday-Sunday. Additional resources and information regarding education and training are available at www.asca.org.au

Dr Cathy Kezelman AM is the president of Adults Surviving Child Abuse and practised as a GP for 20 years.

The Knox Grammar Controversy is a Heartbreaking Story

We now know about the horrors of Knox Grammar. But how many other schools were hiding the same secrets?

As the Royal Commission into Institutional Responses to Child Sexual Abuse shines the spotlight on Knox Grammar we sit aghast at how this school, and, so many others could fail our children so badly.

As parents we all want our children to be safe always…

But what are we talking about? How many schools? How many children?

Then? Now? How have things changed and what can we expect in years to come?

The Royal Commission has shown that there is no one school type implicated – religious, secular, single-sex or co-ed.

More pertinent than features of difference are those of cultural similarity. Failure to notice, failure to believe, failure to report, failure to act.

In some cases there was more than one perpetrator. In others, principals and other teachers were complicit in protecting perpetrators. Those guilty were moved from school to school, exposing more children to harm.

What was it like for the children trapped in a culture in which they were scared to disclose, threatened into silence, punished for speaking out? To be told they were special and plied with treats to prove it – victims of insidious grooming behaviour which went unrecognised. Only to learn that being special brought repeated pain, angst and shame.

As we watch victims come forward to speak out about their horror and entrapment, the incredible betrayal they felt, the power imbalance which kept them disempowered, we are moved by their courage and shocked by their angst. The horrors of living for years with inappropriate shame, guilt and self-blame, imposed on them by their perpetrators and a culture which ostracised and punished victims.

Their daily struggles to feel okay, to make it to work, to hold a relationship, to feel and be healthy, to not drink or smoke to excess in an attempt to try and feel distress. Depression, self-harm, suicide attempts and for some, the ultimate cost – losing their life.

While many of the instances are historical, sadly some are all too recent. It is important to say that many schools are in fact safe. For others the prior culture of secrecy, cover-up, fear and intimidation is starting to change.

The Royal Commission has been a catalyst for greater openness and transparency. And the time in which children were seen and not heard, in which child sexual abuse was named or spoken about has truly passed.

Read more: Carrie has a message for child abuse survivors in Australia.

We now know that children rarely ‘make up stories’ of being sexually abused and we are beginning to understand what it means for a person to be sexually abused as a child – in childhood, as an adolescent and into adulthood. The culture is changing.

Working with children checks, mandatory reporting, child-safe practices, age-appropriate child programs, education and training of all staff. But most important is a fundamental cultural shift which demands strong leadership to produce cultures which are open, transparent and accountable.

The Royal Commission will complete its work in December 2017 and provide recommendations to government. In the meantime and always, we have every right to seek evidence from our schools that they are putting the safety of our children first in everything they do.

If you or another adult you know was sexually abused as a child call ASCA on 1300 657 380.

Read more at http://www.mamamia.com.au/knox-grammar-controversy/#9O6BjYEjjx7e421O.99

Children of domestic violence – the silent lasting effects

The need to respond proactively to trauma and violence in our society, as well as globally, has never been more urgent. From threats of terrorism, civil wars, genocide to those of domestic violence and child abuse we need to understand the impacts of trauma and address them. Repeated traumas reap havoc on individuals, families and societies, even after the overt threats have abated. Repercussions are cumulative, compounded and insidious.

Last week we saw communities unite against the ever-too present reality of violence against women. White Ribbon Day is a public expression of solidarity and collective action championing the need for respectful relationships and attitudinal change. Such movements help mobilise the collective support of the nation, which is often needed to garner the political will to mobilise a government response.

However the challenge is far more complex. Many women affected by domestic and family violence have children who, rather than simply being an addendum to the violence or passively witnessing it, experience violence directly or live in fear in their home, robbed of a sense of safety or protection. The longer the violence continues, the more likely it is to impact children’s attitudes and their sense of relationships and the world.

An estimated 30-60 per cent of families affected by domestic and family violence experience harm from other forms of child abuse. More than half (55 per cent) of Australian children who have experienced physical abuse are also exposed to domestic violence, while an estimated 40 per cent who have experienced sexual abuse are also exposed to domestic violence.

Family violence has potentially profound effects across the lifecycle of an individual – from infancy, through childhood and adolescence, and even through to adulthood. Such trauma has long-term implications on self-esteem, relationships, physical and mental health, daily functioning. When those affected become parents, and have not had the right support to work through their issues, it often impacts the next generation.

The focus on domestic and family violence is much needed and, in addition, at a time dominated by the Royal Commission into Institutional Responses to Child Sexual Abuse we need to extend the focus on the trauma children experience in abusive and violent families, neighbourhoods, institutions and communities.

In a recent report commissioned by ASCA, an individual who has been abused or otherwise traumatised in childhood is at significantly higher risk of impaired social, emotional and cognitive wellbeing as an adult. They are also at a higher risk of adopting coping behaviours, such as alcohol and substance abuse, overeating and smoking, the harmful repercussions of which compound the propensity to mental illness, attempted suicide and suicide. Therefore we must offer the right support to the people across the life cycle who have experienced abuse or trauma in childhood so they get the opportunity to be safe, healthy and connected with their communities.

These scourges thrive on secrecy, silence and the complicit hands-off bystander response, which has characterised our society until now. Compounding these factors is the appalling lack of accessible affordable specialist services. Lack of such services means that victims are not provided with the opportunities they need to rebuild their lives. Trauma is a public health issue of significant proportions and we need to respond in a coordinated informed and integrated way.

Our growing understanding of brain plasticity has established that possibilities for recovery are real. Critical to recovery are the positive relational experiences, which are central to wellbeing and a better future. Victims of all ages need to be and feel safe, and have opportunities to discuss, process and make sense of their experiences. Such support needs to come from the community, including from family and friends but also professionally.

The recent response by Minister Ley to the recommendations of the national mental health commission acknowledged the need for systems’ reform to address the severe and complex needs of many Australians who have previously not had their needs met – many of whom experienced child abuse or other forms of trauma. The recommendations of the Redress report from the Royal Commission into Institutional Responses to Child Sexual Abuse are for ongoing counselling and psychological care as and when and for as long as required for survivors of institutional child sexual abuse.

By addressing childhood trauma and abuse in adults, Australia can save an estimated $9.1 billion annually. It is time for a coordinated government response to the scourge of violence and abuse impacted on our children, which without the right interventions continues to play out, often for a lifetime.

Help and support is available from the ASCA professional support line on 1300 657 380, 9am- 5pm Monday-Sunday.