Child Abuse and Neglect

Child abuse and neglect represents a profound failure of the proper alignment of authority and responsibility. Children are, by definition, unequal to adults in terms of physical size and abilities, intellect, and understanding of the social and emotional world. They do not have the same legal rights and cannot access the resources available to adults. Adults who are bigger and more powerful are entrusted with children and expected to manage themselves physically, sexually, and emotionally in ways that do not hurt children. 

Children are more often abused by those within their family or immediate circle, by a person who has formed a relationship of trust who exploit the child’s earlier attachment relationships. This is a profound betrayal as the abuser takes a process which is positive and life affirming and the basis for future significant relationships and uses it to gain the trust and co-operation of the child. This implicates the child in the abuse and leaves them with a belief that they were complicit and to blame and locks them into silence. If the abuse is initially framed as ‘a game’ that may be confusing but not physically hurtful or disturbing, it may only be that as the behaviours escalate or the child becomes older that they begin to become distressed. By now they feel that this was mutual and agreed upon and carry responsibility that does not belong to them. Not only has the abuser shamed the child and made them feel they colluded in creating the abuse, but it also calls into question the reliability and protectiveness of other adults. This may be exploited by the abuser who tells the child that their parent asked them to ‘teach’ the child these things and that this is an ordinary and normal activity or should they speak no-one will believe them. Alternately they may tell the child that if they disclose the abuser will go to gaol or kill themselves. Such consequences are particularly horrifying where the adult has become a special person in the life of a child who was neglected in the family but became ‘special’ to this person. A tangle of lies, deception and distortion of experience and fact leave a child carrying the responsibility but with no capacity to manage the consequences. 

Those who abuse are often skilled at managing the relationships around the child to further protect themselves. They may connect with the parent and develop a position of trust within the family which gives them ready access to the child and further undermines the child’s conviction that they will be believed. As the abuse continues the child will find themselves increasingly different from their peers and if they do attempt to confide in friends find they are not understood, further enhancing their isolation. 

Application of the Bower Place Approach

The Bower Place Method with its four meta-frames provides a structure to analyze and effectively intervene in matters which are deeply distressing to families, workers, and practitioners. The structure ‘holds’ the practitioner as they make sense of complex and confusing stories and explanations and appeals from competing sources to view the situation through their eyes. Central to this is a child who has already been hurt who the practitioner has been entrusted to guide through the disarray. 

As in all matters, the primary meta frame is that of authority and responsibility which has been corrupted by the abuse. A child may be demonstrating difficult behaviours including acting out the physically violent or sexually inappropriate conduct they have experienced which must be fairly and wisely managed in a way that is congruent with their developmental stage. Parents, carers, teachers and therapists need to agree about what is expected of the child, the constraints created to protect the child and others and consequences when boundaries are breached. Overarching these matters may be questions of child protection and the removal of a child from their home and legal processes around the alleged perpetrator. The legitimate and competing demands at every level of system can become overwhelming and make the proper alignment of authority and responsibility challenging with professional struggling with each other to avoid taking proper responsibility.  

The spatial meta frame focusses attention on the inside neurobiological and outside socio-relational world. Children and adults who have been abused experience changes to the brain with the amygdala easily triggered by events which are perceived as threatening, which can mean ordinary occurrences produce extreme and confusing reactions making functioning in school and family life demanding. The child may be constantly on the alert and unable to relax, fearful and experience learning difficulties. These issues need to be fully investigated and support provided.  

Abuse fracture relationships and creates alliances, especially where there is dispute about the validity of the allegation and where children are removed from their family. It is not uncommon for a child or adolescent to make allegations against a father or stepfather and for the mother to disbelieve based on a conflictual relationship between the two. This central fracture may be played out in the extended family with siblings, grandparents, aunts, uncles, and friends all drawn into the abyss. When this happens, the focus becomes the conflict between family members rather than the child and their protection. The addition of professionals; child protection workers, counsellors, social workers, and psychologists can all build on and escalate the central fracture. The task of therapy is to map, understand and intervene in the rupture, to remove fracture and build alliances around the child that can ameliorate and protect against future abuse. Sometimes the most challenging fractures to address are those between members of the wider system because if these are not effectively resolved, those at the centre, the child and their family have little chance of healing rifts. 

Addressing the time meta-frame allows the practitioner to identify key factors in the past which are significant to the impact of the abuse on the child and the clustering of other events in the family’s life that precipitated abuse or allowed it to continue undisturbed. It focusses on the current patterns and aspects of life that the family wish to remove. A future time focus helps everyone decide what current  behaviours, feelings, thought and beliefs that include abuse the family wants removed and how this can be achieved. 

The final developmental meta-frame locates the current events within the lifecycle of the child and family and considers aspects which have made this child and family more vulnerable. For example, a pre-verbal child or one with a significant disability, a child whose appearance has resulted in rejection by peers or in a culture where abuse cannot be disclosed is more at risk than another of the same age in different circumstances. Attention to the life cycle stage of the family and how the demands of this time intersect with the abuse are also important. Understanding these aspects allows the practitioner to consider how abuse has impacted the identity development of both the person who experienced the abuse and others in the family. For example, a child may stop attending school, disconnect from friends and lose primary attachment figures distorting productive, peer and family identity. Sexual identity is also likely to be affected with a child or adolescent whose sexuality has been precociously enacted inappropriately engaging with others or shutting down and disconnecting from their own emerging sexuality and from the possibility of age-appropriate experimentation and development. 

Working with child abuse is distressing and confusing. It requires a framework for the practitioner to remain clear and focused in making sense of the current situation and act to support child, family and wider system remove those things that allowed abuse to occur and be uninterrupted and create a world that does not need to include professionals to make it safe.