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Incest and suicide attempt in adolescence Kim, Shlomit 1989

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INCEST AND SUICIDE ATTEMPT IN ADOLESCENCE By Shlomit Kim B.S.W., The Un i v e r s i t y of Haifa, 1979 A THESIS SUBMITTED IN PARTIAL FULFILLMENT OF THE REQUIREMENTS FOR THE DEGREE OF THE FACULTY OF GRADUATE STUDIES SCHOOL OF SOCIAL WORK We accept this thesis as conforming to the required standard THE UNIVERSITY OF BRITISH COLUMBIA MAY 1989 (c) Shlomit Kim, 1989 MASTER OF SOCIAL WORK i n In presenting this thesis in partial fulfilment of the requirements for an advanced degree at the University of British Columbia, I agree that the Library shall make it freely available for reference and study. I further agree that permission for extensive copying of this thesis for scholarly purposes may be granted by the head of my department or by his or her representatives. It is understood that copying or publication of this thesis for financial gain shall not be allowed without my written permission. Department of LOORK The University of British Columbia Vancouver, Canada Date hAftY 12. M P } DE-6 (2/88) i i ABSTRACT Research regarding incest victims who attempted suicide i n adolescence has received l i t t l e attention although incest i s considered as one of the most destructive forms of sexual abuse; and the rate of suicide attempts i n adolescence has been on the r i s e . This study employs an exploratory approach, i n v e s t i g a t i n g four female adolescents, aged 15-19, who experienced both, incestuous r e l a t i o n s h i p s i n the past and s u i c i d e attempt i n adolescence. Using an open-ended questionnaire, the subjects were interviewed and the recorded responses were tra n s c r i b e d and analyzed, using Glaser and Strauss' 'constant comparative method of a n a l y s i s ' . The conceptual findings indicate that the incest victims have gone through a process comprising three stages: i ) becoming a v i c t i m , i i ) e s c a l a t i o n of problems, and i i i ) the h e a l i n g process. The t r a n s i t i o n from one stage to another e n t a i l e d change i n the v i c t i m s ' l i v e s . These stages included a number of categories and properties with t h e i r types, dimensions and conditions. The data suggest that i n c e s t i s associated with s u i c i d e attempt i n adolescence thus, incest victims should be considered a high r i s k group regarding s u i c i d a l behaviour i n a d d i t i o n to the other sequels of i n c e s t . The conceptual categories and the themes that emerged from the a n a l y s i s have implications f o r social-work p r a c t i c e , p o l i c y and further research. i i i TABLE OF CONTENTS T i t l e Page i A b s t r a c t i i Table of Contents i i i L i s t of Tables i v L i s t of Figures v Acknowledgement v i Chapter: I. I n t r o d u c t i o n 1 I I . L i t e r a t u r e Review 6 I I I . Methodology 24 Method 24 S e l e c t i o n of Subjects 26 Data C o l l e c t i o n 31 Data A n a l y s i s 32 IV. Findings 36 Stage I : Becomming a V i c t i m 38 Stage I I : E s c a l a t i o n of Problems 55 Stage I I I : The Healing Process 76 V. Conclusions and I m p l i c a t i o n s 85 I m p l i c a t i o n s f o r S o c i a l Work P r a c t i c e and P o l i c y 86 Future Research 93 B i b l i o g r a p h y 97 Appendix A - Interview Guide 103 Appendix B - Consent Form 105 Appendix C - T r a n s c r i p t of a Sample Interview.. 106 Appendix D - Agencies' Approval f o r Research... 140 Appendix E - U n i v e r s i t y of B r i t i s h Columbia E t h i c a l Approval 142 i v LIST OF TABLES Table 1 28 Summary of Main Sample C h a r a c t e r i s t i c s . Table 2 30 Summary S t a t i s t i c s of De t a i l s Regarding the Suicide Attempts. V LIST OF FIGURES Figure 1 37 The Process Figure 2 38 Schematics of Stage 1 Figure 3 56 Schematics of Stage 2 Figure 4 77 Schematics of Stage 3 v i ACKNOWLEDGEMENT I thank Dr. Kloh-Ann Amacher, Dr. Garry Grams and Dr. John Crane for their inspiring instruction, continuous support and encouragement. Thanks to my husband Moshe, whose support made this thesis possible. I also l ike to extend my gratitude and empathy to the adolescents who shared their painful experiences with me, and enabled me to write this thesis. 1 CHAPTER ONE INTRODUCTION In this study, the relationship between incest and suicide attempt w i l l be examined. Since the mid-1970's the phenomenon of sexual abuse has become a topic of concern, many studies and research have been done on this issue. Clinicians as well as researchers have indicated that se l f destructive behaviour is found to be a common problem among the effects of sexual abuse. (Weber, 1977; Justice and Justice,1979; Goodwin,1981; Herman, 1981). Suicide and suicide attempts are of worldwide concern. Stat ist ics indicate increasing rates of suicide and suicide attempts. The number of completed cases of suicide each year is over 500,000 (Battin, 1982). However, research studies regarding the relationship between sexual abuse and suicide attempt or suicide are very l imited. Most of the studies to date have been concerned with the suicide attempt as one of the sequels of sexual abuse in general and not with the specific phenomenon of incest relations. As has been pointed out by Slager-Jorne (1978), the ch i ld is much more l ike ly to get family support when the offender is not known to the family. It is much easier for the ch i ld as well as for the family to deal with the reporting of a case involving a stranger. The chi ld does not have to deal with issues such as blame or dis loyalty. It is understandable then, that psychological problems are more l ike ly to be present when the offender is a family member. It is assumed that this type of sexual abuse would be more traumatic for the incest victims group than i t would be for other sexually abused victims. It would follow that incest victims may well constitute a higher r isk class as far as suicide or i ts attempt is 2 concerned. It was previously found that 90-95 percent of offenders in intra- fami l ia l sexual abuse relations are males (Russel, 1986; Butler, 1978; Finkelhore, 1984). This incidence is supported by other studies such as Weinberg (1955), Maisch (1972), Herman and Hirschman (1977) and Rush (1980), which i n addition, recognize the same percentage of females as victims. For the purpose of this study then, the class of incestuous relationships w i l l be restricted to include only father-daughter incest relations. In this study, incest is defined as sexual vict imization, i t can take various forms: fondling the ch i ld , exposing the ch i ld to pornography or pornographically exploiting the ch i ld , masturbating the ch i ld or forcing a ch i ld to masturbate an adult, and/or oral , anal, or vaginal intercourse. Suicide attempts are defined as self-destructive behaviors taking place in the context of a suicidal plan (Goodwin, 1982). Suicidal threats and ideation are excluded. Adolescents, as an age group, were chosen for several reasons. 1) Data show that prior to the mid-1960's, there has been a linear correlation between age and suicide, but from the mid-1960's a change in this relationship between age and suicide rates began to be observed. For example, in Canada i n 1971, suicide among males aged 15-19 occurred at a rate of 12.7 per 100,000, compared to a ratio of 21.5 per 100,000 in 1982 (Statist ics Canada, 1982). The fact is that since the 1960's, suicide rates among adolescents have increased markedly when rates for older age groups have been dropping. These s tat is t ics reinforce the need for further studies regarding adolescents as a specific population. 2) In the adolescent stage the incest victim acquires other sources of information and she is more fu l ly aware of what is an acceptable 3 father-daughter interactions and perhaps understands that sexual relationships are forbidden. She is able to use increasingly general knowledge, age, psychological and physiological maturity as resources to diminish the father's hold over her,and any further advances by the father may be resisted. The victim at this stage, may also disclose her "secret". (Cantwell, 1981; Pino and Goodwin, 1982). 3) Most of the studies concerning this issue concentrated on adult women and much less on adolescents. These women reported their childhood and adolescent experiences by recal l ing from a retrospective point of view, that i s , reflecting upon past experiences. It is hoped that by studying incest victims who are close to the incest experience and to the suicide attempt, the information gathered would be richer, more authentic, and w i l l contribute to knowledge regarding this complicated phenomenon. The purpose of this study is to explore and develop better understanding of the relationship between incest and suicide attempt. The emphasis in this study w i l l be on the incest effects as well as on the developmental stage of adolescence as factors contributing to the suicide attempt. The following questions w i l l be addressed: 1) What are the experiences of these adolescents following the incest? This w i l l include the disclosure, the changes and the interventions which have taken place after the disclosure. 2) When and under what circumstances have they made their suicide attempts? This w i l l include their perception of how the incest and the adolescent stage affected them in attempting suicide. It is hoped that the proposed study w i l l contribute to both practice-theory and policy development within the social work profession. In practice, therapists working with suicidal adolescents need to be aware of and sensitive 4 t o t h e p o s s i b l e c o n t r i b u t i o n o f t h e i n c e s t e x p e r i e n c e t o t h e a d o l e s c e n t ' s c u r r e n t c o n d i t i o n . I n c e s t i s a k e p t s e c r e t , w h i c h i s n o t e a s y t o d i s c l o s e a n d t h e s u i c i d e a t t e m p t i s s o m e t i m e s a " c r y f o r h e l p " . I n d i v i d u a l s w i t h s u i c i d a l b e h a v i o u r s h o u l d b e e x a m i n e d f o r i n c e s t h i s t o r i e s . H e l p i n g t h e a d o l e s c e n t t o d e a l w i t h h e r e x p e r i e n c e a n d t h e f e e l i n g s i t g e n e r a t e s m a y m a k e t h e a d o l e s c e n t l e s s p r o n e t o s u i c i d a l b e h a v i o u r . I n a d d i t i o n , t h e p r o p o s e d s t u d y w i l l c o n t r i b u t e t o t h e r a p i s t s ' g r e a t e r a w a r e n e s s o f t h e p o s s i b i l i t y o f f u t u r e s u i c i d e a t t e m p t s a m o n g a d o l e s c e n t i n c e s t v i c t i m s , i n a d d i t i o n t o t h e o t h e r k n o w n s e q u e l s o f i n c e s t v i c t i m i z a t i o n . A t t h e p o l i c y l e v e l , t h e k n o w l e d g e o f r i s k f a c t o r s s u c h a s t h e p r o c e s s w h i c h t h e i n c e s t v i c t i m s a r e g o i n g t h r o u g h ; a n d t h e c i r c u m s t a n c e s u n d e r w h i c h t h e y a r e m o s t l i k e l y t o a t t e m p t s u i c i d e a r e a l s o c o n d u c i v e t o t a r g e t i n g p r e v e n t i o n a s w e l l a s b e t t e r i n t e r v e n t i o n s t r a t e g i e s . T h e f o l l o w i n g c h a p t e r o f t h i s t h e s i s w i l l d i s c u s s t h e r e s e a r c h l i t e r a t u r e a v a i l a b l e o n s u i c i d e a t t e m p t i n a d o l e s c e n c e a s a s e q u e l t o t h e i n c e s t e x p e r i e n c e . G i v e n t h e l i m i t e d l i t e r a t u r e w h i c h e m b o d i e s b o t h t h e i n c e s t p h e n o m e n o n a n d a d o l e s c e n t s w h o a t t e m p t s u i c i d e , I w i l l d i s c u s s t h e e x i s t i n g r e s e a r c h l i t e r a t u r e w h i c h t a k e s u p t h e i s s u e s o f s u i c i d e a t t e m p t i n a d o l e s c e n c e a n d t h e i n c e s t p h e n o m e n o n s e p a r a t e l y , a n d t r y t o f i n d o u t w h e t h e r t h e r e e x i s t c o m m o n c h a r a c t e r i s t i c s a n d f a c t o r s i n b o t h w h i c h c o u l d t h e n b e u n i f i e d . C h a p t e r t h r e e o u t l i n e s t h e m e t h o d o l o g y u s e d i n t h e r e s e a r c h . T h i s w i l l i n c l u d e a d e s c r i p t i o n o f t h e s u b j e c t s a n d t h e i n s t r u m e n t . A r a t i o n a l e f o r t h e s e l e c t e d a p p r o a c h w i l l b e o f f e r e d . T h i s c h a p t e r w i l l a l s o d i s c u s s t h e w a y d a t a h a v e b e e n c o l l e c t e d a n d a n a l y z e d . C h a p t e r f o u r p r e s e n t s t h e f i n d i n g s o f t h e s t u d y ; t h e c a t e g o r i e s t h a t 5 emerged from the interviews are grounded and supported by the statements made by these adolescents,and general themes w i l l be discussed. The f i n a l chapter includes the l i m i t a t i o n s of t h i s research and the implications drawn from the findings of t h i s study for s o c i a l work pr a c t i c e , p o l i c y and future research. 6 CHAPTER TWO LITERATURE REVIEW There is l i t t l e research concerning the relationship between sexual abuse and suicide attempt although suicide is of worldwide concern. Stat is t ics indicate increasing rates of suicide. The number of completed cases of suicide each year is over 500,000 (Battin, 1982). The situation regarding suicide attempts is much worse. The ratio of attempted suicide to completed suicide is 120:1, (Emery, 1983; Mi l l e r , 1975). The l i terature concerning the relationship between incest and suicide attempt in adolescence is quite l imited. Sedney and Brooks (1984) report that of the 301 female college students investigated, 16 percent of those with sexual abuse experience had made at least one suicide attempt in the past, compared to 6 percent with no such sexual experiences. Briere (1984) also reported that 43 percent of the 105 female cl ients in a community health centre c r i s i s intervention service had a history of sexual abuse before the age of f ifteen, and that 51 percent of these former victims had made at least one suicide attempt in the past, versus 34 percent in the case of the non victims. Anderson (1981) studied case histories of four g ir l s who attempted suicide, and who were incest victims in their childhood. The four victims were in their mid-teens. The offenders were the victims' fathers or step - fathers. The type of the suicide attempt ranged from an overdose of p i l l s and cutting wrists to setting f i r e . A l l the victims were hospitalized after the suicide attempt. The timing of the attempts varied, two after the disclosure, one 7 after a rape by her drunk boyfriend and one after being molested by her step-father who followed her biological father's molestation. Anderson, concerning the incest victims' motivations with respect to the suicide attempt in adolescence, states: "Many children who have been sexually abused over a period of time in their ear l ier years are extremely vulnerable to feelings of gui l t , depression and unworthiness which are exacerbated once they reach adolescence and have to grip with their own sexual developmental urges." (p.159). Goodwin (1982) studied eight suicide attempts of female incest victims aging 14 to 16 which were recorded in the casework charts. The casework charts included 201 families which were followed for a period of 3 to 33 months in a protective service agency that provides treatment to families where intrafamil ia l sexual abuse has been substantiated. Seven subjects had taken overdoses of a variety of drugs. The other subject pushed her hand through a window. Only one of the subjects was hospitalized after the attempt. Three of the suicide attempts occurred immediately after a sexual c r i s i s with a boyfriend. In three other cases the victims' suicide attempts occurred at a point when the victims interpreted the agency's actions as siding with the mother. In the two other cases the attempts occurred one year after the disclosure. This is interpreted by Goodwin that i t might have signaled an anniversary reaction. The victims had behaviour problems such as running-away, drug abuse and promiscuity, which are seen by Goodwin as signs of masked depression. None of the eight families managed to remain intact after the disclosure, either the father or the victimized daughter had moved out of home. In a l l cases the mothers actively blamed the daughters for the breakup of the family. Two of the mothers attempted suicide themselves. Regarding the adolescence as the time of the suicide attempt occurrence, Goodwin points out 8 that, "It is almost as though that the 14 to 16 age range developmentally produces a vulnerabi l i ty to suicide regardless of the age at which the incest occurred or was revealed. It may be that the combination of adolescent sexual experimentation and adolescent exploration of values rekindles feelings of moral repugnance about the incest, which may be directed toward the se l f as well as toward parents." (p.112) Although providing an informative description regarding the subjects and their suicide attempt experiences, neither Anderson nor Goodwin however, discussed or developed any model providing a fu l ly understandable explanation concerning how the incest i t se l f , along with i ts effects, and the developmental stage, along with i ts characteristics affect the process through which incest victims go unt i l the act of the suicide attempt is committed. There is lack of sufficient information regarding the many factors related to the incest i t s e l f and the process involved in the development of the suicide attempt. Since the l i terature which embodies both incest and adolescents who attempt suicide is l imited, this chapter w i l l discuss the existing research l i terature which deals with the issues of suicide attempt in adolescence and the incest phenomenon separately in order to investigate whether there exist common characteristics in both which could then be unified. Many of the research studies which have been done on suicide or attempt suicide take the view that suicidal behaviour is a coping mechanism concerned with changing the individual's s ituation. According to Lazarus (1966), coping has two functions. F i r s t , coping is concerned with changing a situation which is stressful or cr is i s - laden. This may be achieved by changing the nature of the situation i t s e l f or by changing the person's reactions to the situation. The second function involves the attempt to manage or deal with our thoughts, feelings and bodily reactions under conditions of stress or c r i s i s necessarily 9 t r y i n g t o c h a n g e o u r s e l v e s o r t h e s i t u a t i o n i n a n y s y s t e m a t i c w a y . H o w e v e r , t h e q u e s t i o n i s w h y d o a d o l e s c e n t i n c e s t v i c t i m s c h o o s e s u i c i d a l b e h a v i o u r t o c o p e w i t h t h e i r s i t u a t i o n s ? T h e f o l l o w i n g d i s c u s s i o n c o n c e r n i n g t h e u n d e r s t a n d i n g o f t h e s u i c i d e a t t e m p t i n a d o l e s c e n t i n c e s t v i c t i m s f o c u s e s o n t w o c a t e g o r i e s , t h e c h a r a c t e r i s t i c s o f t h e i n c e s t u o u s f a m i l y , a n d t h e v i c t i m s ' e m o t i o n a l s t a t e . T h e f a m i l y i s t h e i m m e d i a t e e n v i r o n m e n t a l c o n t e x t w h i c h i n f l u e n c e s a n d s i g n i f i c a n t l y c o n t r i b u t e s t o t h e p s y c h o l o g i c a l p r o c e s s e s t h r o u g h w h i c h o n e i n t e r p r e t s a n d r e s p o n d s t o e x p e r i e n c e s . T h e e m o t i o n a l o u t c o m e g e n e r a t e d b y v a r i o u s e x p e r i e n c e s a l s o i n f l u e n c e s o n e ' s c o g n i t i v e p r o c e s s e s a n d b e h a v i o r a l f u n c t i o n s . B o t h t h e s e c a t e g o r i e s m u t u a l l y a f f e c t t h e v i c t i m s ' r e s p o n s e s t o t h e s e x u a l a b u s e e x p e r i e n c e s a s w e l l a s t o t h e p r o c e s s o f t h e s u i c i d e a t t e m p t . B o t h i n t e r a c t i n a c o n t i n u o u s a n d a n u n f o l d i n g p r o c e s s . T h e f a m i l y p l a y s , i n m a n y w a y s , t h e m o s t i m p o r t a n t r o l e i n a n i n d i v i d u a l ' s d e v e l o p m e n t . T h e f a m i l y i s t h e c o n t e x t o f o r i g i n ; i t i s w h e r e a n i n f a n t s p e n d s a l l o f h i s o r h e r t i m e a n d f i r s t d i s c o v e r s t h e j o y s a n d l i m i t a t i o n s o f r e a l i t y . ( B e r g e r a n d L u c k m a n , 1 9 6 7 ) . A t t a c h m e n t t h e o r i s t s v i e w t h e p a r e n t s a s b e i n g t h e s o u r c e f o r m e e t i n g t h e d e v e l o p m e n t a l n e e d s o f t h e g r o w i n g c h i l d , w h o e a r l y i n l i f e , r e q u i r e s a w a r m a n d s e c u r e r e l a t i o n s h i p w i t h t h e p a r e n t s w h o p r o v i d e a s a f e b a s e f r o m w h i c h t h e c h i l d d e v e l o p s a s e n s e o f i d e n t i t y , t r u s t , s e l f - a w a r e n e s s , s e c u r i t y a n d e x p l o r e s n e w t h i n g s , a n d t o w h i c h h e c a n r e t u r n w h e n s t r e s s e d . T h r o u g h e x p e r i e n c e s t h e c h i l d d e v e l o p s t h e s k i l l s n e c e s s a r y f o r g r a d u a t i o n t o s u b s e q u e n t d e v e l o p m e n t a l s t a g e s . C h i l d r e n w h o e n j o y t h i s s e c u r e a t t a c h m e n t a r e m o r e a b l e t o d e v e l o p p r o b l e m - s o l v i n g a n d s o c i a l s k i l l s w h i c h e n a b l e t h e m t o t r y o u t n e w s k i l l s a n d t o t a k e r i s k s b e c a u s e t h e r e i s a s a f e r e l a t i o n s h i p w i t h t h e i r p a r e n t s w h o c a n p r o v i d e 10 reassurance, support and comfort when i t i s needed. The i n t e r a c t i o n a l model assumes that the problems of pathology of a s o c i a l group or system are often expressed through one of the i n d i v i d u a l s who i s a part of the system. Within t h i s framework, suicide i s regarded as a symptom of family system function, expressed through one member of the system (Speck, 1968). Richman (1971), by studying 100 f a m i l i e s with s u i c i d a l members i d e n t i f i e d a number of patterns of family functioning which appeared to be c h a r a c t e r i s t i c of a majority of h i s sample; which he c a l l s the " s u i c i d a l family system". Among the more important patterns i d e n t i f i e d are: 1)intolerance f or separation, 2)symbiosis without empathy, 3 ) f i x a t i o n upon i n f a n t i l e patterns, 4 ) f i x a t i o n upon e a r l i e r s o c i a l r o l e s , 5)closed family system, 6)double-bind r e l a t i o n s h i p s , 7)family depression, 8)communication disturbance, and 9)intolerance f or c r i s e s . The family system o r i e n t a t i o n toward inc e s t i s very s i m i l a r to s u i c i d a l behaviour. Ronald (1984), Spector (1979) and J u s t i c e and J u s t i c e (1979), postulate that in c e s t involves a crossing and s t a b i l i t y function of a homeostatic mechanism of the family system. In the incestuous family the marriage i s unstable i n terms of unmet needs, the spouses f l u c t u a t e between intimacy and abandonment. The t r i a n g u l a t i o n of the daughter i s the s o l u t i o n for the i n s t a b i l i t y . This coping mechanism for staying together suggests fears of abandonment, i n d i r e c t i o n i n communication, and the forming of c o a l i t i o n s . The r o l e r e v e r s a l mechanism has been discovered as one of the c h a r a c t e r i s t i c s which i s c o n s i s t e n t l y found i n f a m i l i e s of father-daughter incest as documented by Ronald (1984), Furniss (1985), Cohen (1983) and Herman and Hirshman (1981). The daughter takes over the t r a d i t i o n a l r o l e of the mother i n the system by performing household chores which are inappropriate 11 for her age. She may also be expected to calm the father when he i s angry and provide emotional nurturance to each spouse as a replacement for the other. The r o l e r e v e r s a l mechanism was also discovered as one of the c h a r a c t e r i s t i c s present i n the s u i c i d a l family (Teicher, 1979; Kneider and Motto, 1974). Role r e v e r s a l , they state, creates h o s t i l i t y because the i n d i v i d u a l i s deprived of normal nurturance and i s being forced to take on r e s p o n s i b i l i t i e s without asking f o r or wanting i t . The adolescent who f e e l s g u i l t y because of these h o s t i l e f e e l i n g s can become s u i c i d a l . A d d i t i o n a l c h a r a c t e r i s t i c which can be found i n both the incestuous family and the suicidogenic family i s a symbiotic r e l a t i o n s h i p which ex i s t s between the c h i l d and the family. This symbiosis, i s seen by Richman (1978) as being the c e n t r a l f a c t o r i n the et i o l o g y of adolescent suicide because the adolescent i s going through a developmental phase i n which d i f f e r e n t i a t i o n , i n d i v i d u a t i o n , and forming r e l a t i o n s h i p s outside the family are important issues. The adolescent seeks and s t r i v e s f o r independence from adults and parental controls. This process involves anxiety, ambivalence, sadness and loosening of i n f a n t i l e object t i e s i n order to become a member of society. The adolescent i n the suicidogenic family i s , as the incest v i c t i m , trapped and unable to see the way out of t h i s symbiotic r e l a t i o n s h i p where separation equals threat, and when the response to t h i s threat i s s u i c i d a l actions. The ince s t experience a f f e c t s the a b i l i t y to develop boundaries, independence and separation which are c r u c i a l i n adolescence and play one of the factors i n the s u i c i d a l behaviour. Scott (1984) who examined the long-term and short-term e f f e c t s of the loss r e s u l t i n g from sexual abuse found that the incest victims experienced loss of the father and mother image, loss of childhood and losses following 12 placement. For a young c h i l d , parents are the primary care providers. They provide love, s e c u r i t y and other emotional and ph y s i c a l nurturance. The c h i l d i s dependent and r e l i e s on them. When incest occurs a l l these aspects are shattered. The parents deprive the c h i l d of nurturance and pr o t e c t i o n which are necessary f o r her development. The father becomes the offender and the mother, whom the daughter expects to provide p r o t e c t i o n and stop the abuse, usu a l l y becomes part of the molestation, pas s i v e l y or a c t i v e l y . A f t e r the disc l o s u r e , i f the mother does not believe the daughter, blames her, takes the father's side and stays with him, the daughter's f e e l i n g s of mother's loss and her experiences of deprivation of the mother's function which i s to love, protect and nurture, i s heightened. Sometimes the abuse has been part of a whole complex of deprivation of emotional, psychological and ph y s i c a l nurturance. The daughter, a f t e r the disclosure, may lose her father, as a source of a f f e c t i o n , who, i n many cases, was the only one to provide love, a f f e c t i o n and at t e n t i o n to the v i c t i m . Childhood i s an enjoyable stage that should provide l o v i n g parents, safety and t r u s t thus, preparing the c h i l d for the passage to adulthood through the experiences which he i s going through. A c h i l d who has been sexually abused experiences fear, anger, i s o l a t i o n , powerlessness, hopelessness and negative self-concept, a l l of which do not help the v i c t i m i n the adolescent stage to reach and pass, i n a normal way, the stage which i s required i n order to develop independence and separation from the parents and explore new and d i f f e r e n t r e l a t i o n s h i p s outside the family, e s p e c i a l l y so with peer-groups. The incestuous family does not prepare the v i c t i m to cope with these kinds of losses and separation which are important features of the adolescent stage. Another loss, frequently connected with sexual abuse, i s the one that accompanies fo s t e r home placement. The 13 removal from a f a m i l i a r family s e t t i n g (mother, friends and the l i k e ) and from the p h y s i c a l environment may p r e c i p i t a t e further losses f o r the c h i l d . Ner L i t t n e r (1956) who discusses the e f f e c t s of the placement points out, "No matter what the r e a l i s t i c reason for the separation, the c h i l d seems to experience f i r s t e i t h e r consciously or unconsciously, a f e e l i n g of abandonment, which contains elements of loss, r e j e c t i o n , humiliation, complete i n s i g n i f i c a n c e and worthlessness".(p.8). Loss and separation are among the factors which studies and research suggest as c h a r a c t e r i s t i c s of the s u i c i d a l adolescent. Freud observed that, "...the s u i c i d a l person ambivalently hating and l o v i n g an object which i s l o s t , or seems l o s t to him. The l o s t object i s i n t r o j e c t e d and t h i s incorporation represents both an attempt to preserve the loved object and an attempt to destroy the hated object. G u i l t f e e l i n g s r e s u l t from the recogn i t i o n of h o s t i l e f e e l i n g s toward the l o s t loved object, followed by a turning inward of these aggressive, h o s t i l e f e e l i n g s , l e a d i n g to s u i c i d a l behaviour as a way of acting out these f e e l i n g s and expiating the g u i l t . " (Gould, 1965; pp.228-229). The family dynamics as well as the incest experience a f f e c t the emotional and the cognitive o r i e n t a t i o n of the c h i l d . I t i s not the event i t s e l f but the i n t e r p r e t a t i o n that the c h i l d gives to h i s experiences and around which he constructs h i s i n t e r n a l and external world. The sexual behaviour i s inappropriate to the c h i l d ' s development. Instead of having and experiencing love, nurturance, warmth and security, which are very important to the process of b u i l d i n g p o s i t i v e self-esteem, the c h i l d experiences fear, b etrayal, l o n e l i n e s s , f e e l s d i f f e r e n t , bad, unworthy,, rejected and so on. These feel i n g s contribute to low self-esteem which i s c r i t i c a l i n the adolescent stage. In t h i s stage, the adolescent concentrates on s e l f evaluation; he has to decide whether he i s good enough, and asks himself whether he has the a b i l i t y to p a r t i c i p a t e i n various s o c i a l a c t i v i t i e s , whether he i s a t t r a c t i v e enough to i n t e r e s t and succeed with the opposite sex. A r i s i n g from c o n f l i c t s between the c h i l d and adult r o l e s , and from h i s cognitive development, i t i s not 14 s u r p r i s i n g that the youngster wants to know 'who am I', 'what am I', etc., (Erikson, 1968). His own views of himself, good or bad, kind or s e l f i s h , popular or unpopular are a f f e c t e d by how other people view him, and by h i s r e l a t i o n s h i p with others. Finkelhor and Browne (1985) state that the sexual experience and the dynamics of stigmatization give the victims the sense of being unworthy and shameful leading to an eventual tendency toward suicide or other form of s e l f destruetiveness. Studies on s u i c i d a l adolescents also in d i c a t e that one of the factors that takes place i s low self-esteem (Meuringer, 1974; Asbacher and Rowen, 1965). Other issues involved i n the sexual abuse phenomenon may b r i n g about fe e l i n g s of g u i l t associated with having taken the mother's place and/or g u i l t over having pleasurable experiences l i k e nurturance, kindness, tenderness and so on. The sense of self-blame and g u i l t may also come d i r e c t l y from the abuser who may blame the v i c t i m f or the a c t i v i t y , "...when there i s pressure for secrecy from the offenders, t h i s can also convey powerful message of shame and g u i l t " , (Finkelhor and Brown, 1985, p.4). They f e e l they must have done something "bad!' to have caused the abuse to happen. Many f e e l that i n some way, they are to be blamed, that they are responsible. A f t e r the disclosure, the v i c t i m may also be blamed by other people i n the family as well as the environment f o r the molestation. At t h i s age, the adolescent i s very much aware of s o c i a l a t t i t u d e s and thus, experiences stigmatization. This i s e s p e c i a l l y so i f during the abuse or a f t e r the disclosure the v i c t i m incorporates r e s p o n s i b i l i t y for the act, or sees h e r s e l f as deserving i t . She i s more l i k e l y to blame h e r s e l f and to become in t r o s p e c t i v e . The notion of self-blame p a r t i a l l y motivates s e l f destructiveness. Anxiety over g u i l t may be a f a c t o r i n the tendency toward ac t i n g out to ward o f f anxiety. The a c t i n g out 15 can also become s e l f - p u n i t i v e i n order to deny f e e l i n g s of g u i l t . Freud mentioned, regarding suicide, that, " . . . g u i l t f e e l i n g s r e s u l t from the recognition of h o s t i l e f e e l i n g s toward the l o s t loved object, followed by a turning inward of these aggressive, h o s t i l e f e e l i n g s , leading to s u i c i d a l behaviour as a way of acting out these f e e l i n g s and expiating the g u i l t " (Gould, 1965; p.229). Hendin (1982) also observes g u i l t as a factor among the youngest s u i c i d a l patients, "One can see f e e l i n g s of g u i l t and the need for self-punishment b l u n t l y . Their g u i l t preoccupations w i l l vary from promiscuous sexual a c t i v i t y , incestuous fantasies, a body racked with imaginary s y p h i l i s , and misdeeds i n service to, i n a very deteriorated case, the f e e l i n g s that he i s a "bad boy". The underlying emotional theme i n these patients involves t h e i r f e e l i n g worthless, no good, a f r a i d , deserving of punishment, and f i l l e d with s e l f - h a t r e d for t h e i r f a i l u r e , fears, and i n c a p a c i t i e s . For them su i c i d e i s a self-punishment i n response to what amounts to delusions of g u i l t and s i n . " (p.209). Anger i s one of the emotions which r e s u l t s from the incest experience. J u s t i c e and J u s t i c e (1979), A l t e r - R i e d (1986), and others suggest that the anger stemming from betrayal i s part of what may be behind the aggressive and h o s t i l e posture of some sexual abuse victims, p a r t i c u l a r l y adolescents. The victims are often b i t t e r and angry towards t h e i r fathers, the offenders, towards t h e i r mothers and toward themselves. When the victims grow up and f u l l y understand that they were betrayed by t h e i r fathers who exploited t h e i r t r u s t i n them as father figures, they f e e l betrayed and angry. The anger towards the mother i s due to not taking the time to f i n d out what was happening, and not stopping the abuse. Most g i r l s b elieved that t h e i r mothers should have known what was going on and d i d not protect them. A f t e r the d i s c l o s u r e , i f the mother stays with and believes the offender, the anger may increase. The daughter may f e e l angry with h e r s e l f for p a r t i c i p a t i n g i n the sexual abuse behaviour, for being too weak to confront the father and by not stopping i t e a r l i e r . I f the sexual abuse e n t a i l s a t r i a l through the court 16 process she may f e e l angry as a r e s u l t of f e e l i n g responsible for a l l the changes r e s u l t i n g from the disclosure such as: divorce, the father's going to j a i l and the mother's depression. Many family aspects which take place i n the incestuous family, such as r o l e r e v e r s a l and symbiotic r e l a t i o n s h i p s , by not allowing the c h i l d to have normal r e l a t i o n s outside the family, and by inducing f e e l i n g s of r e j e c t i o n , loneliness and powerlessness, create a dilemma for the c h i l d . Anger i s also aroused i n s i t u a t i o n s i n which placement takes place, (Ner L i t n e r , 1956.) The daughters are not only victims of parents who are unable to provide genuine and supportive models of adult behaviour, but may also be victims of a society that holds them responsible for the actions of adults and w i l l not permit them to be angry and i n s i s t on t h e i r r i g h t to t h e i r own bodies. Anger i s also one of the s u i c i d a l features. Jacobs (1971) states that, " I t seems that the most important motive for suicide was a need for punishment. The patient had been attempting to escape h i s anger toward h i s mother for some years; f i n a l l y t h i s escape was no longer possible, and i t was necessary for him to see that he was angry towards her. He was unable to t o l e r a t e t h i s f e e l i n g and attempted to deal with i t by running away...yet t h i s was not successful, and f i n a l l y he f e l t hopeless, as i f he had f e l t a l l alone. At t h i s point he made h i s s u i c i d a l attempt. I t would seem that what was r e a l l y operating here was an attempt to get back into the good graces of h i s mother by 'castrating' himself (by attempting to k i l l h i m self), and i n t h i s way to expiate h i s g u i l t . " (pp.10,11). The incestuous family i s a r e l a t i v e l y closed system which i s characterised as being i s o l a t e d from the environment, avoidant of the d i f f e r e n t i a t i o n of r o l e s and functions, and one that uses the incestuous behaviour as j u s t one more means to avoid the growth and change that i s inherent i n adolescents seeking outside contacts and eventually leaving home. The father cuts the daughter o f f from normal s o c i a l experiences, prevents her from forming friendships, and induces her to believe that she i s alone i n the world. The victim's f e e l i n g s such as i n s e c u r i t y , low self-esteem, fears, and 17 g u i l t , discourage her from developing r e l a t i o n s h i p s outside the family and she f e e l s l o n e l i n e s s and being i s o l a t e d from her peer group. Cohen (1983) states, " T y p i c a l l y , the adolescent daughter i s s o c i a l l y i s o l a t e d , f e e l i n g that she can share with no one her sexual experiences, which she knows, are d i f f e r e n t and taboo." (p.156). The interpersonal sequels of sexual abuse include problems of t r u s t i n g others (Courtis, 1971; Briere, 1984), fear of intimacy and long term r e l a t i o n s h i p s , i s o l a t i o n , a l i e n a t i o n and abandonment issues. The daughter f e e l s l o n e l i n e s s also within her family. In spite of the extreme enmeshment, family members seemed to know very l i t t l e about each other. A f t e r the disclosure, as a r e s u l t of shame or the fear of being blamed by the family and the environment, the f e e l i n g s of i s o l a t i o n are i n t e n s i f i e d . The adolescent may f e e l that no one cares for her; and the sense of powerlessness, low s e l f -esteem, anger and fears are enhanced and may push her to destructive behaviour. Briere and Runtz (1986), who i n t h e i r study examined s u i c i d a l thoughts and behaviour i n former sexual abuse victims, state that "A f i n a l p o t e n t i a l dynamic i n the development of s u i c i d a l i t y among sexual abuse survivors r e l a t e s to the e f f e c t s of sexual v i c t i m i z a t i o n on interpersonal functioning." (p.419). Interpersonal r e l a t i o n s h i p s , e s p e c i a l l y with peer group, play a main r o l e i n the adolescent's quest for an i d e n t i t y , which i s one of the important tasks of t h i s stage, because there he can t e s t out h i s self-conceptions as he r e l a t e s to others. Peer r e l a t i o n s h i p s are p a r t i c u l a r l y important i n the formation and maintenance of the self-concept. S o c i a l i s o l a t i o n i s another c r i t i c a l f a ctor that influences s u i c i d a l behaviour. Durkhiem distinguished three types of s u i c i d e : e g o i s t i c , a l t r u i s t i c and anomic. The e g o i s t i c suicide r e s u l t s from lack of i n t e g r a t i o n of the i n d i v i d u a l into society. "The stronger the forces throwing the i n d i v i d u a l onto 18 h i s own resources, the greater the suicide rate i s the society i n which t h i s occurs." (Simpson, 1951, p.14). Stengel (1965) states that lack of a secure r e l a t i o n s h i p with parents may have a long-term e f f e c t on an i n d i v i d u a l ' s a b i l i t y to e s t a b l i s h r e l a t i o n s h i p with others. Such i n d i v i d u a l s may f i n d themselves i n s o c i a l i s o l a t i o n which, Stengel asserts, i s one of the c r i t i c a l causal factors i n s u i c i d a l behaviour. Barter et a l . (1968, p.527) postulate that "The teenager who i s alienated from h i s family and who does not or cannot l i v e at home, who has poor peer r e l a t i o n s h i p s , and an inadequate s o c i a l l i f e may be the one f o r whom the r i s k of committed suicide behaviour i s high." The c h i l d who i s involved i n an incestuous r e l a t i o n s h i p l i v e s i n a destructive environment which produces anxiety, fears, l o n e l i n e s s , i s o l a t i o n , a sense of powerlessness, unworthiness, and lack of s e c u r i t y and love. A l l of these features may contribute to depression. Adams-Tucker (1982) i n h i s study of 28 c h i l d r e n who had been sexually v i c t i m i z e d found that "The c h i l d r e n molested by t h e i r fathers appeared to s u f f e r more than the other c h i l d r e n . Diagnosis for these c h i l d r e n varied, but most indicated depression and/or withdrawal." (p.1253). He also found that, "The most t r a g i c sequel to sexual abuse i s pervasive, depressive fee l i n g s of i n a b i l i t y to enter comfortable adult l i f e , and that rewarding, intimate r e l a t i o n s h i p s are impossible to achieve. More depressing i s the lack of a coherent sense of s e l f and f e e l i n g that whatever fragments of a s e l f e x i s t are degraded and worthless." (p.473). Kaufman et a l . (1954) studied 11 victims of parental incest who had been r e f e r r e d to the Judge Baker Guictance Centre i n Boston. They reported that a l l of the g i r l s were depressed and most of them had s u i c i d a l ideation. Molnar and Cameron (1975) who studied 10 incest victims, who were p s y c h i a t r i c h o s p i t a l patients, also noted depression i n t h e i r sample. This depression was accompanied by s u i c i d a l thoughts, which they suggest to term "incest 19 syndrome". Apparent from the review of the l i terature is the fact that depression has been linked with suicidal behaviour. However, not a l l suic idal individuals are depressed and not a l l depressed individuals are su ic idal . In the Diagnostic and Sta t i s t i ca l Manual of Mental Disorder (D.S.M III) , suicidal behaviour is assumed to be an important symptom of depression. Among young adolescents depression may appear in acting-out behaviour, or in what has been termed "masked depression", restlessness, having feelings of isolat ion, emptiness, loneliness, and restlessness. The victim experiences lack of control over l i f e events which direct ly affect one's well-being. The father is the authoritarian figure for the chi ld . In incestuous relations he uses his power to force the ch i ld to participate in the incest act, usually by continual commands and by threatening serious harm. The daughter experiences a sense of powerlessness. As noted by Finkelhor and Browne (1985), "a basic kind of powerlessness occurs in sexual abuse when a chi ld's terr i tory and body space are repeatedly invaded against the chi ld's w i l l . This is exacerbated by whatever coercion and manipulating the offender might impose as part of the abuse process" (p. 532). Even i f there is no threat, the chi ld 's feelings of being trapped, i f only by the real izat ion of the consequences of disclosure, can created a sense of powerlessness. Katman (1973), and McVicar (1979) also report increased perceived helplessness and powerlessness among sexual abuse victims. If the chi ld was a previous victim of physical or emotional abuse, she may have already been suffering from a dispowering dynamic before the abuse occurred. A situation after the disclosure may also create a greater degree of powerlessness. After the disclosure a great many authorities may become involved in the experience; the 20 c h i l d may be f o r c e d to leave home, and to t e l l the s t o r y i n repeated occasions. One r e a c t i o n to powerlessness i s f e a r and a n x i e t y , as a person f e e l s unable to c o n t r o l anxious events that are o c c u r r i n g . A second major e f f e c t i s the impairment of a person's sense of e f f i c a c y and coping s k i l l s . This sense may a l s o be a s s o c i a t e d w i t h the despair and r e p r e s s i o n which can le a d to s u i c i d a l behaviour o f t e n noted among adolescents. The v i c t i m may f e e l unable to cope w i t h her ongoing p a i n and the surrounding environment and thus, s u i c i d e may become the only s o l u t i o n to her problems. As noted by Farberow and Schneidman (1961), s u i c i d e attempts may represent a "cry f o r h e l p " among c e r t a i n i n d i v i d u a l s who b e l i e v e themselves to have no e f f e c t i v e means of communicating or r e l i e v i n g t h e i r p s y c h o l o g i c a l pain . Farberow (1968) claims that s u i c i d a l m o t i v a t i o n can be e i t h e r of an i n t e r p e r s o n a l nature or of an i n t r a p e r s o n a l nature. I f the m o t i v a t i o n i s i n t e r p e r s o n a l , "the s u i c i d a l behaviour can thus be seen as a means to i n f l u e n c e , persuade, f o r c e , manipulate, s t i m u l a t e , change, dominate, r e i n s t a t e , e t c . , f e e l i n g s or behaviour i n someone e l s e . " (p.392). I f , on the other hand, the m o t i v a t i o n i s i n t r a p e r s o n a l , "the i n d i v i d u a l ' s a c t i o n seems aimed p r i m a r i l y a t expressing the pressures and s t r e s s e s from w i t h i n and at f u l f i l l i n g important needs i n h i m s e l f " (p.392). Schuyler (1973) claims that s u i c i d a l m o t i v a t i o n has two components. The f i r s t component i s death seeking, to escape what i s b e l i e v e d to be an unbearable l i f e s i t u a t i o n . The second i s in s t r u m e n t a l , an attempt to i n f l u e n c e another person's behaviour. Jacobs (1971) described the s u i c i d e attempt as a process, "1. A long-standing h i s t o r y of problems (from childhood to the onset of adolescence). 2. A p e r i o d of ' e s c a l a t i o n of problems' ( s i n c e the onset of adolescence and i n excess of those 'normally' a s s o c i a t e d w i t h adolescence). 3. The pro g r e s s i v e f a i l u r e of a v a i l a b l e adaptive techniques f o r coping w i t h o l d and i n c r e a s i n g new problems which leads the adolescent to a pro g r e s s i v e i s o l a t i o n from meaningful s o c i a l 2 1 r e l a t i o n s h i p s . 4. The f i n a l phase, characterized by the chain reaction d i s s o l u t i o n of any remaining meaningful s o c i a l r e l a t i o n s h i p s i n the weeks and days preceding the suicide attempt." (p.64). The s u i c i d a l process, described by Jacobs, may apply to cases of s u i c i d a l behaviour of inc e s t victims i n adolescence. In the f i r s t phase, a long-standing h i s t o r y of, problems has occurred i n the v i c t i m s ' l i v e s since the time the incest has taken place. Sometimes, the problems were i n i t i a t e d before the incest. This happened when the c h i l d was deprived of emotional and p h y s i c a l nurturance from e a r l y childhood as a r e s u l t of the dysfunctional family and problematic parents. These problems, as described e a r l i e r , i s o l a t e the i n d i v i d u a l from s o c i a l r e l a t i o n s h i p s , create negative f e e l i n g s of low s e l f -esteem, g u i l t , fears, anxiety, powerlessness, depression and anger. In the second phase, according to Jacobs, there i s a period of e s c a l a t i o n of problems. In the case of incest, the disclosure may take place at the adolescent stage, and may i n i t i a t e changes i n the v i c t i m s ' l i v e s such as removal from home, s o c i a l i s o l a t i o n , mothers' blaming and d i s b e l i e f . The d i s c l o s u r e may also a f f e c t the v i c t i m s ' f a m i l i e s by things such as the father's imprisonment or h o s p i t a l i z a t i o n , divorce and loss of f i n a n c i a l support a l l of which may enhance the victims' f e e l i n g s of g u i l t and s e l f -blame. Moreover, aside from the h i s t o r y of the victims' problems and the present e s c a l a t i o n of problems, there are other problems which are associated with the developmental stage. These are: the search for i d e n t i t y , forming r e l a t i o n s h i p s with outsiders, separation and i n d i v i d u a t i o n from parents which are accompanied by emotional turmoil. In the t h i r d phase, there i s a period through which the v i c t i m has a sense of f a i l u r e i n the use of adaptive techniques to cope with her s i t u a t i o n . The v i c t i m who through her childhood has not had a stable home, and l o v i n g and protective parents, could not 22 develop appropriate coping s k i l l s to exercise and t o l e r a t e the stresses and f r u s t r a t i o n s accompanying the sexual abuse e f f e c t s along with the adolescent stage problems. She has not had the gradual lessening of the symbiotic t i e s from her parents, has not gained t r u s t and s e c u r i t y at home, has not developed s o c i a l i z a t i o n s k i l l s , and has been trained to be both dependent as well as passive i n seeking help i n times of s t r e s s . Adolescence i s confounded by anxiety over p a s s i v i t y that mobilizes an active stance against i n f a n t i l e f e e l i n g s , helplessness and incompetence. (Freud, A., 1969). Incest victims may turn to maladaptive behaviour such as, running-away from home (Adams-Tucker, 1982; Herman and Hirshman, 1981; Weber, 1977), p r o s t i t u t i o n ( S i l b e r t and Pine, 1981; Lukianowicz, 1972), and substance abuse (Herman and Hirshman, 1981; Alter-Reid, 1986). Adolescents generally have a d i f f i c u l t time expressing themselves and asking f o r help. This i s e s p e c i a l l y so i n cases of inc e s t victims who are a f r a i d of not being believed or being blamed for the sexual abuse. The v i c t i m may turn to maladaptive solutions as a r e s u l t of a reduction i n the other a v a i l a b l e a l t e r n a t i v e s and resources. The l a s t phase i s characterized by the chain r e a c t i o n -- d i s s o l u t i o n of any remaining meaningful s o c i a l r e l a t i o n s h i p s . The c i r c l e of events c o n s t r i c t s around the v i c t i m who further experiences the fee l i n g s of powerlessness, helplessness, i s o l a t i o n , anger and depression, a l l of which get i n t e n s i f i e d . In t h i s phase there e x i s t s a cognitive state i n which the incest v i c t i m perceives death as the only s o l u t i o n to her ongoing problems thereby putting a stop to her traumatic experiences. The suicide attempt i s a defence or a coping mechanism against the continuation of the sexual abuse or i t s e f f e c t s . As B r i e r and Runtz (1986) have put i t , "The p o s s i b i l i t y that one's own death (or danger of same) could be used as a coping mechanism h i g h l i g h t s the h i g h l y aversive nature of sexual 23 abuse and the extreme powerlessness seemingly experienced by many vic t i m s . " (p.419). This act may play a ro l e of gaining control and be a 'cry for help'. The above discussed l i t e r a t u r e , although dealing with the phenomenon of incest separately from the c h a r a c t e r i s t i c s which e x i s t among s u i c i d a l adolescents, points to the i n t e r e s t i n g f a c t that many of the c h a r a c t e r i s t i c s present i n each, are a c t u a l l y common for both. In f a c t , i t seems that suicide attempts i n adolescence may be the e f f e c t or a way to deal with sexual abuse. Thus, i t seems promising to j o i n the two phenomena, that of incest and of s u i c i d a l adolescents, i n order to further explore and develope a better understanding of the a s s o c i a t i o n that may e x i s t between incest and suicide attempts. This i s the purpose of t h i s study. 24 CHAPTER THREE METHODOLOGY METHOD The purpose of t h i s study i s to better understand the experiences of female inc e s t v i ctims who attempted suicide i n adolescence. The method used for the i n v e s t i g a t i o n i n the present study i s q u a l i t a t i v e . The primary value of q u a l i t a t i v e research i s the gain from the in s i g h t into i n d i v i d u a l needs, problems, dilemmas and behaviour. E s t r o f f (1981) i n h i s ethographic study i n a ps y c h i a t r i c s e t t i n g concludes, "An in d i v i d u a l ' s perceptions, b e l i e f s , f e e l i n g s , experiences and behaviours constitute the most important u n i t of analysis and understanding i n any contemporary s o c i a l s c i e n t i f i c endeavour".(p.37) The emphasis of q u a l i t a t i v e research i s to allow for the c o l l e c t i o n of subjective perceptions on part of the subjects rather than to a more experimental approach which would tend to focus on v e r i f i c a t i o n of s p e c i f i c causal r e l a t i o n s formulated as hypotheses. The q u a l i t a t i v e researcher seeks to understand the g e s t a l t , the u n i f y i n g nature of p a r t i c u l a r events, settings perceptions or i n t e r a c t i o n s . » "Qua l i t a t i v e measures describe the experiences of people i n depth. The data are open-ended i n order to f i n d out what people's l i v e s , experiences, and int e r a c t i o n s mean to them i n t h e i r own terms and i n t h e i r natural s e t t i n g . Q u a l i t a t i v e measures permit the evaluation researcher to record and understand people i n t h e i r own terms." (Patton, 1988, p.22). The intent of t h i s research with i t s focus on the perspectives of female adolescents about t h e i r incest and attempted suicide experiences i s c l e a r l y consistent with the ra t i o n a l e underlying a q u a l i t a t i v e methodology. The major hypothesis i s that the incest v i c t i m goes through a process which begins with 25 the sexual abuse i n childhood (the f i r s t stage) and which ends with the attempt s u i c i d e (the f i n a l stage of the process for the purpose of t h i s study). According to Glaser (1978), "BSP's (Basic S o c i a l Process) are i d e a l l y suited to generation by grounded theory from q u a l i t a t i v e research which can pick up process by f i e l d work continuing over time." (p.97). Researchers who focus on quantitative methods c r i t i c i z e q u a l i t a t i v e methods on the grounds that they employ a small number of subjects and i t s analysis i s biased therefore, i t i s viewed as a preliminary understanding of c e r t a i n phenomena, which i s l i m i t e d to develop, c l a r i f y or modify concepts i n order to generate hypotheses. The assumptions of status hierarchy has been rejected from a v a r i e t y of perspectives. Patton (1980) addressed t h i s c r i t i c -ism by saying, "Numbers do not protect against bias, they merely disguise i t . " (p.336). He also pointed out that, "In many ways the r e a l trade-off between quantitative methods and q u a l i t a t i v e methods i s a trade-off between breadth and depth. Q u a l i t a t i v e methods permit the evaluator to study selected issues i n depth and d e t a i l ; the f a c t that data c o l l e c t i o n i s not constrained by predetermined categories of analysis contributes to the depth and d e t a i l of q u a l i t a t i v e data. Quantitative methods, on the other hand, require the use of standardized stimulus so that a l l experiences of people are l i m i t e d to c e r t a i n response categories. The advantage o f . . . ( t h i s ) i s that i t measures the reactions of many subjects to a l i m i t e d set of questions, thus f a c i l i t a t i n g comparison and s t a t i s t i c a l aggregation of data. By contrast, q u a l i t a t i v e methods t y p i c a l l y produce a wealth of d e t a i l e d data about a much smaller number of people and cases." (p.336). The focus of an exploratory study i s not to generalize or r e p l i c a t e the findings but, rather i t seeks to capture what people say about t h e i r experiences and attempts to understand i n d i v i d u a l s from t h e i r point of view. Yet exploratory research stimulates the development of concepts, hypotheses and theories, rather than s p e c i f i c r e l a t i o n s h i p being e s p e c i a l l y tested f or v e r i f i c a t i o n . Reid and Smith (1981) state, "...the intent, according to many, i s to gain an i n i t i a l look at a piece 26 of r e a l i t y and to promote ideas about i t . At t h i s l e v e l , research y i e l d s a sense of what i s possible, rather than what i s probable, although the p o s s i b i l i t i e s may have generative e f f e c t s i n that they may support other sources of evidence or may provoke new ways of construing r e a l i t y . " The q u a l i t a t i v e and quantitative approaches can complement each other depending on the s p e c i f i c research problem and i t s goals. There i s lack of evidence for " s c i e n t i f i c " s u p e r i o r i t y of one form of data over another. SELECTION OF SUBJECTS The four, non-sampled, adolescents interviewed for t h i s study were incest victims who attempted suicide i n adolescence. Their ages ranged from 15 to 19 years of age. Two of the victims l i v e d i n a group home, two l i v e d i n t h e i r own and one, a native Indian, was a single mother to a one year o l d baby. A l l subjects were i n active treatment at the time of the interview. The issues that were investigated were very s e n s i t i v e and p a i n f u l . Thus, i t was important for the researcher to be sure that the interviewees were i n a stable emotional state and that the issues of the sexual abuse as well as the attempt suicide were discussed throughout the present treatment with the subjects' the r a p i s t s . This c r i t e r i o n was also important i n cases where the interviews activa t e d s t r e s s , pain or other emotions i n the interviewees which were addressed e i t h e r as they arose i n the interview or i n a subsequent interview with t h e i r t h e r a p i s t s . These adolescents were approached v e r b a l l y by t h e i r therapists i n Fairmont Family Practice and i n the regional o f f i c e s of the M i n i s t r y of S o c i a l Services and Housing, to determine t h e i r agreement to p a r t i c i p a t e i n the study. A f t e r they agreed to be interviewed, t h e i r names were given to the researcher and contact was i n i t i a t e d . The interviews took place i n Fairmont Family Practice and i n the s o c i a l worker's o f f i c e at the Phoenix Group Home. 27 The offenders included two natural fathers, who molested the victims a f t e r the divorce from the victi m s ' mothers, and two mothers' common-in-law husbands who s t i l l l i v e with the adolescents' mothers. Three of the offenders had denied that they sexually abused t h e i r daughters, i n the fourth case no confrontation had taken place. The duration of the sexual abuse ranged from two to s i x years and v a r i e d from fondling, to exposing to pornography, masturbation and intercourse. The victims d i s c l o s e d the sexual abuse r e l a t i o n s h i p s f i v e to seven years p r i o r to the present interviews. The dis c l o s u r e , i n one of the cases, was made by the victim's s i s t e r to the mother and i n the r e s t of the cases the victims themselves revealed the secret, i n two cases, to t h e i r mothers and i n one of the cases to the family's s o c i a l worker. Court procedure have not taken place i n any of the cases. A l l the victims had other sexual abuse experiences apart from the incest. The above information i s summarized i n Table 1. 28 TABLE 1 Summary of main sample characteristics regarding incest No. l Subj ect No .2 No .3 No .4 Age 18 19 15 19 The Offender Father Father Mother's Common in law Mother's Common in law Duration of Abuse 2 yrs. (9-11) 6 yrs. (7-13) 5 yrs. (6-11) 3 yrs. (12-15) Type of Sexual Contact Fondling, Intercou-rse . Fondling, Exposing to Pornography. Fondling. Fondling, Inappropriate Kissing, Masturbate the offender. Sexual Abuse Experiences Other than With Father A caretaker, A neighbor, 2 guys in the neighborhood, Daddy's friend. Mother, 2 family's friends, 2 rapes. Grand-father , Uncle. Neighbor, 2 uncles, A guy in the v i l lage . How relations ended Victim disclosed to social-worker . Victim disclosed to mother. Victim's s ister disclosed to mother. Victim disclosed to mother and thera-pis t . 29 A l l the subjects had made at l e a s t one suicide attempt. Two of the subjects, who had more than one suicide attempt, committed i t at the age of eight. One of them t r i e d to jump out of a window, and the other described her suicide attempt as follows: "I thought my daddy hated me, but i t was r e a l l y stupid the way I t r i e d to commit sui c i d e . I have heard about lead poison, I ate lead from a p e n c i l . I was s u i c i d a l , I wrote a note on the door, everything. Nobody ever knew about i t " . These two subjects had serious attempts l a t e r on and were h o s p i t a l i z e d i n a p s y c h i a t r i c ward. The ages of the subjects at the time of the suicide attempt i n adolescence ranged from 15 to 18 years. The type of the attempts were: one dose of p i l l s and/or c u t t i n g w r i s t s . One of them i n t e n t i o n a l l y put h e r s e l f i n a dangerous s i t u a t i o n i n order to die by allowing a v i o l e n t gang to beat her up and was consequently h o s p i t a l i z e d . Table 2. presents summary s t a t i s t i c s regarding the various d e t a i l s of the attempted su i c i d e . 30 TABLE 2 Summary s tat i s t ics of details regarding the suicide attempts Subject Attempt No.l No . 2 No .3 No .4 F ir s t Age: 16 8 15 8 Type: P i l l - Jump out Put Lead overdose. of window. herself poison in from a danger. penci l . Second Age: 16 15 Type: Cutting Cutting wrists. wrists. Third Age: 17 16 Type: Cutting P i l l -wrists. overdose, (hospita-lized) . Fourth Age: 18 Type: Cutting wrists + p i l l overdose, (hospitalized) 31 DATA COLLECTION Experiences of incest as well as of suicide attempts are s e n s i t i v e , personal, p a i n f u l and taboo topics. Thus, face-to-face interviews appear to be the most appropriate technique to obtain the necessary data i n t h i s exploratory study. An interview guide (Appendix A) was developed i n order to address the following p a r t i c u l a r questions: 1) What were the experiences of these adolescents following the incest? This included the d i s c l o s u r e , the changes and the interventions which have taken place a f t e r the d i s c l o s u r e . 2) When and under what circumstances have they made t h e i r suicide attempts? This included t h e i r perceptions of how the incest and the adolescent stage a f f e c t e d them i n attempting s u i c i d e . Using these questions, the researcher focused on the subjects' perceptions, f e e l i n g s , thoughts, b e l i e f s , and i d e a t i o n about t h e i r experiences. A l l questions were open-ended questions. Although the in v e s t i g a t o r went to each of the interviews with the same interview guide, changes and additions were made during the interviews when warranted. Consequently, the interview guide became more f l e x i b l e than was o r i g i n a l l y planned. This f l e x i b i l i t y was more i n l i n e with the subjects' preferences as well as with the researcher's interviewing s t y l e . The questions l i s t e d i n the interview guide were always answered, but only asked d i r e c t l y i f not mentioned i n t h e i r own t e l l i n g of t h e i r experiences. B a s i c a l l y , the subjects t o l d t h e i r ' l i f e story' and the interview guide served as a 'guard' ensuring that a l l the issues, aspects and e s p e c i a l l y t h e i r thoughts and f e e l i n g s concerning the experiences were covered. The interview guide, as Patton (1980) states, "...simply serves as a basic c h e c k l i s t during the interview to make sure that a l l relevant topics are covered. The interviewer i s required to adopt both the wording and the sequence of questions to s p e c i f i c responses i n the context of the actual interview." (p.198). 32 This instrument, on the one hand defines basic parameters and outlines the area which the researcher i s interested to focus on i n the interview and, on the other hand, i t provides f l e x i b i l i t y allowing the subjects to share t h e i r experiences i n t h e i r own way, thereby allowing for added richness of the data. One question which was o r i g i n a l l y posed as: " T e l l me about your attempt to commit s u i c i d e " was changed to "Did you have any attempt to cause harm to y o u r s e l f ? " I t was changed a f t e r the f i r s t interview because the subject's response was "I haven't. I have thought about i t for a long time but never r e a l l y (pause)... One time I took a bunch of p i l l s . . . " This response brought about the thought that maybe each of the subjects labeled "suicide attempt" d i f f e r e n t l y , and maybe l a b e l i n g i t as "suicide attempt" or addressing i t i n a d i r e c t way can r a i s e resistance to t a l k about i t , as a r e s u l t of shame, embarrassment, s t u p i d i t y etc. The revised question was found less threatening. The interviews were taped i n t h e i r e n t i r e t y and hence s e l e c t i o n bias was l i k e l y to be avoided. This also permitted the interviewer to be more attentive during the interviews to factors which might have influenced the way the subjects reported t h e i r subjective data (Patton, 1988). Notes were taken throughout the interviews. Patton (1988) points out that, "Notes can serve at l e a s t two purposes: (1) notes taken during the interview can help the interviewer formulate new questions as the interview moves along, p a r t i c u l a r l y where i t may be appropriate to check out something that was s a i d e a r l i e r ; and (2) taking notes about what i s s a i d w i l l f a c i l i t a t e l a t e r a n a l y s i s . " (p.247). DATA ANALYSIS Glaser and Strauss's constant comparative of analysis was used to analyze the data gathered i n t h i s study. The process of data analysis, following a 33 ground theory approach, began with the t r a n s c r i p t i o n of the taped interviews. Each sentence or a group of such with a common subject l i n k i n g them were constructed as indi c a t o r s and were coded i n the margin (see Appendix C). Miles and Huberman (1984) define a code as: "... abbreviation or symbol applied to a segment of words - most often a sentence or paragraph of transcribed f i e l d notes i n order to c l a s s i f y the words." (p.56). For example, when one v i c t i m was asked about her sexual abuse experience she responded: "Well, I don't know at these days i f I c a l l e d i t sexual abuse, but I guess i t i s i f your father touches you everywhere." This statement was coded as 'uncertainty regarding the d e f i n i t i o n of sexual abuse'. Another v i c t i m responded i n a s i m i l a r manner to the same question, s p e c i f i c a l l y , "Once when I was seven or eight I think that my mom came to my room, rubbing on me for a long time. I was eight, now I am thinking t h i s was not normal. I don't know i f i t i s for a mother putting cream on her kid, she was r e a l l y slow rubbing cream everywhere (pointing to her g e n i t a l s ) . I t i s a very d i s t o r t e d memory. I can't t e l l i f i t ' s healthy or not." This statement was coded as 'confusion about normal and abnormal, healthy or unhealthy mother-touching.' Glaser (1978) states that, "From the comparison of in d i c a t o r to in d i c a t o r the analyst i s forced into confronting s i m i l a r i t i e s , differences and degrees of consistency of meaning between in d i c a t o r s which generate an underlying uniformity which i n turn r e s u l t e d i n a coded category and the beginning of properties of i t . " These s i m i l a r codes were l i s t e d as a group which indicated a common element i n these two responses, and were labeled as 'Attempts To Define Sexual Abuse'. The codes that emerged from the t r a n s c r i p t i o n s were sorted through and developed a system of properties and categories. The question " T e l l me about the sexual abuse" e n t a i l e d a d e s c r i p t i o n and an explanation which included three properties: i ) Other Sexual Abuse Experiences, i i ) Attempts To Define 34 Sexual Abuse, and i i i ) D e t a i l s About Incest. These three properties comprise and appear to be of d i f f e r e n t dimensions of the category Sexual Abuse. This process continued u n t i l each case was analyzed. Throughout the open coding process, codes were memoed when i t was necessary. Glaser (1978) defines a memo as, "... the th e o r i z i n g write-up of ideas about codes and t h e i r r e l a t i o n s h i p as they s t r i k e the analyst while coding." (p.83). Strauss (1989) i n h i s guideline for open coding suggests, "Frequently, to inte r r u p t the coding i n order to write a t h e o r e t i c a l memo. This leads quickly to accumulated memos as well as moves the analyst further from data and into a more a n a l y t i c realm."(p.32). A memo to the above example of the victims' responses might be: The confusion and the attempts to define sexual abuse r a i s e the question of what i s normal and abnormal, and what i s healthy and unhealthy concerning sexual behaviour which may a f f e c t the victi m s ' concepts about sex and heterosexual r e l a t i o n s h i p s l a t e r i n t h e i r l i v e s . At adolescence, when t h e i r search f o r sexual i d e n t i t y and re l a t i o n s h i p s with the opposite sex w i l l take place, confusion and problems might a r i s e . For them, sexual r e l a t i o n s h i p s might be connected with the notions of e x p l o i t a t i o n and being victims, or a ' d i r t y ' issue, a way to get love and closeness, and other d i s t o r t e d thoughts and feelin g s that may enhance t h e i r d i f f i c u l t i e s and problems which may contribute to the s u i c i d a l behaviour. The t r a n s c r i p t i o n was reviewed again u n t i l a l l the ind i c a t o r s agreed with the developed categories and t h e i r properties, and each concept reached a point of saturation. Strauss (1988) postulates that t h e o r e t i c a l saturation occurs "When a d d i t i o n a l analysis no longer contributes to discovering anything new about a category." (p.21). The process was repeated with each of the four cases. The properties and the categories that emerged were co n t i n u a l l y compared with the categories and the properties i n the previously analyzed cases. The coding, properties and categories were changed or modified i n order to better r e f l e c t the data. This process was one of developing a system of categories and properties to a l e v e l of a b s t r a c t i o n that would include and c l e a r l y represent the incest and the 35 s u i c i d e attempt experiences of these adolescents. The data analysis of the vic t i m s ' experiences generated a basic s o c i a l process which encompasses three stages. Each stage groups several categories and t h e i r properties, and has a beginning and an end. A c r i t i c a l juncture l e d to the t r a n s i t i o n from one stage to the next. In the next chapter, which presents the findings, the r e l a t i o n between the categories, the various stages, and the r e l a t i o n and i n t e g r a t i o n among the stages and the e n t i r e process w i l l be discussed. 36 CHAPTER FOUR FINDINGS The data analysis of the victims' experiences generated a Basic S o c i a l Process which encompasses three stages: i ) becoming a v i c t i m , i i ) e s c a l a t i o n of problems and i i i ) the healing process. These stages " . . . t i e together various sets of conditions, properties, etc., i n a manner which allows for a high amount of d e n s i f i c a t i o n and i n t e g r a t i o n at the same time i t allows for conceptual grab and t r a c t a b i l i t y . And, stages allow f o r the t h e o r e t i c a l t r a c i n g of and accounting f o r change over time." (Glaser, 1978, p.99). Each stage had a beginning and an end, and the t r a n s i t i o n from one stage to the next one happened a f t e r a c r i t i c a l juncture which was the turning point. Each stage has several categories with t h e i r respective properties and conditions. Each category r e l a t e s to the other categories and a l l of them grasp the whole stage. Each stage i s connected and i s r e l a t e d to the other stages and to the e n t i r e process. Glaser points out that Basic S o c i a l Process by developing into stages "...allows one to follow changes over time, yet remain i n grasp of a t h e o r e t i c a l 'whole' process which has a beginning and end. When the stages and t h e i r properties, conditions, consequences and so f o r t h are integrated into the 'whole' process, when each stage's r e l a t i o n s h i p to the process and to the other stages - how they a f f e c t i t , shape i t , and so f o r t h , are integrated, then the process can be conceptually followed from stage to stage the change over time being t h e o r e t i c a l l y accounted fo r , without the imagery of the o v e r a l l process being l o s t . " (p.99). The f i r s t stage, termed 'Becoming a Victim', represents the period during which the incest was i n i t i a t e d and ended. The turning point from the f i r s t stage to the second was the disclosure which stopped the incestuous r e l a t i o n s h i p and e n t a i l e d changes i n the vic t i m s ' l i v e s . This stage i s termed 'Escalation of Problems' as the incest victims described i t . The end of t h i s stage happened with the victims' suicide attempt. The suicide attempt had been the c r u c i a l juncture to the t h i r d and l a s t stage which i s r e f e r r e d to as 'The Healing Process'. This BSP i s a t h e o r e t i c a l r e f l e c t i o n and a summary of the patterned, systematic uniformity flows of the vi c t i m s ' s o c i a l l i f e and experiences which they had gone through, and which can be conceptually capture and enhance the understanding of t h e i r experiences which i s the purpose of t h i s study. Figure 1 summarizes The Process. Figure 1: The Process T H E P R O C E S S STAGE 1 STAGE 3 The H e a l i n g P r o c e s s Narrowing Resources 1r Category The B e g i n n i n g of the H e a l i n g P r o c e s s 38 STAGE I: BECOMING A VICTIM The f i r s t stage of the process had sta r t e d when the c h i l d became a sexual abuse v i c t i m and ended when the incestuous r e l a t i o n s h i p had stopped. Becoming a v i c t i m r e s u l t e d not only from the incest experience but also from the environment within which the incest took place which enhanced the problematic s i t u a t i o n and further contributed to the experience of becoming a v i c t i m . This stage includes three categories: i ) the sexual abuse, i i ) the family dynamics and i i i ) the victims' coping mechanisms during that period of time. Figure 2 summarizes the categories, t h e i r properties and types, dimensions and conditions which comprise t h i s stage. Figure.2 : Schematics of Stage 1 TYPES, DIMENSIONS AND CONDITIONS PROPERTIES CATEGORIES STAGE 1 -The age of victims -Details about the offenders -Type of abuse -Location -Confusion between normal and abnormal -Explanations -Type of abuse -Emotional effects -Violence and secrecy -Parents'characieristics -Family characteristics: loss and separation; role-reversal; violence -Generational transmission of problems: alcohol; violence; sexual abuse -Lack of support -Psychological maltreatment -Lack of social skills -Forming negative self-concept -Active insistence -Disclose to others -"Cry for Help": running away; suicide attempt -Activities -Defence mechanisms: dreams; imagination; depersonalization; numbness; supression Other Sexual Abuse Experiences Attempts To Define Sexual Abuse Details About The Incest Dysfunctional Family Extended Family Disruption Of The Development Stage Attempts To Stop The Sexual Abuse Protection Of Self Sexual Abuse ~7sr Family Dynamics Coping Mechanisms Becoming a victim 39 CATEGORY I: SEXUAL ABUSE When the question " T e l l me about the sexual abuse experience" was presented to the victims they provided a d e s c r i p t i o n which included three properties of the f i r s t category: other sexual abuse experiences, attempts to define sexual abuse, and d e t a i l s about the incest experience. In the ensuing discussion I w i l l elaborate on each of these properties. A l l the adolescents had r e c a l l e d other sexual abuse experiences that took place p r i o r to the incest, at the time of the incest and/or a f t e r that. The f i r s t sexual abuse i n i t i a t e d when the victims were very young, the age ranged from 2 to 4 years of age. They remembered the experiences but as young c h i l d r e n not a l l t h e i r r e c o l l e c t i o n s were c l e a r . As one of them r e c a l l e d : "The f i r s t time I remember I was r e a l l y young, maybe two. I grew up not r e a l l y remembering who the fellow was, now I quite sure I do know. I and my s i s t e r were i n t h i s l i t t l e room at t h i s l i t t l e bed, he c a l l e d us i n but not together, I j u s t remember he was touching both of us and he was l y i n g at t h i s bed". The f a c t that the offenders were neighbors, family friends or extended family members f a c i l i t a t e d the p h y s i c a l and emotional access to the victims. The victims, being very young, d i d not have the f u l l capacity to understand the s e v e r i t y of the s i t u a t i o n and as a r e s u l t could not e f f e c t i v e l y r e s i s t the perpetrators or ask for help. "I was 3-year-old, maybe I was a b i t older, but I was quite young. And my mom l e f t me with my uncle. I remember I was i n the bed, having napping and he came i n and j u s t touched me. I know he did i t , I j u s t have t h i s small piece i n my mind" "...my mom's g i r l f r i e n d , her boyfriend,when sleeping on the bottom bed, l i k e , I and my brother had bunkbeds and we came, i t was time to go to bed and I was wearing my nightgown and he grabbed me and he p u l l e d my nightgown up and he touched me and then he b i t me on the inside of leg and I screamed and my mom came down and she grabbed him and she threw him out of the house and her g i r l f r i e n d along with him and urn, another time, we were l i v i n g i n t h i s co-op and the caretaker was going around abusing a l l the l i t t l e g i r l s , l i k e , sexually molesting them and s t u f f , and I 4 0 remember him touching me and giving me quarters and s t u f f and t e l l i n g me not to t e l l , l i k e , t h i s would be our l i t t l e secret, type thing." "I remember so many (sexual abuse experiences), l i k e they (my parents) use to had these p a r t i e s a l l the time and once a guy came up sat down beside me put h i s hand on my bum. And once when I get my h a i r cut, there was a guy fondling me. So I have a l o t of these yucky memories." The victims described t h e i r 'other sexual abuse experiences' as introductory to the incest r e l a t i o n s h i p . The sense of being a v i c t i m was enhanced by the r e p e t i t i o n of the v i c t i m i z a t i o n e s p e c i a l l y so when the offenders were family friends, extended family members and people i n the neighborhood and the community. The offenders used t h e i r power as adults, who the victims could not r e s i s t , e s p e c i a l l y so since they were very young and t h e i r understanding of sexual behaviour was b l u r r e d and l i m i t e d . The victims grew up i n incestuous f a m i l i e s i n which communication i s a problematic issue. Also, the parents, due to t h e i r problems, were p h y s i c a l l y or emotionally unavailable to the victims i n times of st r e s s . These aspects contributed to the e x t r a f a m i l i a l sexual abuse to happen. Being exploited and v i c t i m i z e d by known adults shattered the victims' innocence, t h e i r t r u s t and respect f o r adults i n childhood and l a t e r on i n l i f e . The sexual abuse behaviour enhanced the c h i l d ' s confusion and the sense of being exposed to v i c t i m i z a t i o n without ge t t i n g p r o t e c t i o n or defence from parents as well as other adults i n general. These f e e l i n g s l e d the victims to perceive themselves and t h e i r surrounding environment i n an obscured manner. The accumulated trauma r e s u l t i n g from being abused repeatedly contributed and influenced the incest sequels and the forming of the ro l e of being a v i c t i m . The victims i n r e c a l l i n g t h e i r experiences seemed to attempt to and search f o r a d e f i n i t i o n of sexual abuse. They were confused and t r i e d to draw a l i n e between normal and abnormal sexual behaviour. Although they were young 41 at the time the sexual abuse had taken place, they s t i l l had the sense that something was wrong and inappropriate. "Well, I don't know at these days i f I c a l l e d i t sexually abuse, but I guess i t i s i f your father touches you every where, i t s strange. I think when I was young he was used to c a l l me "we cunty" which was r e a l l y gross word to me when I was young. Because i t i s sexually. And he used to, I don't remember what happened when I was very young, but when I was 7-year-old I used to sleep with him i n the same bed and he was always holding and fondling me and I woke up and h i s hands were on my 'boobs' and he had been said: "I'm so lonely, I'm so lonely." "He had been t r y i n g to grab my bum, t h i s i s i n one occasion, and as I grew older and I started developing my breasts he always comment "Hey you f i n a l l y have t i t s " and t r y to squeeze them every time when he hugged me, I f e l t very uncomfortable. Once he sa i d "I always f e e l uncomfortable to hold your hands because I think maybe you w i l l think that i t i s sexual abuse or in c e s t . " I t was even i n h i s mind. And I hadn't r e a l l y put two and two together. I j u s t knew that he i s an a l c o h o l i c and he i s wierd. But l a t e l y with you and looking back i t was d e f i n i t e l y strange". "I touched him for money. I was too ashamed, because I went there knowing that, I knew that i t was something with sex, but i f someone asked me what sex i s , I wouldn't know what i t was, what sex i s I wouldn't know what i t was." For the victims the molestation and the d e f i n i t i o n of sexual abuse were very confusing. In childhood, and even when they r e c a l l e d t h e i r experiences at a l a t e r stage they were t r y i n g to figure out what was healthy or unhealthy, normal or abnormal. Some experiences were s t i l l being very d i s t o r t e d as one of them, who had been molested by her father described an event with her mother: "Once when I was seven or eight I think that my mom came to my room, rubbing cream on me for a long time, I was eight, now I'm thinking t h i s was not normal, I don't know i f i t i s for a mother putting cream on her kid , she was r e a l l y slow rubbing cream everywhere (pointing to her g e n i t a l s ) . I t i s very d i s t o r t e d memory, I can't t e l l i f i t ' s healthy or not." When the abuse was accompanied by violence and/or by inappropriate explanations by the offenders the victims as c h i l d r e n were more confused, they got a double message which was very d i f f i c u l t to handle and understand. As one of them described: 42 "I didn't understand why he was doing that to me. Like, I knew i t was wrong but I didn't understand why he d i d that to me. And he used to say a l l kinds of things to me l i k e , i f he ever h i t me or something, he'd say something l i k e "I'm only doing t h i s because I love you" or "This hurts me more than i t ' s hurting you" and I couldn't understand that e i t h e r because he's l i k e r e a l l y h i t t i n g me." The confusion of the victims i n childhood about the sexual r e l a t i o n s h i p i n which they were involved brought about the questions concerning what i s normal and abnormal, and what i s healthy and unhealthy. This may have aff e c t e d the v i c t i m s ' concepts concerning sex and intimate t r u s t r e l a t i o n s h i p s l a t e r i n t h e i r l i v e s . A f f e c t i o n and love might have been confused with sex. At adolescence, when search f o r sexual i d e n t i t y and heterosexual r e l a t i o n s h i p s take place, confusion and problems may a r i s e . For them, sexual r e l a t i o n s h i p s might have been connected with the notions of e x p l o i t a t i o n and of being victims. I t may also b r i n g them to view sex as a ' d i r t y issue', a way to get love and closeness or other d i s t o r t e d thoughts and fe e l i n g s that may enhance t h e i r d i f f i c u l t i e s and problems which, i n turn may contribute to the s u i c i d a l behaviour. A f t e r describing the other sexual abuse experiences and the confusion regarding what was a normal or abnormal sexual behaviour, the victims r e c a l l e d t h e i r incest experiences. Whether the offenders were the natural fathers, or whether they were the mothers' common-in-law husbands, who have been father figures to the victims, the types of the sexual abuse varied. The abuse ranged from intercourse through to other experiences such as: fondling, masturbating and exposing to pornography. "When I went to v i s i t him he had a bachelor apartment and I had to sleep i n the same apartment i n the same bed. Sometimes I have seen him walking nude. Or when I was younger and I came over to see him, he was with a bunch of h i s friends looking at porno movies or when I was younger he was i n bed r i g h t next to me and had sex with h i s g i r l f r i e n d and I was t o t a l l y 4 3 awake and I heard them. So i t was r e a l l y weird my l i f e was always r i g h t there with sex." Shame, anger, hate, powerlessness and blame were emotions described by the victims as accompanying the incest experience. "I went seeing him for money but getting money I had to touch him, masturbate him, touching i t or f e e l i t . I remember him touching me, because my pants were down. He used to t e l l me to lock the door. I had sensation when I was touched. I know with him I did, and... I was r e a l l y ashamed about i t . " "And I hated him for the re s t of h i s l i f e . He had a stroke and I had hated him even when he was s i c k and couldn't move, he l o s t h i s mind, I s t i l l hated him, he s t i l l scared me." "I always, I always know, i n my dreams when I sleep I see myself k i l l i n g him. I ' l l stab him, I ' l l beat the s h i t out of him. I see him burning i n a house and we a l l l i v e together and I get my whole family out of the house except for my dad and I watch that, l i k e , that's what I see i n my dreams a l l the time, ever since I was a l i t t l e k i d . He's always been i n a house and he's been burning and I won't save him, I can but I won't, you know. Like sometimes I ' l l have a ladder and I could put the ladder up there and he can climb down but I won't, I ' l l hold on to i t and I won't do i t , you know." Secrecy was a common feature i n the experiences r e c o l l e c t e d by the victims. Keeping the abuse as a secret r e s u l t e d from rewards and d i r e c t threats made by the offenders. For a c h i l d to l i v e with such a kept secret i s harmful, destructive and a powerless enhancing s i t u a t i o n e s p e c i a l l y when the vi c t i m , as a c h i l d , i s threatened by punishment and abandonment. The thoughts about others' reactions to the exposed secret also enhanced fears and helplessness. As one of them described: "We had a s o c i a l worker at the time, and he used to say never to say anything to her because s h e ' l l take you away and s h e ' l l put you i n a bad place and people w i l l beat you up a l l the time." "And at the l a s t time when my pants were down, somebody walked into the house, I heard them coming. I jumped up, I knew i t was wrong, I didn't r e a l l y know what sex was, but I can't explain i t , but I had to jump up to put my pants on." The sexual abuse experience for victims during childhood i s a very 44 d i s t o r t e d one. The secrecy, the verbal and ph y s i c a l violence accompanying the sexual abuse, the e x p l o i t a t i o n and the exposure to sex by adults whom the c h i l d knew, loved and trusted enhanced the confusion, powerlessness, anger, helplessness and other f e e l i n g s which were very d i f f i c u l t f o r the victims as ch i l d r e n to handle. The incest was described as the most destructive sexual abuse experience. Being molested by the father, on whom the c h i l d depends for her basic needs, impairs the bond between the father and the c h i l d and the l a t e r ' s well being. The offenders used t h e i r power and authority against the victims to e s t a b l i s h the sexual abuse r e l a t i o n s h i p , i n ad d i t i o n to the rewards and threats they have i n f l i c t e d upon them. The victims f e l t powerless i n r e l a t i o n to t h e i r v i c t i m i z e r s . The common fe e l i n g s regarding the sexual abuse were anger, depression, low self-esteem, helplessness and shame. Even at the stage of adolescence, the victims attempted to define and understand the sexual abuse, which may indicate how d i f f i c u l t and complex t h i s experience has been. I t has been an experience that l e f t many scars and problems to surface i n years to come. The seXual abuse as a category, which i s described above, had taken place i n the context of a dysfunctional family. Issues r e l a t e d to family dynamics are elaborated on i n the following section. CATEGORY I I : FAMILY DYNAMICS When the adolescents described t h e i r incestuous f a m i l i e s they r e l a t e d i t to three issues which comprise the properties of t h i s category: the victim's dysfunctional family, the extended family and the di s r u p t i o n of the developmental stage. The victims described t h e i r f a m i l i e s as dysfunctional. Their parents 4 5 were perceived as providing inappropriate examples of marital r e l a t i o n s h i p s as well as parenthood. They described t h e i r fathers as a l c o h o l i c , v i o l e n t and not having stable jobs. "I j u s t knew that he i s an a l c o h o l i c and he i s wierd... he i s screwed up a l l the time with drugs and alcohol. He i s adolescent mentally and I deal with him l i k e a t o t a l mental person, he i s such an i d i o t . " "My father was a l c o h o l i c , drinking, they fought a l l the time, I'm sure that he beat her and raped her. When I was a baby he broke my arm once, he used to h i t me a l o t i n serious spank, threats, y e l l i n g , rage, you know, t y p i c a l a l c o h o l i c family." "My father was a l c o h o l i c , he has several jobs. He was a policeman when we were kids. And then he was i n construction and then he fis h e d . I think that's a l l he has done." "He mostly beat me and s t u f f , he j u s t h i t me a l l the time for whatever reasons. I guess sometimes he'd have f i g h t s with h i s g i r l f r i e n d s and s t u f f and he'd take i t out on me that way." The father as the abuser v i o l a t e d the tr u s t of the c h i l d and instead of pro t e c t i o n he became the c h i l d ' s problem. As one of them described her fears and v u l n e r a b i l i t y r e s u l t i n g from the loss of the father's protection. "...when I was then and my dad had already done something to me, l i k e , the guy downstairs was a f r i e n d with my dad and he had brought up a case of beer and he and my dad were drinking. Me and my brother were l y i n g i n bed and reading comic books and he went over to my brother's bed and he sta r t e d french k i s s i n g my brother and then he came over to my bed and he star t e d running h i s hand up the blankets, l i k e underneath them, and I freaked out and I ran into the other room screaming and I stood behind my dad and I j u s t kept on screaming and crying and I couldn't t e l l him what t h i s man was doing because he was doing i t to me too so I couldn't say t h i s man j u s t d i d t h i s and so I didn't. He t o l d me to j u s t get back to bed so I did. I don't think he would have cared anyway." The fathers, i n ad d i t i o n to being the abusers, were also described as weak, inadequate, insecure and incompetent i n t h e i r i n t r a f a m i l i a l and s o c i a l functioning. This father-model has contributed to the victim s ' future problems i n choosing appropriate partners and forming r e l a t i o n s h i p s with them. The mothers were a l c o h o l i c s and/or drug users and were described by the victims as passive and unable to provide support, care and love. They were 46 unavailable p h y s i c a l l y and emotionally. "She was l i k e a stone a l l the time. I always remember l i k e I had nightmares, t e l l i n g her things and she was not l i s t e n i n g , not connecting or not b e l i e v i n g me." "I don't r e l a t e very well with my mom, I think, me and my mom are more l i k e friends than mother and daughter." "My mom was borne on Valentine's day, i t i s wierd, she does not have a heart at a l l . She and her husband abused me a l l the time p h y s i c a l l y and emotionally." The victims expressed ambivalent f e e l i n g s toward t h e i r mothers. On the one hand they viewed them as passive, dependent, s e l f i s h , h e lpless and problematic. They f e l t that the primary bond of nurturing caring and t r u s t was v i o l a t e d and absent, and blamed them for not being a v a i l a b l e and stopping the abuse. On the other hand, they t r i e d to protect t h e i r mothers, love them and cared for them. One of them expressed her ambivalence toward her mother as follows: "I love my mom because she's my mom and the part of me that hates her i s because I couldn't understand why she sent me to l i v e with my dad, you know, and I j u s t , I thought she knew about t h i s , how could she do that to me? Like, what di d she think? Did she think, oh, because I'm h i s r e a l daughter, he wouldn't do that to me? He did, j u s t d i d i t to my s i s t e r s because they're not h i s r e a l daughters? And I didn't understand that." Although they had experienced disappointment regarding t h e i r mothers' reactions, they s t i l l had the fantasy and the longing to have a 'normal' mother; a mother who takes action, a mother who can a l l e v i a t e pain, fears and provide comfort. Each attempt contributed to the accumulated f e e l i n g of being abandoned, unloved, unprotected and a one for whom nobody cares. I f the mother, who i s the nurturing and loving figure, cannot provide the kind of support needed by the c h i l d then the f e e l i n g that no one else can provide i t i s created. Loss and separation were common features i n the vict i m s ' e a r l y l i v e s . 47 P r i o r to t h e i r parents' separation the victims were witnesses to f i g h t s and violence between the parents; they l o s t t h e i r parents as caring, l o v i n g and protecting f i g u r e s . One of them described her experiences: "... when I was young, my mom and dad used to get i n f i g h t s a l l the time. My dad would beat the s h i t out of my mom. My mom would pack up a l l of her s t u f f and we would leave i n the middle of the night. And we went to a t r a n s i t i o n house once and one time my mom l e f t my dad, we moved into a house and urn, my brother got taken away and put into a f o s t e r home and emergency services t o l d my mom that i f she didn't get back together with my dad, then my brother couldn't come back to l i v e with us. So my mom did that and then my dad went t o t a l l y nutso again and he took a two-by-four to her and he beat her up r e a l l y bad and urn, when my mom got a chance then we l e f t again and we moved downstairs from my aunt and uncle and while we were out they changed the locks on the door and everything and they kicked us out and they wouldn't l e t us back i n so my mom had no place to go. She's got me and my l i t t l e brother and she didn't know what else to do so she gave custody of us over to my dad and that was when I was seven years o l d and when I was seven t i l l I was eleven I stayed with my dad." The r o l e r e v e r s a l mechanism was also described by the vi c t i m s . They described themselves taking rol e s such as: taking r e s p o n s i b i l i t y of house chores, taking care of s i b l i n g s , and being the father's wife. I t created f e e l i n g s of unfairness, anger and confusion. "A couple of days before we got taken away from him he took o f f h i s wedding band and put i t on my marriage finger. That's how s i c k he was. Like, I wasn't h i s daughter, he got to a point where I wasn't h i s daughter anymore. I was l i k e h i s g i r l f r i e n d , h i s wife." " I f my dad was home and my brother did something wrong i t would be my f a u l t because I was responsible f o r him, so, I had to take care of him." "She has worked ever since I was... a l l forever. I supposed to do the house chores but i t wasn't f a i r . We had a l o t of f i g h t s , eventually we took turns." The extended family could provide help and support during periods of stress and c r i s i s . The victims described t h e i r respective parents' f a m i l i e s of o r i g i n as dysfunctional when they spoke about t h e i r parents. Problems such as violence, alcoholism, and mental i l l n e s s were features transmitted from generation to generation. The sense of lack of support and help was enhanced 4 8 because the victims knew that t h e i r extended family members were problematic themselves. "His father got shock treatment, he had a nervous breakdown when he was 25. My dad's brother i s manic depressive, he i s always on drugs, and h i s s i s t e r i s married to an a l c o h o l i c . And the other brother seems very passive. And my dad i s d e f i n i t e l y a l c o h o l i c . " "She (her mother) has seven brothers and s i s t e r s . They don't have drinking problems. One of the brothers married a woman who h i s k i d was sexually abused by her grandfather. This family i s screwed up because of that. Other s i s t e r married to dope addict." The victims reported that t h e i r parents were also victims of sexual, ph y s i c a l and/or verbal abuse as c h i l d r e n . Their parents' own resources to deal with stress problems and family r e l a t i o n s appeared d i s t o r t e d to the victims. These parents d i d not have p o s i t i v e and normal models of parenthood and they transmitted problems to t h e i r present f a m i l i e s . As one v i c t i m described: "I know he's s i c k and he's had a rough childhood himself, l i k e , he's been abused sexually by h i s mother. His father shot himself i n the head when he was young. He committed suicide, h i s dad did, my grandfather, from what I was t o l d by my grandmother. My grandmother had her l e f t breast cut o f f once because she had cancer and she used to have one of those foamy bras so you can't t e l l and he used to go up to her and he'd squeeze them and go, "well oh, t h i s one f e e l s pretty r e a l " and I remember him doing that when I was young and remember thinking, you know, there's something wrong here, and I think about i t now and I think, God, he must be r e a l l y sick, I mean, I could never do that to my own mother. I couldn't see anybody doing that to t h e i r own mother. There's j u s t no way." When the victims and t h e i r s i b l i n g s i d e n t i f i e d that they were molested by t h e i r grandparents and t h e i r uncles i t increased the f e e l i n g s of abnormality of t h e i r own family and the fee l i n g s of i s o l a t i o n and lack of support l a t e r i n t h e i r l i f v e s . "He was (the grandfather) b a b y s i t t i n g us also, my brother was at home, he sent us a l l to bed, and then he l e t me and my s i s t e r get out of bed, my brother had to go to sleep. My s i s t e r was under the blanket with him, l a y i n g on the couch, he was touching here, and I'm not sure i f he had never touched me. I don't think so." The vic t i m s ' parents had been abused and p s y c h o l o g i c a l l y maltreated as 49 c h i l d r e n . They themselves were deprived and the cycle of abuse repeated i t s e l f from generation to generation. The parents, as adults, s t i l l had problems with t h e i r parents and transmitted t h e i r immaturity, lack of d i f f e r e n t i a t i o n and t h e i r unresolved f e e l i n g s to t h e i r c h i l d r e n . The victims had the sense that instead of having loving, caring and pro t e c t i n g parents they were abandoned and neglected. As they described: "I can j u s t remember so many nights she wouldn't came home t i l l i t was r e a l l y , r e a l l y l a t e . I was so scared to be attacked or being murdered... I always freaked out, because always I was l e f t alone t i l l r e a l l y l a t e even since I was s i x . " "I hated him sometimes, but I wanted him so bad to love me. He always teased me and made fun of me. He enjoyed doing i t to me because I used to cry. My brother was h i s f a v o r i t e . " "I wanted to have i t (sex) too, because I always didn't have any attention, they were busy with sex, always with t h e i r lovers. My grandmother used to say to my mom I'm going to send her to a f o s t e r home." "She mostly had pot pot pot, they used to l i k e s i t t i n g i n groups smoking pot and passing i t to me. I f e l t my dad was always drunk, I pi c t u r e d him l i k e i n another planet, and my mom had pot, and I f e l t why can't I be there. I hated them leaving me, because I knew when I was looking on a l l these faces they were a l l somewhere el s e . " The victims c a r r i e d memories and fe e l i n g s of longing to have a normal childhood and normal parents. They f e l t that t h e i r needs as c h i l d r e n were not met. As expressed by them: "I wanted so much to have a normal home, you know, chicken on Mondays, salad on Tuesdays, j u s t to have a normal home." "I r e a l l y d i d not have any childhood. I always was so mad I wasn't a c h i l d . I was so mad, how come I knew about sex, drugs, money? Why were a l l my friends adults? I wanted to be a k i d . " "My parents d i d not have any concept about the c h i l d ' s mind. I have never taken a c h i l d to see "Joe's Tommy" or these movies of sex and drugs, i t j u s t freaked me out." The sense of being a v i c t i m was enhanced by the fe e l i n g s of abandonment and emotional neglect. The feeli n g s of unfairness, the fe e l i n g s that the father 50 and the mother could not provide care and love, the loneliness and helplessness of the s i t u a t i o n at home, gave them the sense of being scape-goats, of being victims who have been determined to s u f f e r . The incestuous family and i t s c h a r a c t e r i s t i c s contributed to the d i s r u p t i o n of the victi m s ' development. The c h i l d ' s needs f o r love, care, p r o t e c t i o n and preparation for future developmental stages were ignored and v i o l a t e d . The c h i l d grew up with a sense of loss of childhood, having inappropriate parenting, and lack of love and care. The c h i l d ' s basic foundations of self-concept became negative and confused as a r e s u l t of the traumatic experiences. Throughout childhood one develops her fundamental sense of i d e n t i t y and self-concept. The parents, as well as s i g n i f i c a n t others, play a c r u c i a l r o l e i n t h i s stage. As was described e a r l i e r , the parents, the extended family and the lack of friends have a l l contributed negatively to the c h i l d ' s well-being, v i o l a t e d the c h i l d ' s security, sense of being protected and being loved and thus, contributed to the formulation of a negative self-concept: "At t h i s time the c h i l d r e n at school c a l l e d me names well, 'cause they say that to me, I thought i t s true, I started b e l i e v i n g i t cause they kept saying i t and you know, well, i t must be true i f they kept on saying i t and t h i s happened at grade 6, l i k e , everyone s t a r t e d doing t h i s to me and then I tra n s f e r r e d because I went to the fos t e r home and I started at a new school and they d i d i t to me too, so I thought, okay, f o r sure, man, then I must be r e a l l y ugly or something, you know. I s t i l l don't l i k e having my pi c t u r e taken, and a l l my pictures I think they look bad and s t u f f . " "Uh, he used to c a l l me a b i t c h a l l the time and he c a l l e d me a whore. Once when the p o l i c e brought me home from when I got jumped i n that a l l e y and, urn, he waited t i l l they l e f t and r i g h t i n front of my f r i e n d he slapped me across the face and sa i d "You whore, you probably asked for i t " and that's, I ' l l never forget that." "Well, what my dad used to do to me j u s t makes me f e e l d i r t y , makes me f e e l bad, l i k e , I know that i t s not my f a u l t and everything but, you know, i t s t i l l makes me f e e l r e a l l y , l i k e , gross, s i c k and sometimes I thought when they c a l l e d me these names that they might see i t , l i k e they might somehow know. They might have found out or something and that's why they're c a l l i n g me that too." 51 "I was out-spoken I didn't respect adults obviously because my parents weren't respected. I was very loud, outspoken because that's how I talked to my parents. I was a r e a l l y hard c h i l d to d i s c i p l i n e . " The incestuous family with i t s c h a r a c t e r i s t i c s prevented the victims, i n t h e i r childhood, from b u i l d i n g appropriate s o c i a l s k i l l s . The closed family system, i n which they grew up, d i d not provide the necessary opportunities for e x e r c i s i n g s o c i a l s k i l l s outside the family thus, c o n t r i b u t i n g to t h e i r f e e l i n g s of being d i f f e r e n t , loners and outsiders. As they described: "I had maybe one or two friends when I was i n elementary schools. I was more a loner. I didn't r e a l l y hang around with anybody but my brother." "I never f i t i n because I always f e l t l i k e my innocent was one-like sex, and I used to hate that I knew so much. So I t r i e d to explain them. I t r i e d to see i f they know about sex, smoke, drinking, drugs. I couldn't i n v i t e them over, because my mom had drugs and I had to l i e a l l the time. They came from these l i t t l e happy f a m i l i e s and they didn't understand, worry about good grades or make-up or something, and I became completely i s o l a t e d , loner." The victims also described experiences of being v i c t i m i z e d by peers at school. That further enhanced the perception that they were vi c t i m s : "I went a l l the way through elementary school with people c a l l i n g me dog and saying "you're ugly" and s t u f f l i k e that and t h i s was mostly the g i r l s . I mean t h i s i s why I don't get along with g i r l s very well i s because of that and the only reason why they d i d that i s , that I can f i g u r e , i s because I d i d not dress with l i k e , brand new clothes l i k e that. My clothes were l i k e , my jeans were a l l ripped up i n the knees and s t u f f . My runners were l i k e o l d runners. They had brand new shoes and brand new designer jeans and nice clothes and they d i d t h e i r h a i r nice and they wore makeup and I wasn't allowed to wear makeup and i n the morning I didn't r e a l l y have time to do my h a i r and I didn't know how to s t y l e i t l i k e they did." The i n s e c u r i t y , fears and helplessness, r e s u l t i n g from the sexual abuse and the dysfunctional family, were enhanced by the lack of friendships with peers. There was no place or way to get support or to develop a sense of t r u s t . 52 CATEGORY I I I : COPING MECHANISMS At t h i s stage, the victims t r i e d to achieve a change by two ways of coping which are the properties of t h i s category. The f i r s t i s characterized by attempts at changing the nature of the s i t u a t i o n i t s e l f , that i s to stop the sexual abuse. The second i s characterized by attempts at managing and dealing with t h e i r thoughts and fee l i n g s regarding the s i t u a t i o n using defence mechanisms to protect the s e l f . Despite t h e i r young age, the victims had the sense that something was wierd and wrong and they t r i e d various ways to stop the abuse. They t r i e d to r e s i s t and to say 'no' i n several ways as they described: "When he c a l l e d me names or something, I had s a i d 'don't', I remember, when he t r i e d to touch me, I went to the back when he s t a r t e d to hug me I always p u l l e d away. I t r i e d but I don't think I did." "I'd be sleeping at night and he'd j u s t come i n and he'd climb i n with me... only once, think he was r e a l l y v i o l e n t and i t was when I was f i g h t i n g back and I kneed him i n the nuts and he h i t me a couple of times but I was too scared to do anything so I didn't r e a l l y f i g h t back very much." They also t r i e d to get help from others when t h e i r attempts had not succeeded. One of them described her attempt to get help from a stranger i n a park, as she r e c o l l e c t e d : "This lady was with her kids at the park and she was t a l k i n g with me and I j u s t had to t e l l somebody so I t o l d her everything and then I j u s t got up and I walked away and I l e f t . I never saw her again. I went home but I didn't t e l l her my name or anything so she couldn't have done anything. I've never seen her before e i t h e r . " In cases when the victims t r i e d to stop the abuse by t e l l i n g t h e i r mothers about the abuse they d i d not get any help. The mothers, as described e a r l i e r , were passive, depressed and dependent, and were unable or u n w i l l i n g to defend and protect t h e i r daughters. They ignored the information given to them by t h e i r daughters, denied i t , or refused to believe i t and d i d not take any 53 a c t i o n to a l l e v i a t e the s i t u a t i o n . "I t o l d my mom "can you please t e l l him not to tre a t me t h i s way?" My mom t o l d me "you have to t e l l him yourself." But he didn't l i s t e n to me. I f e l t f r u s t r a t e d and angry. Because I already t o l d him to stop i t , and he j u s t laughed. I wish he'd stop t r e a t i n g me l i k e that, l i k e a sex object. I was scared of him. I was a f r a i d to stay home alone with him then." "So when I was young I don't remember her response, I j u s t remember when I t o l d her about what's going on with my dad, she said, "Oh r e a l l y ! That's not the way i t i s . " She never dealt with me. She even s a i d she went through a nervous breakdown f o r a couple of years. She was l i k e a rack." The sense of helplessness, powerlessness and disappointment, which have re s u l t e d from the lack of help, were enhanced and l e d them to several actions, such as su i c i d e attempt and running-away as a d d i t i o n a l ways to express a "cry for help" and getting a reaction: "Once when I was eight I t r i e d to jump up out the window. I was used to think about i t a l o t . I remember myself t e l l i n g once my mother "you know yesterday I sat on the window t r y i n g to k i l l myself" and she j u s t s a i d as always "Oh". Because she was l i k e a stone a l l the time. So, you see I couldn't get any reaction, i t was l i k e "what can I do? Nothing." "I thought my daddy hated me, but i t r e a l l y stupid the way I t r i e d to commit s u i c i d e . I have heard about lead poison, I ate lead from a p e n c i l , I was s u i c i d a l . I wrote a note on the door, everything. I don't remember what I wrote. Nobody ever knew about i t . " "I used to save my money and then I ran-away. I took t h i s guy with me, nine years old. I t was wierd, I j u s t joked with him that we are going to Niagara F a l l s . I don't r e a l l y know anymore i f I intended to or not. I don't remember the f a c t s . We got caught a f t e r that day and t h i s guy t o l d everyone. I wanted to go to Niagara f a l l s to commit sui c i d e and jump o f f the f a l l s . " "I j u s t have money that I had, at t h i s time I del i v e r e d newspapers and I c o l l e c t e d a l l the money and ran-away for about two weeks. I couldn't stand i t anymore." The lack of outside resources to stop the sexual abuse, the sense of f a i l u r e of other actions and t h e i r young age with i t s l i m i t a t i o n s pushed the victims to t r y and protect the s e l f and to cope with t h e i r problematic s i t u a t i o n by transforming t h e i r fears, powerlessness, helplessness and anger 54 into some a c t i v i t i e s . Being a good student was one way of coping, as one of them expressed, "So I had c e r t a i n things I could do r i g h t -- school, being the best, being a star, there were very few things that I could focus on." Close r e l a t i o n s h i p with s i b l i n g s was also a way to f e e l 'I'm not alone' there i s someone with me, "I was more of a loner. I didn't r e a l l y hang around with anybody but my brother. We used to play together and go out together and we d i d everything together so i t s l i k e I didn't have any other friends and the friends I d i d have, I wouldn't bring them home with me." Using defense mechanisms such as dreams, imagination, suppression and denial helped them to go through t h e i r traumatic experiences. "I wanted to k i l l him, I j u s t imagined k i l l i n g them (the parents) with t h e i r boyfriends and g i r l f r i e n d s . " "I f e l t scared and I hated him. I j u s t wanted to disappear. I also wanted to k i l l him too at the time but I couldn't because I was young." " B a s i c a l l y , I j u s t became the r e a l l y 'good' and the r e a l l y bad g i r l . I had perfect grades, I had been the p r i n c i p a l pat and every one pat. I had been the best athlete, but at the same time I was smoking, looking at playboy magazines. I had these two r e a l l y d i f f e r e n t spaces." In t h e i r dreams and imagination there were s h i f t i n g of power from the offenders to themselves, providing them with a sense of co n t r o l and power, as was described by two of them: "Well, I always, I always know, i n my dreams when I sleep I see myself k i l l i n g him. I ' l l stab him, I ' l l beat the s h i t out of him. I see him burning i n a house and we a l l l i v e together and I get my whole family out of the house except for my dad and I watch him and he's on the top f l o o r and he can't get out and i t burns and he dies. And I always watch that, l i k e , that's what I see i n my dreams a l l the time, ever since I was a l i t t l e k i d . He's always been i n a house and he's been burning and I won't save him, I can but I won't, you know. Like, sometimes I ' l l have ladder and I could put the ladder up there and he can climb down but I won't, I ' l l hold on to i t and I won't do i t , you know." "In my dreams as a c h i l d I dreamt that we are together l i v i n g happily. I pretended that i t was a prefect home. I've never allowed myself to think d i f f e r e n t l y . " 55 In the f i r s t stage, where the c h i l d r e n became victims, the sexual abuse as well as the context i n which i t had taken place (the dysfunctional family) brought about the deprivation of the victims' needs as c h i l d r e n . The victims were sexually as well as ps y c h o l o g i c a l l y abused. Their needs for . l o v e , care, p r o t e c t i o n and s e c u r i t y were neglected and ignored. Their self-concept turned negative, they f e l t d i r t y , unworthy, powerless, helpless and lonely. The problem-solving s k i l l s , the s o c i a l s k i l l s and the strength of t h e i r p e r s o n a l i t i e s were a l l d e f i c i e n t . They t r i e d to cope with the s i t u a t i o n i n a v a r i e t y of ways by act i v e resistance to the abuse, by asking for help and involvement of t h e i r mothers, running-away, attempting s u i c i d e and using several, defence mechanisms. This has continued u n t i l the t r a n s i t i o n to the next stage which changed t h e i r s i t u a t i o n . STAGE I I : ESCALATION OF PROBLEMS This stage of the process began with the dis c l o s u r e . When the secrecy was v i o l a t e d , changes st a r t e d appearing i n the victims' l i f v e s . The duration of t h i s stage was case s p e c i f i c . However, a l l victims had gone through s i m i l a r experiences and changes. This stage includes three categories: ( i ) the disc l o s u r e , ( i i ) narrowing resources and ( i i i ) coping behaviors. The suicide attempt ended t h i s second stage and was the turning point leading to the t h i r d stage. These are depicted i n Figure 3 . CATEGORY I: THE DISCLOSURE The victims described the disclosure category by two main properties: the c r i t i c a l event and the reactions of the s i g n i f i c a n t others to the disclo s u r e . Attempts to d i s c l o s e had taken place e a r l i e r , i n the f i r s t stage, but at that 56 stage i t d i d not bring about change and the sexual abuse had continued. At t h i s stage however, they were older and had more understanding regarding the sexual r e l a t i o n s h i p they were involved i n as well as having more resources than they had before. These fac t s have contributed to t h e i r d e c i s i o n to break the secrecy. The disclosure v a r i e d i n terms of the age range, from 11 to 15. In a l l cases the disclosure stopped the sexual abuse and e n t a i l e d other s i g n i f i c a n t changes i n the victim s ' l i v e s . Figure 3: Schematics of Stage 2 TYPES, DIMENSIONS AND CONDITIONS PROPERTIES CATEGORIES STAGE 2 -The offenders' reactions -Mothers' reactions -The social-system's reactions -Moving to a "new family" -Detached relations with mother and siblings -Limited professional support •Inadequate help reg. the sexual abuse -Lack of school system involvement -Lack of peer relations -Problems with the opposite sex -Searching for identity -Using substance-abuse - drugs; alcohol -Running-away -Prostitution -Forming relationships with marginal peer group -Suicidal ideation -The trigger -Type of attemot -The contributors: intensive negative emouons; tunnel vision and dichotomous thinking; and lack of help and support -A decision making process -To whom disclosed? The Critical Event -By whom disclosed? Reactions To The Disclosure Narrowing Family's Support Narrowing Social-System Support Developmental-Stage Tasks Maladaptive Behavior The Suicide Attempt The Disclosure Narrowing Resources Coping Benaviors Escalation of problems 57 Before d i s c l o s i n g t h e i r secrets, the victims had gone through a decision-making process. They were older, less a f r a i d of the offenders' threats and more prepared to take r i s k s i n order to stop the abuse. They described a c r i t i c a l event which stopped the sexual abuse. One of them made her decision when she got ' t i r e d ' of the abuse and decided to take a r i s k and t e l l the family's s o c i a l worker. "Well, I got t i r e d of being h i t a l l the time and s t u f f and my dad used to t e l l me, l i k e , we had a s o c i a l worker at the time, and he used to say never to say anything to her because s h e ' l l take you away and s h e ' l l put you i n a bad place and people w i l l beat you up a l l the time and s t u f f . And I thought well, maybe he's wrong and I can't handle i t so maybe i t s better there than i t i s here. And I t o l d my s o c i a l worker, I sat i n the car f o r two hours and I c r i e d and I t o l d her everything that ever happened to me i n the house." One of them d i s c l o s e d to her p s y c h i a t r i s t when she was h o s p i t a l i z e d a f t e r a sexual assault event. At t h i s time the discl o s u r e stopped the sexual abuse. E a r l i e r she had di s c l o s e d i t to her mother but the mother d i d not take any action. As she described, "We came to look f o r treatment, I was 15. I t was r i g h t a f t e r that guy t r i e d to rape me. I t was few days a f t e r j u s t I and my mother came here (to Vancouver). She thought that her boyfriend was l i k e that, and that i s not an issue. "He does i t to a l l these l a d i e s " she said. Well, I f e l t 'I'm not a lady, I'm a teenager". He started when I was 12-13-14-15. The thing was that I d i d t a l k to the p s y c h i a t r i s t about i t . He and my mom came to a meeting he sa i d 'you're looking good', whatever he was saying to me. And we confronted him about that, and since then the abused stopped." Moving to another c i t y a f t e r d i s c l o s i n g the secret was the c r i t i c a l event for another v i c t i m . "I t o l d her once I think when I was I don't know how o l d I was, maybe eleven. I s a i d "mom my dad i s scary he touches me and t e l l s me that he i s lonely" and she sa i d "don't sleep there any more", that's a l l . You know denial, not knowing how to deal with things. In the second time, we j u s t moved to Vancouver, and then i t stopped." The victims who through the molestation act have been l e f t with a need for repression and denial a f t e r the f a i l u r e of active resistance to stop the 58 abuse as well as getting help from others, also developed the need for r e v e l a t i o n . At t h i s stage, the victims were more mature and acquired more assertiveness and rebelliousness as t y p i c a l to adolescence. The ongoing abuse with i t s e f f e c t s became unbearable. Although a f r a i d to reveal t h e i r secrets as a r e s u l t of the offenders' threats and the fears of others' reactions to the d i s c l o s u r e , they mobilized an active stance against the helplessness and the powerlessness that they f e l t . The f e e l i n g that nothing worse can happen contributed to the d i s c l o s u r e . The d i s c l o s u r e e n t a i l e d reactions of the parents as well as other s i g n i f i c a n t people. In cases i n which the offenders were confronted, t h e i r reactions included d e n i a l , resentment and anger towards the v i c t i m s . The confrontation was a very uncomfortable and scary s i t u a t i o n for the victims, as one of them expressed: "She (the s o c i a l worker) t r i e d to get me to s i t down and t a l k with him about i t and there was no way I was going to do that and we both kind of sat there and didn't say a word and I couldn't handle i t and they asked so I s a i d I wanted to leave... I wanted to get out there. I'm not -there's no way I could t a l k to him. Like I was scared to even be i n the same room 'cause he t o l d me that he'd k i l l me i f I ever s a i d anything. She t o l d him, he denies everything he hated me, b a s i c a l l y , from what my brother says, I don't know. I didn't, I never went near him again a f t e r that. My brother says he used to t a l k bad about me and s t u f f and s a i d that I'm nothing but a whore and a l i t t l e b i t c h and s t u f f l i k e that." In a l l the cases the disclosure ended up the r e l a t i o n s h i p between the victims and t h e i r offenders. "When I t o l d him again that I think he making sexual passes at me. He was mad, he s a i d "you t o l d your mother and I that we didn't love you and I t r i e d to be compassionate". That's what he s a i d to the p s y c h i a t r i s t . We never talked since. We never looked to the eye, j u s t say 'Hi'." "I haven't seen him since, well, I've seen him, l i k e , I've seen him s i t t i n g at a bus stop, and walking across the s t r e e t and on a bus but I've always managed to get o f f r e a l l y quick or get away from him. Like, I haven't v i s i t e d him or nothing for eight years now since I've been taken away and I don't plan on i t ever again." 59 The abrupt c u t - o f f i n the r e l a t i o n s h i p s between the victims and t h e i r fathers r e s u l t e d from the victims moving to other places, e i t h e r to l i v e with the mother or, i n other cases, i n fos t e r homes. For the victims, not seeing the offenders, apart from ending of the abuse, i t was also a way to deal with the sexual abuse. By keeping p h y s i c a l distance they t r i e d to protect themselves and attempted to resolve the e f f e c t s of the sexual abuse. The mothers' reactions were very disappointing f o r the vic t i m s . The f e e l i n g of being abandoned and unprotected by t h e i r mothers were very p a i n f u l . The mothers d i d not take any action to support t h e i r daughters or to confront the abusers. The mothers remained passive and t r i e d to minimize the se v e r i t y of the sexual abuse experience. In a case where the mother d i d not believe the vi c t i m , i t enhanced the f e e l i n g of helplessness as one of them r e c a l l e d , "My mom t o l d my aunt that I j u s t made i t up. A f t e r that l a s t time that I spoke with her boyfriend, she t o l d my aunt that I made i t up. I was r e a l l y upset, I was crying. And then I didn't know how to deal with i t . Mom l i k e s t h i s guy, she took h i s side. I didn't push i t eit h e r , I j u s t forgot." One of them d i d not even know i f her mother knew about the abuse, she was s t i l l a f r a i d to t a l k with her about that, a f r a i d of being punished and also t r i e d to protect her mother: "I'm j u s t scared that she's not going to t a l k to me. Like, I know she blames h e r s e l f f o r everything that's happened to me. So I'm worried that i f I t e l l her that she's not going to be able to handle i t and she won't t a l k to me anymore . " The mothers' responses generated pain, f e e l i n g s of lo n e l i n e s s , unfairness, i n s e c u r i t y and had e f f e c t s l a t e r i n the victi m s ' a b i l i t y to tr u s t others or to ask help i n s i t u a t i o n s of st r e s s . They had learned that they could only r e l y on t h e i r own resources which were very l i m i t e d as described before. When the social-system support was involved a f t e r the disclosure, the 60 support was very l i m i t e d . As a r e s u l t the victim's f e e l i n g of "I'm alone" was enhanced. Only i n one case the s o c i a l worker and the teachers at school were supportive and h e l p f u l a f t e r the disclosure, as was described: "So at lunch time i n school we got c a l l e d down to the p r i n c i p a l ' s o f f i c e and she t o l d the p r i n c i p a l and the teachers what was going on and teachers and s t u f f and that we were being taken away and put i n a re c e i v i n g home not too f a r away from the school so we s t i l l attend the same school and i f my dad was to come around that we were to go s t r a i g h t to the o f f i c e and t e l l them that he was there and not to go up and t a l k to him....my teacher was r e a l l y nice to me and he gave me extra attention and s t u f f and he didn't get mad at me often f o r not paying a t t e n t i o n because he knew why I wasn't able to concentrate." When s o c i a l workers or other professionals were involved they d i d not r e l a t e to the sexual abuse as an issue for treatment, and b a s i c a l l y the victims were l e f t alone to deal with the e f f e c t s of the sexual abuse by themselves. In a l l cases a court procedure did not take place. The pro f e s s i o n a l interventions were l i m i t e d to apprehend the c h i l d from home and/or to confront the offenders. "I didn't t a l k , I talked about i t to my f i r s t s o c i a l worker. I t o l d her everything and then they took us away and then I never brought i t up again. No, they sent me to see a p s y c h i a t r i s t . . . They j u s t wanted me to go see him and he asked me a l l these questions and showed me pictures and s t u f f and I went once and that was i t . " The d i s c l o s u r e stopped the sexual abuse which was a p o s i t i v e change f or the v i c t i m s . However, i n and by i t s e l f i t was j u s t a temporary r e l i e f which could not have dealt with the severe impact the sexual abuse had exerted on the v i c t i m s ' souls. The reactions on the part of family members and other important people were a disappointment and the fe e l i n g s of lone l i n e s s and helplessness were i n t e n s i f i e d . The victims d i d not receive any support from e i t h e r the non-offender parent or from the social-system establishment. The pattern of deprivation, helplessness, lack of understanding and support continues into t h i s stage and again, leaves the victims stuck with t h e i r 61 traumatic f e e l i n g s and experiences. As i n the f i r s t stage, they had to cope with the trauma on t h e i r own without having s u f f i c i e n t resources. As the process continues, the problems worsen, as w i l l be shown i n the next category of t h i s (second) stage. CATEGORY I I : NARROWING RESOURCES Although the abuse stopped immediately a f t e r the dis c l o s u r e , the victims had the f e e l i n g that the problems worsened. They described three properties which characterized t h i s category: worsening problem within the family, narrowing of social-system support, and worsening problems connected to the developmental stage tasks. A p h y s i c a l change took place a f t e r the disclosure i n that the victims moved to d i f f e r e n t places to l i v e . In two cases the mothers and the victims moved to a new place. In two other cases the victims were removed from t h e i r f a m i l i e s of o r i g i n to fos t e r homes. These changes e n t a i l e d tremendous d i f f i c u l t i e s and gave them the sense that t h e i r l i v e s had worsened. In the cases were the victims were removed to f o s t e r homes the fears, confusion and lonel i n e s s i n t e n s i f i e d . As described by one of them: "She (the f o s t e r mother) drank a l o t and she'd get to the point where she'd pass out on the couch and she'd have l i k e , c i g a r e t t e s l y i n g a l l over the place and she'd say where are my ci g a r e t t e s , d i d you take them, and they're l i k e , r i g h t i n front of her. And, urn, I j u s t , I packed some of my clothes and I took o f f and I wasn't going to go back and the cops picked me up, the cops, and they took me home and she wasn't there so they took me to the emergency services and I waited there f o r two hours and the f o s t e r mom showed up and she was a l l drunk. And she brought me home and we had a b i g f i g h t and she threw a wine glass at G a i l , her daughter, and, um, I ran upstairs and she came a f t e r me and she was y e l l i n g at me saying a l l these mean things to me and s t u f f and I went i n the bathroom and I t r i e d to shut the door and she got i n and pushed the door open and then she grabbed me and she went to h i t me and I slammed her up against the door and I c a l l e d her a b i t c h and then I ran out again, and then I waited a couple of days and then I came back and I packed up a l l my clothes and I l e f t . " 62 The r e l a t i o n s h i p with t h e i r mothers and s i b l i n g s got cut o f f ; they r a r e l y met them and got the f e e l i n g s of l o n e l i n e s s . Although the mothers were described as passive, dependent and a l c o h o l i c or depressed, the victims s t i l l f e l t longing to be i n contact with them. The loss and separation were very d i f f i c u l t f o r them to handle. "I was i n the r e c e i v i n g home and then they took me to a f o s t e r home a f t e r eight or nine months a f t e r being i n the r e c e i v i n g home and I never had any contact with my mom u n t i l I moved into my f o s t e r home. A f t e r eight months I moved into my f o s t e r home and I was there for about a year and I didn't r e a l l y know how to get i n contact with my mom." And when meetings were arranged the daughters s t i l l f e l t detached from the mothers, they could not discuss issues that were important for them such as the sexual abuse. The need to have a mother who cares and loves was not met. "Well I didn't speak with her about the sexual abuse, I j u s t went to v i s i t her and we went to l i k e , Mcdonald's or something l i k e that. I couldn't t e l l her. I'm j u s t scared that she's not going to t a l k to me. Like, I know she blames h e r s e l f for everything that's happened to me. So I'm worried that i f I t e l l her that she's not going to be able to handle i t and she won't t a l k to me any more." "Since I'm here ( i n a group home) I d i d go there anymore. I hate them both. My mother was born i n Valentine's day but she does not have any heart. Yesterday she came here to sign the consent form. So I saw her but we d i d not t a l k much, there are no r e l a t i o n s between us. I j u s t worry about my younger s i s t e r and brother." The victims described l i m i t e d and inadequate p r o f e s s i o n a l support i n a d d i t i o n to the lack of family support, which enhanced t h e i r sense of narrowing resources. The inadequate help and involvement of the professionals increased t h e i r f e e l i n g s of powerlessness, anger, f r u s t r a t i o n and confusion. "When I was f i r s t taken away from my dad I had t h i s lady, Linda, who was my s o c i a l worker and we had her ever since I was a l i t t l e k i d so I trusted her and everything and then a l l of a sudden she said, well, I'm not going to be your s o c i a l worker any more, there's t h i s other lady that's going to and then t h i s other lady, I didn't l i k e her, I never r e a l l y got along with her, I never talked to her or nothing." One of the sexual abuse e f f e c t s i s the victim's f e e l i n g s of powerlessness. The 63 p r o f e s s i o n a l s d i d not have the proper knowledge of or the s e n s i t i v i t y to the e f f e c t s exerted by the sexual abuse. Decisions regarding treatment or removing from home have been made without consultation with the victims themselves, and consequently contributed to power struggles between the victims and the system i n a d d i t i o n to f e e l i n g s of anger, powerlessness and l o n e l i n e s s . I t impaired the v i c t i m s ' sense of e f f i c a c y and coping s k i l l s . This sense may also be associated with the despair and repression which can lead to s u i c i d a l behaviour often noted among adolescents. The victims f e l t unable to cope with t h e i r environment. One of them r e c a l l e d , "No, that's more my s o c i a l worker. She j u s t took over my whole l i f e and made a l l the decisions for me and she didn't ask me or nothing. Like, she put me i n the r e c e i v i n g home and then nine months l a t e r I found out I was being placed i n the f o s t e r home and I had no idea... I was r e a l l y mad because l i k e , I was r e a l l y shy and I was r e a l l y quiet so I wouldn't stand up f o r myself but i t made me r e a l l y angry that she didn't ask me l i k e , you know, what do I want. Where do I want to l i v e and s t u f f . " When the victims had p r o f e s s i o n a l help, the sexual abuse issue was not addressed at a l l . The victims acquired the sense that no one cared about them or r e a l l y understood them. The sense of i s o l a t i o n and abandonment which they had c a r r i e d through t h e i r childhood i n t e n s i f i e d during t h i s stage not only by the detachment from family members but also from others i n the s o c i a l system. One of them described her therapeutic experience as follows: "The f i r s t t h erapist I went to a year before (the s u i c i d e attempt) said that I was so screwed up that I need to go for a year and a h a l f to a farm. That's freak me out, at t h i s time I was r e a l l y bulimic. The f i r s t reason that I got there was my eating disorder. We met when I was 16. The t h e r a p i s t had to understand that the sexual abuse was s t i l l a b i g issue for me, but always they want me to quit. They didn't r e a l l y understand what's going on with me." The school system did not provide any help or was not engaged i n any i n t e r v e n t i o n although the victims showed they had problems. The sense of f a i l u r e and the f e e l i n g s of not being understood or supported i n the school 64 system, a place where adolescents exercise t h e i r various s k i l l s , enhanced the l o n e l i n e s s and i s o l a t i o n . In t h i s stage, i n addition to the worsening problems regarding family r e l a t i o n s h i p s and the lack of the social-system support, the victims had to struggle with tasks which the adolescence, as a developmental stage requires. Peers at t h i s stage are very important, but the sequels of the sexual abuse which include problems of t r u s t i n g others, fear of intimacy, a l i e n a t i o n , low self-esteem and f e e l i n g d i f f e r e n t prevented the victims from developing normal s o c i a l f r i e n d s h i p s . Moving to a new place a f t e r the disclosure, was an event of c r i s i s f o r the v i c t i m s . They d i d not have s o c i a l s k i l l s , t h e i r a b i l i t y to cope with changes and with experiences of separation and loss were l i m i t e d . To change p h y s i c a l environment, schools and the few friends they had gave them the f e e l i n g of i n t e n s i f i e d problems. "I learned how to s o c i a l i z e and growing up, I t r i e d to be happy and achieving goals. I loved the school, I was i n French emersion and I was dancing every day. I was i n the swim team. I was i n everything. And then my mom decided to move. I t was easier for her to deal with her past. I didn't want to move from downtown Toronto to Richmond. In two weeks I got raped. I was at a new school. I didn't know anyone and raped. Everyone at the dance school hated me, people couldn't handle me, I couldn't make fri e n d s . So I became a t o t a l h elpless, I j u s t was very miserable." "In elementary school I was popular at the beginning. I don't know i f the abuse a f f e c t e d me, but l a t e r yes i t di d . . . I drank, I l i k e d to stay home, I didn't want to go out and see or t a l k to anybody, I had a l o t of crying, I was 15." Relationships with the opposite sex and the formation of sexual i d e n t i t y are also s i g n i f i c a n t features of the adolescent stage. The hope to get love, care and closeness through the r e l a t i o n s h i p s with t h e i r boyfriends was shattered and again, they f e l t v i c t i m i z e d . The r e l a t i o n s h i p s were problematic; on the one hand, the victims were a f r a i d of forming r e l a t i o n s h i p s , but on the other hand they were promiscuous. They were confused between care and love and 65 sexual r e l a t i o n s h i p s . They d i d not have the opportunity to l e t go of t h e i r f e e l i n g s regarding the sexual abuse experience, and seek to work out t h e i r c o n f l i c t s , which had re s u l t e d from the incest, within t h e i r heterosexual r e l a t i o n s h i p s . They could not master s o c i a l interpersonal s k i l l s and f e l t that the r o l e of being a v i c t i m goes on. "I was 13 when I r e a l l y l i k e d t h i s guy. He j u s t l i k e that I was a v i r g i n . He didn't r e a l l y l i k e me. Right from the f i r s t night he t r i e d to get to bed with me. That was r e a l l y scary. And he sa i d he doesn't want to see me anymore. I f e l t that I was gonna die. Then we were back together. This was the f i r s t time I stayed out a l l night... he was 16, I was 13. I didn't know about sex. A f t e r three months he l e f t me. I f e l t r e a l l y bad, because that's what he wanted and he got i t and I l e t him do i t . " "Like guys you know. They came up to you and you must meet a guy and he says 'you're very a t t r a c t i v e or you're pretty' or something, I laugh at him because I think that he's j u s t making a pass at me, I don't think he r e a l l y means i t . He j u s t wants to sleep with me, that's a l l I think, r i g h t , so that's I'm very s e n s i t i v e to. And he could be, l i k e , r e a l l y sincere and we could be, l i k e , j u s t t o t a l friends but I'd s t i l l think that, unless he was gay." "I had problems with men, because I kept demanding so much from them. I don't know, I j u s t f e l t they were not there for me when I needed them. I j u s t needed so much love and i f they didn't give i t to me I j u s t got so fr u s t r a t e d . " For the victims, the sexual s i t u a t i o n s aroused unresolved problems connected to t h e i r traumatic experiences. I t seems that the victims engaged i n heterosexual r e l a t i o n s that were not sexually or emotionally s a t i s f y i n g . Having boyfriends meant to be a v i c t i m i n several ways, i t included being a p r o s t i t u t e , as one of them described: "I was sixteen and then I met t h i s guy and he made me l i k e him a l o t and then he'd turn around he sa i d 'I can't see you anymore because I don't have very much money and t h i s g i r l o f f e r e d to work for me and s t u f f and I l i k e d him so much. I sa i d that I ' l l work for him because I want to be with him so I went out and started working the s t r e e t again." Searching f o r an i d e n t i t y and for a firm self-concept also i n t e n s i f i e d the stress and the sense of problems worsening. One bu i l d s his/her i d e n t i t y through experiences, r e l a t i o n s h i p with parents and peers who provide a mirror 66 function. For the victims t h i s task was very confusing. As sexual-abuse victims they perceived themselves as worthless, d i r t y , ugly, powerless and loners. These f e e l i n g s became more problematic because the peer r e l a t i o n s h i p as well as r e l a t i o n s with the opposite sex were very problematic. They described negative s e l f concept, confusion and questioning t h e i r normality: "I didn't know who I was, and I had a low self-esteem. That's why I had to ask people, I didn't know to whom to b e l i e v e . " "They thought I was psycho, because I was, I also thought that I'm crazy." "A number of things af f e c t e d my l i f e - the sexual abuse i s one and the way my dad made me f e e l . I could never do anything r i g h t . I have been c a l l e d 'stupid', I have been c a l l e d names. I s t i l l don't have a good self-image. I f e l t l i k e worthless as human being then I shut myself out of people. I thought that I'm such an ugly person and hated myself so much." "I was bulimic, anoretic, and I had sex at f i f t e e n and doing pots and j u s t had rape. But a l l the adolescents are going through those things. I don't f e e l d i f f e r e n t from others. So I think that I'm d i f f e r e n t from most people. But I d i d not know i f i t s a combination of a l l what happened to me. I know that my reactions are the same to persons that went throughout those experiences. The f e e l i n g s , the anxieties, the i n s e c u r i t y , the traumatic s t r e s s . " The pro f e s s i o n a l s , as described e a r l i e r , were not s e n s i t i v e to the needs and the problems of the victims and by that they also a f f e c t e d the vic t i m s ' a t t i t u d e s toward themeselves, t h e i r i d e n t i t y and t h e i r negative self-concept. As one r e c a l l e d : "At the time to me they weren't people, l i k e , they didn't care they were j u s t putting me l i k e you're a piece of paper, l i k e , you go on t h i s shelf, and you go on t h i s s h e l f . I didn't f e e l l i k e I was being treated l i k e a human being." The i d e n t i t y was very f r a g i l e , and others' attitudes or comments were very powerful and destructive i n the process of searching the s e l f . The sexual behaviour i s inappropriate to the c h i l d ' s development. Instead of having and experiencing love, warmth and. security, which are very important to the 67 process of b u i l d i n g p o s i t i v e self-esteem, the c h i l d experiences fear, b e t r a y a l , l o n e l i n e s s , being d i f f e r e n t , being bad, unworthy, rejected and so on. These f e e l i n g s contributed to the victi m s ' low self-esteem. As was expressed by one of the victims, "People can say whatever they want and other people, they can go "Well, I don't care", that's t h e i r opinion, you know, but I can't do that. Its hard enough as i t i s for me to connect with people and when people l i k e me, i t s r e a l l y hard for me to do that, and i f someone's j u s t walking i n the s t r e e t and they s a i d that to me, I would get r e a l l y offended and I would s t a r t to think, you know, well, am I dressed l i k e a s l u t , do I look l i k e a slut ? Why are they c a l l i n g me that?" The support resources f o r the victims were l i m i t e d as a r e s u l t of being sexually abused as well as due to growing up i n incestuous f a m i l i e s and the c h a r a c t e r i s t i c s they possess as was described i n the f i r s t stage. In t h i s stage i t i s demonstrated that a f t e r the disclosure the resources a v a i l a b l e to the victims have further narrowed down. The narrowing of the a v a i l a b l e resources was r e f l e c t e d i n three major areas: the family, the social-system's support and i n the vi c t i m s ' own resources. The family, that was dysfunctional to s t a r t with, remained unsupportive to the victims who satayed with t h e i r passive, dependent and confused mothers. The s i t u a t i o n was not much better regarding those victims who were removed to f o s t e r f a m i l i e s ; since these f a m i l i e s turned out to be problematic as well and caused the victims to f e e l that t h e i r problems continued and even got i n t e n s i f i e d . The victims had the expectations that many of t h e i r problems w i l l be resolved a f t e r the dis c l o s u r e . However, the family i n i t s role of the immediate surrounding again f a i l e d to be supportive, loving and care giving. The social-system support was minimal, and even when help was given i t was done i n a way that brought about c o n f l i c t s between the victims and the system representatives. The victims had the sense that they were misunderstood and that t h e i r problems emanating from 6 8 the sexual abuse experience were not properly addressed. Consequently, the fe e l i n g s of narrowing resources, powerlessness, helplessness and negative self-concept had a l l i n t e n s i f i e d . In add i t i o n to the narrowing of the external resources a v a i l a b l e to the victims, there was a narrowing of the victi m s ' inner resources r e s u l t i n g from the drain exerted by the needs accompanying the adolescent stage. Due to t h e i r s p e c i f i c s i t u a t i o n , the victims were not able to acquire the necessary tools to cope with the conventional problems present i n adolescence. In the s o c i a l arena, the f e e l i n g of lo n e l i n e s s had i n t e n s i f i e d , s o c i a l r e l a t i o n s with peers were a f a i l u r e and destructive and so i t was regarding the opposite sex. The self-concept, that was negative to begin with, worsened and questions l i k e 'who am I' and 'what i s my i d e n t i t y ' caused confusion, pain and helplessness. These negative f e e l i n g s became e s p e c i a l l y acute when juxtaposed with the lack of supportive i n d i v i d u a l s e i t h e r family members or others. In the ensuing category the victims' coping behaviour w i l l be discussed. CATEGORY I I I : COPING BEHAVIORS The victims had the sense that problems had worsened, the family as well as the professionals involved were not supportive, t h e i r self-concept was negative, peer r e l a t i o n s were also problematic, and t h e i r own resources were very l i m i t e d as a r e s u l t of lack of problem so l v i n g s k i l l s and t h e i r weak pers o n a l i t y . Two properties describe t h e i r coping behaviors: maladaptive behaviour and the suicide attempt. At the beginning of t h i s stage the victims continued to deal with the sexual abuse experience by suppressing and t r y i n g to forget i t . This was the 69 only way that they could handle i t , the lack of family and/or p r o f e s s i o n a l support caused the whole issue to remain a taboo. "I don't think that there's been r e a l l y anyone that's done anything, that was j u s t me, myself, l i k e , I helped myself out and talked to myself. Um, I couldn't, at the time, I couldn't r e a l l y open up and t e l l anybody about i t and I j u s t kept inside of me and f i l e d i t back i n the back of my head and j u s t t r i e d to forget about i t . " "At t h i s time I'm not r e a l l y sure why some things I couldn't remember because I've blocked them out of my head." The victims also t r i e d to deal with t h e i r problems by being good students and by being 'a good g i r l ' . One of them described her e f f o r t s to play the roles and rules that were expected of her, "Well, I didn't l i k e i t too much at the beginning because my s o c i a l worker and her - they sat down and they decided, well, I'm going to come i n at t h i s time and I'm going to school here and I'm going to do t h i s and I'm going to do that and i t s l i k e I had no choice l i k e they were taking over my l i f e and I wasn't used to that. I was used to staying out as lat e as I wanted or not coming home for days and j u s t doing whatever, you know, and they t o l d me that I have to be i n at l i k e , eight o'clock at night or something, and i t s l i k e , say what? I j u s t didn't understand i t at a l l . And I was always la t e so I got grounded a l o t . We went on for about a year and a h a l f . I played along with her and I went with her rules and s t u f f and then I couldn't take i t anymore and she was drinking a l l the time and my dad drank heavily so i t r e a l l y bothered me." As was described e a r l i e r , the victims were not equipped with the necessary s o c i a l or problem-solving s k i l l s . Their l i m i t e d resources and the lack of parental and otherwise support l e d them to an acting-out type of behaviour which i s a way of coping by gaining co n t r o l , e s p e c i a l l y so i n the adolescent stage. The victims t r i e d to a l l e v i a t e t h e i r fears and to f i n d support i n several ways such as using drugs, alcohol and other types of destructive behaviors. "I always f e l t alone no matter what. And I think that i t had a l o t with why I st a r t e d doing my own drugs and drinking, because I hated to ,feel alone. I t was b a s i c a l l y abandonment." "Having no i n h i b i t i o n , or boundaries of nothing, not from men, drugs, sex 70 j u s t nothing, no i n h i b i t i o n s . I didn't see the self- d e s t r u c t i v e n e s s when I started. When I was sixteen I was very bulimic too. I j u s t spent evenings eating and a f t e r a while I s t a r t e d to go out with r i c h people. I flew to Europe and I met t h i s Rock star so I got into drugs and drinking, sleeping around, and I didn't think that something was wrong, because I didn't have any boundaries. When I got to a new place and people ask "where are you from" I j u s t say Canada. I j u s t f e l t that I had no home, I didn't consider Vancouver as a home, because I d i d have only few peers. And I hated i t . With that lack of any foundation i n my mind I could do everything, go everywhere any time. I r a r e l y c a l l e d home, I thought i t was wonderful and f i n e but eventually my l i f e became miserable because I had no foundation, I didn't f e e l loved, I didn't love myself. I was s e l f -d estructive, I kept demanding more and more stress to get comfortable, because my l i f e was so s t r e s s f u l . " The victims f e l t i s o l a t e d and lonely. The peer r e l a t i o n s h i p s were problematic, as was discussed e a r l i e r , and they suffered from a negative s e l f -concept. They found themselves associated with outside marginal peer-groups of rejectees. At t h i s age having s o c i a l friendships, peers and boyfriends are very c r u c i a l and important. Although these were friendships with problematic peers, i t was a way to cope with t h e i r own fee l i n g s of being rejected and powerless. They found comfort and belongingness among these peers: "There was a whole bunch of us, l i k e , j u s t one b i g gang of people and a couple of us g i r l s were runaways, there were some from New West and one from Burnaby and there were two of us from Vancouver and us g i r l s , we a l l hung around together because we're a l l l i k e , the same thing and urn, I don't know, we'd j u s t stay up a l l night partying and i f we got t i r e d we s l e p t on the bus bench at the loop and there was a roof over top of i t so we didn't get wet i f i t was r a i n i n g . We used to go into 7/11 and we'd s t e a l things and we used to go down to F i e l d s and we'd t r y on jeans and put our own jeans over top of them and walk out with them and we used to crash at people's places, l i k e , guy's houses a l l the time and s t u f f l i k e that." "The parents i n the f o s t e r home did not pay any a t t e n t i o n to me, they have t h e i r own baby. I f e l t again l o n e l i n e s s , that no one cared about me, i t was again, l i k e i n my own family that I ran-away. So I ran away again to the s t r e e t , there I had care from the other s t r e e t k i d s . " The victims at t h i s stage were adolescents. The coping mechanisms, such as pretending, dreaming and imagining, which worked at the f i r s t stage, when they were younger, d i d not work any longer. At t h i s age the desire to have 71 c o n t r o l i s very c r u c i a l . Acting-out, rebelliousness, withdrawal or p h y s i c a l separation from the problems are means by which an adolescent may choose to cope with the problems experienced during t h i s stage. The victims choose a v a r i e t y of destructive types of behaviour i n order to gain c o n t r o l over t h e i r i n t e r n a l t e r r o r i z e d environment, fears, l o n e l i n e s s , helplessness, low s e l f -esteem, r e j e c t i o n and confusion. This second stage ended with the victim's suicide attempt. The progressive f a i l u r e of both the adaptive and maladaptive types of behaviour for coping with ongoing problems which have i n t e n s i f i e d during t h i s stage, and the lack of coping s k i l l s had led the victims to a progressive i s o l a t i o n from meaningful s o c i a l r e l a t i o n s h i p s , and to the sense that there was no way out, and that s u i c i d e was the only s o l u t i o n . The s u i c i d a l i d e a t i o n had been with the victims ever since they were youngsters, as they described: "I have thought about suicide l o t s of times." "I was used to think about i t a l o t , I think. I remember myself t e l l i n g once my mother "you know yesterday I sat on the window t r y i n g to k i l l m y s e l f , and she s a i d as always 'Oh', because she was l i k e a stone a l l the time. So, you see I couldn't get any reaction." Another v i c t i m , whose father had committed suicide when she was 11 years old, and two of her friends committed suicide as well, ate lead poison at the age of eight, and r e c a l l e d having s u i c i d a l ideation since she was 13 years of age. She described: "I was v i o l e n t , vulgar, l i k e r e a l l y ugly. I think even I was around 13, I was r e a l l y s u i c i d a l . I used to say ' I ' l l commit s u i c i d e ' . I also remember st r a n g l i n g myself with a nylon bag and I think that a few times I wanted to use a k n i f e , and I d i d not." The s u i c i d a l i d e ation was translated into action i n t h i s stage, a f t e r the incest victims who experienced e x p l o i t a t i o n , pain and t e r r o r saw few options beyond death as a way to avoid further trauma and problems. This act might 72 have played a r o l e of gaining c o n t r o l or a 'cry for help'. They d i d not have the s o c i a l s k i l l s or were a f r a i d of asking f or help, and through t h i s act they t r i e d to get support. These victims, who through t h e i r childhood have not had a stable home, and lov i n g and protective parents, could not have developed appropriate coping s k i l l s to exercise and tol e r a t e the stresses and f r u s t r a -tions accompanying the sexual abuse e f f e c t s along with the adolescent stage problems. They have not had the gradual lessening of the symbiotic t i e s from t h e i r parents, have not gained t r u s t and sec u r i t y at home, had not developed s o c i a l i z a t i o n s k i l l s , and have been trained to be both dependent and passive i n seeking help i n times of str e s s . The t r i g g e r , i n a l l the suicide attempts, was connected to problems and c r i s e s i n the r e l a t i o n s h i p s with a boyfriend. As described e a r l i e r , the re l a t i o n s h i p s with the opposite sex i n adolescence are very important and meaningful. For the victims, these r e l a t i o n s h i p s were attempts at b u i l d i n g a new u n i t of love, care and closeness which they were deprived of ever since t h e i r childhood. When the c r i s i s with t h e i r boyfriends happened, the sense of f a i l u r e and of being hated, i s o l a t e d , and unprotected was overwhelming. These c r i s e s and events opened up scares, fears, pain, l o n e l i n e s s , anger and helplessness which they denied and suppressed, and at that point i n the process i t was too overwhelming and impossible to handle any longer. As was described: "He (the boyfriend) wanted me to work (as a p r o s t i t u t e ) and I didn't want to anymore, and I wanted to be with him a l l the time and i f I didn't work he'd take me home and drop me o f f and we had t h i s b i g f i g h t and he didn't c a l l me f o r two days and I couldn't get him on the phone and I didn't know where he was so I was a l l upset and everything, I didn't want to be without him so I guess that's why I d i d that." A s i m i l a r experience was described by another v i c t i m : "I had a boyfriend, I was drunk at t h i s night and he didn't a r r i v e . I 73 c a l l e d another Saudi-Arabian guy, 'If you love me we have to f l y to Greece or somewhere' I t o l d him. Anyway I ended up i n Greece leaving t h i s boyfriend. I don't know i f I loved him or not. I was screwed up. He (the Saudi-Arabian guy) was a coke addict, he had a boat with tons of drugs, I constantly had drugs and kept drinking. I f e l t t o t a l l y l i k e an object. They spoke Arabic, I couldn't speak t h i s language, I didn't have money. I f e l t l i k e a piece, a t o t a l piece, l i k e a t o t a l p r o s t i t u t e . And one night I don't r e a l l y know what happened. They s a i d that I t r i e d to jump up out of the boat. I grabbed razors and cut my wrists, there was blood everywhere. They s a i d that I kept saying 'Nobody loves me anymore'. I was so f r u s t r a t e d . He was f l i r t i n g with t h i s Turkish g i r l , i n the ship and I knew what's going on. I t was completely f e e l i n g of helplessness. No one to t a l k to, no one would believe me. I j u s t f e l t t o t a l l y h elpless and f r u s t r a t e d and I j u s t couldn't handle i t any more. I j u s t f e l t l i k e a v i c t i m and h e l p l e s s . I t was the same f e e l i n g of being abused." When the question "What were the contributors to the suicide attempt" was asked they provided the following descriptions: "Drugs, alcohol, problems with men, and low self-esteem and f e e l i n g of not having a foundation, f e e l i n g unloved, f e e l i n g empty. I hated my l i f e , I hated everything. My a l l a t t i t u d e s , my anxiety, my ideas about sex and r e l a t i o n s h i p s which were very d i s t o r t e d because of my childhood and the sexual abuse, a l l of these contributed to t h i s . And I'm always seeking love from the wrong people." "I f e l t l i k e nobody cared about me and nobody w i l l ever care about me. People always j u s t hurt me and I j u s t , I wished I was dead. I didn't understand l i k e , why was I ever born? Was I born to be abused and hurt and suffer? So I d i d not understand i t . " The tunnel v i s i o n and dichotomous thinking were also described as contributors to the suicide attempt, "Its (the s u i c i d e attempt) got to do with my boyfriend but a l o t of i t i s got to do with my abuse because that put me i n a s i t u a t i o n where I f e l t that nobody cares about me, and nobody loves me and my dad never loved me, how could he love me and do that to me. And that makes me look at my boyfriend and say, well, he doesn't love me, i f he loved me he wouldn't make me work the s t r e e t , he wouldn't tr e a t me l i k e t h i s . So he obviously doesn't love me. My mother doesn't, she doesn't care about me, otherwise she wouldn't have sent me there and I j u s t f e l t a l l alone and everything. I had no one I could t a l k to about i t and I had a l l t h i s s t u f f kept inside of me and I couldn't get i t out. I didn't know what else to do so that's what I did." "I j u s t didn't f e e l I have any reason for leaving. I can't explain why I f e l t r e a l l y dark and empty, very, very alone. I was f e e l i n g very extreme to the point where I didn't think l o g i c a l l y . I f e l t so empty, that there i s nothing, no boundaries again. Like now, for example, I think i n the 74 same s i t u a t i o n , I can think I have a job, I have my boyfriend, I have my mom, I have so many things, then I hadn't nothing. I t was j u s t l i k e completely out of c o n t r o l . " The victims described lack of a v a i l a b l e help as one of the c r u c i a l contributors to the suicide attempt. They were subjected to progressive i s o l a t i o n from meaningful s o c i a l r e l a t i o n s h i p s , family and profe s s i o n a l s . One of them described her fear of getting help from peers and s t a f f i n the group home because she thought that they might control her, she preferred to attempt sui c i d e , which she perceived as having c o n t r o l , rather than asking for help and r i s k i n g her 'freedom' by having others control her. "I knew that i f I t o l d them, they'd watch me, you know, they'd come down and check on me and everything and urn, I didn't want them to do that, you know, then I'd f e e l l i k e , I don't know, I'd f e e l r e a l l y bad, and I'd j u s t , I'd hate i t , I'd move out, I'd run away or j u s t not come home for long periods of time and s t u f f . " Even when they asked for help before the suicide attempt they d i d not get i t . As one v i c t i m described her l a s t "cry for help" from her boyfriend: "When I took them (the p i l l s ) I c a l l e d him, he asked why I was c a l l i n g him and I s a i d because I wanted to t a l k to him, and um, l i k e , we had a f i g h t a couple of days before t h i s and he wasn't t a l k i n g to me and I asked him, l i k e didn't he hate me now or what? and he sa i d 'No, I don't hate you' and, um, he sa i d 'Well, I'm r e a l l y t i r e d and I'm going to go to sleep' and I heard people i n the background and I heard a g i r l ' s voice that I didn't recognize and I didn't know, I was crying on the phone and I said, 'I need to t a l k to you' and he sa i d 'Well, I ' l l t a l k to you tomorrow' and I said, 'No, I need to t a l k to you now' and he sa i d 'well, I'm r e a l l y t i r e d and I'm going to go so i f you don't say goodbye then I'm j u s t going to hang up' so, um, I said, 'Fine, then' and I hung up on him and I went back to my room and I shut the door." The victims who had more than one suicide attempt described lack of family and pro f e s s i o n a l help even a f t e r the suicide attempt had occurred, and then the f e e l i n g of being alone and not getting help was enhanced: "I have been i n N.Y. and flew to Seattle. I was so screwed up, and I did not get at t e n t i o n from him (boyfriend) I broke up a l l the mirrors, I s l i t my wrist. He was freaked out and sent me home. When I got home I think i t was a couple of nights l a t e r . A f t e r a l l t h i s trauma I have been staying alone i n my apartment. My mom asked me i f I want to go to my grandma or 75 the shrink's house. Why should I go to the fucking shrink's house? I j u s t wanted love and didn't want to go to a p s y c h i a t r i c ward. And when I came from Seattle I wanted to l i v e with my grandmother and she s a i d 'no'. And then I got scared because I thought they also get scared of me, they thought I was psycho, because I was, I also thought that I'm crazy. I admitted myself to a p s y c h i a t r i c ward that night, a f t e r the attempted sui c i d e (the second one). I was there one night. And then I s a i d fuck that, I'm going back to modeling and make a l o t of money. Because the doctors t o t a l l y didn't understand me." A s i m i l a r r e c o l l e c t i o n was described by another v i c t i m : "I can remember when I was 17 I t o l d my mom I'm s i c k of t h i s pain and emptiness. I f e l t that she s t i l l didn't hear me. I don't know what I expected her to do. I wanted her to do something, but she didn't know what to do. A f t e r I slashed my wrists I c a l l e d her to say: 'Mom, do you think coming over staying with me two or three days?' I t seem obvious i f your daughter taking drugs or... don't you think spending sometimes with her? A f t e r the attempted suicide I thought they would take me more se r i o u s l y or put more attention to me but instead the p s y c h i a t r i s t t o l d them: 'You have to p u l l back, there i s nothing you can do. You have to p u l l back they are on s u i c i d a l t r i p . ' I f e l t j u s t alone as ever before." The second stage, which began with the disclosure e n t a i l e d changes i n the v i c t i m s ' l i f v e s . Throughout t h i s stage problems escalated and resources narrowed. Stopping the sexual abuse a f t e r the disclosure created only a short r e l i e f f o r the victims and rather e n t a i l e d e s c a l a t i o n of problems and narrowed t h e i r resources. The victims, whether they stayed with t h e i r mothers or removed from home, had a c r i s i s . Moving to a new place was not an easy change to handle. Separation and loss were problematic features for the victims since t h e i r childhood due to up-bringing i n incestuous f a m i l i e s . They were not prepared to exercise changes and the lack of secure r e l a t i o n s , and s o c i a l and coping s k i l l s enhanced t h e i r f e e l i n g s of i s o l a t i o n , fears, helplessness, anger and powerlessness. Narrowing support occurred i n the family system. The r e l a t i o n s with the offenders were cut o f f but the mothers could not provide the support, love, care and other of the victims' needs as a r e s u l t of being dependent, passive and problematic themselves. The social-system support such as, s o c i a l workers or teachers, d i d not provide help and support, and when 76 provided i t was inadequate. The f e e l i n g s of i s o l a t i o n , powerlessness and not being protected increased also by the adolescent tasks: forming peer r e l a t i o n s h i p and the searching for self-concept and i d e n t i t y . The f e e l i n g s of being unworthy, ugly, bad, abnormal and d i f f e r e n t were common among the v i c t i m s . They t r i e d a v a r i e t y of ways of adaptive and maladaptive coping mechanisms i n order to cope with t h e i r problems. The progressive f a i l u r e to resolve t h e i r ongoing problems and the progressive i s o l a t i o n from meaningful f a m i l i a l , s o c i a l and p r o f e s s i o n a l r e l a t i o n s h i p s contributed to the perception that the only way to resolve t h e i r problems was by attempting s u i c i d e . The suicide attempt was a turning point which ended the second stage and s t a r t e d new stage f o r the v i c t i m s . The suicide attempt was the d r i v i n g force of the beginning of the healing process which i s presented i n the next and l a s t stag of the process. STAGE I I I : THE HEALING PROCESS The s u i c i d e attempt e n t a i l e d changes i n the victims' l i v e s and seems to have catalyzed a new stage characterized by a healing process. The suicide attempts were accompanied by ambivalent f e e l i n g s of a 'wish to die' and of a 'cry for help'. The victims ' h i t the bottom' and might have r e a l i z e d that a d r a s t i c change had to take place. A f t e r the suicide attempt, three of them were h o s p i t a l i z e d and i n addition received a more intensive and appropriate help and support from t h e i r f a m i l i e s and p r o f e s s i o n a l s . This may also explain the beginning of the healing process. This stage includes one category: the beginning of the healing process. Two properties which comprise t h i s category ( i ) dealing with the sexual abuse and ( i i ) the development of new coping s k i l l s . This stage i s depicted i n Figure 4. Figure 4: Schematics of Stage 3 TYPES, DIMENSIONS AND CONDITIONS PROPERTIES CATEGORIES STAGE 3 -The "second-disclosure" -Collecting information regarding the abuse and the offender -Expressing emotions regarding the abuse -Planning confrontation with the offender -Seeking help and support from family, friends and professionals -Cognitive change -Different ways to deal with problems -Becoming helpers to others -Plans for the future Dealing With The Sexual Abuse Developing New Coping Skills The Beginning Of The Healing Process The Healing Process At t h i s stage the victims described a change i n t h e i r ways of dealing with the sexual abuse experience. Instead of suppressing or f o r g e t t i n g the experience they t a l k about i t with friends, family members or p r o f e s s i o n a l s . For them i t became the 'second-disclosure' opportunity and a breaking of the secrecy i n a d i f f e r e n t way than that which happened i n the second stage, when they were younger. Now they are more mature, les s ashamed, have more understanding of the dynamics of the sexual abuse experience and f e e l more capable of speaking about and dealing with i t . They t r y to explore and to f i n d the connection between t h e i r l i v e s , the process they had gone through and the sexual abuse. Talking about the sexual abuse gave them a sense of r e l i e f , of no more keeping the b i g secret. One of them expressed how the disclosure to her s i b l i n g s , 5 years a f t e r the 'formal' d i s c l o s u r e , was important and made her c l o s e r to them than before: "I went to them (her s i s t e r s ) and I t o l d them. I t j u s t came out of me. I couldn't stop once I s t a r t e d and I t o l d them everything that happened. We c r i e d . Then i t brought me and my older s i s t e r together... I want everybody to know about i t , you know, i t s l i k e a b i g secret to me and i t hurts to hold i t i n s i d e . " 78 The victims also t r i e d to get information and/or to discuss the sexual abuse with t h e i r mothers or t h e i r s i b l i n g s . When they were c h i l d r e n t h e i r memories were b l u r r e d and i n a d d i t i o n they d i d not r e a l l y understand what had happened; now they are eager to have more information as means of having more co n t r o l . They make e f f o r t s 'to put small pieces together' i n order to have a c l e a r e r p i c t u r e about the sexual abuse experience. "About two months ago I t r i e d to ask her (the mother) questions about that 'Did I show something?' But she couldn't remember what." " I t was a long time, nobody knew about i t , t i l l my aunt knew about i t . I f e l t g u i l t y , I f e l t r e a l l y ugly and everything, but my mom, j u s t mention that my aunt used to see him also for money." At t h i s stage, the connection between the sexual abuse and the v i c t i m s ' present f e e l i n g s gave them a sense of c o n t r o l and decreased t h e i r fears, "Now I know that my reactions and my emotions are the same as persons who went through these experiences. The f e e l i n g s , the anxiousness, the i n s e c u r i t y , the traumatic stress are connected to the sexual abuse." The victims i n t h i s stage are more capable of expressing t h e i r emotions and fears than before. Expressing anger, for example, became a common feature which was addressed toward t h e i r offenders, t h e i r mothers or others, instead of i n v e r t i n g i t and hurting themselves. As one of them described her anger and revenge toward her father: "No, I hate him, thoroughly. I f e e l sorry for him maybe, that's about as p o s i t i v e as I can get. To me he should be slowly, slowly tortured, long and p a i n f u l death and i f i t were not to k i l l him he should have h i s tongue cut out so he can't say nothing, he should be b l i n d so he can't see any female, and deaf so he can't hear any female, with no hand so he can't touch anybody and that would leave him able to stand and walk around and bump into things and s t u f f . He'd be t o t a l l y nuts. I t ' s the best punishment I could ever give him to make him a vegetable, to have to s i t i n a c h a i r . . . That means, that's because of my anger for him." Plans of confronting the offenders s t i l l arose fears. The victims are a f r a i d of meeting the offenders and t r y to avoid them but planning the meeting i n and by i t s e l f gives them a sense of control, a sense of hope to work on the 79 'unfinished business' of the sexual abuse experience. "Sometimes I think I ' l l plan for i t . Because I always know where he i s . I know where he i s r i g h t now. I have for the past couple of years. I thought of blowing up h i s apartment b u i l d i n g but then I'd injure innocent people, so I haven't done that. And I thought of taking a guy with me, l i k e , a b i g guy and go down and have t h i s guy beat him up and see how he l i k e s i t and say everything that I ever wanted to say to him with t h i s person here with me and then I know that I'm safe and he can't do nothing to me." The victims also searched for information and explanation regarding the sexual abuse. They t r i e d to c o l l e c t information about t h e i r parents' f a m i l i e s of o r i g i n and to see how the problems had been transmitted from generation to generation. Through t h i s searching they t r i e d to understand the abusive behaviour and to answer the c r u c i a l question "Why d i d my father molest me?" "I know that he's s i c k and he's had a rough childhood himself. Like, he's been abused sexually by h i s mother. His father shot himself i n the head when he was young. He committed suicide, h i s dad did, my grandfather, from what I was t o l d by my grandmother." During t h i s stage, there i s a change i n the way of coping with the sexual abuse experience. E a r l i e r , they t r i e d to suppress, forget, pretend or use s e l f - d e s t r u c t i v e behaviour to a l l e v i a t e and cope with the pain and the other emotions r e s u l t i n g from the sexual abuse experience. In t h i s stage, t h e i r behaviors and ways of coping are productive and adaptive. They t r y to gain more c o n t r o l and power by planning confrontation with the offenders; getting information about t h e i r molestation from s i b l i n g s or t h e i r mothers; making connection between the molestation, the family dynamics, and t h e i r parents' f a m i l i e s of o r i g i n . They are more open to discuss t h e i r molestation with f r i e n d s , family members and professionals. They express f e e l i n g s of anger, revenge, lon e l i n e s s and fears more f r e e l y than before. At t h i s stage the victims started to use others' help and support. They used p r o f e s s i o n a l help as well as peers and family members. I t was a 80 meaningful but not an easy change. One of the victims, who l i v e d i n a group home, described that even a f t e r being there for two years she s t i l l d i d not have t r u s t and closeness to the other g i r l s as well as to the s t a f f . In t h i s stage, change took place. I t had taken her a long time to f e e l secure and to t r u s t others, but the suicide attempt and the s o c i a l worker's support made an important s h i f t , as she expressed i t : "When I was used to I used to have a r e a l l y bad, Carolyn c a l l e d i t l i k e , a wall that's i n v i s i b l e but i t s a l l around me and nobody can get to me unless I want them to, l i k e , here there's a l o t of hugging and l i k e , we c a l l i t hug therapy and we a l l cry and we a l l have l i k e , one b i g group you know, everybody hugs each other i n one b i g group c i r c l e and s t u f f l i k e that. When I f i r s t moved i n , nobody could touch me or come near me and I talked to people only i f I wanted to otherwise I would get up and I'd get up and walk away while they're t a l k i n g to me, you know, i f i t was something I didn't want to hear or something I didn't want to t a l k about, I'd j u s t get up and walk away. With Carolyn, i t took her a long, long time, l i k e , she's r e a l l y good, l i k e , t h i s i s the best group home i n Vancouver, I think, and i t took her a long, long time to break through to me but when, I don't know, I guess, she puts i t l i k e when I s t a r t e d getting to a point when I was bringing i t down a b i t , I'd come up and I'd put my arm around her neck so her head would be r i g h t here and t h i s i s about as close to a hug as I could get, you know, I'd be behind her so she couldn't hug me so I'm safe that way. I can sort of hug her and be safe without having her hug me because i t would upset me. That's why I was scared of getting upset, someone touches me I'm going to cry and I didn't want to cry so I'd always avoid a l l these things that would make me get upset." When the question "What advice would you give to adolescents i n your s i t u a t i o n ? " was asked, they provided a d e s c r i p t i o n of the cognitive changes that had begun a f t e r the suicide attempt, and which had contributed to the expansion of t h e i r problem-solving s k i l l s . "Talk to somebody, t a l k to people, t a l k to anybody i f you can t a l k to your parents, j u s t t r y to t a l k to one person at l e a s t , t r y to say everything. I have never talked to anybody about everything. I t o l d pieces to d i f f e r e n t people, but j u s t t a l k to someone that you t r u s t , now I know i t i s very important. To t e l l everything, I kept everything in s i d e , making a l l my own decisions without having any clue what I'm doing. There i s no way you can handle i t alone. You have to v e r b a l i z e what you are f e e l i n g . I have never v e r b a l i z e d i t and i t came i n strong ways - s e l f destructive, s u i c i d e . I t ' s also the intimacy that you have when you are doing that, you can t e l l everything when you t r u s t me. I 81 have never trusted people that maybe why I couldn't t e l l people about i t . But doing that you s t a r t to develop t r u s t . When you don't have t r u s t everything j u s t so imbalance." "My mom and my s i s t e r don't know about i t (the attempted s u i c i d e ) . My s i s t e r would k i l l me because her saying f or that i s 'That's the chicken's way out' which i s true. I mean you can't cope with l i f e and the people around you then, and you want to k i l l y o u r s e l f i t means that you're not strong enough to survive and you're j u s t being a chicken.... I t was l i k e a stupid thing to do and I regret doing i t , I'm glad I'm not dead or anything but I'm j u s t , I didn't want to t e l l them, I was embarrassed about i t , I'm embarrassed about i t now." At t h i s stage su i c i d e attempt i s no longer a s o l u t i o n f o r problems and stress. The dichotomous thinking had changed, they could recognize more adaptive ways to deal with problems. "I think I ' l l never do that (suicide attempt) again. I t made me strong, because at that time I was going through a l o t and I made i t through that, and people t e l l me well, you're a f i g h t e r , and I think now, i t doesn't matter what happens to me, I ' l l always be strong and I ' l l get through i t . ' You know. And i t also made me r e a l i z e that I can't keep..." "I was f e e l i n g very extreme to the point where I didn't think l o g i c a l l y , I f e l t so empty (at the time of the attempted s u i c i d e ) , that there i s nothing, no boundaries. Like now, for example, I think i n the same s i t u a t i o n , I can think I have a job, I have my boyfriend, I have my mom, I have so many things." "I wouldn't t e l l them to commit suicide, that's f or sure. I f anything I'd t e l l them to t a l k to someone and i f they can't t a l k to someone, to write i t a l l down on a piece of paper and then you could e i t h e r r i p i t up or burn i t or save i t 'cause you have to get your problems out of your system or even l i k e , i t s better to t a l k to someone about i t . " "My emotions switch up and down. When I have hard time I'm saying to myself that ' i t w i l l go away'. I t ' s not suicide, i t ' s hating waking up i n the morning, hating to do things, hating myself. But I keep saying I had hard time and I have got over them well enough, things get better, things get worse, but things always get better again. That nothing i s bad enough to k i l l y o u rself." "I always was desperate to someone to understand me, to help me, help me, help me. I didn't know what's going on. Now, today I f e e l the need to t a l k but I don't go around screaming l i k e , c rying f o r help l i k e teenagers do. I'm sure that I'm crying for help but I'm not going to t e l l everybody. Now I know that I can t a l k to my t h e r a p i s t . " The victims also s t a r t e d to deal d i f f e r e n t l y with problems r e l a t e d to the 82 r e l a t i o n s h i p s with the opposite sex and t h e i r sexuality. They talked about discussing and negotiating issues and problems instead of p o s i t i o n i n g themselves i n the v i c t i m r o l e . "With me at the time, I had problems with my boyfriend, for instance, so i f there was someone and they were having problems with t h e i r boyfriend, I would t r y to suggest, l i k e , to s i t down and t a l k with them about t h i s , and f i n d out what's r e a l l y going on and why he's acting that way." "I was sexually abused, I had a hard time dealing with i t , blaming myself, thinking that I am a r e a l l y ugly person because men s l e p t with me. I didn't want to, but I couldn't say no. Now I keep saying to myself i t was not my f a u l t , there are circumstances, something i n my mind, holding me of standing up and saying: 'Hey, I don't need you, I don't need you using me, fuck me and don't want know me anymore'. But now I s t a r t being more and more assertive, and I t r i e d not have r e l a t i o n s with disturbed people, l i k e s i c k guys i n t h e i r heads who s t i l l think about sex. " The victims themselves became helpers to other peers who were i n a s i m i l a r s i t u a t i o n . They expressed s e n s i t i v i t y and concern toward others who are going through the same experiences. I t seems l i k e a r o l e s h i f t i n g ; they st a r t e d a c t i n g as helpers thereby getting r i d of the victim's r o l e . "I was close to my brother before, but I kind of drew myself away about three years ago. He c a l l e d me and talked about s u i c i d e . I was r e a l l y worried about him, something seems r e a l l y wrong with him. My uncle s a i d "This i s the stage, he w i l l be okay" but s t i l l he d i d not get over i t . My brother phoned me up and s a i d he i s going to jump o f f the G r a n v i l l e bridge. I s t a r t e d crying. I t o l d him and for most people I ' l l t e l l that t h e y ' l l hurt more other people. I t wouldn't solve anything i f they make harm to themselves. I f I know them I j u s t t e l l them that I love them, I ' l l mention other people that love them. Try to t e l l them that i t ' s not worth i t . " "I can see i t coming, l i k e I know when people get to the point where they're going to do thing 'cause I know, I've been there and I can see i t happening and I w i l l go down and I w i l l , l i k e , one of them here, goes through a l o t of t h i s s t u f f and I went down to her room one time and I talked to her, you know, l i k e , she's new here so she doesn't r e a l l y understand too much, and she doesn't have anybody she can turn to and I made friends with her rather quickly and um, I went down and I s a i d you know, 'Is there something that you want to t a l k about, or something, you don't look l i k e you're too happy and s t u f f , r i g h t ' and I explained to her, l i k e , 'You don't have to worry, l i k e i f you don't want me to say anything to anybody else or s t a f f then I won't, you know, that's l i k e , that's up to you but i f you need to t a l k to me, I'm here, l i k e I'm here 83 f o r you and she did. Like, she s t a r t e d crying and she t o l d me a l l about what her problems were and s t u f f . . . We were both crying and then I cheered her up a f t e r she got everything o f f her chest, she f e l t better but ever since then she hasn't done anything. She knows that i f she does I ' l l be r e a l l y choked at her. That helps because she cares about me enough to not want me to be mad at her." The victims by t h e i r advice and suggestions as to how to help others who are i n s i m i l a r s i t u a t i o n s described the importance of providing a sense of love, care and support to s u i c i d a l people who f e e l l o n e l i n e s s , i s o l a t i o n and helplessness. The victims f e e l more hopeful about the future. They have productive plans and a c t i v i t i e s . They are again students, getting high school degrees, and plan on having more con t r o l over t h e i r l i v e s . "I'm doing upgrading r i g h t now so I guess I'd be i n grade eleven. Um, and I am also g e t t i n g my independent l i v i n g so I ' l l be l i v i n g out on my own. I'm s t i l l looking for an apartment. I've been looking since December for a place for January so now i t s l i k e February 1st, I'm moving. I've always wanted to be on my own, ever since I was t h i r t e e n years old. I wanted my own apartment, you know, and now I've got the chance to do i t so I'm r e a l l y happy but at the same time I'm sort of sad 'cause I'm going to miss everybody here." "I'm at school again, t h i s i s a way to go on, to f e e l better about yo u r s e l f about your self-worth." The suicide attempt was a catalyzer of the beginning of the healing process which has taken place i n the victims' l i v e s . The victims are i n treatment, t r y i n g to deal with t h e i r traumatic experiences -- the sexual abuse and i t s d e r i v a t i v e e f f e c t s . The victims started to develop new and better problem-solving and s o c i a l s k i l l s . As victims, growing up i n incestuous f a m i l i e s , the deprivation of love, care, security, support and normal development they were not able to develop s u f f i c i e n t and supportive s o c i a l s k i l l s which enhance t h e i r l o n e l i n e s s , powerlessness, low self-esteem and f r u s t r a t i o n that had l e d them to s e l f - d e s t r u c t i v e behaviour. In t h i s stage, a f t e r the suicide attempt, a change happened which l e d them to t r y and develop 8 4 d i f f e r e n t ways of dealing with t h e i r past experiences and the present s i t u a t i o n s . They perceive that there are more options to deal with problems, aside from s e l f - d e s t r u c t i v e behaviors, by getting help from others, by providing t h e i r help to others and by not perceiving the world i n a dichotomous way. They are more aware of t h e i r problems and are more w i l l i n g to face t h e i r s i t u a t i o n s and struggle with them. The process of healing i s i n the midst of i t s development. I t i s a p a i n f u l process escorted by resistance, ups and downs, confusion, fears and uncertainty however, i t i s also a process which provides a great sense of regaining the l o s t power and c o n t r o l . I t i s a process of hope and courage. 85 CHAPTER FIVE CONCLUSIONS AND IMPLICATIONS The i n t e n t of t h i s study has been to explore the experiences of female adolescents who were i n c e s t v i c t i m s and attempted s u i c i d e i n adolescence. The a n a l y s i s of the data, which had been obtained from i n t e r v i e w s , generated the ex i s t e n c e of a b a s i c s o c i a l process (BSP) which has provided a conceptual framework f o r the understanding of the v i c t i m s ' experiences. The data suggest that s u i c i d e attempt i s a s s o c i a t e d w i t h the i n c e s t experience however, causal r e l a t i o n s h i p between these two phenomena cannot be concluded. Several s t u d i e s support t h i s a s s e r t i o n , ( B r i e r and Runtz, 1986; B u t l e r , 1978; Goodwin, 1982; and F r e d r i c k et a l , 1985.) Regarding treatment, whether the s u i c i d e attempt has been caused by the i n c e s t experience i t s e l f or by other v a r i a b l e s such as the d y s f u n c t i o n a l f a m i l y ' s c h a r a c t e r i s t i c s , which were found by Tiecher and Jacobson (1966) as important f a c t o r s regarding adolescents who attempted s u i c i d e , does not matter much. The present data add to the b e t t e r i d e n t i f i c a t i o n and understanding of the experiences shared by these v i c t i m s and the v a r i o u s stages they have gone through which was the purpose of t h i s study. Their perceptions about t h e i r experiences, needs, f e e l i n g s , attempts and f a i l u r e s at coping w i t h t h e i r s i t u a t i o n s and t h e i r encounters w i t h s o c i a l - s y s t e m support c o n t r i b u t e s i g n i f i c a n t l y to the broadening of our understanding the issues i n v o l v e d which may l e a d us to provide and develop b e t t e r s e r v i c e s and support systems at both the p r a c t i c e and the p o l i c y l e v e l s . This study d e p i c t s three stages which comprise the process. The help f o r the v i c t i m s should be d i r e c t l y r e l a t e d to each of these stages and to the 86 s p e c i f i c needs and c h a r a c t e r i s t i c s of the problems faced by the victims as i s expressed i n each of the stages. This study also shows that three mutual l e v e l s of responsiveness occur during the victims' l i v e s throughout the process: ( i ) the i n d i v i d u a l , ( i i ) the family and ( i i i ) the environment. Suitable, adequate and e f f e c t i v e treatment dealing with sexual abuse victims should take these three l e v e l s of intervention into consideration. Neglecting one of them could l i m i t the effectiveness of the support a v a i l a b l e to the victims. Implications for Social-Work Practice and P o l i c y The f i r s t stage. 'Becoming a Victim', i s the stage during which the sexual abuse takes place. Secrecy i s one of the features of sexual abuse which takes place i n a closed family-system that prevents information from flowing w i t h i n and out of the family and hence, preventing p o t e n t i a l support from being given by e i t h e r the family members or the outsiders. In the f i r s t stage, there e x i s t many indic a t o r s that the lack of awareness contribute to continuation of the sexual abuse, sometimes for years. During t h i s stage, the only way to reach t h i s population i s by developing more awareness. Features common to these incestuous f a m i l i e s are being dysfunctional, a l c o h o l i c , v i o l e n t and plagued with marital problems. S o c i a l workers dealing with these f a m i l i e s should be more aware and s e n s i t i v e to the p o s s i b i l i t y that sexual-abuse might e x i s t i n these kinds of problematic f a m i l i e s . Teachers i n the school system who see t h e i r students d a i l y , could also contribute to i d e n t i f y sexually abused c h i l d r e n . They may i n t e r p r e t behavioral problems at school, the absence from school or symptoms of withdrawal and i s o l a t i o n of a c h i l d from peers as alarming signs pointing to problems at home po s s i b l y stemming 87 from sexual abuse. Family doctors also can i d e n t i f y symptoms and ind i c a t o r s which may r e s u l t from sexual abuse. Police o f f i c e r s who encounter run-away c h i l d r e n (as was the case with a l l the subjects i n t h i s study) might also i n t e r p r e t t h i s 'problematic' behaviour as a 'cry for help' on part of these c h i l d r e n who might have chosen t h i s o u t l e t to t e l l t h e i r secret of being victims of sexual assault. Educating these professionals as well as parents and broadening t h e i r information regarding t h i s issue may lead to the u n v e i l i n g of the secrecy e a r l i e r i n the process. Unveiling of the secrecy early i n the process i s a preventive strategy i n that i t might reduce the length of time of being a v i c t i m , which i n turn reduces the p o t e n t i a l cumulative trauma and the destructive sequels of the sexual abuse. As the data show, the sexual abuse had been accompanied by verbal and/or p h y s i c a l violence, by fears and by other psychological maltreatments which disrupted the c h i l d ' s development and her well-being. The f i r s t stage of t h i s process c a l l s f o r t h a p o l i c y which involves and develops p r o f e s s i o n a l and p u b l i c awareness. D i f f e r e n t l e v e l s of expertise, knowledge and programs should be designed to solve the problems alluded to above. During the second stage, which began with the disclosure, the victims described e s c a l a t i o n of problems. The various professionals were not aware of and d i d not have the knowledge concerning the dynamics and sequels of the sexual-abuse experience. Treatment and help, when provided, were l i m i t e d to apprehension or confrontation of the offenders. The victims had not been given treatment enabling them to deal with t h e i r sexual-abuse experiences. The intensive f e e l i n g s of powerlessness, helplessness, low self-esteem, anger and depression had been enhanced by the professionals' inadequate treatment. I t i s 88 of utmost importance to have the victims involved i n the discussions following the d i s c l o s u r e . Powerlessness and helplessness, as described by the victims, were very strong emotions experienced throughout the victim s ' l i v e s . Professionals, therefore, should be aware of and s e n s i t i v e to these fee l i n g s i n order not to i n t e n s i f y them and escalate the problems thereby leading to a power struggle which l a t e r on may r e s u l t i n s e l f - d e s t r u c t i v e behaviour. As was described by one of the victims, "No, that's more my s o c i a l worker. She j u s t took over my whole l i f e and made a l l the decisions for me and she didn't ask me or nothing. Like, she put me i n the re c e i v i n g home and then nine months l a t e r I found out I was being placed i n the fos t e r home and I had no idea... I'm r e a l l y mad because l i k e , I was r e a l l y shy and I was r e a l l y quiet so I wouldn't stand up for myself but i t made me r e a l l y angry that she didn't ask me l i k e , you know, what do I want? Where do I want to l i v e ? and s t u f f . " Children who have been sexually abused need a long-term therapy. The victims through t h e i r f e e l i n g s , i n t e r p r e t t h e i r external and i n t e r n a l world and t h i s influences t h e i r behaviour. Therapy should be the t o o l with which to help the victims express and a l l e v i a t e the fe e l i n g s they had suppressed and t r i e d to forget i n order to cope but, despite the e f f o r t s at suppression, as described by the victims, these f e e l i n g s emerged l a t e r i n the process, and were the most c r u c i a l contributors to the attempted s u i c i d e . Ignoring the sexual abuse and i t s e f f e c t s at the time intervention takes place amounts to narrowing of the c h i l d ' s support resources. The fe e l i n g s of being alone and powerless and the sense that no one cares, helps or protects even a f t e r the dis c l o s u r e , prevents the v i c t i m from seeking help l a t e r when he/she needs i t , f o r example, when the ideation of sui c i d e takes place. I t also narrows the victim's own resources because she continues to f e e l ugly, worthless, powerless and cannot therefore, transform these f e e l i n g s into a p o s i t i v e change regarding her s i t u a t i o n . 8 9 In therapy, helping the v i c t i m to develop new coping and s o c i a l s k i l l s i s very important. The f i r s t step required to achieve t h i s goal i s by providing 'corrective experience' through the therapeutic r e l a t i o n s h i p . Empathy, s e n s i t i v i t y and genuine attitudes on the part of the therapist, aside from knowledge and expertise i n the area, are c r u c i a l i n bringing the sexually-abused victims to therapy, e s p e c i a l l y so i n adolescence when the victims at t h i s age are much less l i k e l y to p a r t i c i p a t e i n long-term therapy. The therapeutic r e l a t i o n s h i p may involve strong expressions of anger, resistance and other transference reactions on the part of the victims however, i t i s also an opportunity for them to develop a sense of t r u s t , a sense that there are people from whom help can be obtained because they care about them. One of the victims expressed her fee l i n g s toward her s o c i a l worker i n a group-home as follows: "Well, we have, they have these groups and s t u f f , and people would t a l k and g i r l s have been there longer than I have, when I f i r s t moved i n so they were l i k e , r e a l l y , connected with Carolyn. Everybody l i k e s her. There's not one person that hates her when they move i n , I've seen g i r l s come and go through there, l i k e , I've been i n here longer than anybody since t h i s place opened and there's not one person I know that doesn't l i k e her... she's l i k e my second mom now, you know. I t a l k to her more than I t a l k to my own mom. I don't think that I could have opened up l i k e t h i s without her help." The findings of t h i s study also suggest that c l i n i c i a n s who work with sexual-abuse victims should be aware of the p o s s i b i l i t y that the victims may attempt s u i c i d e i n a d d i t i o n to the other adverse sequels of the sexual-abuse experience, e s p e c i a l l y so i n adolescence. C l i n i c i a n s should address i t i n a d i r e c t manner by asking about s u i c i d a l ideation or plans. At the family l e v e l , during the second stage ( a f t e r the d i s c l o s u r e ) , the data suggest that the professionals should put more e f f o r t to keep the c h i l d i n contact with her family. This u n i t of intervention i s very s i g n i f i c a n t i n 90 preventing the v i c t i m from being s u i c i d a l or from using other forms of s e l f -d estructive behaviour. The victims, although blaming, hating or being angry at t h e i r mothers, also express love, care and protective f e e l i n g s toward them. They longed f o r r e l a t i o n s h i p s with t h e i r mothers despite them being problematic, not supportive, dependent etc. An abrupt c u t - o f f from the family could be destructive f o r the v i c t i m f o r whom loss and separation are among the problematic features of growing up i n an incestuous family, e s p e c i a l l y so when the v i c t i m i s i n her adolescence - - a stage during which seperation and in d i v i d u a t i o n are of much s i g n i f i c a n c e and for which the v i c t i m had not been prepared to deal. P o l i c y concerning t h i s aspect should r e l a t e to the victim's family and e s p e c i a l l y the non-offender parent, the mother i n the present study, as a target u n i t f o r intervention regardless of whether the c h i l d stays with the mother or removed from home. Helping the mothers to deal with the s i t u a t i o n a f t e r the di s c l o s u r e amounts to the expanding of the resources a v a i l a b l e for the v i c t i m . Relationships characterized by a detachment from family members, af t e r the dis c l o s u r e , turn into j u s t another c r u c i a l component which leads to the i s o l a t i o n of the v i c t i m from meaningful s o c i a l r e l a t i o n s h i p s , a f a c t which has been i d e n t i f i e d as one of the features of s u i c i d a l behaviour. In cases where victims have been removed from home, p o l i c y should address the aspects concerning the pro t e c t i o n of the c h i l d and making sure the c h i l d i s not exposed to a v i c t i m i z i n g s i t u a t i o n any longer. I t i s not only the thorough examination of the sexually abused c h i l d ' s 'new family' which should c a r e f u l l y be addressed, but i t i s also the r e s p o n s i b i l i t y of the s o c i a l services to provide guidance to foster-home members about the c h i l d , h i s v u l n e r a b i l i t i e s and the problems they may be faced with him e s p e c i a l l y at the beginning. Victims who have fears, d i s t r u s t others, f e e l powerless and lon e l i n e s s could transform these fee l i n g s into acting-out type of a behaviour, a s i t u a t i o n which the f o s t e r family may not be able to handle properly. We should be aware of the f a c t that at t h i s stage the v i c t i m i s an adolescent whose rebelliousness and other acting-out types of behaviour are ways of handling, not j u s t the coping with the sexual abuse e f f e c t s , but also the tasks of separation and in d i v i d u a t i o n , and searching for an i d e n t i t y . I nterpreting these behaviors as problematic by the new family members and consequently punishing and/or threatening the v i c t i m j u s t enhance the victim's f e e l i n g s of being a v i c t i m , being abandoned, helpless and having no c o n t r o l , as one of them has described: "I didn't l i k e the f o s t e r home much at the beginning because my s o c i a l worker and her - they set down and they decided, well, I'm going to come i n at t h i s time and I'm going to school here and I'm going to do t h i s and I'm going to do that and i t s l i k e I had no choice, l i k e they were taking over my l i f e and I wasn't used to that. I was used to staying out as l a t e as I want or not coming home for days and j u s t doing whatever, you know, and then they t e l l me that I have to be i n at l i k e , eight o'clock at night or something, and i t s l i k e , say what? I j u s t didn't understand i t at a l l . And I was always l a t e so I got grounded a l o t . " The environment which includes the school system, peer groups, the community or other s o c i a l organizations, should also be accounted f o r i n the intervention strategy. As the data indicate, there e x i s t s mutual influence between the victims as i n d i v i d u a l s and the environment. The s e n s i t i v i t y and the adequate responses from the environment could expand the v i c t i m s ' network of support. I t may help to achieve a cognitive s h i f t i n the victims' perception that there are more resources for them to u t i l i z e apart from su i c i d e and other s e l f - d e s t r u c t i v e behaviours as ways of coping with t h e i r s t r e s s f u l s i t u a t i o n s . By excluding the victims from social-support systems which e x i s t i n the vic t i m s ' environment, e s p e c i a l l y the school system, the 92 victims w i l l remain stuck with t h e i r own and l i m i t e d resources. The environmental context i s s i g n i f i c a n t to the psychological process during t h i s stage. During the t h i r d stage, when the healing process begins a f t e r the suicide attempt, the therapist should be aware of the p o s s i b i l i t y that s u i c i d e attempt could happen again due to the f a c t that developing new coping s k i l l s i s a time consuming process. I t i s important to reframe the suicide attempt and other s e l f - d e s t r u c t i v e behaviors as coping and s u r v i v a l responses. By providing t h i s reframing they may gain more understanding of and i n s i g h t to t h e i r s e l f -d estructive behaviors and w i l l probably be less l i k e l y to cope i n l i k e manner i n the future. This stage i s a beginning of a new process that the victims are going through, a process of dealing with the sexual abuse, and developing new s o c i a l and coping s k i l l s . I t seems that the adolescents i n t h i s study have gotten appropriate help, though unfortunately only a f t e r the suicide attempt or a f t e r several attempts and not a f t e r the dis c l o s u r e . I t may be the case that i f t h i s kind of support would have been given to them immediately a f t e r the di s c l o s u r e , the s u i c i d e attempt might not have occured. The findings of t h i s study suggest that when working with s u i c i d a l adolescents, sexual abuse experiences should be investigated and examined. Sexual abuse i s a taboo topic, and by revealing the sexual abuse experiences and dealing with i n a proper manner we may be able to prevent the reoccurrence of such s u i c i d e attempts. As i s suggested i n the present study, attempting suicide can serve as a coping mechanism. 93 Further Research This study has explored the experiences of four non-sampled adolescents who were childhood incest victims and attempted suicide during adolescence. The findings of t h i s study and the l i m i t a t i o n s concerning the data set r a i s e several suggestions f o r further research which are h i g h l i g h t e d i n a point form. (1) Glaser and Strauss (1967) claim that the l e v e l of g e n e r a l i t y of the concepts derived from the raw data i s f l e x i b l e enough to be applicable to a v a r i e t y of s i t u a t i o n s , "To achieve a theory general enough to be applicable to the t o t a l p i c t u r e , i t i s more important to accumulate a vast number of diverse q u a l i t a t i v e f a c t s on many d i f f e r e n t s i t u a t i o n s i n the area. This d i v e r s i t y f a c i l i t a t e s the development of a theory with both a s u f f i c i e n t number of general concepts relevant to most s i t u a t i o n s and p l a u s i b l e r e l a t i o n s among these categories to account for much everyday behaviour i n the s i t u a t i o n . " (p.243). However, the sample used i n t h i s study i s small from a quantitative perspective and l i m i t s generalizations. Thus, to enhance the conclusions a r r i v e d at i n the present study i t would be h e l p f u l to follow a s i m i l a r analysis applied to a d d i t i o n a l subjects. (2) As was mentioned e a r l i e r , although the data generated an a s s o c i a t i o n between ince s t and s u i c i d e attempt, t h i s study does not claim a causal r e l a t i o n s h i p between these phenomena. It i s important to note though, that several studies have found that among s u i c i d a l adolescents the family i s dysfunctional and the c h a r a c t e r i s t i c s of these f a m i l i e s such as problems of loss and separation, r o l e - r e v e r s a l mechanisms, and symbiotic r e l a t i o n s h i p s are contributors to s u i c i d a l behaviors, (Richman, 1971; Speck, 1968.) These va r i a b l e s are also found i n incestuous f a m i l i e s , (Finkelhor, 1984; Ronald, 1984; Spector, 1979). These va r i a b l e s have not been s t a t i s t i c a l l y c o n t r o l l e d 94 for (kept constant) thus, causal r e l a t i o n s h i p s can not be claimed since incest can be c o r r e l a t e d with other s i g n i f i c a n t v a r i a b l e s that contribute to the phenomenon of suicide attempt. Further research using quantitative methods may shed l i g h t on t h i s r e l a t i o n s h i p . (3) While several s i m i l a r i t i e s among the studied adolescents such as t h e i r age group, the (father) abuser, the f a c t that a l l had at l e a s t one suicide attempt and that a l l were i n treatment, there were also several differences among the subjects such as age, the type of the incest, the duration of the abuse period, the age the suicide attempt took place, the numbers of attempts, and the amount of support they had received from the f a m i l i e s and the social-system support. A more d e t a i l e d research of incest and attempted s u i c i d e , taking into account the v a r i a b l e s mentioned above, would increase our knowledge regarding the various aspects of the incest phenomenon that d i r e c t l y contribute to the suicide attempt. (4) One of the reasons for choosing t h i s age-group was that they are c h r o n o l o g i c a l l y close to the experiences involved i n incest and e s p e c i a l l y to the attempted s u i c i d e . However, as was mentioned e a r l i e r , i t i s quite possible that t h i s very same reason could have introduced a l i m i t a t i o n to the study. One of the subjects was 15 years-old, one was 18 years-old and the two others were 19 years-old. There was a wide gap between the 15-years-old's interview and the others' interviews. I t seems that she was i n a d i f f e r e n t developmental stage as well as i n a d i f f e r e n t stage of dealing with her sexual abuse and the suicide attempt experiences. She was less a r t i c u l a t e i n her thoughts and f e e l i n g s regarding her experiences compared to the other subjects. Her s o c i a l worker, who concurred with t h i s impression, s a i d that t h i s victim's verbal a b i l i t y i n expressing h e r s e l f i s very l i m i t e d , and i n art-therapy she i s one 95 of the most cre a t i v e g i r l s i n the group. The experience with t h i s subject brought about questions regarding the use of a d d i t i o n a l instruments i n a d d i t i o n to the face-to-face interviews with adolescents of her age. I t may be useful to add p a r t i c i p a n t s ' a r t work, which i s another form of s e l f expression, to the data base, i f i t i s a v a i l a b l e . Documents from the subjects' d i f f e r e n t therapists can also be used as an a d d i t i o n a l data source to be analyzed. The i n t e r e s t of t h i s study has been with the subjects' perceptions, thoughts, and f e e l i n g s about t h e i r experiences expressed i n t h e i r own words and not i n the i n t e r p r e t a t i o n that others give to these experiences. I t would be i n t e r e s t i n g to study the p r o f e s s i o n a l workers' perceptions about these subjects' experiences. The researcher has acquired the sense from the data that a gap w i l l be detected, and may add to the understanding of the t r a g i c s o l u t i o n of attempting s u i c i d e and other s e l f - d e s t r u c t i v e behaviors of t h i s population. (5) I t i s of importance to study adolescents who were incest victims and di d not attempt suicide i n adolescence. By knowing the s i m i l a r i t i e s and d i s s i m i l a r i t i e s between these two groups of victims we may broaden our understanding of the matter and be able to provide better services and support to those who are i n need. Possible valuable questions are: have victims i n the two groups gone through the same process and i f so, what have t h e i r coping mechanisms been? Have the victims who have not resorted to a suicide attempt received more support from t h e i r f a m i l i e s and from professionals? (6) A l l the p a r t i c i p a n t s i n t h i s study were i n treatment. I t i s of i n t e r e s t to investigate l i k e subjects who were not i n treatment. Comparing d i f f e r e n t types of subjects i n such a context may help resolve questions of whether the s u i c i d e attempt i t s e l f serves as a c a t a l y z i n g f a c t o r f o r the 96 i n i t i a t i o n of the healing process or whether other important f a c t o r s , such as the treatment i t s e l f , generate the healing process. Do subjects who share s i m i l a r experiences but without treatment go through d i f f e r e n t stages a f t e r the suicide attempt? Also, of much importance i s the r e a l i z a t i o n that research which deals with subjects who are not i n treatment r a i s e s questions r e l a t e d to e t h i c a l issues which have to be dealt with by the researcher. (7) A follow-up study of the investigated population i s recommended i n order to further explore the healing process and i t s c h a r a c t e r i s t i c s . 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Vol.3, Table 3, "Age S p e c i f i c Death Rates by Selected Causes and Sex". Canada, 16-18. Stengel, E. (1965), Suicide and Attempted Suicide. B r i s t o l , England, MacGibbon and Kce Ltd. Teicher.J.D., (1979), "Suicide and Suicide Attempts", i n J.O., Nashpitz, (ed.), Basic Handbook of C h i l d Psychology, Vol.2. New York: Basic Books. Teicher, J.D. and Jacobs, J . , (1965), "Adolescents Who Attempted Suicide: Preliminary Findings." American Journal of  Psychiatry. 122, 1248-1257. Weinberg, S.K., (1955), Incest Behavior. New-York: C i t a d e l Press. Wenz, F., (1977), "Subjective Powerlessness, Sex, and Suicide P o t e n t i a l . " Psychol Rep. 40, 927-928. ) 103 APPENDIX A INTERVIEW GUIDE 1) T e l l me about the sexual abuse. - when d i d i t begin? - where d i d i t take place? - how long had the abuse continued? 2) Looking back over t h i s period of l i f e , how would you describe the e f f e c t s of the sexual abuse on your r e l a t i o n s h i p s ? (with each member of your family, with peers, or others.) 3) How would you describe your f e e l i n g s and thoughts at t h i s time? 4) How was your sexual abuse experience disclosed? - by whom? - to whom? - when? 5) What were your family members' responses? (thoughts, f e e l i n g s , actions.) 6 ) How d i d non family members respond? 7) How d i d the discl o s u r e change things f o r you? (moving from home? court? contact with professionals? contact with friends?) 8) What was the discl o s u r e l i k e f o r you? (thoughts, f e e l i n g s ) 9 ) In what ways d i d you t r y to handle the situation? - yourself? - your family members? - professionals? - friends? 10) Who, i f any one, was h e l p f u l to you, and what d i d they do that you found he l p f u l ? 104 11) Who, i f any one, was not h e l p f u l , and what d i d they do that made things d i f f i c u l t ? 12) Did you make any attempt to cause harm to yourself? - what d i d you think? - what were your feelings? - what l e d you up to i t ? - what d i d you do? 13) Where you able or d i d you t r y to t a l k to or get any help from others? 14) What do you view as the major contributing factors to your sui c i d e attempt? (things/people). 15) Has anything p o s i t i v e come out of this? - has i t changed your situation? I f so, how? 16) What advice would you give other adolescents who are faced with s i m i l a r issues? 17) We have talked a l o t about your experiences today, are there any other things that have not been discussed that you think are important? 105 APPENDIX B INTERVIEW CONSENT FORM For the research study e n t i t l e d : "Incest and Suicide Attempt i n Adolescence" Researcher Shlomit Kim B.S.W, M.S.W (candidate) School of S o c i a l Work, U n i v e r s i t y of B r i t i s h Columbia. Research Consultant Dr. Garry D. Grams Assi s t a n t Professor, Department of Family Practice. The i n v e s t i g a t o r i n t h i s research i s studying s e l f destructive behaviour i n adolescents who have been sexually abused. The purpose of t h i s interview i s to better understand your experiences and by sharing these you w i l l help us improve our knowledge i n t h i s area. The interviews are conducted by Shlomit Kim, a U.B.C. graduate student who i s working as a the r a p i s t i n Fairmont Family Practice Unit which includes a Sexual Abuse Project. C o n f i d e n t i a l i t y w i l l be respected, with the exception of new disclosures of sexual abuse, which by law must be reported to the M i n i s t r y of S o c i a l Services. No i d e n t i f y i n g information such as names or addresses w i l l be used i n the research study. I f you consent to the interview, you are free to withdraw at any time, or refuse to answer any of the questions. Any such choice w i l l i n no way jeopardize further treatment or services. The interview w i l l take approximately two hours, and to ensure accuracy, interviews w i l l be audio-taped. Following the t r a n s c r i p t i o n and analysis of the data these recordings w i l l be erased. As you are aware from your therapy, dealing with issues regarding the sexual abuse and the suicide attempt can be d i f f i c u l t and p a i n f u l . Strong emotions may be aroused i n you, and these can eit h e r be addressed as they a r i s e , or i n a subsequent interview with your therapist. Please indicate your formal consent to being interviewed and to the u t i l i z a t i o n of the interview material for the above noted research project. Your signature also acknowledges your r e c e i p t of a copy of the consent form. As you are under l e g a l age, your parent or guardian w i l l have to give consent to your p a r t i c i p a t i o n i n the study. Signature(Subject) Date Signature(Interviewer) Date I consent/do not consent to the c h i l d i n my care p a r t i c i p a t i n g i n the above mentioned study. Signature(Parent/Guardian) Date APPENDIX C 106 I: I r e a l l y appreciate you w i l l i n g to p a r t i c i p a t e i n t h i s interview. Before we s t a r t I have to get you to sign a consent form. I t b a s i c a l l y talks about my research and why I am doing that. S: O.k I: I have a l i s t of some questions that I have been asking a l l the part i c i p a n t s i n t h i s study. I t w i l l take about one hour and a h a l f . I have been working i n t h i s f i e l d for about ten years and found that there i s not a l o t known about the sexually abused adolescents who attempted suicide. In t h i s study I would l i k e to further explore and study the experiences which these adolescents go through i n order to improve our knowledge and to provide better treatment and help to these adolescents. Let's s t a r t . How was the sexual abuse l i k e f o r you? S: Yea, i t s . . . I don't know what to say. Your asking me to j u s t say i t ? I: Um.. S: Um... I t would be easier i f you asked me a question. Um...1 was j u s t about ten but I had, l i k e , other experiences, l i k e , yea, when I was r e a l l y young, I didn't r e a l l y get abused but my mom's g i r l f r i e n d , her boyfriend when sleeping on the bottom bed, l i k e , me and my brother had bunkbeds and we came, i t was time to go to bed and I was wearing my nightgown and he grabbed me and he pul l e d my nightgown up and he touched me and then he b i t me on the inside of leg and I screamed and my mom came down and she grabbed him and she threw him out of the house and her g i r l f r i e n d along with him and um, another time, we were l i v i n g i n th i s co-op and the caretaker was going around abusing a l l the l i t t l e g i r l s , l i k e , sexually molesting them, and s t u f f and I remember him touching me and giving me quarters and s t u f f and t e l l i n g me not to t e l l , l i k e , t h i s would be our l i t t l e secret, type thing. But one of the g i r l s he took Timing F i r s t sexual abuse Offender Location Type of the abuse Mother's re a c t i o n Second sexual abuse Type of the abuse Reward Secrecy 107 into the shed and he raped her and she was l i k e i n r e a l l y bad shape and her mother was going around with, asking a l l t h i s g i r l ' s friends and she was y e l l i n g i t at me and I got a l l upset and I was scared and I was crying. I didn't know what to say and my mom said, i t s okay, l i k e , you didn't do anything wrong, she said, t h i s guy's a bad man and he needs to be punished f o r i t and so i f he d i d anything to you or to anybody else that you know you should t e l l us so I t o l d and t h i s guy got sentenced to j a i l and when I was l i v i n g with my dad when I was ten and my dad had already done something to me, l i k e , the guy downstairs was friends with my dad and he had brought up a case of beer and he and my dad were drinking. Me and my brother were l y i n g i n bed and reading comic books and he went over to my brother's bed and he s t a r t e d french k i s s i n g my brother and then he came over to my bed and he st a r t e d running h i s hand up the blankets, l i k e underneath them, and I freaked out and I ran into the other room screaming and I stood behind my dad and I j u s t kept on screaming and crying and I couldn't t e l l him what t h i s man was doing because he was doing i t to me too so I couldn't say t h i s man j u s t did t h i s and so I didn't. He t o l d me to j u s t get back to bed so I did. I don't think he would have cared anyway. •I: When d i d the sexual abuse with your father begin? S: I was nine these two guys jumped me i n the back a l l e y and then the p o l i c e brought me home to my dad and then a f t e r that he started. I: Your father... S: Yea. Um... well i t didn't happen very often. He mostly beat me and s t u f f , l i k e , he j u s t h i t me a l l the time f o r whatever reasons. I guess sometimes he'd have f i g h t s with h i s g i r l f r i e n d s and s t u f f and he'd take i t out on me that way. Ef f e c t s of abuse Mother's support Timing T h i r d sexual abuse Abuse of s i b l i n g Type of the abuse Feelings Helplessness Feeling unprotected Timing Incest Physical abuse Reasoning the abuse 108 I: Where were your mother at t h i s time? S: Me and my brother l i v e d with my dad and my mom l i v e d with her boyfriend. Well, when I was young, my mom and dad used to get i n f i g h t s a l l the time. My dad would beat the s h i t out of my mom. My mom would pack up a l l of her s t u f f and we would leave i n the middle of the night. And we went to a t r a n s i t i o n house once and one time my mom l e f t my dad, we moved into a house and urn, my brother got taken away and put into a f o s t e r home and emergency services t o l d my mom that i f she didn't get back together with my dad, then my brother couldn't come back to l i v e with us. So my mom did that and then my dad went t o t a l l y nuts again and he took a two-by-four to her and he beat her up r e a l l y bad and urn, when my mom got a chance then we l e f t again and we moved downstairs from my aunt and uncle and while we were out they changed the locks on the door and everything and they kicked us out and they wouldn't l e t us back i n so my mom had no place to go. She's got me and my l i t t l e brother and she didn't know what else to do so she gave custody of us over to my dad and that was when I was seven years o l d and when I was seven ' t i l l I was eleven I stayed with my dad. I: U n t i l when d i d the sexual abuse take place? S: Well...urn... I guess when I was around - i n between that year and ten and eleven 'cause I got taken away from him s h o r t l y a f t e r . I: So i t was about one year. S: Yes. I: Looking back over t h i s period of l i f e , how would you describe the r e l a t i o n s h i p s with your family members, with your peers, friends? Description of family Violence Separation Emergency services Extended family r e l a t i o n s Explanation regarding custody Timing Duration of incest S: Well, I don't have a l o t of fr i e n d s . I have a couple of friends and most of my friends are, most of Peer's r e l a t i o n s h i p 109 them are guys, a c t u a l l y I get along with guys bet t e r than g i r l s . Um... I don't r e l a t e very well with my mom, I think, me and my mom are more l i k e f r iends than mother and daughter because, um, well I blame her because she sent us to l i v e with my dad when she could have put us i n care but she didn't and I decided no I can't bring i t up and t e l l her that t h i s happened l i k e , you know, say something and, um..., she never asked me or anything and we j u s t bypass that subject. L i m i t a t i o n of s o c i a l s k i l l s Relationship with mother Blaming mother I: What were your thoughts at t h i s time? S: I have two older s i s t e r s and my dad went a f t e r the oldest one and she ran away from home and then he raped the other one and they went to court about i t but a l l the charges were dropped and, um, so my mom knew, l i k e , she knew - I don't know i f she wanted to beli e v e i t or not. She s t i l l knew about i t . Abuse of s i b l i n g s Blaming mother I: How would you describe your f e e l i n g s at the time the sexual abuse took place? S: I f e l t scared and I hated him. I j u s t kind of wanted to disappear. Um... also I probably wanted to k i l l him too at the time but I couldn't because I was young. At t h i s time the c h i l d r e n at school c a l l e d me names we l l , 'cause they say that to me, I thought i t , I st a r t e d b e l i e v i n g i t 'cause they kept on saying i t and you know, well, i t must be true i f they keep on saying i t and t h i s happened at grade 6, l i k e , everyone s t a r t e d doing t h i s to me and then I tr a n s f e r r e d because I went to the fo s t e r school and I sta r t e d at a new school and they d i d i t to me too so I thought, okay, f o r sure, man, then I must be r e a l l y ugly or something, you know, I s t i l l don't l i k e having my pi c t u r e taken, and a l l my pictures I think they look bad and s t u f f . Hate Fear Homicidal ideation Helplessness Being v i c t i m i z e d by peers Negative self-concept I: What do you think made you f e e l l i k e that? S: Uh, he (her father) used to c a l l Verbal abuse 110 me a b i t c h a l l the time and he c a l l e d me a whore once when the p o l i c e brought me home from when I got jumped i n that a l l e y and, um, he waited ' t i l l they l e f t and r i g h t i n fro n t of my f r i e n d he slapped me across the face and sa i d "You whore, you probably asked f o r i t " and that's, I ' l l never forget that. Well, what my dad used to do to me j u s t makes me f e e l d i r t y , makes me f e e l bad, l i k e , I know that i t s not my f a u l t and everything but, you know, i t s t i l l makes me f e e l r e a l l y , l i k e , gross, s i c k and sometimes I thought when they c a l l e d me these names that they might see i t , l i k e they might know somehow know. They might have found out or something and that's why they're c a l l i n g me that too. Ef f e c t s of incest on s e l f Questioning peer's behaviour I: Did your brother who l i v e d with you and your daddy know about the sexual abuse? S: No, I don't think... he wasn't around. He's my l i t t l e brother and so even i f he knows he wouldn't be able to do anything. Role-reversal-protection of s i b l i n g I: And what d i d you think at t h i s time? S: I didn't understand why he was doing that to me. Like, I knew i t was wrong but I didn't understand why he d i d that to me. And he used to say a l l kinds of things to me l i k e , i f he ever h i t me or something or something he'd say something l i k e "I'm only doing t h i s because I love you" or "This hurts me more than i t s hurting you" and I couldn't understand that e i t h e r because he's l i k e r e a l l y h i t t i n g me. I mean he's not one that's f i l l i n g , the h i t s so.. Questioning the incest Offender's explanation regarding abuse. Confusion I: Could you t e l l me more about the sexual abuse? S: Well, I'd be sleeping at night and he'd j u s t come i n and he'd climb i n with me um... only once, I think, he was r e a l l y v i o l e n t and i t was when I was f i g h t i n g back and I kneed him i n the nuts and he h i t me a couple of times but I was too scared to do De t a i l s about incest V i o l a t i o n Resistance I l l anything so I didn't r e a l l y f i g h t back very much. I: Who d i d the chores at home? S: Who d i d the chores? I: Um... S: I d i d everything. I: Do you think i t af f e c t e d your l i f e then? S: I didn't... I don't r e a l l y know. Like, at the time I d i d i t , l i k e , I didn't know what my friends d i d at home. I had no ideas. I had maybe one or two friends when I was i n elementary school and I used to get l i k e comments from teachers l i k e "She doesn't p a r t i c i p a t e with the r e s t of the c l a s s . She mopes around. She seems depressed a l l the time" S t u f f l i k e that. You know. Like I didn't, I was more a loner. I didn't r e a l l y hang around with anybody but my brother. We used to play together and go out together and we d i d everything together so i t s l i k e I didn't have any other friends and the frie n d s I d i d have, I wouldn't b r i n g them home with me, 'cause I was scared of what he might do or, you know, I didn't want them to see anything, hear anything so I j u s t didn't b r i n g them home. I: What d i d you f e e l about i t ? S: Um... I don't know. We j us t, we were always together l i k e we got i n trouble together and s t u f f l i k e that. I f my dad was home and my brother d i d something wrong i t would be my f a u l t because I am responsible for him so, I had to take care of him and s t u f f . I: Who was the f i r s t one you t o l d about the abuse? S: Um... a stranger i n the park. I j u s t . . . t h i s lady was with her kids at the park and she was t a l k i n g with me and I j u s t had to t e l l somebody so I t o l d her everything and then I j u s t S o c i a l i s o l a t i o n Loneliness Relationship with s i b l i n g Reasoning s o c i a l i s o l a t i o n R elation with s i b l i n g Role-reversal Disclosure 1 1 2 got up and I walked away and I l e f t . I never saw her again. I: And then what happened? S: What happened a f t e r I t o l d her. I j u s t got up and I walked away. I went home but I didn't t e l l her my name or anything so she couldn't have done anything. I've never seen her before e i t h e r . Explanation regarding lack of response to disclosure I: You t o l d me that the sexual abuse took place u n t i l you were eleven. What made i t stop then? S: Well I got t i r e d of being h i t a l l the time and s t u f f and my dad used to t e l l me, l i k e , we had a s o c i a l worker at the time, and he used to say never to say anything to her because s h e ' l l take you away and s h e ' l l put you i n a bad place and people w i l l beat you up a l l the time and s t u f f . And I though we l l , maybe he's wrong and I can't handle i t so maybe i t s better there than i t i s here. And I t o l d my s o c i a l worker, I sat i n the car for two hours and I c r i e d and I t o l d her everything that ever happened to me i n the house and I said, you know, she s a i d "well i t might take time to get you out", and I said, "well you better have me out by tomorrow a f t e r school or I ' l l take my brother and we'll both be gone and y o u ' l l never see us again." So at lunch time i n school we got c a l l e d down to the p r i n c i p a l ' s o f f i c e and she t o l d the p r i n c i p a l and the teacher what was going on and teachers and s t u f f and that we were being taken away and put i n a r e c e i v i n g home not too f a r away from the school so we s t i l l attend the same school and i f my dad was to come around that we were to go s t r a i g h t to the o f f i c e and t e l l them that he was there and not to go up and t a l k to him. I: And f o r how long have you stayed i n the r e c e i v i n g home? S: I was i n there f o r about eight months, I think. Making d e c i s i o n regarding d i s c l o s u r e Offender's threats The c r i t i c a l event regarding d i s c l o s u r e School- system's involvement Placement School-system's support Timing I: With your brother? 113 S: Um... Well my brother was there f o r about maybe four or f i v e and he couldn't handle i t because he was always ge t t i n g grounded and these people were r e a l l y mean to us and he moved back i n with my dad and um... there was no way I was going to do that so I stayed there and then they sent me to a f o s t e r home. Separation from s i b l i n g Explanation regarding placement I: What was your father's r e a c t i o n to the disclosure? S: Yea. She (the s o c i a l worker) t r i e d to get me to s i t down and t a l k with him about i t and there was no way I was going to do that and we both kind of sat there and didn't say a word and I couldn't handle i t and they asked so I s a i d I wanted to leave... I wanted to get out here. I'm not - there's no way I could t a l k to him. Like I was scared to even be i n the same room 'cause he t o l d me that he'd k i l l me i f I ever s a i d anything. He denies everything. Confrontation Fears of offender Offender's denial I: How d i d he react towards you a f t e r the disclosure? S: Um... Well, he hated me, b a s i c a l l y , from what my brother says, I don't know. I didn't, I never went near him again a f t e r that. My brother says he used to t a l k bad about me and s t u f f and say that I'm nothing but a whore and l i t t l e b i t c h and s t u f f l i k e that. Offender's r e a c t i o n to dis c l o s u r e Verbal abuse I: Did you meet him since then? S: No, I haven't seen him since, well, I've seen him, l i k e , I've seen Relation with offender him s i t t i n g at a bus stop, and walking across the s t r e e t and on a bus but I've always managed to get o f f r e a l l y quick or get away from him. Like, I haven't v i s i t e d him or nothing f o r eight years now since I've been taken away and I don't plan on i t ever again. I: What do you f e e l about seeing him? S: I t scares me. My heart pounds and I don't know what to do, l i k e , Feelings Fears 1 1 4 part of me i s r e a l l y scared and everything and part of me wants to j u s t k i l l him r i g h t , and i t puts me i n a p o s i t i o n where I don't know what to do so I j u s t s i t there and i n the long run I end up running away. Revenge Confusion Running-away I: Avoiding t h i s meeting or sit u a t i o n ? S: Yea, but I bet probably i n a couple of years I ' l l be able to go up to him and I ' l l h i t him, I ' l l punch him r i g h t i n the... I: How do you imagine the meeting? When you dream about him, what do you dream? Healing-planning confrontation and revenge S: Well, I always, I always know, i n my dreams when I sleep I see myself k i l l i n g him. I ' l l stab him, I ' l l beat the s h i t out of the him. I see him burning i n a house and we a l l l i v e together and I get my whole family out of the house except for my dad and I watch him and he's on the top f l o o r and he can't get out and i t burns and he dies. And I always watch that, l i k e , that's what I see i n my dreams a l l the time, ever since I was a l i t t l e k i d . He's always been i n a house and he's been burning and I won't save him, I can but I won't, you know. Like, sometimes I ' l l have a ladder and I could put the ladder up there and he can climb down but I won't, I ' l l hold on to i t and I won't do i t ; you know. I: And when you imagine t h i s meeting, what do you think? S: Um, sometimes I think I ' l l plan for i t . Because I always know where he i s . Like, I know where he i s r i g h t now. I have f or the past couple of years. I thought of blowing up h i s apartment b u i l d i n g but then I'd inj u r e up innocent people so I haven't done that. And I thought of taking a guy with me, l i k e , a b i g guy and go down and have t h i s guy beat him up and see how he l i k e s i t and say everything that I ever wanted to say to him with t h i s person here with me and then I know that I'm safe Homicidal dreams Having power & control S h i f t i n g r o l e s Planning revenge Control Concern f o r others 115 and he can't do nothing to me. Safety I: What would you l i k e to say to him? S: Um, j u s t that you're s i c k and you need help. And, j u s t that... I know that he's s i c k and he's had a rough childhood himself, l i k e , he's been abused sexually by h i s mother. His father shot himself i n the head when he was young. He committed suicide, h i s dad did, my grandfather, from what I was t o l d by my grandmother. My grandmother had her l e f t breast cut o f f once 'cause she had cancer and she used to have one of those foamy bras so you can't t e l l and he used to go up to her and he'd squeeze them and go, well oh, t h i s one f e e l s p r e t t y r e a l and I remember him doing that when I was young and I remember thinking, you know, there's something wrong here, and I think about i t now and I think, God, he must be r e a l l y sick, I mean, I could never do that to my own mother. I couldn't see anybody doing that to t h e i r own mother. There's j u s t no way. I: Do you have any p o s i t i v e f e e l i n g s toward your daddy? S: Like, p o s i t i v e , l i k e what, l i k e good fe e l i n g s ? I: Uhmm. . . Concern f o r offender Offender's family of o r i g i n Abuse of offender Grandfather's s u i c i d e Normal vs. abnormal regarding sexual abuse S: No, I hate him, thoroughly. I f e e l sorry for him maybe, that's about as p o s i t i v e as I can get. To me he should be slowly, slowly tortured, long and p a i n f u l death and i t were not to k i l l him he should have h i s tongue cut out so he can't say nothing, he should be b l i n d so he can't see any female, and deaf so he can't hear any female, with no hand so he can't touch anybody and that would leave him able to stand and walk around and bump into things and s t u f f . He'd be t o t a l l y mute. Its the best punishment I could ever give him to be make him a vegetable, to have to s i t i n a ch a i r . . . That's mean, that's because of my anger f o r him but I never think about doing Hate Torture the offender Offender's helplessness, powerlessness Punishment Anger at offender 116 that to anybody else, l i k e , i f somebody asked me, do I have a l o t of enemies, I would say no, and i t s true, I don't have anybody I hate, you know, there might be some people that don't l i k e me but I don't hate them for that, that's there choice but with my father i t s l i k e , he's the only person I r e a l l y hate. I mean, the l a s t , a couple of days before we got taken away from him he took o f f h i s wedding band and put i t on my marriage f i n g e r . That's how s i c k he was. Like, I wasn't h i s daughter, he got to a point where I wasn't h i s daughter anymore. I was l i k e h i s g i r l f r i e n d , h i s wife. ???? I t makes me wonder what he d i d to h i s other wife 'cause I know he was married before and had kids and he was divorced. Explanation regarding punishing the offender. Hate Role-reversal Questioning offender's h i s t o r y I: And then he got married with your mom? S: Yea, so i t makes me kind of wonder what they went through. And i t s funny because one of my ex-boyfriends went out with my s t e p s i s t e r from my dad's family. I t was shocking. He said, that she's doing r e a l l y good and she j u s t got married and now she's got a baby due. I: How d i d your mother react to the disclosure? S: I'm not sure i f she knows or not about i t . So I have no idea. R e l a t i o n with mother I: Did you meet her a f t e r the disclosure? S: No, I was i n the r e c e i v i n g home and then they took me to a f o s t e r home a f t e r eight or nine months a f t e r being i n the r e c e i v i n g home and I never had any contact with my mom u n t i l I moved into my f o s t e r home. A f t e r eight months I moved into my f o s t e r home and I was there for about a year and I didn't r e a l l y know how to get i n contact with my mom but my mom, she c a l l e d my s o c i a l worker and my s o c i a l worker c a l l e d me and gave me the number. Receiving home Foster home Renewing contact with mother 117 I: And then d i d you speak with your mom about that? S: Well, I didn't speak with her about i t , I j u s t went to v i s i t her and we went to l i k e , MacDonald's or something l i k e that. I couldn't t e l l her. I: Why? What d i d you feel ? S: Well, I'm j u s t scared that she's not going to t a l k to me. Like, I know she blames h e r s e l f f o r everything that's happened to me. So I'm worried that i f I t e l l her that she's not going to be able to handle i t and she won't t a l k to me anymore. I: How d i d non-family members respond to that? S: Well, my teacher was r e a l l y nice to me and he gave me extra a t t e n t i o n and s t u f f and he didn't get mad at me so often f o r not paying a t t e n t i o n because he knew why I wasn't able to concentrate. I didn't t e l l anybody el s e . My f o s t e r mom - I didn't t e l l her u n t i l I l i v e d there f o r about a year and a h a l f , I think and then I t o l d her b i t s and pieces but not very much. And she j u s t f e l t sorry f o r me, sort of. Fears of being abandoned by mother Protection of mother Fears of mother's reactions to disclosure School-system support Disclosure I: How was i t l i k e f o r you i n the fo s t e r home? S: Well, I didn't l i k e i t too much i n the beginning because my s o c i a l worker and her - they sat down and they decided, well, I'm going to come i n at t h i s time and I'm going to school here and I'm going to do t h i s and I'm going to do that and i t s l i k e I had no choice, l i k e they were taking over my l i f e and I wasn't used to that. I was used to staying out as l a t e as I want or not coming home for days and j u s t doing whatever, you know, and then they t e l l me that I have to be i n at l i k e , eight o'clock at night or something, and i t s l i k e , say what? I j u s t didn't understand i t at a l l . And I was always l a t e so I got grounded a l o t . Involvement of s o c i a l -worker Feelings Being c o n t r o l l e d Powerlessness Rebelliousness I: And then what happened? 118 S: Well, we went on for about a year and a h a l f . I played along with her and I went with her rules and s t u f f and then I couldn't take i t anymore and she was drinking a l l the time and my dad drank h e a v i l y so i t r e a l l y bothered me. Timing Attempts to adjust Fears of being v i c t i m i z e d I: Wasn't there a father? S: Oh, there was j u s t one. Her husband died a long time ago. But she drank a l o t and she'd get to the point where she'd pass out on the couch and she'd have l i k e , c i g a r e t t e s l y i n g a l l over the place and she'd say where are my c i g a r e t t e s , d i d you take them, and they're l i k e , r i g h t i n fro n t of her. And, um, I j u s t , I packed some of my clothes and I took o f f and I wasn't going to go back and the cops picked me up, the cops, and they took me home and she wasn't there so they took me to emergency services and I waited there f o r two hours and the f o s t e r mom showed up and she was a l l drunk. And she brought me home and we had a b i g f i g h t and she threw a wine glass at G a i l , her daughter, and, um, I ran upst a i r s and she came a f t e r me and she was y e l l i n g at me saying a l l these mean things to me and s t u f f and I went i n the bathroom and I t r i e d to shut the door and she got i n and pushed the door open and then she grabbed me and she went to h i t me and I slammed her up against the door and I c a l l e d her a b i t c h and then I ran out again, and then I waited a couple of days and then I came back and I packed up a l l my clothes and I l e f t . I: To where? S: Well, I went down to t h i s bus loop, a l l these people, l i k e , I knew a couple of people down there and I sta r t e d hanging around with these people and I met t h i s guy and we sta r t e d going out and used to stay over at h i s place or i n odd places or j u s t stay up a l l night and walk around and party with these people. Des c r i p t i o n of fos t e r family Running-away Po l i c e involvement Relations with f o s t e r mother Verbal abuse Physical abuse Joins s t r e e t kids 119 I: Did you go to school at t h i s time? S: No, I missed three months of school so they f a i l e d me i n grade eight. I: Did you have friends at school at t h i s time? Problems regarding scho S: Um, we l l , I had, two g i r l s were my friends i n a r t cl a s s and there was a g i r l , l i k e , there's one of the guys i n my c l a s s I was friends with, h i s older s i s t e r . And me and her used to do s t u f f a f t e r school but I wouldn't, l i k e , I wouldn't, l i k e nobody else from the school I r e a l l y made friends with. I was never r e a l l y good at making f r i e n d s . I'm s t i l l not. I: During t h i s period have you met your mom again? S: Yea, there were a couple of times. My f o s t e r mom l e t me spend one night with her but my mom, she l i v e d i n a h o t e l so i t s not very appropriate for me to stay over there. L i m i t a t i o n of s o c i a l r e l a t i o n s Lack of s o c i a l s k i l l s R e l a t i o n with mother I: In what ways di d you t r y to handle the s i t u a t i o n ? S: When I was f i r s t taken away from my dad I had t h i s lady, Sarah, who was my s o c i a l worker and we had her ever since I was a l i t t l e k i d so I trusted her and everything and then a l l of a sudden she said, well, I'm not going to be your s o c i a l worker any more, there's t h i s other lady that's going to and then t h i s other lady, I didn't l i k e her so I didn't r e a l l y , l i k e , I never r e a l l y got along with her, I never talked to her or nothing. I: Do you think you had any opportunity to speak with someone about the sexual abuse experience at t h i s time? Frustration/anger at social-support system S: Right now? I: No, not r i g h t now, back then,after the di s c l o s u r e . 120 S: Um, I didn't t a l k , I talked about Limited treatment i t to my f i r s t s o c i a l worker, Sarah. regarding abuse I t o l d her everything and then they took us away and then I never brought i t up again. No, they sent me to see a p s y c h i a t r i s t and um... I: What for? S: They didn't t e l l me. They j u s t wanted me to go see him and he asked me a l l these questions and showed me pictu r e s and s t u f f and I went once and that was i t . I: Did your case go to court? S: No. Probably because I didn't, I Lack of court procedure couldn't have pressed charges anyway i f i t d i d go to court. I'm not r e a l l y sure why. Some things I can't remember because I've blocked them out of my head. We might have gone Coping mechanism to court, I'm not sure. But I don't remember. I: What were your f e e l i n g s at that time? S: She (the s o c i a l worker) j u s t took over my whole l i f e and made a l l the decisions f o r me and she didn't ask me or nothing. Like, she put me i n the r e c e i v i n g home and then nine months l a t e r I found out I was being placed i n the f o s t e r home and I had no idea...Well, I'm r e a l l y mad because l i k e , I was r e a l l y shy and I was r e a l l y quiet so I wouldn't stand up f o r myself but i t made me r e a l l y angry that she didn't ask me l i k e , you know, what do I want. Where do I want to l i v e and s t u f f . Powerlessness Timing Frustration/anger at social-system support I: Who, i f anyone, was h e l p f u l to you and what d i d they do that was hel p f u l ? S: Um... j u s t , well, I don't think Loneliness that there's been r e a l l y anyone that's done anything l i k e , with back then, that was j u s t me, myself, l i k e , I helped myself out and talked to Protection of s e l f myself. Um, I couldn't, at the time, I couldn't r e a l l y open up and t e l l anybody about i t and I j u s t kept inside of me and 121 f i l e d i t back i n the back of my head, and j u s t t r i e d to forget about i t . Coping mechanism I : Who, i f anyone, was not h e l p f u l and what d i d they do that made things d i f f i c u l t ? S: Well, my f o s t e r mom for one, I mean, I don't know, i t used to, i t bothered me a l o t that, that my s o c i a l worker knew that my dad was an a l c o h o l i c and she took me away from him and put me i n with t h i s f o s t e r parent and she was an a l c o h o l i c too, and so i t r e a l l y bothered me and that had a l o t to do with i t . I t used to always stay i n the back of my mind that she was going to get l i k e my dad. I: Could you t e l l me more about your f e e l i n g s at that time? S: Well, I was angry, wanted to t e l l everybody where to go and j u s t to leave me alone. I hated a l l s o c i a l workers, the whole government and everything, I hated them a l l . I guess, I was upset too. At the time to me they weren't people, l i k e , they didn't care they were j u s t putting me l i k e , you're a piece of paper, l i k e , you go on t h i s s h e l f , and you go on th i s s h e l f . I didn't f e e l l i k e I was being treated l i k e a human being. I: Then what happened a f t e r you l e f t the f o s t e r home? Frustration/anger at system Fears of being v i c t i m i z e d F r u s t r a t i o n , helplessness, anger at social-system S: Well, I was on the stre e t s f o r S e l f - d e s t r u c t i v e behaviour about s i x months and I sta r t e d drinking and smoking pot and we d i d a l l kinds of things. I: What do you mean? S: We didn't know when, there was a Joins s t r e e t kids whole bunch of us, l i k e , j u s t one b i g gang of people and a couple of us g i r l s were runaways, there was some from New West and one from Burnaby and there was two of us from Vancouver and us g i r l s , we a l l hung around together because we're a l l l i k e , the same thing and um, I don't know, we'd j u s t stay up a l l night partying and i f we got t i r e d we s l e p t 122 on the bus bench at the bus loop and there was a roof over top of i t so we didn't get wet i f i t was r a i n i n g . Um, we used to go into 7/11 there and we'd s t e a l things and we used to go down to F i e l d s and we'd t r y on jeans and put our own jeans over top of them and walk out with them and we used to crash at peoples' places, l i k e , guy's houses a l l the time and s t u f f l i k e that. And I guess I d i d that f o r about s i x months and then, um, I was over at the school grounds with my boyfriend and h i s f r i e n d and my f o s t e r mother saw me and came running up and she grabbed me by the wris t and she st a r t e d c a l l i n g me a fucking l i t t l e s l u t and s t u f f l i k e that and she slapped me across the face and I ran down the s t a i r s away from her and I c a l l e d her a b i t c h and I ran across the s t r e e t and I almost got h i t by a car. There was about ten cop cars a l l d r i v i n g around i n the same area looking f or me so i t was l i k e , I couldn't run away from them, every time I turned a s t r e e t they were there so I sat down behind a parked car and I c r i e d f o r a while. And then I went to f i n d my friends and they s a i d there's t h i s black cop who wants to help you and he's waiting f o r you by 7/11 so I went into Bino's and I clean the mascara o f f my face 'cause i t ran down my face 'cause I was crying and I went over and I talked to him and then he s a i d well we'll take you to emergency services i f you don't want to go back i n your f o s t e r home, we won't put you there we'11 put you i n a group home and um, I was 1ike, I don't know, they treated me l i k e I was some cri m i n a l or something. They put me i n the back of the car and a female lady sat beside me and the guy drove and another car was behind us escorting us down to emergency servi c e s . I f e l t l i k e , you drive past people i n cars and they stare at you and they think what d i d you do, k i l l somebody? I j u s t , I f e l t r e a l l y bad about that. And then I got to ES, they put me i n Cypress House and I stayed there f o r a couple of months and then I ran away again and I l i v e d downtown and I st a r t e d working the Delinquency Timing Physical and verbal abusive r e l a t i o n s with f o s t e r mother Poli c e involvement Emergency services Frustration/anger at system Group-home Running- away 123 st r e e t . I: Why d i d you leave t h i s group home? S: Well, i t was okay, l i k e , I l i k e d i t and everything and um, I j u s t , the kids, there, most of them were from downtown and were hookers and s t u f f and I got involved with these people and then I s t a r t e d doing, I started working the s t r e e t myself and I found out that I could make a l l t h i s money j u s t from doing t h i s , sleeping with these men and so I d i d i t . Description regarding p r o s t i t u t i o n I: What d i d you do a f t e r you the group home? l e f t S: Well, I s t a r t e d working i n the stree t s i n down-town when I was th i r t e e n . I worked u n t i l I was f i f t e e n and when I was f i f t e e n I decided to quit doing that and to stop drinking and stop doing drugs and everything and I d i d that, I quit and u n t i l I was sixteen and then I met t h i s guy and he made me l i k e him a l o t and then he'd turn around and he s a i d I can't see you anymore because I don't have very much money and t h i s g i r l o f f e r e d to work for me and s t u f f and I l i k e d him so much I sa i d that I ' l l work f or you because I want to be with you so I went out and sta r t e d working the st r e e t again when I was sixteen and then I stopped. Shortly a f t e r , I broke up with him because he used to say he loved me a s t u f f and I loved him, l i k e I'd do anything f o r him. That's why I went out and I worked but slowly he st a r t e d saying w e l l , i f you don't go out and work I'm taking you home, r i g h t , and he'd know that I wanted to be with him and he'd take me home because I wouldn't go out to work. And I got r e a l l y choked about i t and I s t a r t e d hating him for a l l these things that s t a r t e d b u i l d i n g up and b u i l d i n g up and then I couldn't take i t anymore so I broke up with him and then I stopped and I haven't worked since. Duration of being p r o s t i t u t e Timing Abusive r e l a t i o n s h i p s with boyfriend Decision regarding ending p r o s t i t u t i o n I: At the time you worked i n the st r e e t , where d i d you l i v e ? 124 S: Well, I was staying at a Cypruss Moving from a group-home House and then I s t a r t e d making l o t s of money and some friends of mine they wanted to get a h o t e l room and so I grabbed myself from there, form Cypress House and moved into t h i s h o t e l with them and then we stayed there f o r a month or two and then we got a new apartment. This guy, he had the apartment and i t wasn't even a one bedroom, i t was a bachelor but there was t h i s couch that folded down to a bed, and a c h a i r that folded into a bed, and we had sleeping bags and s t u f f so there was about f i v e of us l i v i n g i n there. I: Uhmm... S: Me and my g i r l f r i e n d and three guys and a dog and two k i t t e n s . At the time, I was into partying a l o t and s t u f f , and I didn't, l i k e , I didn't care about myself, you know, I S e l f - d e s t r u c t i v e behaviour didn't care what happened, l i k e I didn't even think about what could have happened to me. I thought, well, my dad used to do t h i s to me so E f f e c t s of abuse on s e l f i t wouldn't bother me i f one of these men d i d i t to me and I ' l l get paid for i t and I j u s t kept on getting a l l t h i s money so I'd j u s t l i e there and I wouldn't think about i t . And then I'd have a l l t h i s money and we'd get beer and we'd s i t and drink and we'd party and we'd j u s t hang around restaurants and s t u f f . I: What made you q u i t or t r y d i f f e r e n t p o s s i b i l i t i e s ? S: Well, I s t a r t e d getting s i c k of doing i t a l l the time and everything and I decided that I didn't want to do that anymore and I had no place to go because the guy we were l i v i n g with, he moved to L.A., he went to L.A. and he got the locks changed so our keys wouldn't f i t and a l l our s t u f f was there so I had no money and no place to go and I was hungry. So I c a l l e d up my s o c i a l worker and asked her to meet me and I s a i d I wanted to be placed i n Cypress House again so she got me placed i n Cypress House and from Cypress House I went to Equinox, from Equinox I moved i n Decision regarding ending p r o s t i t u t i o n Asking f o r help Group-home 125 here. I: When d i d the attempted suicide take place? S: I haven't. I have thought about i t l o t s of times but never r e a l l y . . . . One time I took a bunch of p i l l s but I made myself get s i c k because I thought of my mom and I thought, l i k e , i f I'm doing t h i s , how was she going to handle that, l i k e , i s she going to do the same thing and I didn't want to do that to her, because I didn't know i f she, how she would take that. S u i c i d a l i d e ation Overdose p i l l s P rotection of mother I: How o l d were you when you took the p i l l s ? S: When I was, um, sixteen. I: Did you l i v e here i n the group home? Timing of the suicide-attempt S: Yes, I l i v e d here. I: Was i t at the beginning of your coming to t h i s group home? S: Yea, um, a c t u a l l y when I was going out with that guy, h i s name's Reasoning the attempt Paul. And i t had a l o t to do with him. I j u s t couldn't handle i t . I: What were your d i f f i c u l t i e s at t h i s time? S: Well, he wanted me to work and The t r i g g e r of the s t u f f and I didn't want to anymore suicide-attempt and, um, you know, l i k e I wanted to be with him a l l the time and i f I didn't work then he'd t e l l me, l i k e he'd take me home and drop me o f f and we had t h i s b i g f i g h t and he didn't c a l l me for two days and I couldn't get him on the phone and I didn't know where he was so I was a l l upset and everything, and um, I was j u s t , I didn't want to be without him so I guess that's why I d i d that. I: What d i d you think at t h i s time? S: Well, I f e l t l i k e nobody cares about me and nobody w i l l ever care about me. People always j u s t hurt me Feelings as contributors to the suicide-attempt 126 and I j u s t , I wished I was dead. I didn't understand l i k e , why was I even born? Was I born to be abused and hurt and s t u f f so I didn't understand i t . I: And what happened a f t e r that? S: Well, I made myself s i c k and the Physical e f f e c t s of the next day I was r e a l l y s i c k . I kept suicide-attempt on ge t t i n g s i c k . I couldn't stop and every time I ate something or I moved I got s i c k . I: Because of the p i l l s ? S: Yea. I: How many p i l l s d i d you take? S: The whole b o t t l e . There's about t h i r t y - s i x p i l l s i n the b o t t l e . I: Did anybody here knew about that? S: No. I t was l i k e about, three, Timing of the suicide-four o'clock i n the morning and I was attempt down i n my room l i s t e n i n g to the radio and I got a l l depressed and I s t a r t e d w r i t i n g a note. I: To whom? S: Well, I wrote one f o r Paul (her ex-boyfriend) and I wrote one for my mom and my family, type thing. And I kept r e w r i t i n g them, rewriting, r e w r i t i n g them, and I took a l l these p i l l s and then I sat there and I read these l e t t e r s over and over and over and then-I s t a r t e d thinking about my mom and I got upset and I s t a r t e d c r y i n g and I changed my mind and so. . . s u i c i d a l notes Ambivalence regarding the suicide-attempt I: Do you remember what you wrote on these l e t t e r s ? S: Well, I wrote, to Paul, I wrote Content of the s u i c i d a l that I love you and j u s t s t u f f l i k e notes that, b a s i c a l l y . And to my mom I wrote that I'm sorry and I j u s t can't handle t h i s anymore and to forgive me for doing t h i s , f o r what I'm doing. And I wrote that she could have a l l my s t u f f . 127 I: And then you took the p i l l s and... S: I took them and then sat and I waited for i t to set i n , the more I waited the more upset I got and the more i t made me think about i t too, and then I got r e a l l y upset and I didn't want to do i t because I f e l t w e l l , i f I'm k i l l i n g myself, maybe t h i s w i l l k i l l my mom too. And I didn't want to do that so.. . and part of me loved her and part of me hated her and then the part of me that loved her won. And I didn't go to sleep, I got up and I went to the laundry sink and I put my fingers down my throat and made myself throw up the p i l l s . I: Uhmm S: Yea, and some of i t was i n my system and so i t made me get s i c k and I couldn't stop getting s i c k and the shakes and every time I moved I had to run to the bathroom. I: I would l i k e to understand when you s a i d that part of you loved her and part of you hated her. What do you mean? S: Well, I love my mom because she's my mom and the part of me that hates her i s because I couldn't understand why she sent me to l i v e with my dad, you know, and I j u s t , I thought she knew about t h i s , how could she do that to me. Like, what d i d she think, d i d she think, oh, because I'm h i s r e a l daughter, he wouldn't do that to me? He d i d j u s t d i d i t to my s i s t e r s because they're not h i s r e a l daughters? And I didn't understand that. Feelings & thoughts a f t e r the attempt Upset Concern for mother Ambivalence towards mother Physical e f f e c t s of the overdose p i l l s Ambivalence towards mother Blaming mother I: And what were the f e e l i n g s towards your father at these moments? S: Well, at that time, I r e a l l y didn't think about him too much. Feelings towards offender Like, I t r i e d to forget him, l i k e , that he was my father, l i k e , as f a r as I was concerned my father was dead. 128 I: Was i t h e l p f u l f o r you to trea t him l i k e that? S: Yes. I: When you took the p i l l s , where you able or d i d you t r y to t a l k to or get any help from others? S: Yea, I c a l l e d my boyfriend. I: Uhmm... S: When I took them I c a l l e d him and Lack of boyfriend's help & he said, he asked me why I was support c a l l i n g him and I s a i d because I wanted to t a l k to him and, um, l i k e , we had a f i g h t a couple of days ago before t h i s and l i k e , he wasn't t a l k i n g to me and I asked him, l i k e , didn't he hate me now or what and he sa i d "No, I don't hate you" and, um, he s a i d "Well, I'm r e a l l y t i r e d and I'm going to go to sleep" and I heard people i n the background and I heard a g i r l ' s voice that I didn't recognize and I don't know, I was cryi n g on the phone and I said, "I need to t a l k to you" and he s a i d "Well, I ' l l t a l k to you tomorrow" and I said, "No, I need to t a l k to you now" and he s a i d "well, I'm r e a l l y t i r e d and I'm going to go so i f you don't say good-bye then I'm j u s t going to hang up" so, um, I said, "Fine, then" and I hung up on him and I went back i n my room and I shut the door. I: And what about the g i r l s or the s t a f f here? S: No, everybody was sleeping, there, everybody was sleeping, nobody was awake. I: Before taking the p i l l s , d i d you try to seek help from the s t a f f or the g i r l s here? S: Well, see, i n February I w i l l have l i v e d here four years and i t was i n the second year when t h i s happened and um, I wasn't - i t takes me a long time to get close to people and t r u s t them, a l r i g h t , and at the time I wasn't, l i k e I trusted them but not Timing E f f e c t s of abuse on s e l f 129 enough to say t h i s to them. And I knew that they'd do something about i t - they'd watch me a l l the time or something, so I didn't t e l l them about i t . Even a f t e r when I was getting s i c k and they were, l i k e , a l l thought oh, I j u s t had stomach f l u or something because I didn't t e l l them. Just t h i s year, s o r t of, people found out. I think Sandy and Carolyn know about i t - Maybe Ronny. I couldn't t e l l him I was - I st a r t e d getting my l i f e together and s t u f f and understanding - and I didn't want to t e l l them - i t was l i k e a stupid thing to do and I regret doing i t , I'm glad I'm not dead or anything but I'm j u s t , I didn't want to t e l l them, I was embarrassed about i t , I'm embarrassed about i t now. I: Because ... S: Well, my s i s t e r , my mom and my s i s t e r don't know about i t . My s i s t e r would k i l l me because her saying f o r that i s that "That's the chicken's way out" which i s true. I mean you can't cope with l i f e and the people around you then, and you want to k i l l y o u r s e l f and you go through with i t means that you're not strong enough to survive and you're j u s t being a chicken. I: Your s i s t e r s , as you t o l d me, were also sexually abused... S: Um, the younger one was, the older one, my dad, he grabbed her a couple of times but that was i t . There was always a b i g f i g h t . Like, he never raped her. One time when he t r i e d to she ran out of the house and he couldn't catch her and she went and she stayed with her boyfriend. I: And d i d you speak with them about your experiences? S: Um, my s i s t e r s know now. I t a l k to them about i t because, I talked to the younger one f i r s t and um, she has a r e a l l y b i g mouth and she t o l d my s i s t e r , the older one and then she t o l d me, Rina t o l d me t h i s , r i g h t . But she didn't push, l i k e , l i k e one Fears of being c o n t r o l l e d Secrecy Healing-cognitive change Secrecy Healing-cognitive change Abuse of s i b l i n g s Disclosure to s i b l i n g s 130 night I spent the night there and we were both l y i n g on the couch, they have one of those b i g square couches and we were l y i n g on them sideways and we both had our heads i n the middle and we were t a l k i n g about s t u f f and i t was rather l a t e at night and I s t a r t e d t e l l i n g her about these things and um, she goes, "I know, Rina t o l d me" and I got r e a l l y upset - Rina t o l d her, you know, and I made her promise me that she wouldn't t e l l anybody and she t o l d my other s i s t e r so I got choked at her but I t o l d her and everything and i t made me f e e l a l o t b e t t e r when I a c t u a l l y t o l d her. Now i f I j u s t t e l l my mom then everything would be okay, but I can't so. E f f e c t s of discl o s u r e D i f f i c u l t y to di s c l o s e to mother When d i d you speak with them? S: Um, when I was about sixteen. I talked to my younger s i s t e r and then I guess I was almost seventeen when I t o l d the older one. Timing of discl o s u r e to s i b l i n g s I: How was i t l i k e f o r you to share with them t h i s experience, and what pushed you to do that? S: Well, we, the house, l i k e , we have Wednesday groups, once a week and we t a l k about t h i s s t u f f and um, sometimes i f we get r e a l l y upset we'll come i n here with Carolyn and we t a l k to her about i t and s h e ' l l help us to understand why we're f e e l i n g t h i s way and what we can do to stop f e e l i n g t h i s way or to get support when we do f e e l t h i s way and we were t a l k i n g and I was t e l l i n g her how I'd l i k e to t e l l my s i s t e r s and everything but I'm scared to, r i g h t , and she goes, she talked to me about i t and, um, I can't r e a l l y remember what she t o l d me but I j u s t , I went to them, and I t o l d them. I t j u s t came out of me. I couldn't stop once I s t a r t e d and I t o l d them everything that happened. We c r i e d . Then i t brought me and my older s i s t e r together and i t sort of pushed me and the other one apart but nobody get along with my younger s i s t e r anyway because she's such a b i g mouth. Group- therapy Social-worker supportive and h e l p f u l E f f e c t s of disclosure 131 I: Why was i t important for you to speak with them about t h i s experience? What do you think? S: Um, I want everybody to know about i t , you know, i t s l i k e a b i g secret to me and i t hurts to hold i t insi d e so, um, I wanted them, at the time I wanted them to know and I t o l d them I was working the streets too and they got r e a l l y choked at me for that. The one, the younger one didn't, r i g h t , she asked me for money, a c t u a l l y , she asked me i f she could borrow f i f t y d o l l a r s so I got choked at her because of that and i t pushed us apart and we don't r e a l l y t a l k now. And the oldest one gave me s h i t f o r i t and that's what I was looking for, someone to get mad at me fo r doing these things to myself and also to hug me f o r knowing what I went through with my dad. But I had to t e l l her what happened with him so that she'd understand why I sta r t e d working the s t r e e t . I: Do you think she might have helped you to decide to quit? S: Um, no. I quit by myself. That Decision-making regarding was me myself. There's g i r l s out ending p r o s t i t u t i o n there who l i k e sex a l o t and i t doesn't bother them to do i t . They can do i t , and do i t and do i t . You know, and then there's other ones out there who j u s t , you can do i t for a while and then you stop and then when you go back to second time, i t s , you have a t o t a l d i f f e r e n t look, you're disgusted, you can't handle i t and i t makes you f e e l r e a l l y d i r t y inside and outside. S i b l i n g s rea c t i o n to disclo s u r e regarding p r o s t i t u t i o n I: What do you f e e l about that r i g h t now? S: Um, part of me sees i t as a learning experience and the other part, I regret doing i t and sometimes l i k e , um, I was with my mom once and we were shopping i n Chinatown, and t h i s man, he used to be a regular date of mine, drove up and he sta r t e d y e l l i n g my name out across the st r e e t but the thing i s that when I was working I t o l d everybody that my name Feelings & thoughts regarding the p r o s t i t u t e experience 132 was Kathy, my name's Sheila, and he kept on going Kathy, Kathy, Kathy and my mom's going "Who's he y e l l i n g at?" and 1 said, "I don't know" and we and j u s t kept on walking and he followed us around f o r a b i t and then he j u s t l e f t us alone. But I thought I was going to die, that he was going to k i l l me. I was so scared I didn't know what to do. I: What do you view as the major co n t r i b u t i n g f a c t o r to your attempted sui c i d e , or taking the p i l l s ? S: Um, yea, well, i t s got to do with The contributors to the my boyfriend but a l o t of i t s got to suicide-attempt do with my abuse because of that put me i n a s i t u a t i o n where I f e l t that nobody cares about me, you know, and nobody loves me and my dad never loved me, how could he love me and do that to me. You know, and that makes me look at my boyfriend and say, well, he doesn't love me, i f he loved me he wouldn't make me work the str e e t , he wouldn't t r e a t me l i k e t h i s . So obviously doesn't love me. My mother doesn't, she doesn't care about me, you know, otherwise she wouldn't have sent me there, and I j u s t f e l t a l l alone and everything. I had no one I could t a l k to about i t and I had a l l t h i s s t u f f kept i n inside of me and I couldn't get i t out and I didn't know what else to do so I that's what I did. I: How do you explain that even though you have l i v e d here i n the group home for about two years, you s t i l l f e l t l o n e l i n e s s , and you didn't ask f o r help? S: Well, I knew that i f I t o l d them, D i f f i c u l t to go for help they'd watch me, you know, they'd come down and check on me and everything and um, I didn't want them to do that, you know, then I'd f e e l l i k e , I don't know, I'd f e e l r e a l l y bad, and I'd j u s t , I'd hate i t , I'd move out, I'd run away or j u s t not come home f o r long periods of time and s t u f f . I: I t s sounds to me that you are s e n s i t i v e when people watch you, or give you orders. 133 S: Well, I care about people and people's f e e l i n g s and I care about what they think about me and whether I l i k e them or not, you know, I mean, I might, I might hate the person but I s t i l l care about what they think about me. You know, l i k e i f I was walking down the st r e e t , and someone didn't even know me and they gave a d i r t y look and said, "Hey Slut" or something I would get very upset, I wouldn't understand why, why i s t h i s person c a l l i n g me a s l u t , they don't even know me. You know, l i k e I'm r e a l l y , I don't know. Concern f o r others f r a g i l e self-esteem I: How do you understand t h i s , that even i f you don't know these people you s t i l l get hurt. How do you understand that? S: Yea, I know, yea. People can say whatever they want and other people, they can go "Well, I don't care", you know, that's there opinion, you know but I can't do that. Um, l i k e , i t s hard enough as i t i s f o r me to connect with people and when people l i k e me. Like, i t s r e a l l y hard f o r me to do that and i f someone's j u s t walking on the s t r e e t and they s a i d that to me, I would get r e a l l y offended and I would s t a r t to think, you know, well, am I dressed l i k e a s l u t , do I look l i k e a s l u t . Why are they c a l l i n g me that, you know, I never d i d anything to them and i t would upset me. You know, I went a l l the way through elementary school with people c a l l i n g me dog and saying "you're ugly" and s t u f f l i k e that and t h i s i s mostly the g i r l s . I mean, t h i s i s why I don't get along with g i r l s very well i s because of that and the only reason why they d i d that i s , that I can fi g u r e , i s because I dress with l i k e , brand new clothes l i k e them. My clothes were l i k e , my jeans were a l l ripped up i n the knees and s t u f f . My runners were l i k e o l d runners. They had brand new shoes and brand new designer jeans and nice clothes and they d i d t h e i r h a i r nice and they wore makeup and I wasn't allowed to wear makeup and i n the V u l n e r a b i l i t y Explanation regarding s e n s i t i v i t y and v u l n e r a b i l i t y 134 morning I didn't r e a l l y have time to do my h a i r and I didn't know how to s t y l e i t l i k e they did, so i t was l i k e . . . Well, no, l i k e , a l l the way through growing up and s t u f f , I always f e l t I'm r e a l l y ugly and s t u f f but to have a female s i t down with me and say we l l , you are good looking and explain things to me, you know, and s t u f f , that would help, but.... I: Uhmm... S: Yea. Like once i n a while I'd be on the bus, or something and a o l d couple would be on the bus and they'd s i t and they'd look at me, you know, l i k e I was on the 49th bus one time and t h i s o l d couple were s i t t i n g there and they kept on looking back at me and they were smiling and when they got up to leave the lady got o f f the front and she smiled at me as she went o f f and the o l d man got o f f the back and he winked and waved at me and I'm j u s t thinking "Whoa.." (giggle) You know, i t made me kind of laugh but i t made me wonder why are they smiling at me, you know. Feeling insecure I: How do you f e e l and what do you think when people l i k e you or l i k e the way you look? S: I guess. ( g i g g l e ) . Its l i k e , w e ll, people, l i k e guys, you know, they come up to you and they, or you j u s t meet a guy and he says you're very a t t r a c t i v e or you're pr e t t y or something, I laugh at him because I think that he's j u s t making a pass at me, I don't think he r e a l l y means i t . He j u s t wants to sleep with me, that's a l l I think, r i g h t , so that's, I'm very, l i k e , s e n s i t i v e to that s t u f f . And he could be, l i k e , r e a l l y sincere and we could be, l i k e , j u s t t o t a l f riends and I'd s t i l l think that, you know, unless he was gay. (laugh). D i f f i c u l t i e s regarding r e l a t i o n s with the opposite sex I: Then you are sure that sex i s not involved. S: Right. Yea. I: You t r i e d to protect yourself, somehow. 135 S: Not so much as I used to, when I was used to I used to have a r e a l l y bad, Carolyn (the s o c i a l worker) c a l l e d i t l i k e , a wall that's i n v i s i b l e but i t s a l l around me and nobody can get to me unless I want them to, l i k e , here there's a l o t of hugging and l i k e , we c a l l i t hug therapy and we a l l cry and we a l l have l i k e , one b i g group hug, you know, everybody hugs each other i n one b i g group c i r c l e and s t u f f l i k e that. When I f i r s t moved i n nobody could touch me or come near me and I talked to people only i f I wanted to otherwise I'd get up and walk away while they're t a l k i n g to me, you know, i f i t was something I didn't want to hear or something I didn't want to t a l k about, I'd j u s t get up and walk away. With Carolyn, i t took her a long, long time, l i k e , she's r e a l l y good, l i k e , t h i s i s the best group home i n Vancouver, I think, and i t took her a long, long time to break through to me but when, I don't know, I guess, she puts i t l i k e when I s t a r t e d getting to a point when I was bringing i t down a b i t , I'd come up and I'd put my arm around her neck so her head would be r i g h t here and t h i s i s about as close to a hug as I could get, you know, I'd be behind her so she couldn't hug me so I'm safe that way. I can sort of hug her and be safe without having her hug me because i t would upset me. That's why I was scared of getting upset, someone touches me I'm going to cry and I didn't want to cry so I'd always avoid a l l these things that would make me get upset. Protection of s e l f Group- therapy D i f f i c u l t i e s regarding interpersonal r e l a t i o n s P o s i t i v e f e e l i n g s towards s o c i a l worker and group -home. Maintaining c o n t r o l and safety Protection of s e l f I: So how would you explain that Carolyn could reach you? S: Well, we have, they have these groups and s t u f f , r i g h t and people would t a l k and g i r l s have been there longer than I have, when I f i r s t moved i n so they were l i k e , r e a l l y , connected with Carolyn. Everybody l i k e s her. There's not one person that hates her when the move i n , I've seen g i r l s come and go through here, Social-worker supportive, h e l p f u l 136 l i k e , I've been i n here longer than anybody since t h i s place opened and there's not one person I know that doesn't l i k e her besides my ex-boyfriend and he doesn't l i k e her because she's a r e a l person and he's playing pretend games and she's t e l l i n g him to be r e a l , r i g h t , and t e l l i n g me that he's not good for you, i f he d i d love you he wouldn't make you work the str e e t , he wouldn't do a l l these things, and I'd go and I'd say to him, well, Carolyn says, you know, i f you r e a l l y did, and I'm s t a r t i n g to be l i e v e that and he'd get a l l p i s s e d o f f so he's the only person I know that doesn't l i k e her. I: Has the r e l a t i o n s h i p with Carolyn change anything f o r you? S: Yea, she's l i k e my second mom, now, you know. I t a l k to her more than I t a l k to my own mom. I don't think that I could have opened up l i k e t h i s without her help. Social-worker a "second mom" I: That's great. Going back to the event of taking the p i l l s , has anything p o s i t i v e come out of t h i s , has i t changed your s i t u a t i o n a f t e r that, what do you think? S: Well, I think I ' l l never do that again. Its made me strong, because at that time I was going through a l o t and I can get through that, l i k e , I made i t through that, and, l i k e , people t e l l me w e l l , you're a f i g h t e r , you know, and I think now, i t doesn't matter what happens to me, I ' l l always be strong and I ' l l get through i t . You know. And i t also made me r e a l i z e that I can't keep my problems and i f I everything inside, I have to t a l k to someone about i t and i f I don't get them out of my system I ' l l blow up and, you know, I ' l l e i t h e r beat someone up, which I haven't done for ages, or, um, I ' l l j u s t do something stupid. I won't do i t again, but, you know. Healing-suicide-attempt a. c a t a l i z a t i o n to a p o s i t i v e change. Importance to t a l k out I: So a f t e r t h i s experience you thought that there are d i f f e r e n t ways to deal with your problems l i k e t a l k i n g to people, and getting outside help. 137 S: Yea. I: What advice would you give other adolescents who are faced with the same experiences? Importance to t a l k out S: Well, I wouldn't t e l l them to commit s u i c i d e , that's f o r sure. I f anything I'd t e l l them to t a l k to someone and i f they can't t a l k to someone, to, l i k e , write i t a l l down on a piece of paper and then you could e i t h e r r i p i t up or burn i t or save i t 'cause you have to get your problems out of your system or even l i k e , i t s better to t a l k to someone about i t , how you f e e l , but i f you can't, l i k e , you know.... I: Uhmm... Awareness of others' S: Well, I can see i t coming, l i k e I s i t u a t i o n know when people get to the point where they're going to do t h i s 'cause I know, I've been there and I can see i t happening and I w i l l go down and I w i l l , l i k e , one of them here, goes Healing-helping others through a l o t of t h i s s t u f f and I went down to her room one time and I talked to her, you know, l i k e , she's new here so she doesn't r e a l l y understand too much, and she doesn't have anybody she can turn to and I made friends with her rather quickly and um, I went down and I sa i d you know, "Is there anything that you want to t a l k about, or something, you don't look l i k e you're too happy and s t u f f , r i g h t " and I explained to her, l i k e , "You don't have to worry, l i k e i f you don't want me to say anything to anybody else or s t a f f then I won't, you know, that's l i k e , that's up to you but i f you need to t a l k to me, I'm here, l i k e I'm here for you and she did. Like, she sta r t e d c r y i n g and she t o l d me a l l about what her problems were and s t u f f . I: Did i t help her knowing that you had the same experience i n the past to be more open to you? S: Yea, we were both crying and then I cheered her up a f t e r she got Being supportive, empathic and caring f o r others 138 everything o f f her chest she f e l t b e t t e r but every since then she hasn't done anything so... I: I t s h e l p f u l when you have someone... S: She knows that i f she does I'11 be r e a l l y choked at her, too so that helps because she cares about me enough to not want me to be made at her and I s a i d I won't hate you, I can never you, I ' l l s t i l l care about you and everything but I w i l l be piss e d o f f , and I said, and I don't get p i s s e d o f f . When I do i t s not for very long, i t i s there. I: Can you think about more advise for adolescents with the same experiences that you had? S: Well, with me at the time, I had problems with my boyfriend, for instance, so i f there was someone and they were having problems with t h e i r boyfriend, I would t r y to suggest, l i k e , to s i t down and t a l k with them about t h i s , and f i n d out what's r e a l l y going on and why he's acting that way. Um, with f e e l i n g bad about myself, um, I don't think that there's r e a l l y much I could say for that, l i k e , you know, i f I had someone else there t e l l i n g me s t u f f about myself to make me f e e l better, then I wouldn't, you know, that might have changed my mind a b i t . I: Now you are going back to school. Which grade? S: Um, I'm doing upgrading r i g h t now so I guess I'd be i n grade eleven. Um, and I am also getting my independent l i v i n g so I ' l l be l i v i n g out on my own. I'm s t i l l looking f o r an apartment. I've been looking since December for a place for January so now i t s l i k e February 1st, I'm moving. I: What do you f e e l about that? S: I hate i t . Healing - new problem -sol v i n g s k i l l s regarding heterosexual r e l a t i o n s The importance of having support Healing - plans for future I: You hate i t ? 139 S: Well, I can't f i n d a place. Like, I've always wanted to be on my own, ever since I was t h i r t e e n years old. I wanted my own apartment, you know, and now I've got the chance to do i t so I'm r e a l l y happy but at the same time I'm sort of sad 'cause I'm going to miss everybody here and uh, I'm worried, I can't f i n d a place so I'm thinking, "What, am I never going to be able to f i n d an apartment, or what?". That's how I f e e l , r i g h t . Hope Ambivalence regarding leaving the group-home I: Are you going to l i v e by yourself? S: Yes, by myself. I: Oh, i t sounds l i k e a b i g change. S: I t ' s going to be so nice. Peace and quiet. I've always... that's what I wanted ever since I was t h i r t e e n . I: You went through very d i f f i c u l t s i t u a t i o n s and experiences. We have talked a l o t about your experiences. Are there any other things that have not been discussed that you think are important? S: Uh, no, I don't think I can think of. . . I: Good luck, hope your future plans be successful and thank you very much. S: Thank you, I f e l t a l i t t l e anxious before the interview, but now I f e e l ok. I t was a nice experience for me. I: Thank you again. END OF TAPE. 

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