Reconceptualizing Collateral Damage:

A Family Systems Perspective on Siblings of Sexually Abused Children

Doreen Arcus

University of Massachusetts Lowell, USA

Paper presented at the 9th

European Conference on Trauma Studies

Stockholm, Sweden

June 20, 2005

Children in Families

• Context: Family

• Parents and siblings

• Family system• Inter related roles in dynamic interplay• Balance & homeostasis• Effect to one member has influence on all

Siblings and CSA

• Popular misconception: If one child is sexually abused then others are likely to be abused also

• Parents as perpetrators: Less likely to be non-abused or non-targeted siblings

Perpetrators: All Maltreatment Types, US 2003

14%

80%

Combined

Other Relative

Parent

Source: National Child Abuse & Neglect Data System (NCACDS) 2003

Perpetrators: Child Sexual Abuse, US 2003

6%

8%

23%

27%

30%

Combined

Unmarried partner

Missing/unknown

Other

Other relative

Parent

Source: National Child Abuse & Neglect Data System (NCACDS) 2003

CSA Perpetrators against Females

51.1% 48.9%

Non-family

Family

Vogeltanz et al (1999) National (US) Survey. CSA defined by Russell criteria

Family CSA Perpetrators against Females

11%

7%

14%

24%

12%

8%

18%

Other Male Relative

Female Relative

Grandfather

Uncle

Male Cousin

Brother

StepFa/MoBoyfrnd

Father

Vogeltanz et al (1999) National (US) Survey. CSA defined by Russell criteria

Sexual Abuse Perpetrator outside family

Less likely to target multiple children in family

More likely that family contains children who have been abused and children

who have not

How Many Siblings Do Children Have?

(US Census 2002; N = 72,320)

Number of Siblings

Five+FourThreeTwoOneNone

30000

25000

20000

15000

10000

5000

0

Mean = 1.42

Siblings in Adoptive Families

• Public agency adoptions due to care and protection issues

• High probability: Maltreatment history

• 40% US adoptions in 2000

• Private adoptions: History unknown

Households with Adopted Children, US 2000

47.9% 48.4%

Adopt + Bio + Step

Adopt + Step

Adopt + Bio

Adopt only

Census, 2000; Note 85% households with adopted children have one adopted child

Clearly there are siblings involved.

So, where are they?

Research Literature

• PsycINFO search

• KW: Child sexual abuse or sexually abused child*

• N = 2210

• Combined terms:

• Family or families

• Parent*

• Mother* or maternal

• Father* or paternal

• Sibling* or bro/sis

Number of articles in PsycINFO Keyword search

Child sexual abuse AND ...

SiblingsFatherMotherParentsFamily

500

400

300

200

100

0

Search 06/05 using PsycINFO (1840-Current) Database

Sibling & CSA: Content

• Sibling as perpetrator: 33%

• Effects on sibling: 25%

• Sibling role in treatment: 17%

Effects

• Vicarious traumatization• Sibling has a trauma history• Target child’s trauma evokes sibling’s history• Sibling emotionally assumes role of victim

• Secondary traumatization• No trauma history • Trauma experienced by empathetic connection to

victim and listening to victim’s story• Sibling experiences symptoms parallel to PTSD

Parenting the Sexually Abused Child US Dept Health & Human Services,

National Adoption Information Clearinghouse

“Siblings who are aware of a brother or sister's victimization, but are not actually abused themselves, may also suffer many of the same effects as an abused child.”

Alternatively: CSA in Family System

• Crises in the family system around the child who has been sexually abused

• Effect on sibling not direct but via role in family

• Sibling motivated to help, as individual is overwhelmed by target child needs

• Sibling is not a parent but another child.

• Can’t deal with PTSD directly, can support system by doing his or her part not to tax resources needed for target child

Family System• System cannot be reduced to parts without altering

the relationships between components.

• Components are interdependent and interconnected

• System is self organizing; drive toward balance & homeostasis

• Systems with permeable boundaries will only survive if more energy imported from environment than expended in the process of getting it

Sibling Contributes to Family Functioning

• Dynamic inter-relationships

• Keep system intact and moving forward

• Needs and resources in balance

• Target child in crisis: demands on system

• Sibling in response: demands on system

Illustration

Parental Coping Resources & Children’s Needs

System Balanced

Balanced System: Sufficient Resources to Meet Fluctuations in Need

CSA: Parental Coping Resources Limits Exceeded

Homeostasis disturbed

System unstable & unsustainable

Long Term Solution:

Add reserves of coping via therapy & support

Reduce need via therapy & support

Problem:

It takes time

Redistribute Parental Coping Resources by Needs Reduction in Non-targeted Sibling: Homeostasis Restored

Non-targeted Self-sufficient child

• Under the radar screen

• Doesn’t drain resources

• Takes care of own problems

• Clings to NORMAL

Risks for non-targeted child

• Lack of maturity poor decision making

• Low profile underachievement

• Vulnerability increased during transitions• Consequences of poor help seeking exacerbated

Support: Lukens et al 2004Siblings on Severe Mental Illness: Family Dynamic

“I can imagine being more emotionally open if I hadn't been faced with such … wild emotions when I was growing up and in my teens.”

“It was my job to be sane, to leave the house, to go to college.”

“I think we overcompensate. We do everything better than normal.”

“I subjugate my needs; do everything to not upset my parents.”

“I am almost shocked that I am remotely sane.”

Support: Lukens et al 2004Siblings on Severe Mental Illness: Anger

“In all honesty it has been a trial from Day 1.”

“How could I have fun if my brother is in the hospital?”

“How could I have fun when my parents are devastated?”

“How could I go and do something that is good for me when I know what he is going through?”

“You start to feel like, my problems are so inconsequential. She's mentally ill, she's schizophrenic for god's sake. I had a bad day at work, how can you compare the two?”

Sibling essay excerpt

Explaining low grades HS & beginning College

“In high school I had little drive for education, and my grades showed it. In fact, I was hesitant to stand out in anything, academically or otherwise. Undoubtedly, my complex family situation had something to do with that. My younger and only brother suffers from Post Traumatic Stress Disorder and has required substantial attention from my parents over the past 10 years. Since I knew how much extraordinary attention he needed, I decided unconsciously that I didn’t need any. I had to do my part and take care of myself. I rarely asked for help in school and tried to keep everything low key.

Essay

Essay, cont’d

“This laid back, self-sufficient approach to school carried over to my first semester at [college]. At the end of the semester, a 1.9 GPA and notice of academic probation offered clear evidence that my approach wasn’t working. I was angry with myself and vowed that I would never be a slacker again. Since then, I have completely retuned the way I approach school and have gotten nothing but A’s and B’s.”

Sibling Resistent to

• Individual therapy

• Support groups

• Clinging to role as Normal child

Research Challenges

• Control group• Presenting child v. Potential child• Clinical samples v. Prospective studies

• Reliance on self-report• Filtered through Self-as-Normal lens

• Interaction with • Pre-morbid family interaction patterns• Temperament of child

Next steps…

• Research: Family contexts CSA

• Research: Sibling experience

• Interventions: Support family systems to support both CSA victims and non-targeted siblings

Support: Lukens et al 2004Siblings on Severe Mental Illness: Positive Impact

“I can really tune in with people's pain—this is both a curse and a blessing. I've developed a deep compassion for people and [learned] not to make quick judgments. Wherever I work people will congregate in my office—I think they feel safe with me.”

“Perhaps it has made me more compassionate.”

“I think this has actually helped me to develop a deeper understanding of the human condition and what it is that makes us human. It's very deep and very complicated.”