Mental health articles

The issue of ambivalence in child’s sexual abuse The difficulty with conceptualizing ambivalence in nonoffending guardians as a stance of nonsupport is that it neither takes into consideration normative nor traumatic responses to disclosure. Both are critical considerations. First, ambivalence may be a normative response to the disclosure of abuse by a nonoffending guardian’s loved one, who may have strong feelings towards both the victim and offender. This dual allegiance could result in vacillating emotions, thoughts, and behaviors that are expressed as ambivalence in support. An ambivalent response might also be normative if the costs associated with the disclosure are so great that the integrity of the family structure is threatened by acknowledging the abuse. Indeed, Hooper’s (1992) qualitative analysis in an earlier section suggested that ambivalence was a normal response. This ambivalence could also reflect a breakdown of adaptive coping mechanisms brought on by spiraling losses. Having lost internal, social, and community resources, nonoffending guardians may then employ self-defeating coping mechanisms (Hobfoll et al., 1996) that may present as ambivalence. Regretfully, the cost to these mothers of appearing ambivalent, even if that ambivalence is normative, is that they most often lose their children. Another consideration is that ambivalence may reflect a posttraumatic response to the abuse disclosure. Indeed, a large number of nonoffending guardians develop posttraumatic symptoms or posttraumatic stress disorder (De Jong, 1988; Wagner, 1991). One of the hallmarks of this symptom presentation is the alternation between avoidant and approaching symptoms and behaviors (American Psychiatric Association, 1994). These symptoms may present in nonoffending guardians as vacillations between belief and disbelief of the child’s disclosure and even between supportive and nonsupportive behaviors. Considering that the disclosure has so many adverse and overwheIming meanings to nonoffending guardians, their ambivalence may be more keenly related to posttraumatic symptoms than to an unsupportive stance. Regardless of whether an ambivalent response is normative or posttraumatic, an argument can be made that children remain in danger when allowed to stay with nonoffending guardians who are responding ambivalently to the abuse disclosure. This is certainly an important issue but one that retains prominence only because nonoffending mothers have primary responsibility for maintaining the safety of their child from the alleged offender and because successful treatment strategies have not yet been developed or widely implemented. By increasing supportive behaviors, well-designed intervention strategies might be successful in averting removal of the child. Further, if the burden for protection could be removed from mothers, or shared among others, then they would have greater freedom to work through their reactions to the abuse disclosure without such grave penalties. While it may seem implausible that our policies will change, we must still consider whether to so harshly penalize nonoffending guardians whose inability to cope adequately with the abuse disclosure may be normative or posttraumatic, or may even be exacerbated by the interventions of professionals.

Tags: child, sexual abuse