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Archive for March, 2010

I’ve just fielded a question on the Talk page of the Wikipedia article on PTSD. It’s a good question (a couple, actually), and my answer might be useful to repeat here. The visitor asks why the article says this:

“Children may develop PTSD symptoms by experiencing bullying or sexually traumatic events like age-inappropriate sexual experiences.”

The concern is the reference to “age-inappropriate sexual experiences” rather than “rape”.  “Why does it say that instead of simply rape?  The Webster dictionary defines rape is having sex with who is below a certain age [http://www.merriam-webster.com/dictionary/rape%5B3%5D].  And what does age-inappropriate mean?  Would it be less dramatic if the person was their own age, instead of significantly older?”

My response (edited very modestly, for this venue):

I don’t have time to provide you with the reference citations which I’d like to offer, in responding to your questions, but  will respond using the knowledge I’ve acquired from many trustworthy sources in over 30 years of work in clinical and research psychotherapy, involving adults, adolescents, and children, many of whom had experienced what we call age-inappropriate sexual activity, often with negative consequences. I hope you’ll forgive my not backing up what I say with proper sourcing.

First, your questions are excellent ones. Please understand that casual language is often sloppy, and this won’t help us here. What the law, or the dictionary, defines as rape may well be different in important ways from a medical or psychological definition. The dictionary you cite appears to be giving a pseudo-legal definition. There is no “right” definition. Linguists write definitions (and dictionaries which contain them) on the basis of how people USE words. Philosophers and other thinkers are free, of course, to ”stipulate” definitions, as well. In formal, thoughtful writing, we usually stipulate definitions so that they help us with our thinking. They become tools, used to accomplish goals. That’s why legal people see “rape” differently than, say, anthropologists, or therapists. And note that even in groups of professionals in the same field, definitions can differ significantly.

So, let me begin by saying simply that from my perspective rape is always inappropriate (!), and is AGE-inappropriate when it involves a sexually immature individual. Note that physiological sexual maturity bares only a loose relationship to legal sexual maturity, and for good reasons (which I won’t take up here). If only some rape is ”age-appropriate”, as opposed to simply ”inappropriate”, it is also true that not all age-inappropriate sexual behavior is rape – which I think should be obvious, upon a little reflection. Inappropriate touching, for example, isn’t necessarily rape.

Age-inappropriate sexual experiences, in psychology/psychotherapy are those generally seen as those which involve an individual doing something sexual which is clearly not usual or expected for their age. This can be tricky to distinguish, however. Clearly, many, if not all, infants and children explore their sexual organs, and each others’, as well. This is normal, and generally harmless. At what point is something age-inappropriate occurring? There is no clear dividing line. It not dissimilar to the problem of distinguishing pornographic literature from erotic literature. I can offer no easy solutions to these problems.

That said, the key concept here is that sexual experiences involving children/adolescents who are not sexually mature ”can” have immediate and/or delayed long-term negative consequences. This is clearly cause for concern. It is very important to note that not only are not all sexual experiences children have inappropriate, not all of them cause any problem at all. Event consequences are driven by the degree of involvement, the nature of the act, whether or not there was coercion, how the child felt about it at the time, the reaction of adults who came to learn of the event, and so on. Many factors influence the consequences of a sexual experience involving a child.

We should never simply stipulate that something MUST be a problem (although this is commonly done in courtrooms). Rather, when we let the individual involved tell us of their experience and what it means to them, then we can know the real psychological consequences.

Well-meaning people can create a problem where none existed, with a child. Some individuals come through quite serious experiences with very little if any damage. Others are greatly hurt by what appear to be modest experiences. And, regardless of the consequences, those of us who come to learn of a given experience may have good cause for concern. It would be nice if we could view all this in simple terms, but I don’t think that would be accurate, useful, or intelligent.

Among the problematic consequences of age-inappropriate sexual behavior which we deal with in clinical psychotherapy are these:

* Lose of a child’s sense of safety: Loss of control over what’s done with your body is at the least unpleasant, and at worst traumatic. It may be difficult to feel safe in the world for some time after such an event.
* Loss of trust of key individuals in a child’s life: A sexually inappropriate relative becomes an untrustworthy relative. Children need families they can trust. A sexual abuse incident is one way to lose a functional relationship with a sibling, or a parent, or a grandparent. This can have long term consequences.
* Outright psychological trauma: When there substantial levels of fear involved, and the child is unable to resolve these feelings. enduring trauma may result. This is how once acquires PTSD.
* Premature sexualization of the child: This is the problem non-professionals usually forget or ignore or have no awareness of. Children introduced to sexual experiences before they are ready or desirous of them, may come to think that sex is a part of emotional intimacy. This may lead them to be sexual with other children, or other adults, in unwanted and unacceptable ways, and in ways that can damage others as well. I once knew a very pretty, charming 10 year old girl who had been removed from a succession of foster homes because she couldn’t keep her hands where they belonged. She had been “prematurely sexualized”. She thought what she was doing was OK, and her behavior led to repeated social rejection. This sort of thing is far more common than most people realize, and definitely one of the reasons why we’re concerned about age-inappropriate sexual behavior. It can lead to an child’s experiencing themselves as unacceptable to others in general, which can lead to depression, self-medication with various psychotropic substances, and other long-term damaging consequences.
* Disturbance to individuals associated with the child: Even when inappropriate sexual experiences are not a problem for a child, they can be for others. I dealt with a 9 year old boy once whose parents were quite upset because his female babysitter (age 13 – and not a relative) had climbed into bed with him late at night. They couldn’t imagine that he wasn’t somehow injured by this experience – clearly (one would think!) age-inappropriate sexual behavior. It turned out that he was only annoyed. He couldn’t make sense of what she was doing, and got up, went downstairs, and slept on the family sofa. Problem solved. All I had to do was calm down the parents, so they wouldn’t continue to disturb their son.

This is not intended to be a complete list, but I do believe it addresses most major issues.

Relative to a hypothetical age-inappropriate sexual experience, you ask “Would it be less dramatic if the person was their own age, instead of  significantly older?” It could well be, although “drama” is not the issue, as I’m sure you realize. The problem with older individuals is their misbehavior can lead to a needless and inappropriate distrust of all older people. Also, older individuals are likely to initiate more mature (and thus age-inappropriate) activities with younger individuals. At the same time one must note that in most cultures it is deemed appropriate for young, sexually mature hetersexuals to pair off such that the male is older than the female – one major research effort determined that the age difference deemed ideal by many cultures was about 3.5 years (with the male being older).

I will conclude my remarks by saying that I’m concerned about the tendency in some families, communities, and schools, to pathologize the normal. Two six year old girls simulating intercourse, because they are curious and cannot make sense of why adults would do this, do not really need a semi-hysterical, or punitive, or any other negative reaction from adults. I could cite other cases, many of them not so easy to think about…and that’s my point. A thoughtful examination of an event is a far wiser response than is a knee-jerk negative reaction of any kind. I prefer to act from knowledge rather than pre-drawn conclusions based on some principle rather than good data. It think that we don’t yet have all the knowledge about age-inappropriate sexual experiences that we’d like to have. The situation is clearly better than it has been in the past, without doubt, but we’re not finished out work, so to speak.

I hope my responses are useful to you. Thanks for your great questions!

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