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Print version ISSN 0104-1169
Rev. Latino-Am. Enfermagem vol.17 no.4 Ribeirão Preto July/Aug. 2009
Child sexual abuse: the perception of mothers concerning their daughters' sexual abuse
Quitéria Clarice Magalhães CarvalhoI; Marli Teresinha Gimeniz GalvãoII; Maria Vera Lúcia Moreira Leitão CardosoIII
IUniversidade Federal do Ceará, Brazil: Doctoral student, e-mail:email@example.com
IIUniversidade Federal do Ceará, Brazil: Ph.D. in Tropical Diseases, Adjunct Professor, e-mail: firstname.lastname@example.org
IIIUniversidade Federal do Ceará, Brazil: Ph.D. in Nursing, Adjunct Professor, e-mail: email@example.com
Domestic violence affects all members in a family and children are considered the main victims. This qualitative study aimed to grasp the perception of mothers whose daughters were sexually abused. Data were collected between February and March 2007 in a governmental facility in Fortaleza-CE, Brazil through semi-structured interviews with ten mothers of sexually abused children. Data were submitted to the Collective Subject Discourse Technique from which three themes emerged: Guilt is rooted in the motherhood myth, unhealable pain and despair as a consequence of a feeling of powerlessness. Results evidenced that mothers experience a range of feelings in which pain, revulsion and powerlessness are highlighted. Society should be engaged in the subject and interested in understanding violence, its magnitude and the whole affected chain, otherwise, only good intentions will remain, lost in the void from the lack of action.
Descriptors: sexual violence; child abuse, sexual; mother-child relations
Violence is a concept difficult to conceptualize because of the numerous situations that characterize it. Hence, this study adopted the concept used by the Brazilian Ministry of Health in its policy developed to fight the problem. Violence is defined as actions perpetrated by individuals, groups, classes or nations that cause physical, emotional, moral and/or spiritual harm to oneself or to another(1). There is also the notion that violence involves rules and power relationships in which the aggressor dominates the victim, whether through physical force or economic or emotional power, among others.
Although violence is a problem worldwide, there is not a specific element explaining why some people behave violently toward others or why violence occurs more frequently in some communities or homes than in others. What is known is that violence results from a complex interaction of factors composed of socioeconomic, political and cultural determinants. Violence committed against children and adolescents is specifically classified as physical, psychological or sexual violence, neglect, and also as Münchausen syndrome by proxy, which is a disorder in which the parent or guardian ensures the child has health problems(2).
The most common form of violence against children, however, is intra-family violence. It is so-called but it is not exclusively limited to the family because it can involve people who share the same domestic environment and may or may not be related to the child(3). Children have their own personal characteristics, which are formed according to biological and emotional components and the family is a determining element in this biopsychosocial formation(4).
Among the types of violence that occur in the family sphere, there is sexual abuse, understood as a sexual act, and heterosexual or homosexual relations, wherein the aggressor is psychosocially more developed than the child or adolescent and aims to sexually stimulate or use the child to obtain sexual satisfaction(5).
Sexual abuse varies from acts that involve sexual contact with penetration: oral, vaginal or anal intercourse; or without penetration: improper touches (manipulation of genital organs), kissing, masturbation, pornography, photos, exhibitionism, or obscene phone calls(6).
Statistical data regarding the theme lead to reflection about the family components, especially the maternal figure. According to the literature, the mother is the person most required to provide help(7).
The mother is, in the family context, the closest person to the child and "should" be more attentive to signs of sexual abuse, although oftentimes, due to unconscious processes determined by her own life history, she denies the evidence. This fact, however, does not justify the idea that mothers should be punished. Instead, one should try to understand the family dynamics as a whole(7). In this context, the maternal figure is also part of the victimized universe; she is considered a secondary victim(8). In this way, the relevance of this study is based on the statement that not only the child needs to be cared for, but also the mother and the whole family. Based on the preceding, this study aimed to understand the perceptions of mothers whose daughters suffered child sexual abuse.
This qualitative-descriptive study aimed to understand the problem from the perspective of those who experience it, that is, part of their daily life, satisfactions, feelings and desires.
Data collection was carried out between February and March 2007 in a government facility in Fortaleza, CE, Brazil. This organization attends to children and adolescents who are victims of sexual violence, abuse and exploitation. It provides special social protection of average complexity delivered by a multiprofessional team that includes: social work assistance, psychosocial care and legal support to victims and their families.
Participants were ten mothers of female children from 4 to 10 years old, all victims of sexual abuse. The number of participants was determined by the principle of saturation, verified when reports started to repeat(9).
Data were collected through individual and recorded semi-structured interviews conducted in a private room. Interviews were fully transcribed.
By interview, we understand an instrument to collect the raw material of reports. The first part of the instrument used in this study was composed of social identification and economic and demographic information. Its second part contained a question related to the study subject: How was it for you to learn that your daughter was sexually abused?
Reports were analyzed according to the Collective Subject Discourse method (CSD). According to the literature, the CSD is not interested in the mechanical or automatic mathematization of collective thought or in the use of meta-language. Its role is to make the social express itself in a scientifically rigorous way, using explicit, clear and standardized procedures, developing the social report with the empirical content of individuals' reports(10).
CSD is composed of the following elements: key expressions, central ideas and anchorage. Grouping key expressions that give origin to central ideas or related anchorage result in one, or several, synthesis discourse(s), expressed in the first person singular and which symbolize the collective; that is, the collective is expressed through one "person".
After the interviews were fully transcribed, they were submitted to careful readings in which key expressions emerged. After reading was concluded, several central ideas/anchorages were obtained, which are represented by the following themes: I. Guilt is rooted in the motherhood myth, anchorage emerged from - the search for the perfect mother myth; II. Unhealable pain; III. Despair as consequence of a feeling of powerlessness.
The study was approved by the Ethics Research Committee at the Federal University of Ceará (Protocol No. 11/07). The letter "M" followed by a number according to the order of interviews (1 to 10) was assigned to each participant so as to ensure their anonymity.
The description of the participants presented in Table 1 lists some characteristics of mothers (informants) to help understand the CSD. The mothers were young, had either a paid job or were housewives, and had other children. The girls who suffered sexual abuse ranged from four to ten years old. With the exception of one participant, all the girls were closely related to the aggressors. In four cases, the aggressors were their own fathers. Based on the individuals' characteristics, the succession of cultural and subjective elements to which they are exposed become clearer.
Central ideas and collective discourse were obtained from and are represented by three themes. Analysis of central ideas and reports of the collective subjective aimed to understand the feelings of mothers, which were derived from each report.
The CSD that refers to the guilt rooted in the maternal myth is directly related to cultural elements that demand the desired perfection from the maternal figure.
Theme I - From the central idea: guilt is rooted in the maternal myth
It is an immense pain, I wish to die, I feel so guilty because everybody says that a child without a father is no good, because mothers don't know how to raise a child. Sometimes I think, why did I let her go??? If I hadn't, none of this would have happened. The worst thing is that I gave him a second chance. I suffer so much, I even considered killing my daughter and myself, we'd go to sleep and never wake up. She was abused when I was breastfeeding her one-year old sister, the little time I left, it seems she was totally unprotected. He took his chance at that moment because I wasn't around to protect my daughter, this was my mistake. I suffer a lot, I keep imagining the scene. I always ask myself how did I let this happen. If I were there, none of this would have happened.
Everybody says that a child without a father is no good, because mothers don't know how to raise a child. Is it because of this that she is going through all this? The little I know, it seems she was totally unprotected. How did I let this happen? If I were with her, none of this would have happened.
Theme II presents unhealable pain, evidencing the participants' difficulty in overcoming the experience of seeing their daughter victimized in sexual abuse.
Theme II - From the central idea: unhealable pain
It was a terrible thing, I guess I'll never recover, even knowing that she is fine and there was no penetration. I have no words to express how I feel. It is a terrible pain, Jesus, I wish to die. God is helping me; I'm not completely cured because you can never heal from a tragedy like this [...] things settle down, but the pain remains. It was so sad, because, after all he is her father. I was down in the dumps, you know? Couldn't sleep, there was a night she saw me awake and asked me if I was sick or anything, I said I had a pain in my leg, but what wouldn't let me sleep was a much worse pain. No matter how hard I try, I can't express the pain I feel [...].
Despair, as a consequence of the feeling of powerlessness, is presented in Theme III. We can sense the revulsion and powerlessness revealed in the reports in an exacerbated way, which makes these emotions the tormentors of their victims.
Theme III - From the central idea: despair as a consequence of a feeling of powerlessness
If I had a gun at the time I'd have killed him with no pity. I suffer so much. I think she'd suffer even more if I killed myself, because she'd be without me. If I killed her, I'd die of suffering, so I thought that we both should die. I hate him so much, after all he is her father. I was taken aback, I held myself so as not to do anything stupid. It's terrible. I had no structure. I felt so powerless because I didn't see it. In the hour of despair, I spanked her because she hadn't reacted, hadn't screamed. When I took her to the hospital, the doctor said her hymen had been breached, it seemed that the news took me out of the ground. I despaired, went to the streets as if mad, looking for that despicable person, the neighbors went to look for him with me.
The CSD revealed many of our society's beliefs relating to the maternal figure. It is believed that the mother is the best person and the only one capable of taking care of her children. She has to incorporate the qualities traditionally associated with femininity. It is intended that she be so, and thus she seeks to be. She has to have an extreme capacity of offering herself through immense sacrifices(11).
Guilt pairs with the maternal figure and consequently it became a natural feeling(12). Such a feeling, clearly speaking, transformed maternity into a minefield and the woman walks in it, without a map to guide her. We observed that M4 expresses self-reprobation for her maternal "mistake": he took his chance at that moment, because I wasn't around to protect my daughter; this was my mistake.
The mothers have the need to search for the guilty. They unconsciously transfer guilt from the aggressor to the maternal figure, which reveals their disappointment for not having protected their daughters from sexual abuse and therefore they are revealed as imperfect mothers.
There is a narrow view in regard to issues brought by sexual identity and promoted by conceptualizations related to family systems. Society has increasingly failed to acknowledge the central dilemma of many women, given that the rules of motherhood require them to give up their own needs in favor of family needs. They take to themselves the basic responsibility and, oftentimes exclusive responsibility, of raising their children and protecting them, though many times they do not have the needed resources and power(13) .
Accordingly, there are several pressures that allude to irreproachable motherhood. In this context, the feeling of failure becomes perfectly natural, because the myth of the perfect mother was created to be imposed on human beings who have both qualities and defects. There is a model of the mother to be followed, the "perfect," and always patient and kind, attentive to all her child's needs, a totally devoted mother. Any divergence from this standard leads to feelings of guilt or frustration.
Women discover the impossibility of achieving this ideal in their daily life. The guilt experienced by the participants originates in a complex motherhood model that comes about in the absence of errors. This paradigm, initiated by society, makes mothers feel diminished, especially because they are not able to avoid fatalities that occur to their children.
Different forms of communication such as written and spoken communication in addition to the community, generally preach the "gospel" of the maternal figure involved in an atmosphere of "perfection" with the duty of developing her role impeccably. This image ends in guilt, the great tormentor of a happy motherhood. However, this image has to be abolished with a view to make mothers happy and aware of their limitations.
"Pain" is a fundamental characteristic of the emotive life, more precisely a negative one, almost always understood as a sign or indication of a hostile character, against a situation in which a living being is inserted(14). As we can see in this study, the report of M4 evidences the certainty of permanent pain and difficulty in overcoming it: I'm not completely cured because you can never heal from a tragedy like this [...] things settle down, but the pain remains. In the face of this statement, we can conclude that violence is extremely functional, that is, it achieves its goal, destroys, marks and kills.
The violent action represents an attitude in which the abused being serves as a means to realize a destructive fantasy, object of satisfaction, of a desire of death. Violence is the intentional use of aggressiveness to achieve destructive ends. Once violence is perpetrated, the abused individual has to be observed, because this is an issue of complex subjectivity with destructive pain and not only a phenomenon with cultural and social contours that drives the legal system in its punitive function(15).
Violence affects more than the biological sphere. The need to supplant the model of the positivism has been constantly discussed, though, according to what has been highlighted, professionals who attend victims of violence should view this clientele in a systemic way and focus on the subjectivity in their situations.
It is urgent that the multiprofessional team observes the trauma and pain produced by violence because this phenomenon goes beyond sociocultural and legal factors. It immediately acts on one's psyche, on the "self" and life of the abused being as well as on the whole family structure. Knowing the implications of the dynamics of pain, which is the product of violence, should be a priority. For that, objective measures should be taken; care delivered to victims of violence should focus on the biopsychosocial aspects of violence.
We also observed that individuals face the difficult reality of revulsion as a result of the powerlessness feeling. The difficulty in overcoming the situation leads to revulsion and at the same time to a feeling of powerlessness, feelings expressed by the participants. The mothers find it immensely difficult to live with the idea of not having been able to prevent their daughters' suffering, that is, to protect them from being sexually abused.
We can perceive in the reports that revulsion and powerlessness are revealed in an exacerbated way, which turn them into the victims' aggressors. A warning follows: despite the fact that the children were sexually abused, it would be frivolous to state that there was maternal neglect in all the cases. Specifically, in the studied cases characterized by intra-family abuse, the aggressors were people whom mother and daughter trusted and even loved.
The role of the mother as non-abusive parent reveals that sexual abuse also happens in families in which the mother-daughter relationship is close and protective. In this case, the abuse does not continue over years, because these mothers, almost always, denounce the abuse after grasping the manifestations of abuse in the victimized child. The child, in turn, talks about it and is believed. When mothers detect signs that their daughters have been sexually abused or actually see the phenomenon, they take what they have seen and heard very seriously and generally take measures to protect the child(16). However, when the mother does not recognize the sexual abuse, her maternal protection becomes fragile because she is not able to perceive the risks the child is exposed to. Hence, her sons and daughters might be more vulnerable to violent situations.
As shown in the literature, sexual abuse committed against children is potentially traumatizing due to the feeling of powerlessness and fear, among other devastating feelings(13). Thus, the mother of a child victimized by sexual abuse is included in the group of victims affected by sexual violence. Such a statement is based on negative and destructive feelings expressed by the participants, among which, suicidal and homicidal ideas, according to the report of M3, who declared: I think she'd suffer even more if I killed myself, because she'd be without me. If I killed her, I'd die of suffering, so I thought that we both should die.
The suicidal and homicidal ideas expressed in the mother's report reveals her hopelessness. This hopelessness is a "mortal" disease because it makes human beings fragile and incapable of self-realization, that is, they experience the death of the "self"(14). This reinforces the idea that violence, most of the time, is not unidirectional, because it acts in the life of its victims in a systemic way.
Human beings easily understand things when they are fragmented, that is, when a phenomenon is isolated from its context, as when people are divorced from their reality. That the universe of people correlates and forms a set where everything interacts, including those who observe it, is not so easily understood.
It represents a great challenge. If society is not interested in understanding violence, its magnitude and the whole chain affected by it, there will not be adequate instruments to fight it or to care for its victims and there will only be good intentions lost in the void from a lack of action.
Child sexual abuse is a phenomenon that affects the whole family structure and many times aggravates family disaggregation, especially in cases of intra-family sexual abuse. The maternal figure is highlighted among family members with its universe of feelings. In the child sexual abuse scenario, such feelings are represented by pain, many times expressed as pain from which there is no recovery, and revulsion related to a feeling of powerlessness. The study participants report guilt as the most responsible for their suffering, which is rooted in the strong cultural element of "perfect motherhood". In the face of the feeling of guilt, the maternal despair expressed in the reports as suicidal and homicidal ideas was considerable.
We observed, however, that there is a desire to overcome the consequences for the life of the sexually abused daughter, the hope to alleviate and even "erase" all the pain and also alter the behavior manifested by the daughter. Based on the above, the feelings evidenced by the participants represent a motive to reflect on the urgent need to inform and strengthen a social support network.
It is also necessary to emphasize the importance of an efficient practice of professionals directly and indirectly involved in the care delivered to victims of child sexual abuse and their families. Nurses stand out among these professionals and are considered the most present professional in the care setting. Nurses have the opportunity to identify, fight and even report child sexual abuse as well as to deliver care to its victim and families. Therefore, nurses can decisively contribute to overcoming the severe consequences of such a devastating type of abuse.
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Recebido em: 25.9.2008
Aprovado em: 30.6.2009
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