Academic journal article American Journal of Psychotherapy

Child Abuse and Neglect: Influences of Qualitative Research and Clinical Practice on Child-Care Legislation and Policy

Academic journal article American Journal of Psychotherapy

Child Abuse and Neglect: Influences of Qualitative Research and Clinical Practice on Child-Care Legislation and Policy

Article excerpt

ROSTEN CHORN, M.A. (Clinical Psychology)*

ANGINA PAREKH, D. Phil.**

In a previous paper on research findings with adolescent sexual offenders, formal and informal responses to offenders were discussed in terms of offenders' crystallization of foreclosed deviant social-sexual identity. This paper, therefore, seeks to modulate, with critical psychotherapeutic factors, legislative, judicial, social, interpersonal, and psychotherapeutic attitudes to offenders and victims alike. Chief among these is the twinship transference that, the authors argue, is the essential antidote to secondary trauma in child protection.

INTRODUCTION

This paper arises from two primary sources: a qualitative study of the intrapsychic, interpersonal, and social dynamics surrounding adolescent sexual offending1 and clinical experience of the treatment of adolescent perpetrators and survivors of sexual abuse. These data have provided the psychologically informed input to the deliberations of the National Working Group: Child Abuse and Neglect*** (NWGCAN) of the South African Ministry of Welfare. Work on the NWGCAN has mirrored the work of Browne2 (now Taylor-Browne) in research and public policy in child sexual abuse in the United Kingdom. The gist of Taylor-Browne's argument is that child-abuse response systems in the United Kingdom are likely to fail in their protective and therapeutic purposes because they gather power to themselves and devolve little to the survivors of abuse. A participative, survivor-directed model of research and service delivery, based in part on research and clinical experience in South Africa, is suggested as one possible means of designing an appropriate response system. A critique is offered of Taylor-Browne's views and they are extended by proposals, within service-delivery structures, for the imperatives of psychiatric, psychodynamic, and self-psychological diagnosis.3,4 These suggestions are illustrated with clinical vignettes from the treatment of an adolescent offender and a child survivor of sexual abuse.

QUALITATIVE RESEARCH IN THE TREATMENT OF ADOLESCENT SEXUAL OFFENDERS

In an earlier paper,1 the views of Anechiarico5 regarding self psychology in the treatment of adult, incarcerated sexual offenders, were qualitatively researched with a group of adolescent sexual offenders referred for treatment in a community setting in Durban, South Africa. Anechiarico argued that the treatment of sexual offenders is best conceptualized using the principles of self psychology.3,4 At the core of this approach is the principle that the psychopathology of personality is of two major categories: (1) predominantly deficit pathology and (2) conflict pathology. The former arises from inadequate structuralization of the personality during preoedipal6,7 or preseparation8,9 stages of infancy and childhood, while the latter arises from inadequate resolution of the triadic conflicts of the oedipal period. Anechiarico contends that sexual offending is associated with predominantly deficit pathology.

In self psychology, the self is regarded as the primordial, integrative psychic structure3,4,10-13 and the nuclear self, present in nascent form from birth comprises three major sectors, namely, the mirroring (exhibitionistic) sector, the idealizing (voyeuristic) sector, and the alterego-twinship sector.3,4 In preseparation phases that subtend the neonatal period and end with the onset of the separation-individuation phase,89 the person has a weakly established sense of differentiation from important others. In Kohut's terms, the person has selfobject needs of others who are regarded as integral to the self and its functional regulation, both internal and interpersonal. The person looks to the other with undifferentiated selfobject needs for mirroring (grandiose and exhibitionistic, demanding affirmation and admiration), idealization (voyeuristically as a source of immense strength), and twinship (as a partner or soul mate with whom to merge). …

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