Sexual Abuse within the Family, 2013

  

 

 

Journal of Child Sexual Abuse, 22:677–694, 2013 Copyright © Taylor & Francis Group, LLC

ISSN: 1053-8712 print/1547-0679 online DOI: 10.1080/10538712.2013.811139

 

 

SEXUAL ABUSE WITHIN THE FAMILY

 

A Study of Shame from Sexual Abuse Within the Context of aNorwegian Incest Center

 

KAARE TORGNY PETTERSEN

Oestfold University College, Halden, Norway

 

 

Working with those who have experienced sexual abuse is a complicated matter because such abuse not only involves the vio- lation of the victim’s body, but it often generates shame in those involved. This article is based on empirical data from 26 hours of videotaped focus group interviews with 19 adult men and women in a Norwegian incest center who spokeopenly of the shame they experienced from sexual abuse as children, parents, and employees. Findings from this study show that shame from sex- ual abuse can be groupedinto seven major categories: (a) family,

(b) emotions, (c) body, (d) food, (e) self-image, (f) sex, and (g) therapy.

 

KEYWORDS shame, sexual abuse, victimization, focus groups, incest center, therapy

 

 

The study presented here was inspired by Nussbaum (2004), who argued that hiding from humanity isassociated with feelings of disgust and shame. Lewis (1995a, 1995b, 2000) explained this need to hideas an expression of shame and argued that shame arises when individuals judge their actions as failuresin regard to their standards, rules, and goals and then acknowledge these failures. The personexperiencing shame wishes to hide, disappear, or

Received 15 November 2011; revised 15 March 2012; accepted 15 May 2012.

The author is grateful to the 19 sexually abused men and women who bravely stood forth with their stories of shame from sexual abuse and made this study possible.

Address correspondence to Kaare Torgny Pettersen, Department of Health and Social Science, Oestfold UniversityCollege, 1757 Halden, Norway. E-mail: kaare.t.pettersen@hiof.no

 

 

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even die. It can be a highly negative and painful state that disrupts behavior and causes confusion in thoughts as well as an inability to speak (Retzinger, 1987, 1991, 1995; Scheff, 2000, 2003, 2004; Scheff & Retzinger, 1991). The body of the shamed person seems to shrink, as if trying todisappear from the gaze of others. Because of the intensity of this emotional state and the global attackon the self-system, all one can do when facing such a state is to attempt to rid oneself of it (Miller, 1997; Oatley, Keltner, & Jenkins, 2006; Tangney & Dearing, 2002; Tangney & Fischer, 1995).

The relationship between shame and sexual abuse has been investigated in several studies (Kirkengen, 2001; Pettersen, 2009), which have shown that shame often involves an acutely painful experience; individuals who experience shame can feel a sense of worthlessness, incompetence,and a generalized feeling of contempt. These negative evaluations can engulf the entire self. Victims of sexual abuse not only suffer from the assault on their bodies but from the violation of their dignity. Understanding shame and sexual abuse is the starting point for this study, which seeks a clearer understanding of shame as described by victims of sexual abuse. This study was part of a largerresearch project put forth in a doctoral dissertation in Norway (Pettersen, 2009). The research question was: How can shame from sexual abuse be described within the context of a Norwegian incest center?

 

THE NORWEGIAN INCEST CENTERS

 

The Norwegian incest center movement started in the early 1980s when two women, Marianne Gilje and Inger Lind, met each other for the first time (Pettersen, 2009). They had both experienced sexual abuse as children, and they began to tell each other their stories of sexual abuse. They felt they couldspeak openly with each other despite the shame they both had tried to hide for many years. They began to include other victims of sexual abuse in their conversations, and in 1986, they established Norway’s first incest center and chose “help for self-help” as the motto for their work. The center found that sexual abuse was shameful to speak about in the community. The ability to help was minimalbecause of the collective silence that reigned in the community with regard to sexual abuse. Today, there are 20 incest centers located in all parts of the country, and they are all financed through the Norwegian state budget.

An investigation by Pettersen (2009) showed that these centers have around 150 employeesnationwide. Their main task is to speak and listen to people who call the centers by telephone becauseof sexual abuse. Some of them also have face-to-face conversations with users of the centers. The vastmajority (90%) of employees are women. Sixty-four percent of the employees have a bachelor’s degree.

Five incest centers do not use personal experience with sexual abuse as a qualification for being employed and hence do not know whether their employees have experienced sexual abuse.The other 15 centers wish to have employees who have experienced sexual abuse represented intheir staff, but this is not a necessary condition for employment. Pettersen’s (2009) investigation shows that 43% of the employees in 15 of the 20 incest centers in Norway have been sexually abused aschildren.

 

DEFINING SEXUAL ABUSE

 

The incest centers in Norway use the following definition of child sexual abuse that has beenadapted through 20 years of working with sexually abused men and women: “Child sexual abuse is physical or psychological exploitation of the sexual integrity of children committed by one or more per- sons the child is dependent on or is in a trusting relationship with” (Pettersen, 2009). This definition does not distinguish between different kinds of sexual abuse that are specified in theNorwegian Penal Code (1902/2005). Here, one finds descriptions of acts that are defined asillegal, such as how the genitals are touched. The law distinguishes three different forms of sexualcontact: (a) sexual behavior, (b) sexual action, and (c) sexual intercourse. Sexual behavior is the mildest form of sexual offenses, which includes inde- cent forms of behavior in either words oractivities but does not include any form of physical contact. Sexual action is a more severe form of sexual abuse and includes actions toward someone who has not given their consent (e.g., being pawed, having their sexual organs touched, or doing the same toward children under the age of 16).Sexual intercourse is the most severe form of sexual abuse and includes sexual contact withchildren under the age of 16 (e.g., intercourse—vaginal, anal, or oral, intercourse-resembling conduct, masturbation, or licking or sucking of genitals).

 

DEFINING SHAME

 

This study emphasizes the social and moral aspects of shame (i.e., how it appears in social systems). Scheff (2003) argued that shame is the most important of emotions in everyday life and the most important of all social emotions because shame has more features than other emotions. Shame is a major component of our moral conscience and signals a moral transgression even without thoughts and words. Shame arises in situations of threat to interpersonal relationships, problems in a relationship, and feelings of having failed to live up to social and moral expectations of others.

Helen Lewis (1971) developed a comprehensive working definition of shame and used this as anoperational definition in her work. She showed

TABLE 1 Working Concept for Shame

Shame

1. Stimulus                                                         1. Disappointment, defeat, or moral transgression

2.  Deficiency in self

3.  Involuntary, self becomes unable

4.  Encounter with “other”

2. Sexual desire                                                 1. Specific connection to sex

3. Consciousness                                               1. Painful emotion

2.  Autonomic reactions

3.  Connections to past feelings

4.  Many variants of shame feelings

5.  Fewer variations of cognitive content (the self)

6.  Identity thoughts

4. Self                                                                  1. Self is passive

2.  Self is focal of awareness

3.  Multiple functions of the self at the same time

4.  Vicarious experience of “other’s” view of self

5. Hostility                                                          1. Humiliated fury

2.  Discharge blocked by guilt and/or love of “other”

6. Defences                                                         1. Denial

2.  Repression of ideas

3.  Affirmation of the self

4.  
Affect disorder (depression)

Note. Adapted from Lewis (1971), pp. 90–91.

 

how shame is connected to six different aspects of social relationships: (a) stimulus, (b) sexual desire, (c) consciousness, (d) self, (e) hostility, and (f) defenses (see Table 1).

Lewis (1971) stated that shame is dependent on specific aspects of social relationships, andthis makes shame different from other emotions. She emphasized the idea that shame is a social emotion in a biopsychosocial manner. Shame is an instinct, she said, which has the function of signaling threats to the social ties. She argued that shame often combines with other emotions such as guilt. Guilt serves an important social function by leading one to make amends for one’s transgressions,but, at the same time, it serves to hide shame. Guilt does not replace shame but instead oftenfunctions as a mask that shame can hide behind. Shame does not disappear—it just becomes hidden.

 

METHOD

 

The main method in this study is qualitative, where 19 victims of sex- ual abuse were interviewed in six focus groups. Before the focus group interviews were carried out, two surveys were conductedin order to find out

if people who have been sexually abused have a greater degree of shame- proneness than others. The test that was used was the Test of Self-Conscious Affects (TOSCA-3), which was developed by Tangney and Dearing (2002) and measures the following: (a) shame-proneness, (b) guilt-proneness, (c) detachment, (d) externalization, and (e) two forms of pride (being proud of oneself and pride from others). The first survey consisted of 201 university college students (first year health and socialwork students from a univer- sity in southern Norway). The second survey was carried out withthe help of all of the 20 incest centers in Norway who found 180 adults alleged to have been sexually abused as children to take the same test as the students (Pettersen, 2009). The findings showed that Pearson’s correlation between shame-proneness and guilt-proneness was high (r = .68) in the casegroup of sexually abused men and women and moderate (r = .42) in the case group with university college students. A question that arises is whether the high correlation shown in the group of sexual abuse victims can be explained by their experience of sexual abuse. This high correlation mightalso suggest that victims of sexual abuse have difficulty treating shame and guilt as two different emotions. These were relevant questions to consider during the focus group interviews.

 

Participants

The qualitative study included focus group interviews (Bloor, Frankland, Thomas, & Robson, 2001;Litosseliti, 2003) with 19 persons who alleged to have experienced sexual abuse. The focus group interviews were carried out in one of the 20 incest centers in Norway, and all of the 19 participants hada close relationship with this center. The 19 participants were chosen by the leader of the centerwho knew all of them and could assign them to 6 focus groups according to how well the participants would fit together in the same group.

The purpose of using focus groups was to create an atmosphere in which the participants could speak freely with one another (Pettersen, 2009). This method for gathering data is considered to be particularly well suited for revealing patterns of social groups’ stories, interpretations, norms, andinter- actions. The researcher not only presides over the meetings but assumes an active role. Holsteinand Gubrium (1995) argued that this form of active inter- viewing is an alternative to the form ofinterviewing where the researcher is an observer. Active interviewing is characterized by the fact that the par- ticipants and the researchers cooperate by using co-constructive storytelling and searching for meaning. This implies a social-constructivist perspective on research; it postulates that meaning itself is also a social construction (Berger & Luckmann, 1966/1991). The researcher is not a passive observer, but an active discussion partner who creates meaning through storytelling together with participants (Pettersen, 2009).

 

The combination of focus groups and active interviewing gives the researcher the opportunity toboth encourage and assist the participants to talk openly about the shame, and at the sametime the researcher is able to engage in a normal conversation with the participants about shame. This makes it possible to carry out a conversation where a highly sensitive subject like shamecan be addressed without inducing further shame in the partici- pants. The participants are given the possibility to support one another and thereby avoid the need to hide when speaking of one’sshame. The danger with this approach is that the researcher can become too involved in the conversation and become preoccupied with one’s own life history, thereby making the interview highly biased. The active interview demands first and foremost active listening, concern, and respect. Thegoal is not only to see the participants and make them visible but also to give them prestige through recognition—not to treat them as victims but as important participants in the co-construction of meaning.

All of the 19 participants in the focus group interviews had experience with sexual abuse. Sixteen of the participants were women, and three were men. Sixteen of the 19 participants had been sexually abused as children, one was not certain, and two said they had not experienced sexual abuse them- selves but had experienced sexual abuse in their families. Ten were abused by family members, two byneighbors, and four by other perpetrators. All of the 13 women and two of the three men were abused bymale abusers (one of the men was abused by both male and female abusers), while one man was sexually abused by a female abuser. None of the women were abused by female abusers. The 16 informants who were sexually abused in this study were abused by a total of 31 different male abusersand four different female abusers. In all these cases, according to the participants, sexual abuse consistedof oral, vaginal, and/or anal penetration. Eight of the participants were employed at the incest center where the interviews were carried out, and 11 were users of the center.

The 19 participants were divided into five focus groups. One group consisted of three men who were all users of the center. The other eight women, who all were users of the center, were divided into two groups with four members in each. The last eight women participants, who all worked at thecenter, were also divided into two groups of four members in each. The participants were dividedinto these five focus groups in accordance with the leader of the center. The problem of a biased sample was a relevant limitation to this study since the leader of the center made the selection of which participants should be in each group. The criteria used for the selection was highly subjective and based on her knowledge of all of the participants in order to make functional groups. This limitation should be carefully considered when reading this research.

All of the five groups were small, with three to five members. Focus groups should initially bebetween 10to 15 participants, but in studies with

sensitive issues or vulnerable groups, it can be an asset with a smaller num- ber of participants ineach group. Some groups may come down to three to five participants when special circumstances require it (Bloor et al., 2001; Litosseliti, 2003). The benefit of small groups is that it is easier to talk about sensitive topics. The disadvantages are that the groups may be compromised if someone doesnot show up to the agreed meeting.

 

Ethical Considerations

The study was subjected to the Privacy Issues Unit at the Norwegian Social Science Data Services(NSD). One of the important tasks of the Privacy Issues Unit is to review research projects in relation to the privacy and licens- ing requirements of the Norwegian Personal Data Registers Act. This was completed, and permission was given to complete the collection of data.

Ethical considerations include reflecting on how to conduct research in order to avoid unjustifiableethical consequences for individuals, groups of individuals, or society. Three considerations were important in relation to research ethics in this study: (a) the right to self-determination and auton- omy, (b) respect for peace in private life, and (c) an evaluation of the risk of damage or injury. Since the topics were highly sensitive matters to talk about, it was possible that some of the participants could have the need for further conversations after the interviews. There was therefore always an employeefrom the incest center available after the interviews for those who needed this. However, this precautionary measure was not used by any of the participants.

 

ANALYSIS

 

The analysis was based on four steps (Kvale, 1996). The first step was to let the participants describe freely, without interpretation or explanations, their experiences in focus groups interviews. The secondstep involved dis- cussions in the focus groups in which the participants asked questions and gave their response to the story that was told. New elements could arise, and the participant might see factors he or she was not previously aware of. Here the participants gave their own interpretation of the story. In the third step, the interviewer arranged the material into meaningful categories. This is what Kvale (1996) called condensation of meanings, where the inter- viewer interpreted what the participants have talked about. The fourth step was to transcribe the 26 hours of conversations into 633 written pages.The transcription was given back to the participants for validation and approval. The interviews werethereafter transferred to the computer program QSR

NVivo (Gibbs, 2002). Quotations were chosen to give meaning to topics that were discussed in the focusgroup. The different topics that were discussed

were coded, which is a process in QSR NVivo that consists of identifying a passage of text in the written document that exemplifies some idea or concept and then connecting it to a node that represents that idea or concept (Gibbs, 2002). The coding process led to 70 different topics, or nodes, in QSR NVivo, which can be understood as an object that represents an idea, theory, dimension, or characteristic of the data (Gibbs, 2002). These 70 nodes were again linked together by similarity toform 7 node trees, which is the arrange- ment of nodes in a hierarchy, also known as a node hierarchy (Gibbs, 2002). All citations were recorded and transcribed in Norwegian and translated into English inthe writing of the doctoral dissertation that this study was a part of. These 7 node trees or categories of shame in this study, which has been conducted within the context of sexual abuse and a Norwegian incest center, are: (a) family, (b) emotions, (c) body, (d) food, (e) self-image, (f) sex, and

(g) therapy. These will be discussed further in the following section.

 

RESULTS

 

The seven categories have come forth through what Charmaz (2005) called constructivist groundedtheory. This means that reality is understood and defined as data in a construction between the researcher and the par- ticipants. The categories are therefore interpretations of data rather than objective reporting of reality that is untouched by the researcher, as Glaser (2002) argued should be the principle for grounded theory. Constructivist grounded theory assumes a more dynamic, reciprocal relationship between interpretation and action (Blumer, 1979; Charmaz, 2005).

 

Family

The participants spoke in the interviews about a vast amount of family mem- bers, including grandparents, parents, siblings, children, uncles, and aunts. Families were also spoken of as stepfamilies, foster families, and adoptive families, as well as constellations of these.

When the participants spoke of their fathers, it was most often in con- nection to the abuse they had committed. Fourteen of the 19 participants spoke of their fathers 79 times in relation to shame.Ruth, who has worked at the center for many years, and who is the mother of an abused daughter, argued that women who have been sexually abused by their fathers most likely do not feel shame toward their fathers. She believes that they feel that they themselves are responsible for participatingin the abuse and that this is why they feel guilt. She was asked if victims of sexual abuse are ashamed of their abusive fathers. Shame, she said, is reserved for their mothers:

 

Ruth: No, I think they feel something else there, guilt and responsibility for their actions. They become apart of the action in a way and give it

to themselves, so that they have a role here, and they don’t blame their father; therefore, they don’t feelshame in relation to their fathers. But they often feel shame in relation to their mothers.

 

Nonabusive mothers were spoken of almost twice as often as abusive fathers—123 times—and were spoken of by all 19 participants. This seems to suggest that after being sexually abused by one’s father, the fathers might not be conceived of as a significant other because emotional bonds are bro- ken. Mothers might be conceived of as more significant others than fathers. It might also have to do with traditional gender relationships within families in Western society that result in children having a closer emotional relation- ship to their mothers than to their fathers. Finding the motives that seem to cause these differences will demand further investigation.

Why do victims of sexual abuse seem to feel more shame toward their mothers than toward their fathers? In one of the focus groups, Camilla, Bodil, Dagny, and Anne, who are all users of the center and who experienced extensive sexual abuse as children from grandfathers, fathers, and uncles, were not as concerned with the abuse as they were with not having a mother who protected them. They spoke of sadness and shame in relation to their mothers. Camilla and Bodil said that their mothers were aware of the abuse but did not do anything to stop it.

 

Camilla: I have a mom whom I am very ashamed of because she didn’t do anything, and she should have.

Bodil: Yeah, me too.

Camilla: They should have stepped in and found out what was happening.

My mother knew.

Dagny: My mother just blocked it out. Bodil: My mother did too.

Camilla: That’s the thing I feel most ashamed of.

Researcher: Are you ashamed of your mother?

Camilla: Yeah. And that hurts a lot. And it’s sad as well.

Researcher: Are you proud of your mother?

Camilla: No. I think I’ve protected her, both her and myself.

Researcher: So you’re ashamed of her and at the same time you protect her?

Camilla: Yeah. That’s what I do.

Anne: I am also ashamed. I’m ashamed of her not doing anything.

Dagny: Your mother should protect you until the roles are reversed and you have to take care of her.

 

Emotions

All of the participants spoke of emotions in the interviews. They dis- tinguished between many different emotions, and shame was the one mentioned most often (a total of 203 times), followed by guilt, which was spoken of 168 times in the interviews. Ruth explained that when they work

with shame at the incest center, they work with all of the emotions. It takes courage to feel and to let one’s emotions out. Knut is a user of the center and was abused as a child by his aunt for many years. He explained what happened when he denied his emotions:

 

Knut: I’ve pushed away a lot of the unpleasant stuff, just closed the door. And I needed to open the door again when I was older. Living a life without feeling anything was a great burden as time went by. Iknew that I had problems relating to other people because of this. I was never happy.

 

Ruth explained that the way Knut relates to his emotions is typical of a lot of people who seek help coping with shame. They’re locked up and emotionally paralyzed. She argued that the key tounderstanding shame is to focus on the body and the problems people have with intimacy. Seeking help involves a search for intimacy with the object of their emotions, namely themselves.

 

Ruth: They’ve been locked up for many years; paralyzed, degraded with- out being able to have any control, no place to escape; they’ve been completely locked up in a corner, completely locked. Most of them have problems with intimacy. Being touched, receiving a hug, and sometimes they ask: “Can Iput my head on your shoulder?” They’ve never done that before. They start to work with their shameafter a while with confidence and security. Some people cry for the first time, feel anger for thefirst time, and they ask what these new emotions mean.

 

Body

All of the 19 participants spoke of the relationship between shame and the body in one form oranother in the interviews. They spoke of the body a total of 225 times, which makes the body the category that was most often invoked in the interviews. This vast interest in speaking of the body when the theme for the interview was shame seems to indicate that this relationship is important. Being sexually abused is experienced by many victims as losing this control; the abuser takes over the control of the abused’s body. Linda argued that all the painful acts her body had been subjected to because of sexual abuse made her whole body shameful and filthy.

 

Linda: You feel shame, because of the things that have happened to your body. That’s why your body is so shameful. So I’d say that your whole body is shameful. That’s something that never goes away. All those experiences make you feel horrible, disgusting, and dirty and that’s something you don’t want toshow others. It’s because the body has been

used, it’s filthy; your body is not yours and something has been destroyed and that’s why you are the way you are.

 

Dagny and Gunhild also spoke of being ashamed of their bodies, being filthy, and not wanting to relate to their bodies. They said that everything about the body is difficult.

 

Dagny: Everything about the body is difficult. You’re either too fat or too thin; it’s like that foreveryone, too much of this or too little of that. If you also have had someone fool around with yourself-image, it gets even worse. Shame, body, and sexuality are very closely interwoven.

 

Gunhild: I feel like shit. I’m filthy. I don’t care about my body; I don’t want to relate to my body.

 

Food

Thirteen participants talked about food in relation to shame in the interviews, and they mentioned fooda total of 79 times. Food was also a topic brought up in relation to the body as being a means of control; some tried to take control of their body by controlling their eating routines in distorted ways. Therelationship with food that Camilla experienced had put her in situations where her health had been at risk. She appeared to have anorexia, and for periods as an adult weighed 33 kilos (72 lbs.). Weighing so little made it necessary to undergo hospital treatment, which was experienced as shameful because shelost control over her body. It might seem that victims experience shame when others take control of their body, making life difficult.

 

Camilla: I feel ashamed every time I eat. I feel ashamed then. I really do. I feel that I’m doing something I’m not supposed to do. Then I feel shame. I’ve weighed as little as 33 kilos. I’m much betternow, but I still feel ashamed every time I eat. When I weighed 33 kilos I knew I had to go to the hospital. It was awfully shameful to gain weight again. I felt that I lost control. I’m terrified of losing control. Eventhough I have a normal weight now, it’s very difficult to cope with. It has to do with trusting others. At least for me it does, it’s not dangerous to eat.

 

Self-Image

All of the participants talked about their self-image and mentioned it a total of 186 times. This seems to confirm the assumption that shame is more closely related to how we view ourselves rather thanto our actions. In relating to one’s self, one creates a self-image: what we see when we seeourselves and how we relate to ourselves. Ellen, Dagny, and Gunhild were all sexually

abused by close family members in their childhood, and they all spoke of the importance of one’s self-image.

 

Ellen: Isn’t self-image related to self-confidence? That’s why it’s so low. It’s because of all the shit I’ve hadto take. You’re stepped on, and stepped on, and stepped on, and turning that around is not easy.

 

Dagny: If one can increase one’s pride, then shame diminishes. You have to develop a better self-image, and then you’ll feel less shame.

 

Gunhild: I’ve never felt that I was good enough the way I am. I feel like shit. I don’t feel that I’m goodenough. I haven’t taken care of myself. I’m not worth anything. It doesn’t matter. It’s awfully hard todescribe myself.

 

Sex

Eighteen of the participants talked about the effect shame had on their sex lives and theirrelationships with their partners. They touched on this subject 92 times in the interviews. This suggests that sex was of concern among the participants in this study. Most of the participantsspoke of various problems they had in relation to having sex. Camilla had used sex as a way ofpunish- ing herself, and sometimes she had just given up. She talked about feeling shame inrelation to her sex life and how she would throw up after having sex with her partner. Dagny said she averted her face when she had sex and didn’t want to see her partner’s face. She tried to thinkabout something else.

 

Camilla: I’ve used sex as a punishment. It’s a way of holding my emotions at a distance. It’s not okay formy husband. I usually throw up afterwards.

 

Dagny: If you’re sexually abused as a child, that’s not sex. It’s like rape; it’s not sex. It has very manyconsequences. I feel sick, it’s filthy. I hide my head or turn my face away so I can’t see him. It only takes 7–8 minutes and then it’s over. It’s not right. I avert my face because if I make eye contact, then I’m there.I try to think about something else while it’s going on.

 

Camilla: One just gives up because one can’t stand being there. But it’s something I’m not proud of. I love my husband very much and all that. Even though I’m very ashamed, it’s just not possible becauseeverything has to do with sex. I wish things were different. And then I feel ashamed about that too.

 

Having sex with partners may be a reminder of the sexual abuse suffered as a child, and one may have problems being physically touched in certain ways because of this. Memories of sexual abuse seemto be stored in one’s body.

Therapy

Fifteen of the participants spoke of shame 68 times in connection with ther- apy. The most often mentioned occurrences were crying and trusting another person as something that was shameful in therapy. Linda argued that shame engulfs the whole body and that it seems impossible to rid oneself of it. She said that helping others demands the courage to travel into the depths of the lives of others and to feel their pain.

 

Linda: It is shame that makes you look away and not meet the eyes of others. That takes a long time for some people. It’s shame. You’re ashamed of things that have happened. You’re ashamed ofthings you have experienced with your body. So I’d say that your whole body is full of shame. Youhave to turn off some of your emotions. But at the same time you have to dare to travel into thedepths and dare to feel some of the pain.

 

It seems to be important in the process of healing shame to have the courage to face one’s past andshare one’s life stories with others. Ruth said that one must dare to rethink things that have happened inthe past. Having the possibility to do so might feel like standing on a precipice overlooking a great void.One does not know what the future will be like when the shame disappears. She concluded that it’s aquestion of being courageous enough.

 

Ruth: You have to place shame where it belongs, and dare to think that right now you’re standing at a crossroad where it’s possible to choose a completely different way of thinking. You don’t know how you’re sup- posed to think or what it will be like when you no longer have to bear the shame for what happened. You don’t know about any of this. It’s a question of having enough courage.

 

 

DISCUSSION

 

The findings show seven categories in which shame after sexual abuse can be found. A focus on these categories would seem purposeful in the healing process for victims. Mothers are often described as being the primary caring adult at home, and several of the participants in this study concluded that mothers should have been there for them and protected them from the harm they suffered. Mothersseemed to be perceived as significant others even after the abuse, but since they did not live up to the ideals of motherhood, victims were ashamed of being their children. Jensen (2005) argued that mother-blaming is so strong that it seems to prevail despite the fact that many mothers in fact supporttheir children after disclosures of sexual abuse.

 

Emotions seemed to be obscured after sexual abuse, and at the same time, victims of sexualabuse are in need of acceptance and empathy from others in order to regain faith in both oneselfand others. This is needed in order to find the security that is necessary for disclosing all of one’s emo- tions. Skårderud (2001) argued that courage means daring to share in order to heal shame.It is important to understand that courage is not a prede- fined quality; it is something that evolves through dialogical emotional work. Healing shame involves developing a relationship that givesone the courage to expose one’s inner self to others.

In this study, body shame was connected to the sexual abuse. Participants said that theirwhole body felt shameful and filthy. Research shows that body shame has a mediating role in the relationship between experiences of childhood sexual abuse and a variety of psychological andphysical problems later in life (Andrews, 1997; Kirkengen, 2001; Gilbert & Miles, 2002). Johnson (2006) has argued that this feeling of one’s body being filthy has to do with feeling worthless, and atthe most severe level of shame, we are afraid of any kind of self-expression because to be seen isto be seen as dirty, disgusting, worthless, and unlovable. To be seen by others can even sometimes befelt as putting one’s whole existence in danger. Security lies only in withdrawal and isolationbecause everyone seems to know or see that one is completely worthless. Helping victims regaintheir sense of worth is essential here.

Food can be used as a control mechanism for those who feel that they have lost control. They can regain control both by eating too little or too much (Burney & Irwin, 2000). They may feel shame about their bodies and use food to control them (Nordbø, Espeset, Gulliksen, Skårderud, & Holte, 2005); others feel shame in relation to food and over the associations that different types of food arouse, represented as signs (Innis, 2005). Focus on shame when dealing with eating disorders is important.

Revealing one’s self-image to oneself and others can be an ordeal for many, and the torment may be even greater for those who must reveal themselves as victims of sexual abuse. Thomas andParker (2004) argued that in a healing process, the focus should be on facilitating the emergence of the self. By strengthening the emergent self, one is able to become secure enough to assume responsibility for one’s actions. Until one becomes stable enough to distinguish oneself from one’s actions, the person will continue to confuse the two. In working to weaken the grip of shame,emotional work is important and involves nurturing the self so that one is able to move away from the massive self-condemnation that prevents one from making a realistic assessment of one’s actions and choosing appropriate responses.

Sexual problems seem to arise from the shame caused by sexual abuse. Van Berlo and Ensink(2000) argued that sexual problems can be prevented by paying attention to shame in the healingprocess. Talking with one’s

sexual partner about shame seems have an important preventive function in relation to one’s sex life.

Therapy involves helping victims to overcome unbearable shame by building strong relational bonds between the caregiver and the shamed self. Kaufman (1980, 1989) argued that the first step in the healing process is to construct a relational bridge. Since nurturing the emerging self is the focus in healing shame, the method must be relational and not behavioral. One has to find the hiding self and restore the relational breach by first asking where the individual is. Shame involves moving away from relationships and hiding.

Even though much still remains to be learned about shame, it is clear that shame is a painful, self-conscious emotion that operates, albeit quietly and hidden, in the development of a wide variety of personal and social problems. It is also clear that for an individual to be freed of shame, victims of sexual abuse should be approached with sensitivity and tact. Perhaps listening to sexually abused children and adults with an open ear for the voice of shame may support helpers in their efforts to reduce shame and free victims of sexual abuse from their distress.

 

Limitations

This is a limited single culture study based on data collected through interviews in small focus group interviews. The research is retrospective in the manner that it investigates stories of childhood sexual victimization as remembered and narrated by adult informants, and this limitation should be carefully considered. The participants in this study all chose to participate voluntarily, but how they were chosen and how they were placed in differ- ent focus groups may have had an impact on the findings. The participants were chosen by the leader of a Norwegian incest center based on her knowl- edge of the participants and who she felt would be strong enough to endure talking about their shame experiences.

Many victims of sexual abuse have significant mental health and emo- tional problems because of the sexual abuse they have experienced, while others seem to have very limited problems. The participants in this study should not be viewed as being representative of all victims of sexual abuse. On the contrary, these participants were chosen because they had already worked a considerable amount on the consequences of sexual abuse they have experienced and were considered strong enough to endurethe sharing of their experiences with others. For many victims of sexual abuse, it would seem impossible to participate in a study like this without being revictim- ized. It was of ethical importance to choose participants who could endure speaking of their traumatic experiences, even though this can beunderstood as a significant limitation to the study and may have made the sample highly biased.

 

Since shame in this study is understood as both a social and moral emo- tion, the expression of shame varies naturally from one culture to another, whether between different countries around the world or within a small com- munity where cultures may differ because of religion or other differences in cultural background among the inhabitants (Wo, 2005). Despite these limita- tions, it is my hope that the study will help contribute to the field of child sexual abuse and treatment.

 

 

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AUTHOR NOTE

 

Kaare Torgny Pettersen, LMSW, PhD, is an associate professor at the Department of Health and Social Science, Oestfold University College, Norway. He has worked for more than three decades withchild welfare in Norway with special focus on domestic violence and the sexual abuse of children. He received his MSSW and PhD from the Norwegian University of Science and Technology, Trondheim, Norway.