Psychological Maltreatment: A Widespread and Often Overlooked Form of Child Maltreatment

We know now that psychological maltreatment is widespread. Estimates vary depending on whether data are collected from self-report (the participants reporting on their own experiences) or from informants or official records (such as child protection cases). However, it is safe to conclude that between 10% and 30% of the general population has experienced moderate levels of psychological maltreatment during their lifetime. We also know that exposure to PM is associated with a host of negative outcomes for individuals and that when combined with other forms of childhood maltreatment PM will exacerbate their effects as well. Protecting children from this insidious form of childhood maltreatment should be a high priority for anyone working with children and families. We are concerned that that too many mental health professionals and others working with high risk families are not actually trained to identify PM, to know how to differentiate it from poor parenting, and to determine when a case should be called in to child protection. We consider this a very serious omission and plan to develop a series of recommendations based on a current survey of APSAC members (see research page for more information about our study). -- Amy J.L. Baker

Book Review: Room

I just completed reading the 2013 book, Room, by Emma Donoghue. For anyone who hasn’t read the book or seen the movie, it is written from the perspective of a five-year-old boy who—at the time the book opens—has spent his whole life in an 11 x 11 room with his mother. The mother and son are captives of a man who abducted the mother when she was 16 years, kept her locked in a shed, and forced her to have his child who is the narrator of the story. The captor has total control of the mother and son and holds them completely isolated from the outside world. Although the boy feels safe with his mother, he is experiencing multiple forms of psychological maltreatment by the captor including isolating, terrorizing, and failing to provide for his medical, mental health and mental health needs.

What makes the book so powerful is that it truly captures the world from the perspective of a child and what the story shows so clearly is that what adults think and believe and know about what is best for children is not always consistent with what children like or want.

From the adult point of view, the child was being abused and damaged because of his constrained life, but from his point of view he was happy as long as he had the love and attention of his mother. Thus, once the mother and son escaped/were rescued (I won’t give away the plot), the child was actually traumatized by the experience. Adults acted as if he was finally safe now that he was removed from his abduction situation, but for the first time in his life he actually felt unsafe. This is not to say that he should have been left where he was, only that when mental health professionals work with abducted children it is essential to recognize that the child’s experience may be very different than what we as adults and professionals think it should be.

This is consistent with what we know about abused children who are generally not grateful for being “rescued” from the abuser, especially at first. Working with children requires knowing what is best for them but also knowing what feels right to them and understanding that the two might not always be the same. Being sensitive to the perspective of the child victim is an essential part of the healing process. -- Amy J.L. Baker