Kim Oates. Don’t forget children when talking about domestic violence

Jan 2, 2016

Children are victims of domestic violence too.

Last week the Children’s Commissioner released this year’s children’s rights report. It provided new data about the prevalence of child physical and sexual abuse and their links with domestic violence.

Christmas, traditionally a time of peace and goodwill is sadly, a time of increased domestic violence, thought to be due to increased alcohol consumption and family gatherings where there can be the potential to cause resentment and open old wounds.

Our awareness of the extent of domestic violence has been slow in coming. It parallels the way awareness of child sexual abuse came about almost 40 years ago.

When I was a medical student attending psychiatry lectures in 1966, our very eminent professor of psychiatry mentioned that sometimes men sexually abused girls, but that this was very rare. He explained to us that it often occurred at the instigation of the mother who, not wanting sex, pushed her daughter forward instead. Like good students we took notes and learned this “fact” in case it came up in an exam. We did not realise how outrageous and how wrong this teaching was.

Then in 1977 a US paediatrician, Henry Kempe wrote a seminal paper “Sexual abuse, another hidden paediatric problem”. He documented what happens to these children, that it happens in outwardly respectable families, that it is not the child’s fault or the mother’s fault and that it is not rare. Kempe wasn’t the first to describe the sexual abuse of children but having described “The Battered Child Syndrome” 15 years earlier, his stature was such that when he wrote, people took notice.

Brave victims came forward and spoke of their childhood experiences.  Other prominent women, social workers and concerned paediatricians spoke about the problem. A backlash followed. There was denial about its extent. Child victims were accused of fabricating stories. It took many years until the community became aware that this was a serious and widespread problem for the whole of society and that prevention as well as treatment and care for the victims was needed.

The awareness of domestic violence has been similar, although occurring much later. For many years it was swept under the carpet,  considered to be family business, “better not to get involved”. Victims were blamed as if it was their fault. Police did not give it high priority.

Like child sex abuse, it was a problem that made us feel uncomfortable, a problem we’d rather not know about, a problem that perhaps occurred in “other families”, but certainly not amongst people we knew.

It took some horrific cases, it required concerned women who set up refuges, and it needed brave victims, such as Rosie Batty, to speak up. Only now are we becoming aware of the extent and seriousness of domestic violence, violence that on average causes the death of at least one woman each week and causes physical and psychological harm to countless others.

So what about the link between domestic violence and the abuse of children? We used to teach that they had little in common. Now we know that domestic violence has very serious effects on children.

Children who witness domestic violence can have a range of reactions. Some become fearful, living in constant anxiety, some may feel guilty that they are unable to protect their mother, some feel guilty because they still love their father and they just want him to stop.  Others become aggressive. Some learn that this is the way fathers behave towards their wives, leading to the possible intergenerational transmission of domestic violence if this is the only role model they are exposed to.

And then there is the physical and sexual abuse of children in families where domestic violence occurs. Research has shown that between 45 per cent and 75 per cent of women living in refuges report some form of abuse to their children, whether it be physical, emotional or sexual. Other studies suggest that approximately 60 per cent of child physical abuse occurs in homes where there is family and domestic violence. Sometimes a perpetrator uses violence against his partner to prevent her from revealing that he is sexually abusing her child.

It is ironic and sad that the home, where one expects to be safe, can be the most dangerous place of all for some women and children.

With Christmas approaching, this is yet another reason not to forget the children.

Kim Oates is an Emeritus Professor of Paediatrics at Sydney University and a past president of the International Society for the Prevention of Child Abuse and Neglect.

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