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07 August 2005 |
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Help for Adult Victims Of Child Abuse. A non-profit making organisation based in the UK dedicated to provide help, support and information to any adult who is suffering from past childhood abuse. |
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Deaf Survivors of Sexual Abuse: A Look at the Issues
To be nobody but yourself, in a world which
is doing its best to make you everybody else, means to fight the hardest
battle which any human being can fight, and never stop fighting.
-e.e.cummings
By Marge Elder (hearing)
Author's note: This article focuses on
people who have been deaf since early childhood. In keeping with
preferences in the deafness field, the lowercase d is used when a general
reference to hearing loss is intended. The uppercase D is used when
referring to the specific sociocultural group known as the American Deaf
Culture described herein.
At a time of relatively widespread media
attention focused on sexual child abuse issues, one group in our society
remains largely unrecognized: survivors of sexual child abuse who are deaf.
Stories about the abuse of deaf children have not drawn the attention of the
national press. In fact, there has been a notable absence of dialogue about
sexual abuse even in the Deaf media. The NAD Broadcaster (a publication of
the National Association of the Deaf), Deaf Life, and Silent News have not
yet published a feature story exploring this issue, and since 1985, The
American Annals of the Deaf has published only one study dealing with sexual
abuse and deaf children (Sullivan et al., 1987).
Therapeutic professionals have also been
largely silent on this issue, according to Florrie Burke, M.Ed., M.A.,
clinical director of the University of California San Francisco (UCSF)
Center on Deafness. Burke, a hearing person, says that for years the same
people have been making presentations on sexual abuse at professional
conferences related to deafness.
Does this mean that few deaf children are sexually abused?
Solid empirical evidence about the incidence
of abuse of deaf children is scarce. The findings of the few preliminary
studies that have been conducted are "tenuous due to sampling
problems,"
note the researchers (Sullivan et al., 1987). Additionally, most of the
research has been based on clinical populations of deaf children.
Therapeutic professionals point out that these data are not directly
applicable to the general population.
Notwithstanding these considerations,
however, it is clear from the research that deaf children are being sexually
abused. Data from one study of 482 children with documented maltreatment
evaluated at the Center for Abused Handicapped Children at Boys Town
Research Hospital in Omaha, NE, reveal that 53.4 percent of the
"hearing-impaired" children were reported to have been sexually abused
(Sullivan et al., 1991). And Tovah Wax, Ph.D., C.S.W., who is deaf and
staff chair of psychological services at the National Technical Institute
for the Deaf/Rochester institute of Technology (NTID/RIT), Rochester, NY,
says that approximately 25 percent of their clinical population reports
having been sexually abused.
And Some of Us Are Deaf To understand the challenges facing
deaf
survivors of sexual abuse as they attempt to deal with the aftermath of
their abuse, it is first necessary to understand some of the ramifications
of being deaf in a hearing society.
Hearing people often equate success, intelligence, and
communication with one's ability to hear and understand
the speech of the majority (e.g., English). Like other groups considered by
some to be oppressed in the United States, deaf persons have been told
directly or indirectly that they are somehow less than complete and are less
than equal members of the larger society (Padden & Humphries, 1988). Until
1988, when students at Gallaudet University in Washington, DC, won the
battle to install a Deaf president at the university, hearing people have
been in control of most aspects of deaf peoples' lives, according to Robert
Pollard, Ph.D., a hearing person and a psychologist at the University of
Rochester (U of R) Medical Center and director of the National Institute of
Mental Health (NIMH) Program for Deaf Trainees.
People in the deaf community have responded
to these challenges in a variety of ways, Wax says. Some people who are
deaf identify with the American Deaf culture. Members of the Deaf culture
do not consider their deafness a disability, viewing it rather as a
biological characteristic "intimately bound up" with their culture (Padden
&
Humphries, 1988). American Sign Language (ASL) is their first language;
most live, work, and marry within the Deaf culture, interacting with the
hearing world only when they must.
A slightly larger group consists of bilingual (English and ASL)
people who do not identify with the Deaf culture
and who may not be fluent in either language. In fact, Wax notes, just as
among people in the hearing world, people in the deaf community are making
many choices as to mode of communication, social interactions, and
lifestyle.
Within these social and political currents,
deaf survivors -- boys and girls, men and women -- are struggling to address
their histories of sexual child abuse. Their biggest obstacle, according to
Linda Lytle, Ph.D., a Deaf psychologist in Washington, DC, is communication.
Talking About Abuse
Hearing children and deaf children often do
not report abuse for a variety of reasons. However, when deaf victims of
sexual abuse want to disclose they might have trouble finding an adult who
is fluent in their mode of communication. Hearing psychologist McKay
Vernon, Ph.D., author of ground-breaking work in the deafness field, says,
"The more likely situation is they don't even try [to tell] because they
know the communication limitations of the hearing person."
Adult survivors face additional obstacles.
While adults probably have more accessibility than children to people who
can communicate with them, they face the pressure of living in a small
community in which news travels fast and anonymity is extremely hard to
maintain, according to NTID/RIT counselor Geri Stanton, N.C.C., M.Ed. Like
residents of a small town, Deaf persons across the entire country know each
other, or at least know of each other, because of residential school
connections and social networks within their nationwide community. Computer
networks, facsimile machines, and TDDs (telecommunication devices for deaf
people) can carry rumors from the East to the West Coast, even into the
international community, in a matter of minutes.
Some deaf persons who have grown up in the
mainstream hearing world and are not part of the Deaf culture are somewhat
insulated from the rumors, according to Stanton. She adds, however, that
the effect of rumors on survivors is determined more by a person's
self-esteem and other related factors than by their affiliations within the
deaf community.
Nonetheless, such rumors take their toll.
"Those rumors can be absolutely devastating to an
individual," says Stanton.
"They can label an individual, can ostracize an individual, can control the
person's behavior. It damages their self-esteem. One person tells another,
another tells another. Pretty soon this whole group decides on this person.
The person is set aside or labeled or some way put down, or emotionally
hurt. That's the reason why it's very difficult to get women together
sharing information about sexual assault and their experiences in the
past."
Psychologist Wax agrees that the "gossip
mills" have a powerful influence. She says that reputation is very
important to people in the Deaf culture, and that sexual abuse "is
something
that's so stigmatized and so private that in the context of a society that
is otherwise very open and very communicative about things about other
people, it's very difficult to talk about something full of shame."
Rumors about sexual abuse might damage a
person's reputation because, as in the hearing world, there has been a
tendency to blame the victim. Burke, of the UCSF Center on Deafness, says,
"The idea that sexual abuse is something that is pervasive, and we don't
want to revictimize the victim, and it's OK to talk about it, has been very
slow coming."
Because of these concerns, some people
choose to enter therapy with an "outsider" rather than with someone
associated with the larger deaf community. One survivor says she chose this
route because she knew that otherwise she would invariably run into her
therapist in both social and work environments.
Recently, some of NTID counselor Geri
Stanton's clients have found the courage to talk about their abuse despite
the fears of being labeled or rejected. "Some will tell a roommate or close
friend first," she says. "Generally, people are supportive. The more
they
disclose it, the less of a big secret it becomes, the less power it has.
[People] ... say, 'I'm really sorry that happened to her, and she's part of
our group and we love her."'
A Threat to Deaf Culture?
Like hearing children, deaf children have
been sexually abused at home by relatives, parents, or siblings. However,
several court cases (most recently in Ontario, Canada) have focused
attention on alleged abuse in some residential schools for the deaf.
Controversy swirling around these cases is, in most respects, similar to
that surrounding sexual child abuse cases involving institutions in society
as a whole. Charges of denial of abuse in the schools, cover-up and
kid-glove treatment of perpetrators, the purported unreliability of
children's testimony, and calls for closing the schools are factors that
fuel the debate in these cases (Sullivan et al., 1987).
This controversy differs in one respect,
however. For many Deaf people, school closure has serious ramifications,
according to U of R psychologist Robert Pollard. "Anything which can
threaten the viability of the residential schools for the deaf is perceived
as a very, very serious threat ... [to Deaf culture]," he says. "Some
would
go to the very large extreme of equating it with genocide."
According to Pollard, many Deaf people fear
this threat because they consider residential schools to be cradles of the
Deaf culture where the Deaf culture's history, traditions, and language are
transmitted from Deaf children steeped in the culture to deaf children who
know little or nothing of it. Deaf children born to hearing parents, for
example, often do not meet another person who is deaf until they attend
these schools.
Margaret Bibum, a Deaf person who is deputy
director of Deafpride, Inc., a nonprofit, community-based organization in
the District of Columbia that "works for the empowerment of Deaf persons
and
their families," is outraged by sexual abuse incidents in residential
schools and saddened by the possibility that repercussions from scandals
might threaten the existence of the schools.
". . . The schools themselves have Deaf
principals now," Bibum says. "Children have role models to look up to,
people in leadership positions who are Deaf.... You can see what a dichotomy
of issues is involved here. If you bring up the sexual abuse, then you're
hurting the school."
Unlike Bibum, Sullivan of Boys Town Research
Hospital does not think that confronting the abuse will hurt the schools.
She argues, "[lf] they don't fix the abuse, there is major danger of
schools
closing. Knowledge is power."
As this school-related debate continues,
educators, therapeutic professionals, and parents are working to make the
schools safer for children. They point out that some schools already take
preventive measures against abuse and warn against assuming that all schools
have such problems. Psychologist Vernon says, "Children in residential
schools, whether they are schools for the deaf here or in very exclusive
private schools in England that are not deaf but hearing, are at special
risk ... only [emphasis added] if proper precautions are not taken, which
involves [sic] (1) educating children about what sexual abuse is and (2)
screening employees very carefully."
However, some therapists say that until the
hearing people who control deaf education become more appreciative of the
role schools play in Deaf culture, some Deaf adult survivors of sexual abuse
will continue to feel the bind in which many hearing survivors find
themselves: speak out, and you will hurt the family. The "family" in
this
case is not the biological family but the Deaf culture itself.
Seeking Treatment
Deaf survivors, many of whose primary mode
of communication is sign language, face enormous challenges when seeking
treatment. U of R psychologist Robert Pollard says that the lack of
sign-fluent professionals makes the mental health system inaccessible to
many deaf people.
Burke, of the UCSF Center on Deafness,
concurs with Pollard, but she also adds that sign-fluency does not guarantee
competent therapy. "For many years, there have been very few people who
have
solid clinical training and have understanding of both sign language and the
Deaf culture," she says. "Many professionals who get into positions of
providing counseling and therapy are not clinically trained. They might get
into these positions because they are the only one [sic] in the community
who can sign."
Finding an accessible, trained specialist in
sexual abuse treatment is extremely difficult for deaf survivors, according
to Burke. "When you try to link up deaf persons with hearing professionals
who are experts in sexual abuse, you have to add an interpreter, and it
becomes just too much for the deaf individual."
She adds that some therapists consider an
interpreter an added financial burden. The Americans With Disabilities Act
(ADA), passed in 1990, requires that doctors' offices be accessible.
Therapists must make appropriate communication accommodations for deaf
people, which in some cases means paying interpreter fees. These fees vary
widely across the country, ranging from approximately $28 to $85 per hour;
some services require that they be paid for a minimum of two hours' work.
Some therapeutic professionals feel that an
interpreter is an encumbrance therapeutically as well as financially They
say that despite the best efforts of an interpreter, adding an intermediary
to the treatment process leaves open the possibility of misinterpretation or
miscommunication of a client's words.
However, according to psychologist Tovah
Wax, interpreters are not the only way to make therapists' services
accessible to deaf people. Deaf people communicate in a variety of ways,
and accessibility must be determined on a case-by-case basis.
"Accommodations are going to range from bringing in a
sign language
interpreter, [employing] cross-cultural counseling techniques, all the way
over to more simple maneuvers such as better lighting in the room or
positioning oneself more effectively [for purposes of speech reading]," she
says.
When determining which type of accommodation
is appropriate, a therapist should respect the wishes of the deaf client,
psychologist Pollard says. For example, one Deaf survivor sought a
therapist who would be willing to use a computer for dialogue because she
felt threatened by the presence of an interpreter.
It might be reasonable to ask why deaf
people do not avoid such complications by seeking out therapists who are
deaf. Some do. But there are only 20 deaf psychologists in the country.
Until recently, deaf people wishing to enter the mental health professions
have found most direct paths to clinical psychology degrees closed to them,
according to Pollard. The higher the degree a deaf therapist wishes to
obtain, the less accessibility there is within universities that offer
programs in the subject.
Deaf therapists who have succeeded in
overcoming such obstacles face an additional barrier when trying to get
training in the field of sexual abuse treatment. "I have had hundreds of
hours of special training," says Burke, who is hearing. "My deaf
co-workers
don't have that luxury. They not only have to pay the training fees; they
have to hire interpreters. It has been very hard to get these [training]
organizations to pay for interpreters."
Unfortunately, the lack of trained
professionals in the field of deafness and mental health has resulted in
some distressing experiences for deaf people, writes Allen E. Sussman,
Ph.D., professor in the department of counseling at Gallaudet University.
"We continue to learn of horror stories.... Abounding are cases of
misdiagnoses, non-treatment, improper treatment, negligent treatment,
misplacement in institutions, and malpractice -- some cases resulting in
clients committing suicide" (Sussman, 1990).
Burke agrees that misdiagnosis can be a
problem, adding that she ". . . is amazed as to how many people don't ask
the questions about sexual abuse as part of their standard intake
interview." This is a concern that has been raised time and time again by
many specialists throughout the field of sexual abuse treatment.
Deaf survivors respond to the challenge of
dealing with a mental health system that has not adequately served them in
the past in a variety of ways. They turn to the Deaf culture's network for
information about a specific therapist to find someone with whom they can
feel safe, or they turn to no one, therapists say.
Making the System Work
From California to New York, deaf and
hearing people have been challenging the status quo -- at times subtly, at
times with an intensity that has made the entire country stand up and take
notice. And they point out that they have had some successes:
* The l988 protest at Gallaudet University that resulted in the
appointment of a Deaf president was a watershed event, according to
psychologist Pollard. In his view, there will never again be a time when a
hearing person is automatically appointed to a position of authority over
deaf people.
* Survivors are overcoming their fear of exposure and are
joining
outpatient therapy groups.
* Gallaudet University's doctoral Program in clinical
psychology and
the U of R's NIMH Program for Deaf Trainees will sharply increase the number
of deaf therapeutic professionals in the United States.
* The American Psychological Association now has a working
accessibility policy for deaf professionals.
As change continues, it is hoped that deaf
survivors will find an environment more conducive to healing. One survivor
says that she hopes the Deaf community will begin to deal with the issue of
sexual abuse. She speaks of the relief she would feel if people talked more
openly, saying that she would not feel so isolated if they did.
But responsibility for change does not lie
solely in the hands of deaf people and hearing people who work in the
deafness field. For additional substantive change to occur, hearing people
need to --
* Educate themselves about deafness.
* Examine how they might be discriminating against deaf persons.
* Endeavor to make their organizations and conferences, both
professional and social, accessible to deaf persons.
In any case, it would probably be helpful
for both hearing and deaf people to consider that communication, whatever
form it takes, is a shared responsibility, and that those involved must seek
to create forums in which to make dialogue possible.
Note: Interviews for this piece were
conducted using several modes of communication: interpreters, typing
conversation into a computer word-processing program, speech reading, fax,
and telephone relay (makes connections between a TDD and a telephone by
means of an intermediary).
Marge Elder is a freelance writer and author
of the book Into the Silence: Healing the Wounds of abuse (Marj), published
by White Oak Publications.