Diocese of Greensburg to hold listening sessions at area parishes

by Amy Fauth

In the wake of the state's grand jury report and the effect it is having on parishioners all across the Diocese of Greensburg, Bishop Edward C. Malesic announced that the diocese will be hosting a series of listening sessions, including one from 6:30 to 8:30 p.m. Wednesday at St. Therese, Little Flower of Jesus in Uniontown.

A second will be from 1:30 to 3:30 p.m. Oct. 31 at Holy Family in West Newton.

According to a notice from Jerry Zufelt, office of communications and evangelization for the diocese, the sessions provide an opportunity for the Bishop to listen to the concerns of parishioners and respond to their questions.

"These sessions will give people the opportunity to express their feelings, observations and suggestions," Zufelt said.

The wounds remain fresh as news broke over the weekend that the diocese had permanently removed another priest from ministry after an allegation against him was found to be "credible and substantiated."

That priest, the Rev. James W. Clark, was removed in June due to a nearly 50-year-old sexual abuse allegation. The alleged abuse occurred prior to Clark becoming a priest while he was a janitor at the former St. James School in Apollo. Clark served as parochial vicar of St. Mary (Nativity); St. John the Evangelist; St. Therese, Little Flower of Jesus and St. Joseph Parishes all in Uniontown, and as chaplain of Uniontown Hospital.

He will not be permitted to continue as a priest in Greensburg or any other diocese. There has yet to be a ruling issued by the diocese about the return of Msgr. Michael Matusak, pastor of St. Therese, who was removed in August after an allegation of inappropriate contact from decades ago surfaced against him.

Recently, the diocese formed what's being called, the Safe Environment Advisory Council to ensure that the church "never becomes complacent about the protection of children," according to Malesic.

The council will consist of laypeople - Catholic and non-Catholic - and includes an abuse survivor. Members are from a variety of backgrounds and from all four counties the diocese represents.

"I have talked with survivors of clergy abuse," said Malesic. "Their pain and anguish and their accounts on how the church failed to protect them have had a tremendous impact on me. I want to be sure we do everything possible to prevent these tragedies from happening again in our church and our communities."

The council is overseeing the upcoming listening sessions. According to the diocese, these sessions play a vital role in recovery and members are looking forward to hearing from parishioner on not only their feelings on the report, but also their observations and suggestions moving forward.

The suggestions will be analyzed by the council, who will then develop and implement an action plan, issue a yearly review of diocesan compliance with requirements that protect children and vulnerable adults and ensure the church's processes and procedures meet with best practices.

In addition to the Uniontown and West Newton sessions, additional listening sessions planned include:

Oct. 29, St. Margaret Mary, Lower Burrell;

Nov. 5, St. Mary, Our Lady of Guadalupe, Kittanning;

Nov. 8, Mother of Sorrows, Murrysville;

Nov. 29, St. Bernard of Clairvaus, Indiana.

The first listening session was held Monday at Blessed Sacrament Cathedral in Greensburg.

"It cannot be overstated how important the church's actions and level of transparency are to survivors, parishioners and clergy in the wake of the grand jury report," said Malesic.

While they can't change the past, Malesic said the formation of the advisory council and the scheduling of these listening sessions are just two ways that the church demonstrates how it will act in the future to accomplish the most important thing - and that is to re-establish trust in the church and its leaders.

https://www.heraldstandard.com/news/local_news/diocese-of-greensburg-to-hold-listening-sessions-at-area-parishes/

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Smacking Children Should Be Banned To Protect Mental Health, Psychologists Say

Hitting children as a form of punishment may encourage them to behave in a more aggressive way, experts state

by Sabrina Barr

Psychologists are calling for the smacking of children in the family home to be outlawed due to the effect it can have on their mental health.

A motion has been put forward to the Trades Union Congress (TUC) from the Association of Educational Psychologists (AEP) urging the government to “acknowledge that physical punishment can have negative long-term effects on a child's development.”

Parents and carers are currently legally allowed to smack children lightly if it can be described as a “reasonable punishment”, as outlined in section 58 of the Children Act 2004.

Smacking children makes them ‘more aggressive and antisocial'

However, psychologists who have backed the ban state that hitting is never an effective method of disciplining a child, no matter the circumstances.

Corporal punishment became illegal in British state schools in 1986, but remained legal in private schools until 1998 in England and Wales, until 2000 in Scotland and until 2003 in Northern Ireland.

John Drewicz, president of the AEP, is due to speak today at the annual TUC Conference in Manchester.

He'll outline how smacking impacts a child's mental health and perpetuates damaging messages about violence.

His speech will discuss how smacking a child can negatively impact their mental health and can encourage them to behave in a more aggressive and violent manner.

Furthermore, he'll reference several countries where a full ban on smacking children is already in place, including Sweden, Ireland, Spain, Germany and Portugal.

The motion being put forward by the AEP references similar initiatives in Scotland and Wales.

Welsh plan to ban smacking children goes to public consultation

Earlier this year, it was announced that the Welsh government was proposing to ban smacking children by asking the country's population for its views on the issue.

Furthermore, earlier this week Green MSP John Finnie put forward a bill in Holyrood to outlaw the smacking of children, which received the backing of the Scottish government and numerous MSPs from different political parties.

Children's charity Save the Children states that all children have a “right to protection from violence, exploitation, abuse and neglect,” and describes the act of smacking a child as a form of “child abuse."

https://www.independent.co.uk/life-style/health-and-families/mental-health-psychology-smacking-children-hit-slap-punishment-parents-ban-a8534116.html

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Arizona

Two dozen arrested in child sex crime operation

MESA, Ariz. — Authorities say a multi-agency operation to crack down on child sex crimes has resulted in the arrest of 24 men in the Phoenix metro area.

Mesa police say they partnered with the Tempe, Gilbert and Chandler police departments and the Arizona Attorney General's Office as part of the recent undercover operation.

Over a six-day period, undercover detectives placed ads on websites commonly used by suspects looking to perform illegal sex acts, particularly with children.

Police say all 24 suspects solicited or made deals for various sex acts with the undercover detectives before they were arrested.

The suspects ranged in age from 21 to 80 years old.

https://nypost.com/2018/09/12/two-dozen-arrested-in-child-sex-crime-operation/

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New Jersey

Police sergeant, firefighter among 24 busted in child-sex sting

A New Jersey police sergeant was among 24 men who were arrested in a child-sex sting in the state, law enforcement officials said Tuesday.

In addition to the sergeant, a nurse, a firefighter and a Bronx resident were netted by the multi-agency sting based out of Toms River, authorities said.

The New Jersey State Police led the operation, and had the 24 men believing they were chatting with underage girls and boys online and arranging a meet-up, prosecutors said.

When the men showed up to meet the underage kids — actually undercover police officers — they were arrested, authorities said. The 24 men were taken into custody over a five-day period from Sept. 5 to Sept. 9.

“It is a frightening reality that sexual predators are lurking on social media, ready to strike if they find a child who is vulnerable,” New Jersey Attorney General Gurbir Grewal said in a press release.

Howell Township police Sgt. Richard Conte, 47, was arrested in the operation for trying to meet a 15-year-old girl, authorities said. He was suspended from his job and ordered to turn over his weapons.

Richard Hoffman, a 23-year-old firefighter from Mays Landing, was arrested for trying to meet a 14-year-old girl, prosecutors said.

And 24-year-old Nabindranauth Nandalall was arrested in the operation after traveling from his home in the Bronx to Toms River in an attempt to meet a 15-year-old girl.

All 24 suspects were held in the Ocean County Jail and faced detention hearings last week for attempting to lure or entice a child with a purpose to commit a criminal offense. One of the defendants — registered sex offender Thomas Blumensteel — was detained, and the rest were released under pre-trial supervision.

https://nypost.com/2018/09/18/police-sergeant-firefighter-among-24-busted-in-child-sex-

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Wisconsin

Brother of teen starved to death wrote letter begging for help: police

by Associated Press

MADISON, Wis. — The younger brother of a 15-year-old boy who starved to death while their family prayed and fasted for weeks wrote a letter that investigators found inside the locked southern Wisconsin apartment pleading with lawyers to save him.

The emaciated 11-year-old boy was clutching a Bible and an envelope containing pamphlets about death on Monday when officers found him, his mother and his brother's body in the family's Reedsburg apartment, which had no power and was padlocked from the inside, authorities say. Investigators also found the younger boy's handwritten letter, which was addressed to “Lawyers of Sauk County.”

“The hunger is too much,” the boy wrote. “Please help me now so I may eat. I can't continue in such a life with no food. If I don't get food now I'll probably die of hunger.”

The parents, Kehinde and Titilayo Omosebi, were charged Tuesday with child neglect causing death and child neglect causing great bodily harm. The charge involving death carries a maximum prison term of 25 years.

According to the criminal complaint, Kehinde Omosebi walked to the Reedsburg police station Monday to report that his 15-year-old son had died in their apartment during the fast.

Officers found the apartment's doors padlocked from the inside and the power turned off. The family had no food in the home and the only furniture was a bed and four metal folding chairs arranged in a square. In one of the chairs was the 15-year-old boy's body. Officers wrote that the boy was so emaciated they could see his backbone and ribs under his skin.

According to the police, the father said the boy died on Friday and that the family prayed for two days, in accordance with their religious beliefs, before he walked to the police station to report it. Police Chief Timothy Becker said Kehinde Omosebi told investigators that he is a minister with Cornerstone Reformation Ministries, but they don't believe him because they haven't been able to find any record of such a ministry. He said the couple is originally from Nigeria.

Kehinde Omosebi told police the last time the family had eaten was July 17, according to the complaint. He said the family had fasted before but never for so long. Titilayo Omosebi said the family previously had lived in Missouri and Iowa, and they had planned to fast until they earned God's blessing to leave Reedsburg. Kehinde Omosebi said God had told him to move to Atlanta, police contend.

Leonie Dolch, a public defender who represented Kehinde Omosebi during his initial court appearance Monday, told the court that Omosebi had worked at a local iron foundry, Grede Foundries, but had been unemployed since February. The company didn't immediately reply to a voicemail left Wednesday.

Reedsburg, a city of about 9,000 people, is about 50 miles northwest of Madison.

https://nypost.com/2018/09/05/brother-of-teen-starved-to-death-wrote-letter-begging-for-help-police/

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Thailand

Buddhist monk accused of beating child to death during prayer session

by Caleb Parke

A Thai boy was beaten to death by an incensed Buddhist monk after the child displayed “playful” behavior during a temple prayer session, Thai police said Friday.

Monk Suphachai Suthiyano, 64, allegedly assaulted Wattanapol Sisawad, 9, with a bamboo stick and slammed the boy's head against a pillar before Sisawad fell into a coma last weekend, AFP reported. Sisawad died as a result of his injuries on Thursday.

Suthiyano reportedly flew into a rage after the young boy disrupted a Buddhist ceremony at the temple in Kanchanaburi, Thailand, two hours west of Bangkok.

Thai police originally charged Suthiyano with assault when he was arrested Sunday, but, after the boy's death, the charge will be revised to assault resulting in death, authorities said.

Suthiyano lost his status as a monk following the arrest.

Sisawad's mother told Thai media she “will not forgive” Suthiyano.

This monk's alleged attack on the child comes amid investigations into sexual misconduct, extortion and drug use accusations leveled at high-profile monks in Buddhist-majority Thailand and China.

https://nypost.com/2018/08/24/buddhist-monk-accused-of-beating-child-to-death-during-prayer-session/

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New York City

An Esteemed Doctor, Child Sexual Abuse Claims and a Hospital That Knew for Years

by Christina Goldbaum

For almost 30 years, parents sought out Dr. Reginald Archibald when their children would not grow. They came to his clinic at The Rockefeller University Hospital, a prominent New York research institution, where he treated and studied children who were small for their age.

He also may have sexually abused many of them.

The hospital sent a letter last month to former patients of Dr. Archibald asking about their contact with him. Ten days later, on Oct. 5, it posted a statement online saying it had evidence of the doctor's “inappropriate” behavior with some patients and that it first had learned of credible allegations against him in 2004. The letter went out to as many as 1,000 people, said a former patient who spoke with a hospital administrator.

Dr. Archibald, an endocrinologist who spent most of his career at Rockefeller, died in 2007. His son, Larry, declined to comment. “This doesn't make any sense to me,” he said.

The New York Times spoke with 17 people, most of them men, who said they were abused by Dr. Archibald when they were young boys or adolescents. Most of them learned of the possibility of other victims for the first time when they received the letter. A few, however, said they had filed complaints with the hospital or authorities in the past, but their allegations were not investigated.

“To know that they knew about this in 2004 and didn't reach out to people, it's absolutely outrageous,” said Matt Harris, now 58, a former patient of Dr. Archibald.

The men all described similar experiences with Dr. Archibald, who would tell them to disrobe when they were alone in his examination room. He would masturbate them or ask them to masturbate, sometimes to ejaculation.

The doctor took pictures of them, while they were naked, with a Polaroid camera, and measured their penises both flaccid and erect, the men said.

Some of the former patients said they saw Dr. Archibald only once and some went back annually for many years as subjects in his studies.

Their stories paint a picture of an esteemed doctor who wielded great authority with parents desperate to help their children and patients too young to know the difference between legitimate medical practice and molestation. The alleged abuse would have occurred in an era in which few safeguards existed for those patients.

“You are robbed of knowing what's real and what's not real. That's the real cost of this thing,” said Mr. Harris, who, like many of the patients who spoke with The Times, has talked to a lawyer.

In response to questions from The Times, the hospital said in a statement Thursday that after the letters were sent, it heard from many former patients alleging abuse. The hospital said it has set up a fund to provide counseling for the victims.

“We are appalled to hear those accounts of Dr. Archibald's reprehensible behavior. We deeply regret pain and suffering caused to any of Dr. Archibald's former patients,” the statement read.

A hospital spokesman declined to answer questions about when the hospital first learned of the allegations and why it did not try to contact a wider array of former patients earlier.

In its earlier statement, the hospital said that in 2004, it received an allegation of “impropriety” during Dr. Archibald's physical examinations, which it did not specify.

The hospital said it informed the Manhattan district attorney's office, the state office that oversees medical conduct and a federal research agency. It also hired Debevoise & Plimpton, a law firm, to investigate. The inquiry turned up two additional reports dating to the 1990s.

The hospital did not say where the allegations from the 1990s were filed and what the response to them had been. A spokeswoman for the Manhattan district attorney, Cyrus R. Vance Jr., could not immediately confirm whether the office had received the allegation from the hospital in 2004.

Earlier this year, separate allegations against Dr. Archibald were reported to the hospital, which again hired Debevoise & Plimpton.

“Based on its investigation, the law firm concluded that some of Dr. Archibald's behaviors involving these patients were inappropriate,” the statement said.

The hospital said it has scrubbed Dr. Archibald's name from its web pages and rescinded his emeritus status.

The possibility of a large number of victims could pose a serious financial threat to the research institution. Under current New York law, the statute of limitations for victims to sue the hospital has long passed.

But a proposed change to the law, supported by Gov. Andrew M. Cuomo, would lengthen the statute of limitations for filing criminal charges and civil suits in child sexual abuse cases, and crucially, create a one-year window in which all victims could sue, regardless of when the abuse happened. The legislation has been held up in the State Senate and is vigorously opposed by institutions, including the Roman Catholic Church, which has argued that the one-year window could lead to catastrophic financial damage.

Dr. Archibald worked as a doctor, researcher and professor at The Rockefeller University Hospital from 1941 to 1946 and again from 1948 to 1980. He kept his affiliation with the institution, as an emeritus, until 1987.

His former patients remembered him as avuncular and authoritative, with white hair as he grew older. They also remembered his strange methods. Their allegations suggest a pattern of sexual abuse from the 1950s through the 1970s among patients as young as 6 and as old as 17.

Michael Manfre, now 57, recalled Dr. Archibald asking him to masturbate when he was about 12 years old and then doing it himself. “Keep trying,” Mr. Manfre, of Massapequa, N.Y., remembered Dr. Archibald saying, encouraging him to ejaculate.

Mr. Harris, who now lives in Port Washington, N.Y., said that during a visit in the 1970s, the doctor massaged the area between his testes and anus, asking if it felt good.

Many of Dr. Archibald's patients were short for their age, and their parents worried about the teasing and shame they might experience in school if they hit puberty years behind their peers.

Dr. Archibald was known as a growth specialist who administered hormones, such as testosterone, which he hypothesized could help spur puberty and increase the height children would reach. To better understand children's growth and create a control group, he often had siblings come to the clinic, former patients said.

Taking measurements of boys' genitals when doctors were concerned about delayed puberty was considered normal until the 1980s or 1990s, said Dr. Howard Markel, a professor of medical history at the University of Michigan. But doing so when they were erect, asking them to masturbate, particularly while the doctor was present, was not considered acceptable, even at that time, he said.

Nearly every victim remembered having to strip naked, stand against a wall and hold their palms out facing forward while Dr. Archibald took photographs. One patient provided a copy of a release signed by that person's mother giving Rockefeller permission to photograph her child “for the advancement of medical science.”

At least two articles published by Dr. Archibald contain pictures of naked boys in the stance described by these victims. One of those articles also contains close-ups of the boys' genitals.

While almost every alleged victim said the abuse occurred in the doctor's examination room, one described a dark encounter far away from the hospital. A 58-year-old Brooklyn man said he believed Dr. Archibald raped him on a trip to the doctor's Canadian summer home.

The former patient, who asked to be identified only by his first name, John, because of the nature of the alleged assault, said Dr. Archibald watched him masturbate during examinations at the hospital. But one summer, when he was about 13, the doctor convinced his parents to let John accompany him to the house.

One of Dr. Archibald's former neighbors in Pelham, N.Y., who visited the lake, recalled that every year Dr. Archibald would take a young boy to help prepare the wooden cabins for his family's visit.

John said Dr. Archibald tried to shower with him at a motel on the two-day trip to the house but he ran out of the bathroom. Once they arrived, John said, he believed Dr. Archibald drugged and raped him. He angrily insisted on being taken home, he said.

Dr. Archibald spent only two years of his career away from Rockefeller when, in 1946, he took a job at Johns Hopkins University.

https://www.nytimes.com/2018/10/18/nyregion/dr-reginald-archibald-rockefeller-abuse.html

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Ohio

This Student Wrote About Being Raped And It Sent Her Alleged Abuser To Prison

by CAITLIN CRUZ

After writing about the sexual abuse she and her sisters allegedly suffered as children, an Ohio student's essay led to the conviction of their abuser, according to The Associated Press. Anthony Knight, 43, was sentenced to 20 years in prison after Knight pled guilty to three counts of rape on Tuesday, CBS affiliate WTOL reported.

Knight will also register as a sex offender. He was initially indicted on 12 counts of rape, the television station reported. Bustle has reached out to a representative for Knight for comment.

Knight was arrested after a high schooler wrote an essay about obstacles she had overcome in her life, and one of them was childhood sexual abuse. The Associated Press reported that the sisters said they were reluctant to come forward at first. "The class was asked, I believe, to write an essay pertaining to obstacles that they had overcome in their life and she had disclosed that she had been sexually abused as a child," St. Kenneth Arp of the Sandusky County Sheriff's Office told WTOL.

The Associated Press reported the youngest girl was 7 when the abuse happened, but didn't report her current age. "This happened years ago," Arp told the wire service.

Arp told WTOL that the school was helpful in the course of the investigation. "The biggest thing was the help and support that I got from the school. They were a tremendous asset in the investigation," Arp said.

Knight's attorney didn't return The Associated Press's request for comment. The school declined to comment to the wire service to protect the girls' privacy.

On Wednesday, the Freemont News Messenger's Craig Shoup reported that the sisters' stories were "corroborated." Arp told the newspaper that each sibling reported differing types of abuse.

In August, when Knight was first charged, Arp told the Fremont News Messenger that all three siblings had been abused.

"This happened years ago," Arp told the Fremont News Messenger. "All three siblings said they were abused."

The siblings showed a lot of courage, Arp told the newspaper. "At least it came to light now," Arp told the Fremont News Messenger.

The Port Clinton News Herald reported in August that Knight was taking care of the three sisters when they were assaulted. The assaults apparently took place over many years, the newspaper reported.

Sandusky County Prosecutor Tim Braun told The Port Clinton News Herald that child sexual abuse is still happening. "Most of our sexual offenses still involve child victims, and that is something that most of the public has a hard time grasping, because it doesn't make sense to people," Braun told the newspaper in August.

Knight will have to report as a Tier III sex offender, according to Newsweek. The Cuyahoga County Sheriff's Office in Ohio explained that Tier III offenders "means a sex offender whose offense is punishable by imprisonment for more than 1 year."

In 2017, My Daily Dayton News reported that there were more than 17,000 people on the registry in the state of Ohio. Less than one-third of the registry were considered Tier III, the highest label, according to the news outlet.

https://www.bustle.com/p/this-student-wrote-about-being-raped-it-sent-her-alleged-abuser-to-prison-12630940

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Wounds That Time Won't Heal

The Neurobiology of Child Abuse

by Martin H. Teicher, M.D., Ph.D.

We easily understand how beating a child may damage the developing brain, but what about the all-too-common psychological abuse of children? Because the abuse was not physical, these children may be told, as adults, that they should just “get over it.”

But as developmental neuropsychiatrist Martin H. Teicher reveals, scientists are discovering some startling connections between abuse of all kinds and both permanent debilitating changes in the brain and psychiatric problems ranging from panic attacks to posttraumatic stress disorder. In these surprising physical consequences of psychological trauma, Teicher sees not only a wake-up call for our society but hope for new treatments.

We know that the abuse or neglect of children is tragically common in America today. Nor are most of us surprised when studies point to a strong link between the physical, sexual, or psychological maltreatment of children and the development of psychiatric problems. To explain how such problems come about, many mental health professionals resort to personality theories or metaphors. Perhaps the child's adaptive or protective mechanisms have become counterproductive or self-defeating in the adult. Perhaps childhood abuse has arrested psychosocial development, leaving a “wounded child” within the adult. Although such explanations may offer gen uine insight and may support patients in therapy, too often they instead minimize the impact of early abuse. They make it easy to reproach the victims, to say, in so many words, “Get over it.”

Research on the effects of early maltreatment, including the work of my colleagues and myself at McLean Hospital in Belmont, Massachusetts, appears to tell a different story: that early maltreatment, even exclusively psychological abuse, has enduring negative effects on brain develop ment. We see speci?c kinds of brain abnor malities in psychiatric patients who were abused as children. We are also beginning to understand how these abnormalities may account directly for the personality traits and other symptoms that patients manifest.

With The Etiology of Hysteria (1896), Sigmund Freud ?rst introduced the topic of childhood sexual abuse in a scienti?c context. He was convinced that, as children, many of his patients had been sexually abused by their parents, older siblings, or other relatives. Furthermore, he claimed, based on his new analytical method, that their hysterical and neurotic symptoms could be traced directly to repressed memories of that early abuse. This hypothesis marked the birth of psychoanalysis. Freud later retreated from this theory, though, refusing to believe that childhood abuse could be as prevalent as he had initially claimed. He evolved the more complex theory that “memories” of early sexual abuse were merely repressed childhood fantasies. This theory has so swayed psychiatry for almost a century that it has largely blinded us to the frequency of real abuse in psychiatric patients' childhoods and to the role of abuse in psychopathology.

Physical abuse of children by their parents remained a hidden problem until 1962, when C. Henry Kempe published The Battered Child Syndrome, and an avalanche of publicity led to the enactment of child abuse reporting laws. During the 1970s, case reports of sexual abuse and incest appeared with increasing frequency in medical literature. By the 1980s, scienti?cally valid studies of the incidence and consequences of childhood sexual abuse were being published.

Today, episodes of serious neglect and physical abuse are featured regularly in the news, constantly reminding us of the horrifying cruelty adults in?ict on children. In separate surveys in San Francisco, Los Angeles, and Canada, and of college students in New England and Texas, the percentage of women reporting sexual abuse during childhood ranged from 19 to 45. The medical literature is replete with research on this problem; clinicians, super-sensitized to it, increasingly suggest that childhood abuse lies behind a patient's problem, even in the absence of direct evidence. Despite occasional hysteria and misuse of the diagnosis, however, the problem is all too real.

It is our hope that as we identify the speci?c physiological pathways by which abusive experiences alter brain development, our society will take more seriously the challenge of uprooting the violence against the children in our midst.

A HARVEST OF PSYCHIATRIC DISORDERS

Physical, sexual, and psychological trauma in childhood may lead to psychiatric dif?culties that show up in childhood, adolescence, or adulthood. The victim's anger, shame, and despair can be directed inward to spawn symptoms such as depression, anxiety, suicidal ideation, and post-traumatic stress, or directed outward as aggression, impulsiveness, delinquency, hyperactivity, and substance abuse.1

Childhood trauma may fuel a range of persistent psychiatric disorders. One is somatoform disorder (also known as psychosomatic disorder), in which patients experience physical complaints with no discernible medical cause. Another is panic disorder with agoraphobia, in which patients experience the sudden, acute onset of terror and may narrow their range of activities to avoid being outside, especially in public, in case they have an attack.

More complex, dif?cult-to-treat disorders strongly associated with childhood abuse are borderline personality disorder2 and dissociative identity disorder3 Someone with borderline personality disorder characteristically sees others in black-and-white terms, ?rst putting them on a pedestal, then vilifying them after some perceived slight or betrayal. Such people have a history of intense but unstable relationships, feel empty or unsure of their identity, often try to escape through substance abuse, and experience self-destructive impulses and suicidal thoughts. They are plagued by anger, most often directed at themselves.

In dissociative identity disorder, formerly called multiple personality disorder (the phenomenon behind Robert Louis Stevenson's “Dr. Jekyll and Mr. Hyde”), at least two seemingly separate people occupy the same body at different times, each with no knowledge of the other. This can be seen as a more severe form of borderline personality disorder. In borderline personality disorder, there is one dramatically changeable personality with an intact memory, as opposed to several distinct personalities, each with an incomplete memory. People with dissociative identity disorder have two or more (on average, eight to ?fteen) personalities or personality fragments that control their behavior at different times. Often there is a passive, depressed primary identity who cannot remember personal history as fully as can the other more hostile, protective, or controlling identities.

Post-traumatic stress disorder (PTSD) af?icts some people who have undergone a traumatic event involving serious injury or a threat to life or limb. Initially identi?ed in combat veterans, PTSD seems to result as well from natural disasters, child abuse, and other devastating experiences. People with PTSD keep re-experiencing the traumatic event in waking life or in dreams, and they actively avoid situations that might bring back memories of the trauma. They may also suffer a general numbing of their responsiveness, show diminished interest in signi?cant activities, restrict the range of their emotions, or have feelings of detachment or estrangement from others. Finally, they may also experience increased arousal (such as dif?culty falling or staying asleep), irritability or outbursts of anger, dif?culty concentrating, hyper vigilance, and an exaggerated startle response.

ABUSE AND THE DEVELOPING HUMAN BRAIN

For a century or more, scientists have hotly contested the relative importance of experience versus genetic endowment in the development of the brain and behavior. We know now that our genes provide the foundation and overall structure of our brain, but that its myriad connections are sculpted and molded by experience. Based on animal studies, scientists have long believed that early deprivation or abuse may result in neurobiological abnormalities, but until recently there has been little evidence for this in humans.

Then, in 1983, A. H. Green and his colleagues suggested that many abused children evidenced neurological damage, even without an apparent or reported head injury. Interestingly, although minor neurological disturbances and mild brain-wave abnormalities were more common in children who had been abused than in those who had not, Green and his colleagues did not believe that the abuse had caused them. Instead, they saw these neurological disturbances as a possible additional source of trauma, amplifying the damaging impact of an abusive environment. In 1979, R. K. Davies reported that in a sample of 22 patients involved as a child or as the younger member in an incestuous relationship, 77 percent had abnormal brain waves and 36 percent had seizures. In Davies's interpretation, however, these children were more vulnerable to being sexually abused by family members because of their neurological handicap.

My hypothesis is that the trauma of abuse induces a cascade of effects, including changes in hormones and neurotransmitters that mediate development of vulnerable brain regions. Testing this hypothesis in humans is dif?cult because abuse is not always a random act. If we observe an association between a history of abuse and the presence of a physical abnormality, the abuse may have caused that abnormality. But it is also possible that the abnormality occurred ?rst and elevated the likelihood of abuse, or that the abnormality ran in the family and led to more frequent abusive behavior by family members or other relatives. To try to sort out these competing hypotheses, we conducted studies of analogous early stress in animals, where the potentially confusing elements can be carefully controlled. Observing parallel outcomes in animals and people has bolstered our belief that trauma causes brain damage, not the other way around.

A CONSTELLATION OF ABNORMALITIES

Our research (and that of other scientists) delineates a constellation of brain abnormalities associated with childhood abuse. There are four major components:

1) Limbic irritability, manifested by markedly increased prevalence of symptoms suggestive of temporal lobe epilepsy (TLE) and by an increased incidence of clinically signi?cant EEG (brain wave) abnormalities.

2) De?cient development and differentiation of the left hemisphere, manifested throughout the cerebral cortex and the hippocampus, which is involved in memory retrieval.

3) De?cient left-right hemisphere integration, indicated by marked shifts in hemispheric activity during memory recall and by underdevelopment of the middle portions of the corpus callosum, the primary pathway connecting the two hemispheres.

4) Abnormal activity in the cerebellar vermis (the middle strip between the two hemispheres of the brain), which appears to play an important role in emotional and attentional balance and regulates electrical activity within the limbic system.

Let us look brie?y at the main evidence for each of these.

People with temporal lobe epilepsy (TLE)— .25 percent to .5 percent of the U.S. population—have seizures in the temporal or limbic areas of the brain. Because these areas constitute a sizable, varied part of the brain, TLE has a veritable catalog of possible symptoms, including sensory changes such as headache, tingling, numbness, dizziness, or vertigo; motor symptoms such as staring or twitching; or autonomic symptoms such as ?ushing, shortness of breath, nausea, or the stomach sensation of being in an elevator. TLE can cause hallucinations or illusions in any sense modality. Common visual illusions are of patterns, geometric shapes, ?ashing lights, or “Alice-in-Wonderlandlike” distortions of the sizes or shapes of objects. Other common hallucinations are of a ringing or buzzing sound or repetitive voice, a metallic or foul taste, an unpleasant odor, or the sensation of something crawling on or under the skin. Feelings of déjà vu (the unfamiliar feels familiar) or jamais vu (the familiar feels unfamiliar) are common, as is the sense of being watched or of mind-body dissociation—the feeling that one is watching one's own actions as a detached observer. Emotional manifestations of temporal lobe seizures usually occur suddenly, without apparent cause, and cease as abruptly as they began; they include sadness, embarrassment, anger, explosive laughter (usually without feeling happy), serenity, and, quite often, fear.4

TLE is dif?cult to diagnose because its symptoms can mimic those of other psychiatric and nonpsychiatric illnesses. The characteristic electrical discharge of TLE can be observed only in an electroencephalogram (EEG) during a seizure that is close enough to the brain's surface to be picked up by scalp electrodes. Without this objective EEG data, a diagnosis must be based on the frequency and severity of symptoms and the ruling out of other likely causes of those symptoms.

To explore the relationship between early abuse and dysfunction of the temporolimbic system, we devised the Limbic System Checklist-33 (LSCL-33), which calibrates the frequency with which patients experience symptoms of temporolimbic seizures.5 We studied 253 adults who came to an outpatient mental health clinic for psychiatric assessment; slightly more than half reported having been abused physically, sexually, or both. Compared to patients who reported no abuse, average LSCL-33 scores were 38 percent greater in the patients with physical (but not sexual) abuse, and were 49 percent greater in the patients with sexual (but not other physical) abuse. Patients who acknowledged both physical and sexual abuse had average scores 113 percent greater than patients reporting no abuse. Males and females were similarly affected by abuse.

As we expected, abuse before age 18, when the brain is still rapidly developing, had a greater impact on limbic irritability than later abuse. Patients physically or sexually abused after age 18 had scores not signi?cantly different from nonabused patients. Patients with both physical and sexual abuse, however, were strongly affected regardless of when the abuse occurred, and those ?rst abused after age 18 were almost as affected as those ?rst abused earlier.

Brain Wave Abnormalities

Our second study tried to ascertain whether childhood physical, sexual, or psychological abuse was associated with speci?c evidence of neurobiological abnormalities. We reviewed the records of 115 consecutive admissions to a child and adolescent psychiatric hospital to search for a link between different categories of abuse and evidence of abnormalities in brain-wave studies. We found clinically signi?cant brain-wave abnormalities in 54 percent of patients with a history of early trauma but in only 27 percent of nonabused patients. Among patients who had been abused, abnormal EEG ?ndings were observed in 43 percent of those with psychological abuse; 60 percent of the sample with a reported history of physical abuse, sexual abuse, or both; and 72 percent of the sample in which serious physical or sexual abuse had been documented. The overall prevalence of abnormal EEG studies in patients with a signi?cant history of abuse or neglect was the same for boys and girls and for children and adolescents.

The salient speci?c difference between abused and nonabused patients was in left-sided EEG abnormalities. In the nonabused group, left-sided EEG abnormalities were rare, whereas in the abused group they were much more common, and more than twice as common as right-sided abnormalities. In the psychologically abused group, all the EEG abnormalities were left-sided.

To dig deeper into the possibility that abuse may affect development of the left hemisphere, we looked for evidence of right-left hemispheric asymmetries in the results of neuropsychological testing. We compared patients' visual-spatial ability (predominantly controlled by the right hemisphere) to their verbal performance (predominantly controlled by the left hemisphere). In the nonabused group, left-hemisphere de?cits were about twice as prevalent as right-hemisphere de?cits, but in patients with physical, sexual, or psychogical abuse, left-sided de?cits were more than six times as prevalent as right. In patients with a history of psychological abuse, left-hemisphere de?cits were eight times as prevalent as right-sided de?cits. This corroborated our hypothesis that abuse is associated with an increased prevalence of left-sided EEG abnormalities and of left-hemisphere defects in neuropsychological testing.

Problems on the Left

In order to investigate the effects of childhood trauma on development of the left hemisphere, we then used a sophisticated quantitative method of analyzing EEG that provides evidence about the brain's structure.7 In contrast to conventional EEG, which reveals brain function, EEG coherence provided information about the nature of the brain's wiring and circuitry. In general, abnormally high levels of EEG coherence are evidence of diminished development of the elaborate neuronal interconnections in the cortex that would process and modify the brain's electric signals.

We used this technique to study 15 child and adolescent psychiatric inpatients who had a con?rmed history of intense physical or sexual abuse compared with 15 healthy volunteers. Patients and volunteers were between 6 and 15 years of age, right-handed, and with no history of neurological disorders or abnormal intelligence. Measuring EEG coherence indicated that the left cortex of the healthy controls was more developed than the right cortex, which is consistent with what is known about the anatomy of the dominant hemisphere. The abused patients, however, were notably more developed in the right than the left cortex, even though all were right-handed. The right hemisphere of abused patients had developed as much as the right hemisphere of the controls, but their left hemispheres lagged substantially, as though arrested in their development.

This abnormality in the cortex showed up regardless of the patient's primary diagnosis, which could be depression, PTSD, or conduct disorder. It extended throughout the entire left hemisphere, but the temporal regions were most affected. This ?nding of left cortex underdevelopment is consistent with our earlier ?nding that abused patients had increased left-hemisphere EEG abnormalities and left-hemisphere (verbal) de?cits as shown by neuropsychological testing.

Effects on the Hippocampus

The hippocampus, located in the temporal lobe, is involved in memory and emotion. Developing very gradually, the hippocampus is one of the few parts of the brain that continues to produce new cells after birth. Cells in the hippocampus have an unusually large number of receptors that respond to the stress hormone cortisol. Since animal studies show that exposure to high levels of stress hormones like cortisol has toxic effects on the developing hippocampus, this brain region may be adversely affected by severe stress in childhood.

J. Douglas Bremner and his colleagues at Yale Medical School compared magnetic resonance imaging (MRI) scans of 17 adult survivors of childhood physical or sexual abuse, all of whom had PTSD, with 17 healthy subjects matched for age, sex, race, handedness, years of education, body size, and years of alcohol abuse.8 The left hippocampus of abused patients with PTSD was 12 percent smaller than the hippocampus of the healthy controls, but the right hippocampus was of normal size, as were other brain regions, including the amygdala, caudate nucleus, and temporal lobe. Not surprisingly, given the role of the hippocampus in memory, these patients also had lower verbal memory scores than the nonabused group.

Murray Stein and his colleagues also found left hippocampal abnormalities in women who had been sexually abused as children. Their left hippocampal volume was signi?cantly reduced, but the right hippocampus was relatively unaffected. Fifteen of the 21 sexually abused women had PTSD; 15 had a dissociative disorder. They suffered a reduction in the size of the left hippocampus proportionate to the severity of their symptoms.

These studies suggest that child abuse may alter development of the left hippocampus permanently and, in so doing, cause de?cits in verbal memory and dissociative symptoms that persist into adulthood.

Shifting from Left to Right

The left hemisphere is specialized for perceiving and expressing language, the right hemisphere for processing spatial information and also for processing and expressing negative emotions. We wondered, then, whether abused children might store their disturbing childhood memories in the right hemisphere, and whether recollecting these memories would activate the right hemisphere more than it is activated in those without such a history.

To test this hypothesis, we measured hemispheric activity in adults during recall of a neutral memory, then during recall of an upsetting early memory.10 Those with a history of abuse appeared to use predominantly their left hemispheres when thinking about neutral memories and their right when recalling an early disturbing memory. Those in the control group had a more integrated bilateral response.

A Deficient Pathway

Since childhood abuse (as we found) is associated with diminished right-left hemisphere integration, we wanted to know whether there was some de?ciency in the primary pathway connecting the two hemispheres, the corpus collosum. We found in boys who had been abused or neglected that the middle portions of the corpus collosum were signi?cantly smaller than in the control groups. Furthermore, in boys, neglect exerted a far greater effect than any other type of maltreatment; physical and sexual abuse exerted relatively minimal effects. In girls, however, sexual abuse was a more powerful factor, associated with a major reduction in size of the middle portions of the corpus collosum. These results were independently replicated by Michael De Bellis at the University of Pittsburgh, and the effects of early experience on the development of the corpus collosum have been con?rmed by research in primates.

Calming Irritability in the Brain

Decades ago, Harry Harlow compared monkeys raised with their mothers to monkeys raised with wire or terrycloth “surrogate mothers.” Monkeys raised with the surrogates became socially deviant and highly aggressive adults. Building on this work, other scientists discovered that these consequences were less severe if the surrogate mother swung from side to side, a type of movement that may be conveyed to the cerebellum, particularly the part called the cerebellar vermis, located at the back of the brain, just above the brain stem. Like the hippocampus, this part of the brain develops gradually and continues to create new neurons after birth. It also has an extraordinarily high density of receptors for stress hormone, so exposure to such hormones can markedly affect its development.

New research suggests that abnormalities in the cerebellar vermis may be involved in psychiatric disorders including depression, manic-depressive illness, schizophrenia, autism, and attention-de?cit/ hyperactivity disorder. We have gone from thinking of the entire cerebellum as involved only in motor coordination to believing that it plays an important role in regulating attention and emotion. The cerebellar vermis, in particular, seems to be involved in the control of epilepsy or limbic activation. Couldn't maltreating children produce abnormalities in the cerebellar vermis that contribute to later psychiatric symptoms?

Testing this hypothesis, we found that the vermis seems to become activated to control— and quell—electrical irritability in the limbic system. It appears less able to do this in people who have been abused. If, indeed, the vermis is important not only for postural, attentional, and emotional balance, but in compensating for and regulating emotional instability, this latter capacity may be impaired by early trauma. By contrast, stimulation of the vermis through exercise, rocking, and movement may exert additional calming effects, helping to develop the vermis.

ATTENTION, HORMONES, AND THE BRAIN

We know that through their effects on hormone levels, early experiences in?uence brain development. Fifty years ago, Seymour Levine and Victor Denenberg showed that small alterations in their environment led to lasting changes in rats' development, behavior, and response to stress. Something as seemingly inconsequential as ?ve minutes of human handling during a rat's infancy produced lifelong bene?cial changes. We now understand through the research efforts of Michael Meany and Paul Plotsky that the effects of brief handling were highly bene?cial and were due to increased maternal attention. Those pups whose mothers spontaneously lick and groom them the most (about one-third in a laboratory setting) display the same bene?ts as the rats with the human handling. By contrast, long isolation produces stress that has a deleterious effect on brain and behavior development.

If we assume that lots of attention, licking, and grooming are the natural state of affairs and that lower levels of attention are a form of neglect, we can use this model to explore some of the biological consequences of neglect or abuse in children. Low rates of maternal attention decrease the production of thyroid hormone by the rat pups. This, in turn, decreases serotonin in the hippocampus and affects the development of receptors for the stress hormone glucocorticoid. Since corticosterone, one of our primary stress hormones, is kept in check by a complicated feedback mechanism that depends on these same stress hormone receptors, their inadequate development increases the risk of an excessive stress hormone response to adversity. For this and certain other reasons, lack of maternal attention predisposes the animals to have a heightened level of fear and a heightened adrenaline response. Some of the consequences of this are altered metabolism and suppressed immune and in?ammatory responses, neuronal irritability, and enhanced susceptibility to seizures. Still other consequences of an abnormally intense corticosterone response are reduced brain weight and DNA content, suppressed cell growth in the cerebellum and hippocampus, and interference with myelinization—the process of sheathing nerve ?bers to enhance conduction of electrical impulses.

These consequences seem consistent with inadequate development of the corpus collosum, which is a highly myelinated structure, and abnormal development of the hippocampus and cerebellum. High levels of cortisol can also hinder development of the cerebral cortex, the extent of vulnerability dependent on how rapidly the brain was growing at the time of the insult. During the years of rapid language acquisition (approximately 2-10 years of age), the left brain develops more rapidly than the right, making it more vulnerable to the effects of early maltreatment.

Finally, diminished maternal attention also appears to be associated with a lifelong decrease in production of the hormone oxytocin in the brain, and enhanced production of the stress hormone vasopressin. Recent research by Thomas Insel suggests that oxytocin is a critical factor in af?liative love and maintaining monogamous relationships. Both hormones may also help control sexual response, with vasopressin enhancing sexual arousal and oxytocin triggering climax and release. By affecting these hormones, early neglect or abuse theoretically could predispose mammals to experience enhanced sexual arousal, diminished capacity for sexual ful?llment, and de?cient commitment to a single partner.

FROM NEUROBIOLOGY TO SYMPTOMATOLOGY

In summary, we now know that childhood abuse is linked with excess neuronal irritability, EEG abnormalities, and symptoms suggestive of temporal lobe epilepsy. It is also associated with diminished development of the left cortex and left hippocampus, reduced size of the corpus callosum, and attenuated activity in the cerebellar vermis. We see a close ?t between the effects of early stress on the brain's transmitters—our discoveries about the negative effects of early maltreatment on brain development— and the array of psychiatric symptoms that we actually observe in abused patients.

Many disorders are associated with childhood abuse. One is depression or heightened risk for developing it. Many scientists believe that depression may be a consequence of reduced activity of the left frontal lobes. If so, the stunted development of the left hemisphere related to abuse could easily enhance the risk of developing depression. Similarly, excess electrical irritability in the limbic system, and alterations in development of receptors that modulate anxiety, set the stage for the emergence of panic disorder and increase the risk of post-traumatic stress disorder. Alterations in the neurochemistry of these areas of the brain also heighten the hormonal response to stress, producing a state of hyper vigilance and right-hemisphere activation that colors our view with negativity and suspicion. Alterations in the size of the hippocampus, along with limbic abnormalities shown on an EEG, further enhance the risk for developing dissociative symptoms and memory impairments.

We have also found that 30 percent of children with a history of severe abuse meet the diagnostic criteria for attention-de?cit/hyperactivity disorder (ADHD), although they are less hyperactive than children with classic ADHD. Very early childhood abuse appears particularly likely to be associated with emergence of ADHD-like behavior problems. Interestingly, one of the most reliable neuroanatomical ?ndings in ADHD is reduced size of the cerebellar vermis. Some studies have also found an association between reduced size of the mid portions of the corpus callosum and emergence of ADHD-like symptoms of impulsivity. Hence, early abuse may produce brain changes that mimic key aspects of ADHD.

Our discoveries that abused patients have diminished right-left hemisphere integration and a smaller corpus callosum suggest an intriguing model for the emergence of one of psychiatry's least understood af?ictions: borderline personality disorder. With less well integrated hemispheres, borderline patients may shift rapidly from a logical and possibly overvaluing left-hemisphere state to a highly negative, critical, and emotional right hemisphere state. This seems consistent with the theory that early problems of mother-child interaction undercut the integration of right and left hemispheric function. Very inconsistent behavior of a parent (for example, sometimes loving, sometimes abusing) might generate an irreconcilable mental image in a young child. Instead of reaching an integrated view, the child would form two diametrically opposite views—storing the positive view in the left hemisphere, the negative view in the right. These mental images, and their associated positive and negative world views, may remain unintegrated, and the hemispheres remain autonomous, as the child grows up. This polarized hemispheric dominance could cause a person to see signi?cant others as overly positive in one state and as resoundingly negative in another. Couple this with possible alterations in oxytocin- and vasopressin-mediated sexual arousal, and you see why patients with borderline personality disorder have tumultuous relationships.

DEALING WITH THE DAMAGE

I hope that new understanding of childhood abuse's impact on the brain will lead to new ideas for treatment. The most immediate conclusion from our work, however, is the crucial need for prevention. If childhood maltreatment exerts enduring negative effects on the developing brain, fundamentally altering one's mental capacity and personality, it may be possible to compensate for these abnormalities—to succeed in spite of them— but it is doubtful that they can actually be reversed in adulthood.

The costs to society are enormous. Psychiatric patients who have suffered from childhood abuse or neglect are far more dif?cult and costly to treat than patients with a healthy childhood. Furthermore, childhood maltreatment can be an essential ingredient in the makeup of violent individuals, predisposing them to bouts of irritable aggression.

One day we will ?nd ways to chart the progress of brain development so that we can spot early signs of stress-mediated abnormalities and monitor each patient's progress and response to treatment. In the meantime, early intervention should be our priority. The brain is more plastic and malleable before puberty, increasing our chances of minimizing or reversing consequences of abuse. If we are right that many abuse-related changes result from a cascade of stress-mediated neuronal and hormonal responses, then we could minimize the impact of abuse by ?nding ways to reduce ongoing stress or suppressing an excessive stress response.

One consequence of childhood maltreatment is limbic irritability, which tends to produce dysphoria (chronic low-level unhappiness), aggression, and violence toward oneself or others. Even into adulthood, drugs can be useful in alleviating this set of symptoms. Anticonvulsant agents can help, as can drugs that affect the serotonin system.

Abuse also causes alterations in left-right hemisphere integration. Some research suggests that anticonvulsant drugs may facilitate the bilateral transmission of information. Left-right hemisphere integration may also improve through activities that require considerable left-right hemisphere cooperation, such as playing a musical instrument. Certain existing psychotherapies may be helpful. Cognitive-behavioral psychotherapy, which emphasizes correcting illogical, self-defeating perceptions, may work by strengthening left-hemisphere control over right-hemisphere emotions and impulses. Traditional, dynamic psychotherapy may work by enabling patients to integrate right-hemisphere emotions while maintaining left-hemisphere awareness, strengthening the connection between the two hemispheres.

A powerful new tool for treating PTSD is eye-movement desensitization and reprocessing (EMDR), which seems to quell ?ashbacks and intrusive memories. A moving visual stimulus is used to produce side-to-side eye movements while a clinician guides the patient through recalling highly disturbing memories. For reasons we do not yet fully understand, patients seem able to tolerate recall during these eye movements and can more effectively integrate and process their disturbing memories. We suspect that this technique works by fostering hemispheric integration and activating the cerebellar vermis (which also coordinates eye movements), which in turn soothes the patient's intense limbic response to the memories.

THEIR CHOICE—OR OURS?

Society reaps what it sows in nurturing its children. Whether abuse of a child is physical, psychological, or sexual, it sets off a ripple of hormonal changes that wire the child's brain to cope with a malevolent world. It predisposes the child to have a biological basis for fear, though he may act and pretend otherwise. Early abuse molds the brain to be more irritable, impulsive, suspicious, and prone to be swamped by ?ght-or-?ight reactions that the rational mind may be unable to control. The brain is programmed to a state of defensive adaptation, enhancing survival in a world of constant danger, but at a terrible price. To a brain so tuned, Eden itself would seem to hold its share of dangers; building a secure, stable relationship may later require virtually superhuman personal growth and transformation.

At the extreme, the coupling of severe childhood abuse with other neuropsychiatric handicaps (for example, low intelligence, head trauma, or psychosis) is repeatedly found in cases of explosive violence. Dorothy Otnow Lewis and Jonathan Pincus have analyzed the neurological and psychiatric history of violent adolescents and adults. In one study they evaluated all 14 juveniles condemned to death in four states and found that all had suffered head injuries, most had major neurological impairment, 12 had subnormal IQ's, 12 had been severely physically abused as children, and 5 had been sodomized by relatives. In another study, they reviewed the childhood neuropsychiatric records and family histories of incarcerated delinquents. What might have been a tip-off to those who later were arrested for murder? The future murderers were distinguished from other delinquents by psychotic symptoms, major neurological impairment, a psychotic ?rst-degree relative, violent acts during childhood, and severe physical abuse.

In a follow-up study of 95 formerly incarcerated juvenile delinquents, they found that the combination of intrinsic neuropsychiatric vulnerabilities and a history of childhood abuse or family violence effectively predicted which adolescents would go on to commit violent crimes. Lewis concludes that child abuse can engender all pivotal factors associated with violent behavior, namely, impulsivity, irritability, hyper vigilance, paranoia (which she interprets as an extreme version of hypervigilance), decreased judgment and verbal ability, and diminished recognition of pain in oneself (dissociation) and others. As our review shows, these factors ?t closely with the enduring neurobiological consequences of abuse.

To be convicted of a crime in the United States, one supposedly must have the capacity both to know right from wrong and to control one's behavior. Those with a history of childhood abuse may know right from wrong, but their brains may be so irritable and the connections from the logical, rational hemisphere so weak that intense negative (right-hemisphere) emotions may incapacitate their use of logic and reason to control their aggressive impulses. Is it just to hold people criminally responsible for actions that they lack the neurological capacity to control?

Prosecutors and pundits are quick to coin catchphrases like the “abuse excuse” to dismiss childhood trauma's pervasive and enduring consequences for behavior. This is as unthinking as the exhortation to “get over it.” Childhood trauma is not a passing psychological slight that one can choose to ignore. Even if the abused person comes to terms with the traumatic memories and chooses (for the sake of sanity) to forgive the perpetrator, this will not reverse the neurobiological abnormalities. The only sound legal approach to a person with a history of abuse who commits a violent crime is to take into account the person's neurobiological capacity to control his behavior. If it is irrational and hypocritical to hold a minor to the same standard of behavioral control as a mature adult, it is equally unjust to hold a traumatized and neurologically impaired adult to the same standard as one not so af?icted. Childhood abuse, age, and neurological impairments can be critical mitigating factors that a just society should not ignore.

If we know that the roots of violence are fertilized by childhood abuse, can we make a long-term commitment to reduce violence by focusing on our children rather than our criminals? What if we set a goal of reducing the cases of childhood abuse and neglect by 50 percent a year? What if we monitored statistics on childhood abuse as avidly as we track housing starts, in?ation, or baseball scores? We would have to commit ourselves, seriously, to improving access to quality day care and after-school programs. We might need to educate and support parents so they could know how to nurture their children more effectively. We certainly would need to foster better relationships among peers and siblings.

Think of what we could save if we needed fewer prisons and fewer mental health professionals. Think of the bene?ts of moving one step closer to a society that everyone could experience and enjoy.

Our brains are sculpted by our early experiences. Maltreatment is a chisel that shapes a brain to contend with strife, but at the cost of deep, enduring wounds. Childhood abuse isn't something you “get over.” It is an evil that we must acknowledge and confront if we aim to do anything about the unchecked cycle of violence in this country.

http://www.dana.org/Cerebrum/2000/Wounds_That_Time_Won%E2%80%99t_Heal__The_Neurobiology_of_Child_Abuse/

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Los Angeles

University of Southern California to Pay $215 Million Over Sex Abuse Scandal

by Jennifer Medina

LOS ANGELES — The University of Southern California has agreed to pay $215 million to settle a federal lawsuit filed by hundreds of women who say that they were sexually abused by the former head gynecologist at the student health center and that school officials did not address their complaints.

The settlement, which still needs to be approved by the court, is among the largest to be reached by a university facing accusations of sexual misconduct. Still, it is unlikely to end the school's legal battles over the issue: Nearly 500 women have sued U.S.C. claiming mistreatment by the gynecologist, Dr. George Tyndall.

More than 90 of those women came forward for the first time this week, saying that he had molested them as patients. One woman said that when she complained, she was told by officials from the health center, “We'll look into it.” But there was no follow-up, she said. One lawyer for the women dismissed the settlement as “just a public relations effort.”

Under the terms of the tentative settlement, women who were patients of Dr. Tyndall during his three decades at U.S.C. will be eligible for $2,500 payments, whether or not they have alleged abuse. Women who allege the worst abuse and offer additional information will be eligible for up to $20,000, while those who are willing to be screened by a psychologist could receive a maximum of $250,000.

After an internal university investigation concluded that he had acted inappropriately and that his behavior had amounted to sexually harassing patients, Dr. Tyndall reached an agreement with the school and quietly resigned with a payout in 2017. Although the report found that complaints had come in since at least 2000 and it was not clear why he was allowed to stay, U.S.C. officials did not report the findings to the state medical board or any of his former patients.

After a major outcry over the way school officials handled the issue, the president of the university, C.L. Max Nikias, stepped down earlier this year.

The interim president, Wanda Austin, sent a letter announcing the settlement Friday to students, faculty and staff, calling it “an important step forward” that she hopes it will “help our community move collectively toward reconciliation.”

“I believe this will go a long way toward the students feeling like they have been heard and I believe get us on a path toward healing,” she said in an interview. “They are certainly getting the message that we care about the students and we certainly regret this happened.”

But John Manly, who is representing 180 former patients of Dr. Tyndall suing U.S.C., said that the settlement “does nothing other than sow confusion and deceit.” He said his office received calls from dozens of women on Friday morning, who were confused and concerned.

“Now that has turned to anger,” he said. “The idea that you go into your doctor's office at 17 or 18 years old and he brutally sexually assaults you and offends your body and psyche, and that you can then declare victory if you get $2,500, is absurd. But I am not surprised, because sadly what the university cares about is money and public relations. They are mistaken if they think this will go away.”

Mr. Manly said he would continue to pursue the case in state court to demand documents and depositions from university officials. Mr. Manly, who represented women and girls who were abused by Larry Nassar, the sports doctor at Michigan State University, said that the case was not settled until after it was clear what role the administration played.

“We know no more about who knew what at U.S.C. and when than we did 90 days ago,” he said. “What survivors all want to know is, how this could have happened.”

Money for the settlement will come from reserve funds and the university's insurance, not tuition or donor money, according to details outlined on a U.S.C. website. The settlement covers all defendants named in the federal class action case: the university and the board of trustees, as well as Dr. Tyndall. All former patients of Dr. Tyndall's, which U.S.C. estimates to be between 14,000 and 17,000 women, would be eligible for the settlement.

In court documents and in interviews, former patients of Dr. Tyndall's have accused him of a variety of abusive practices, including invasive and unnecessary pelvic exams, touching their vaginas, asking them to undress in front of him and making sexually explicit remarks about women's bodies.

He has denied all allegations of harassment and mistreatment.

The state medical board suspended his license to practice in August and the Los Angeles Police Department has said it is investigating possible criminal charges.

In June, the federal Education Department said it was beginning an investigation into how U.S.C. handled the complaints, which it did not disclose during another separate federal investigation over allegations against faculty and staff members, which was concluded in January.

The settlement is the latest multimillion-dollar financial payout from a university facing accusations of sexual misconduct. Michigan State agreed to a $500 million settlement with hundreds of women who say they were sexually assaulted by Dr. Nassar, who worked there for decades.

https://www.nytimes.com/2018/10/19/us/usc-sex-abuse-settlement-george-tyndall.html

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United Kingdom

20 Men Convicted of Abusing Young Girls in U.K.

by Reuters

Twenty men in Britain were convicted of trafficking and sexually abusing several young girls, prosecutors said on Friday, after a judge lifted reporting restrictions in the latest of a series of sexual abuse trials involving large gangs.

The men were found guilty in a series of trials this year of more than 120 sex crimes against 15 girls in Huddersfield, in northern England, between 2004 and 2011. Sixteen of the men were sentenced to prison for terms ranging from five to 18 years, and the remaining four will be sentenced next month.

A number of child sexual abuse and trafficking cases in Britain have come to light in recent years, revealing that hundreds of girls have been exploited by so-called grooming gangs whose members were usually men of Asian heritage.

“These men deliberately targeted their vulnerable victims, grooming and exploiting them for their sexual gratification,” said Michael Quinn of the Crown Prosecution Service.

“The men sometimes used threats and violence and plied their victims with alcohol or drugs,” Mr. Quinn, a senior prosecutor, said in a statement. “These men cared only for themselves and viewed these girls as objects to be used and abused at will.”

Right-wing groups have tried to exploit the trials to generate hostility toward migrants, particularly Muslims. Tommy Robinson, the former leader of the English Defense League, was arrested in May after he discussed the case live on Facebook, and now faces a new hearing after his initial conviction was invalidated.

The government in August announced that it would spend 2 million pounds, about $2.6 million, to help the authorities prevent children at risk from falling into the grip of traffickers and criminal gangs. The girls are often raped and forced to carry drugs from cities to rural areas.

At least 550 children believed to have been abused and trafficked by such gangs were referred to the government last year, although many victims are not classified as having been trafficked, so the total number is hard to establish, experts say.

Sarah Champion, a Labour Party member in Parliament, said last month that cases in the public domain were “the tip of the iceberg” and that no action was taken after many child victims spoke out.

Ms. Champion represents Rotherham, a northern English town where it was revealed in 2014 that hundreds of children had been sexually abused by gangs over a 16-year period.

https://www.nytimes.com/2018/10/19/world/europe/grooming-gang-sexual-abuse-uk.html

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Tommy Robinson celebrates jailing of Asian sex gang whose trial led to his arrest

Slams 'establishment' for bailing them but locking HIM up after claiming one on-the-run rapist is in Pakistan

by Richard Spillett

Tommy Robinson has celebrated the jailing of 20 sex abusers - despite nearly causing their trial to collapse - after a grooming gang who targeted vulnerable girls as young as eleven in Huddersfield were jailed for a combined total of more than 220 years.

As with similar cases in a string of British towns and cities, the gang plied their victims - some of whom were as young as 11 - with alcohol or drugged them before carrying out horrific sex attacks.

The court heard evidence from 15 victims during the trials and the judge said he fears none of them will ever recover from their ordeals.

In victim statements the girls described coming into contact with the abusers after being bullied at school and said the relationship became 'one of those things that you couldn't get out of'.

EDL founder Robinson - who was jailed for contempt of court after posting a video in breach of reporting restrictions in May, a move which put the trial in jeopardy - claimed without providing evidence that one defendant on the run had fled to Pakistan.

The pattern of exploitation of mainly white girls by groups of men of mainly Pakistani heritage mirrors what has happened in a number of other towns around the country, including Rotherham, Rochdale and Telford.

The Leeds trials attracted protests by right wing groups and EDL founder Tommy Robinson, who was jailed for contempt for endangering one of the cases with social media posts. He has since been freed but faces another hearing.

Amere Singh Dhaliwal, described as a ringleader of the gang, got a life sentence for 22 rape offences

Abdul Rehman - whose nickname was 'Beastie' - was jailed for 16 years

Mohammed Azeem (right) got five years for drugs offences related to the gang's activities

Nahman Mohammed, known as 'Dracula' got 15 years

Zahid Hassan was jailed for 18 years

Manzoor Hassan got five years for drugs offences

Mohammed Kammer got a 16-year jail term

Irfan Ahmed got eight years for sexual exploitation

Faisal Nadeem got 12 years

The abuse, which centred in Huddersfield, West Yorkshire, took place 'in cars, car parks, houses, a snooker centre, a takeaway, a park and other places', the court heard.

At least one of the victims attempted suicide and another had to have an abortion after becoming pregnant, prosecutor Richard Wright QC told the jury.

The men referred to each other using a series of nicknames - 'Beastie', 'Dracula' and 'Nurse' - which were also used as their monikers during the trials.

Ringleader Amere Singh Dhaliwal, 35, was jailed for life earlier this year and told he must serve a minimum of 18 years in prison by a judge who said: 'Your treatment of these girls was inhuman.

https://www.dailymail.co.uk/news/article-6294939/amp/Huddersfield-Asian-sex-gang-jailed-200-years.html

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United Kinbdom

British pedophiles target children in poor countries for online abuse

National Crime Agency warns of challenge to safeguarding posed by live streaming and other tech advances

by Annie Kelly

Tens of thousands of British citizens who pose a sexual threat to children online are increasingly seeking out victims in poor and war-torn countries, the nation's top law enforcement agency has said.

The Philippines has become recognized as a commercial hub for child abuse imagery and live streaming of child abuse for foreign buyers. Children in Kenya, Cambodia, Vietnam, Thailand and other countries are also increasingly at risk as broadband access and free encrypted technology spreads across the world, the National Crime Agency (NCA) has warned.

“There is an increasing threat to children in developing countries where safeguarding capabilities cannot keep pace with advancing technologies, and this threat is likely to grow,” said Rob Jones, an expert on the sexual exploitation of children online for the NCA.

“We estimated that 80,000 UK nationals pose a sexual threat to children online – and this is a conservative estimate. What we know about offending pathways leads us to conclude that there are significant risks that many of these individuals will be taking advantage of the ready availability of free end-to-end encrypted technologies and inciting abuse through live streaming.”

Jones said it was impossible to know the number of children potentially at risk, but added: “If there are tens of thousands of potential perpetrators here, then children in countries around the world will also be targeted by offenders from elsewhere – the US, Canada and across Europe.”

Europol has identified live streaming of overseas child abuse, paid for and directed by westerners, as a key threat in the rise of global child exploitation.

The European crime agency said that mobile connectivity, growing internet coverage in developing countries, and the rollout of pay-as-you-go streaming, which provides a high degree of anonymity to the viewer, are furthering the availability and market for this type of abuse.

In the past decade, the Philippines has become a commercial hub for live-streamed child abuse, with webcam footage often paid for and facilitated by sex buyers thousands of miles away.

Many children are abused by their own families or neighbors, watched and directed by foreigners on smartphones, tablets or laptops.

Yet child protection experts are warning that this profit-driven model is being increasingly and rapidly replicated in other countries.

“Any country where there is high smartphone usage, where there are ways to transfer money quickly and relatively anonymously, and where there are high levels of poverty are likely to become places where children will be sought out,” said Jos de Voogd, spokesperson for Terre des Hommes, a Dutch child protection organization.

“We have recently conducted work in Kenya, where we found that the problem of commercialized live-streamed sexual abuse of children to order is not only occurring, but rapidly rising. We are trying to assess the problem in Cambodia as well.”

There have been a growing number of prosecutions of British citizens for cyber sex crimes involving foreign children. Last year Alain Charlwood-Collings, a 39-year-old man from Devon, was sentenced to 18 years in prison, after it was proved that he paid £33,000 for more than 100 hours of recorded footage of the abuse of 46 different children in the Philippines. It took three years for the Philippine authorities to arrest those responsible for the abuse and recover some of the victims.

The UK arm of Every Child Protected Against Trafficking (Ecpat), an anti-trafficking children's charity, said agencies like the NCA must be given the resources to tackle the growing commercialization of online child sexual abuse, both here and in the countries where it is being perpetrated.

“Our concern is that here in the UK we have developed the technology to identify the perpetrators, but that it is harder to identify and locate the children thousands of miles away who are not being safeguarded,” said Bharti Patel, Ecpat UK chief executive.

“Agencies like the NCA urgently need to be given the resources they need to tackle these crimes, and help facilitate an international response in the country where this abuse is taking place.”

The NCA said that technology companies urgently need to be more proactive in preventing their platforms from being used to commit crimes against children.

Text messages urge Zambians to report online child abuse

“These live-streaming offences are technically enabled. Currently, anyone with a phone can do this,” said Jones. “Understanding the role of the networks we all use in this horrendous crime is the only way to combat this. Where there is vulnerability, pedophiles will seek it out, whether it is here in the UK or thousands of miles away.”

Jones said the NCA was working with law enforcement and government agencies across the world to ensure that perpetrators are sought out and prosecuted.

In August, the British government announced it was funding a cyber-security center in Kenya to support the authorities in tracking down foreign pedophiles.

“This is a growing threat but this is being matched by a growing awareness, and we are currently working with 84 countries around the world to grow and develop our response to this,” said Jones.

“Let me be clear, if you are a British national or have British residency and are committing these crimes, we will hunt you down and bring you to justice, wherever you are or wherever your crimes are being committed.”

https://amp.theguardian.com/global-development/2018/oct/08/british-paedophiles-target-children-poor-countries-online-abuse-national-crime-agency

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India

Where's the support to help minor survivors of sexual abuse recover from their trauma

On the occasion of World Mental Health Day, HT interacted with two such survivors to understand how it has affected their psyche.

by Aneesha Bedi

As the #MeToo movement gains momentum across the country with sexual harassment survivors coming out in the open, many have also expressed how their mental health has suffered.

Abuse needs to be prevented in any environment, but imagine the helplessness of children who have been victims - some so young that they cannot fathom what has happened to them.

If not given adequate support, psychiatrists say they can be scarred for life.

The impact of sexual abuse on a minor's mental health continues to be undermined. On the occasion of World Mental Health Day, HT interacted with two such survivors to understand how it has affected their psyche.

Scared of stepping out of home

“I couldn't go to school or step out of my house alone,” says a 15-year-old boy, a student of Class 10, who has been allegedly sexually assaulted by his female tutor. The matter is under trial and he's sitting in a room outside the Protection of Children from Sexual Offences (POCSO) Court waiting for his statement to be recorded, looking disturbed.

CASES RECEIVED BY THE CHILD WELFARE COMMITTEE FROM POLICE

His mother talks about how he missed school for nearly a week as the accused, currently out on bail, threatened and followed him, asking him to take back the complaint.

“He's a child. Imagine how this has affected him if we find his story so disturbing,” says the mother. Unable to focus on his studies ahead of his examinations, his health has deteriorated. “He lies awake at night,” she laments. The father is optimistic that the teenager has shown progress in the past one week.

The teacher lived in the same colony as him. The alleged sexual abuse case hit the headlines after police arrested the tutor on May 24 after the child helpline filed a police complaint.

The families know each other well, which is why the teenager and his sister started taking tuitions from her from September 2017. The police complaint said the woman asked the teenager's parents to send the sister for tuitions at a different time to enable her to focus on their son.

She was sexually abusing him since March.

She faints often: Father of 6-year-old rape survivor

Two months after a 35-year-old man got life term for the rape of a 6-year-old girl, her father's tears continue to flow.

“How can I be fine if my daughter isn't?” he asks. Back from the hospital after getting her checked up,this peon with a private firm talks on the phone.

“She collapses every now and then and keeps talking about what happened to her. She's a child and does not quite know or understand what has happened to her,” he says.

She was raped in December 25 last year after being lured by the man with the promise of a biscuit and kidnapped. Last month she joined school. Her family is yet to receive the Rs 2 lakh compensation the court ordered.

The father does not know what a counsellor is when asked if they were receiving any support for the child to help her forget the incident.

Treatment gap?

While effective adolescent mental health programs are in place in the country, there's a lot to be desired when it comes to treatment of survivors. Children should be helped to tackle changes at various levels, emotional, hormonal, bodily changes, making them susceptible to peer pressure or enhancing risk taking behavior.

Sangita Vardhan, head, Child Welfare Committee, Chandigarh, believes adverse childhood experiences result in significant mental health impairment. However, only very rudimentary mental health services are available in children's homes.

“We need more inter-agency convergence to leverage support for children with adverse childhood experiences,” she told Hindustan Times.

The most significant outcome of childhood abuse was the dropout rate of girls in Chandigarh due to sexual abuse in childhood.

Mental health support a must

According to Manjit Sandhu, lawyer and member of the POCSO panel, Chandigarh, “Even though POCSO courts award compensation to victims, the amount at times doesn't even reach them. There should a separate mandate for mental health support as even families are not educated enough to help their children. The counsellors are there temporarily during the trial post which they aren't seen around. This is when the child is most vulnerable.”

Former dean and head of psychiatry department, PGIMER, Chandigarh, Savita Malhotra said a huge percentage of depression cases are due to some sort of sexual abuse encountered during childhood.

“It is important to bring a change in mentality and outlook in the society otherwise nothing helps. I've personally tried to tell mothers who have come to me with a children who have been sexually assaulted by their own fathers, that it was a criminal case. This one lady and her brother vanished and never came back to me. Imagine, how violated the child, the victim, must have felt after that,” she says.

https://m.hindustantimes.com/punjab/where-s-the-support-to-help-minor-survivors-of-sexual-abuse-recover-from-their-trauma

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National

Sex trafficking: Police get special training to spot it early

by TAYLOR GOEBEL

There are several warning signs for human trafficking, including poor physical and mental health, a lack of control over their lives and harsh working conditions. If you see any of these signs, call the National Human Trafficking Hotline at 1-888-373-7888.

When Barbara Amaya was being sold for sex as a child in New York City, she hated the police.

The blonde-haired, blue-eyed girl ran away from her abusive Fairfax, Virginia, home the summer she turned 12. Vulnerable, young and alone in Washington, D.C., she made for an easy target for sex traffickers.

Amaya was sold to a pimp in the nation's capital, then taken to New York, where she was trafficked for more than a decade. Throughout the 1960s and 1970s as a child and young adult, she was arrested multiple times on charges of loitering for the purposes of prostitution.

"I was told by my trafficker that I would be treated like a criminal," said Amaya, now living in the Washington, D.C., area as a trafficking advocate who helps train law enforcement agencies on sexual slavery. "And I was."

Each time she was arrested, the booking was quick: She'd throw police a name, address and age that didn't match hers. They never took a second look, which "validated" what the trafficker had programmed into her worldview, Amaya said.

It's possible Amaya could have escaped sooner than she did, at 24 years old, had those officers been trained to look for the warning signs of trafficking: Maybe she had no identification or her trafficker kept hold of her personal belongings. Did she avoid eye contact with law enforcement? Was her purse full of condoms? Was she really as old she claimed to be?

'No clue what human trafficking is'

These are just a few of the many indicators police officers and other first responders across the country are being trained to identify. The increased awareness and training reflects a shift as law enforcement agencies focus more on catching the trafficker than arresting victims as prostitutes.

This fall, Delaware State Police will begin training its sworn officers and cadets on how to spot and handle sex trafficking incidents. Trafficking-specific training is now required to graduate from the academy.

"We have law enforcement in the state who have no clue what human trafficking is," said Detective Joshua Rowley, who met Amaya in August at Wilmington University's Human Trafficking Symposium, where she was the keynote speaker.

The International Association of Chiefs of Police is providing DSP with an online training course on recognizing and responding to sex trafficking.

Delaware passed anti-trafficking legislation in 2014, even though it's been a federal crime since the passage of the Trafficking Victims Protection Act of 2000.

Human trafficking cases regionally, nationally

There have been 74 reported cases of human trafficking in Delaware since 2007, including 21 last year, according to the National Human Trafficking Hotline.

In 2016, DSP charged Rashawn B. Davis and George L. Dunn with human trafficking after an eight-month investigation with the Ocean City Police Department revealed a trafficking ring operating in Sussex County.

Dunn and Davis "used coercion, verbal abuse and the withholding of heroin to control the behavior of the victim," and all money incurred from the victims went back to the two men, according to a DSP release.

Nationally, more than 8,500 human trafficking cases were reported last year, the majority of which were sex trafficking-related. Maryland accounted for 115 of those cases, while Virginia totaled 156, though those numbers are likely higher in reality, experts say.

"We've met detectives from other jurisdictions," said Cpl. Chris Heid of the Maryland State Police Child Recovery Unit. "It's happening everywhere whether you know it or not."

Changing the mindset

Before the Delaware legislation, traffickers were often not prosecuted and victims were arrested as prostitutes.

"It takes time," Rowley said of the slow progress Delaware has made to address the crime, adding that half the training involves changing the mindset of officers.

That means no longer seeing a 19-year-old woman on the streets of Wilmington and assuming, "Oh, well, she's just a prostitute" but instead developing a more holistic approach.

"Where did that girl come from?" Rowley said, echoing what officers should be thinking. "What situations was she in? And what can we do to help — rather than writing her off."

Just 15 years ago, Rowley said law enforcement had similar perception flaws when taking domestic violence calls: Why can't the wife just run away, the husband's at work?

While those mindsets have since changed, both officers and the general public ask the same about trafficking victims: Why can't the girl just leave?

"They don't understand the control of the trafficking," Rowley said. "That will change as more public awareness comes out."

The training program for Delaware State Police, which Rowley said has no associated costs, will focus on the types of human trafficking situations most encountered in Delaware through scenario-based modules, from street-level "prostitution" in Wilmington to intrafamilial trafficking, which has become more visible, Rowley said, as Division of Family Services workers are now being trained on how to identify the crime.

"Nobody ever wants to think about a mother prostituting her daughter, but that type of (trafficking) is occurring as well," Rowley said.

Delaware hospitals are also working to address trafficking by creating universal screening questions so doctors and nurses can better identify victims, just as they do for domestic and child abuse.

Local health care providers believe these screening guidelines could be implemented in the coming year.

"Training goes the entire gamut," Rowley said. "We need to train the prosecutors, the defense attorneys, the judges, the people picked for jury. Everybody needs to have (trafficking-specific) training."

Even language has an impact on the way first responders approach a victim, Amaya said, remembering a law enforcement training session in Chicago, when an officer used the term "child prostitute" to describe a minor.

"There's no such thing as a child prostitute," she said, her voice blatantly incredulous over the phone. "That's an oxymoron."

Helping victims

When Cpl. Heid, the officer with Maryland State Police Child Recovery Unit, approaches someone who is potentially being trafficked, he isn't dressed in uniform, and he doesn't introduce himself as a police officer.

"We try to play the persona that we're 'regular' people," he said. "We sit on their level. We don't envision this as a crime."

Maryland State Police have been training troopers for the last five years. They learn about indicators and how trafficking victims should be approached with particular sensitivity.

Out of the 2,000 girls Heid has encountered in the last eight years, he estimates five of them were actual sex workers.

"Typically these girls are doing this for someone else," Heid said. "We've had women doing it to support a child at home, or to go to school. Very rarely do they do it because they want to."

Police officers in Maryland try to help these women through referrals rather than handcuffs. If they have an addiction, they'll encourage them to seek counseling. If they don't have a home, the officers will try to get them in contact with an agency that can help.

"We joke sometimes that most of what we do is not being a police officer: It's being a social worker," Heid said.

Helping victims won't happen in a five-minute conversation at the police station, said Amaya, who now helps train law enforcement agencies. Sex trafficking is one of the most notoriously difficult crimes to prosecute, according to several law enforcement officials and advocates.

That's because victims will often develop trauma bonds with their manipulative and coercive traffickers, a phenomenon Amaya likens to Stockholm Syndrome.

Many times when a victim is sitting across from an officer, "getting back to the trafficker is all they're thinking about," she said.

So it takes time to break that bond and escape, especially if the victim is in love with or afraid of the trafficker and depends on them for money, drugs — even a sense of family.

But if a police officer gives that victim their phone number and tells them to call if they're in danger, or if they just want to talk, that can "get the ball rolling," according to Amaya.

"Later, when they're beaten to a pulp or thrown out a window by a trafficker, they'll think back to that officer," she said.

https://amp.delmarvanow.com/amp/1369477002

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United Kingdom

OPINION

I've been in and out of psychiatric hospitals for 20 years – it's no surprise that patients are being abused while detained under the Mental Health Act

Lack of awareness by health professionals means, for example, that female abuse survivors can be forcibly restrained and injected, often by a team of men, without consideration of how this might be triggering

by Jay Watts

I have been coming in and out of psychiatric hospitals, first as a patient, later as a professional, for over 20 years. In this time, I have met people whose lives have been saved by compulsory detention under the Mental Health Act. But I have also met many others who have been traumatized, silenced and degraded by their experiences. It is yet to be seen whether the new government-commissioned report on the Mental Health Act, published today, will provoke the revolution in inpatient care that psychiatric survivors have been demanding for over 40 years.

Being detained under section is a disorienting experience. Suddenly, you are in a strange environment that you cannot leave, at least not straight away. Other people dictate what you eat, who you share space with, where you sleep. You are surrounded by other people in acute distress. Professionals may decide you need medication whether you like it or not, meaning you might be subjected to an injection in the bum. You may be physically restrained if you become agitated. If you are under observation at level one or two, a nurse will either be watching you at all times or checking in every 15 minutes – and this experience of proximity can feel extremely threatening.

A survey of over 2,000 patients found that only a third felt they had been treated with dignity and respect throughout their detention. Many felt subject to “potential coercive mistreatment, abuse and deprivation of human rights leading to physical and psychological harm”. This included “witnessing physical violence, verbal abuse and threats, bullying and harassment, sexual predation, pain-based restraint, coercive rewards and punishment systems for access to open air, leave or family contact”. Even those who later thought that being detained had been the best course of action for their mental health often raised serious concerns about the manner in which they had been detained and subsequently treated.

Mentally ill feel ‘unsafe' while held under Mental Health Act

Thankfully, the current review has a particular focus on improving the experiences of young men of African and Afro-Caribbean descent who are more likely to be detained under section, restrained and overmedicated. As the interim report suggests, these experiences are partly due to health professionals' unconscious biases, such as believing that black men are more likely to be aggressive. Acting upon prejudice reproduces a “hostile environment” on hospital wards that reinforces BAME communities' distrust in mental health services. Seni's Law, already in the legislative pipeline, offers hope of real change on this.

Another focus must be on an international movement called Trauma Informed Care, which changes the focus from “What is wrong with you?” to “What has happened to you?” Staff are trained to consider how gendered, cultural and historical contexts, as well as experiences of childhood trauma, have an impact on who breaks down and how.

TIC emphasises the need to reduce Iatrogenic Trauma, broadly defined as anything that a health professional or health system does that unintentionally causes patient trauma. Consider female inpatients, for example. Research shows that 46 per cent of women on inpatient wards have been sexually abused as children. Yet few women are asked about their experience of abuse and violence, despite the fact that the Department of Health has required staff to do so since 2003. This means that understandable reactions to abuse that persist into adulthood, from dissociation to emotional turbulence and self-harm, are read as signs of illness rather than desperate attempts to cope. Lack of awareness means that abuse survivors are also forcibly restrained and injected, often by a team of male professionals, without consideration of how this might be triggering. Experiences of sexual predation and assault by fellow inpatients and, occasionally, staff are often ignored or minimized, with friends of mine having been told not to report this as their diagnosis means that they are perceived to be unreliable narrators.

The traumatic impact of poor psychiatric care is something people struggle to keep in mind. This is one reason why services have failed to maintain the momentum of change ignited by former initiatives, such as attempts to reduce institutional racism following Rocky Bennett's tragic death in 1998, and calls to stop mixed-sex psychiatric wards following testimonies of abuse collated for 2003's Mainstreaming Gender and Women's Mental Health Strategy.

The current review of the Mental Health Act gives us an opportunity to do something different.

We could fund alternatives to inpatient care, such as crisis houses, that are more palatable to patients and avoid the need for compulsory admission in the first place. We could reverse cuts to community services and outreach programs that build links with people from communities who have historic reasons for distrusting psychiatry and are therefore more likely to have a coercive, traumatic pathway into care. We also need to provide staff with the skills to be aware of patients' pain rather than trying to keep patients at a distance.

It is easier, psychologically speaking, to “other” people who suffer from a profound breakdown, and treat patients as objects to be assessed, categorized and chemically coshed. It is easier to divorce “them” from the social contexts, structural discriminations and life experiences that so often provoke a breakdown. But what may be easier in the short term comes at the cost of the ethics of care and opportunities for healing that we must insist upon to be able to call our society.

https://www.independent.co.uk/voices/mental-health-act-detention-review-psychiatric-hospital-abuse-trauma-a8332301.html

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Iowa

Washington Sent Abused Kids To Jail-like Iowa Group Home With "Abusive" Prectices

by Tina Pinedo

At Clarinda Academy in rural Iowa, workers "use physical restraint for questionable reasons at best, and in some cases without justification," states a new report.

Youths entrusted to Washington's foster-care system have endured “abusive” practices in a jail-like Iowa group home that inappropriately used painful physical restraints on children, according to a new report by a government-designated watchdog group.

The report, released today by the nonprofit Disability Rights Washington, documents numerous instances in which youths between the ages of 14 and 16 were held down by three or more workers. One child's glasses were broken when staffers pushed the youth to the floor, and another was restrained for 45 minutes.

Washington social workers knew of the practices — some of which would not be allowed under Washington regulations — but failed to “ensure the rights and safety” of the teens, the report says. It focuses on the cases of three teens who were among about 20 Washington youths confined at the for-profit Clarinda Academy, which also houses juvenile delinquents, and a sister Iowa facility, Woodward Academy.

“It hurt, I had bruises,” Kathie, 16, said of the restraint holds she says Clarinda staffers used on her a few times a week throughout her recent six-month stay at the facility. She spoke to InvestigateWest from a phone in her new group home in South Carolina and on the condition that this story use only her first name.

The report points out that the state places young people in the custody of out-of-state group homes like Clarinda “without consent or due process,” circumventing protections against involuntary commitment.

Youths' case files obtained by Disability Rights show that Clarinda workers “use physical restraint for questionable reasons at best, and in some cases without justification,” the report says.

Many of the youths in question would not have to be sent out of state if not for Washington's long-festering and desperate shortage of foster homes and group homes for youth with behavioral and mental health challenges. Washington increasingly relies on facilities spread across a dozen states to house neglected and abused children removed from their parents.

Between 80 and 100 Washington children are now in out-of-state facilities. As those numbers have risen in recent years, attorneys and advocates for foster youth have sounded the alarm about the state's ability to adequately monitor children in distant states, as InvestigateWest reported last month.

Disability Rights Washington

Map shows locations of group homes where foster youths have been sent by Washington State Department Children, Youth and Families, according to new report.

The investigation released today by Disability Rights Washington, a group appointed under federal law to monitor the care of people with disabilities and mental illness, suggests those concerns are well-founded.

In interviews with a dozen youths at Clarinda and Woodward in early 2018, the organization heard consistent allegations of verbal and physical abuse. That prompted Disability Rights to launch an in-depth examination of three youths' case files and internal Clarinda documents. Those records, it concludes, “demonstrate that Washington and Clarinda Academy are both failing to protect against the use of restraints for coercion and punishment for not following expectations.”

Clarinda Academy management and a lawyer for the company did not respond to multiple phone calls and emails requesting comment.

“Children in foster care do not lose these rights by virtue of having been removed from the care of their parents. They have the same rights as any other child in this state, and these rights are being ignored when they are essentially involuntarily committed to secure facilities that not only sit next to prisons but also possess many of the same restraints on their personal freedoms as prisons.”
-Lisa Kelly, University of Washington law professor.

Washington sends dozens of foster youths to some of the other 29 similar group homes owned by Clarinda's parent company, Sequel Youth and Family Services. As of 2017, about three-quarters of Washington youths in out-of-state group homes were in Sequel facilities, and the company had plans to begin operating in Washington, according to Disability Rights.

State officials said they took the report seriously and, based on a draft sent to the state in August, stopped sending kids to Clarinda and created plans for all children still there to find permanent homes or return to Washington by the end of next January. They also dispatched state workers to check on all foster children in out-of-state facilities.

For young people like Kathie with a history of childhood trauma, being physically restrained can cause further harm and worsening behavior, studies show. Yet treatment plans at Clarinda weren't designed to effectively address youths' traumatic history, according to Gauri Goel, a psychologist who interviewed the youths and reviewed their records as part of the Disability Rights inquiry. Instead, she wrote, “the treatment they are receiving is likely to be ineffective and potentially counterproductive.”

Reprimanded teens are expected to stand completely still, and the report documents instances where teens were restrained merely for moving an arm or hand. ‘Say that I was going to wipe my tears or cover my face because I'm crying. Any sudden movements, I would end up getting restrained,' ” said Kathie, 16.

A 2014 investigation of Clarinda by Disability Rights Iowa also found that the facility uses a “one-size-fits-all” approach to treatment and schooling, the Des Moines Register reported.

Clarinda policy, as well as Iowa and Washington regulations, say youths should be physically restrained only when they present an imminent danger to themselves or others. But at Clarinda, residents who are being reprimanded are expected to stand completely still, and the report documents instances where the teens were restrained merely for moving an arm or hand.

“Say that I was going to wipe my tears or cover my face because I'm crying,” Kathie told InvestigateWest. “Any sudden movements, I would end up getting restrained.”

One teen was restrained for not obeying an order to stop scratching his legs, another for disrupting other residents in a dining area and refusing to leave.

Disability Rights Washington

Confidential Exhibit A from new report is an excerpt from a youth's letter pleading with Washington State to take him and others “back home.”
Youths showed Disability Rights how workers would “pull their elbows behind their backs and then force them to the ground by putting pressure on the backs of their knees,” the report says. Unlike Washington's more stringent regulations around the use of restraints, Iowa's do not prohibit pressure on joints, the chest or vital organs.

Originally set up as a facility for “delinquent” young men, Clarinda Academy now houses up to 266 young people ages 12 to 18. Its “typical student” is a juvenile offender, according to the parent company website.

That helps explain why Clarinda is run “like a correctional institution,” according to Disability Rights, even though Washington youths are sent there through the foster care system, not because they have committed a crime.

Clarinda Academy houses up to 266 young people and is run “like a correctional institution,” according to Disability Rights, even though Washington kids are sent there through the foster care system, not for committing a crime. Clarinda sits across the street from a medium-security prison.

The facility is tightly controlled. Boys and girls are strictly segregated, and in one case a youth was restrained for refusing to leave a hallway where children of the opposite gender were going to pass, the report says.

The youths attend school onsite, and they rarely leave. If they attempt to leave without permission, staffers restrain them and bring them back.

“For all practical purposes, they don't have a choice to say, ‘I don't think I need this level of treatment' or ‘This program is not helping me.' They don't have that power,” said Disability Rights attorney Susan Kas, who made two trips to meet with youths at Clarinda.

In Washington, young people age 13 and older have the right to leave an inpatient mental health or substance abuse treatment facility they entered voluntarily. State laws also protect them from continued involuntary treatment without a hearing.

“Children in foster care do not lose these rights by virtue of having been removed from the care of their parents,” Lisa Kelly, a law professor at the University of Washington, wrote in an email. “They have the same rights as any other child in this state, and these rights are being ignored when they are essentially involuntarily committed to secure facilities that not only sit next to prisons but also possess many of the same restraints on their personal freedoms as prisons.”

Beyond the potentially harmful treatment practices at places like Clarinda, being cut off from family and other important adults in their lives is one of the most damaging consequences of out-of-state placements, advocates say.

Isolation is a key danger. Phone calls home are limited to 10 to 20 minutes per week. Washington provides financial help if family members want to visit foster youths sent out of state. But for children who are not connected to kin, the system rarely offers similar aid to family friends or others who might agree to take in the young person. Kathie said she didn't receive a single in-person visit during her six months at Clarinda. As a result, connections with adults who might adopt or foster children upon their release tend to wither. “That was very devastating to the young people,” Kas said.

To help kids get back into a family setting, rather than another institution, Kas said, it's essential to support them in developing and maintaining those relationships.

“There's a tendency to say, we don't have enough group home beds here in Washington, so let's get more group home beds, and then we can just shift everybody back to Washington,” Kas said. But discharging them to a family home, and hopefully a permanent one, “should be the goal of our system if we are going to do right by these kids.”

Washington social workers also did not visit their charges in Clarinda, relying instead on reports from Iowa social workers. Even when they receive written reports from Iowa and Clarinda case workers about use of restraints, “Washington social workers do not follow up on allegations of abusive restraints,” Disability Rights found.

The Department of Children, Youth and Families said in a press release embargoed for release today that it will begin requiring case workers to call out-of-state youths monthly and visit them quarterly.

The department wrote that it “agrees with Disability Rights Washington's main premise that children in out-of-home care are in general better off as close to home as possible, and that we should place all children in in-state facilities where possible.” However, it continued, “DCYF can't cavalierly ‘bring them home' without a plan to address each child's individual needs and a placement option that is better than the placement they are in today.”

Department Secretary Ross Hunter called in his recent budget proposal for bringing all out-of-state Washington foster youth back within two years. Part of his plan involves shoring up capacity in Washington group homes, which have cut beds in recent years due in part to low reimbursement rates from the state.

The department did not respond to a query from InvestigateWest about how much it pays Clarinda, but similar facilities in Washington are eligible to receive more than $12,000 per month. Sequel's projected 2017 revenue for all of its residential treatment centers was $161 million, or more than $69,000 per bed, according to an investor presentation. A private equity firm acquired a majority stake in Sequel last year, citing “tremendous continued growth opportunities.”

Over the past few months, the state has removed the three youths who were the focus of the Disability Rights Washington report from Clarinda, but two remain in other group homes.

Kathie, who has been in foster care since age 13, said her new group home is “just as terrible” as Clarinda, and that staffers there still physically restrain her.

Yet, Kathie said, she's doing better. She hasn't harmed herself in almost two months. She dreams of returning to live with her best friend in Washington and to her school choir. Someday, maybe she can sing on “America's Got Talent,” she prays.

In the meantime, she hopes the state will give kids like her another chance and bring them home. Keeping them out of state is “making us kids more and more stressed,” she said. “It doesn't help anything at all.”

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OHIO

Seven arrested in joint human trafficking operation in Defiance

NOTE from NAASCA's MJ Goyings: This article doesn't give details, but 15 girls, unsure of the ages, were found locked in a basement in a house in Defiance. The man with the gray hair and beard* lived 4 miles from me, was a former Paulding Police officer, and his wife works at our library.

Seven people were arrested Thursday after a joint operation in Defiance.

According to a press release, the Defiance Police Department, FBI's Violent Crimes against Children Task Force, the Defiance County Sheriff's Office, and the Defiance County Prosecutor's Office conducted the operation "to deter human trafficking and sex trafficking in the City of Defiance."

Authorities did not release a location of the operation.

Arrested were:

William Deatrick, 56, Cecil, solicitation. * (gray hear and beard)

Chase Roberts, 33, Edon, solicitation.

Megan Pickard, 39, Bryan, solicitation.

Dale Miller, 54, Spencerville, solicitation.

Benjamin Njogu, 35, Mason City, Iowa, solicitation.

Aleasha Cain, 36, Fort Wayne, Ind., solicitation, felony drug charges pending.

Brandon Perkins, 37, Fort Wayne, Ind., felony promoting prostitution, felony drug charges pending.

Njogu, Cain and Perkins are incarcerated at CCNO pending today's initial court appearances.

All solicitation charges were third-degree misdemeanors.

All misdemeanor cases have been referred to Defiance Municipal Court. The felony offenses will be referred to the Defiance County Prosecutor's Office.

https://www.crescent-news.com/on_the_wire/editors_pick/seven-arrested-in-joint-human-trafficking-operation-in-defiance/article_b6142a68-0e16-53c2-99ae-afb431732779.html