The Child Sexual Abuse Accommodation Syndrome
The Child Sexual Abuse Accommodation Syndrome was developed by Roland Summit, M.D. It is a simple and logical model which can be used to help in understanding and accepting the ways in which many children react to sexual abuse. The syndrome classifies the most typical reactions of child sexual abuse victims, dividing them into five categories.
It is worth noting that children are often put through a "grooming process" before the sexual abuse commences. They are initially chosen for being compliant and therefore unlikely to complain or tell anyone. The offender may then go to considerable lengths to build up the child's trust, for example the child may be given presents or told that they are "special".
The five categories of the syndrome are:
Abused children tend to keep the abuse a secret. They do so for a variety of reasons. They may be afraid of the abuser who may have threatened the child or someone whom the child loves. Physically abused children may be afraid of being beaten again. The abuser may have promised safety to the child or child's loved ones if the child keeps quiet. Neglected or emotionally abused children long for their parents' approval and affection - they may keep silent for fear of losing the parents' love.
Children are inherently helpless and subordinate. They are small, dependent, and emotionally immature. For all of these reasons, they cannot escape from a dangerous situation. Children who try to protect themselves are usually overridden by more powerful adults. When their attempts to protect themselves fail, these children come to believe that they are helpless. Eventually they stop trying to protect themselves overtly. Instead they may withdraw, go physically limp or dissociate.*
*Dissociation" is a way in which some children survive abuse by escaping mentally while the abuse is happening. The body and the mind seem to separate. While the body is being hurt, the child no longer feels it because the mind manages to escape to a safe place. Different children may dissociate in different ways. One example is "leaving" the body and floating on the ceiling over the bed where the abuse is occurring. The child may even watch what is happening but it is as if it were happening to someone else. The child feels nothing.
3. Entrapment and accommodation
Children who keep their abuse a secret and continue to feel helpless inevitably feel trapped. However, they learn to accept the situation and survive. The helpless child faced with continuing victimisation must learn to somehow achieve a sense of power and control. The child may eventually come to blame him or herself, believing s/he has provoked the abuse. Physically abused children may refer to their bad behaviours as reasons why their parents must punish them. Emotionally abused or neglected children may imagine unacceptable traits in themselves. Physically, sexually and emotionally abused children may also employ defensive mechanisms (e.g. dissociation or blocking out the memory) in an attempt to accommodate to the abuse.
4. Delayed, conflicted and unconvincing disclosure
Adults who ask a child to disclose abuse must recognise that this request may precipitate an acute crisis for the child. Initial disclosures may be fraught with anxiety, retractions and inconsistencies. Therefore it may sound unconvincing. Because the child has used various defensive mechanisms to cope with the abuse, memory may be fragmentary, perceptions may be altered and information may be scattered and sparse.
Children who do disclose abuse may be flooded with guilt, fear and feelings of betrayal or confusion. The adults' immediate responses may frighten them further. For example, the child may be removed into foster care, the parent may be put in prison and members of the child's family may suffer. All this may make the child retract the disclosure. Children gravitate towards the safety of a familiar situation, no matter how painful it is. Most abused or neglected children remain loyal to their families and, if given a choice, frequently want to stay with their abusive parents.
It should be noted that this is a "model" describing reactions, not an absolute. Like all models it does not mean each child will show all aspects of this syndrome. There have been some problems reported in the U.S. with courts taking the model so literally that if children don't demonstrate all the features they are under suspicion of lying.