Institutional abuse is the maltreatment of a person (often children or older adults) from a system of power. This can range from acts similar to home-based child abuse, such as neglect, physical and sexual abuse, and hunger, to the effects of assistance programs working below acceptable service standards, or relying on harsh or unfair ways to modify behavior. Institutional abuse occurs within emergency care facilities such as foster homes, group homes, kinship care homes, and pre-adoptive homes. Children, who are placed in this type of out of home care, are typically in the custody of the state. The maltreatment is usually caused by an employee of the facility. Out of home placement care is meant to be temporary; however, it can be permanent.
With institutional abuse, it is said to be considered mainly applicable to four categories of people:
adults with learning disabilities
adults with mental health problems
Institutional abuse can further be divided into three categories:
overt abuse – similar to familial abuse in its overt physical, sexual, or emotional abuse by a foster parent or child care worker.
program abuse – unique to an institutional situation, in which a program must operate below acceptable conditions or improperly use power to modify the behavior of person.
system abuse – involves an entire care system that is stretched beyond capacity, and causes maltreatment through inadequate resources, employees that have ingrained prejudice or personal vendettas towards the person’s behaviour, or in care. Including corporate malpractice.
In institutions where the person has committed an immoral act, such a sexual abuse against a minor, the staff at the centre will have internal prejudices and beliefs regarding the act committed, which allows them to accept their actions. This puts the relationship at risk of covert and indirect abuse tactics.
System abuse can involve all types of psychological manipulations to force compliance from a vulnerable child or adult. People with a mental health disability or who have a learning disability are the most vulnerable and, the easiest to abuse.
In assistance programmes, the mothers under assessment may have an un-diagnosed mental health or trauma related disability where she may have been subjected to horrific abuse, the assessment unit is in place to assess the persons parenting skills. Bullying and coercively abusing the mothers to tell on each other and manufacturing drama and conflict between them. Using neuro linguistic programming to indirectly confuse and de-stabilise the mother into signing their baby up for adoption are becoming widespread practices.
Long term effects of institutional childhood abuse (Moore et al 2014)
Criminality. (Especially in men)
Marked marital problems
Multiple Broken cohabitations
Having children removed from mothers care.
This adds to and impacts on the health care system immensely. As victims of institutional abuse go on to depend on the psychiatric community to alleviate their symptoms of suffering. Or, they enter the criminal community and their life becomes embroiled in crime. Both outcomes are highly costly to the community in which the person lives and also to the persons well-being. Currently, the NHS is making huge cutbacks in all areas of health, which is having a detrimental impact on society and funding. Personality disorders are created through childhood emotional neglect or abuse. Both concepts are equally damaging to child development and will have a direct impact on the person. A child sent to boarding school is at the same risk of developing a personality disorder as those who live in a brutal and violent home. Both children are affected emotionally.
Post-traumatic stress disorder (PTSD) and other anxiety disorders such as depression and alcohol abuse were the most common disorders. Studies on the long term effects of institutional upbringing has shown that compared with children reared in families, those raised in institutions had poorer adjustment (Moore et al 2014). Many survivors need to experience a therapists willingness to engage with them as an individual, not as a client slotted into a System! This approach uses normal therapeutic boundaries which underpins success in working with survivors and is more successful for those who can’t tolerate authority because of their early abuse they experienced from authority.
Other research has identified that survivors report more negative experience in health care settings when therapists or practitioners appear to lack knowledge, understanding or sensitivity to CSA and its effects.
In their 1999 study, Teram et al. found that survivors may be hesitant to mention a history of CSA because of experiences of feeling rejected in the past, which also was reported to worsen symptoms. Survivors reported being labelled as difficult patients by health care providers because of reactions and relational struggles related to CSA and the distress caused when professional demonstrated a lack of understanding (Schachter et al., 1999). Survivors explained that they would often prefer to disclose the abuse to other survivors, but if that was not possible they wanted to speak with individuals who understood their upbringing and were not shocked by their experiences.
People who have experienced systematic abuse, may go on to lead fragmented and dysfunctional lives, due to repressed pain, traumas and other symptoms associated with trauma. The either learn emotional resilience to enable them to continue to function or they internalise the pain, which then acts as the driving force behind any unconscious, or reactive behaviour.
The effects of systematic abuse has devastating consequences for the victim.
A child who was abandoned or rejected from their parents, consequently removed from their home, enters an institution where they are faced with further trauma complexes impacting their already fragmented psyche, isolation and loneliness to ensure their survival, they either retreat and comply to the overt rules. Or they react rebelliously and disobey, depending on their core wound and the associated emotion they attached to the experience. The example demonstrates not one core wound, but four core wounds – abandonment, rejection, isolation, fear, initiated from removal from their family, damaging attachment bonding further and ensuring a fragmented and damaged psyche. The original wounds damage the early development and creates a traumatic bonding complex, leading to dependency on medicine (psychiatric or psychological) and social welfare (dysfunctional bonding and welfare dependency).
Addictions and personality complexes are the result from damaged attachment bonds, where mother and child are separated. This then creates a fertile breeding ground for core wounds to further impact against the developing personality and psyche, creating neurosis, phobias and dysfunctional bonding.
Psychological projection is a theory in psychology in which humans defend themselves against their own unconscious impulses or qualities (both positive and negative) by denying their existence in themselves while attributing them to others. For example, a person who is habitually rude may constantly accuse other people of being rude. It incorporates blame shifting, projecting their own shadow onto an innocent and rejecting this part of them-self. Unconsciously, the rejection acts as a protective layer to their fragile psyche. Hiding in the shadow, it breathes life.
Addictions, homelessness and mental ill health all link together through traumatic bonds formed during childhood. The traumas of the child, becomes the fertile breeding ground for addictions to breathe and grow. Abandonment, rejection, fear and isolation are the main core themes that contribute to homelessness. Ironically, these four core wounds, also become the driving denomination behind the stigma, that society attaches to the victim, from its own community.
Rising homelessness is a direct reflection of the beliefs, assumptions, opinions projections and attitudes of the inhabitants in the community and the governing body that is responsible for their welfare!
Friedman, Matthew J; Resick, Patricia A; Bryant, Richard A; Brewin, Chris R (Sep 2011). Considering PTSD for DSM-5. Depression and Anxiety 28. 9 : 750-769. /PTSD/professional/articles/article-pdf/id35490.pdf
Gelso, C. J., Palma, B., & Bhatia, A. (2013). Attachment theory as a guide to understanding and working with transference and the real relationship in psychotherapy. Journal Of Clinical Psychology, 69(11), 1160-1171. doi:10.1002/jclp.22043
Herman, J. (1992). Complex PTSD: A syndrome in survivors of prolonged and repeated trauma. Journal of Traumatic Stress, 5(3), 377-391. Retrieved fromhttp://0download.springer.com.opac.sfsu.edu/static/pdf/155/art%253A10.1007%252FBF00977235.pdfauth66=1397291211_b786a4a9c1d38270ee589ae3f4bf7c75&ext=.pdf
Herman, J. (1997). Trauma and recovery: The aftermath of violence from domestic abuse to political terror. New York: Basic Books.
Moore. J, Thornton. C, Hughes. M, & Waters. E,. (2014) A toolkit of sensitive practice for professionals working with survivors of institutional childhood abuse.