Epidemiological and Psychological Perspectives: Researching Harm Without Adding to It
Child abuse has to date been primarily investigated in the disciplines of public health/epidemiology and developmental psychology, where the focus has been on quantitative assessments of the scale of the issue and of the developmental, behavioral, and health impacts of traumatization in childhood (cf.
D’Andrea et al. 2012; Spinazzola et al. 2014). Consensus has been reached in this literature that these impacts are “profound” (Katz and Barnetz 2014: 1033). According to Katz and Barnetz (2014: 1033-1034), they include short-term effects such as symptoms of post-traumatic stress disorder (PTSD) (e.g., anxiety, fears, intrusive thoughts, flashbacks, physical fighting, aggressiveness, unresponsiveness to authority, depression, low self-esteem, sleep disorders, sexualized behaviors, panic and anxiety attacks, powerlessness, and feelings of guilt about the abuse) and long-term effects such as “impaired sexual functioning; self-reports of promiscuity, which are a function of low self-esteem; vulnerability to repeated victimization; depression; guilt; selfblame; fear; substance abuse; anxiety; hostility; and delinquency [...].”Developmental psychologists such as D’Andrea et al. (2012) and Spinazzola et al. (2014) have further emphasized the need to include psychological maltreatment (PM) in analyses of the impacts of childhood traumatization, as it can be “the most challenging and prevalent form of child abuse and neglect” (Hibbard et al. 2012, p. 372, cited in Spinazzola et al. 2014: 19) and is understood to “produce adverse developmental consequences equivalent to, or more severe than, those of other forms of abuse” (Spinazzola et al. 2014: 19). Psychological maltreatment has been defined by the American Professional Society on the Abuse of Children (APSAC) as “a repeated pattern of caregiver behaviour or a serious incident that transmits to the child that s/he is worthless, flawed, unloved, unwanted, endangered, or only of value in meeting another’s needs” (Myers 2002, cited in Spinazzola et al.
2014: 19):PM represents a breach in the attachment relationship between caregiver and child through (a) a lack of emotional nurturance, attunement, and responsiveness (emotional neglect) and/or (b) overt acts of verbal or emotional abuse that (c) result in harm to the child, disruptions of psychological safety, and impediments to the normative development of essential capacities such as emotion regulation, self-acceptance and -esteem, autonomy, and self-sufficiency [...]. (Spinazzola et al. 2014: 19)
Research such as this has also found that risks of traumatization are cumulative, meaning that the consequences for health and well-being are more severe with exposure to more types of traumatic stress, greater frequency, and longer duration (D’Andrea et al. 2012: 188).
Recognition of this complexity has, however, also sparked debates about protective factors and the conditions within which children and adult survivors may develop coping mechanisms and resilience (Wells, Scarpa and Wells et al. 2015), although many authors stress the need to place “resilience” in context and not to romanticize it. Thus, resilience is mostly described as a long-term process that is emotionally costly and fraught, as survivors of abuse frequently experience retraumatizations in the process of disclosure, investigation, reflection, and healing (Swanston et al. 2014).
Contextual aspects are highlighted particularly in work informed by transactional-ecological approaches, which emphasize the need to investigate the intersections between a range of factors, at individual and environmental levels, as Frederick and Goddard (2007: 324) explain:
This perspective combines the transactional model of development, described by Sameroff and Chandler (1975), which proposes that development results from the interaction of the individual and his or her context through time in continuous, dynamic process, and the ecological model of Bronfenbrenner (1979), where the individual’s development is seen as embedded in multiple systems (Cicchetti and Toth 1998; Masten and Wright 1998; Davies 1999; Luthar et al. 2000; Fraser et al.
2004). This perspective assists understanding that individual developmental outcomes are caused by dynamic processes involving a complex range of factors at different levels that require continuing adaptation [...].However, while transactional-ecological perspectives understand the child as relationally situated, they tend to rely on and reproduce strong assumptions about the scaling of childhood, the primary importance of the family, and “normal” development. Critical scholars, especially from the New Social Studies of Childhood, have taken issue with the risks of essentializations and pathologizations that they see as inherent in such approaches (cf. Horschelmann and Colls 2009), while feminist scholars and counseling researchers have questioned the absence of survivor accounts and of theorizations starting from their perspectives. Further, from a critical geographic perspective, the theorization of children’s developmental contexts as differently scaled systems, in which the family occupies center stage, can be criticized as unreflective of the historical specificity of western understandings of childhood, family, and home, and as mapping an ordered world that bears little resemblance to the complex spatialities of children’s everyday lives.
Alternative conceptualizations such as those proposed by Scheper-Hughes and Bourgois (2004), Stanko (2003), and McKie (2005) concur with transactional- ecological models on the need to consider how social norms inform family practices and influence which practices are seen as violent or not, how violence is understood and rationalized and which practices are legitimized, ignored, or problematized. However, they dispute the universal applicability of developmental models and their explanatory powers and instead place greater emphasis on understanding the historical and cultural specificity of different rationalizations of violence and of the ways in which different forms of violence intersect. As Scheper-Hughes and Bourgois (2004: 2) explain:
Violence itself [...] defies easy categorization.
It can be everything and nothing; legitimate or illegitimate; visible or invisible; necessary or useless; senseless and gratuitous or utterly rational and strategic [...] Rather than sui generis, violence is in the eye of the beholder. What constitutes violence is always mediated by an expressed or implicit dichotomy between legitimate/illegitimate, permissible or sanctioned acts, as when the ‘legitimate’ violence of the militarized state is differentiated from the unruly, illicit violence of the mob or of revolutionaries (...).The geographer James Tyner (2012) further argues that violence should be understood as situated in the broader context of political and structural conditions and as taking place as well as producing place. Tyner asks for more thorough analyses of the spatialities of interpersonal (and not just structural or political) violence, proposing to study violence as “an act to regulate people through a discipline of space” (ibid: ix), that shapes our perceptions and conceptions of particular places, with these places in turn informing our understanding of violence (ibid: 3).
Ecological models and quantitative analyses of the scale and impacts of child maltreatment only allow partial insights into these spatialities. More complex understandings emerge from the few studies that have analyzed the accounts of children and adult survivors and it is to these that the chapter now turns to consider the contributions that geographical research can make to understanding children’s experiences with domestic, interpersonal violence at home.
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