Activists and researchers are struggling to ensure that awareness of child sexual abuse and child sexual exploitation are embedded in the minds of practitioners. Quite rightly – no child should have to find ways to overcome traumas that could be prevented; traumas that twist and cramp spontaineous growth and development. But we also have the challenge of an older age population for whom no such committment existed. Many of our elderly are carrying a lifetime of abuse and a legacy of trauma that shapes their experience of accessing support and care. The political withdrawal of funding from the violence and abuse sector delivers us into a climate where we have no option but to haggle over the resources that scarcely cover the categories of child and/or adult vulnerability. A question that troubles me as I age is how we might balance our concern for future generations with our concern for the children of yester-year. In a culture that is demonstrably ageist in outlook – invisibility for those age 55+ appears to be the norm. 

At the European conference on domestic violence in Belfast last year a number of presenters explored the similarities and differences between elder abuse and domestic abuse.  What became clear was that there has been limited development in research or service provision for this population.Since that conference  I have had cause to examine london based service responses to vulnerable adults at risk of current abuse from partners, family and carers. One of our students looked in depth at experiences of domestic violence in the older age population in Kent. Our findings left us both very troubled by the lack of knowledge and skills available to practitioners and the consequent experiences of older women in particular.  This aspect of abuse prevention now falls far below the level of protection we try to provide to children who are vulnerable to the coercive behaviours of sex offenders or domestically abusive father figures.  The level of research, training, policy and legislation we can draw on for child protection is not matched at the level of adult vulnerability. When adults lose capacity (either physically or mentally) they too become dependents on the care of family or services, often without adequate safeguards to ensure the safety of that care.

What becomes evident as you look into the older age experience of current abuse is the extent to which previous experiences of abuse(s) complicate the picture.  Adults of both genders reaching their 80s have had little or no opportunity to disclose child or adult sexual abuse over their lifetime.  Conditions like dementia break down the psychological defences that they may have used to block out or supress unwanted memories or flashbacks. Suddenly they are confronted by triggers like being touched, washed or dressed by adults who may or may not feel trustworthy. Although we have the Care Quality Comission (CQC) inspecting care homes we hear of abuses and neglect – sometimes only detected when relatives instal hidden cameras.  As with children, going into care may be the most appropriate option but the care setting can also be a site of harm. Limited investment in adult care means that homes are frequently staffed by poorly paid undervalued migrant workers with very limited training. The training gaps around dementia and around violence and abuse conflate to create a vacuum in adult services. For example, how will those workers know that sexual abuse trauma lies behind  the distress a person with dementia shows when receiving everyday physical care?  How are these expressions of trauma deciphered when they are so often classified as symptoms of confusion or memory loss?  

For those elderly who remain in their homes their evident vulnerability makes them easy target for a host of rogue traders or unscrupulous family members.  Cast around any social group of women in their 50’s and you will hear accounts of elderly relatives being taken by builders to cash point machines to ‘pay up front in cash’.  These are not stories the elderly easily tell as they battle to retain an appearance of independence and avoid the indignity of a care system that will strip their identity of sexuality, religion and dietry choice.  For the person managing a history of abuse related trauma the sanctuary of their own home may be their only space where they felt safe.  Even this possibility will be compromised by abusive partners, adult children or other close relatives who take control of the older person.  That control is coercive control – threats with consequences; affection proferred or withdrawn; financial control; isolation and intimidation.  Adult social workers fall to colluding with relatives who claim to be speaking for the older person or who offer to take on care and relieve a public service of the strain on staffing.  The Court of protection is most areas is full of cases of disputed care management, and situations where one side or the other claims that the older person has or lacks the capacity to change wills, spend money or make basic decisions.  In this setting where vulnerable adults are the focus, the concept of coercive control has yet to take root.  Health and Social care workers involved in the earlier stages of the case appear unable to identify coercion and give equal weight to all the accounts they hear from people around the older person.  Consequently the charity Action on Elder Abuse is swamped with calls from distressed relatives and friends who spot a sudden change in the life pattern of the older person.

I am not sure how we should proceed with this problem in economic terms – funds are short and we have many children and adults in a category of need.  Raising awareness amongst ourselves and our fellow workers, friends, community is at least a start.  Training people to keep alert to issues of violence and abuse in the older population is a critical need.  I have seen no evidence that this occurs so perhaps anyone reading this who has evidence that such training occurs can respond.  The interplay of dementia and abuse related trauma is something I am trying to track down in the literature out there.  I hope to come back with some more on this in a future post.

Its been quite a week for media explorations of domestic violence and sexual abuse.  On Sunday we had ‘Savile‘, on BBC2, Louis Theroux’s truth and reconciliation-style revisioning of his 2000 documentary  about Jimmy Savile.  The clips of Savile give us the chance (with hindsight) to notice coercion in action.  Theroux returns to the aspects of the earlier documentary that are most indicative of Savile’s coercive style and of Theroux’s naive interpretations or responses. In one clip we see Theroux turn away as Savile gets horribly physical with a mother and her daughter.  This sequence should serve as a reminder that these types of abuse often involve an array of characters – victim – perpetrator and bystander.  The event takes place in a crowded space where everyone can see Savile’s inappropriate behaviour but as far as we can tell no-one consciously registers it.   Theroux interviews several of Savile’s female victims – interestingly no male victims – and offers them the chance to give their accounts of what they thought during the first documentary.  This was a particularly helpful aspect of his endeavour giving voice to the women who are most affected when the media coludes with or minimises domestic violence or sexual abuse.  It would have been interesting to hear Theroux reflect more on his feelings about being duped by Savile but he tends to sidestep discussing any sense of personal shame.  

The Archers is of course ongoing (and has been since the 50’s!) allowing Radio 4’s nightly drama to unfold a portrait of coercive control, domestic violence and sexual abuse in a timeframe that mirrors real life. The story of Rob Titchener’s abusiveness has been well constructed over 18 months or so but in the last week we heard him beginning to show his abusive side more publically.  In his efforts to flout child contact arrangements he begins to attempt coercion of the baby minder gradually escalating his efforts to physical threats when she will not comply.  We hear members of the Ambridge cricket team loudly rejecting Titchener as he tries to re-enter the team as if the public accusation that he raped his wife has no meaning. His wife Helen, meanwhile has begun to refind her voice after an extensive period of being coerced and controlled by her husband’s mind games.  The great thing about this drama is the focus it provides for women like Helen, (middle class, good family support, ability to earn money) who are often the hidden faces of victimisation.  The stereotype of the abused wife is more frequently drawn from the poorly resoured women whose only recourse to support is through public services.  The Archers are showing that the comfortable white majority of families are also exposed to the vagaries of abusive men.

On tuesday we had Channel 4 offering up ‘National Treasure‘ a four part drama about a celebrity accused of rape.  We follow the immediate aftermath of the accusation as the police cart away computers and mobile phones and the main character, Paul Finchley  is left to face up to his wife.  We discover that whether the allegation is true or false, Paul is a man with a string of sexual encounters that his wife Marie has managed to disregard for the sake of the marriage.  He is a user of violent porn and his celebrity status gives him resources and access to adoring fans.  This is a dark and complex drama that shows the extent to which the mechanisms of sexually abusive behaviour are at the reach of the many through household technology.  The casual use and distribution of porn; turning a blind eye to everyday sexism; being a mute bystander; subservient female roles; these are all the ingredients of sexual abuse. The drama concludes next tuesday but you can catch up on the All 4 on demand service.

Finally we had a report on the autobiography of Peter Hook, from Joy Division and New order in which he talks of his brief marriage to comedy heroine Caroline Aherne (Gaurdian 3 October 2016).  Hook describes a troubled 3 year marriage in which he experienced put downs, controlling behaviour and a range of violent assaults.  He describes feelings of shame so typical of being victimised and revealed that the relationship had left him clinically depressed. Its useful to hear men speak about the feelings of shame and embarrasment that go with abuse experiences – it reminds us that abusive behaviour corrodes self esteem in ways that overide gender differences.  Aherne, who died in July this year was much revered as a comedian which will make this revelation a contentious one for Hook.  On the following day the Gaurdian (4 October 2016), reported that Aherne’s brother, Patrick, had spoken out against Hook for his disclosures as they were historic and sister was not alive to defend herself.  

In Savile, National Treasure and the Peter Hook story we see the public struggle to make and maintain heroes at all costs.  In The Archers we see a similar process on an ordinary scale – Rob is elevated in the community because of his public display as perfect husband and father – it gave him a heroic status. The capacity to be duped by an abuser is not in itself shameful – the act of attempting to appear safe when you intend to be predatory IS shameful.  It seems that being funny, or charitable or nice generates an impression that you are safe and kind too. We need more media coverage of these complex dynamics and we got that this week. The purpose of those reports like the fairy stories of my youth (Little Red Riding Hood or The Emporer’s new clothes) is to remind us that what you see is not always what you get.