The Voice of the Child has become a world wide phenomenon in which the wishes and feelings of children are sought in the family courts, in matters concerning the care of a child and in areas of hea…
Practitioners working with children aged 13-18 years may observe some of the key features described in the previous section. Getting help for the child and family as early as possible gives the best chance of a good outcome. Neglect and emotional abuse are often not recognised in teenagers and even where they are they may not be taken seriously by professionals. Not much is known about their personal experiences, as there is a lack of research which identifies the feelings, or experiences of this population. Many of the behaviours exhibited by emotionally abused or neglected teenagers may be interpreted by others as a lifestyle choice or ‘acting out’ when they may in fact be an indicator of neglect or emotional abuse. Consequently their conduct may lead them to enter the juvenile justice system rather than the child protection system. A better understanding of teenage neglect and emotional abuse may enable teenagers to access appropriate and timely help.
• All practitioners coming into contact with teenagers who exhibit the behaviours and issues above must actively consider neglect or emotional maltreatment, rather than simply addressing the problems they present, such as alcohol use.
• Remember, teenagers who have experienced neglect or emotional abuse may be particularly vulnerable to other forms of victimisation; therefore appropriate action should be taken.
• A sensitive exploration of teenagers’ experiences may help professionals understand their situation, and allow the teenagers to access appropriate support themselves.
• Hospital emergency departments and mental health providers need to be particularly aware that teenagers, especially the victims of violence, may be experiencing neglect or emotional maltreatment.
While early recognition and intervention are vital, it is never too late to help a child or teenager. If concerns about possible neglect or emotional abuse arise it is important you take action as soon as possible regardless of the age of the teenager.
If you have a concern you can call the police, social services or the NSPCC (0808 800 5000). And remember that children can contact ChildLine 24/7 (0800 1111; childline.org.uk).
This report is based on a number of premises concerning neglect and emotional harm, drawn from the robust research findings referred to in Section 4 (p29). Neglect of a child can take a variety of forms (see p15). Emotional harm is linked with neglect throughout the report. It is one possible outcome of all forms of maltreatment, and we draw attention to the strength of current evidence that all forms of neglect are particularly associated with damage to children’s emotional competence – their sense of identity, their self-esteem and confidence with others, in ways that compromise all of the Every Child Matters outcomes. Signs of such damage emerge from the pre-school years onwards and can endure into adulthood. Successful substitute care becomes increasingly hard to achieve (see p37, quote p47). This can happen whatever form neglect takes, and whether it is intentional or otherwise. 7 Neglect and other forms of maltreatment Emotional abuse is treated in this paper as a separate form of maltreatment often with implications of intended harm (see p15). It can co-exist with emotional and psychological neglect, particularly in the form of emotional unavailability, indifference or coldness.
Emotional abuse is treated in this paper as a separate form of maltreatment often with implications of intended harm (see p15). It can co-exist with emotional and psychological neglect, particularly in the form of emotional unavailability, indifference or coldness. The overlap between neglect and many other forms of maltreatment to children is one of the many challenges the report identifies. For example, over-discipline of a child by one parent may mask neglect by another, and adults’ problems often have a similar effect of making the child invisible. Neglect is associated with future maltreatment (p24) and the most serious and life-threatening abuse is often found to follow a history of increasing neglect (see p25). It is therefore vital to achieve consistency across agencies in the understanding and use of definitions by the various professionals involved, and in how these are applied to thresholds for action. Agencies should not revise their definitions and thresholds without full consultation, which may itself clarify issues of joint working. Otherwise the debate (“is this neglect?”) has to be repeated at length case by case, delaying the response to a child’s or a family’s needs. Professionals were unanimous in feeling that best practice should mean a sensitive but prompt and pre-emptive response to early signs of child neglect (i.e. if in doubt, respond), rather than the current prevalent “wait and see” approach, which was at best potentially damaging and at worst dangerous. The report describes tools that assist multi professional groups in achieving a more rapid joint assessment of neglect. It pulls out salient features of neglect identified in the study and proposes action points.
The findings reported here challenge the “failure in the mind” that is one response to the neglect of children; the attitude that no action will make any difference. Other responses to neglect were familiar to the professionals (one hundred, across all the main disciplines involved) who were interviewed. These responses included anger, avoidance, fear, blame, disagreement and denial. Some thought that they mirrored the feelings of many parents and the powerless state they often felt themselves to be in.
On the other hand there were also many examples of families, community members and professionals who overcame huge practical problems, engaged others to help and reinforced parental responsibility. Innovative and supportive resources were delivered. Occasionally the child could not remain with the family but, with the right support, the great majority were able to do so safely.
The report outlines what we believe is a strong and urgent case for a national strategy for child neglect that better reflects the holistic policy framework of Every Child Matters. Evidence-based strategies and international comparisons are discussed.
Analysis of the literature and interviews with professionals made it clear that this is one area where the scale and nature of the problem require a systemic and systematic response. Neglect makes up half of all child protection registrations (cases requiring a multi-agency protection plan); up to three quarters in some areas when joint categories of registration are included. A high proportion of children who are looked after have suffered neglect. All professions agreed that thresholds are so high that these figures represent the extreme tip of a much bigger phenomenon. Community based workers such as head teachers, school nurses and health visitors in some areas described up to eighty per cent of children they saw as showing signs of neglect.
Emotion recognition and empathy
A large body of research suggests that psychopathy is associated with atypical responses to distress cues (e.g. facial and vocal expressions of fear and sadness), including decreased activation of the fusiform and extrastriate cortical regions, which may partly account for impaired recognition of and reduced autonomic responsiveness to expressions of fear, and impairments of empathy. The underlying biological surfaces for processing expressions of happiness are functionally intact in psychopaths, although less responsive than those of controls. The neuroimaging literature is unclear as to whether deficits are specific to particular emotions such as fear. Some recent fMRI studies have reported that emotion perception deficits in psychopathy are pervasive across emotions (positives and negatives). Studies on children with psychopathic tendencies have also shown such associations. Meta-analyses have also found evidence of impairments in both vocal and facial emotional recognition for several emotions (i.e., not only fear and sadness) in both adults and children/adolescents.
A recent study using offenders with psychopathy found that under certain circumstances they could willfully empathize with others. Functional neuroimaging was performed while the subjects were watching videos of a person harming another individual. While reduced empathic brain activation relative to the controls was observed in the control condition, the empathic reaction of the psychopathic offenders initiated the same way it did for controls when they were instructed to empathize with the harmed individual, and the area of the brain relating to pain was activated when the psychopathic offenders were asked to imagine how the harmed individual felt. The research suggests that individuals with psychopathy could switch empathy on at will, which would enable them to be both callous as well as charming. The team who conducted the study say it is still unknown how to transform this willful empathy into the spontaneous empathy most people have, though they propose it could be possible to bring psychopaths closer to rehabilitation by helping them to activate their “empathy switch”. Others suggested that despite the results of the study, it remained unclear whether the experience of empathy by these psychopathic individuals was the same as that of controls, and also questioned the possibility of devising therapeutic interventions that would make the empathic reactions more automatic.
Work conducted by Jean Decety with large samples of incarcerated offenders with psychopathy offers additional insights. In one study, the offenders were scanned while viewing video clips depicting people being intentionally hurt. They were also tested on their responses to seeing short videos of facial expressions of pain. The participants in the high-psychopathy group exhibited significantly less activation in theventromedial prefrontal cortex, amygdala and periaqueductal gray parts of the brain, but more activity in the striatum and the insula when compared to control participants. In a second study, the subjects with psychopathy exhibited a strong response in pain-affective brain regions when taking an imagine-self perspective, but failed to recruit the neural circuits that were activated in controls during an imagine-other perspective—in particular the ventromedial prefrontal cortex and amygdala—which may contribute to their lack of empathic concern.
Despite studies suggesting deficits in emotion perception and imagining others in pain, professor Simon Baron-Cohen claims psychopathy is associated with intact cognitive empathy, which would imply an intact ability to read and respond to behaviors, social cues and what others are feeling. Psychopathy is, however, associated with impairment in the other major component of empathy—affective (emotional) empathy—which includes the ability to feel the suffering and emotions of others (what scientists would term as emotional contagion), and those with the condition are therefore not distressed by the suffering of their victims. Those with autism, on the other hand, often are impaired in both the affective and cognitive facets of empathy.
Fear, Obligation And Guilt: How We Allow Loved Ones To Control Us
In their 1997 book, Emotional Blackmail: When the People in Your Life Use Fear, Obligation and Guilt to Manipulate You, authors Susan Forward, Ph.D. and Donna Frazier state that “emotional blackmail is a powerful form of manipulation in which people close to us threaten to punish us for not doing what they want. Emotional blackmailers know how much we value our relationships with them. They know our vulnerabilities and our deepest secrets. They can be our parents or partners, bosses or coworkers, friends or lovers. No matter how much they care about us, they use this intimate knowledge to win our compliance.” According to Forward and Frazier, fear, obligation and guilt (“FOG”) are the tools of emotional manipulators.
“Emotional Blackmail” and “FOG”, terms coined by psychotherapist Susan Forward, Ph.D., are about controlling relationships and the theory that fear, obligation or guilt (“FOG”) are the transactional dynamics at play between the controller and the person being controlled. Understanding these dynamics are useful to anyone trying to extricate themselves from the controlling behavior by another person and deal with their own compulsions to do things that are uncomfortable, undesirable, burdensome, or self-sacrificing for others.