Paper: Shame, Blame and the Thinking Community by Janine Cherry-Swaine

Paper by Janine Cherry-Swaine


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Authored on :
14/01/2025by :
Jackie Horsburgh

Containing Groups

by Janine Cherry-Swaine

It defies credulity that large groups of children, more often than not girls, could be subjected to cruelty and contempt, wrapped in a carapace of seduction, groomed, and sexually exploited. Moreover, that this can seemingly be hidden in plain sight within communities and services that struggle to come to a realisation of the abuse. As we know, this was the case within such notable towns as Rochdale, Oxford, Telford (Crowther, T 2022) Rotherham (Jay, A 2014) Humberside and many more not specifically named in the public domain. Jay suggested that 1400 victims could be identified and over a 1000 in Telford going back into the 1980s, however, recent reports have suggested that over sixteen thousand child sexual exploitation victims can be identified in England alone (Edwards, J 2023). This is a disturbing figure which indicates that nationally Child Sexual Exploitation (CSE) is still very much a problem for services and all of society.

Given the extent of outrage that is triggered by each revelation, and a societal consensus on the need to eradicate it, we need to ask what hinders us in getting to grips with this problem.    We need, I think, to regard it as a ‘wicked problem’ (Grint, K 2005):  a problem whose complexity creates huge and seemingly insoluble difficulties in the professional and legal networks that attempt to address it, and that is compounded by the existing difficulties within the individuals, services and communities that it affects. 

In this chapter I will be presenting a series of case examples to illustrate some aspects of this complex problem, and to explain how the consultation service that I run attempts to address it, and to mitigate its impact on both staff groups and survivors.  

CSE is clearly not constrained to any one area, yet the excruciating extent of the shame that communities are forced to carry when the prevalence has been exposed, persuades us to feel that it is contained and constrained to certain areas.  This indicates the power of the unconscious dynamics of splitting and denial that are at play, and the wish to create scapegoats, who can then be vilified: creating the illusion that other areas are free of the problem.  For this reason, my case examples will be drawn from communities and staff groups where the prevalence of CSE has not been exposed, as well as from various places where it has.   To preserve confidentiality, these cases are themselves composite examples, that explore the impact upon individual survivors of CSE, of services that support them, and of the professional networks in which these services operate. 

A Projective System  

Child Sexual Exploitation typically involves a gang mainly consisting of men who get together to recruit young girls to be shared for sexual purposes.  The sexual acts often involve extremes of violence, sadism and humiliation.  Recruitment is achieved through a process of expert grooming, which resembles traditional courtship.   Grooming is thus a hidden crime that cannot be easily distinguished, and which can deceive observers as well as the victims, and thus go unremarked.

The particular nature of the process of grooming leads to an extraordinarily complex agglomeration of conflictual feelings.  Adult survivors have described the initial pleasure’ and enjoyment’ at the emotionally attentive and expertly executed courtship, led by attractive young men, seemingly offering themselves to be boyfriends’ to often vulnerable, lonely young girls.  For the children and young women involved, the ensuing ‘relationship’ is felt at first to be wholly consensual.   Although courtship is soon replaced by intimidation, threats and physical abuse, the process typically creates in the victim a confused attachment relationship - not unlike that found in many victims of adult domestic abuse.

Victims of domestic abuse find it hard to extricate themselves from the projections of a single partner:  these are projections that can leave the victims full of shame, blaming themselves and colluding with a process that keeps the abuse secret and isolates them from friends and family. 

The victims of CSE are recipients of group projections - projections that are exponentially greater than the projections of a single individual - and find it correspondingly harder to extricate themselves from these projections.   Their recruitment into the secret, shameful activities of the gang serve similarly to isolate them from their communities.  They are faced with a conflict between their previous attachments - which may in themselves be confused and ambivalent - and their attachment to the gang, complicated by feelings of shame and humiliation which are so powerful that they may need to be denied.

As a psychotherapist working with individual survivors, my counter-transference response has informed me of the strength and confusion of these emotions.   In my work with staff groups and communities, I am struck by the parallel strength and confusion of emotions engendered in those attempting to work with them, which can affect me as strongly as my work with individual survivors.   This is a measure of the power of the projective system created by the process. 

As a psychoanalytic thinker, I assume that gangs of sexual abusers come together because of their own unconscious need to rid themselves of powerful negative emotions by projecting a toxic mix into their victims, that they themselves have been unable to process.   And there is evidence to support this view.  It is widely reported, for instance, that some of the convicted abusers came from an Asian heritage, often from generations of traumatised adults previously displaced from historical conflict zones, and subsequently marginalised and humiliated by their adopted country.  Perhaps they and their families have themselves felt seduced and tricked by false promises of security and prosperity that have not been fulfilled by the reality of their experiences of Western capitalism.

However, there has been very little research about the perpetrators of this form of abuse, other than that which is written in newspapers or in court proceedings.  The impression is that the criminals are either full of guile, brazen or deny knowledge:  smiling young men who admonish social workers, accusing them of failing to protect young girls only later to be charged with the crime themselves. Or the opposite; mug shots of older men from criminal proceedings that give nothing away about who they were in their younger days when the abuse took place. 

While it is not within the scope of this chapter, to explore the predicament of the abusers, it is likely that a fuller understanding of their histories would greatly aid our work in preventing continuing abuse, and untangling its impact, just as we know that a greater knowledge of the histories of both partners helps us to better understand and prevent domestic abuse. 

The Projective Parcel

In the absence of fuller research, I would suggest that the nature of Child Sexual Exploitation provides copious evidence of what is being projected.  

Child Sexual Exploitation involves the projection of shame, which must then be denied and kept secret.   Through the process of grooming, victims are typically tricked into becoming complicit with sadistic sexual acts.  They are corrupted and humiliated, and sometimes forced into recruiting new victims.  This process leaves survivors with an agglomeration of conflictual feelings which they find almost impossible to untangle - a messy parcel of feelings that has been passed to them and that they find themselves passing on in turn.  The less able they are to make sense of their tangled feelings, the more likely they are to deny them and project the whole agglomerated parcel into others.

The abuse often occurs within a close community, where people know one another, but where those around them dont know that it is happening:  the victims are made to feel aliens within their own peer groups.   Abusers and victims are often drawn together through an unconscious recognition of an experience of alienation that they have in common:  abusers are drawn to vulnerable victims with a valency for being shamed and humiliated, and often with a similarly denied experience of projected toxicity as a result of childhood abuse, abandonment, disability, or sometimes simply an ordinary mischance that has set them apart from their peer group.

Because these accreted experiences of toxic projections have not been digested and processed either by the abusers or by the victims, the projections into the community and into its services have an aggregated force that is particularly hard for staff groups to think about or to contain.  Like the abusers and the victims, staff groups and communities find themselves humiliated and powerless, the target of outrage and blame.  

This is evidenced by the response of the press, and the flurry of resignations that follow new exposures.  

In what follows I will attempt to describe through case material something of how this plays out for the staff groups that work with individual survivors, and attempt to cope with the complexity of their projections.

Working with Staff Groups

The services I have worked with include a variety of NHS, Social Care, Housing, and Voluntary Sector organisations in various towns. When I started working, I was astonished - given the wide-spread nature of the media coverage in some of these areas - to find that it was almost impossible to locate many adult survivors of CSE - as if they remained a ‘shameful secret’ (Crowther, 2022). 

It took time and patience to unearth names and details, and I soon discovered that in order to do so I had to be hyper-sensitive to the issues of blame, shame and scapegoating, feared and sometimes experienced by workers in relation to the individual victims.  

I also noticed an initial misguided wish to find a way of treating the impact of CSE as if it was a distinct layer that could be eradicated and split off from any pre-existing trauma and complexity:  a denial of any need to address the previous history of victims that might have made them more vulnerable to exploitation.   This led to fragmented thinking and non-collaborative service responses.

I quickly came to the conclusion that this was a reaction to the nature and complexity of the problem that services were attempting to deal with. 

My decision to work consultatively was based on my understanding that the projection of blame, shame, and scapegoating needed to be countered by a group response; that professional networks needed to collaborate to process, understand and detoxify the complex parcel of emotions that had been projected into individual survivors and through them into the staff groups attempting to help them.  

The team of consultative clinicians that I have gathered together and trained to work with the professional networks have been hugely successful in supporting survivors through supporting their workers. 

The following vignette offers an example of what can be projected into staff groups and individual staff members, by the nature of what individual survivors are carrying - and of how these staff groups and staff members can be supported in their painful and difficult work. 

Case Example:  Jane

A project worker, whom I will call Jane, asked for help from a multi-agency group of workers. Very quickly, and shockingly for the group, she began sharing graphic and sadistic details of the story of a victim being sexually abused by a series of men. The details were very explicit and involved a re-telling of the exact narrative that had been shared with her by the victim. The group members later reported feeling frozen when they heard this. They felt shocked, and in a bind:  on the one hand they did not want to turn away or prevent Jane from continuing with her narrative, as they were concerned that this would seem unprofessional; but on the other hand, they were filled with a mixture of really unbearable emotions when they listened to her: perverse sexual excitement, shame and rage.  We can see here an echo of the victims feelings:  she wanted to appear cooland unfazed by her boyfriendsdemands, but like the group members was also shocked, humiliated and perversely excited.  

The group members responded by turning their anger and outrage on to Jane; they felt that she had abused the group by exposing them to pornographic content, ‘awful stuff’ as they called it, that they had unwittingly been forced to consume.   Jane was shamed and ashamed, blamed for being sexually provocative rather than understood as having been overwhelmed by her client's projections. 

The groups response to Janes presentation - the ‘awful stuff’ - threatened to disturb a culture of cooperation and partnership that had just begun to be established in this multi-agency forum. However, with consultative help, both Jane and the group were able to see and work through what had happened to them. The groups incoherent rage at feeling the shame of being made to be complicit in their exposure to sexually explicit material, and their attempt to blame and to scapegoat Jane, were transformed into a very powerful emotional learning experience that instead supported their cohesiveness and their ability to appropriately express and articulate traumatic content, filtering out the sadism and the perverse sexual projections, without denying their existence.

Without consultation, the original trauma of sexual exploitation risked being catapulted through the system, fracturing emotional boundaries and psychological defences and leading to the scapegoating of one member - Jane - and a refusal to take on board and to address the ‘awful stuff’, the content that she was trying to communicate to them.  

Responses to the ‘awful stuff’

If staff groups and professionals can stay with the ‘awful stuff’, a number of responses can be identified, and patterns can begin to emerge - a developing framework that makes it easier to think in the face of the extreme feelings engendered by the trauma of CSE.

The learning and experience that I and my team have gained from consultation to staff groups can be described through a series of case examples.  

The emotional legacy for individual survivors of CSE is complex, and survivors cope in a variety of ways as they begin to process the experience.   The descriptions here are of course over-simplified, but serve to illustrate the stages that victims may go through in coming to terms with what has happened to them - the ‘awful stuff’ that nobody wants to think about.

At first, the predominant feelings of shock, outrage, fury and shame are likely to be denied, and the individual may insist on maintaining an attachment to the grooming gang and may reject offers of help.  

This was the case with Tilly.

Case example: Tilly and staying with the awful stuff.

Tilly was fourteen when she eventually entered a childrens home; she had been known to social services for some years as a result of parental neglect but was subsequently found to have been passed around by groups of men, returning to them time and time again, despite the degradation and abuse that she suffered at their hands. 

On her first day of arrival in a small detached house on a quiet residential street, she immediately opened the windows and screamed a stream of obscenities in the direction of the elderly neighbour: she then invited him into the house to have sex with her and the staff. 

The staff were mortified.  They were extremely embarrassed by her and dreaded the thought of being seen in public with her.  The owners felt threatened as any complaints would affect their rating with OFSTED.  

In consultation sessions, the staff described her as excited,deceitfuland animalisticsome of the time, and at other times exhibiting moments of unfocussed passivity, as if disconnected from reality and caught up in her own internal world. They admitted that she was hard to warm to. The situation worsened when they had reason to suspect that she had been ‘tampering’ with the shared food in the fridge and they were really worried that she had poisoned the food and that they might be harmed. Such was the level of anxiety that they insisted to her social worker that she needed to refer Tilly to a secure unit:  they did not feel able to continue her placement in the home.  

However, in the consultation sessions, as we became more able to discuss and understand the ‘awful stuff’, the specific abuse that she had suffered, and how she was filled with the degradation emanating from the abusers, their anxiety decreased; they withdrew their insistence that Tilly be placed in a secure unit, and agreed that she could stay.  They began to realise that Tilly felt that her mind and body had been poisoned by these experiences, and that she had a sparseness of pre-existing stability and love to draw upon prior to the abuse to counteract the poison and tether her to reality.  Through a period of consultation, the staff were able to see that they too felt that they had been poisoned:  filled up with a host of uncomfortable feelings, awful stuffbeing projected into them by Tilly, and that this had led them to believe that Tilly was poisoning their food.  As they worked through a process of articulating these feelings, sorting them and making sense of them, the staff group were able to begin to decipher what had been projected into them. This was a process of emotional decontamination that Tilly was not yet able to manage on her own behalf.  However, it made the difference between staying in the home and going to a secure unit.  

Gradually, over about a year, Tilly became more settled into a routine and started to attend college. She became more organized in her thinking and in her relationships. The risky behaviour decreased and she seemed to be less in thrall to her abusers.   She was able to accept the support of her staff group rather than identify with the abusers and she began showing this in her own ability to contain and manage her own feelings rather than project them into others. When a new child was introduced to the home Tilly could admit how she felt troubled at having to share her staff - an example of her growing ability to be more realistically in touch with the normal conflicts of ordinary life. 

Tilly is an example of a victim who retreated into dissociative states, denying her own emotional reality and projecting her unbearable feelings into the staff.   Because her identification with her abusers was understood and processed by the staff around her, she was able to make contact with her own emotional reality, and grow authentic relationships with those around her.

For adult survivors, the oscillation between identification with the abusers and an attempt to reach out for help may become entrenched and it can be harder for professionals to intervene.  They seem to embody both the abuser and the victim, and they can become both the accused and the accusers. 

Case Example:  Helen - embodying the ‘awful stuff’.

Helen was in her late thirties; she had been introduced to drugs at thirteen as a result of sexual exploitation and continued to use them to block out her nightmares. The professional network around her had found her difficult at first - it had seemed hard to make a properly empathic relationship with her - but they had eventually warmed to her and worked hard to make progress.  They were devastated when it was revealed that, having been groomed herself, she was suspected of having later procured other young girls for the gang, and subsequently charged by the police. They felt blindsided by this news and could not find a way of joining these two versions of Helen.  

In the course of consultation, they admitted feeling betrayed by her, even duped, doubting the warmth and attachment that had developed and struggling to disentangle the complexities of their own responses.  They discussed the nature of grooming, and the complexities of the conflictual feelings that had been projected into Helen.   They thought about the topsy-turvy world of the victim, and of how a victim might try to escape from being the one at the bottom by any means if it kept them alive and rescued them from sadistic attack, powerlessness and painful humiliation.   They were able to empathise with the heartbreak of Helens story, while fully recognising that she had lured others in to take her place and undergo the same sadistic treatment. 

Helen had lived with the impact of CSE for some years, and had not had sufficient help to process her conflictual feelings.  Instead, she seemed to have split her identity:  one part of her appeared to be authentic in her presentation as an innocent victim to the professional network.  Another hidden part of her retained a firm identification with the abusive gang. 

For many victims, the experience of CSE becomes embodied through an entrenched identification with the abusers that is hard for them to acknowledge.

Gail, in my next example, was younger than Helen;  she oscillated between her attempts to reach out for help and her attempts avoid any kind of rescue.   But in her case the conflict was more overt and because her early history was better known it was easier for the professionals to make sense of her behaviour.

Case Example: Gail - in flight from the awful stuff.  

Gail was in her mid-twenties and had lived in around eight different places in a similar number of months.  She was constantly being given notice, absconding or getting involved in some disaster that warranted a move.  She would make what seemed to be good starts - warm relationships with housing support staff, for instance - and then she would flee and lose these relationships.  She was also in and out of domestic abuse relationships and financially vulnerable. This volatility was affecting every aspect of her health and welfare:   it meant that she was inaccessible to her GP who was unable to offer her any onward referrals for checkups. 

This transitory existence was matched by her mood, which was up and down like a rollercoaster. When it was disclosed that the man who had been put in prison for grooming and exploiting her was soon to be released, the anxiety amongst the professionals heightened.  Her workers began advocating strongly for her to have a mental health service to help with her depressive and self-harm risks.  The staff became angry with faceless mental health services and social care for refusing to provide Gail with a ‘better' service and ‘better’ placements, and assumed that she, and they, would be abandoned.

Initially staff were frustrated and angry, if not insulted, at being offered consultation to understand their concerns about Gail in context. There were reservations about calling a wider network meeting with both past and present housing support staff but eventually they agreed to a series of consultative meetings between them and the wider professional network.  

During these meetings, a fuller chronology of Gails history was re-visited, which helped her current workers to better understand how transience had been a feature throughout Gails life, right from being an infant to being a child in multiple families. The details of her early childhood were very painful for all to hear but enabled them to understand that Gail did not expect to stay anywhere for long. In a way she perpetuated a series of new starts where the grass always promised to be greener. They also realised that in some subtle but powerful ways organisations had historically been unconsciously playing into this.  

In the end the group met for more than a year; there were consistent members with some people joining for a particular reason, but in each meeting the participants would share observations in turn, and consider in detail the presenting issue in Gails life.  Group members would share in confidence their own emotional responses, and how they felt towards Gail:  sometimes these were acutely ambivalent, and they admitted that they hated her for going back to men who harmed her.  The consultants were sensitive in their handling of these painful counter-transference responses, and this helped the staff to admit that on occasion they had a strong desire to be rid of her, as she caused them to feel so much pain, guilt and inadequacy because of their inability to protect her. 

 In a sense the group was undergoing psychotherapy on Gails behalf.  The group had learned to manage the consistency that hitherto Gail had not been able to manage herself.  In particular, they resisted fleeing from the problems by onward referrals to betterplacements or betterservices.

 After some time, the group looked back and was astonished to notice the changes that had taken place: Gail had not moved once during this period and her health and well-being had significantly improved. The staff were proud of their work with her. 

The network around Gail had been able to help her both physically and emotionally.  

It was significant that Gails problems included unexplained illnesses which were a source of concern to her GP.   For many victims, the experience of CSE becomes embodied not only through an entrenched identification with the abusers but also through the physical sequelae of unprocessed emotional pain.  

 Self-harm, suicide and physical illnesses are common amongst survivors.  Susan, for instance, withdrew from the world, and seemed just to give up.  She disengaged from all offers of professional help. She eventually died of a failure of her internal organs for which the hospital where she was taken could offer no explanation.

Working alongside the Legal System

I hope that through these case examples I have illustrated one element in particular of the many problems that are the consequence of CSE:  the shame and conflictual feelings of the survivors.   Through a systemitised grooming process somewhat akin to brainwashing, CSE victims have been tricked into colluding in their own abuse; because they have been complicit and because they struggle to free themselves of their identification with their abusers, it can be hard for them to maintain their innocence to themselves, let alone to a court. 

However, for just this reason, a court process, and a verdict delivered by the Criminal Justice System affirming the guilt of their abusers, is of huge psychological importance for victims, exonerating them, providing public vindication, and restoring them to full membership of their communities.  

However, seeking and gaining justice is a complicated matter, and separating guilt from innocence may not be easy, as Helen’s case illustrates.

Achieving justice in cases of rape, or multiple rapes, such as many of the victims have suffered, may also be impossible for other reasons.  Many women who have attempted to stick with the long investigations that have been a feature of life in several of the towns affected have ultimately been told that there will be No Further Action.    Prosecution Services have had to conclude that a case cannot be pursued in the theatre of the court. 

Sometimes, the necessary evidence is not available or not sufficient.  Women are often unable to describe the rapists:  they couldn’t bear to look them in the face.  Sometimes the emotional vulnerability of the witness may indicate that it is unlikely that a trial will reach the desired conclusion, or that the witness will emerge safely from the ordeal.

Police officers and investigative teams in this situation can find themselves feeling full of guilt:  they feel that they and the system have failed the witnesses, giving them hope, but then letting them down and seeming to abandon them.   This dynamic can be all the more powerful because of the painful emotional work involved for the victim in presenting her case.

I’ll give one example.

Case example:  Lesley.

Lesley had just about survived into her thirties with a history of repeated overdoses and frequent visits to Accident and Emergency.  She was the mother of two children, who had been in and out of the care of the local authority; much as she had herself as a child.

In a consultation to the professional network the criminal justice representative, John, explained the current circumstances:    Lesleysevidence was being scrutinized to see what inconsistencies it contained and whether it was sufficiently robust to allow Lesley to be considered a reliable witness’. The group doubted her capacity to withstand harsh cross examination, especially given the level and frequency of the dissociative states from which she suffered, and her unconvincing and chaotic presentation.

This was hugely disappointing for all the professionals, and especially for Lesley’s support worker, Nancy:  the group became very depressed.  

Nancy reported that Lesley, despite her vulnerable health and the risks involved, was adamant that she should give her evidence in court and have the abuse fully acknowledged. 

 In the subsequent discussion she and John were able to share some very detailed observations of Lesley:  they observed that she came across as disconcertingly childlike, giggling and seeming much smaller than her real height.   They admitted to feeling very protective of her, as though she were a very little girl.   The group wondered whether they were being unconsciously pulled into acting towards her as if they were parents of a very small and sexually innocent child.   

Members of the group wondered whether their recognition and acceptance of Lesley’s childlike dependency had supported Lesley in overcoming her conflictual identification with the abusers, but whether it was now hindering her in achieving the more adult autonomy she needed if she was to give evidence in court.    Nancy and John acknowledged that they had somehow become confused about the reality of her chronological age.  She did, after all, manage some degree of maturity in her wish to be a better parent for her children.  They wondered how they could use this insight to support and encourage the more mature part of Lesley’s personality, and help her to communicate more authoritatively as the adult she was, rather than to retreat into a state of infantile mindlessness.

The group understood that this could only be achieved if the workers themselves were able to recognise and stay alongside the sexually mature adolescent Lesley that had been drawn into collusion with the abuse, whilst still recognising and sympathising with the little girl Lesley who had longed to be loved and wanted at any price. 

Through this work, Lesley’s professional network was eventually able to support her in achieving a guilty verdict.

It requires a sophisticated relational effort on the part of the professional support services and the community around them to find a way to consistently assert and communicate their innocence to CSE survivors:  to confirm that their stories are believed and that, despite their collusion, they are not to blame.   However, although it can be very helpful to victims to have ‘had their day in court’, this is not always achievable.   Where it is not, such a professional network can provide alternative vindication.   And because this is in the context of longer-lasting and ongoing relationships it may contribute to a more substantial outcome and an alternative and more healing legacy. 

A system wide model 

The examples I have given, and the model of consultation I and my team provide, are not unfamiliar to child psychotherapists, organisational therapists and consultants working to support teams and services.   What may be less common is the opportunity to provide coverage across the wider landscape of services that support victims of CSE.

Sexual abuse of any kind, but particularly CSE, involves a very closed system in order to exist. A consultation and training offer ensures that the staff who support victims are part of an open system of collaborative learning; this stands in contrast to the dynamics of abuse. Where the whole of a community over a wide geographical area has been shamed and publicly humiliated, an approach that serves to detoxify this shame and understands the origins of the projections has many advantages. 

The model my team uses has grown incrementally, supported not only by the perseverance of commissioners to seek funding for this project, but with their willingness to share their honest concerns about their communities.  It has been based upon a great deal of trust earned over several years by the avoidance of any hint of shaming or of ‘pointing the finger.   The crucial importance of this was brought home to me once when after a group that I had facilitated the senior manager said that went really well. Pleased with this comment I asked her what she thought had been most helpful.   ‘You didn't tell anyone off!, she said.

I was a little disappointed as this seemed a low bar for the success of my work but it did give me an indication of how powerful were the expectations of being blamed and shamed. Cooper (2015) talks about the ‘‘persecutory anxiety’ arising out of the fear of public humiliation’ where there is organisational failure. It takes great deal of time and emotional effort for organisations to work though these projections.  

In the case of towns blighted by CSE, a whole geographical area containing many services are affected. This impacts not only their relationship with themselves but their relationships with other services and with how they collaborate and link up together.  The potential for splitting between services and for projecting all the problems, the shame and the blame, into one scapegoated location is high. 

People who suffer from complex presentations, with or without CSE as a factor, depend upon services working well together and being compassionate towards one another. Therefore, the advantages of working to support the whole of the workforce covering the geographical spread encourages reciprocity. It mitigates against the sense of being passed on or being dropped, be it survivor or professional; helping people sustain their hope and their energies in the face of the emotional chaos and fragmentation that is caused by the shame of CSE.  

Developing a networked model of consultation means that schools which have perpetrators children and survivors children in the same playgrounds and classrooms, and where their families meet at the school gates, are able to seek support to think about seemingly intractable issues. They can find help to work with children and families who have been affected by generational trauma whether the context is as a result of their father being charged and shunned by his community or their mother struggling to manage court appearances. 

The spread of consultation across services whether they be voluntary or statutory, criminal justice, housing, drug and alcohol, mental health, social work or schools or a combination of services, has enabled the problem to be located in the abuse and not the work.  Shame is understood in context rather than projected. The Telford report mentions the offer of individual counseling for staff employed within services that have failed. This is a noble attempt to notice the impact of taking away the secrecy while acknowledging the risk of exposure. However, there is an advantage in having a work-based system of consultation to staff groups to explore their work and the impact of it, and which locates the problem in the emotionally difficult work and its concomitant projections rather than suggesting that it is located in the psychopathology of the individual. 

As you will surmise, working across a geographical area with many staff groups requires a team of professionals working cohesively together to provide congruent interventions. Whilst the work is underpinned by a systems psychodynamic approach, the individual team members are drawn from a variety of professional backgrounds. This brings a richness of differing viewpoints as well as reflecting the multi-professional nature of the work around victims. 

Internal staff consultation and team support is vital when there is a risk of vicarious trauma.  The team does not work directly with the victims, but I hope I have illustrated here the infectiousness of the toxicity of trauma, how easily it passes from one group to another, and how great is the risk of replicating the very dynamics that we are working to mitigate (Cardona, F 2020) (Moylan, D 2019).   Our team has needed to engage in a committed exploration of its own counter-transference responses in order to help other staff groups to do the same. 

Conclusion

Casey (2015) doubted mental health services capacity to respond to the distress and the trauma experienced by victims of CSE and their families. She was correct: a traditional approach to mental health support alone is likely to be frustrated in places affected by CSE.   In my view, the challenge posed by the fact that victims are spread across various services, rather than presenting a hindrance to supporting them, can in fact provide an opportunity to establish a networked approach. Survivors with an enduring emotional complexity can then be provided with a more efficient and responsive offer, bespoke to their needs; and the staff who support them can be nurtured rather than risk being shamed in their turn. 

Consultation of the kind I have described applies ‘a methodology for using counter- transference to help an organisation as a whole, just as (psychotherapists have) been taught to use it to help an individual’ (Sprince, J 2002)   This methodology has the great merit of helping staff to understand that their uncomfortable feelings of shame, humiliation, confusion, rage and impotence are not solely their own:  they form part of a projective parcel, which if left unpacked and unprocessed threatens the cohesion and well-being of individuals, services and communities alike.  If instead of concealing such feelings, professionals can learn to explore them in order to make sense of the complex problems that they and their communities are struggling with, they can detoxify this parcel and help others to do so too.

It is my assertion that working across the system consultatively is the therapeutic intervention of choice to support those traumatised individuals who present the most complex problems and who have the greatest difficulty accessing services: presenting a public health challenge to workers and to the community as a whole. Staff consultation contributes to an emotional experience becoming more coherent, which is a foundation for emotional health (Fonagy, P 2003).  It works to reverse the tendency towards fragmentation and contributes towards confidence, resilience, and self-compassion both in staff groups and in those whom they support. 

 

Acknowledgments

I would like to recognise:  the help of survivors of CSE in giving direction to this work and the commitment and trust of colleague’s, including commissioners, from across the various networks. Also, for the steadfast support of Jenny Sprince who has helped me process and attend to ‘the awful stuff’ in various places over the years: I would like to say thank you.

Janine Cherry-Swaine is a consultant psychotherapist in the NHS. Having originally trained as a child and adolescent psychotherapist, at the Tavistock Clinic, she later trained there as an organisational consultant. She consults to a variety of services and organisations in relation to workplace post incident response, as well as to organisations with respect to the impact of vicarious sexual trauma upon team and organisational effectiveness.

16-digit ORCID identifier is 0009-0008-0530-5053

 

References

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Word Count:  6,716

Abstract:

A traditional approach to mental health support alone is likely to be frustrated in places affected by CSE. It is my assertion that working across the system consultatively is the therapeutic intervention of choice to support those traumatised individuals who present the most complex problems and who have the greatest difficulty accessing services. Helping staff to understand that their uncomfortable feelings of shame, humiliation, confusion, rage and ‘awful stuff’ arises out of the work:  they form part of a projective parcel, originating in the abuse, which if left unpacked and unprocessed threatens the cohesion and well-being of individuals, services, and communities alike.