Motherhood Among Incest Survivors: Parenting Skills & Challenges

Child Abuse & Neglect, Vol. 19, No. 12, pp. 1423-1429, 1995
Copyright © 1995 Elsevier Science Ltd
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M O T H E R H O O D A M O N G INCEST SURVIVORS
TAMAR
COHEN
Meital-Israel Center for Treatment of Child Sexual Abuse, Jerusalem, Israel
Abstract--This is a preliminary report of an investigation of the maternal functioning of woman survivors of child
sexual abuse. One possible long-range consequence of child sexual abuse is its effect on the victim's future ideas
about parenting, as well as her functioning in this role. Clinicians have observed a multigenerational "transmission"
of this abuse, yet most empirical findings are insufficient in substantiating this notion. A study group of 26 mothers
who are adult survivors was compared with a control group of 28 mothers with no such abuse in their background.
Seven areas of parenting skills were investigated: role-image, objectivity, expectations, rapport, communication, limitsetting, and role-support. Significant differences were found on all seven scales, characterized by a tendency of the
study group to be less skillful in the maternal functioning than the control group. Particularly high differences were
found on the scales of role-support, communication, and role-image. Secrecy, shame, and self blame, so often associated
with this abuse, are offered as partial explanation of the study group's general undeveloped social skills. However,
other factors, such as age of onset and termination of the abuse, its severity as well as family dynamics and relationship,
may contribute to these results. Further research in this area is therefore needed. Meanwhile, therapists should pay
more attention to the maternal functioning of CSA survivors who are under their care.
Key Words---Child sexual abuse, Incest victims, Motherhood.
STUDIES OF THE future impact of child incestuous abuse show that women who were
victims experience a variety of difficulties. Among them are sexual dysfunctions and difficulties
in heterosexual relationships, low self-esteem, a propensity toward repeated victimization in
various forms, various psychiatric disorders including PTSS and dissociative disorder, and
antisocial behavior such as prostitution, delinquency, alcohol and drug abuse (Baisden &
Baisden, 1979; Gelinas, 1983; Herman, 1981; Meiselman, 1980; Silbert & Pines, 198l; Tsai,
Feldman-Summers, & Edgar, 1979).
One possible sequelae of childhood incest is its contribution to the victim's ideas about
parenthood, and consequently to the survivors' function in this role.
The paucity of a systematic inquiry into this area is indeed surprising since most professionals
tend to accept the probability that this form of child abuse effects a sizable segment of the
female population. Such an inquiry assumes even greater social importance when we consider
that in our society women still have almost exclusive responsibility for raising children.
Mothering might indeed prove to be a problematic consequence for the adult woman who
was a victim during their childhood, as can be inferred or surmised from the few existing
empirical studies. For example, reports on exposed cases of incest describe families in which
one or both parents were themselves victims of this abuse in their childhood. These reports
give the impression that incest may "pass" in families from one generation to the next, and
while intergenerational transmission of incest is not inevitable, a few clinicians attempted to
postulate a model of continuity of this abuse (Cohen, 1983; Gelinas, 1983; Kaufman, Peck, &
Presented at the 10th Congress of the International Society for the Prevention of Child Abuse and Neglect, Kuala
Lumpur, Malaysia, September 1994.
Received for publication February !, 1995; final revision received May 30, 1995; accepted June 1, 1995.
Reprint requests should be addressed to Tamar Cohen, Ed.D., 14 lbn Gabirol Street, Jerusalem, Israel, 92430.
1423
1424
T. Cohen
Tagniri, 1954; Lustig, Dresser, Spellman, & Murray, 1966). In addition, an incestuous background was found in mothers who exhibited other forms of child maltreatment or were at risk
of doing so (Cole & Wooleger, 1989; Cole, Wooleger, Power, & Smith, 1992; Egeland,
Jacobovitz, & Papatola, 1987; Goodwin, McCarthy, & Divasto, 1981; Newberger, Gremy,
Waternaux, & Newberger, 1993).
Accumulated clinical observations of mothers who were victims of incest and sexual abuse
point to several areas of difficulties in their maternal role: Gelinas observed that those mothers
find it difficult to provide an organizing dally structure for their children, and to sustain a
reasonable balance of discipline and affection (Gelinas, 1983). Herman reports that these
mothers show an inability to derive satisfaction from the maternal role and relates it to their
unrealistic standards and expectations (Herman, 1981). A heightened sense of responsibility,
hypervigilance, and inability to use support systems was observed as well (Cohen, 1987).
Clinicians suggest that these difficulties may tax the mother emotionally, thus hinder her ability
to cope with the " n o r m a l " demands of her children. These reports hold a general difficulty
that stems from their use of clinical observations, or the utilization of small samples drawn
from reported cases of child maltreatment. In both cases, the generalizability of the reported
findings to all mothers who were incest victims is questionable.
This preliminary investigation of mothers who were incest victims is an attempt to fill the
gap of knowledge and contribute to the understanding of the problem by addressing both the
issue of the sample base as well as that of objective, quantitative inquiry.
Sample
The subjects for this study consisted of 54 mothers. The focal group (N = 26) was drawn
from the total caseload at Meital Israeli Center for Treatment of Child Sexual Abuse. Meital
offers clinical therapeutic services to children an adolescents who were victims and their
families as well as to adult survivors, and operates regional activities in the three largest cities
in Israel. About half of its caseload (53% in 1993; 52% in 1992) are adult survivors, of which
73% were female. Twenty-eight clients at the middle stage of therapy were contacted, of which
26 agreed to participate.
A control group was drawn from among professionals in the community who attended
lectures on child sexual abuse. From the 30 willing to participate in the study, we collected
demographic information. Information about the possible existence of CSA among the control
group was collected as well, and revealed that of the 30 participants, 2 had experienced this
form of abuse. The two questionnaires were therefore excluded from the control group. We
have thus reached a control group consisting of 28 mothers with no incestuous background.
The data on the past sexual abuse among the focal group reveals that of the 26 mothers,
16 (61.5%) reported on consummated intercourse, sodomy, and oral sex. Nine of them (34.6%)
experienced various forms of molestation or simulation of sexual intercourse, and one woman
(3.9%) reported voyeurism and sexual exhibitionism. The average age at onset of sexual abuse
was 7 years and average age if its cessation was 14 years. The average age in the focal group
was 37.3 years and in the control group 42.4 years (standard deviation for the two groups was
7.3 and 9.5, respectively).
There was no difference in educational background between the two groups: 39% of the
mothers in the focal group held academic degrees, 54% graduated from high school, and 7%
had elementary education. Among the mothers in the control group, 52% had academic education and 43% completed high school.
Marital status was quite similar in both groups: In the focal group, 81% were married and
in the control group, 96% were married. Similarly, no differences were found between the
two groups in the socioeconomic status of the families of origin, or their parents' education.
Motherhood among incest survivors
1425
Measures
A. The measure used to determine maternal functioning was the Parenting Skills Inventory
(PSI). The PSI is a known tool developed by Nash (Nash & Morrison, 1984) for assessing
ordinary parenting skills. The questionnaire consists of 86 agree-disagree items that measure
self-reported feelings, attitudes, and behaviors descriptive of parenting skills. It is used for
assessment of parenting skills in seven areas:
I. Role Support (11 items): explores parental cohesiveness--agreement versus lack of
agreement between parents concerning the children, joint effort, cooperation, mutual support
and assistance versus rigid role expectations, noncooperation, cross-purpose, and lack of
shared responsibility.
2. Role Image (10 items): explores positive, self-assured, confident and enthusiastic perception
of self as a parent, versus negative, insecure-unsure, overwhelmed or exhausted perception,
colored by feelings of inadequacy, incompetence, failure, guilt and defensiveness.
3. Objectivity (11 items): measures balanced, "cool-headed," encouraging and reassuring
attitude versus fearful, over-involved, intrusive and overprotective approach to the child;
thus it explores the existence of a balanced perspective on the part of the parent toward
the child, which enables the child's independent problem solving an autonomy.
4. Expectations (11 items): This scale explores realistic, reasonable, fair, and democratic
expectations versus unrealistic, unreasonable, rigid-inflexible and autocratic expectations
for the child's age and level of development.
5. Rapport (14 items): This category explores the existence of mutual acceptance, warmth
and closeness between parent and child versus rejecting, unaccepting attitudes on the part
of the parent and the lack of rapport or closeness in the parent-child relationship.
6. Communication (10 items): This scale explores communication skills--the ability of the
parent to communicate in an open and direct manner, share positive or negative feelings,
listen with empathy and facilitate resolution of conflicts and problems versus an inability
or reluctance to share feelings, a tendency to be indirect and manipulative, poor listening
skills and alienating behavior.
7. Limit-Setting (19 items): This category explores the parent ability to set logical, influential,
consistent and effective limits and to structure appropriate consequences for "out of bound"
behavior versus an inability to secure the child's world by means of rules and limits and
an inability to follow through when the child "misbehaves."
These seven scales are relatively independent of each other and yield high internal reliability
scores. The questionnaire was translated from English to Hebrew by two independent professionals, then back to English by a third one.
B. Additional information was collected about both focal and control groups. This information,
also in the form of a questionnaire, included family background, present socioeconomic status,
as well as past existence of family violence, sexual, physical, or emotional abuse or neglect.
We have also collected specific information from the focal group about their past sexual abuse.
Administration
Clinical social workers, experienced in the field of child sexual abuse, administered the PSI
to the focal group, and collected the additional data. Information about the past sexual abuse
was obtained through a questionnaire and a structured interview. The average time for each
interview was two hours. A student in a graduate social work program administered the PSI
to the control group. Collection the data was spread over several months during 1992/1993.
1426
T. Cohen
Table 1. PSI Scales: Internal Reliability Coefficients: Means and Standard Deviations
Mothers with Incest
Background
Control Group
Eta
PSI Scale
KR-20
N
Mean Score
SD
N
Mean Score
SD
T
Square
Role Support
Role Image
Objectivity
Expectations
Rapport
Communication
Limit Setting
0.87
0.68
0.54
0.53
0.54
0.74
0.76
23
26
26
26
26
26
26
5.8
6.0
6.9
6.8
10.8
5.7
13.0
3.3
2.2
2.2
2.2
2.2
2.7
3.9
27
28
28
28
28
28
28
8.8
7.4
8.0
7.7
12.0
7.8
15.0
2.7
2.1
1.5
1.5
2.4
2.0
3.0
-3.6*
-2.4*
-2.1 *
- 1.7*
-I.8"
-3.2*
-2.1 *
21.3
9.9
8.0
5.3
5.9
16.6
8.1
*p < 0.05 (one-tailed test).
Statistical Analysis
A l l answers to the PSI questionnaire were c o d e d (value o f " 1 " was given to answers
expressing high, positive response and " 0 " to low level response). Internal reliability score
for each o f the seven scales was calculated, using KR-20.
The averages and SD o f each o f the seven scales was calculated for both the focal and
control group. A T-test for independent samples was then applied to each one o f the scales,
in order to determine t h e statistical significance o f the differences b e t w e e n the means o f the
two groups. Next, effect size o f the g r o u p ' s means for each scale was calculated using Eta
Square. In addition, and in order to establish that the results were not due to the age difference
found between the two groups, an A N C O V A was calculated for each scale. Finally, a Discriminant A n a l y s i s was carried out in order to estimate the j o i n t contribution o f all PSI scales to
the differentiation b e t w e e n the two groups, as well as to estimate the unique contribution o f
each one o f the scales.
RESULTS
The c o m p a r i s o n o f parenting skills show that mothers who were incest victims generally
function on a l o w e r level than mothers w h o d i d not experience this c h i l d h o o d trauma. The
m e a n scores o f PSI scales for both groups are presented in Table 1.
A s can be seen from this table, the m e a n score on each o f the seven scales a m o n g mothers
w h o were victims was l o w e r than that o f the control group, and these differences are statistically
significant. Large differences were found b e t w e e n the means o f the two groups on the scales
o f Role S u p p o r t and C o m m u n i c a t i o n . H o w e v e r one should be cautious in concluding that
Table 2. Standardized Discriminant
Function Coefficients of PSI Scales
PSI Scale
S.D.F. Coefficient
Role Support
Communication
Role Image
Rapport
Expectation
Limit Setting
Objectivity
0.68
0.64
0.42
-0.34
-0.13
-0. I 0
-0.09
Motherhood among incest survivors
1427
these two areas are affected more severely by the past trauma, than other areas, as this unusual
result may be partially due to differences in reliability of these seven scales (see Table 1: KR20 column).
Since there was a difference in the average age between the two groups, ANCOVA was
calculated on all seven scales, controlling the variable of mothers' age, but essentially the
same findings were obtained.
In light of these reported results, we wished to examine the contribution of PSI joint scores
to differentiate between the two groups. This was carried out by calculating Discriminate
Analysis (n = 50). The results of this calculation yields a Canoninal Correlation Coefficient
of .59 with statistical significance; X2 = 18.5; df = 7; p < .05. Further calculation of the
relative contribution of each PSI scale (Table 2) yields the following:
These results reaffirm the finding concerning the possible connection between past incestuous
abuse and future mothering skills.
An unusual finding worth mentioning is the high and negative direction found on the scale
of Rapport. A possible explanation is that mothers who were incest victims have intuitive
sensitivities and identifications with their child's feelings and needs.
DISCUSSION
The unfolding picture of this study suggests that mothers who were incest victims function
generally on a lower level than mothers who were not exposed to this trauma in their childhood.
It thus substantiates clinical reports, and adds to the few existing empirical studies.
Of special interest are the differential results obtained from the seven PSI scales: As can
be seen from Table 1, lower differences were found on the scales of Objectivity, Expectation
from Children, and Limit Setting. One may ponder that the parenting skills measured by these
three scales are more clearly defined by community standards and social expectations, thus
given to easier learning and internalization than the skills measured by the other PSI scales.
Indeed the general plight of women who were incest victims, and the specific difficulties
they experience as mothers may well be linked to the past abuse. Incest and child sexual abuse
is above all a betrayal of the child's trust, and as such it nlay hinder the victim's developing
ability to trust others. In addition, these mothers may experience a constant fear that their
children may also become victims, a fear which contributes to their seclusion. The past abuse
may thus inhibit the victims from enlisting the support of husbands and friends in sharing
child care responsibilities, leaving them overburdened and overextended with the unavoidable
result of physical as well as emotional depletion.
Future difficulties in the mothers' perceived role image which was evident in this study,
can also be traced to past sexual abuse and the family dynamics. Motherhood is, after all, not
only a biological act, but a socially learned role, the capacity for which is psychologically
developed through relational transaction within the family. (Benedek, 1959; Chodorow, 1978;
Welldon, 1988). Past parentification and especially mother-daughter role reversal and alienation
so prevalent among incestuous families, may contribute to a general distortion of the psychological capacities for mothering, and also to future unrealistic perception and expectations regarding this role.
Communication skills may be adversely affected by the past sexual abuse and specifically
linked to its secretive nature: The ensuing subjective experiences of the child victim are ones
of isolation, inadequacy and guilt over the past abuse, and the grown woman may continue
to feel responsible for its past occurrence--as well as its continuation long after its cessation.
The resulting reluctance, shame and fear to share her past abuse, coupled with "learned
submissiveness" in her family of origin, may well interfere with her developing ability to
1428
T. Cohen
communicate freely and openly, thus constrict her capacity in general, and eventually hinder
open and spontaneous expression of feelings towards her children.
Critic and Implication
This study addressed the question o f the relationship o f present motherhood to past incestuous
abuse. The findings which were presented are very preliminary indeed, yet suggest that the
effects of this abuse may hinder the victim's future capacities for motherhood, and that the
long range consequences o f incest and child sexual abuse may thus prove to last 1 0 - 1 5 years.
H o w e v e r the results which are reported should be considered with some caution: First, the
sample base of the focal group consisted o f w o m e n who sought therapeutic help regarding
their past abuse. A comparison of mothering among clinical group with a nonclinical group
of mothers who were incest victims is necessary. An even better design would be a nonclinical
sample drawn randomly from the community where those women with abuse histories were
compared with w o m e n without abuse in their past. Another possible control group might be
a clinical group with no history o f abuse. We may be seeing an effect due solely to the
women feeling insecure about their mothering due to mental health issues independent of
abuse histories.
Secondly, a more refined PSI tool, with higher reliability score is needed to validate the
findings. O f special importance is an inquiry and a careful analysis of the differential effects
and contribution of the various elements o f the past abuse to future maternal functioning.
Other mediating variables should be studied as well.
Mothers who were incestuously abused are nonetheless concerned and extremely sensitive
to the needs and feelings o f their children. The deficiency in their parental skills requires the
development o f specific programs: A cognitive guidance program that emphasizes children's
normative stages o f development seems appropriate. Such a program should also include
learning of acceptable parental responses to the child and techniques that will strengthen
mother-child relationship.
REFERENCES
Baisden, M. J., & Baisden, J. (1979). A profile of women who seek counseling for sexual dysfunction. American
Journal of Family Therapy, 7, 68-76.
Benedek, T. (1959). Parenthood as a developmental phase. Journal of American Psychoanalytic Association, 7, 389417.
Chodorow, N. (1978). The reproduction of mothering: Psychoanalysis and the sociology of gender. Berkeley, CA:
University of California Press.
Cohen, T. (1983). The incestuous family revisited. Social Casework, 64, 154-161.
Cohen, T. (1987). Experiences of motherhood among women who were victims of childhood incest. Doctoral Dissertation, University of Michigan, Ann Arbor, MI.
Cole, P. M., & Wooleger, C. (1989). Incest survivors: The relation of their perceptions of their parents and their own
parenting attitudes. Child Abuse & Neglect, 13, 409-416.
Cole, P. M., Wooleger, C., Power, T. G., & Smith, K. D. (1992). Parenting difficulties among adult survivors of
father-daughter incest. Child Abuse & Neglect, 16, 239-249.
Egeland, B., Jacobovitz, D., & Papatola, K. (1987). Intergenerational continuity of abuse. In J. Lancaster & R. Gelles
(Eds.), Biosocial aspects of child abuse. New York: Jossey-Bass.
Gelinas, D. J. (1983). The persisting negative effects of incest. Psychiatry, 46, 312-332.
Goodwin, J., McCarthy, T., & Divasto, P. (1981). Prior incest in mothers of abused children. Child Abuse & Neglect,
5, 87-95.
Herman, J. (1981). Father-daughter incest. Cambridge, MA: Harvard University Press.
Kaufman, I., Peck, A. L., & Tagniri, C. K. (1954). Family constellation and overt incestuous relation between father
and daughter. American Journal of Orthopsychiatry, XXIV, 266-277.
Lustig, N., Dresser, J. W., Spellrnan, S. W., & Murray, T. B. (1966). Incest: A family group survival pattern. Archives
of General Psychiatry, 14, 31-40.
Motherhood among incest survivors
1429
Meiselman, K. C. (1980). Personality characteristics of incest history in psychotherapy patients: A research note.
Archives of Sexual Behavior, 9(3), 195-197.
Nash, L., & Morrison, W. L. (1984). Manual for the parenting skills inventory. Seattle, WA: Parenting Press.
Newberger, C. M., Gremy, I. M., Waternaux, C. M., & Newberger, E. H. (1993). Mothers of sexually abused children:
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Silbert, M. H., & Pines, A. M. (1981). Sexual child abuse as an antecedent to prostitution. Child Abuse & Neglect,
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Tsai, M., Feldman-Summers, S., & Edgar, M. (1979). Childhood molestation: Variables related to differential impacts
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R6sum6----Cet article donne un rapport pr61iminaire sur une enqu~te aupr~s de femmes agress6es sexuellement durant
leur enfance, afin de voir comment elles fonctionnent aujourd'hui dans ieur r61e maternel. On estime qu'h long terme,
ces agressions affectent la faqon dont les victimes envisagent leur r61e maternel et leurs capacitEs en ce sens. Les
cliniciens ont observe que ces agressions semblent se transmettre de gEn6ration en gEnEration pourtant les constats
empiriques n'appuient pas cette notion. L'Etude a compar6 28 m~res non abus6es et 26 m~res survivantes d'agressions
sexuelles en enfance, selon sept aspects de la comp&ence maternelle : I'image que les m~res se font du ce r61e,
l'objectivitE, les attentes, la capacitE d'Etablir une relation, la communication, la capacitE de poser des limites
l'enfant, et l'appui du r61e. Pour chacun de ces aspects, on a remarquE des differences importantes, h savoir que les
m~res agress6es Etaient moins dou6es en temps que parents, principalement Iorsqu'il s'agissait du support dans le
r61e, de la communication et de l'image du r61e. Ceci peut s'expliquer en partie par certaines conditions entourant
les agressions, soit son aspect secret, la honte et le bl~rne de soi--traits typiques du phEnom~ne des agressions
sexuelles. Toutefois, d'autres facteurs pourraient jouer : I'~ge o/l les agressions ont commence, l'age ou elles se sont
terminEes, leur gravit6, la dynamique familiale et la qualit6 des relations entre les membres de la famille. I1 faut
davantage pousser les recherches, et entre temps, pr&er attention aux capacit6s matemelles des fammes jadis agress6es.
Resumen--Este es un informe preliminar de una investigaci6n sobre el funcionamiento materno de mujeres que
fueron vfctimas de abuso sexual en la infancia. Una posible consecuencia a largo plazo del abuso sexual infantil es
su efecto en las futuras ideas de las vfctimas acerca de la maternidad, asf como su funcionamiento en este papel. Los
clfnicos ban observado una "transmisi6n" intergeneracional de este maltrato, a pesar de que la mayoria de los
hallazgos empfricos son insuficientes en la comprobaci6n de este concepto. Un grupo de estudio de 26 madres que
fueron vfctimas de abuso sexual en la infancia fueron comparadas con un grupo control de 28 madres sin tal abuso
sexual en su historia personal. Se investigaron siete ~treas de sus habilidades parentales: autoimagen del propio rol,
objetividad, expectitivas, compenetraci6n, comunicaci6n, establecimiento de lfmites y apoyo en el rol matemo. Se
hailaron diferencias significativas en las siete escalas, caracterizadas pot una tendencia de las madres del grupo de
estudio a ser menos h~ibiles que las del grupo control en el funcionamiento materno. Particularmente, las diferencias
mils altas se encontraron en las escalas de apoyo en el rol matemo, comunicaci6n y apoyo en el rol matemo. El
secretismo, la vergtienza y la autoinculpaci6n, tan a menudo asociadas con este tipo de maltrato, son ofrecidas como
explicaci6n parcial de la falta de desarrollo general de las habilidades sociales en el grupo de estudio. Sin embargo,
otros factores, como la edad de aparici6n y terminaci6n del abuso, su severidad, asf como la din~imica y ias relaciones
familiares, pueden contribuir a estos resultados. Pot tanto, se necesita investigaci6n adicional en este :imbito. Entretanto,
los terapeutas deben asignar m~is atenci6n al funcionamiento materao de las vfctimas de abuso sexual infantil que se
encuentren bajo su atenci6n.