abuse – UAB Institute for Human Rights Blog

Marriage, Inequality, and Human Rights: Rethinking a Cultural Norm 

As a philosophy student, I find the debate around marriage fascinating because it’s something almost everyone has personal experience with—whether through their own relationships, family, or society at large. On the surface, marriage might seem like a simple institution built on love and commitment, but when we dig deeper, we start to see cracks in its foundation. 

Marriage has long been regarded as a cornerstone of social life, providing structure for intimate relationships, legal benefits, and a framework for raising children. But as legal scholars and human rights advocates have increasingly pointed out, marriage also functions as a gatekeeper to economic security, legal protections, and social recognition—and it does not serve everyone equally. This raises serious ethical questions: Does marriage reinforce systemic inequality, particularly for women and non-traditional families? Is it time to reform, replace, or abandon it altogether? In this blog, we’ll explore three contemporary philosophical arguments about marriage and their implications for justice and human rights. 

Susan Okin: Marriage Makes Women Vulnerable

Susan Okin argues that marriage, as it exists today, creates and reinforces gender-based vulnerabilities, particularly for women. In Vulnerability by Marriage, she explores how society expects women to take on most of the caregiving responsibilities, which leads to an unfair division of labor both at home and in the workplace.  

According to the American Time Use Survey by the U.S. Bureau of Labor Statistics, in 2022, women spent an average of 2.4 hours per day on household activities, compared to 1.5 hours for men. Women were also far more likely to provide unpaid caregiving for children and elderly family members. Even in so-called egalitarian households, studies show that men’s careers tend to take priority, affecting decisions about where to live and how to divide time and resources. 

A woman overwhelmed during a tense office meeting. Her head is down and people are yelling at her. — Image 2: An overwhelming woman in a workplace. Source: Yahoo Images.

These patterns have real economic consequences. Women who step back from paid work to care for children often experience long-term wage penalties and loss of retirement savings. After divorce, the gender wealth gap becomes even more stark. A report from the U.S. Government Accountability Office found that women’s household income fell by 41% after divorce, compared to just 23% for men. 

Okin’s critique points to a larger human rights issue: economic dependency can limit women’s autonomy and political participation. Without systemic support, such as paid parental leave, subsidized childcare, or equitable divorce laws, marriage remains a structural disadvantage for many women. 

Laurie Shrage: Should the State Be Involved in Marriage at All?

In her piece, The End of Marriage, Laurie Shrage takes Okin’s critique even further. Rather than just reforming marriage to be more equitable, she questions the role of the State in structuring intimate relationships. Shrage argues that marriage, as a state-sanctioned institution, provides legal and social privileges to some relationships while marginalizing others. If you’re married, you get tax breaks, easier access to healthcare, and legal rights over your partner’s well-being. But what about people in non-traditional relationships, cohabiting partners, or polyamorous families that don’t fit into the legal mold? 

Consider this: The U.S. Government Accountability Office identified 1,138 federal statutory provisions in which marital status is a factor in determining benefits, rights, and privileges. But for unmarried partners—even those in long-term caregiving relationships—those same protections are often unavailable. This creates a system of legal exclusion that disproportionately affects LGBTQ+ individuals, lower-income families, and those outside traditional family structures. 

Shrage does not argue that the state should entirely remove itself from intimate relationships. Instead, she believes the law should be restructured so that protections and benefits are not solely tied to marriage. Instead of privileging marriage, we could develop alternative legal structures that support all kinds of caregiving relationships without requiring people to fit into a specific mold. Some states have made attempts to implement this. For instance, Colorado’s Designated Beneficiary Agreements allow individuals to assign rights such as hospital visitation or inheritance without marriage. Yet these reforms are patchwork and often limited in scope. 

Scissors cutting through a marriage contract — Image 3: Restructuring the Institute of Marriage. Source: Yahoo Images.

Shrage’s argument forces us to rethink what marriage actually does. If it’s primarily about securing legal and financial benefits, then why should it be tied to romantic relationships at all? Shouldn’t anyone be able to create binding legal partnerships that reflect their chosen family structures? Shrage proposes an alternative: decoupling legal benefits from marital status. Legal agreements could allow individuals to designate financial partners, medical proxies, or co-parents without needing a state-sanctioned marriage. By ensuring equal access to legal protections regardless of relationship type, we could create a system that better serves the diverse ways people build their lives together. 

Claudia Card: Tear It All Down

While Okin and Shrage suggest ways to reform or restructure marriage, Claudia Card takes a more radical approach in Against Marriage and Motherhood. She argues that marriage is not merely flawed but fundamentally coercive—and often serves as a mechanism for control and abuse. 

One of Card’s most powerful arguments is that marriage can trap individuals in violent or exploitative relationships. Because marriage is a legal contract that binds two people together, leaving an abusive marriage often requires legal intervention—something that can be expensive, slow, and emotionally exhausting. According to the National Intimate Partner and Sexual Violence Survey by the CDC, 1 in 4 women and 1 in 9 men have experienced severe intimate partner violence. Due to financial dependency and legal entanglement, many people find it difficult to leave abusive marriages. A 2020 study by the Institute for Women’s Policy Research found that economic abuse, like controlling access to money or employment, was a key barrier to leaving. In many cases, the legal system inadvertently works to sustain abusive relationships by making it harder for the abused partner to leave, which is the fundamental reason why Card believes marriage, in any form, is beyond repair.   

A sad child looks at the camera as her distressed parents sit behind her — Image 4: A visual representation of the harms marriage can bring. Source: Yahoo Images.

Additionally, Card critiques the cultural glorification of motherhood. While motherhood is often idealized, mothers in the U.S. face one of the highest unpaid caregiving burdens in the developed world. The U.S. is the only wealthy country without guaranteed paid maternity leave. Women, especially single mothers, are left to shoulder the costs of caregiving without adequate support, leading to heightened rates of poverty, stress, and burnout. 

Card’s radical proposal—to abolish marriage as a legal institution—calls for building new social structures based on mutual care and autonomy rather than control and dependency. From a human rights standpoint, her argument challenges us to rethink whether any institution should have the power to limit freedom, security, or self-determination.

Where Do We Go From Here?

In philosophy, we often come back to the same fundamental question: Should we work within the system to make it more just, or should we tear it down and start over? Okin, Shrage, and Card each offer different visions for the future of marriage, but they all agree on one thing—the way things are now isn’t working. 

At its core, the debate about marriage is a human rights issue. Who gets access to economic security, legal protections, and social recognition—and at what cost? And marriage laws don’t just reinforce inequality for adults; they also impact vulnerable populations in ways we rarely acknowledge. For example, child marriage remains legal in parts of the U.S.—a reality that raises serious ethical concerns. 

Our three authors all highlight different ways in which marriage has historically marginalized certain groups, particularly women, and ask us to consider alternative frameworks that promote justice and equality. Whether through reforming marriage, removing state involvement, or abandoning it altogether, the goal should be to ensure that all individuals—regardless of their relationship status—have equal rights, protection, and autonomy. As we continue to challenge traditional norms, we must prioritize human dignity, fairness, and inclusivity in the ways we structure relationships and social institutions. 

Group Homes for People with Disabilities are Harbors for Abuse

By James DeLano

“I don’t feel safe here.”

That statement was uttered repeatedly in interviews performed by the Alabama Disabilities Advocacy Program (ADAP) with residents of Sequel Courtland, a psychiatric group home for boys in Courtland, AL. The residents of the home reported consistent patterns of abuse. One boy “reported witnessing a staff member lifting another resident up by the throat and slamming him to the floor.” Multiple boys reported being slammed into the ground and not being allowed to receive medical attention.

Sequel Courtland is a facility for boys. At the time the letter was sent in July 2020, there were “at least two transgender girls inappropriately placed at Courtland,” one of whom reported that she “is constantly touched, smacked on the butt” and that “they [other residents] try to watch me dress.”

At a Sequel facility in Owens Cross Roads that was part of the same investigation, “male staff repeatedly enter girls’ bedrooms and put them in violent containments.” At the same facility, residents were frequently ordered to sleep in common areas rather than in their bedrooms as a punishment. Staff also failed to report or make any attempt to prevent suicide attempts.

Sequel Montgomery practiced “Group Ignorance” as a punishment. Group Ignorance, or GI, involved staff and other residents completely ignoring the person being punished. The isolated person was unable to interact with peers in any way; just being within ten feet of another resident would be considered a violation. The facility’s then-current guidelines read that “They can participate with peers only during direct billable services—BLS and therapist-led group therapy.” One resident reported attempting suicide specifically because of the stress of being isolated under GI.

Sequel Tuskegee utilized a “time-out room” for up to days at a time as a means of controlling residents. There was no mattress present in the room; boys were required to move the mat from their bedroom into the confinement area. It also lacked a toilet or sink. Because of that, residents were forced to either try – and often fail – to gain staff’s attention to use the restroom or, failing that, “urinate in the corner of the room and clean it up later.”

A Sequel group home in Ohio was also investigated by that state’s protection & advocacy (P&A) agency, Disability Rights Ohio. They reported that one of the children living at that home told them he was “Put in a hold so strong that it almost broke my arm; they kept holding me tighter and tighter; my hands and arms were tingling and going numb.” Another said, “I don’t feel safe.”

Abusive group homes are not exclusive to Sequel. Group homes are often abusive, no matter what company owns them.

At a residential facility called Canyon Hills Treatment Facility in North Carolina, “at least one-third of residents lost weight after they were admitted for treatment.” Canyon Hills’ residents were children who should still have been growing. When residents asked for more food, their portions were cut even further. At another facility in North Carolina called Anderson Health Services, “Ten staffers at this facility have been charged with child abuse since 2017.”

At a group home in California, a woman with severe autism often went out on rides in the home’s van. She occasionally tried to stand up, after which “the staff member driving would slam on the brakes and, like, brake check her.” That practice caused bruises. The same woman, who had harmed herself in the past, was frequently left alone and unsupervised, during which time she banged her head into the wall, leaving large holes in the process.

Neglect in Group Homes

Many group homes are chronically understaffed. That, along with low pay and a lack of care from and proper training for staff, collectively leads to preventable injuries and death.

A woman choked to death at a New Jersey group home in 2017. She was unable to swallow large pieces of food; everything needed to be in small pieces, and she required supervision while eating. Two years prior, she had been taken to the hospital after choking on a bagel – an incident her family was never told about.

As a result of poor staffing, a resident of an Oklahoma group home named Terry Brown was strangled by his roommate. There was only one staff member on duty; when she intervened, she was attacked as well and “watched Terry’s body turn purple, go limp and fall lifeless.” At a group home owned by the same company, a resident drowned in 2011 on an outing. He was supposed to be wearing a life jacket. When he died, there was no life jacket for him to wear.

One Texas caregiver worked for almost 70 hours straight while caring for two disabled women; her only breaks were a short nap and a trip to run errands. She is the only caregiver for two women who require constant care and supervision. She was clocked in from 8:16 Tuesday morning to 10:08 Friday morning, and only four hours after clocking out she returned for another 19-hour shift. She said that, “I’m always here. The only thing I do for fun — besides sleep — is go to church, read my Bible, hang out with my family.” The only occasional help she has comes from equally understaffed and exhausted workers at other group homes. For her work – providing constant, necessary care to two people – she makes $9 per hour, which is a wage that is not uncommonly low and serves as one of many reasons group homes are so often neglectful.

At the previously mentioned Sequel group home in Courtland, Alabama, ADAP investigators found blood and feces on windows and floors. The same investigation had residents report insufficient and inadequate food and water, nonexistent education and medical treatment, and that “there’s mold in the showers, and rats and roaches in our bedrooms and the hallway.”

Physical and Chemical Restraint

Mental healthcare professionals generally agree that restraining someone who is in crisis only makes things worse. Many group homes do it anyway.

As part of the previously mentioned investigation into Sequel facilities in Alabama, numerous instances of inappropriate restraint were reported. A report compiling the results of several investigations by various state Protection & Advocacy Agencies (P&As) reads about an Alabama group home, “One boy described his head being caught on a nail in the wall during a restraint; another said he was picked up and slammed on his stomach onto the concrete. A boy who had visible gashes to his head said that facility staff had slammed him against a wall the previous night.”

In 2020, a 16-year-old boy was physically restrained by several staff members at a Sequel facility in Kalamazoo, Michigan, for twelve minutes. They used their body weight to restrain his torso and legs. He died two days later due to being asphyxiated while he was restrained. His name was Cornelius Frederick. In the 18 months preceding his death, emergency services visited the facility 237 times.

A group home in Carlton Palms, Florida has yet another pattern of restraints being used. Those restraints include cuffs, residents being strapped to chairs or being tied down, and straitjackets. These restraints directly cause physical harm – broken bones, bruises, and broken teeth, to name a few.

A box of Seroquel in front of a laptop. Source: Wikimedia Commons

Seroquel is an antipsychotic drug that is approved by the FDA to treat some severe mental illnesses. Seroquel does not have an immediate effect. It is not approved as a form of chemical restraint or as a treatment for insomnia or anger management, among other off-label uses, but that is what it has been marketed and used for. Disability Rights Tennessee, the P&A agency in Tennessee, reported that “In one facility, staff increased a child’s Seroquel dosage from 50 mg to 300 mg as an emergency intervention.” The same problems occurred in North Carolina; “staff had administered Seroquel numerous times to a child who did not have any diagnoses that would indicate use of antipsychotics.”

What Is Being Done?

Several of the group homes mentioned above have shut down since investigations into them concluded, including some Sequel group homes. Sequel changed its homes’ names to Brighter Path due to the negative press. In other cases, states have stopped sending children to abusive group homes or, rarely, revoked their licenses. Other group homes, while not yet shut down, are no longer receiving new residents or are being downsized.

Anti-Trafficking Day on November 18

It has been estimated that each year 600,000 to 800,000 men, women, and children are trafficked across international borders. November 18 was established as Anti-trafficking day by the European parliament. This day is used as an opportunity to spread and raise awareness to prevent and combat human trafficking. Human trafficking is a “crime that involves compelling or coercing a person to provide labor or services or to engage in commercial sex acts.” Any person can be a victim of human trafficking. Human trafficking is a “global problem and one of the world’s most shameful crimes.” It affects the lives of millions while also “robbing them of their dignity.” The most known form of trafficking is for the purpose of sexual exploitation, but many other victims are trafficked for the purpose of forced labor, domestic slavery, child begging, or the removal of their organs. Every country is affected by human trafficking, it is important to understand why and how this happens, and the ways to prevent it or recognize the signs.

What is Human Trafficking?

There is no single profile or defining characteristics of a trafficking victim. Victims include men, women, and children from any age and any background. Traffickers are known to often prey on individuals that come from low socioeconomic statuses. They target victims who are poor, vulnerable, in search for a better life, or are living in an unsafe or unstable situation. Trafficking victims are misled by “false promises of love, a good job, or a stable life.” They are forced into scenarios where they are forced to work under terrible conditions with little to no pay. In Birmingham, Alabama, human trafficking is a major issue. The interstate I-20 is the “most heavily trafficked stretch of interstate in the U.S.” The 140-mile road between Birmingham and Atlanta is been known as the ‘sex trafficking superhighway.’ Additionally, the intersection of I-20, I-59, and I-65 makes the city of Birmingham a central exchange for trafficking activity.

Graphic explaining what human trafficking is in the United States — Yahoo Images

Traffickers use different methods and resources to get their victims. Physical force, threats, psychological manipulation are mostly used. Newsome Law points out that there are two general ways traffickers are able to attain victims. First, victims are lured in. Traffickers will go to the lengths to “put up a ruse that their intended victim buys into.” They will make false promises, present desired relationships, large paycheck, or another prize that will seem worthwhile. These prizes are fake, they are just used to gain attraction and attention. In some cases, it’s found that the trafficker will play along to make it believable until they have the victim with them. Secondly, another way victims are recruited is through force and coercion. Some traffickers will use threats of physical harm or actually use physical violence to get their victims. They will use weapons of physical restraints to grab the victim off the street. Tactics of threats, violence, drugging are very commonly used with either method whether they are trying to capture the victim or when they already have the victim.

Who is most at risk?

Human trafficking is important for an array of reasons. First, in the United States, some of the most vulnerable populations include people within marginalized groups. These include “American Indian/Alaska Native communities, LGBTQ+ individuals, individuals with disabilities, undocumented migrants, runaway and homeless youth, temporary guest-workers, and low-income individuals.” These conditions make these communities and individuals more at risk than they already are.

As pointed out, there is not a clear picture of who and what type of person is most at risk. Human trafficking can happen to anyone, but there are some who are more vulnerable than others.

An article by BhamNow suggested several risk factors:

Those involved in the DHR system
Those placed in foster or group homes
Those with limited adult supervision
Those with a history of trauma (including being taken from your own home which is traumatic)
Those with a history of sexual and/or physical abuse
Runaways / homeless youth
Those suffering from substance abuse or with a family history of substance abuse
Young women who learn that their body is something they can use for money
Young men who are taught not to talk about abuse
Queer and trans youth are also vulnerable because they often experience rejection by their families, churches, schools, and communities

What is being done to limit it

With human trafficking being a global problem, many countries and organizations have been developing tactics to prevent and protect victims from being trafficked, while also prosecuting those who traffic. In 2017, the Department of State and Labor and the U.S. Agency for International Development handles a total of 120 international counter-human-trafficking projects among 40 countries. Their projects had three goals: to prevent, protect, and prosecute. They prevented trafficking through public awareness, outreach, education, and advocacy campaigns. They protected and assisted victims “by providing shelters as well as health, psychological, legal, and vocational services. Lastly, they prosecuted human trafficking by providing resources such as training and technical assistance for police, prosecutors, and judges.

Other organizations such as the United Nations (UN) uses similar tactics to prevent, protect, and prosecute when trying to limit human trafficking. The UN started a global project called Start Freedom. This project aims to “engage and raise awareness among young people.” It empowers young people to know the signs of human trafficking and how they can prevent it from happening to them. Both projects have a common conclusion that the best way to avoid being trafficked is through education and knowing the signs.

What can we do?

It is vital to spread awareness and learn about all the risks involving human trafficking and what to do if you are being trafficked or have reason to believe someone is being trafficked.

Signs of Human Trafficking:

The National Human Trafficking Hotline provides a list to recognize if you are being trafficked or if you believe someone else is being trafficked.

How traffickers Lure people in:

A would-be employer refuses to give workers a signed contract or asks them to sign a contract in a language they can’t read.
A would-be employer collects fees from a potential worker for the “opportunity” to work in a particular job.
A friend, family member, co-worker, or student is newly showered with gifts or money or otherwise becomes involved in an overwhelming, fast-moving, and asymmetric (e.g., large difference in age or financial status) romantic relationship.
A friend, family member, or student is a frequent runaway and maybe staying with someone who is not their parent or guardian.
A family member, friend, co-worker, or student is developing a relationship that seems too close with someone they know solely on social media.
A family member, friend, or student lives with a parent or guardian and shows signs of abuse.
A family member, friend, or co-worker is offered a job opportunity that seems too good to be true.
A family member, friend, or co-worker is recruited for an opportunity that requires them to move far away, but their recruiter or prospective employer avoids answering their questions or is reluctant to provide detailed information about the job.

Recognizing Labor Trafficking:

Feel pressured by their employer to stay in a job or situation they want to leave
Owe money to an employer or recruiter or are not being paid what they were promised or are owed
Do not have control of their passport or other identity documents
Are living and working in isolated conditions, largely cut off from interaction with others or support systems
Appear to be monitored by another person when talking or interacting with others
Are being threatened by their boss with deportation or other harm
Are working in dangerous conditions without proper safety gear, training, adequate breaks, or other protections
Are living in dangerous, overcrowded, or inhumane conditions provided by an employer

Recognizing Sex Trafficking:

Want to stop participating in commercial sex but feel scared or unable to leave the situation.
Disclose that they were reluctant to engage in commercial sex but that someone pressured them into it.
Live where they work or are transported by guards between home and workplace.
Are children who live with or are dependent on a family member with a substance use problem or who is abusive.
Have a “pimp” or “manager” in the commercial sex industry.
Work in an industry where it may be common to be pressured into performing sex acts for money, such as a strip club, illicit cantina, go-go bar, or illicit massage business.
Have a controlling parent, guardian, romantic partner, or “sponsor” who will not allow them to meet or speak with anyone alone or who monitors their movements, spending, or communications.

People to contact:

If you think someone is being trafficked contact:

The National Human Traffic

king Hotline: Call 1-888-373-7888 or text 233733

Call 911

U.S. Government Trafficking-Related Links:

OFFICE OF REFUGEE RESETTLEMENT TRAFFICKING EFFORTS
http://www.acf.hhs.gov/programs/orr/programs/anti_trafficking.htm

OFFICE FOR VICTIMS OF CRIME TRAFFICKING EFFORTS
http://www.ojp.usdoj.gov/ovc/help/tip.htm

PTSD is Not Just for Veterans; It’s A Trauma Disorder

by Marie Miguel

Some people believe that PTSD is only a mental health condition that affects those who have come back from war, but this isn’t the case. People who have Post Traumatic Stress Disorder aren’t just veterans. Individuals with PTSD have experienced severe trauma. It’s not only people that come back from combat, but that’s how many of us associate the disorder. PTSD can happen to anybody who experiences trauma such as a sexual assault, a natural disaster, or many things that would prompt someone to have a traumatic reaction, so let’s stop talking about PTSD as though it’s something that only war veterans experience. Anyone who has been through a traumatic experience can develop PTSD. According to the National Alliance on Mental Illness (NAMI), PTSD affects 3.5% of the U.S. adult population. That works out to eight million American people living with the condition. Approximately 37% of people diagnosed with PTSD display serious symptoms. Women have higher rates than men. Later in this article, we’ll discuss the gender divide.

What is Post Traumatic Stress Syndrome?

Post Traumatic Stress Syndrome happens after a person experiences trauma, and it’s something that sticks with a person. Symptoms can include flashbacks, night sweats, insomnia, panic attacks, and isolating from friends and family. We need to understand that people with PTSD aren’t dramatic; they’re traumatized. When you experience trauma first-hand it changes your brain. According to the U.S. National Library of Medicine – National Institutes of Health, Several areas of the brain are involved when a person experiences PTSD. A stress response includes the amygdala, hippocampus, as well as the prefrontal cortex. PTSD and trauma can cause lasting changes in those areas of the brain.

What causes PTSD?

The cause of PTSD is that a person experiences trauma and never adequately deals with the issues because it sticks with them. People think that PTSD is caused by being in combat because combat can be a traumatic experience, especially if you see someone die in front of you. The cause of PTSD is when an individual has difficulty adjusting after a traumatic event; their brain changes and the memory of the traumatic event gets stuck in their brain. These intrusive memories make it difficult for an individual to function. The root cause of PTSD is a traumatic event, but the symptoms are what overwhelm people to the point where it’s diagnosable. People with PTSD often have recurring distressing and upsetting memories of the trauma, and when you continually have upsetting memories and can’t stop them, it makes you want to shut down, which is a problem that many people face when living with PTSD, and it can seriously impact your relationships.

Causes of PTSD

A stressful experience
Trauma
Mental Illness
Predisposition to mental illness or family history of mental illness

Risk factors for PTSD:

Long lasting trauma
Childhood sexual abuse
Other childhood trauma
A job where you’re exposed to trauma such as a military position
If you don’t have a sound support system
Seeing someone get hurt
A history of substance abuse

Types of trauma

When we think of PTSD, we might think of combat, but it’s not just that. Anyone who has experienced trauma is at risk of developing PTSD. Whether you witnessed a violent act or you were physically attacked yourself, you’re at risk for PTSD. In addition to combat, types of trauma that can induce PTSD include but aren’t limited to:

Childhood sexual abuse
Other childhood trauma
Sexual assault or violence
Physical assault
Natural disaster
Being attacked with a weapon

Symptoms of PTSD

Symptoms of PTSD can range from mood symptoms to physical symptoms. These symptoms can include but aren’t limited to nightmares, irritability, being easily startled or frightened, trouble sleeping or concentrating, or even feeling completely emotionally numb. These symptoms occur after a traumatic event and are only some of the possible signs that an individual could experience. Everyone reacts to trauma differently. And it’s understandable that someone may shut down, lash out, or break down crying. These are all responses that could happen.

How intense are your symptoms?

Depending on the person, the intensity and type of PTSD symptoms will differ. If you have suicidal thoughts or ideation, it’s incredibly crucial to reach out to a friend, loved one, or to contact the national suicide prevention hotline (1-800-273-8255 or 1-800-273-TALK in the United States.) It’s essential that you talk to your doctor if you’re experiencing difficulty functioning.

Complications of PTSD

PTSD can impair someone’s function to the point where they’re unable to engage in normal life activities. Someone might develop substance abuse issues, an eating disorder, or other comorbid mental health conditions. PTSD can be debilitating. It can lead people into a state where they can’t work. It can make it so that they’re unable to attend social functions, and it can severely impact a person’s life. If you’re diagnosed with PTSD, you need to have the following symptoms:

One avoidance symptom – Avoidance is where you’ll stay away from things that remind you of the trauma. Avoidance symptoms include avoiding places and situations that remind you of the trauma, and avoiding thinking about upsetting thoughts connected to the event

At least two arousal symptoms– Arousal symptoms of PTSD make a person extremely anxious. Arousal symptoms include:

Getting startled easily
Feeling tense
Having problems sleeping
Angry outbursts

At least two cognition/mood symptoms – Cognitive symptoms of PTSD can rob people of things they once enjoyed. Cognitive symptoms include difficulty remembering the trauma, distorted emotions including guilt, and loss of interest things you once enjoyed

One re-experiencing symptom – Re-experiencing a key marker of PTSD, and it sounds exactly like what it is; re-experiencing. Re-experiencing symptoms include flashbacks or reliving the trauma, nightmares, or scary thoughts.

a lone little boy sitting on a platform — Source: John Smith, Creative Commons

Children vs. Adults With PTSD

Children can have different responses to trauma in comparison to adults. They might wet the bed or have selective mutism, they might start acting out during play time, or they might begin experiencing separation anxiety. According to the National PTSD center, seven or eight out of every 100 people experience PTSD at some point during their life. Not every person who has PTSD has been through a dangerous incident; some people experience it after a loved one has suffered harm.

According to The U.S Department of Veteran Affairs Studies, approximately 15% to 43% of girls and 14% to 43% of boys experience significant trauma. Of the children and teens that experience trauma, 3% to 15% of girls and 1% to 6% of boys go on to develop Post Traumatic Stress Syndrome.

We can see that females seem to develop PTSD more than men do. What is the reason for this? Many women are survivors are sexual assault, try to speak up and aren’t believed. According to the National Sexual Assault Resource Center, one in five women and one in 71 men will be raped at any given point during their lives. Yet, we as a society do not believe survivors as we should. We need to start believing women when they come forward. When we do they can get treated for what happened to them appropriately.

Why do some people get PTSD and others don’t?

You may be wondering why some people develop PTSD while others do not. Part of it has to do with having the risk factors listed above, but there’s nothing wrong with you if you have PTSD and someone else in the same situation did not. There are other disorders that can go along with PTSD. An individual with PTSD can have additional mental health conditions. They may also struggle with suicidal ideation and may attempt to take their life. Here are some mental health conditions that people with PTSD also manage:

Generalized Anxiety Disorder
OCD
Depression
Borderline Personality Disorder
Substance Abuse

How to prevent PTSD

PTSD isn’t necessarily preventable because you can’t control when trauma happens, but you can deal with the trauma after it happens. After experiencing a traumatic event, it’s vital to seek mental health treatment in the form of therapy and, if you need to, a psychiatrist. You can reach out to people in your network and find someone to treat your symptoms. Whether you see someone online or in your local area, PTSD is treatable and even preventable if you address trauma right away. If you develop PTSD, it’s okay, and there’s no need to feel shame. It’s a treatable mental illness, and you’re not alone. Many people live with PTSD, and with support, you will get through this. It starts with getting help from a mental health professional, whether that’s working with someone in your local area or finding the help of an online counselor, like one at BetterHelp, you can find a treatment plan and get the help that you need to health from PTSD. You’re not alone, and remember that millions of Americans live with the condition. By going to therapy, you’re doing something incredibly brave, which is taking charge of your mental health. You will get better, but it’s going to take time. Be patient with yourself. Healing from trauma can be difficult, but it’s worth it.

Marie Miguel has been a writing and research expert for nearly a decade, covering a variety of health-related topics. Currently, she is contributing to the expansion and growth of a free online mental health resource with BetterHelp.com. With an interest and dedication to addressing stigmas associated with mental health, she continues to specifically target subjects related to anxiety and depression.

The Impact of Child Abuse

A sad boy sitting outside and staring into the camera. — Sad. Source: tamckile, Creative Commons

Childhood is a time in life that should be filled with joy and imagination, and free of fear and any serious responsibility. However, for many people, this not their reality, as abuse and trauma have warped their experience of it. In 2014, about 702,000 children were found to be victims of some form of abuse in the United States – this number does not take into account situations of abuse that went unreported. It is estimated that 1,580 children died “as a result of abuse and neglect” in that same year, though it is possible that this number is actually much higher due to “undercounting of child fatalities by state agencies.” The general impact and potential trauma caused by abuse can have a significant harmful influence throughout childhood development and adulthood.

What is Child Abuse?

Child abuse is “when a parent or caregiver, whether through action or failing to act, causes injury, death, emotional harm, or risk of serious harm to a child.” This includes many different forms of abuse, such as physical abuse, emotional abuse, sexual abuse, and neglect:

Physical abuse is “when a parent or caregiver causes any non-accidental physical injury to a child.”
Emotional abuse, which is recognized less often, is “when a parent or caregiver harms a child’s mental and social development or causes severe emotional harm,” and can include (but is not limited to) isolating a child, terrorizing, ignoring, and humiliating them.
Sexual abuse is “when an adult uses a child for sexual purposes or involves a child in sexual acts,” but it does not have to involve physical contact with a child. In addition to “contact abuse,” it can also include inappropriate sexual language, “making a child view or show sex organs,” and forcing a child to watch a sexual act.
Neglect is “when a parent or caregiver does not give the care, supervision, affection, and support needed for a child’s health, safety, and well-being,” and it occurs when an adult fails to meet even the most basic requirements for taking care of a child that they are responsible for. Neglect can physical, emotional, medical, or educational.
- Physical neglect relates to reception of “care and supervision.”
- Emotional neglect relates to reception of “affection and attention.”
- Medical neglect relates to “treatment for injuries and illnesses.”
- Educational neglect relates to a child’s “access to opportunities for academic success.”

Effects of Child Abuse

Experiencing abuse as a child can have serious, long-term effects on an individual. Those who have experienced child abuse are at an increased risk for intimate partner violence, substance abuse issues, and mental illnesses. Experiences of abuse also lead to children having an increased risk of exhibiting criminal behavior. In the United States, “14% of all men in prison and 36% of women in prison” experienced child abuse. Children who are survivors of child abuse are about “9 times more likely to become involved in criminal activity” than those who are not. Many survivors must deal with intense negative effects of their trauma for the rest of their lives.

Trauma and Child Abuse

Trauma is “an emotional response to a terrible event, like an accident, rape or natural disaster.” When considering the issue of trauma, people often think of veterans who suffer from Post-Traumatic Stress Disorder (PTSD). Both PTSD and Complex Post-Traumatic Stress Disorder (CPTSD) are common in survivors of child abuse, but they differ in exactly what circumstances causes them. PTSD results from a specific event, while CPTSD results from repetitive experiences of trauma. In terms of child abuse, PTSD is caused by a specific incident of abuse, while CPTSD is caused by experiencing numerous incidences of abuse over a period of time.

The three main categories of PTSD symptoms are “re-experiencing trauma through intrusive distressing recollections of the event,” “emotional numbness and avoidance of places, people, and activities that are reminders of the trauma,” and “increased arousal such as difficulty sleeping and concentrating, feeling jumpy, and being easily irritated or angered.” In addition to the symptoms of PTSD, people with CPTSD also experience problems with forming and maintaining relationships, negative views of themselves, and problems with regulating their emotions. These symptoms negatively affect the ability of individuals with PTSD and CPTSD, including child abuse survivors, to live their lives in normal, healthy ways.

Treatments for coping with PTSD and CPTSD include individual and group therapy, medications (such as antidepressants) that help with some symptoms, and the establishment of a reliable support system. Dealing with trauma is a life-long process. Healing is possible for survivors of child abuse, but the impacts of their experiences will never fully disappear.

A sad boy sitting next to a dog on a couch. — Nathaniel. Source: Tony Alter, Creative Commons

The Cyclical Nature of Child Abuse

The presence of abuse can be seen as a cycle with the potential to perpetuate itself throughout the generations of a family. According to the Child Welfare Information Gateway, around one in three of all survivors of child abuse will “subject their children to maltreatment”. This is because many survivors who become parents believe that the way they were treated as a child is the correct way to parent. In other cases, parents believe that if they simply treat their children better than their parents treated them, then they are not being abusive. This way of thinking is incorrect, because abuse is abuse, even if one example of abuse is not as overtly severe as another. By spreading information and reporting incidences of child abuse we can help to interrupt the cycle.

Child Abuse is a Human Rights Issue

There are numerous ways in which child abuse can be clearly seen as a violation of human rights. Article 18 of the Universal Declaration of Human Rights states that “everyone has the right to freedom of thought, conscience and religion,” and Article 25 states that “everyone has the right to a standard of living adequate for the health and well-being of himself and of his family.” How can someone utilize these rights while living in fear (whether it be as an adult or as a child)?

The Convention on the Rights of the Child also deals with child abuse as a violation of human rights. Article 19 calls for States Parties to “take all appropriate legislative, administrative, social and educational measures to protect the child from all forms of physical or mental violence, injury or abuse, neglect or negligent treatment, maltreatment or exploitation…” Article 24 states that children have the right to “the highest attainable standard of health,” which is a right that cannot be fully enjoyed in an abusive situation. Article 27 describes the right “to a standard of living adequate for the child’s physical, mental, spiritual, moral, and social development,” and abuse is a known hindrance to childhood development. Article 34 relates specifically to sexual abuse, stating that States Parties should do everything they can to “protect the child from all forms of sexual exploitation and sexual abuse.”

It is important that we remember that children are limited in what they can do to help themselves in any given situation. It is the responsibility of the adults around them to protect and nurture them. Adults should be attentive toward the well-being of the children they contact. Adults need to be able to recognize and report abusive situations when they witness them and/or are aware of them.

Resources

Warning Signs of Child Abuse
State Child Abuse and Neglect Reporting Numbers
Resources for Adult Survivors of Abuse
Loving a Trauma Survivor (For individuals in a relationship with an abuse survivor.)