Addressing Sexual Behavior in Children

“I caught my 7 year old child hiding in the closet with our neighbor’s child.  Their clothes were off and they looked guilty.  I told them to get dressed and sent the neighbor child home.  I don’t know what to do now.  I’m tore up inside and do not want my child suffer the rest of their life because of this”.

The call came from a desperate mom just hours after this event took place.  It really is one of a parent’s worst nightmares.  After the initial shock, the questions  set in, “will this affect them for the rest of their life?”  “What do I do?”  “Does my child need help?” “Do I call the police?”

While this is one of the worst moments a parent can find themselves in, there is a step by step structured approach you can help them take in the moment of discovery and post discovery.  If you are a professional who gets this phone call, consider walking that parent through the following steps. 

Instructions to Parents---

If you catch them in the act:

1.       The most important thing is stay calm.  Take a deep breath and ask the children to either dress, or stop engaging in the behavior they are engaging in.

2.       Separate the children and ask what was going on- After the children have dressed ask one to stay in one room and another in the other room.  Calmly talk to each child to get the story of what they were doing, what made them decide to do it, and how often have they done it.  (avoid shaming the child by telling them what they did was dirty, disgusting, or bad)

3.       Bring the children back together and talk about Sexual Behavior Rules:  Say it’s ok to be curious about body parts however it is not okay to do the following with that curiosity:

School Age

1.       It is not ok to touch other people’s private parts.

2.       It is not ok to show private parts

3.       It is not ok for other people to touch your private parts

4.       It is ok to touch your private parts in private

5.       It’s not ok to make other’s feel uncomfortable with your sexual language or behavior

Preschool Age

1.       No touching other people’s private parts

2.       No other people touching your private parts

3.       No showing private parts to other people

4.       No touching your own private parts when others are there

5.       Touching your own private parts when you are alone is ok

Begin enforcing these Sexual Behavior rules in your home from here forward.

4.       When trying to decide if you need to call your local authorities, you may find the following link for TN related sexual behaviors and reporting helpful.  Click Here  (Be aware that the laws are different in each state, so check out your own state Gov. website to be sure).

5.       Allow your child to come talk to you about what they did or experienced as they need too.  If they have questions you do not know how to answer, let them know you would like to talk with them further but would like to set a specific time and place to do that.  Then you can find some helpful resources to help prepare you for that conversation by contacting an area professional or even your local pediatrician.

Lastly as you worry about if this will have a lasting impact on your child, consider watching for the following signs.  If they are present, your child may need to see a professional about what happened.  If they are not present you may just continue monitoring your child, allow space for them to talk to you more and trust that they have processed what happened in a way that will not make a lasting impact.

Signs you may need to consult a mental health professional:

a.       Extreme change in their behavior (they go from outgoing to isolated or vise versa)

b.      They become fearful of people or places

c.       They begin wetting the bed

d.      They begin having regular nightmares

e.       They play with their toys in a sexual nature

f.        They become aggressive

g.       They complain of their tummy or head hurting

To summarize for them remind them they are being a great parent by being concerned.  Moving forward  they need to 1) Address rules about touch  2) allow space for their child to talk about it  3) monitor their child for signs they may need additional help. 

Checking Out

The ‘checking out’ phenomenon, otherwise known as dissociation, is one of the most feared symptoms experienced in our profession (next to suicidality and psychosis of course).  Specifically, those clinicians who have decided to dedicate their career to focusing on trauma, addictions, eating disorders or personality disorders are starting their path with an understanding that dissociation may show up somewhere along the journey.  Other clinicians hold the blissful denial that they will never have to deal with it.  Reality is, dissociation shows up in all of our offices at some point, and it is advantageous to know when it does.  Then of course is the logical next step, what to do.

In the context of experience, dissociation is a natural phenomenon in all human beings. Consider a time you took a regular route in your vehicle and you remember getting into your vehicle, starting it, backing out, then starting on your way.  Then sometime later you realize you are pulling into your destination with little memory of actually how you got there.  A phenomenon we can all relate too.  This is the most basic of dissociation levels.  Bruce Perry, M.D., Ph.D. postulates “Dissociation is the most primitive of reactions: earliest life forms, infants, and the very young rarely escape dire situations of their own accord. For infants and young children, dissociative response to extreme stressors is common. If it’s prolonged it is connected with increase in PTSD symptoms.”  Under this explanation we understand that trauma in the developmental timeframe of childhood, commonly results in dissociation.  Continual trauma in childhood results in the regular occurrence of dissociation which can eventually become habitual. 

What does it look like in your office? On the simple end of the spectrum it can be experienced as a client stating they feel foggy, floaty, or numb.  On the more complex end the client may describe feeling robotic, disconnected from the present moment, or even shift before your eyes into someone quite different than what you have experienced in your client before.  A lot of times clients do not really know they are dissociating.  Those who do it often do not know that it is something unusual, and frankly if they do they are embarrassed to let others know.  In my experience they do not come out and tell you this is something they do regularly, because they think it makes them ‘crazy’ (their word not mine). 

I’ve learned to ask in my intake process about childhood experiences, this can be done in a psychosocial, genogram, timeline, or family history assessment.  When trauma’s are mentioned by the client, I make it a point to add in an element of psychoeducation on trauma, it’s impact on the brain and common reactions/symptoms of trauma.  Part of that psychoeducation includes explanation of dissociation.

That is the beginning process of how to notice it and then what to do.  As the clinician the next step is teaching the client ‘present living’.  Present Living is part of many treatment models today, including many marital/relationship models, family models, and solution oriented models.  These models are about helping the client live in the moment and out of reactivity.  This is exactly what the objective with clients who dissociate is as well.  For those clinicians who practice ‘present living’ models, just add one additional step of teaching a client who regularly dissociates how to ground.  Simply put, it’s teaching the client to be mindful or aware of when dissociation is happening and then giving them the tools to stop the dissociative process and return to the present moment. 

Watch the following video to get an example of an effective therapeutic tool to use to help ground clients who are dissociating. 

Or click on the following link to watch a demonstration of the “Senses Bag” a technique I use to teach clients how to ground.

Dissociation doesn’t have to be scary.  At the simplest explanation it’s a symptom.  Now you the clinician have some resources that can help address and eliminate this symptom for a client.

****Dislcaimer- Complex forms of dissociation should only be addressed by clinicians trained to address the complexity of those symptoms (e.g. DID, dissociative fugue, and depersonalization disorder). However basic forms of dissociation can be addressed by all clinicians.  If the symptom persists or gets worse, seek consultation. ****