Is lifetime abuse forgivable in old age?

Old age is characterized by reflection and a retrospective examination of the multiple meanings of various life experiences, including lifelong abuse. Forgiveness is found to have a salutary effect, especially for older adults. To understand the place and role of forgiveness in the reflective process during aging, we performed a secondary analysis of in-depth, semi-structured interviews (N = 78) with older women survivors of abuse. Inductive thematic analysis was based on concepts developed deductively from the literature review. The findings include three main themes: (1) The dimensions of forgiving: The victim as subject; (2) Being forgiven: Between lost forgiveness and hope; and (3) Self-forgiveness and the aging self. Despite the known salutary effect of forgiveness, we must consider that this is not a universally desirable process. We included the dimension of forgiveness in the study of abuse throughout the older person's life course and identified further complexities in addition to the "forgiveness"/"unforgiveness."

Constructing Professional Intervention with IPV Across Generations in a Faith-Based Society: An Intersectional Perspective.

The intersectionality between the social and personal dimensions influencing the construction of intimate partner violence in the ultra-Orthodox Jewish community is examined by studying attitudes toward professional intervention among community members coping with IPV. Semi-structured interviews were conducted among 38 information-rich participants coping with IPV, from three generations in the ultra-Orthodox community. Three themes emerged: "Don't think you can do it alone": Professional intervention as a preferred option; "I did everything to hide the situation": The end of the era of shame?;"If it's not his problem, then it's my problem": Professional intervention as a concept of reference. The study findings indicate the ways in which professional intervention among ultra-Orthodox couples coping with IPV is affected and affects the community.

Reluctance Versus Urge to Disclose Child Maltreatment: The Impact of Multi-Type Maltreatment.

Child maltreatment is a major public health issue in Israel. According to a recent Israeli national epidemiological survey, approximately half of Jewish and Arab girls and boys between the ages 12 and 17 experienced at least one type of child maltreatment, at any severity level. The purpose of the present study was to investigate the influence of multi-type maltreatment on Israeli children and youth survivors' reluctance versus urge to disclose; with the effects of gender, age, and ethnicity taken into account. The study is important since non-disclosure has deleterious effects in terms of continuation of the abuse, delays in criminal prosecution and commencement of treatment. A self-report questionnaire incorporating the following instruments was administered: the Juvenile Victimization Questionnaire, the Childhood Trauma Questionnaire, and the Disclosure of Trauma Questionnaire. The sample consisted of 6,253 Jewish and Arab children and youth who reported experiencing at least one lifetime child maltreatment event. Study results indicated that children and youth's reluctance to disclose is positively associated with their emotional reactions to disclosure, as well as with higher instances of child maltreatment exposure; whereas urge to talk is negatively correlated with their emotional reactions to disclosure.

Prevalence of Child Maltreatment in Israel: A National Epidemiological Study.

The current study is based on data collected from Jewish and Arab 6th, 8th and 10th grade students (age range 12-17) within the Israeli national school system (N = 12,035). Data collection for the study utilized two complementary instruments: the Childhood Trauma Questionnaire (CTQ) and the Juvenile Victimization Questionnaire (JVQ). Study results revealed that the lifetime prevalence of child maltreatment in contemporary Israeli society is within the range of estimates from other countries. However, contrary to others, Israeli boys reported higher rates of abuse, including sexual abuse, compared to girls. Additionally, Arab compared to Jewish children and youth reported higher rates of all types of abuse. The need for widely accepted, uniform definitions of the various child maltreatment types, a standardized methodology of data collection, and regularly updated national and international data bases is discussed.

Torn: Social Expectations Concerning Forgiveness Among Women Who Have Experienced Intrafamilial Child Sexual Abuse.

The authors examine how women who experienced intrafamilial child sexual abuse (IFCSA) perceive social expectations of society toward forgiveness, how they incorporate IFCSA and reconstruct their life stories in relation to these expectations, and the costs and gains from such reconstructions. This is part of a larger study on the phenomenology of forgiveness for IFCSA among grown women. Twenty Jewish Israeli women who had experienced IFCSA were interviewed in depth. Interviews were tape-recorded and transcribed verbatim. Data analyses lead to four types of social expectations: forgiveness by forgetting, avenging, family preservation through forgiveness, and satisfying the voyeuristic needs of society, which has limited interest in forgiveness. These contradictory expectations are discussed in light of the cultural context and the experience of the women interviewed. Implications for practice are suggested.

Adult women survivors of intrafamilial child sexual abuse and their current relationship with the abuser.

This article examines the adult perceptions of women survivors of intrafamilial child sexual abuse and their current relationship with the family member who abused them in their childhood. Twenty Jewish Israeli women were interviewed in depth between 2008 and 2009. Interviews were tape-recorded and transcribed verbatim. Data analysis produced 2 interrelated continua with regard to the presence of the perpetrator in the women's life: a continuum of his actual daily presence in the woman's living space, ranging from complete absence to a continuous presence, and a continuum of his experiential presence, ranging from a high level of intrusiveness to encapsulation and total dissociation. The 2 continua are discussed and implications for practice are suggested. (PsycINFO Database Record

Toxic Knowledge: Self-Alteration Through Child Abuse Work.

The purpose of the present article is to examine the multiple ways in which the private lives of professionals are affected by involvement with child abuse intervention and prevention. Using a descriptive-phenomenological perspective and 40 in-depth interviews with professionals to present a model based on qualitative data, we studied the ways in which child abuse professionals conceptualize, understand, and integrate their experiences into their personal and family lives. We find that the process of internalizing child abuse knowledge occurs in two domains: One affirms or denies the existence of the phenomenon; the other concerns the strategies used to contend with the effects of working in abuse. Knowledge of child abuse is toxic, in the sense that it serves as a catalyst leading to the alteration of one's self-perception and parental identity. We present a typology of self-alteration resulting from child abuse knowledge and describe the mechanism of this change.

Dissociation and the experience of channeling: narratives of Israeli women who practice channeling.

"Channeling" is a phenomenon in which people describe themselves as receiving messages from another personality or dimension of reality. Channeling is often regarded as dissociation, which is a disruption in the usually integrated functions of consciousness, memory, identity, or perception. This study explored the interface between channeling and dissociation through a phenomenological analysis. Qualitative data were obtained through interviews with 20 Israeli women who practice channeling. The analysis revealed 3 themes: dissociation, absorption, and control. The channelers' descriptions correspond with what is coined as "dissociative states" and enable an emic view of the etic definition of dissociation.

Free will in total institutions: The case of choice inside Nazi death camps.

Nazi death camps, as any total institutions, were designed to deny any free will or choice from inmates. Furthermore, former inmates in such extreme conditions often account for their own actions and behavior in such settings as inevitable ("I had no other choice"). This study examines the questions of free will vs. determinism in death camps from a descriptive-phenomenological perspective. Data was collected through in-depth interviews with 20 former death camp inmates. The following themes emerged from the qualitative analysis of the data: the 'selection' experience; 'borrowed time' perception; and the experience of 'nothingness'. A conceptual model grounded in these data was developed to illustrate the inmate's lived experience of choice in the reality of the camps. Analysis of the model indicates that under the extreme conditions of the death camp, free will and existence are interchangeable: "I choose - therefore I am".

Violently reactive women and their relationship with an abusive mother.

This article sheds light on the abuse of mothers toward their daughters and its potential influence on the violent behavior of the latter as adults. It contributes to the scarce knowledge on the effects of abuse of each parent on their children by gender. The article is part of a larger study describing the experience of 30 women in Israel who were abusive or violent toward their male partners. It presents the stories of 14 women from the sample who, when sharing their memories of childhood and family-of-origin, spoke of an abusive relationship with their mothers. The various types of these relationships are presented along a continuum based on the severity of violence and emotional detachment of the mothers toward the interviewees, ranging from physical and emotional distancing, through chronic expressions of bitterness and criticism, and ending with severe physical violence. The findings are analyzed through the prism of social construction, relating to the interviewees' use of the psychodynamic discourse when accounting for their past and present abusive relationships. Some limitations and clinical implementations of the study, and needs for further research, are addressed.

Factors affecting disclosure among Israeli children in residential care due to domestic violence.

Disclosure of child abuse may enable initiating interventions to end maltreatment and mediate its negative physical and psychological consequences. The present study reviews the field of disclosure and examines factors affecting disclosure among a service population of abused children who were placed in residential care due to various forms of abuse (e.g., physical, sexual, emotional, neglect and witnessing domestic violence). The sample consisted of 286 Israeli (Hebrew and Arabic speaking) children aged 12-17 (mean=14±1). Following approval of the Ethics committee of the University and parents' written consent, participants were administered a self-report questionnaire that included the following measures: a Socio-Demographic Questionnaire, the Childhood Trauma Questionnaire (CTQ), the Juvenile Victimization Questionnaire (JVQ), and the Disclosure of Trauma Questionnaire (DTQ). Results indicated that the three key factors enhancing the likelihood of disclosure were: moral factors, external initiatives and intolerable physical pain. The three key factors inhibiting disclosure were feelings of shame, fear of losing social support and uncertainty as to how and to whom to disclose. Results also showed that children preferred to disclose to their nuclear family members (parents and siblings) in comparison with professionals.

The social construction of social problems: the case of elder abuse and neglect.

The interaction and inter-penetrability overlap of abuse and neglect has been previously described. Therefore, the question is not whether a distinction can be made between the two, but how specific events are constructed into abuse and/or neglect based on how each of the protagonists involved (researchers, professional workers, family members, and the older persons themselves) make sense of abuse and neglect. The purpose of this paper is to explore the social and psychological construction of elder abuse and neglect and illustrate the theoretical constructs using case material and its application to the field.

Between rigidity and chaos: worldviews of partners experiencing intimate partner violence.

The goal of this article was to examine the worldviews of cohabiting or married men and women who experienced domestic violence in their relationships. The study was based on content analysis of in-depth interviews with 48 men and women (24 couples), who were living together after experiencing at least one violent event in their relationships over the previous 12 months. Using constructivist grounded theory, the authors examined the deep structure of the ways by which partners living with intimate partner violence constructed their world. The men and women under study constructed heuristic models in two major life domains-psychological processes and how the world works overall. The analysis has revealed two axes resulting in four worldviews. The two axes were the construction of the world and the construction of the mind. Constructions of the mind ranged from chaotic to deterministic. Constructions of external reality ranged from static to fluid and uncontrollable. The theoretical model developed suggested four different types of basic worldviews. The suggested typology was examined in relation to existing typologies in the field of intimate partner violence and in relation to future research and interventions.

Male social workers working with men who batter: dilemmas in gender identity.

Research into the impact of dealing with intimate partner violence has focused mainly on women who treated victims. The present article explores the interaction between male social workers and battering men. The sample included 15 male social workers who worked with battering men in social services. Data collection was performed through semistructured interviews. The main theme emerging from the interviews describes the reconstruction and renegotiation of the worker's professional and personal self in light of his experiences with violent clients. Two major motifs describing their experience emerged: The first is self-doubt arising from adopting a broad definition of violence, thus creating increased sensitization to and inclusion of a wide range of behaviors under the term violence . The second motif is related to compromising with reality by renegotiating their identity as aggressive, at times, but not violent. Findings were discussed in the light of the constructionist perspective.

Approaches to and outcomes of dyadic interview analysis.

Qualitative studies on dyads have increased over the last two decades. However, emphasis has been on their thematic content, and very few methodological advances have occurred for conducting this type of research. For instance, literature exists about ways to collect dyadic data, but not how to analyze it. Our aim with this article is to discuss dyadic analysis using data from separate interviews, which is then analyzed on both individual and dyadic levels. We focus on the contrasts and overlaps between the partners' versions as reflected in the text and subtext, and on the descriptive and interpretive levels, based on data from our recent study on second couplehood in old age. We examine how dyadic analysis assists in deriving themes related to the nature of couple relationships, which could otherwise not have been reached.

Is elder abuse and neglect a social phenomenon? Data from the First National Prevalence Survey in Israel.

This article discusses findings from the First National Survey on Elder Abuse and Neglect in Israel, conducted during 2004-2005 under the sponsorship of The Association for Planning and Development of Services for the Aged in Israel (ESHEL) and the National Insurance Institute. The goals were to examine the prevalence and severity of various forms of abuse and neglect from the victims' perspective, to examine correlates and predictors, and to develop profiles of elders at risk. Data were collected through personal interviews from a national representative sample of community urban dwellers age 65 and older, using cluster sampling techniques and sampling proportionately both Arab and Jewish elders. The sample was composed of 392 males and 650 females, 89% were Jews and 11% were non-Jews. The instrument included sociodemographic data, health and activities of daily living (ADL), a measure of safety, and a battery to examine seven types of abuse (physical, emotional, verbal, limitation of freedom, financial exploitation, sexual, and neglect). Findings indicate that 18.4% of the respondents were exposed to at least one type of abuse during the 12 months preceding the interview, the highest form being verbal abuse followed by financial exploitation. The rates were quite similar between Jews and Arabs. Women were more exposed to physical violence and Arab women were the most vulnerable. Physical, emotional, verbal, limitation of freedom, and sexual abuse occurred mostly among partners. The rates of physical, sexual, and limitation of freedom abuse, however, were relatively low. Financial exploitation was mostly inflicted by adult children. Partners as perpetrators had more chronic health problems and physical and mental disabilities. Children as perpetrators were unemployed, had various mental health problems, and were substance abusers, often in a process of separation or divorce and tended to live with the victims. Neglect in answering primary needs was found among 20% of the sample, regarding the 3 months preceding the interview. This high rate might be related to elders tending to avoid seeking help or sharing their needs with their families. When victims sought help it was mostly from medical and health services. The findings thus corroborate that elder abuse and neglect is a social problem in Israeli society and has to be addressed in policy discourse and service developments.

Physician as partner or salesman? Shared decision-making in real-time encounters.

The results of recent research have led to the increased advocacy of shared decision-making regarding medical treatment. Nonetheless, only a limited number of studies have focused on the process of decision-making in real-time encounters. The present paper aims to document and analyze this process. Specifically, we assess whether these decisions are the result of partnership or of persuasive tactics based on power and hierarchical relationships. We will describe and analyze different strategies used by pediatric gastroenterologists in breaking bad news encounters, as well as their consequences. The analysis is based on a multi-method, multi-participant phenomenological study on breaking bad news to adolescents and their families regarding a chronic illness. It included 17 units of analysis (actual encounters and 52 interviews with physicians, parents and adolescents). Data were collected from three hospitals in Northern Israel using observations and audiotapes of diagnosis disclosure encounters and audio-taped interviews with all participants. The analysis identified eight different presentation tactics used in actual encounters during which physicians made various use of language, syntax and different sources of power to persuade patients to agree with their preferred treatment choice. The tactics included various ways of presenting the illness, treatment and side effects; providing examples from other success or failure stories; sharing the decision only concerning technicalities; and using plurals and authority. The findings suggest that shared decision-making may be advocated as a philosophical tenet or a value, but it is not necessarily implemented in actual communication with patients. Rather, treatment decisions tend to be unilaterally made, and a variety of persuasive approaches are used to ensure agreement with the physician's recommendation. The discussion is focused on the complexity of sharing a decision, especially in the initial bad news encounter; and the potentially harmful implications on building a trusting relationship between the physician and the family when a decision is not shared.

Between the professional and the private: the meaning of working with intimate partner violence in social workers' private lives.

This qualitative study examines the impact of working with intimate partner violence on therapists' marital relationships and gender identity. Data were collected by in-depth semistructured interviews with 14 experienced women social workers working in domestic violence treatment centers in Israel. Findings indicate that the boundaries between workers' private and professional lives are blurred and work experiences influence their intimate relationships and gender role identities, leading to overall questioning of their relationships. This newly rediscovered consciousness reshapes the meaning of workers' couple relationships. Such shift between private and professional should be considered when training workers to intervene with intimate partner violence.