Breaking The Cycle Program 1 ***Cassette tapes of this program are available by calling The Radio Store at 1-800-747-7444. CHADWICK: Hello from National Public Radio in Washington DC - I'm Alex Chadwick. STAMBERG: And I'm Susan Stamberg.... and this is Breaking The Cycle, a series of special reports on child abuse prevention. CHADWICK: You may already have heard a lot about child abuse in the last few years - maybe enough so that it feels like too much. It's such an ugly topic and it's said to be so widespread it seems overwhelming - although some critics complain it's the reporting of child abuse that's getting out of hand, and creating hysteria. STAMBERG: Still, even the skeptics don't dispute that child abuse and neglect go on happening everyday in this country, and that we can measure the effect in every community - in drug use and street crime; in young pregnancies; in homelessness and mental illness. CHADWICK: Now, in a series of four hour - long programs, Breaking The Cycle will examine what can be done to bring about what seems almost unimaginable now - a world for our grandchildren's generation in which child abuse could be as scarce as polio is today. We'll speak with parents, teachers, community leaders, therapists and politicians from around the country, asking how we can make growing up safer and healthier for children everywhere. STAMBERG: We're especially interested in stories of what works to reduce child abuse and neglect. And in these programs we will take you to visit some of those places where practical efforts that offer hope are under way. Places such as Santa Fe New Mexico. CHADWICK: It's a city where many different ethnic groups mix and parts of Santa Fe suffer poverty that's as bad as anything to be found in the country. Nonetheless it's also where reporter Michelle Trudeau found a child abuse prevention program called Healthy Families. SANSOM: Hi. How ya doin'? Just thought I'd stop by and see if you have any first time mothers today. NURSE: I do... SANSOM: Ya do? Great. TRUDEAU: Doreen Sansom is a social worker here in Santa Fe... and the local coordinator of "Healthy Families", an innovative new program to prevent child abuse. Every few days or so, Sansom comes over to Saint Vincent's Hospital, the largest hospital in the community, to see if there are any first-time mothers who've just delivered... Mothers who may need help caring for their new and unfamiliar babies. Sansom carefully reads through the hospital chart of the new mother who just two days ago gave birth to a baby boy. She's looking for clues for what's called a "high risk" parent... SANSOM: It also says here that the parent is alone, and she may not have any support. So I don't know anything about the father of the baby, and we'll finding out that during the interview. TRUDEAU: This mother seems to be isolated... She's new to the area, with no family or friends here. It's a red flag to Sansom that this mother may, with a new baby, be feeling overwhelmed... SANSOM: And there's even a note here to call Healthy Families- Santa Fe because she's interested in talking to us. So I'm gonna proceed now to go into the room and talk to her. SANSOM: Hi, Kayla. Can I come in? I'm Doreen, from Healthy Family-Santa Fe. And I wonder if I could take just a few minutes of your time to tell you a little bit about our program and to see how things are going for you. TRUDEAU: Sansom sits on the edge of Kayla's bed... and gently, artfully asks this new mother about her life, her background, how she was raised, how she was disciplined, what her feelings are about being a new mother. KAYLA: Mostly scared, a little bit excited, but mostly scared. Like, am I ready for this yet? SANSOM: Did you plan on having the baby, or did you...? KAYLA: No. SANSOM: Had you thought about perhaps giving the baby up for adoption or abortion? KAYLA: No. I just knew in my mind that I would keep the baby but I was scared. I wasn't sure how everything was gonna turn out. TRUDEAU: Sansom is looking for signs of stress, or conflict, or being overburdened.... SANSOM: Kayla, what do you think is the biggest concern or hassle, you know, going on in your life right now? KAYLA: My relationship with the baby's father. TRUDEAU: The answers mothers give to these questions are significant... for they give some hint as to which mother might - just might - neglect or abuse her child... SANSOM: We're picking out the risk factors and the stressers in people's lives that could eventually lead to child abuse and neglect. TRUDEAU: Very specific stressers associated with an increased likelihood of hurting a child... like living alone, having no phone, having had poor parental care, not having finished high school, having a history of abortions, or substance abuse, or having marital problems. It's not any single factor, or any one type of person, says Sansom, but a constellation of these stressers that puts a new parent and baby in jeopardy. SANSOM: It could happen to anyone. Anyone who has enough stress in their life may just lash out at their child, and really may not want to do it. TRUDEAU: So the strategy for preventing child abuse, say proponents of the Healthy Families program, is to offer help to new mothers in any way possible. ATENCIO: Hi Lynn, how's it going? Pretty good? TRUDEAU: Help comes to Lynn and her 5-month old boy Ryan once a week. Home visits by trained caseworkers are really the heart and soul of this prevention program. Once a week during the first year, and then monthly for several more years. Maria Atencio, Lynn's home visitor, is teacher, counselor, advisor, even a role model for being a good parent... ATENCIO: I brought some toys today... so that Ryan could play with them... TRUDEAU: The idea is to teach a new mother the basic skills of parenting. If she learns something about child development, the thinking goes, she will be better equipped to raise a happy, healthy baby. So the program isn't just about preventing child abuse... it's also about helping a parent be a better parent: finding a pediatrician... helping the parent go back to school...or back to work...providing the connection to numerous support systems already out there. TRUDEAU: Lynn says the program has helped.. that she's come a long way. Her first three children no longer live with her, they were adopted by other families...She's reluctant to talk to us about this... LYNN: All I can really say with that, you know, getting all those memories back is... I love them... I miss them. And I wish I could bring them back to me, but I can't. I legally con not see the children until they're 18 years old. ATENCIO: Are you a different mom now with Ryan? LYNN: Definitely. I'm a lot calmer, a lot calmer. When I had my others, I was all stressed out. I was the victim of being abused verbally, emotionally. By my parents when I was growing up. TRUDEAU: She says she treated her first three children the way she'd been treated. But now having lost them, she's resolved to behave differently with her new baby. So when this prevention program was offered to her at the hospital, Lynn grabbed the chance to learn how to be a better mother. LYNN: I didn't want to make the mistake in doing something wrong. I want Ryan to be happy. I want him to be very healthy. I want him to be happy and healthy. I want to see him turn 1 year, 2 years, all the way up, until my dying day. I just want him to be in a stable home. TRUDEAU: There's a study done by an anthropologist... in a small village in rural Italy a study about being a new parent. The researcher found that within five minutes of the baby's birth, the parents, grandparents, and at least 5 other relatives had kissed the baby. Within the first six weeks of the baby's life, over 80% of all the households in the village had come to see and touch the new baby. New mothers were invariably surrounded and helped by their community. GARBARINO: It's not uncommon in our society for mothers to bring children home to an empty house. TRUDEAU: That's psychologist James Garbarino... President of the Erickson Institute in Chicago which does research on child abuse... GARBARINO: Most mothers who bring a child home to and empty house are seized with terror. The terror of having the responsibility for this little life. Particularly, if you -- if you don't feel like you know what you are doing. TRUDEAU: And so it begins, says Garbarino... often with these feelings of incompetency... GARBARINO: And for a young mother, a first time mother whose being kept up all night, who has them get up in the day and try to take care of business, just the sleep deprivation alone can push them to the edge and beyond. And when they are faced with the child, who then is also crying, and won't be soothed, you're likely to feel rage. And in that rage, you may do things which can hurt a vulnerable infant. You may shake them in frustration. You may slam them down onto the bed or the changing table. You may even begin hitting them. It's pretty clear that people who begin slapping babies before they are six months old are headed right down the road to child abuse. TRUDEAU: On the road out of town toward the southern edge of Santa Fe there's a complex of two-story terra-cotta buildings. Public housing with a view of the deep purple Sangre de Cristo Mountains. Annette lives in a tiny but tidy one- room apartment with Alex, her 18 month old son... TRUDEAU: Annette sits on the floor cross legged... Alex snuggles in her lap; she nuzzles the top of his dark head casually. Rocking rhythmically as she speaks... Annette recalls the sense of being overwhelmed when she first came home with her new baby... ANNETTE: Having him was really a shock to me. It made me realize, my God, I am a parent now. How am I gonna raise this child? TRUDEAU: And so she contacted Healthy Families. And a home visitor has been coming out regularly to see her ever since. ANNETTE: You know, the came along, and made me feel a little bit more confident that, you know, I can do it. And bring this child up healthy. Giving me strength and self-esteem. And really pushing to do something for me and my child. TRUDEAU: Annette feels that the Healthy Families program has been a lifeline for her, and while researchers are now formally evaluating the program's real impact on preventing child abuse, many specialist are convinced that this method is working. The Healthy Families America program is spreading nationally... with now over 50 sites in 16 states, and plans to implement this program in every state. Some charge that by targeting only those considered "at risk" the Healthy Families program is biased against certain groups while allowing other potential abusers to slip through the cracks. But supporters of the program say you have to start somewhere. And the ultimate goal of Healthy Families America is to provide home assistance to all new parents. This is Michelle Trudeau reporting. CHADWICK: Consider how our ideas of child abuse have developed. Many of us remember when there were no child abuse hotlines. Indeed, the very idea that society can define child abuse, can outlaw it and even act against parents is a very recent notion. STAMBERG: Lloyd DeMause is an historian who's spent 35 years studying childhood, and how ideas about raising children have changed over the centuries. He is a leader in the field of psychohistory - using psychoanalytic theories to interpret the diaries, books, letters and notes of those long past. The results can be chilling when applied to the lives of young people. In one of his books, Mr. DeMause writes "the history of childhood is a nightmare form which we have only recently began to awaken..." a statement which seems to demand further explanation. DEMAUSE: Well it means that our usual expectations that there's a golden age in the past some time when there were family values, you know. When there were good mommies and daddies and everything was nice and quiet instead of being the uh, urban ghettos. Uh, is just wrong. Uh, the further back in history you go the more likely a child is to be abused or uh, or uh, abandoned or even killed. STAMBERG: Take us through history will you, because I know that you've really broken it down into certain kinds of periods and seen trends -- I hate to use such a lightweight word for the kinds of serious uh, mistreatment of children that you've discovered through various periods from antiquity to the fourth century A.D., you say that's a time when infanticide was prevalent, although it still exists today in many societies, but uh, tell us about what you've learned about infanticide in that earliest period. DEMAUSE: Well I call it the infanticidal period because uh, the central proposition is shall the child live or not and uh, probably about half the children that were born were done away with one way or another and uh, uh, the uh, but uh, uh, we have evidence as far back as the twelfth century B.C. and the, practice of circumcision was supposed to have been a substitute for uh, the actual infanticide uh, or rather sacrifice of children. Uh, you've got uh, places say in uh, in uh, Carthage uh, that have tens of thousands of pots with bones of children in it uh, that say on the outside of it, here's my newborn, dear God, thank you very much for having success giving me my success, I promised you him at sending somebody so and so... and uh, uh, so the circumcision in the Bible was supposed to have been a uh, substitute for that, just chop off the foreskin uh, and uh, that's -- gives some sort of uh, of uh, token sacrifice. STAMBERG: According to your work, things didn't get any better from the fourth to the thirteenth century, that you call a period of abandonment, when babies were actually turned over to others. I had no idea until I poked around in your literature that wet nurses often meant that a child left home for many, many years. DEMAUSE: Well at least a couple of years uh, and as far as the child was concerned of course uh, if at birth they're shipped off to a local um, um, peasant out in, in the countryside someplace and the parents don't visit them for two years, as far as they're concerned that's their parent, right? That's the mommy that brought me up and daddy and then, of course, at the age of two uh, the real mommy and daddy come from the city uh, and by the way they need not be very rich uh, as late as uh, as 1900 in Paris, eighty-five percent of all the mothers were and fathers, were sending out their children to wet nurse. STAMBERG: Fourteenth to seventeenth century, you call that sort of an age of ambivalence - it's a time when child care manuals begin popping up, so maybe people are beginning to have a concept of childhood as something less than little animals that are kicked around or bound up or, or young adults who - or future adults who, who need to be hurried along so they'll grow up. DEMAUSE: Yeah, individual people throughout uh, society are experimenting with new ways in the fourteenth and the fifteenth century and that's what produced the Renaissance and the Reformation and the whole modern world and individuation and property and all the things that, that uh, we know of as modern society as soon as you begin to feel that you're an individual human being, that you're, that you're -- you own your own body, then you say, well gosh I'd like to own uh, my own, my own plot of land too. I'm not going to let the lord come in and take all of it and I'd like to own my own uh, tools and, and my tools, well maybe I'll work on them and I'll invent things with them and boom we exploded into the -- now, at that point, we're doing something that the East has not yet done uh, and uh, the reason for the East not doing it is that the East invented foot binding. Well that's not so good for the next generation of mothers and that was so bad that essentially China go frozen at that time until they unbound the girls at the age of, at, in the twentieth century. The same thing goes in the, in the uh, Middle East or the Near East uh, in most of the circum- Mediterranean Arab countries and some of the African countries, you've got cliterodectomy, in which they just chop off the genitals of the little girls. Well, that's not so good, for growing girls is it? Uh, and uh, and uh, the West was able to begin to experiment in not mutilating and not swaddling and not sending out and not beating uh, uh, during this period of time and that's what produced the modern world. STAMBERG: We had the industrial revolution so to what extent does that bear on any of this, I keep giving you economic reasons and you keep giving me sociological - psychological ones. DEMAUSE: But, but preceding - preceding every economic - see I'm a -- I was originally trained as an economist and, and uh,- have earned my living thirty years at it and uh, I keep pointing out uh, the, the economic side if the human material that invents and, and does the things economically is able to feel the freedom to do that. And first you have to have a child-rearing revolution then you have an economic revolution or a technological revolution STAMBERG: Mr. DeMause, the eighteenth century seems to be really an age of enlightenment for uh, children and their parents. Uh, pediatrics is born in the eighteenth century, the first founding - the first foundling hospital is set up in England. Toilet training they decide needs to begin earlier in life. Uh, nineteenth to the mid-twentieth century, you call a period of socialization uh, in which the notion is that parents will guide - parents particularly will guide and train and socialize the children. DEMAUSE: Once you don't uh, farm your child out, you've got this little body of, of energy to then do something with, don't you? And uh, the idea is to form social and, and psychological pressures to turn them into the kind of person that you want to be and uh, I say that's, that's a big step forward, at least you've got uh, you've got the physical uh, punishment out of there and uh, you begin to give them some, some sort of empathy and uh, even some of the things you think of as, as horrible are at least advances. If indeed, up until that time uh, the children were sexually molested as a regular uh, part of growing up uh, then what you then had is, is reformers who said, you shouldn't touch the boys genitals at night, uh, or the girls and uh, you ought to keep your hands to yourself, and at the same time, make them do so. So you would have the first anti-masturbation literature. And uh, the, the people who, you say, you know, they're scaring them to death, that they're going to cut their hands off or they'll get diseases or whatever they are, if they touch themselves, are essentially trying to control themselves as well as control the child. STAMBERG: Uh, something else that you say, which is that child abuse, physical and sexual, has been societies most important ritual. DEMAUSE: Yes, it, it uh, unfortunately is, just as, just as dysfunctional families find some scapegoat and, and pour all of their feelings and, and uh, punishments into that scapegoat and everybody says, well that's, it's Johnny, he's the only problem with this family, he goes out and robs stores or whatever. Uh, or, or Mary, she goes out and she's promiscuous. Uh, but as soon as you treat the uh, the uh, child and uh, and bring them away from the family projections, the rest of the family falls apart because they're really solving their own inter marital problems and their own problems with authority and their own problems with themselves, through the use of the child. Well the child is a kind of like a, like a poison container for all of the horrors of each one everybody's life. And they're expected to cheer the parents up and when they're depressed and they're expected to uh, to be the dog to kick when you're mad and they're expected to uh, be the narcissistic object to do what you wanted to when you were - with your life when you -- when they grow up. Uh, and so on, so they become, if you will the poison container or the, the comfort blanket for uh, for uh, all the people in society. STAMBERG: They become our mirrors in a way, they reflect back to us our own uh, greatest advantages I suppose, but our own darkest problems as well. DEMAUSE: That's right and as soon as you begin to, pull yourself away from that, from that use of the child as a container for your problems, and see them as an individual person struggling to become uh, autonomous then you begin to get the individuality the uh, mark of the modern world and that's the point at which we have the most leverage today. You know, that if - if that, if I'm right as a psychohistorian in saying that child abuse and child neglect are the, are the sources of, of our uh, our violence in, in the world today, both locally in, in terms of crime and, and uh, internationally in terms of unnecessary wars then in fact uh, it's ridiculous for us not to spend a couple billion dollars and then waste what we're spending now is something like a half a trillion dollars, just on crime alone. The cost of crime. Give me one one-hundredth of that and I will, within ten years reduce dramatically to, to a small proportion ah, ah, the child ah, ah, abuse and thereby the next generations' violence STAMBERG: Lloyd DeMause is president of the International Psychohistorical Association. He spoke to us from our bureau in New York. CHADWICK: You're listening to "Breaking The Cycle" a special broadcast on child abuse prevention from National Public Radio. I'm Alex Chadwick. With me are two experts on this subject: Doctor John Conte teaches social work at the University of Washington, he's editor of one of the leading publications in the field "The Journal Of Interpersonal Violence". Also with us, the Director of the National Center on Child Abuse Prevention Research, Doctor Deborah Daro. She's with us from our bureau in Chicago. Hello Doctor Daro. DR. DARO: Hello. CHADWICK: Doctor Daro having listened to a report on changing definitions of child abuse over time, what can you tell us about the definition today? DR. DARO: I think today people consider child abuse to encompass a wide range or behaviors ranging from the physical mistreatment of a child: a beating, hitting, intentionally striking out at a child to child neglect: the failure of a parent or a provider to provide basic nurturance and support for a child. Also including today among the actions that are considered abusive today are child sexual abuse, any form of misuse of a child for an adult sexual gratification. And most recently, emotional maltreatment: the constant belittling of a child, making a child feel worthless, really hitting your child with your words rather than your fists. CHADWICK: Doctor Conte when you talk about categories like child neglect, child emotional abuse, does it get so gray that it's hard to draw lines? DR. CONTE: Well I think in some cases certainly it's difficult to distinguish between a mild form of child maltreatment and perhaps inappropriate parenting. In the more severe cases, almost everyone looks at it and can recognize it. I think often what happens though because when you talk about child abuse many parents identify that they yell at a child or maybe they believe in spanking and so they somehow feel that what they're doing is being labeled by the experts as child, excuse me, as child abuse. And I think that's generally not true. I think that most of us can tell serious child abuse from normal parenting. CHADWICK: How prevalent is child abuse then? DR. DARO: Last year alone there were over a million children that were reported and confirmed as victims of child abuse in this country, children that experienced very severe harm at the hands of their parents. We also know that there are many cases that continue to go unreported particularly most likely in the area of child sexual abuse and I suspect also in the area of child neglect and in the area of emotional maltreatment. CHADWICK: Let me welcome another guest from member station WAMC in Albany, Doctor Kathy Spatz Widom is Professor of Criminal Justice and Psychology at the State University of New York in Albany. Welcome Doctor Widom. DR. WIDOM: Thank you. CHADWICK: How would you describe the effects of child abuse on children? DR. WIDOM: Well research and clinical work has suggested a relationship between childhood maltreatment and a variety of short and long term consequences. For example, some of the physical consequences range from minor injuries to severe brain damage and in some cases even death. Psychological consequences range from chronic low self esteem to higher suicide attempt rates and to what has been called severe- dissociative states and probably of great concern to all of us are the behavioral consequences that we see ranging from poor peer relations all the way to extraordinarily violent behavior so that the victims of childhood maltreatment not only harm themselves but also are harmful to the larger society in which we live. CHADWICK: Doctor Daro. DR. DARO: I think when we're talking about trying to get positive parenting practices in place, trying to produce children that don't exhibit this, the negative outcomes that Kathy and John are talking about, we're really talking about children who are raised in families that from the very beginning are situations where parents have the support they need to get the job done. Parents don't wake up in the morning and decide, I'm going to abuse my child. They do it because they lack knowledge, because they lack skills and because they're isolated and really separated from those services that might help them. I think if we really want to get a handle on the child abuse problem we need to start resolving that problem rather than simply expect that the treatment system can be refined to a point where we won't have the tragedies we have today. DR. WIDOM: Well I think it's important to recognize what it means to be growing up in a neglectful household. If you have to go to school every day without having adequate clothing and if you don't know when your next meal is coming and if you don't know whether you'll be able to sleep that night, how can you go on and become a productive member of society? I mean it's simply, there is no security in that child's life and it in some ways it's not surprising to see the disasters that are coming from this environment. DR. CONTE: It would not be that hard to have people trained in schools to recognize those kids and to provide services through the school to those kids and perhaps those families. But what we have to create is or recreate is sense that our children are everyone's responsibility and that it's possible to provide healing or mental health or rehabilitative services through schools and churches and other community agencies. All of us benefit, society benefits if we provide services to those kids and families. CHADWICK: Dr. John Conte of the University of Washington is editor of the Journal Of Interpersonal Violence, also Doctor Deborah Daro who's the Director of the National Center on Child Abuse Prevention Research and Doctor Cathy Spatz Widom, Professor of Criminal Justice and Psychology at the State University of New York in Albany. CHADWICK: You're listening to Breaking The Cycle from N.P.R. I'm Alex Chadwick with Susan Stamberg. In our next half hour; How to prevent child abuse from within the family including special programs for parents, psychological maltreatment and the link between substance abuse and child abuse. END FIRST HALF-------------------------------BEGIN SECOND HALF CHADWICK: I'm Alex Chadwick. While the ultimate goal of Breaking The Cycle of child abuse is to prevent it's occurring in the first place. It's also important to help those families where abuse takes place right now. One of the oldest and largest organizations to address this need is Parent's Anonymous, which runs hundreds of support groups across the country. NPR's Katie Davis spent time with a Parent's Anonymous group in Baltimore. DAVIS: Up the narrow steps of a rowhouse, five single mothers, are getting silly talking about the bad haircuts they have given their kids. (Ambience of mothers talking) DAVIS: These women come to this weekly meeting voluntarily... About half of parent's anonymous members nationwide are self referred... and others are court ordered; fathers, mothers, upper class and working class... only first names are used here... but this is not a 12 step program... Unlike Alcoholics Anonymous this group has two trained facilitators... who on this night picked the women up and drove them to this community center to talk. (Ambience continues) DAVIS: The things parent's do to children. Delve into it and those things can be startling and yet so commonplace. Two of the mothers here... Dawn and Samantha, learned about violence from their parents... They were hit and spanked so they did the same... This past year though they joined the group... Samantha and Dawn, say the confrontations they were having with their teenage boys were escalating beyond hitting. DAWN: I would also throw knives, TV's at my children. I had very little control over my temper and for the longest time I knew there was something wrong with me and I seriously could not control this. The need, and the want to control it was there but I could not. SAMANTHA: Like I said it was pretty ugly in my home. There were nights that I'd lock them out. When I used to give him his curfew at 11:00 during the summer, this child wants to come in 2, 3, 4:00 in the morning and when I had locked him out on a few occasions this boy had busted down my door and things were getting to the point that I went and got a bat and I was telling everybody. When I called the police department, social services, whoever I called I always told them somebody's going to get hurt in here. DAVIS: These women don't want to continue to pass on the habit of yelling and hitting. Dawn's strategy with her 15 year old now is to resist lashing out, even when he's defiant. Samantha now goes to her room when her 3 boys bring her to the brink of violence. Dawn and Samantha say the simple act of meeting and talking without fear of judgment have helped them change their behavior. This evening... both have little victories to share and even brag about a little. SAMANTHA: I had my 14 year old son come home, he had extended his curfew a little bit and instead of coming home at the time he was supposed to he came in the house at 2:00 in the morning. When I asked him where he was he said , a club and I thought I was really going to go off but I kept my cool and I managed to hold back. DAWN: My son I don't try to hit as well, OK. I was saying something earlier about my son has a hightop fade and when you don't keep it up it gets a little bushy and my son has tennis shoes a couple months old and I was telling him if he wants his hair cut and he wanted new tennis shoes he had to do his chores everyday. Mr. man didn't want to do his chores everyday so his head is getting very bushy and his tennis shoes are getting raggedy so this week he's done really good he's cleaned the bathroom and it looks like he was on his hands and knees with a tooth brush cleaning the bathroom. DAVIS: I'm learning says Dawn to the smiles of the other women... and it's clear they are inspired by Dawn's non-violent disciplinary methods... And that is how Parents Anonymous works... people learn how to be a good parent and then they help each other put the philosophy in practice...When things get difficult, they can call each other for support...or dial the Parents Anonymous stress hotlines. Dawn says she's seen her son change as she has. DAWN: Whatever he did, knock over a glass, I would yell at him or cuss at him to be honest with you and now I am trying that opposite approach with, awe Byron get it up boy ,you know being calm without the yelling and the cussing and I find out that with me being calmer he'll do more. So it's not just him, it's how I respond to him so it is the hardest job in the world, it is. I don't want this job again. Once I retire from it I don't want it again. DAVIS: Samantha's shaking her head. SAMANTHA: I don't want anymore children but I'm going to finish up what I'm doing now and hopefully what I've taught my children , my boys they'll be able to be good fathers. DAVIS: And if Samantha's re-invented parenting helps mold a good father out of her son... then she and Parents Anonymous can claim success... The single mothers here in this group like to call it a sisterhood... but Parents Anonymous has groups for couples, for fathers, teen parents, Hispanics, rural families, homeless families... and the list goes on. These groups of people sharing their problems in churches and community centers across the country have become an extended family... the extended family many no longer have in their lives. DAVIS: This is Katie Davis reporting. STAMBERG: The task of being a parent is filled with stress, from tending to a crying baby night after night to coping with the exhausting demands of a teenager. The trials the tests never stop and it is in those stressful times that child abuse most often occurs. CHADWICK: The most common form of abuse is also the most incedious because it's the kind of abuse that any one of us might perpetrate without even knowing it. It used to be called emotional abuse or mental injury but most professionals now prefer the term psychological maltreatment which covers everything from verbal abuse to terrorizing. Because it leaves no physical marks it's the hardest to detect and thus the hardest to prevent. STAMBERG: The oldest of 4 children, Peggy who doesn't want us to use her real name was born and raised in the North Shore area of Massachusetts in the 1930's and 40's. Now 61, a parent and grandparent, Peggy is a successful psychotherapist in private practice in a suburb of Hartford Conn. In 1970 Peggy herself entered therapy to deal with the repercussions of having been psychologically abuse by her parents. And even now after almost 25 years in various types of therapy she is still haunted by the effects of that abuse. I asked Peggy what kinds of things her parents would say to her when she was a child. PEGGY: Well one of the things that my mother would say, and it's very interesting, this I don't remember, my sister talks about this, that when we would fall down, she would say that's God punishing you. I remember that if I came home with something good about myself that my mother would say, well so and so didn't say anything good about that. She would take away whatever piece of good I wanted to report. I remember once playing outside and having her run outside and drag me upstairs and throw me in the bathtub and just start spraying me with cold water. I kept crying and saying why are you doing this, what did I do wrong? She would say, You know, you know what you did wrong. And I had no idea of what I was doing wrong I no sense that I was doing anything wrong STAMBERG: What did you do as children do to protect yourself or just get through the day, would you hide or would you be so terrified that you wouldn't open you mouth or say a word for fear of giving offense of some sort. PEGGY: Well it certainly taught us to say the right thing. I'm still learning to how to confront people and say I disagree with you . That s very difficult for me to do because if you disagreed, sometimes the consequences. for that were terrifying, I think that's the right word. And also because my mother, you could offend her, without knowing what the offense was it varied from time to time. You never knew whether what you were doing was acceptable or not acceptable Yet on the outside we were in many ways except to close neighbors perceived as your typical American family. STAMBERG: Tell me, didn't you as do most children think that that was normal? PEGGY: In some ways, I remember reading as a child The Five Little Peppers and How They Grew. STAMBERG: Yes I remember that book too. PEGGY: And remembering that and having a sense of this yearning, absolute gut yearning that our family would be like that too. Of course that was idealize but at least it gave me a sense of the possibilities and I think that gave me hope. That I would do it differently, that was one of my goals was that I would do this differently I would not be the mother that my mother was. I would not marry somebody who would be the father that my father was because in many ways he's still the maternal role for us and showed us he was much safer than my mother there were times when he lost his temper a well and I can remember him going after my sister once and I thought he would kill her and I was pleading and crying and saying stop your killing her. STAMBERG: Peggy you are a parent now so could you keep those childhood vows? PEGGY: For the most part yes, and my children and talk about the happy childhood that they had which was a great relief to me but when my youngest was born he was so hyper that one day I found myself spanking him and spanking him not being sure that I can stop and I thought oh I have to do something about this. And so I put him in a nursery school for a short while though I hadn't put my other children in a nursery school both because I loved being with them and because we didn't have the money. I did get him in nursery school for about 4 months 3 mornings a week. It gave me some space and that seemed to do it but that came out of that helplessness that powerlessness that I don't know what to do. STAMBERG: I understand you do public speaking on the subject of child abuse and tell us what you most want us to understand about pychomaltreatment.. what it does to a child and how to avoid doing it. PEGGY: Well I think that we live in a society where we can measure things and if you can't measure them they are not real and they don't exist and sexual abuse and physical. abuse as difficult as they are as horrendous as they are somehow we can see the results of that so its easier for us to focus on that. The emotional abuse is different, any time that we use coercion that is unnecessary we do have to prevent our children from jumping out the window but when we use shame humiliation.........angry and we don't own that anger. When we don't say I m angered with you because you forgot to empty the garbage. Instead of saying to them you never do what you are told you are always doing something wrong your just a stupid ungrateful wretch. That to me is emotional abuse. We live in a society that doesn't like children. We really don't provide for children, legally or in the work place or even in the supermarket. When children run in and they are all excited and make a lot of noise look at all the faces of the people they are not enjoying all this life. STAMBERG: They are angry. PEGGY: So that I think we have to re think our values, we really have to say children are the most important thing for our society they are the next generation the.... generations and we need to think about that. STAMBERG: Peggy, it's the part of your name that you want us to know. Many thanks for telling us your story. PEGGY: Thank you Susan. CHADWICK: Of all the influences which place children at risk for abuse, parental drug and alcohol addiction can have some of the most devastating effects. A year long study of child abuse and neglect incidents in New York city showed that half involved chemical abuse. Researchers say the literature documenting a link between substance abuse is scant, but what there is shows a strong correlation. STAMBERG: Now a growing number of residential treatment facilities can house children with their mothers. As these mothers struggle to change they have to face what their addictions meant to them and their children. From Portland, Oregon Katrin Snow reports on one such program at a place called Clare House. HAYES: I didn't beat my children, you know if they were whining I would shove something in their face just to get 'em to shut up, 'cause I didn't wanna listen to it. I didn't tell my children that I loved them ever, really. DE MARK: I was drunk for three days, I yelled at my son, you know. I ruined Christmas, basically, destroyed it. Real cranky, real what do ya want, you know, just real snappy and ugly. HUNT: She went through withdrawals when she was inside me, we both did, we went through the withdrawals. She shook inside, I could tell even when we were coming off cocaine, she trembled inside, in my stomach. SNOW: Nearly every story that links child abuse with substance abuse begins in two places: One is when and addicted woman has a child. The other is when that woman was a child. ANDERSON: Most of our clients that we see today are themselves victims of sexual, physical, and emotional abuse as children, because they are adult children of practicing alcoholics and addicts. SNOW: Nancy Anderson directs Addictions Recovery Association, which operates Clare House. ANDERSON: Why I was encouraged about doing alcohol and drug treatment for women with children was because I saw a lot of women struggling in recovery for their children. They wanted to have better life for their children. Even though they didn't know how to do that, they knew that they didn't want their children to have the life that they had. BAYS: Drugs and alcohol affect people in so many way that interlink with the risk factors for child abuse. SNOW: Dr. Jan Bays is a nationally recognized authority in the field of child abuse and its link to substance abuse. Bays says parents addicted to drugs and alcohol are often more violent, aggressive, and paranoid. And their children are more likely to be abused psychologically, physically and sexually, and are almost universally neglected. In many cases, addicted parents might let their children go hungry while they divert money from food or other basic needs to buy alcohol or drugs. Especially to support expensive drug habits. Dr. Jan Bays. BAYS: Where would you or I get an extra 200 dollars a day? Well you do it by selling things and people do, they sell their possessions, and their kid's possessions so you end up with a kind of poverty of no toys, few clothes and so on. Then they will sell themselves, it they're women, or sell their children so we have children that are sold into prostitution to earn money for the family's habits. And then they steal, and sell those things, or sell drugs. SNOW: Despite the evidence showing a strong link between chemical dependency and child abuse there is no nationwide requirement that investigators should routinely assess child abuse cases for possible drug and alcohol abuse. Bays feels that such a standard should exist. At Portland's Clare house, staff and therapists say chemical abuse and child abuse are so entwined that in order to change successfully mother and children need to be together in residential treatment. There, women can learn to be parents away from the environment that bred their addiction. And children can experience more stable and predictable patterns. Program director Nancy Anderson says that before coming to Clare House most children here lived in a constant state of chaos and crisis, often not knowing when they would eat next or when they might be subject to abuse. ANDERSON: In alcoholic families, even if dad went to work every day no one ever knew what was gonna happen tonight. Were you gonna come home and all sit down and have dinner, or was dad gonna come home and throw dinner out the back door? SNOW: Clare House prohibits name calling, spanking or verbal or physical violence of any kind. And residents adhere to a strict daily schedule. ANDERSON: We're trying to build a structure around doing normal living skills that most people just automatically know how to do. You get up, you get dressed, you get the baby dressed, you get your children dressed, the kids go to school, you have lunch, dinner, you have everything at a specific time, and you have a plan. SNOW: Many of these addicted mothers have few of these skills and arrived at Clare House having formed little or no bond with their own child. For them, bonding is the first step. BISETH: As a staff, we all work on that. Where's your daughter, she needs to be on the same floor as you are. It's lunch time, you need to take your daughter down and have lunch with her. SNOW: Child therapist Phyllis Biseth says it's typical for children to take care of their addicted parents. She often has to teach mothers basic skills to nurture their children, and to establish their role as parent. Often she says, this means telling a mother and daughter they need to eat off separate plates, and sleep in separate beds. BISETH: You each have your own bed, you each sleep in your own bed. If she's scared to sleep alone, which she probably will be if she slept with mom up until now, then instead of her sleeping in your bed- which also has the underlying tone of the child needs to take care of mom - we have the mom get up and to the child's bed and say, If your scared I'll stay here with you until you fall asleep. Which is the message of I'm the mom and I'll take care of you. BAYS: You're going to do a much better job of treating that parent if you treat them in the context of being a parent. We don't have enough foster homes, possibly, to raise this many children. And we want to empower the primary caretaker to become the parent again, they are the parent and should remain the parent if we can at all make that possible. And the best way to make that possible is in a setting where both the children and the addicted parents are in treatment. SNOW: Fueling by federal funding, the number of residential treatment centers that include children doubled in the earl 1990's. A 1991 survey by the National Committee to Prevent Child Abuse found 269 such centers. But the survey also found that 80% of pregnant woman who are substance abusers are not being treated. Clare House and its companion facility turn away about 150 women a year simply for lack of space. HAYES: I've just come a long way and it's 'cause I was really willing to do this. 'Cause I really, really wanna live this way, I wanna be clean and sober, and I'm, I'm a wonderful mother today ant that's something I never thought I'd be, ever. DE MARK: I told him, you know, Tony, mommy is an alcoholic and I can't drink beer anymore because I'm really mean, and he knows and he remembers. Because he said, Yeah I didn't like you momma when you was drinkin' beer. I didn't like you, but I like you now. BEELER: I can look at him and I can see what color hair he has, and I can see whether he's got a hangnail on his toe or not and when I was on drugs I couldn't see those things. I couldn't even see whether it was night or day. I just went through life at a 100 mile per hour pace, wish that I would just go to sleep and never wake up, and, wishing that one hit would just kill me. Wishing that just one trick would never let me out of his car, you know, that's what I wished for. Because that's what I believed I deserved. When in the back of my head I just had one dream that someday I'd be different. Someday I'd make it, and I'm making it today, I am, I'm making it. CHADWICK: That report was produced by Katrin Snow in Portland, Oregon. We heard from Clare House residents Leslie Beeler, Trisha Hayes, Darlene Hunt and Cheryl Van De Mark. STAMBERG: Breaking The Cycle is a series of special reports on child abuse prevention. The executive producer for this series is Dan Gediman; the producers are Dan Gediman and Jay Allison; the assistant producer is John Gregory; Barbara West is associate producer; Danwen Feng, research assistant; Cathy Stearns, administrative assistant, Terry Walker, studio liaison. Technical director is Michael Schweppe with engineering help from Christine Senko. Our thanks to public radio stations KOBP, Portland, Oregon, WAMC, Albany, WFYI, Indianapolis and KUER in Salt Lake City, Utah. CHADWICK: If you would like more information about child abuse you can contact the National Child Abuse Hotline, toll free, at 1-800-442-4453, that's 1-800- 422-4453. If you would like to contact us with your comments about the series, our email address is btc@iglou.com or you can write us at Breaking The Cycle PO Box 4962, Louisville,KY. 40204. STAMBERG: Coming up in our next Breaking The Cycle special, How child abuse is viewed in different cultures and countries. Including some where child abuse is practically non-existant. .