As a paediatrician, I have had to face the reality of child abuse as being part of everyday life for many children. In this article, I want to present a biblical perspective on the problem of child abuse in order more clearly to understand its roots and learn how we can respond.

Background

Child abuse is not a new phenomenon and it occurs in all cultures. Both professional and public perceptions of abuse have changed with time and vary between cultures. To illustrate this, just consider the appalling conditions under which even very young children were expected to labour a century ago. Thirty years ago it would have been inconceivable that the use of a cane in schools could be considered abusive; today, even smacking is considered by many to be a form of abuse. What is acceptable in some countries may be quite inappropriate in others. Whilst working in Cambodia, I had to deal with one mother who was distraught that her teenage daughter had run away from home. 'I've tried to be a good mother,' she told us, 'I have beaten her every day to make sure she grows up properly'.

In the 1960s, Henry Kempe described the phenomenon of the 'battered baby'.[1] This brought child abuse onto the agenda in the western world. Since that time, awareness of child abuse and of its effects has grown.

Child abuse is typically considered under four categories, although there is considerable overlap. Other forms of abuse such as bullying, 'societal abuse' (ie the abuse of children by society) and abuse by professionals are also recognised.

Physical abuse

This is the most obvious form of abuse and includes all those instances in which a child is physically harmed. Within this category though, applying a precise definition can be difficult. There is clearly a difference between the child presenting with a few bruises from a parent who has gone too far in their discipline and the baby dying from multiple fractures and an intracranial haemorrhage. Professor David Hall suggests a helpful 'Pyramid of severity' (figure 1).[2] Many children fall into the bottom levels where there is perhaps a degree of chaos or 'inadequate' parenting; however, there is no deliberate, wilful harming of the child. At the other extreme are a minority of cases where the child is intentionally harmed. In between there are huge dilemmas as to what constitutes 'good enough' parenting and at what level the authorities need to intervene.

Neglect

Children are by nature vulnerable and dependent on others for certain basic needs (figure 2). Neglect can be looked at as a denial of any one of these needs. As such, it may be physical - for example, lack of clothing, inadequate diet or failure to change a baby's nappy - or emotional, through lack of love and stimulation. Neglect is often picked up as failure to thrive or developmental delay. A lack of warmth and affection may result in the child being unduly affectionate towards strangers in a search for some love. Alternatively, she may draw into herself, leading to the state of 'frozen watchfulness' that was so evident in Gemma.

Sexual abuse

Sexual abuse seems to differ from other forms of abuse in that it is never an inadequacy or excess of what could be considered normal behaviour. It is very clearly deviant, deliberate and often pre-meditated behaviour. As with most forms of abuse, sexual abuse is usually by an adult or older child known to the child. There is often a period of 'grooming' in which the abuser draws close to the child, subsequently involving her/him in progressively more direct sexual behaviour. Such involvement is always kept secret, often through threats that leave the child trapped and confused.

Emotional abuse

In the area of Southampton where I live, the usual mode of communication between mothers and their children is through shouting: it is not unusual to hear phrases such as 'If you don't get your **** *** back on the **** pavement right now, I'll hit you so hard you won't be able to sit down for a **** week!' Whilst the language itself is eloquent and perhaps part of the culture, the threatening tone and the inappropriate expectations it places on the child are undoubtedly abusive. Whilst abuse is distinctly emotional for some children, all forms of abuse do involve emotional abuse. Children who are physically harmed or who grow up in an atmosphere of neglect will inevitably suffer some damage to their emotions, even more so when they are sexually exploited.

Why is child abuse important?

Child abuse is important from two perspectives: the immediate harm to the child and the long term damage that may be done. Whilst much physical abuse is of a minor nature, severe physical harm can result in the child dying or being left handicapped. One of the most profoundly handicapped children I have looked after was a little boy who had been shaken by his father at the age of three months. Fourteen months later he was blind, unable to speak, feed, or sit without support. He was totally dependent on his foster parents for everything.

However, even in less severe cases, the immediate injury is not the end of the story. As indicated above, all forms of abuse involve some emotional abuse, the scars of which take a lot longer to heal. Every GP, psychiatrist and church leader is aware of the devastating damage done to thousands of adults as a result of childhood abuse. Effectively, abuse says to the child 'you are worthless'. Rather than seeing themselves as loved and cared for, they consider themselves hated, despised and filthy. A young child who has been sexually abused may consider herself no better than a toilet - an understandable interpretation of what has happened. Sadly, the feelings do not only relate to the abuser. Children may believe that others know what has happened and that they themselves are somehow to blame.

The biblical perspective

God's nature

Child abuse presents a terrifying picture. Without the perspective of a loving heavenly father, it could easily lead to hopeless despair. In the Bible we read of God the creator who has made all men in his own image: 'in the image of God he created him; male and female he created them' (Gn 1:27). That in itself places an incredible value on each human life. But God's nature goes further: not only has he made man but he loves each one of us, completely and unconditionally. God's love is the fullness of all a father's love should be. 'How great is the love the father has lavished on us, that we should be called children of God!' (1 Jn 3:1) God loves all men equally, yet as we read the Bible, we see a God who has a special concern for the weak and vulnerable. This includes children: 'Let the little children come to me, and do not hinder them, for the kingdom of God belongs to such as these'(Lk 18:16).

When God created mankind, he instructed them to 'fill the earth and subdue it' (Gn 1:28). With this mandate, God delegated responsibilities to mankind: we all have a responsibility to love our neighbour (Lv 19:18); parents have a particular responsibility to care for and nurture their children.

Satan's work

In contrast to our Father God's abundant love, we see in child abuse the destructive work of Satan in a fallen world. Satan is described as a thief who 'comes only to steal and kill and destroy' (Jn 10:10). What better description of abuse in which children are robbed of their worth, their lives are taken or they are left permanently scarred both physically and emotionally? Child abuse denies the worth of the child. Rather than being a person created in God's image and loved by him, the child is made an object to be beaten, shouted at and used for the gratification of another.

Where God has a particular concern for the weak and vulnerable, Satan specifically targets them as objects of his malice. Not only is it children in general who are abused, we find that child abuse is more common amongst handicapped children who are even more vulnerable. In a distortion of all logic and mercy, those children who have been abused are more likely to go on to abuse their own children.

Throughout the Bible, parents' love for their children is used as an example of God's love for his people (see for example Is 49:15; Lk 11:11-13). Child abuse totally distorts the meaning of parenthood. How can a child, whose father has so broken the trust placed in him, ever understand the meaning of a loving faithful God?

God's work

Child abuse denies the individual's worth. It distorts the meaning of fatherhood and it specifically targets the weak and the vulnerable. It is the epitome of Satan's work. However, we know that while Satan may be at work in this world, he is nevertheless a defeated enemy. We can still have hope: through Jesus' death on the cross, God has freely provided redemption for all men. This redemption includes healing for the abused, healing and forgiveness for the abuser and cleansing from all that has defiled us (Is 53:5; Mt 26:28; Heb 9:14). We know too that Jesus will come again - as judge and as restoring king. When he comes, Satan's power will be finally destroyed, and there will be a new heaven and a new earth with 'no more death or mourning or crying or pain' (Rev 21:4).

How should we respond?

When, as Christians, we are faced with the horror of child abuse, how do we respond? Do we ignore it, pretending that it is not our problem, isn't really happening or doesn't really cause any harm? Do we shrink away in hopeless despair? Does our faith remain a vain hope in a time to come? Alternatively, do we confront the issues, seeking to put our faith into action, bringing reconciliation, healing and forgiveness where it is needed? I would suggest a few guidelines:

Do not take it lightly

Child abuse is a difficult and upsetting area to work in. We need to acknowledge this and also acknowledge our own weaknesses. As professionals, none of us has the whole picture, hence the importance of working with others. We need to be able to recognise when we are treading out of our depth, and to know where to refer to. Recognise that child abuse will raise strong emotions in you. When I have been dealing with a child abuse case, I often come away feeling stained and abused myself, perhaps with feelings of anger or sadness. We all need to find someone to whom we can express our feelings, whilst maintaining confidentiality. Above all, we need to recognise that ultimately child abuse is more than an issue of flesh and blood. It is part of the spiritual battle for which we need spiritual protection (Eph 6:10-18).

The welfare of the child is paramount

This is the key principle on which the 1989 Children's Act is based. I interpret this in the light of God's concern for the weak and vulnerable. All of us, if we become aware of a situation in which abuse may be happening, have a legal and a moral duty to act to protect the child. First and foremost, this means alerting the statutory authorities. This does not mean that the child will immediately be whisked away from their home. The priority within child protection procedures is to work where possible with the family. God's intention is that every child should grow up in a loving, caring family.

Don't be too hasty to judge

The motives of those who abuse children can be very hard to understand. My perception though is that in most cases it doesn't represent a malicious desire to harm the child but occurs in families where the parents genuinely love their children. No matter what underlies the abuse, the abuser too is a person loved by God and is very often a broken, hurt and needy person. We have all sinned and fallen short of God's glory (Rom 3:23) and are equally in need of God's grace. There must be few parents who can truthfully say that they have never, out of anger, frustration or desperation, come close to abusing their child either physically or emotionally. In protecting the child and promoting his welfare, we need to support and protect the abuser too.

Look for the 'third' option

When presented with a woman caught in adultery and the mutually exclusive options of upholding the law or showing compassion, Jesus found a third option that combined the two (Jn 8:3-11). As Christians we need to seek radical, God-inspired alternatives to the world's solutions.

The Church has a responsibility

If the church is truly to be Christ's body on earth, it needs to get its hands dirty and get involved where it is needed. This will take two strands. Firstly, the Church needs to be supporting families. Where abuse has occurred, the Church needs to be there with the parents and with the children. Even before that, we can be acting to prevent abuse. Parenting, perhaps the hardest role any of us will have to fulfill, comes with no vocational training. The Church has the resources to teach parents to be parents. We need to see that promoted. Above all, the Church needs to be involved where it is most needed. Although child abuse occurs across the spectrum of socioeconomic differences, there is no doubt that those in more deprived circumstances, the homeless and children of single parents, are more at risk. It is to those families that we should be going. Secondly, the church needs to support its professionals who are working with child abuse - doctors, health visitors, social workers. Such people are putting themselves in a vulnerable position and need support.

Acknowledge that God has power to heal and forgive

The scars of abuse run very deep but not so deep that Jesus cannot heal them. God 'heals the broken hearted and binds up their wounds' (Ps 147:3). We need to offer healing where it is needed so that we and others may 'draw near to God ... having our hearts sprinkled to cleanse us from a guilty conscience and having our bodies washed with pure water' (Heb 10:22). As you read this, you may be feeling hurt, broken, guilty, dirty. If so, God does want to help you. If you have been abused in the past or if you know someone who has, God can change things. Talk to a Christian you respect. It may not be easy but God deals tenderly with his children.

Postscript

Child abuse is a poignant reminder of the fact that we live in a fallen world; however, there is hope. Jesus, who has entered our world and faced all its ugliness, said 'let the little children come to me and do not hinder them'. In taking the little children in his arms (Mk 10: 13-16) he both leaves us an example and offers us his strength. In following him we look forward to a new heaven and new earth where children are not 'doomed to misfortune'(Is 6:23) and where 'the city streets will be filled with boys and girls playing'(Zech 8:5).