Better understand for better care. This Wednesday, the Independent Commission on Incest (Ciivise) unveils the first conclusions of the call for testimonies launched on September 21. In two months, 3,800 people responded to the online questionnaire made available to victims of childhood sexual violence. A valuable source of information that makes it possible to measure the extent of the trauma suffered and the consequences of these rapes or sexual assaults throughout their lives.
The figures collected by Ciivise and consulted by 20 minutes testify to the chaos caused by this violence when it is committed against minors. Thus, one in three victims reports having already made a suicide attempt in their lifetime. A vast majority of them – nine out of ten – say that the violence has had a negative impact on their self-confidence and on their psychological health. And mental health is not the only area affected by incest. According to the questionnaires collected, one in three victims indicates having no sex life and one in three women suffers from gynecological problems.
“It took me 35 years to associate my symptoms with what I experienced”
To explain these figures, we must delve into the functioning of psychotrauma specific to incest. While most victims (90%) reveal what they experienced, many do so several years after the fact. According to Ciivise, seven out of ten victims who spoke about this violence did so more than ten years later. However “the more time passes between the aggression and the revelation, the more the physical or psychic symptoms associated with this trauma will worsen”, explains the doctor in clinical psychology Karen Sadlier. In addition, there is a glaring lack of information for children who have suffered rape or sexual assault. “It took me 35 years to associate my symptoms with what I experienced,” says Isabelle Aubry, for example. Raped by her father when she was a child, the founder of the association Facing incest points to a “scourge of public health”.
“In 2010, already, we carried out a survey in partnership with Ipsos to measure the medical and psychological consequences of incest. We alerted the government and the public authorities, but nothing has been done to improve the care process for victims ”. At the time, however, the survey showed that 98% of incest victims feel or have felt “regularly very depressed”, against 56% for the rest of the population. In Isabelle Aubry’s case, participating in a support group enabled her to understand that she was “no longer alone”: “When I heard them talk about their symptoms, their addictive behavior, trusting in themselves or in others, I was completely overwhelmed. I thought to myself: “But actually, I’m normal”. “
Improve spotting
These new data, extracted from the testimonies of 3,800 people, should make it possible to refine the care of incest victims, hopes Louis Jehel, professor at the University Hospital of Amiens and president of the Institute of victimology in Paris. “The figure concerning the prevalence of suicide attempts among these patients should enable us to improve the identification of victims. When a person arrives at the emergency room for this reason, they should be questioned systematically about the existence of previous sexual violence. These are delicate questions – and they must be as open as possible – but it is absolutely necessary to encourage health professionals to do so, ”he believes.
Ditto for gynecological and sexual issues, he argues: “The gynecological examination can be traumatic and generate apprehension for some women victims of violence. Training needs to be improved to be able to spot this vulnerability. “
Develop an adapted treatment path
And improving identification must be accompanied by work on a more suitable course of care, warns Isbelle Aubry. “When I started the association, almost 20 years ago, I went to Canada. There, there are specialized care centers. They are so well known and identified that they are signposted in the street, ”she recalls. In France, the management of psychotrauma was consolidated after the attacks of Saint-Michel in 1995, recalls Karen Sadlier. “But these advances were above all built to support the victims of a unique traumatic event. However, in cases of incest, assaults or rapes often took place repeatedly and over a longer period of time, ”adds the psychologist. A specificity that requires a different approach.
Within his institute, Professor Louis Jehel has developed a “transversal approach”: “Incest causes psychological problems but also physical, sometimes social or legal. We try to offer coordinated support, but we encounter funding difficulties, ”he regrets. At present, more than 400 people are awaiting treatment at the psychotrauma center in Paris. Isabelle Aubry pleads for a better “readability” of the treatment path: “Today, when you have your credit card stolen, you know exactly what to do and who to contact. But when you are a victim of incest, you don’t know who to contact or where. It’s not normal “.
In November 2017, Emmanuel Macron announced the creation of ten specialized units in the overall management of psychotrauma. An initiative hailed by Louis Jehel but insufficient in the eyes of Isabelle Aubry: “The offer of care remains too scattered and not sufficiently identified. You see it when you listen to the victims of incest. Too many of them still say “I was lucky because I ran into the right people”. It shouldn’t be luck. “