Child abuse can cause mental disorders

Deutsche Welle: What goes on in the mind of a mother who abuses her own child and sells him to men who also abuse the boy?

Dr. Michael Kölch: In such a case, empathy is clearly lacking as well as a feeling of motherly concern for the child. Dependence on the pedophile partner could also play a role. All this is connected with a lack of empathy for the child. While pedophiles are concerned with sexual lust, the mother was probably more interested in stabilizing her relationship with her partner.

These cases of extreme pedophilia are shocking time and again — especially that children must experience such things over a longer period of time. This boy's experiences are shocking in any case.

What mental disorders could the boy suffer from?

In general, such experiences can lead to a variety of psychological symptoms and disorders. Depression and violence can occur. He seems to have drawn attention at school through violence and aggression. Of course, such children can develop post-traumatic stress disorders, but it is usually a very complex psychopathology that accompanies these children and adolescents into adulthood if there is no corresponding therapeutic reaction.

Read more: Opinion: German abuse revelations call for intervention

What other consequences can such abuse have?

Victims of abuse later develop poorer physical health, as we now know from research findings. There are many different patterns of explanation. Such people take less care of themselves and go to the doctor less often. Diseases are often only recognized at a late stage. Such severe, traumatic experiences can also lead to epigenetic changes. To put it simply: The body may age more quickly.

How was the boy able to endure the constant abuse?

Most children develop a certain dissociation mechanism. This means they separate what they have experienced from their everyday life. In the long term, however, this means the children may have problems with their own bodies. This can be seen in the fact that they often take little care of themselves or cause injury to themselves. They need to to feel their body "negatively," and only through these extreme behaviors can they achieve this.

What consequences could the abuse have for the boy?

We know that the consequences can be relatively diverse, especially because so much has come together here. If he only had such an experience once, the probability that he would develop a post-traumatic stress disorder, for example, would be relatively high. But this boy was neglected and abused over a long time period. This can lead to a very broad spectrum of affective disorders, from depression and anxiety to highly impulsive social behavior disorders. However, these disturbances do not necessarily occur. It also depends on how it is handled now.

How can you treat such a child?

First of all, we need to see if symptoms develop. Is there a need to talk? Is he afraid, for example? Is he aggressive, impulsive? Is he having trouble sleeping? Does he hit other kids? Is he afraid to go down to the basement? Does he have panic attacks? Does he show any psychiatric abnormalities? It's also about what he wants to recount about his experiences. Ultimately, the therapist must try to achieve emotional stabilization and respond to emotional needs in a manner appropriate to his age.

Psychiatrist Michael Kölch is a professor at the Brandenburg Medical School for Child and Adolescent Psychiatry and deputy president of the German Society for Child and Adolescent Psychiatry.