Psychiatric Impact of Organized and Ritual Child Sexual Abuse, Sexualized Violence in Organized Structures of Violence and in Ritual Structures of Violence

December 3, 2019 § Leave a comment

Psychiatric Impact of Organized and Ritual Child Sexual Abuse: Cross-Sectional Findings from Individuals Who Report Being Victimized

by Johanna Schröder , Susanne Nick, Hertha Richter-Appelt and Peer Briken
Institute for Sex Research and Forensic Psychiatry, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany

Int. J. Environ. Res. Public Health 2018, 15(11), 2417;


Organized and ritual child sexual abuse (ORA) is often rooted in the child’s own family. Empirical evidence on possible associations between ORA and trauma-related symptoms in those who report this kind of extreme and prolonged violence is rare. The aim of our study was to explore socio-demographic and clinical characteristics of the individuals reporting ORA experiences, and to investigate protective as well as promotive factors in the link between ORA and trauma-related symptom severity. Within the framework of a project of the Independent Inquiry into Child Sexual Abuse in Germany, we recruited 165 adults who identified themselves as ORA victims via abuse- and trauma-specific networks and mailing lists, and they completed an anonymous online survey. We used variance analyses to examine correlations between several variables in the ORA context and PTSD symptoms (PCL-5) as well as somatoform dissociation (SDQ-5). Results revealed a high psychic strain combined with an adverse health care situation in individuals who report experiences with ORA. Ideological strategies used by perpetrators as well as Dissociative Identity Disorders experienced by those affected are associated with more severe symptoms (η2p = 0.11; η2p = 0.15), while an exit out of the ORA structures is associated with milder symptoms (η2p = 0.11). Efforts are needed to improve health care services for individuals who experience severe and complex psychiatric disorders due to ORA in their childhood.

Psychiatric Impact of Organized and Ritual Child Sexual Abuse: Cross-Sectional Findings from Individuals Who Report Being Victimized
Full article

ORA, defined as organized child sexual abuse where a (pseudo-)ideological (i.e., ritual) content serves as legitimization for violence, is a complex and polarizing issue in mental health care contexts as well as in research. At present, the uncovering and reprocessing of ORA is a problem that remains to be solved in Germany, as well as internationally. Given the paucity of research in this field, we believe that this study contributes to closing this evidence gap, as it presents empirical data on reported practices of ORA and its impact on trauma-related symptom severity in self-identified victims, in which reported ideological/ritual strategies by the perpetrators and an exit out of the ORA structures play a major role. A key policy priority should therefore be to intensify efforts on the understanding of ORA-related structures, as well as the complex clinical presentation of those affected. Services like information websites and exit programs should be developed by experts in the field in order to contribute to generating appropriate treatment services for this group of clients. Mental health professionals and centers specialized in the treatment of severely traumatized clients with CPTSD and dissociative disorders would contribute to a better support of clients who report such trauma histories. The therapeutic process of detachment from perpetrator networks is intense, and supporters of individuals who experience ORA face special difficulties, like, for example, dissociative personality states.”

Sexualized Violence in Organized Structures of Violence and in Ritual Structures of Violence
Strengthening Prevention, Intervention and Help for Victims and Survivors from the Expert Committee

“Sexualized Violence in Organized Structures of Violence and in Ritual Structures of Violence”,
at the German Federal Ministry for Family Affairs, Senior Citizens, Women, and Youth April 2018

“In traumatic situations which are experienced early and repeatedly, dissociation enables sur-vival by forming separate structures of consciousness in the as yet immature personality. The structures thus created can appear and act as independent personalities. This can result in a dissociative identity structure with an inner system of more or less separate personalities/personality parts. Without protection and appropriate support, the structure persists through adolescence and adulthood (like any long-term trauma symptom) since it was created as a survival mechanism. This falls into the clinical category of dissociative disorders and/or dis-sociative identity disorder.

Dissociative identity disorder (DIS)

Since the standard ICD diagnosis manual in Germany is currently being reissued, we refer to the most current diagnosis manual for mental disorders DSM 5.

It describes dissociative identity disorder using the following criteria:

a) Presence of two or more distinct identities or personality states. There are clear differences in the awareness of one’s self and one’s actions, accompanied by related changes in affect, behaviour, awareness, memory, perception, thinking, and sensory-motor functions. Different personality parts take control of the person’s behaviour at different times, which can lead to visible changes. These changes can be observed by the person himself/herself as well as by others.b) An inability to remember important personal information, important everyday and/or traumatic incidents, which cannot be put down to ordinary forgetfulness. The revised version ICD 11 scheduled for 2018 is expected to contain a similar definition.

Intentionally induced DIS

This involves intentionally utilizing the dissociative protection mechanism and forcing split-ting by means of planned, repeated use of severe violence. The resulting personality parts are trained for specific purposes. Intentionally induced DIS can go unnoticed for long periods of time. There is usually no discernible personality change, instead there is an external everyday person, alongside of or through whom other personalities act. As a rule, this occurs without the everyday person being able to detect or talk about it.”….

“Intentionally induced DIS

Dissociation is an instinctive survival mechanism of the human organism. It is possible to trigger this dissociative protection mechanism intentionally. Forms of severe violence experienced in early childhood which are planned and repeatedly applied bring on dissociation (splitting) and the creation of personality parts which are more or less separate from each other in one person. The individual personality parts are trained for specific purposes defined by the perpetrators/groups of perpetrators, e.g. sexual exploitation, trafficking in drugs or human beings, espionage, specific tasks determined by the ideology of the group, control of the inner personality system. This makes a child especially profitable, e.g. within the scope of commercial sexual exploitation, with the child fulfilling the needs of various “clients” by means of personality parts which can be made to respond to codes or triggers. One possible example: Part A is insensitive to pain and can be used for extreme sexual violence; B knows specific patterns and automatically obeys; C shows physical arousal/“desire” etc.

Intentionally induced DIS can remain unnoticed for a long time. There is usually no discernible personality change; instead there is an external everyday person, besides whom and/or through whom other personalities act. As a rule, this occurs without the everyday person being able to detect or talk about it. In addition, some of the personality parts are only active in defined situations, e.g. while being sexually exploited or within the context of the group’s ideology. At the same time, there are everyday personalities who, for example, go to school and have no memory of the violence. The gaps in memory and/or inner dissociative barriers protect the perpetrators from being discovered (see also Mind-Control, Conditioning, Programming).

Mind control

Mind-control is the deliberate and planned control of a person. Dissociation, conditioning, and program-ming begin at a very early stage, often from birth on (cf. Intentionally induced DIS). The child or per-sonality parts learn that taking any kind of initiative or seeking help in any way is pointless and will be severely punished.

Person, personality, personalities, personality parts

Various terms are used in the specialized literature and in this text. It is an attempt to express complex phenomena in words. Normally, a person is considered to be an individual (Latin individuum “indivisible”, “single thing”). The term “individual” is used especially for designating people as moral subjects, i.e. as possessing rights, responsibilities, and obligations. In this context, the term “persons” is used rather than “individuals”. In the case of persons, individual characteristics, interests, and features are also attributed to subjective elements of the personality, of individuality (Source: Wikipedia). The individual/person is a consistent unit – albeit with many facets and possible roles.In the case of people with severe dissociative disorders/dissociative identity disorder (DIS), this consist-ency is no longer given. The personality is split as a result of dissociation serving as a survival mechanism.

The emergent parts are more or less rigorously separate from each other. In the case of intention-ally induced DIS in particular, the separation may be very extensive and expressed in completely distinct behaviours and thought patterns, memories, capabilities, etc. Depending on the perspective, this can be considered a matter of autonomous personalities or parts or personality parts or personality conditions. It is critical that the formation and existence of the individual parts be considered, in addition to observing the whole (inner system of the personalities). Every person is unique and impossible to control completely – despite inner systems which, in part, were intentionally created by the perpetrators and controlled by them. People with DIS can, through progressive integration (overcoming inner dissociative barriers and amnesias) and self-regulation, develop and use individual strengths, capabilities, and traits for themselves.

Post-trauma disorders

Experiencing sexualized violence normally has consequences which not only result in psychiatric illnesses but also have huge impacts on abilities to interact socially, on professional development, and on physical health. The earlier in life sexualized violence is experienced, and the more frequent and more intense the violent acts are, the more complex the consequences are, that is to say, the consequences overlap with each other. Victims and survivors of organized violence and ritual violence have to live with the consequences of complex traumatisation and with the effects of severe dissociative disorders.


Programming refers to intentionally linking different conditioned behavioural patterns to various corresponding inner parts. These behavioural patterns can then be activated by means of conditioned stimuli/triggers and thus controlled. The automated actions (programmes) may have different, possibly life-threatening, effects: e.g. a return to the group of perpetrators, refusal to eat, inability to accept help, self-mutilation, or suicide.

Sexualized violence/Sexual abuse

The term sexualized violence emphasizes the fact that the focus of the act is violence and not sexuality. Sexuality is functionalized for the purpose of committing violence and exercising power. Based on UBSKM definitions, according to social law the definition of sexual abuse corresponds to that of sexualized violence and denotes actions which are performed on or in the presence of girls or boys against their will, or to which they cannot consciously consent as a result of their being in an inferior position physically, psychologically, intellectually, or verbally. The perpetrator uses his/her position of power and authority to satisfy his/her own needs at the expense of the child. According to criminal law: anyone who forces children into sexual acts, demands that they perform sexual acts, or forces them.

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