By: Rae Sampson-McMillan, LCSW-R, SIFI

September 22, 2026

I. Opening

There is a particular kind of silence that does not mean nothing happened. It means something happened to someone who could not afford to say so.

Incest and sexual assault of minors by family members, paramours, or other trusted adults occupy a different psychological terrain than abuse by a stranger. The child is not asked to identify a threat from outside the circle of safety — they are asked to identify the circle of safety itself as the threat. About 90 percent of child sexual abuse is committed by someone known and trusted by the child or their family, according to the Centers for Disease Control and Prevention. Family members alone account for nearly half of the abuse committed against children under six, tapering to roughly a quarter of cases by adolescence, according to a national law enforcement analysis conducted for the U.S. Department of Justice. These are not statistics about danger lurking at the margins of a child’s world. They are statistics about the center of it.

For the purposes of this essay, “child” and “minor” refer to anyone under eighteen, consistent with federal child welfare law. Within that range, however, developmental capacity varies enormously — and so do the ways abuse is experienced, defended against, and later expressed. A six-year-old lacks the language to name what has happened; a twelve-year-old may have language but not yet the psychological architecture to resist self-blame; a sixteen-year-old may have both, and still weigh the very real social and legal consequences of speaking. What follows moves across this range, and the reader should hold in mind that a behavior or defense described in one section may look different, or emerge differently, depending on where a given child sits within it.

This essay is concerned with what happens in that center — what keeps a minor from naming the person who has harmed them, what it costs them to hold that silence, and what those of us who sit across from these children in a therapy room owe them in return. It is written from thirty plus years of human services experience that include child welfare, domestic violence and clinical practices in New York City, not from theory alone, though the two will meet often in what follows.

II. The Power Structure Inside the Family

To understand why a child stays silent, it helps to understand what, exactly, the perpetrator holds power over. It is rarely only the child’s body. It is very often the child’s version of reality.

A parent, stepparent, or other trusted family figure typically holds two kinds of power at once. The first is relational — control over food, shelter, affection, belonging, the basic architecture a child depends on to survive. The second, and the one I have come to believe is underappreciated in both clinical training and public understanding, is narrative power: the authority to define what the family is, what happens within it, and who gets blamed when the truth threatens to surface. A child who discloses is not simply accusing an individual. They are contradicting an entire authored account of their family’s life — one that other members may have every incentive to protect, even unknowingly.

This is how a child who tells the truth becomes, in the family’s eyes, the one who caused the disruption. The perpetrator’s power does not end at the moment of disclosure, and it certainly does not end when that person is removed from the home. The narrative they built often stays intact — reinforced by relatives who cannot or will not revise their understanding of someone they love, by financial or social consequences the family now faces, by the plain difficulty of accepting that harm came from inside rather than outside. The child, meanwhile, is frequently left to carry the label of the one who broke the family — rather than the one who was left broken by it. This dynamic is not confined to any one country; it recurs wherever these power structures exist.

This dynamic does not exist in isolation. It sits inside a broader structural condition — what the Oppressiveisms™ framework identifies as adultism: the near-total authority adults hold over children as a class, independent of any individual relationship. Children cannot leave, cannot independently access help, and cannot consent to most decisions made about their own lives. A parent or trusted adult who commits incest or sexual assault is not creating power from nothing. They are borrowing from a structure that already grants adults substantial authority over children, and turning that borrowed authority toward harm. Understanding this distinction matters because it relocates the source of a child’s powerlessness — the child is not powerless only because of the abuse; they were already structurally powerless before it began, simply by virtue of being a child inside a system built around adult authority. Within the Oppressiveisms™ framework, this pattern is named Borrowed Systemic Power™ — power the abuser does not create, but draws from a structure that already grants it to them.

A gendered pattern runs through this from the outset: girls make up roughly 82 percent of identified child sexual abuse victims, boys about 18 percent, according to Department of Justice data — one of the starkest disparities in this entire picture. Family members account for a substantial share of the abuse committed against both: 47 percent of offenders against girls under 12, and 40 percent against boys under 12. The sharper disparity is not in how often a family member offends against a girl versus a boy, but in what happens after disclosure: girls are more often met with suspicion that they somehow invited the attention, while boys are more often silenced by pressure not to appear weak, or by the added shame of being presumed complicit. Different mechanisms, same structural root — sexism operating within the family and social system that assigns different value and different credibility to a child’s account depending on their gender.

Ableism follows a similar structural logic. Children with intellectual, developmental, or physical disabilities are roughly three times more likely to be sexually abused than children without disabilities, according to a 2013 Vera Institute of Justice analysis — a pattern driven less by any characteristic of the child and more by the conditions disability creates: greater physical dependency on caregivers for intimate daily care, which normalizes a level of bodily access an abuser can exploit; communication barriers that make disclosure harder to produce and easier to dismiss; and a credibility gap in which a disabled child’s account is more readily discounted as confused, suggestible, or unreliable, regardless of its accuracy. The same structural pattern seen with adultism and sexism repeats here: an abuser does not need to manufacture power over a disabled child from nothing. They borrow it from a social structure that already treats disabled children’s dependency as license, and their testimony as inherently less credible than a non-disabled child’s would be.

Linguicism and culturalism operate through the same structural logic. Children in families with limited English proficiency, or dependent on a family member’s immigration status in an unfamiliar country, are also at elevated risk for sexual assault — isolation from outside support systems and fear tied to language or status barriers can make them easier targets, and harder to reach once harm has occurred.

I learned that asking this important question — not only “what happened,” but “what position of power did this person hold, and who else’s stability depended on that position remaining unquestioned” — matters in any case involving a family member or trusted individual, and so too should any practitioner sitting across from one. The answer to that second question usually explains the silence far better than fear alone does.

III. Why Minors Don’t Tell — The Psychological Barriers

If Section II asked who holds power, this section asks what that power does to a child’s inner world.

The most basic bind a minor faces in incest and trusted-perpetrator abuse is an attachment bind: the person harming them is very often the same person their survival depends on. Psychologist Jennifer Freyd named this betrayal trauma — the mind’s tendency to suppress conscious awareness of abuse specifically because the abuser is essential to the child’s attachment needs (Freyd, 1996). This is not a failure of courage. It is a survival adaptation. A child cannot afford, in any functional sense, to fully register betrayal by the person feeding, housing, or loving them, so the mind finds ways not to.

Grooming compounds this. Perpetrators frequently reframe abuse as love, as a special secret, as a game — vocabulary a child has no framework to challenge. By the time a child has language sophisticated enough to name what happened as wrong, the abuse may have already been folded into their understanding of what closeness with this person means.

Self-blame follows closely behind, and it deserves to be named plainly rather than euphemized: many children believe, with real conviction, that they caused what happened to them — sometimes because of confusion over an involuntary physiological response, sometimes because a perpetrator told them so directly, sometimes simply because a child’s mind reaches for causality and finds itself the only available explanation close at hand.

And beneath all of this sits a fear that is often underestimated in clinical training: fear of what disclosure will do to the family itself. Fear of being blamed rather than believed. Fear that the person who caused harm remains, in every practical sense, still in control — of the household, of the household’s account of events, of what happens to the child next. This is not paranoia or excessive caution on the child’s part. In many cases, it is an accurate read of the situation, and treating it as irrational does the child a disservice. The child’s silence, too, is not irrational — it is a reasonable response to an unreasonable position, and it should be understood by the adults around them as exactly that.

III-A. Religious and Spiritual Authority as a Channel of Trust

Trust rooted in religious authority carries its own particular weight. When the person who harms a child also holds spiritual authority over them — a pastor, an elder, a religious mentor, or a parent who invokes faith to frame the abuse itself — disclosure can feel like it threatens not just the family, but the child’s entire moral or spiritual framework. This form of trusted-perpetrator abuse deserves its own fuller treatment elsewhere; here it is enough to note that faith-based authority is one more channel through which silence can be enforced, not exempted from it.

IV. Defense Mechanisms

The mind of a child carrying incest or trusted-perpetrator abuse does not simply store the memory and wait for a safe moment to speak it. It reorganizes around the abuse, often in ways that look, from the outside, like something other than trauma.

Dissociation is among the most common — a psychological distancing from the event as it happens or afterward, so that the memory feels distant, foggy, or as though it happened to someone else. Repression can follow, particularly with abuse that began very young: not a conscious choice to forget, but an authentic loss of access to the memory, which can resurface unpredictably years later, sometimes in therapy itself.

Splitting deserves particular attention in family-perpetrator cases: the child holds two contradictory versions of the same person — the parent who tucks them in and the parent who hurts them — without integrating them into one coherent, dangerous whole. This is not confusion. It is a defense that allows the child to keep receiving care from someone they also fear, which is often the only viable option available to them.

Minimization (“it wasn’t that bad,” “it only happened once”) and identification with the aggressor — where a child comes to see the perpetrator’s perspective as more valid than their own experience — are two more common defenses.

V. Communicating the Unexpressed

When a child cannot say what happened to them — through fear, dissociation, self-blame, or the simple absence of words adequate to the experience — the body and behavior often say it instead.

Somatization is among the most common forms this takes: stomachaches, headaches, and other physical complaints with no identifiable medical cause, appearing and recurring in ways that track closely with proximity to the perpetrator or with anniversaries of the abuse. These are not fabricated symptoms. The body is registering something the conscious mind has not yet been permitted to say aloud, process, and express.

In adolescents, this can escalate into self-harm, disordered eating, and substance use — behaviors that function, however destructively, as a way of exerting control over a body that was once controlled by someone else, or of expressing pain that has nowhere else to go. Sexualized behavior beyond developmental norms in younger children is one of the more direct behavioral signals, though it is often misread by adults as precociousness rather than exposure.

Regression deserves particular mention in younger children — a return to earlier developmental behaviors (bedwetting, thumb-sucking, clinginess) that had already been outgrown. This is the child’s system reaching backward for a time when it felt safer, even if only in memory.

Left unaddressed, these are not phases that resolve with time alone. They are the child’s only available language for an experience they have not yet been given permission, safety, or words to speak directly.

VI. Signs to Look For

Because minors so often cannot say directly what has happened to them, the signs available to caregivers, teachers, and clinicians are frequently behavioral, physical, or emotional rather than verbal, consistent with guidance from the CDC and Australia’s National Office for Child Safety. No single sign confirms abuse on its own, and many overlap with other stressors in a child’s life — but a cluster of these, especially a change from a child’s prior baseline, warrants attention.

Behavioral signs

• Sexualized knowledge or behavior beyond what is developmentally expected for the child’s age
• Sudden decline in school performance or social withdrawal
• Regression to earlier developmental behaviors in younger children
• Avoidance of a specific person or resistance to being alone with them
• Self-harm, disordered eating, or substance use in adolescents
• Overcompliance or excessive eagerness to please adults, paired with difficulty asserting boundaries

Physical signs

• Somatic complaints with no identifiable medical cause — stomachaches, headaches, recurring pain
• Sleep disturbance, nightmares, or bedwetting regression
• Physical injury inconsistent with the explanation given, though physical findings are absent in the majority of cases and their absence should never be read as absence of abuse

Emotional and relational signs

• Flat affect or dissociation when certain topics, people, or places arise
• Heightened startle response or hypervigilance around a specific individual
• Shame or guilt disproportionate to the situation as the child describes it
• Difficulty trusting adults generally, or conversely, indiscriminate trust that lacks normal boundaries

For those working directly with children — clinicians, teachers, coaches, extended family — the most reliable signal is often not any single item on this list, but a change: the child who becomes someone different than the child you knew a season ago.

VI-A. When Silence Outlives Childhood

Left unaddressed, these patterns do not resolve simply because a child turns eighteen. They migrate.

The dissociation that once protected a child during abuse can persist as a pattern of disconnection in adult relationships. The hypervigilance that once kept a child alert to danger in their own home can settle into chronic anxiety that no longer has an identifiable source. The self-blame instilled in childhood does not expire; it simply finds new material to attach itself to — a difficult relationship, a professional setback, a parenting struggle — each reinterpreted through a lens of unworthiness whose true origin may go unnamed for decades. Adult survivors of childhood sexual abuse also carry a markedly elevated risk of suicidality — roughly three times the risk of suicide attempts as adults who were not abused, according to a 2019 meta-analysis of 36 studies in Psychological Medicine, rising to nearly five times the risk among survivors of repeated or complex abuse — a fact that underscores how much is genuinely at stake in a child’s early experience, not simply their comfort in the years that follow it.

If you or someone you know is a survivor of childhood sexual abuse and experiencing thoughts of suicide, the 988 Suicide & Crisis Lifeline is available 24/7 by calling or texting 988 in the United States. Outside of the U.S., please contact your country’s designated suicide and crisis hotline for assistance.

This is not a detour into adult treatment, which is its own subject entirely. It is a reminder of the stakes. What is not addressed at seven, or twelve, or sixteen does not stay contained to seven, twelve, or sixteen. It becomes the architecture something else gets built on. Which is precisely why what happens next — how a minor’s disclosure is received, handled, and responded to by the adults and systems around them — carries weight far beyond the moment it occurs.

VII. The Disclosure Bind — Why the System Itself Silences Children

If the psychological barriers in Section III explain why a child struggles to speak, this section addresses something different and, in many ways, more solvable: how the systems built to help a child speak often make it harder instead.

Mandated reporting exists for good reason. But the way it is typically introduced in a therapeutic setting creates a bind with no clean exit. A child who begins to approach disclosure is, in that same moment, approaching the threshold at which their therapist becomes legally obligated to report — often to the very system whose involvement the child fears most: one that could remove them from their home, destabilize their family, or expose them to further blame. The therapeutic alliance, built carefully over weeks or months, can rupture in the instant a child realizes that speaking further will trigger consequences entirely outside their control.

This is frequently not framed to the child as protection. It is experienced as betrayal — proof that even the one adult who seemed safe cannot, in the end, keep their trust.

There is a structural fix available that does not require rewriting statute. The conversation about mandated reporting should happen at intake, generically, before any disclosure content is on the table — not introduced reactively in the moment a child begins to approach the material. When it arrives reactively, the child correctly reads it as a direct response to what they just said, which makes disclosure itself feel like the triggering offense.

Language matters as much as timing. “I have to tell someone” reads to a child as betrayal. “My job is to make sure you’re not carrying this alone anymore” describes the same legal act, but relocates its meaning from punishment to protection. This distinction provides emotional safety to the child, and carries a weight deserving in clinical training.

The child should not be the one to whom consequences are explained. Disclosure of what happens next — investigations, safety planning, family meetings — should be directed to the caregiving adults responsible for the child’s safety, while the child’s own sessions remain focused on stabilization. A child should not be expected to sit across from the person explaining a system they have no power over. Such a situation requires improved practice.

Safety planning should anticipate family rupture, not just respond to it. When a parent reacts to disclosure by pulling a child from therapy altogether — which happens with real frequency — the child loses access to care precisely when they need it most. Identifying alternate points of contact early — a school counselor, a pediatrician, a trusted relative — before disclosure occurs, rather than after a parent has already withdrawn consent, can mean the difference between continuity of care and total loss of it.

None of this requires HIPAA or mandated-reporting statute to change. It requires practitioners, and the systems that train them, to treat sequencing and language as clinical tools with real consequences — not as procedural formalities that are then checked off.

VIII. Getting to the “Aha” Moment — Therapeutic Breakthrough

If Sections III through VII explain why a child stays silent and how systems inadvertently reinforce that silence, this section asks what actually moves a child toward disclosure — not through pressure, but through safety sufficient to make disclosure possible at all.

A safe environment is the precondition for everything else. Before any approach to content, a child’s nervous system must register the therapy room itself — its consistency, its privacy, its non-reactivity — as safe. This is where trauma-informed and somatic modalities often succeed where direct verbal questioning fails: EMDR, sensorimotor psychotherapy, and play therapy for younger children work with the body’s own pacing rather than pushing against it. The evidence base for EMDR with children, while growing, remains preliminary — a 2018 systematic review found meaningful promise but called for more research, particularly with pre-adolescent children — which argues for using it as one tool among several rather than a stand-alone approach. Safety here is not a mood in the room. It is a structural condition the therapist builds deliberately, session by session, before it is ever tested.

Externalization creates distance that makes proximity possible. Art, sand tray work, third-person narrative (“tell me about a girl who…”) allow a child to approach the material sideways, without the direct first-person weight of “this happened to me” — a weight many children are not yet able to carry aloud, even when they are able to carry it in another form.

Psychoeducation can remove shame before it has the chance to calcify. Naming, in advance and without waiting for disclosure, that the body sometimes responds involuntarily regardless of what the mind wants, or that secrecy is a tool abusers use deliberately, gives a child language that pre-empts self-blame rather than trying to dismantle it after the fact.

Consistency does the work that persuasion cannot. The moment a child finally discloses is rarely the result of a single well-timed clinical intervention. It is far more often the cumulative result of a child testing the same relationship for loyalty and safety, repeatedly, over weeks or months — and receiving the same steady, non-reactive response each time, without exception, until the accumulated evidence of that consistency outweighs the fear. A single inconsistency — one reactive expression, one broken confidence, one moment of visible alarm — can undo months of that accumulated trust in an instant. This is, in a sense, the therapist offering the child a different model of loyalty than the one the child has known: loyalty that does not require silence in exchange for care.

Before meeting with a child in these circumstances, a clinician benefits from applying the DARE Test™ as a model to guide their own preparation, not to the child’s process. Discover the power systems likely at play for this particular child — adultism, and depending on the child, ableism, sexism, linguicism, or culturalism, among others — before assuming a single generic script will fit. These power systems are drawn from the Six Domains of the Oppressiveisms™ Framework. Acknowledge those systems honestly, including any the clinician might be inclined to minimize or overlook. Reflect on what the child may possibly be navigating — including silence, the loyalty bind, fear, or the specific dependency at play in their situation. Reflect, too, on who holds the power in the child’s life, and where that power fits into the scenario at hand. Empower, in this context, means using that self-examination to shape a room, a pace, and a presence the child can actually feel safe in — safety built from the clinician’s own clarity, not from technique alone.

Understanding why the child protects the person who harmed them is more useful than trying to talk them out of it. The loyalty a child shows toward a perpetrator is not confusion to be corrected. It is, as Sections II and III laid out, an adaptive response to genuine dependency, attachment, and fear — and it usually cannot be dismantled by argument. What helps is a therapist who can hold both truths without flinching: that the person hurt them, and that the child’s continued attachment to that person makes complete sense given everything the child depends on them for. A sentence like “it makes sense that you’d want to protect someone who has also hurt you” speaks directly to that bind, without asking the child to abandon the loyalty or produce disclosure on demand. Children who have spent years being told, implicitly or explicitly, that their experience isn’t real often describe this kind of statement as the first moment someone actually understood the position they were in — the “aha,” not of the abuse itself being revealed, but of finally being seen accurately.

IX. Closing

Return, for a moment, to the question this essay opened with: who holds the power, and who else’s stability depends on that power remaining unquestioned. Every barrier to disclosure described here — the attachment bind, the grooming, the self-blame, the defense mechanisms, the fear of family collapse — traces back to that single structural fact. A child does not stay silent because they are weak, confused, or complicit. They stay silent because the architecture around them, built by adults and by the systems adults created, has made silence the only viable option available to them.

This is not only an American story. The same structural conditions — adultism, the credibility gaps that fall along lines of gender, disability, language, and culture, among others — recur across the globe wherever these power structures exist: wherever a child depends on an adult for survival, and an adult abuses that dependency precisely because the child is powerless to stop them. The particulars differ by place; the architecture of power does not.

If there is a single call to action this essay is built to make, it is this: the response to a child’s disclosure should be judged not by whether it satisfies a legal or procedural requirement, but by whether it protects the relationship that made disclosure possible in the first place. A reporting statute followed correctly but delivered thoughtlessly can still cost a child the one adult they trusted. A therapeutic breakthrough achieved through genuine safety and consistency can still be undone by a system that was never built with the child’s felt experience in mind. Getting the law right and getting the relationship right are not the same task, and this essay has tried to insist, throughout, that practitioners cannot treat the second as automatically solved by the first.

What years of both administrative leadership and direct clinical practice have taught me is this: the “aha” moment — the moment a child finally feels safe enough to be known — is not produced by cleverness. It is produced by adults who are willing to be steady long enough, and honest enough about Borrowed Systemic Power™ and the structures that grant it, for a child to test whether this time might be different. That is the work. It has always been the work. What changes, and what must continue to change, is how well the systems around that work support it rather than undermine it.

References

Angelakis, I., Gillespie, E. L., & Panagioti, M. (2019). Childhood maltreatment and adult suicidality: A comprehensive systematic review with meta-analysis. Psychological Medicine, 49(7), 1057-1078.

Centers for Disease Control and Prevention. About Child Sexual Abuse. Child Abuse and Neglect Prevention.

Chen, R., Gillespie, A., Zhao, Y., Xi, Y., Ren, Y., & McLean, L. (2018). The efficacy of eye movement desensitization and reprocessing in children and adults who have experienced complex childhood trauma: A systematic review of randomized controlled trials. Frontiers in Psychology, 9, 534.

Freyd, J. J. (1996). Betrayal Trauma: The Logic of Forgetting Childhood Abuse. Harvard University Press.

National Office for Child Safety (Australia). Signs and Indicators of Child Sexual Abuse.

Sampson-McMillan, R. (2026). Oppressiveisms™ Part One: The Framework. Unpublished manuscript.

Snyder, H. N. (2000). Sexual Assault of Young Children as Reported to Law Enforcement: Victim, Incident, and Offender Characteristics. U.S. Department of Justice, Bureau of Justice Statistics.

Vera Institute of Justice. (2013). Sexual Abuse of Children with Disabilities: A National Snapshot.

About the Author

Rae Sampson-McMillan, LCSW-R, SIFI, is a social work leader, clinician, and organizational strategist with three plus decades in human services. Her career has spanned clinical, management, and executive leadership roles, including having served as Chief of Staff to the Executive Deputy Commissioner in the Division of Child Protection within the NYC Administration for Children’s Services (ACS) — one of the largest child welfare agencies in the United States. She holds a Master’s Degree in Social Work (MSW) from Columbia University and a Bachelor of Science (BS) from Fordham University, and is the recipient of the NASW-NYC Award for Exemplary Mid-Career Social Work Leadership in New York City. She is the originator of Oppressiveisms™, a word she coined in 2002, and the developer and author of its framework — A Transformative Framework: Magnified, Collective, Clarified and Inclusive for Social Justice and Public Well-Being — further explored at oppressiveisms.com. She has authored and published related Oppressiveisms™ articles. She currently is an independent consultant on the Oppressiveisms™ framework.

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