Adults generally are the perpetrators of sexual assaults that occur within their families, and usually it is a man who assaults his wife or child. Although rapes committed by adolescents have been reported in the medical literature, to our knowledge the raping of a parent by a teenager or child has not. We report a case of a child who sexually assaulted his mother and nearly sodomized her.
CASE REPORT Bobby, an 8-year-old boy who lived with his natural parents and three younger siblings, was treated unsuccessful- ly for 1 year with methylphenidate when he was 6 years old. He was referred to our clinic I year later because of complaints of fighting with classmates and siblings, defying teachers and parents, setting fires, stealing money from his mother, and engaging in sexual activity with his 6- and 4- year-old brothers (e.g., aggressively fondling their genitals, forcibly attempting to insert his fingers into their rectums, and coercing them to perform fellatio on him). At age 6, Bobby unsucessfully attempted sexual intercourse with an Received May 27, 1983; revised Jan. 6 and April 16, 1984; accepted April 24, 1984. From the Departments of Psychiatry, Los Angeles County-University of Southern California Medical Center and Neuropsychiatric Institute, University of California at Los Angeles. Address reprint requests to Dr. Arroyo, Graduate Hall, 1937 Hospital Place, Los Angeles, CA 90033. The authors thank Drs. Robert Stoller and Kerrin White for their comments on an earlier draft of this manuscript. Copyright 1984 American Psychiatric Association. adolescent babysitter, and at age 8 he was forced by a 9-year- old playmate to perform fellatio on him. The details of Bobby’s sexual activities were provided by him and corrobo- rated by his mother. Before her marriage, Bobby’s mother lost custody of her first two children because of neglect. Two years before Bobby came to our clinic, his mother attempted suicide by overdos- ing after her husband learned of her sexual affair with her brother-in-law. Bobby’s father also had a history of extra- marital affairs. Bobby denied having any sexual activity with adults until he was 8 years old. His observations of adult sexual activity were limited to his father’s accessible pornographic literature and one viewing of his parents during sexual intercourse. On weekend mornings Bobby and his two brothers joined their parents in bed. While his mother slept alone one morning, 7-year-old Bobby climbed into her bed and began to squeeze her breasts. She awakened, reprimanded him, and ordered him out of the room. Five months later while his mother again slept alone, he quietly sneaked under the sheets, began fondling her anogenital area, and attempted to insert his erect penis into her anus. His mother was appalled and angry with Bobby. He told his therapist that he had been viewing pornographic materials just before entering his parents’ bedroom and that he had intended to “fuck” his mother. Bobby claimed to have received a severe scolding by his father later that day. Physical abuse of Bobby by his father had not been reported by the mother or the child; however, our suspicions were raised by the fears of the mother and Bobby that if the father learned of certain behavioral prob- lems, “he would kill” Bobby. Bobby’s father refused to attend any of the weekly family therapy sessions and repeatedly discouraged Bobby from attending his individual psychotherapy sessions. The father knew that the local authorities had been anonymously notified that Bobby was suspected of being a victim of child abuse. Bobby’s sexual assault successfully elicited a brief period of firm limit-setting and supervision by his parents in what was an otherwise chronically chaotic personal world. Treat- ment provided an opportunity to explore his relationships with his father, whom he perceived as threatening, and his Am J Psychiatry 141:9, September 1984 1107 CLINICAL AND RESEARCH REPORTS mother, whom he perceived as erratic, in the context of a safe, consistent, and nonstimulating play psychotherapy. His therapist’s attention to the sexual and impulse control issues seemed to offer some external restraint on all family mem- bers and validated the child’s sense of victimization. After 1 year of weekly treatment, Bobby continued to seek porno- graphic materials but was not known to have engaged in sexual contacts; at his age this behavior is further testimony to both the seriousness and the chronicity of his psycho- pathology.
