'That kind of psychological manipulation surrounding the physical abuse, that does the primary psychological damage'

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[Dr. James Cantor, sexologist:] The research is more complicated than most people would appreciate. What appears to cause the greatest harm, [...] the research seems to indicate that it's less the actual physical contact, and more the pressure and the coercion and the techniques that the perpetrator uses in order to gain access to the kid. It's the manipulation, it's the threats, it's the threats of what the perpetrator will do if the kid tells anybody. The betrayal of not being able to talk when other family members are present (the majority of these cases happen inside families). That kind of psychological manipulation surrounding the physical abuse, that does the primary psychological damage.

Now as I said that's something that requires some expansion so as to not be misinterpreted. I'm not talking about the profoundly violent rape, the forced penetration of orifices. I'm talking about the cop-a-feel kissing inappropriate grossly abusive full leg of the law should be there, but not causing great physical trauma on the kid. As I say it's very strange to be taking child abuse and saying "oh that's not so black and white." But when is looking at what is causing what in trauma, and again is going to actually treat it, one has to realize that the majority of this is really from the manipulation and the psychological stuff that went on rather than the physical touching, even though most adults imagination is, oh we imagine what the rape of an adult would be, oh it's physically traumatic, and we start projecting what we think it was like from the kid's point of view, but that's not really generally the kid's point of view. With exceptions, that does happen, and we need to deal with them, and we need to treat them as the exceptions.

source: Interview 'A Crash Course in Sexology | with Dr. James Cantor' by Benjamin A. Boyce; Transcript from: www.boychat.org/messages/1550487.htm; Posted by 'Cherubino'; Original: www.youtube.com/watch?v=r6oJj6b5FQM&t=5055; YouTube; 19 January 2019