With the Spring holidays, family gatherings are the norm rather than the exception. Considering the recent #MeToo campaigns where assault victims have come forward with revelations they thought they’d never make, one needs to evaluate how the such circumstances could collide into a major familial mishap. We love our families, but unfortunately, some of the hardest things we ever face are related to unexpected friction with the people we should be able to trust the most. Sometimes we bear our hearts and souls at such family functions, but is it really the best thing to do?As a rule, family secrets can devastate and divide family members, and we’re not just talking about sharing Grandma Fredericka’s prize-winning roast chicken recipes, which might make her angry (at the very most). Rather, many dysfunctional families include some relatives who have such deep, dark secrets that they keep as private matters, so everybody who knows about them tends to keep such information to themselves. Believe it or not, this can be the very thing that dissolves family unity.Maybe great-great-Aunt Matilda, the last holdover from Victorian times, would be embarrassed to hear certain things about her precious relatives, and perhaps family members have been encouraged to keep certain things quiet to keep from offending her sensibilities. Maybe Cousin Rufus was in jail for a year after he turned 18, and his socialite mother doesn’t want to disgrace the family name by talking about it. Or, Brother-in-law Guido is a chronic gambler and bad check artist, and his devoted offspring want to ensure that they receive the massive “piece of the pie of Grandpa’s estate” they think they so rightfully deserve. The reasons for keeping secrets are myriad and as varied as the individuals holding the secrets.One area where there should not be any family secrets comes in the arena of one’s minor children and are they (or have they been) put in a position where they have suffered sexual and other physical abuse. From the time children are very young, they should be encouraged to share any such information with their parents. They should be taught about appropriate touching and inappropriate touching, say within the area that a child’s bathing suit covers. (Of course, there are always the kids who won’t let their parents give them baths after hearing that, but that’s a separate problem.) It is important to distinguish between healthy, acceptable familial affection and unhealthy behaviors. (One family I knew called it “yucky touching” where the child feels uncomfortable and maybe even confused.)When it comes to grooming and corporeal discipline, the same care-givers should be the ones providing the care and all of the “character development”. Discussing the latter is such a personal choice and every family has to work out their own dynamic for correction and guidance. A lot of the approaches used really depend on the child needing “disincentives for misbehavior”. Remember, different children respond to techniques; what works for one doesn’t always work for another.During the acts of personal care, explaining why the child needs to have things done is a good thing – like having their hair brushed or the dirt scrubbed off of their hands. But, if the little one complains that their scalp is getting too stimulated during hair care sessions or if the caregiver notes red marks forming in the groomed areas (most likely suggesting “dermographism”), the caregiver needs to back-off and try a more gentle approach. While the children are still in diapers, reinforcing that clean, dry skin and undies are a whole lot more comfortable to have than soiled nappies (and this actually helps while potty training children to give them incentive to remain dry).In other words, it isn’t appropriate for young Cousin Felix’s best friend, Sloppy Oscar, to undress a child at a family function and put the child in the bathtub, or change a dirty diaper. Some of the more egregious abuse, especially to little girls, happens under such pretexts. It makes me wonder, “What was their parent thinking?” Or, “Why weren’t the parents supervising this child during encounters with other and/or older children?”Having a set of rules at relatives’ houses helps limit some of the nastiness that can happen. Things such as “don’t play in the street”, “stay in Grandma’s yard”, “tell me when you’re going outside with Cousin Merlin”, and “don’t play with anybody who bullies/hurts you” are good to establish before arriving at family visits. Believe it or not, many kids should have been told things like “don’t play with anything that isn’t a toy or swing set”, “don’t hit/hurt Uncle Ulysses’s pet”, and “don’t use sporting goods without proper instruction first”.Some of the worst injuries happen when preschool-aged children go outside to play with teenage and pre-teen cousins. These preschoolers really should be supervised to ensure they play only with age-appropriate recreational equipment. A three-year old girl (not my patient) decided it looked like fun to “ride the skate board” just like an older cousin. Only she sat on it and rolled down a steep, concrete driveway only to “wipe out sitting down” on the street. The result was a horrible laceration that resembled a delivering mother’s episiotomy, requiring an OB/GYN physician to surgically repair the wound while the girl was under general anesthesia. That is a lot for a 3-year old child to have to endure.If a small child is napping at a relative’s house, it is may be appropriate for one parent to stay in the room where the child is sleeping to ensure their safety. Some people don’t think their babies are big and strong enough to roll off of the antique trundle bed until the baby actually rolls off and injures their head. Talking to adult victims of childhood sexual assault, it is uncanny the number of women who say as a child, they were suddenly awakened from sleeping (usually at a relative’s house) by a male family member “acting inappropriately.” In such cases, usually the care-taking adults get so engrossed in conversation and visiting that they are not aware their children are vulnerable to predators.When the unthinkable happens, the immediate family of the victim needs to support whatever revealed confessions are voiced, and give the victim the benefit of the doubt that these scenarios happened. This is when a young person clearly remembers abuse (although, the dubious subject of “false memory syndrome” is a different thing altogether, and a topic for another time). The primary family members’ job is to protect, nurture, unconditionally accept, and emotionally support these children, and not make them feel shame or blamed in anyway. It is better for there to be a misunderstanding over something questionable and investigate what actually occurred than there is to discount what a victim says – especially when it is a child who is visibly upset and talking about adult actions/consequences of which they should be naive at their tender age.The saddest part is many a mother has had to face the reality that their young daughter(s) faced abuse at the hands of someone they love and who the mothers think cannot possibly be abusers. A terrible statistic is that most cases of childhood sexual assault in the home are perpetuated by the mothers’ significant other – whether it be a step-father, fiance, or boyfriend. The first words that usually come flying out of these mothers’ mouths (without any thought given to what they are saying) are, “There’s no way my man could hurt my child!”Nothing could be more likely than for a mother’s child to be victimized by the mother’s male partner. In the animal kingdom, there is a survival instinct among males (this instinct is stronger in some species than others) that in order to ensure the maximum propagation of their genetic material, they will kill off the competing offspring of other males. This includes the offspring of their current female mate which were fathered by another male. Now, animals are one scenario, and people should be another who should know better than to harm a child in this way. But some people are not as far along the social evolutionary scale as others and it happens, much to society’s chagrin and disbelief.In the context of the #MeToo movement, what should be done if a grown person or teen clearly remembers that they secretly suffered abuse as a child and he/she is now in a safer situation? There are two answers:1.) in the case where the abuser is still alive and not incarcerated for their crime(s), the victims need to tell at least the authorities what they experienced (especially if they think the abuser could repeat the offense[s] with other children); and2.) if the abuser is dead, it is probably best not to talk to the victim’s families about it at first.In both cases, these unfortunate people need to find a support group or therapist where they can discuss what occurred in a safe, non-judgmental environment and work out whatever ambivalent feelings they have about their experience. Therapists also have a better sensitivity to determine “if and when” it is a good time to discuss the past abuse with the victims’ closest relatives.Families actually break up when such revelations occur because there will usually be family members who won’t accept the facts of what happened under their very noses. Victims have been blamed for the abuse in a lot of cases by dismissive relatives who believe somehow the victim promoted, encouraged, or even wanted the abuse. These dismissive relatives are usually ones who cut off contact with the victims and sometimes they don’t cut off contact with the perpetrators. If people like this can’t blame the victims for the perpetuation of the abuse, they even go as far as to blame the victim that their family unit dissolved. This is wrong on every level and victims should never accept any blame like this.If an adult feels that revelations along the line of abuse will not be accepted by other family members, in the case of deceased abusers, it is probably better not to tell family members. As much as I disapprove of family secrets, some things are just better left unsaid and buried. Psychiatrist friends have said they think this is the best course as well. It seems that the deceased often becomes “lionized” and “almost sainted” where older family members don’t remember that their “dearly departed” ever did anything wrong or offended other people. In these cases, the surviving family members could be completely devastated that the father/husband/brother/uncle/grandfather they practically idolized actually would do anything as evil as abusing a child, and a family split usually results.I don’t say “keeping abuse secrets is okay in this one situation” lightly, because I grew up in a family where both sides had their “family secrets”. In one scenario, some relatives did what they thought they had to do in order to survive adverse social conditions, and this is understandable (although disappointing they couldn’t admit the truth). But in other cases where relatives had double (and even triple) lives, or someone is raised to believe two people are their parents when they were “adopted”, or secret divorces/love children abound, or some committed illegal activities for their own selfish gain – it was an enormous shock to learn that these things were done by beloved relatives sharing a common gene pool and family bond with me. As a middle-aged adult, I think it is best to know these things about one’s family history. But I don’t think that they should have been “hushed up” for a long period of time. Knowing the truth is liberating in many ways.