[humanser] The Trauma Myth: Understanding the True Dynamics of Sexual Abuse

[Mary Ann Rojek]

The Trauma Myth: Understanding the True Dynamics of Sexual Abuse

By Susan Clancy, Psychotherapy Networker
Posted on June 4, 2010, Printed on June 5, 2010
>From the book The Trauma Myth: The Truth About the Sexual Abuse
of
Children and Its Aftermath by Susan A.  Clancy.  Copyright B)
2009 by Susan
A.  Clancy.  Reprinted by permission of Basic Books, a member of
the Perseus
Book Group.  Tell us what you think about this article by e-mail
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on every page of the online Magazine section.
  As a graduate student at Harvard in the mid-1990's, I
participated in
research studies carried out by the psychology department that
began in
October 1996 and continued until August 2005 to interview adults
who had
experience sexual abuse as children and learn what effects the
abuse had
had on their lives.  Although I was sure I knew what I would
discover-that
the abuse would be remembered as a horrible experience that
overwhelmed
the people I interviewed with fear when it happened and had
always been
viewed as a traumatizing occurrence-what I heard in the hundreds
of
interviews I conducted was quite different.  In nearly all the
cases, the
adults I questioned had not experienced the abuse as traumatic
when it
occurred and only came to regard it as so years later.  And in
many of the
cases, they had never been questioned about their evolving sense
of the
abuse and the ongoing impact that it had on their lives, but only
about
what the traumatic experience had been like at the time.  These
findings
led me to question the progress professionals in the sexual abuse
field
have made when it comes to understanding and treating child
sexual abuse.
  Certainly we have advanced to the point that the right things
are being
said (sexual abuse is common and harmful; it is never the child's
fault).
  Funding in the trauma field has been secured, research
conducted, studies
and books published, treatment centers established, and public
awareness
raised through sex-education programs and campaigns in the media.
But is
any of it translating into actual progress for victims? Do they
feel that
they're being helped, that they're understood and their needs are
being
served effectively?
  The trauma model's main purpose-one of the primary reasons why
mental
health professionals welcomed it with such enthusiasm in the
1980's-was to
provide an explanation for how and why sexual abuse wreaks such
psychological and social havoc in victims.  Armed with a better
understanding of the impact of abuse, mental health professionals
hoped to
be better able to help victims cope with and recover from these
damaging
crimes.
  The problem is that today, after more than twenty-five years,
predictions
based on the trauma model have not proved accurate.
Characteristics of the
sexual abuse experience related to trauma (like how frightening
it was,
whether penetration or force was involved, and how many times it
happened)
do not do a good job of forecasting the level of long-term
psychological
harm experienced.  There appears to be no direct, linear
relationship
between the severity of the abuse and the psychosocial
difficulties
victims experience in adulthood.  Worst of all, we have developed
no
clearly effective treatments for sexual abuse victims.  They
continue to
suffer from psychological and social problems in the aftermath of
their
abuse, and mental health professionals still have not reached a
consensus
as to exactly why or what precisely to do to help them recover.
  This state of affairs is far from surprising.  How can trauma
be the cause
of harm if most victims say that the abuse was not traumatic when
it
happened? A growing number of scholars in the sexual abuse field
are
coming to agree that understanding how and why sexual abuse
damages
victims probably has little to do with the actual abuse and a lot
to do
with what happens in its aftermath.  For example, as David
Finkelhor
concluded in his recent book Childhood Victimization, continuing
research
efforts that seek to track the consequences of early events
through
developmental, cognitive, and behavioral pathways may prove more
fruitful
than continuing the restrictive focus on the severity and nature
of
event-specific trauma.  I believe that the victims themselves
have always
known this.
  --------------
Jen was a sixty-five-year-old, divorced, retired administrative
assistant.
  A tall, big-boned redhead with long purple fingernails, she was
up front
about lots of things.  She did not like the coffee I gave her, my
office
was too cold, and she did not like the color of my hair.  We were
at the
part of the interview when I asked her to rate how traumatic her
abuse had
been when it occurred.  She did not like the questions I asked.
  "Nothing personal," she said, "but these questions are kind of
dumb.  If
you are trying to do what you say you're trying to do, and figure
out why
the abuse screwed me up so badly, why are you asking so many
questions
about what it was like when it happened? What you need to be
focusing on
was what it was like later on."
  I asked what she meant.  "What I mean is that what it was like
when it
happened and what it is like now are two separate things
entirely."
  At that point in my career, I did not have a lot of experience
interviewing sexual abuse victims.  I had, however, a lot of
experience
interviewing victims of other kinds of horrible experiences
(motor vehicle
accidents, combat, natural disasters, abductions), and I had
asked these
subjects to rate how traumatic the events were at the time.  No
one in
these studies had ever said this to me before.  And as far as I
knew at the
time, scholars were not talking how perceptions of the traumatic
nature of
an abuse experience change over time-how an event not initially
perceived
as horrible could become so.  They certainly talked about how
symptoms of
trauma (depression, anxiety) might not manifest themselves until
long
after the abuse, but they were not talking about how perceptions
of the
abuse itself can change.
  I knew I had to consider Jen's words seriously.  From that
point on, I
asked my question in two parts: What was the experience like when
it
happened? And what is the experience like for you today, looking
back on
it.
  By the end of the study, the data was clear.  Although sexual
abuse was not
a particularly awful experience for many victims when it
happened, looking
back on it, from their perspective as adults, it was
awful-ratings of
shock, horror, disgust, and even fear were all high.  Obviously,
perceptions of abuse when it occurs and when victims look back on
it years
later are entirely different.  In addition, sexual abuse is very
different
from other kinds of terrible life experiences.  For example,
getting into a
car accident is traumatic both at the time it happens and later
when it is
recalled.  Sexual abuse, however, becomes traumatic later on.
Why? What
happens in the aftermath of sexual abuse?
  According to victims, they did not experience the abuse as
awful when it
happened because most simply did not understand clearly the
meaning or
significance of the sexual behaviors they were engaging in.  That
being
said, at some point later on in life, they do.  Over time, the
"cloak of
innocence lifted," as one victim described it.  Victims
reconceptualized
the formerly "confusing and weird experiences" and understood
them for
what they were-sexual in nature and clearly wrong.  Only at this
point-when
the sexual abuse is fully apprehended-does it begin to damage
victims.
  Reconceptualization
When Anne, a twenty-eight-year-old mother of two, was eight years
old, her
mother started working outside the home.  Between 3 P.M.  when
Anne got home
from school and 6 P.M.  when her mom came home from work, a
neighbor and
friend of her mother's named Frank would babysit.  Frank sexually
abused
Anne.  Sometimes, when Anne was sitting in his lap, he would "put
his
fingers inside my panties and feel me up . . .  and while this
was going on
he would thrust himself up against my butt and he would be
breathing
heavy."
  When it was happening, Anne said she did not like what he was
doing but
was "definitely not traumatized." And she was not different from
most of
the victims who spoke to me.  "I knew it was something I
shouldn't talk
about with my mother, but not really exactly totally sure why."
After
about eight months of intermittent abuse, Frank left town, and
Anne said
she "just didn't think much about it again." But then something
changed.
  Anne reconceptualized her abuse-she figured out the meaning of
these
previously ambiguous experiences.  "I remember this like it was
yesterday.. . .  I was in eighth grade and my friend Jennie was
over and she had seen
her brother and his girlfriend making out and she was reenacting
them
rolling around on the ground and moaning and it was then [that] I
remembered what happened; it reminded me of what happened. . . .
I
realized, totally all of a sudden, that what had happened to me
was
sexual-that I had basically been having sexual experiences with
my
babysitter when I was kid." It took Anne six years to cognitively
reconceptualize what happened to her and understand that it was
wrong.
  Betrayal
When they discover that they have been abused, victims most
frequently
report feelings of betrayal.  As Cheryl, a forty-three-year-old
high school
teacher on maternity leave with triplets, put it, "I realized
that I
trusted him, what he was doing, and I should not have.  He knew
he was
doing something wrong, and he knew I didn't know. . . .  It was
all an
elaborate game of sexual betrayal." As Neil, an AIDS activist
working for
a hospital in Boston, said, "I realized that it wasn't just what
he did to
me physically.  At that moment [of discovery] I lost my father.
He was no
longer someone who loved and took care of me.  I was just being
used by him
for his personal gratification."
  For the victims who spoke to me, the degree of the betrayal was
a function
of two main variables.  First, it depended on how close the
victim felt to
the perpetrator, on how much he or she trusted, cared about, or
loved him.
  The second variable was the degree to which the victim believed
he or she
had been emotionally manipulated by the perpetrator or "taken in"
by the
situation.  In those cases in which the abuse was traumatic when
it
happened (it involved force, violence, or pain), victims
subsequently felt
less betrayal.  Since in these cases the children clearly
understood the
wrongness of the situation, any sense of betrayal arose
immediately.  And,
because the children understood they were being victimized, the
abuse was
unlikely to happen again (or if it did, the child remained well
aware of
his or her victimization).  Thus, victims did not have to undergo
long
periods in which they unknowingly fell prey to, as one subject
told me,
the perpetrator's "elaborate games of sexual betrayal." As Tom, a
neurosurgeon, put it, "For two years, while it was happening I
felt good
about him.  I believed him, all his lies and let him do whatever
he wanted.
  It makes me sick to think about how much I trusted him, how
much, for how
long he took advantage of that." In other words, the degree of
betrayal
victims felt in the aftermath was an inverse function of how
traumatic the
abuse was when it happened: the less traumatic it was, the more
betrayal
victims reported.
  As a consequence, many told me, this betrayal forced them to
rethink the
past.  For many victims, a former sense of security is shattered;
many
report feeling a new sense of interpersonal insecurity and
vulnerability.
  As Maria told me, "The day I understood what happened to me, I
completely
lost my own sense of security.  The childhood I imagined I
hadbthe safety
that enveloped me-was shattered.  The people who were supposed to
be
looking out for my well-being [and] taking care of me were not."
  Betrayal affects not only victims' feelings of security and
trust in
others but also their self-worth.  They feel that since they must
not have
been loved, perhaps they were not worth loving.  As Charles, a
history
professor, explained to me, "You learn that who you are and what
you might
want or need just does not matter."
  Considering the degree and extent of the betrayal victims felt,
I expected
anger at the perpetrator to be a common reaction.  Yet only 5
percent
spontaneously reported feeling angry at their abuser.  Why would
the victim
of a crime punishable in almost any court system in the world not
be angry
at the perpetrator? According to victims, it is because they
turned the
anger inward.  Most, to a shocking extent, blamed themselves.
  Self-Blame
According to philosophers, psychiatrists, and intellectuals from
Aristotle
to William James, from Sigmund Freud to Donald Spence, when bad
things
happen to people-like discovering they were sexually abused by an
adult
they trusted-it is human nature to want to engage in a search for
meaning,
to understand why the event occurred and what its implications
for one's
life are.
  As victims struggle to make sense of their experiences, they
engage in an
attribution process: they scan through all the possible
explanations they
can generate to come up with the one that they believe fits best.
  Traditionally defined, attributions are individual causal
explanations for
why events occur.
  If a victim asks, why did someone I trusted abuse me? there
are, of
course, endless possible answers.  For example, he was screwed up
or drunk,
or I was in the wrong place at the wrong time.  The famous
attributional
theorist, Martin Seligman, would refer to this category of
answers as
"external explanations for negative events." It assigns
responsibility for
the event to someone or something else.  But almost all the
victims I've
spoken with, to some degree, endorse an "internal" explanation.
They see
the abuse as their fault-caused by their own characteristics or
behavior.
  I asked victims who was to blame for the abuse-them, the
perpetrator, or
both.  Almost 80 percent felt both were at fault.  While almost
all could
acknowledge that the perpetrator was responsible, they also
thought they
had done something wrong too.
  Again, I have found that the degree of guilt victims feel in
the aftermath
of sexual abuse is strongly related to the degree of trauma
experienced
during the abuse when it happened.  Specifically, the less
traumatic
(forceful, frightening, threatening) the abuse was while it
occurred, the
more guilt and self-blame the victims report later on.  Those
victims whose
abuse involved force or violence usually report the least guilt.
In such
cases, the victims know it was not their fault.  One of the
victims I spoke
with summarized this quite well: "I was bleeding.  I screamed
when it was
happening.  He ran away.  I got rushed to the hospital.  It was
pretty cle
to me that he had done something wrong, that it was definitely
not my
fault." Victims who report no trauma at all during the abuse (for
example,
those who loved the perpetrator, enjoyed the attention, or
occasionally
welcomed the contact) feel extremely guilty.
  Today, most adult victims' knowledge about sexual abuse, about
what it is
like when it happens and how children react at the time, is a
function of
what they hear, read, and see in the media-the culturally
available,
standard scripts about this crime.  Because of the trauma myth,
according
to these scripts, sexual abuse usually involves fear, force, and
threat.
  The experience is portrayed as terrible for the victims.  They
are
frightened when it happens.  They try to resist the abuse.
Whatever happens
clearly happens against their will.  Books, films, and websites
repeatedly
assure victims that they had no control, that they were utterly
helpless.
  Words like "rape," "assault," and "violation" are commonly used
to
conceptualize the experience.
  No professionals explicitly discuss with victims or highlight
the real
dynamics of sexual abuse-that victims rarely resist it, often
care about
the perpetrators, and often receive "benefits" for participation,
like
praise, attention, and gifts.  In fact, this kind of information
may
actually be suppressed.  It appears to be an article of faith
among
professionals that you should not talk about aspects of sexual
abuse that
run counter to the trauma model at all.  A wildly popular book
written for
professionals by Judith Herman warns professionals not to talk
about the
issue of consent as doing so will likely make the victims "feel
revictimaized again."
  Because of the trauma myth, I am aware of no public information
campaigns
that say, "Kids don't know enough to say no." There are no books
telling
victims, "You let it happen, and it's okay.  It's normal.  You
were too good
to know bad." I know of no newspaper stories in which the victim
comes
forth after years to press charges and explicitly says, "I would
have done
it earlier, but I just didn't understand I was abused until now."
Today,
as a function of the mental health field's relentless emphasis on
trauma,
force, and violence and the subsequent embargo on any real-world,
practical information about the reality of sexual abuse, most
victims'
experiences slip under the radar-their stories are ignored,
dismissed,
overlooked, or denied by the very people who purport to be trying
to help
them.
  What is the consequence? For victims, it is significant.  They
naturally
compare what happened to them with the depictions of abuse in
cultural
scripts.  As James, a nurse, told me, "What happened to me was
different
from other kids.  I . . .  well . . .  it's hard to say out loud,
but
basically I let it happen." There is something wrong with me.  As
Denise, a
bathing-suit model, noted, "I wasn't afraid.  Sometimes I liked
it.
  Obviously something's screwed up with me." I am alone.  Claudia
explained,
"My abuse did not involve such force and violence.  I basically
let it
happen . . .  so it wasn't classical abuse."
  Given the degree of betrayal, guilt, and isolation victims
feel, it is not
surprising that they also commonly report shame.
  Shame
Shame is an awful emotion, one in which the self is viewed as
incompetent
and as an object of ridicule, contempt, and disgust.  Individuals
feeling
shame often view themselves as damaged and unworthy.
Unfortunately, most
victims use the word "shame" to describe how their abuse makes
them feel
as adults.  As one victim summed it up, "I think the heart of the
damage is
shame.  It eats away at me.  It has eroded my sense of
self-esteem and my
confidence, my ability to love and feel loved.  The abuse stopped
when I
was twelve; the shame remained my whole life."
  Further support for the perspective that what damages most
victims has
little to do with any trauma they experience during the abuse and
a lot to
do with the shame, guilt, and isolation they feel later on in
life comes
from the fact that in the handful of studies that have
specifically tested
it, therapeutic techniques involving cognitive
retraining-identifying
victims' irrational beliefs (for example, that the abuse was
their fault)
and then helping them to modify these beliefs (for example, by
providing
convincing information about why it was not their fault)-have
shown solid
promise in improving the lives of victims in the aftermath of
sexual
abuse.
  Today, victims need to hear the truth.  This requires us all to
highlight
publicly the true dynamics of sexual abuse-to expose the painful
reality
that most victims care for and trust the perpetrator (before, and
sometimes during and after, they are abused), that they do not
really
understand the nature of what is being asked of them, that they
feel they
>every receiving love and attention, that it does not hurt and
sometimes
feels good, and that, for all these reasons, participation is
common.
  Once exposed to the truth about how victims feel and behave
during sexual
abuse, victims need to hear, loudly and clearly, why they were
not at
fault.  We cannot accomplish this with platitudes or blanket
statements
like "You were not to blame" or "It was done against your will."
They
consented not because they were forced to but because they did
not
understand enough not to.  And victims need to know that this is
normal.
  Although they made an error of judgment-ideally they should
have said no;
they should have resistedbwe must reassure victims that given
their age
and level of cognitive and physical development, this error of
judgment
was understandable.
  In short, in order to help victims feel less stigmatized in the
aftermath
of sexual abuse, we must all communicate that they were helpless
victims-not, as the trauma model portrays them, literally
helpless but
metaphorically helpless, victims of their own level of
development.
  This information needs to be highlighted in the form of
prevention
campaigns, books, websites, and other culturally accessible
outlets.  Until
that happens, victims will continue to feel alone, guilty, and
ashamed.
  Professionals may fear that raising attention to children's
participation
in abuse will elicit in others a tendency to condemn victims, but
I think
we better get past this.  Victims are already condemning
themselves.  Here
is the tragic paradox.  If the victim's cognitive interpretation
of the
event guides the process of psychological adaptation after sexual
abuse,
then the trauma theory is not only wrong but actually backwards.
The less
traumatic sexual abuse was when it happened, the more betrayal,
guilt,
isolation, and shame victims will feel and the more psychological
distress
and dysfunction they may experience in the aftermath.  And
because it is
backwards, the trauma model is not just failing to help victims;
it is
actually causing some of the harm it was supposed explain by
simultaneously exacerbating the victim's damaging beliefs ("It
was my
fault," "I am alone," "There is something wrong with me") and
suppressing
the information that would neutralize them.
  Susan Clancy is the author of The Trauma Myth: The Truth About
the Sexual
Abuse of Children and Its Aftermath
  B) 2010 Psychotherapy Networker All rights reserved.
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