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

Sharin coffeemommy at verizon.net
Mon Jun 7 14:09:54 UTC 2010


I really like this article and will be looking for a copy of the full text. 

Sharin
-----Original Message-----
From: humanser-bounces at nfbnet.org [mailto:humanser-bounces at nfbnet.org] On
Behalf Of Mary Chappell
Sent: Sunday, June 06, 2010 5:09 PM
To: 'Human Services Mailing List'
Subject: Re: [humanser] The Trauma Myth: Understanding the True Dynamics
ofSexual Abuse

Maryann,
Thank you for sharing this article. It was truly a thought  provoker.
Regards,
Mary Tatum Chappell 

-----Original Message-----
From: humanser-bounces at nfbnet.org [mailto:humanser-bounces at nfbnet.org] On
Behalf Of Mary Ann Rojek
Sent: Sunday, June 06, 2010 12:27 PM
To: blind-counselors at topica.com; Human Services Mailing List
Subject: [humanser] The Trauma Myth: Understanding the True Dynamics
ofSexual Abuse

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 at
letters at psychnetworker.org  This e-mail address is being protected from
spambots.  You need JavaScript enabled to view it , or at
wwwddpsychotherapynetworkerddorg.  Log in and you'll find the comment
section 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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