“The conceptualization that has won the most support is the idea that the impact of sexual abuse constitutes a form of posttraumatic stress disorder . . . But the theory behind PTSD does not readily adapt to the experience of sexual abuse. The classic PTSD theory says the symptoms result from “an overwhelming event resulting in helplessness in the face of intolerable danger: anxiety and instinctual arousal. . . . This theory is well suited to traumas such as war shock and rape and probably to sexual abuse that occurs under violent circumstances. However, much sexual abuse does not occur under conditions of danger, threat and violence. . . . Abuse experiences may be degrading, humiliating and stigmatizing but not necessarily frightening or threatening to bodily integrity. . . . Sexual abuse cannot be subsumed or explained within the framework of Post Traumatic Stress Disorder.” – David Finklehor, director of the Crimes against Children Research Center.
All I had to do was find sexual abuse victims, ask them questions about what the experience was like when it happened, and then test the hypothesis that the more traumatic the sexual abuse was when it happened, (1) the more psychological damage victims would report in the aftermath, and (2) the more likely they would be to repress their memories. Both hypotheses made sense: I just needed to collect the data. In fact, they were so straightforward I was surprised the research had not already been completed and reported.
They were a diverse group, but they shared two very important characteristics.
The first I expected: Almost every victim I spoke with reported that their childhood sexual experiences had damaged them. As the sexual abuse research I was familiar with predicted, they commonly experienced symptoms of psychological disorders (for example, depression and posttraumatic stress disorder). Although not all met criteria for actual psychological disorders, most reported multiple adverse effects from the abuse. They believed that what had happened to them had negatively affected their lives and their relationships with others. In addition, forgetting sexual abuse (alleged repression) was not uncommon: I had no trouble finding people in the general population who reported periods during which they did not remember their sexual abuse.
The second commonality between victims I did not expect. In striking contrast to the assumptions of the traumatogenic model, whatever was causing the psychological and cognitive damage these victims reported had nothing to do with trauma; very few victims reported any fear, shock, force, or violence at the time the abuse occurred.
Everything I knew dictated that abuse should be a horrible experience, that the child should be traumatized at the time it was happening—overwhelmed with fear, shock, and horror. But the sexual abuse described by the victims I spoke with was much different. It was not a black-and-white situation. It was complicated, subtle. A trusted person had asked each of these children to do something he or she did not fully understand. Although they could often sense it was wrong, they were not sure why.
So what did they do? In stark contrast to everything I had come to believe about sexual abuse, they did not fight it. It was not done against their will. They went along—did what was asked of them. In their own words, they “participated,” “consented,” and “allowed it.” In fact, of those who sensed the behavior was wrong, only 5 percent tried to stop it—by saying no, running away, or telling a parent. Why? The trauma theory holds that a child will only participate in abuse if forced, threatened, or explicitly coerced. This was true in a very small minority of cases. Most of the victims I spoke with had very different motivations. According to them, they did not resist the abuse for three reasons.
First of all, they told me that when they were children, adults often asked them to do things they did not really understand or want to do. Accepting confusing, unpleasant things is, for better or worse, an inevitable part of life as a child. As Dave, an accountant, put it, “I would say I had no idea what was going on. What he was doing just made no sense. . . . But I think as a kid so much of what happens to you is weird and confusing that this just sort of joined the ranks with the rest of the stuff. . . . Basically I was the sort of kid who just learned to accept what they are told by adults and not complain much.”
Second, not only are kids routinely asked to do things they do not understand or like, but they are told to listen to adults in positions of authority. As Bob, a construction worker, put it, “I was brought up in the kind of family that you listen to adults. You do what they say and you don’t ask too many questions.” “It never occurred to me to say no to anything a teacher asked me to do,” noted Joy, a therapist. In the words of Robert, an attorney specializing in medical malpractice, “He was a priest. You listen to priests. I told my father I didn’t want to go, and I didn’t want to spend time with him and he [said,] ‘Just shut up. . . . Be happy such a person even wants to give you attention.’”
Resisting the abuse would require children to challenge authority, something they are told not to do. Many reported being very concerned about the negative consequences of saying no to the perpetrator.
Now add this third factor to further complicate matters: The abusers often conferred “rewards” on their victims for saying yes. These ranged from concrete rewards like gifts (“He took me to Penny’s and would buy me something afterwards,” “I liked ice cream a lot and he gave me ice cream”) to abstract but powerful reinforcements like love and attention (“He told me I would [do it] if I loved him and I wanted him to know I loved him,” “As a kid I never got much attention and at least this was attention,” “Back then I was looking for any kind of love or approval I could get,” “I remember thinking this person would like me more if I did it. . . . I wanted so much for him to like me, to want to be around me”)
To determine whether the victims who participated in my research study experienced more benign abuse than most, I needed to track down all the national probability studies that existed on the objective characteristics of sexual abuse. According to all of them, I had to disagree with the clinical psychologist who specialized in treating victims of sexual abuse. There was nothing particularly benign or unusual about the abuse the subjects who participated in my study had endured. In terms of the objective characteristics of the abuse, their experiences mirrored those of the general population of people who are sexually abused. Abusers are almost always someone the children and their families know, the type of abuse reported usually involves kissing and genital touching, force or violence is rarely involved, and injuries (minor or severe) occur in less than 10 percent of cases. What happened to the victims in my research study was remarkably consistent with national sample studies of victims in the United States.
Of my sample, 75 percent reported self-esteem problems; 50 percent reported feeling cut off from others or alienated because of the abuse; almost 90 percent reported difficulties in relationships.
Perhaps victims were not reporting their abuse as traumatic because they were not remembering it correctly. Perhaps the retrospective nature of the study rendered it vulnerable to inaccurate recollections … But there were problems with this explanation. Experts on the field had specifically advised me to collect data on adults. Why? Because kids rarely report abuse (more on this later), and those who do often experience abuse severer than the norm. Further, I had no proof the victims were remembering incorrectly. Neither did anyone else. In addition, retrospective research is the most common type of research done in the trauma field. In fact, the diagnosis of post-traumatic stress disorder is based on patients’ memories of past experiences. If my data were going to be explained away as subject to inaccurate memory recall, then trauma professionals would have to explain away most of the research conducted in the field. Finally, even if this inaccurate memory theory was correct and my victims were misremembering what had happened, they should be remembering it as more traumatic than it actually was. Research shows that people have a tendency to let currently psychological states bias their memories of past events. The worse you feel at the time someone asks about a previous event in your life, the worse you remember the past event to be. If the people I interviewed were psychologically distressed at the time I spoke with them (which they definitely were), one might expect them to, if anything, remember the abuse worse than it actually was.
Perhaps sexual abuse was so traumatic when it happened that victims dissociated and thus “forgot” the pain. The theory sounded intriguing … but the victims had a different explanation, a simpler one. They made it very clear to me that the abuse was not traumatic for them when it was happening because they had not understood what was going on.
Given the choice between a complicated, theoretical, unconscious defense mechanism and victims’ explanations, according to Occam’s razor, I should listen to the victims. They said they did not understand what was happening to them. And if they did not get it, on what basis would they be traumatized? On what basis would they dissociate or repress feelings of terror? Where would the feeling of terror be coming from?
What’s more, science, as I had been taught, is about developing theories that can be falsified; hypothetically, data could emerge that would actually disprove them. Yet, it seemed the assumption that sexual abuse is traumatic was itself “unfalsifiable.” Anything a victim said that ran counter to the trauma theory professionals in the trauma field reinterpreted to support it instead. The theory could not be proven wrong. It appeared victims could say nothing that would make experts believe them.
I found approximately twenty published studies conducted within the last one hundred years that asked victims specifically to describe what their abuse was like when it happened … While the methodology of these studies differed widely in terms of the questions asked and how the data was analyzed, the takeaway is fairly consistent. Sexual abuse, for many victims, is not a traumatic experience when it happens. While most report sexual abuse as a negative experience, the word “negative” is simply not synonymous with terror, horror, fear, or pain. As clinical psychologist Eve Carlson reminds researchers, to be classified as traumatic, an abuse experience either has to involve the threat of death, serious injury, or harm or at least produce the kind of overwhelming fear and helplessness responses that such threats do.
What I discovered as I explored this body of research reassured me. But considering all the evidence that existed indicating that sexual abuse was not a traumatic experience, why is the trauma model so dominant, so entrenched in the study of this sexual crime?
One explanation comes from the field of child development, specifically from researchers who study how average children understand and react to sexual information. Such researchers believe that professionals in the sexual abuse field suffer from an adultcentric bias; they try to understand sexual abuse experiences using an adult framework. In their excellent book Treatment and Prevention of Childhood Sexual Abuse: A Child-Generated Model, child clinical psychologists Sandra Burkhardt and Anthony Rotatori elaborate on this idea: “Due to the morally reprehensible nature of child sexual abuse, researchers have an understandable tendency to use project their adult fears, repulsion, and horror onto child victims, to assume they react like they do when faced with sexual situations.” Their anger is barely contained: “Amid the adult posturing, children’s views are seldom heard,” and other researchers agree. In a controversial chapter titled “The Professional Response to Child Sexual Abuse,” the authors, all respected professionals in the sexual abuse field, conclude, “It is amazing that well-meaning professionals acting in children’s interests have chosen to all but ignore children’s experiences of these actions.”
The professional conclusion for most of the twentieth century was consistent and clear. When victims reported sexual abuse, reactions included disbelief, blame, and minimization. As one scholar, Erna Olafson, summarized, “For most of the 20th century, when child victims were not viewed as liars, they were labeled as sex delinquents. When a man sexually assaulted a child, it was the victim, not the offender, who was blamed and held accountable for this crime.”
Professional assumptions about child sexual abuse began to change in the 1960s. Initially members of the child-protection movement led these changes. In 1962, Dr. C. Henry Kempe published “The Battered-Child Syndrome,” a report of a nationwide survey dealing with the symptoms of young children who had been repeatedly physically injured by their caregivers, in the prestigious Journal of the American Medical Association. In an editorial accompanying the article, he urged doctors to report suspected abuse and suggested that more children might die from battery at the hands of parents or guardians than from diseases like leukemia, cystic fibrosis, or muscular dystrophy. This paper attracted massive national attention concerning the physical abuse of children (and between 1963 and 1968, every state passed a requiring the reporting of child abuse). It also spurred research on all forms of child abuse, including sexual.
Around the same time, a second group, feminists, emerged to champion the issue of child sexual abuse. In The Dialectic of Sex, a cofounder of the New York Radical Feminists, Shulamith Firestone, urged feminists to make the issue of child sexual abuse part of their analysis and to “think of children’s liberation from male oppression as being linked to women’s liberation,” to consider it part of their analysis broader subjugation of women in a male-dominated society.
The feminists involved in this crusade had an interesting challenge to overcome: how to explain the fact that victims themselves said that they rarely resisted their abuse, that they often participated, and that most chose not to report what happened and kept silent about their experiences? The feminist solution was to conceptualize sexual abuse as a violent crime, to treat sexual abuse the same way they treated rape. As Judith Herman explains in her widely acclaimed book Trauma and Recovery, “The feminists involved movement offered a new language for understanding the impact of sexual assault. . . . Feminists redefined rape as a crime of violence rather than a sexual act.” As Herman herself says, this “simplistic formulation” was advanced to counter the view that rape or the sexual abuse of children was in any way the victims’ fault … Both rape and sexual abuse were considered a function of the inferior status of women (and female children) in a male-dominated society. Framing sexual abuse as a violent crime tended all characteristics of the victim and the victim’s circumstances, except vulnerability, irrelevant.
Is sexual abuse really in the same category of crime as violent rape? According to what victims have said, not really. It is far more complex and multifaceted. But as sociologist Joel Best has noted, such “domain expansion” has important rhetorical benefits, allowing “claim makers” to build new claims on an established foundation, to delay controversy over peripheral issues, and to galvanize professional and societal attention to the topic.
Public and professional attention soon followed. From the mid-1970s on, the topic of sexual abuse was put squarely on the agenda of both the child-protection and feminist movements. Federal money began to flow in, child abuse and neglect demonstrations became more common, research grants were awarded, the child welfare organizations’ efforts (such as establishing child abuse hotlines) increased … Media attention followed. In 1977, an explosive article titled “Incest: Sexual Abuse Begins at Home” by Ellen Weber was widely cited and broadly distributed. The article captured and popularized the growing professional conviction that sexual abuse was rampant in American society, that it occurs in families of every social, economical, and ethnic background, and that the topic had been virtually ignored despite the fact that “many professionals” had seen a correlation between sexual abuse and a multitude of adult psychological symptoms and disorders.
Ten years before, mental health professionals had initiated systematic, large-scale studies of the psychological aftereffects of exposure to combat. This was a result, in large part, of Vietnam veterans’ accounts of psychological problems and symptoms experienced upon their return to civilian life. Antiwar psychiatrists and veteran’s advocacy groups theorized that this psychological distress was related to trauma—the overwhelming fear, horror, and helplessness veterans experienced when confronted by life-threatening experiences they faced in battle.
During this period … professional interest in the long-term effects of trauma experiences grew exponentially. An entirely new and well-funded wave of research, trauma studies, subsequently emerged and became enormously popular.
During this period, professionals in the trauma field discovered that the pattern of psychological symptoms and problems that veterans reported in the aftermath of combat exposure appeared to be the same as those reported by victims of other kinds of horrible experiences—including rape, natural disasters, concentration camp confinement. The traumatogenic theory was subsequently born, and the argument was quickly accepted that exposure to any event that induced high levels of psychological trauma could directly cause psychological damage (even though this damage might not manifest itself until a later time).
The professional ratification of PTSD, a traumatic stress model for understanding psychological harm, was a watershed moment for feminists, child-protection workers, and other advocates for sexual abuse victims. If sexual abuse was a traumatic experience when it happened, a solid theoretical framework existed to explain many of the problems victims reported in the aftermath.
The problem, of course, was that initially the link between the PTSD diagnosis and and sexual abuse was by no means obvious. The theory behind PTSD did not readily adapt to the experience of sexual abuse as described by victims. The classic PTSD theory states that symptoms stem from an overwhelming event that results in helplessness in the face of intolerable danger, anxiety, and/or arousal. It is a theory well suited to trauma such as war shock and rape and to the (rare) occurrence of sexual abuse that take place under violent circumstances. Furthermore, sexual abuse is less an event and more a situation, relationship, or process, one that often continues for a period of time.
It did not seem to matter much. Beginning with the work of Denise Gelinas in 1983, articles and books began to articulate the harm of sexual abuse as a form of posttraumatic stress—as a direct function of the trauma victims experienced during the abuse. From then on, adult-child sexual encounters were understood as psychologically traumatic for the child in nearly every case.
Social movements, according to experts David Snow and Robert Benford, “frame and assign meaning to and interpret relevant events and conditions in ways that are intended to mobilize potential adherents and constituents, to garner bystander support and to demobilize antagonists.” By framing sexual abuse as traumatic, child welfare advocates, feminists, and mental health professionals accomplished all of the above … As Judith Herman states in the opening of Trauma and Recovery, “Without the context of a political movement, it has never been possible to advance the study of psychological trauma.”
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 significance of the victim’s psychological harm in the aftermath. 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, and mental health professionals still have not reached a consensus as to exactly why or what precisely to do to help them recover. It is thus not surprising that recently some medical health professionals have begun to ask what “twenty years of passionate rhetoric about trauma” has actually accomplished for victims.
As I discussed in chapter 2, 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.
Lucy Berliner and Jon Conte in their 1990 study noted that a majority of the children they interviewed reported not knowing initially that they were being sexually abused. Berliner and Conte quoted victims saying such things as “I was led to believe it was a teaching process” and “I didn’t know there was anything wrong with it, because I didn’t know it was abuse until later. I thought he was showing me affection.” More recently, two cognitive psychologists, Michelle Epstein and Bette Bottoms, specifically hypothesized that due to the confusing and secretive nature of abuse, many victims may fail to understand the meaning of the sexual acts committed (and subsequently forget them for periods), but then, at a later point, come to “relabel” the experience as “traumatic.” I believe I am, however, the first to highlight this “relabeling” as characterizing most cases of sexual abuse—to posit that due to the nature of most sexual crimes against children (not painful or forceful) and the age of most victims (under twelve), the majority will fail to understand the exact nature or meaning of these experiences until some point later in life.
When they discover 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 puts 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 own personal gratification.”
As a consequence, many told me, this betrayal forced them to rethink the past—to question some of their fundamental assumptions about being loved and protected. For many victims, a firmer 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 had—the 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.”
These feelings of insecurity and vulnerability are not confined to the perpetrator and the event. They have global and pervasive repercussions; they extend far beyond the actual abuse situation. Many experience a profound breakdown of trust, not just in the perpetrator but in other people.
I asked victims who was to blame for the abuse—them, or 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.
Particularly heartbreaking about this guilt is its pervasiveness. Victims feel that whatever it was about them that caused the abuse was not confined to the specific situation they were in (for example, “It happened because at that time in my life I did not understand sex”); instead, as attributional theorists would say, it is global and stable (it extends to other situations across time). In other words, victims do not just feel like they did something wrong regarding the abuse; they feel there is something wrong with them as individuals, that whatever caused the abuse is characterological or traitlike. As Samantha, a veterinarian in her forties molested by her stepfather between ages of seven and nine, explained, “I think it happened because I was damaged. . . . This is why he sought me out; this is why I responded the way I did. I know what he did was wrong, but I cannot escape the feeling that there is something wrong with me.” As Suzie, a twenty-eight-year-old columnist for a popular teen magazine, put it, “People can tell me it was not my fault but in my heart of hearts, you know what I think? Bad things happen to bad people.”
None of these explanations even come close to matching the one most victims give. I’ve found that victims have a pretty clear reason, one that has nothing to do with anything the perpetrator told them, anything they unconsciously want to believe, or any irrational or psychiatrically disordered thinking on their part. Ironically, many of us find their answer too “politically incorrect” to address or discuss. Victims say they feel guilty because the abuse was not done against their will. From their perspective, they feel that they allowed it to happen.
Some victims feel so guilty, so complicit, that they are not sure they were abused.
“Can it technically be abuse if I let it happen? You know that expression, about how you can’t rape the willing?”
“I am not sure that technically it can be called abuse if I didn’t fight it. Plus, I took what he gave me. I didn’t take them [Star Wars action figures] and throw them back in his face.”
“For it to be abuse I think it has to be done against the person’s will. The way it happened to me was more like something I would say I allowed.”
I have found that the degree of guilt victims feel in the aftermath of sexual abuse is indeed 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.
Victims who report no trauma at all during the abuse (for example, those who lived the perpetrator, enjoyed the attention, or occasionally welcomed the contact) feel extremely guilty.
Although aware that, as children, they were confused, they felt that this confusion itself was abnormal. They thought that they should have known or that they should have acted differently. Indeed, many victims suffer from “perceptions of avoid ability”—the belief that they could have avoided what happened—and that other children could have and did. The degree to which victims believe they could have avoided their abuse predicts self-blame more than anything else. Why? Tragically, part of the reason relates directly to the trauma myth of sexual abuse.
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 the real dynamics of sexual abuse—that victims rarely resist it, often care about the perpetrators, and often receive “benefits” for participating, like praise, attention, and gifts. In fact, this kind of information may actually be suppressed. The preface of a best-selling book, Secret Survivors, opens “This is a book about the aftereffects of sexual abuse. It is not about what sexual abuse is, but what sexual abuse does.” 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. Florence Rush notes that during her psychotherapy training, she was specifically told not to deal directly with issues of consent in treatment because the victims “feel too guilty or ashamed.” A wildly popular book written for professionals by Judith Herman echoes this sentiment: She warns professionals not to talk about the issue of consent as doing so will likely make the victims “feel revictimized again.” Katrina Meiselman, in her influential book for professionals, tells therapists that although the patient can explore his or her guilty feelings in therapy, “the therapist will not endorse expressions of guilt.” In The Courage to Heal, the most widely read book about sexual abuse, the authors go to extremes to assure victims that what happened to them was against their will. On page 121 a victim in therapy blames herself because at age twelve she said no to the perpetrator, and he stopped. “Why couldn’t I have done that right away, at four, when he started?” the victim chastises herself. “I did have the power to stop him.” But the authors are quick to remind any victim reading the book feeling similarly, “Abusers don’t stop because you say no. . . . You have less control than you think.”
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.
The trauma conceptualization results not only in victims’ negative feelings of guilt and isolation not being neutralized but in their being exacerbated; victims feel worse. The fact that their abuse bears little resemblance to what, apparently, happens to all other victims reinforces their sense that they did something “wrong” or, perhaps even worse, that there is something wrong with them. They are different from most victims. Consider the irony: After professionals have worked tirelessly for over thirty years to raise awareness that sexual abuse is common and never the victims fault, actual victims still feel alone and guilty.
Shame, as most researchers and clinicians in the field can attest, is a recurrent theme in the context of sexually abused people. It 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. Guilt, at least, can be productive as it sometimes motivates changes in behavior. But shame is overwhelming. 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.”
I cannot offer a clear theoretical model as to exactly how and why sexual abuse damages victims. It is beyond the scope of my research. I can say with great confidence, however, that based on what victims have to say, the trauma theory needs to go. It is not a good fit for most cases of sexual abuse. First, and most obviously, sexual abuse, for most victims, is not a traumatic experience when it happens. Second, clearly the harm sexual abuse causes is not direct and immediate; before it begins to damage victims, it has to be understood (“reconceptualized”) and that often occurs many years after the sexual abuse. Third, the cause of the damage appears to have nothing to do with any objective characteristics of abuse vis-à-vis trauma and everything to do with the aftermath—specifically, with how victims come to feel about themselves and others and how these feelings influence their emotions, cognition, and behavior.
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 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.
By systematically avoiding the truths about sexual abuse, professionals have failed to communicate to victims that what happened to them is common and that they are not at fault. Victims still feel alone. They still report guilt, isolation, and shame, feelings so potent and pervasive that they may actually be at the root of the psychological harm the trauma model was supposed to address.
Thirty years ago—prior to the adoption of the trauma conceptualization of sexual abuse—back when many professionals denied the existence of sexual abuse or blamed victims, feminists bemoaned a “conspiracy of silence” forced most victims to bear the burden of their secret alone. As Florence Rush put it, “Concealment is the victim’s only recourse. . . . Sexual abuse is thus the best kept secret in the world.”
Since then, the pendulum of professional beliefs has swung widely. Today, sexual abuse is widely accepted as common and never the victim’s fault. But not much has changed regarding victims’ decision to speak out about their abuse. According to a large and consistent body of data, most victims either delay or refrain from disclosing entirely. Less than 10 percent of actual crimes ever get reported. Consider the results from the National Health and Social Life Survey, the largest and most methodologically sound national study on sexual abuse. Prior to interviews with researchers, only 22 percent of victims randomly sampled in the general public had disclosed their sexual abuse.
Less than half of the victims I have spoken with over the last decade had talked about their abuse prior to their interviews with me. Initially I found this extremely hard to understand. Why would a victim of crime, never mind a crime that damaged him or her, choose to keep silent about what happened?
As children, they do not speak out because they do not know they should; they fail to fully understand the meaning or significance of the activities they are being asked to engage in. As I discussed in chapter 2, many can sense that something is wrong with these activities, but they are not sure what. As one victim put it to me, “As a kid it was like a double bind. I didn’t know enough to justify saying no to someone like him, but I did know enough to know I probably shouldn’t tell anyone. . . . I was stuck in the middle.”
As adults, victims say they do not disclose for different reasons. Later in life, as I discussed in chapter 4, they do come to understand that what happened to them was wrong and that they should have spoken out (and most certainly shouldn’t have participated). But since they remained silent and did participate, as adults, they feel tremendously ashamed and guilty. Many subjects told me that they feared these feelings might be confirmed if they told others–that they would be blamed.
Professionals rarely discuss or highlight explicitly the type of nontraumatic abuse most victims experience—one in which victims are confused and trusting, do not resist, and care for and love the perpetrators. As a consequence, most people in the general population do not know this sort of abuse exists. This is why victims still fear disbelief and blame.
We idealistically assume that as victims become empowered to speak out, other people will respond appropriately and support them. Unfortunately, in the real world, this is not the case. According to victims, when they do speak out (most often to family members), the following three reactions inevitably occur.
DISBELIEF/DENIAL
Victims are particularly likely to face disbelief in cases in which the perpetrator appears trustworthy, respectable, and successful. In the words of one victim, “They said a person like that would not have done such a thing.” Victims also tend to confront denials in cases when there is a delay in disclosure, a long period between when the abuse occurred and when they actually reported it: “My mother kept asking the same thing: ‘If it happened, why did you wait so long to tell anyone?’”
BLAME
Even if victims are believed, many then get blamed for the abuse. Again, victims’ own words best highlight this terrible result of disclosure:
They said if it happened I must have done something to encourage it. . . . I was like, what could I have done? I was eight. They said . . . I was always after him for attention, following him around like a puppy.
I told my sister first. I thought that maybe it might have happened to her too–her bedroom was right next to mine; we were only a year apart. . . . She said it did not happen to her, and she was clearly disgusted. . . . She asked me, how could I have done such a thing?
In fact, this tendency to ascribe blame to victims, to place some or all the moral opprobrium for these crimes onto the child, was the main impetus behind the social movement feminists and child welfare advocates began in the 1970s. Most studies on blame attribution indicate that culpability continues to be distributed between the child and the offender. According to a series of studies published in the 1990s (conducted using different types of subject populations, involving actual cases of sexual abuse), only 12 percent of subjects exposed to accounts of sexual abuse held the offender entirely responsible.
MINIMIZATION
In the unusual cases in which victims manage to be believed and not blamed, the significance of the abuse experiences is minimized or overlooked. Victims have reported,
My father said, “What’s the big deal? So he played with your hoohoo. . . . What’s the harm of such a thing? . . . Just let it go.”
I told my parents . . . but then they never mentioned it again. It was like it did not happen. The message to me was clear–to not bring it up. . . . They still invite him to family events; he is still a part of the family. So either they don’t believe me or they don’t care.
All victims who participated in my research were asked the same question at the end of our work together: What was the worst part of the sexual abuse? Those who had disclosed the abuse to someone else prior to the interview always gave the same answer. The worst part of the sexual abuse was how other people reacted. According to one recent study, the first to investigate the psychological impact of disclosure on victims, the intensity of negative emotions some victims experience during the process of disclosure might actually cause posttraumatic stress disorder in the aftermath.
Researchers do not focus exclusively on damage; some concentrate on resilience (why some victims can emerge from sexual abuse unscathed while others fall apart). It turns out there is an inverse relationship between psychological damage and social support. The more support victims receive from others (belief, caring, sympathy, attention) the less negative psychological consequences are. Social support from mothers emerges as one of the most potent predictors of outcome.
Given the importance of social support for victim’s psychological health, it is important to consider the reasons why so many people do not support victims—why such damaging reactions as denial, blame, and minimization are so likely to occur.
I think a lot of it comes back to the same phenomena: the trauma myth. After thirty years of indoctrination into the idea sexual abuse is a traumatic experience when it happens, others besides victims do not understand sufficiently well the unique nature of child sexual abuse, it’s underlying dynamics, and the victims’ likely responses.
Nothing the victim says bears any resemblance to the “common and damaging crime” that professionals have portrayed and everyone else has understood over the years. The situation is tragically ironic. By highlighting trauma—thereby emphasizing characteristics of a type of abuse that rarely exists—many mental health professionals advocating for victims to be believed and supported, not blamed or doubted, are fostering the conditions that lead to denial, blame, and minimization in the first place.
Our allergy to the truth is a function of three widespread, persistent, and powerful misconceptions that have historically hindered sustained societal attention the topic of child sexual abuse. First, if a victim consents to sexual abuse—fails to resist the sexual actions imposed upon him or her—most assume that the abuse is partly the fault of the child. This, as I discussed at length in the book, is preposterous. To admit that children consent is not to exclude recognition of the developmental and cognitive factors that lead to this consent in the first place. Children should not be held responsible for their developmental immaturity. Today, as cognitive psychologists are well aware, a large body of evidence shows that children are not capable of understanding sexually toned encounters in the same way that adults are. Given the circumstances perpetrators put them in, it would be unreasonable to expect them to act otherwise. Many, if not most, children end up allowing the abuse to occur; to point this out in no way removes any of the opprobrium for these crimes from the perpetrator.
Second, it is widely assumed that if sexual abuse is not a traumatic experience when it happens, it will not harm the victims—that “no trauma” at the time of the abuse means “no harm” for the victim later on in life. Sexual abuse may not be a horror show for most victims when it happens, but it certainly can become so later on in life … What hurts most victims is not the experience itself, but the meaning of the experience—how victims make sense of what happened and how these understandings make them feel about themselves and others subsequently impact their emotions and behaviors. In short, an event does not have to be traumatic when it happens to cause harm later on. It is the retrospective interpretation of the event that mediates subsequent impact.
Third, a disturbing tendency exists among many people to equate wrongfulness to harmfulness. Thus, if sexual abuse was not traumatic for the victims when it happened, if it did not immediately and directly cause harm, many people conclude “not wrong.” Sexual abuse is very wrong, regardless of how it affects victims. As the brilliant social psychologist Carol Tarvis has written, “A criminal act is still a criminal act, even if the victim recovers.” If I was mugged and it was not a traumatic experience at the time, would this mean a crime had not occurred? Absolutely not. What is wrong about mugging is that a person did something he or she should not have. It does not matter how I reacted. It is the nature of the action itself that makes it wrong, not the consequences. Similarly, it is the act of sexual abuse and not the damage it causes that makes it wrong. It is time to develop a stronger ethical position on the matter, one less dependent on the presumption of harm and more dependent on the premise that the act is inherently vile and unfair to the child. Adults knowingly take advantage of innocent and trusting children, incapable of providing full and informed consent, for the purposes of the adults’ sexual gratification. To paraphrase the famous psychiatrist Judith Herman, the true horror of sexual abuse is not in the sexual act but in the exploitation of children by the very people they trust to protect them.
According to the most recent results from a panel of experts convened by the prestigious National Research Council, no clear progress has been made in the field in terms of definitions, treatments, identification, or prevention of sexual abuse. And, as a consequence, the health and welfare of abused children and their families are compromised. Given that a stubborn and tenacious trauma myth was used to frame assumptions underlying the policies and programs developed to treat and prevent abuse, this lack of progress is not surprising. How can we understand or learn from what we refuse to acknowledge?
John Kenneth Galbraith, the brilliant economist, famously wrote, “People associate truth with convenience, with what most closely accorded with self-interest and personal well-being, what promised best to avoid awkward efforts or unwelcome dislocation of life. We find highly acceptable what contributes most to personal self-esteem. What we like to believe is not what is true but what is simple, convenient, comfortable, and comforting.” Of course, sexual abuse is none of these things. Would it not be better not to know? By denying the truth and focusing on theories that are false, we can feel good that we are doing something about the crime, but we do not actually have to confront it.
In The Culture of Fear, Barry Glassner explores why we become afraid of things we should not fear. We are all afraid of dying, for example. So why do we not worry about what we might actually die of—like heart disease? Instead, we focus our worry—and money, attention, and time—on unlikely threats (like terrorist attacks). Glassner argues compellingly that psychologically this serves a very important purpose for us: It allows us to express our fears and to feel morally upright—as though we are taking a stand, doing something, acting like caring and concerned professionals and citizens—without our actually having to face directly the real thing that bothers us or to take responsibility for doing anything about it.
So, why do we fail to confront the truth about sexual abuse? Not because we do not know it is there. Not because we think doing so is serving victims well, but because it serves us well. We do not want to know the truth about sexual abuse. Powerful cognitive and psychological incentives exist to blind us from the a truth that, if acknowledged, would disrupt the lives of many people. Like the victim, we would have to suffer. Is it possible that deep down we feel it is better if victims feel betrayed, guilty, and ashamed so that we do not have to?