the Introduction to Betrayed As Boys (1999),
Richard Gartner, Ph.D.
1988, I started treating the first man I specifically conceptualized
as having been sexually abused in boyhood. I had been in practice
for more than fifteen years, as a dynamically oriented psychotherapist,
as a systems-oriented family therapist, and finally as an interpersonal
psychoanalyst. In retrospect, I realize that patient, whom I call
Patrick in my clinical descriptions later in this book, was certainly
not the first man I treated who had a history of childhood sexual
betrayal. He was not even the first to tell me about inappropriate
or unwanted premature sexual experiences with older friends, relatives,
or caretakers. I was, however, a product of my own training and
a prevailing conventional wisdom among clinicians that such stories
should be treated cautiously because of the likelihood that they
emerged from patients' fantasy lives and wish fulfillments.
So, while I had not doubted my patients' stories, I also
had not encoded them as descriptions of sexual abuse. Nor had
I thought about patterns of behavior common in men with histories
of childhood sexual betrayal.
work with Patrick proved to be a watershed for me. As he slowly
began to recall horrifying stories of sexual abuse in early childhood,
I was forced to rethink how to understand them. If they were entirely
fantasies, then Patrick was floridly psychotic, which I did not
believe. But if his stories were even partly true, then he had
been the victim of grievous crimes perpetrated by his father and
brother. As time went on, the picture became fuller as his sister
confirmed that she too had been sexually abused by their father.
My doubts about Patrick's stories dissipated. Instead, I
began to think about how his adult symptoms of recurrent depression,
night terrors about a stranger breaking into his room, obsessive
but impersonal sexual fantasies, long-term isolation, and difficulties
in interpersonal relationships all made sense in the context of
chronic sexual abuse in early childhood.
time, I educated myself about the literature on childhood sexual
abuse, which focuses mainly on women. As I sought help from colleagues,
my interest in sexually abused men grew, and I began to get referrals
of other men (and women) with similar histories. More referrals
came when I started a group for these men after I could not find
one in New York City for Patrick.
I began to work with men who defined themselves as having been
sexually abused, I started to think about other patients differently.
I was more likely to inquire into their early sexual histories.
Interestingly, more patients told me about inappropriately sexual
childhood histories without my ever asking. My receptivity about
the subject had in some way been communicated to them.
a patient I had treated for several years during and after my
psychoanalytic training returned to see me after an absence of
some five years, I was especially struck by how much my thinking
had been transformed. He reminded me that just before he stopped
treatment he had asked whether I thought he might have had a history
of boyhood sexual abuse, even though he had no actual memories
of it. Confused about how to explore this possibility in the absence
of memories, I had given an equivocal response. He now told me
that shortly thereafter he stopped the treatment "in despair."
I now realized how limited my thinking had been. This man's
symptom picture, which included obsessive and compulsive sexuality,
masochism, cross-dressing, and severe interpersonal isolation
and distrust, was certainly consonant with a history of childhood
sexual abuse. Nevertheless, I had never thought in such terms
during his earlier treatment. Nor had it ever been brought up
by any of the four excellent teachers and supervisors to whom
I had presented my work with him while in training.
My work with this man in his second treatment sequence did not
reveal overt childhood sexual abuse. Nevertheless, the incestuous
sexuality and abusiveness he witnessed in his extended family
came to the forefront as inappropriately stimulating. From this,
I came to see him as having suffered a covert sexual betrayal
as a boy.
is the kind of pattern I was now able to recognize and work with
in my male patients. Sexual abuse is certainly not a universal
experience for boys, nor is it the explanation in every case for
complex symptomatic pictures like those I describe in this book.
It is, however, far more often present in boys' histories
than any of us would like to believe.
and the sexual abuse of children have long been taboo and misunderstood
subjects in the popular culture and in the clinical literature.
Sexual victimization of all children has chronically been denied
in our society. The sexual victimization of boys, however, is
even more universally minimized, underestimated, and ridiculed
than the abuse of girls, for reasons I will discuss throughout
this book, but especially in Chapters 2 and 3.
these social views of male sexual victimization have started to
change as stories about boys' sexual victimization gain
greater currency in the popular press. I will discuss in Chapter
2 the well-publicized cases of two women brought up on child rape
charges for their sexual involvement with boys. Scandals have
also been widely reported about extrafamilial victimization of
boys by men in church, scouting, Internet, child care, and sports
venues. I refer here to such stories as:
sexual abuse of young boys by Catholic priests and seminarians
in such diverse locations as Maryland, California, and Texas,
leading to numerous guilty pleas and successful civil suits (New
York Times, December 2, 1993, p. A18; New York Times, October
21, 1995, section I, p. 10; New York Times, July 25, 1997, pp.
multiple successful suits against the Boy Scouts of America brought
by former scouts and their families because of sexual abuse by
scoutmasters (Boyle, 1994);
criminal convictions and financial settlements in Newfoundland
and Ontario during the 1980s and early 1990s following the revelation
of sexual, emotional, and physical abuse by Christian Brothers
of hundreds of boys confined to training schools (Henton and McCann,
male nanny who pled guilty to abusing a twelve-year-old boy in
Armonk, New York, while already on probation for abusing a nine-year-old
boy in Greenwich, Connecticut (New York Times, September 26, 1996,
guilty plea of a Canadian hockey coach accused of molesting several
young hockey players, followed by the further accusation by National
Hockey League player Sheldon Kennedy that he too had been abused
by this coach as a teenager (New York Times, January 4, 1997,
p. I34, and January 16, 1997, p. A10), in turn followed by the
arrest and subsequent conviction of Toronto Maple Leaf Garden
employees who lured at least twenty-four boys into exchanging
sex for hockey tickets, hockey sticks, and player autographs (New
York Times, February 20, 1997, p. B19); and
the controversy when a teenage boy accused of sexually assaulting
and murdering an eleven-year-old boy was revealed to have been
himself abused by an adult man he met in an America On-Line chat
room (New York Times, October 3, 1997, p. B6).
in each of these stories the victimizer came from outside the
family. This does reflect some research findings that most abused
boys suffer from extrafamilial victimization. Incestuous abuse
of boys is virtually never reported in the press, however, even
though its prevalence is also well-documented, as we will see
in Chapter 1. Indeed, denial of the extent of childhood incest
has been almost universal in our society. There is a deep cultural
taboo against accepting how common it is. To believe in the widespread
incidence of incest is to question the sanctity of the family,
where children are thought to be protected from harm.
pervasiveness of the denial of childhood sexual betrayal, especially
the sexual abuse of boys, was illuminated for me several years
ago. I was invited to an international conference to give a paper
about the treatment of sexually abused men. Just as I was leaving
for the foreign city that was hosting the meeting, the conference
program arrived. My paper was not listed in it. Surprised, I called
the program chair when I arrived. He did not remember me or my
paper. At that moment, I felt the sense of unreality that patients
have told me they experience in the face of their family's
denial of ongoing sexual abuse. Flustered and confused after a
day-long flight, I momentarily wondered if I was mistaken about
the initial request to read my paper. I grounded myself when I
realized that the conference chair's letter of invitation
was in my hand as I spoke to him. He apologized and found a place
for me on a panel at the meeting, albeit one on which none of
the other papers related to mine. The addition of my paper to
the program was announced once at the conference opening, but
was not listed on any of the notices posted around the meeting
rooms until I insisted. At the panel itself, the moderator, an
American scholar and psychoanalyst, permitted the speaker before
me to go on for fifteen minutes beyond his allotted twenty-five.
Seven minutes after I began to talk about the experiences of sexually
abused men, however, this moderator handed me a note that read
"Can you wrap this up? We're supposed to be having
a coffee break now." Luckily, several colleagues in the
audience protested that they wanted to hear my paper.
events were not directed at me personally. At first, I thought
my experience arose from the overall disorganization of the conference
itself. Now, however, I realize that hearing about boyhood sexual
abuse is intolerable to many of us. Our unconscious reactions
affect how we feel, how we act, and how we enact.
Stories of childhood sexual abuse have been central to acrimonious
debates as long as psychological treatment itself has existed.
This started when Freud's early work on hysteria (Breuer
and Freud, 1893-1895; Freud, 1896) was followed by his retreat
from the so-called seduction theory. Later, there was a notorious
dispute between him and his closest and most gifted student, Sandor
Ferenczi, after Ferenczi (1933) wrote a paper, "Confusion
of Tongues between Adults and the Child," that cogently
described how sexual trauma affects a child in later life. In
the decades that followed, childhood incest and other childhood
sexual betrayals were relegated to the realm of fantasy throughout
the psychoanalytic, psychiatric, and psychological literatures.
As recently as 1976, a leading psychiatric textbook claimed that
actual incest between father and daughter occurred only once in
a million cases (Freedman, Kaplan, and Sadock, 1976).
Since 1980, howver, the pendulum has been swinging away from the
fantasy theory about sexual betrayal, and a rich literature has
emerged in both the psychoanalytic and trauma-based arenas of
sexual abuse work. This literature, in turn, has stimulated new
controversy. In particular, criticism has been made by those who
felt too easy credence was given to patients' vague memories
or to therapists' feelings that abuse took place.
is indeed possible both for memories of abuse that have been long
forgotten to be remembered and for adults to construct pseudomemories
for events that never occurred (Alpert et al., 1994; see also
Lindsay and Read, 1994). I have elsewhere edited a book that considers
this complex controversy about memories of sexual betrayal (Gartner,
1997c). In this book, unless otherwise noted, I accept the patient's
memory as basically true, though not necessarily representing
a point-to-point, literal, videotape-like recollection. Such recall
is rare when any adult remembers what happened at a developmentally
early stage of life. Instead, I believe the essence of my patients'
stories, which usually means that severe boundary violations took
place, some of a specifically and explicitly sexual nature, and
that frequently the abusers were trusted parents and caretakers
(see Hedges, 1994).
is a book about what happens to boys who grow up in pernicious
circumstances, often in a family where incestuous boundary violations
repeatedly recur. It is also about the psychotherapeutic treatment
of these boys when they become men who at last must face their
abusive histories. Finally, it is about the inner experience of
therapists who try to draw on their skill and inner resources
as they evolve in very complex treatment situations.
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