Page 2, Memories of Sexual Betrayal
In
addition, it is important to remember that people who have lived
through a period of sexual victimization by a trusted caretaker
have had to learn a kind of double-speak language (Orwell 1949).
This point is also made by Wallen (1994), who says: "[For
the incest victim,] pain felt by the body has been called pleasure.
Violation has been called love. When the body has actually felt
pleasure, or the heart love, [the] mind has felt betrayed, [and
is] deeply ashamed for having failed to fully resist the encounter"
(p. 38). Thus, as dissociated memories emerge, still in double-speak
language, the adult has every reason to mistrust them, deny
them, find them illogical, and feel both betraying and betrayed
once again, this time by her or his own self.
The Current Research
The literature about childhood sexual abuse is growing so
fast that it is difficult to keep current. In the past several
years there have been special issues of the Journal of Applied
Cognitive Psychology (1994, Vol 8, No. 4), The Journal of
Interpersonal Violence (1993, Vol. 8, No. 3) and Psychoanalytic
Inquiry (1992, Vol. 12, No. 1) devoted to the subject. Multiple
important articles have also appeared in Psychoanalytic Psychology
(Brenneis 1994a, Greer 1994, Lerner 1994), American Psychologist
(Byrd 1994, Gleaves 1994, Gold et al. 1994, Loftus 1994, Olio
1994, Peterson 1994, and Pope 1996), and the Journal of the
American Psychoanalytic Association (Brenneis 1994b, Person
and Klar 1994).
While
I cannot review this literature in depth here, I would like
to discuss briefly two lines of work that promise to add a
great deal to our understanding of memories of sexual betrayal.
One is about the biology of traumatic memory, and the other
is about the prospective study of recall of childhood sexual
abuse.
The
psychobiology of traumatic memory recall has been of interest
to a number of investigators, including Kolb (1987) and van
der Kolk (1988, 1989, 1991, 1995; van der Kolk and Greenberg
1987; van der Kolk, McFarlane, and Weisaeth 1996). In a 1994
article in Nature, a group of California investigators (Cahill,
Prins, Weber, and McGaugh) corroborate that traumatic memory
is encoded differently than conventional memory in humans.
They did this by administering propanolol to subjects being
exposed to both neutral and traumatic stories. Propanolol
is a beta-blocker, a drug that blocks the effects of adrenaline
and noradrenaline, both of which are released during emotional
arousal. The researchers found that the beta-blocker significantly
impaired memory of the emotionally arousing story but not
of the emotionally neutral story. Since the drug affected
traumatic memory only, the study suggests a separate biological
system for encoding and recalling emotional trauma. Specifically,
the study supports the idea that enhanced memory for emotional
experiences involves activation of the beta-andrenergic system.
Blocking this activation therefore blocks traumatic and emotion-laden
memory. To my knowledge, this study is thus the first reported
experimental induction of the process of dissociation.
While
retrospective studies have added to our understanding of traumatic
memory, they are not as persuasive as prospective studies, in
which subjects are followed over time rather than asked to recall
their history. Linda Meyer Williams (1994) of the University
of New Hampshire has done a longitudinal prospective study of
the recall of women whose childhood sexual abuse was documented
at the time in hospital records. Seventeen years later, she
followed up on these girls and found that 38 percent of them
recalled neither the abuse for which they had received medical
attention at the time nor other molestations by the same abuser.
This group of nonrecallers included women who were able to discuss
with the researchers other incidents of sexual abuse in their
lives with other abusers. When girls younger than seven were
eliminated from the sample in order to control for the unreliability
of early childhood memory, 28 percent still did not recall the
abuse. Williams concludes that "forgetting is associated
not only with age but with the relationship to the offender"
(p. 1174, italics added). Girls abused at a very young age were
most likely to forget, as were girls abused by someone they
knew. Abuse by a stranger, however, was more likely to be remembered
even when the study controlled for age, thus suggesting that
"age-related, cognitive developmental theories are not
sufficient explanation for memories of traumatic events"
(p. 1174). Thus some women recalled abuse by a stranger that
occurred even before age three, while others did not recall
repeated abuse by a family member that occurred at much later
ages. The Williams study, then, is a powerful support for the
idea that sexual abuse trauma is often not remembered by the
victim, particularly if it was incestuous and occurred at an
early age.
What Does Contemporary Psychoanalysis Offer?
What do we as psychoanalysts and psychoanalytically oriented
therapists uniquely have to contribute in our work with sexually
abused patients? I believe the most important thing we offer
is our training to tolerate and help our patients tolerate
ambiguity. This training helps us and our patients to live
with the uncertainty of not always knowing what is true, what
we believe, or what fits together.
Writing
in another context, Earl Witenberg (1978) wrote about the inevitability
of uncertainty in psychoanalysis. He warned analysts not to
confuse what they believe with what they know, saying, "When
one transforms belief into knowledge, one does the patient an
injustice. . . . Theories are always necessary to guide us,
but there is a great deal of uncertainty in the practice [of
psychoanalysis]. . . .[T]he hazard is that we cling to our beliefs
. . . and explain the patient in terms of our theories and not
attend to how or what the patient is saying" (pp. 278-279).
When this is applied to the subject of this volume, Witenberg
is sensibly warning us not to approach patients with preconceived
ideas about whether sexual betrayal did or did not take place,
but rather to allow the material to unfold from the patient
without our prior judgment of it. Likewise, we must not allow
our patient's or our own anxiety to rush us to conclusions
about the veridicality or lack of it in emerging memories of
sexual betrayal.
A Poet's Perspective
Before you read the papers on memory that constitute the remainder
of this discourse, I want to conclude by reminding you what
the playwright and poet Tennessee Williams had to say about
it. As is so often true, in this case an artist captures in
a few words qualities of human experience that psychoanalysts
can only attempt to delineate in lengthy papers such as these.
In the
opening monologue of The Glass Menagerie (1944), Williams'
semi-autobiographical re-creation of his own traumatizing
family, Tom Wingfield, the writer's alter ego and the play's
narrator, says: "The play is memory. Being a memory play,
it is dimly lighted, it is sentimental, it is not realistic"
(p. 341). Williams thus lets us know immediately that memory
distorts.
The
question for us all to address here is whether these distortions
do essential damage to truth. Anyone who sees The Glass Menagerie
knows that distorted memory can highlight and communicate human
truth. Any therapist who sits with a patient reaching for elusive
memories of childhood sexual betrayal also knows that even distorted
memories can lead to fundamental and healing psychological truths.
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