Memories of Sexual Betrayal: The
Controversy in Context
Richard Gartner, Ph.D.
reprinted from Memories of Sexual Betrayal: Truth,
Fantasy, Repression, and Dissociation (1997)
Before
describing the context of the sexual betrayal controversy,
I want to say what this discourse is not about. It is
not about whether sexual abuse of children takes place.
Even the most disparaging observers do not make that claim.
Indeed, in their critical but balanced review of the literature
on recovered memories of child sexual abuse, cognitive
psychologists Lindsay and Read (1994) state, "[R]eal
sexual abuse of children is a larger problem than therapy-induced
memories of abuse. Real abuse has a longer history and
is more deeply embedded in our culture than [recovered
memory] therapies" (pp. 283-284).
Boys
and girls both suffer sexual abuse, including incest.
In random nonclinical samples, one-third of women reported
direct, penetrating, or tactile childhood sexual abuse
(Russell 1983, 1984, 1986). When noncontact seductive
and excitatory abuse was included, the figure rose to
over half. In analogous studies of nonclinical male populations
(Lisak et al. 1996, Urquiza and Keating 1990), about 17
percent described direct sexual abuse as boys, with an
additional 9 to 14 percent reporting noncontact sexual
abuse. (These figures for men are likely to be underreported
[Gartner 1993, Mendel 1995, Peake 1989]. See Bolton et
al. 1989, Finkelhor 1986, Herman 1992, Lindsay and Read
1994, and Urquiza and Keating 1990 for fuller discussions
of the prevalence of sexual abuse.)
Thus,
millions of adults have a history of sexual childhood
abuse. They cope with these histories in various ways.
Some deal with it creatively and heroically on their own.
Some become addicted to drugs, alcohol, food, or sex.
Some continue an abusive pattern as adults themselves.
Some lead seemingly successful lives at great inner cost.
Some become severely dissociated. Some come into psychotherapeutic
or psychoanalytic treatment to try to put their lives
together.
Most
remember their abuse, at least partially, all their lives
(Alpert et al. 1994, Lindsay and Read 1994). This discourse
is about how to understand those who as adults seem to
recall hitherto "forgotten" memories of sexual
betrayal, especially those who "recover" these
memories while in a therapeutic setting
An
Acrimonious Psychoanalytic Debate
The papers in this volume add a new chapter to an old
and acrimonious debate about how to understand stories
of childhood sexual abuse. The controversy about these
memories is as old as psychoanalysis itself. In 1895,
Freud and Breuer had just written Studies on Hysteria
(Breuer and Freud 1893-1895) and Freud was about to publish
Origins of Hysteria (Freud 1896). They remain powerful
statements about the later effects of childhood sexual
betrayal on its victims. These early papers were highly
controversial when they appeared, making psychoanalysis
itself a questionable pursuit. But, while Freud may never
have absolutely repudiated his so-called "seduction
theory" about the origins of hysteria in childhood
sexual abuse, he never again considered it a central psychoanalytic
concept after deciding that memories of childhood abuse
are usually fantasies and wish fulfillments.
Thus
began a psychoanalytic tradition in which emerging memories
of sexual betrayal were almost universally understood
as inventions of the inner world of the oedipal child.
This way of looking at abuse memories was firmly entrenched
by the time Sandor Ferenczi began to believe the stories
of childhood sexual betrayal he heard from a number of
patients, including such therapists and analysts as Elizabeth
Severn and Clara Thompson (Ferenczi 1932/1988, Fortune
1993, Rachman 1993, Shapiro 1993). Ferenczi was the Hungarian
psychoanalyst considered to be among Freud's most
brilliant students as well as one of the most gifted clinicians
of the time. His belief in his patients led to one of
psychoanalysis' most celebrated rifts (see Masson 1984),
variously described as "a trauma on the psychoanalytic
world" (Balint 1968, p. 152) and "one of the
darkest moments in the history of psychoanalysis"
(Rachman 1993, p. 89). Freud tried in 1932 to convince
Ferenczi not to read his paper "Confusion of tongues
between parents and the child" (Ferenczi 1933/1988)
at the International Psychoanalytical Congress at Wiesbaden.
When Ferenczi did read the paper, still one of the most
cogent descriptions of how childhood sexual trauma affects
the victim in later life, he did it at great personal
and professional cost. Ferenczi was dead of pernicious
anemia nine months after reading the paper, arguably a
death hastened by the furor his paper caused, and particularly
by the continued coldness of Freud, his mentor, analyst,
and much-beloved father figure. The paper was suppressed,
not published until 1939, and not published in English
until 1949. Meanwhile, Ferenczi's detractors, including
Ernest Jones, Freud's loyal biographer, said that Ferenczi
was psychotic when he wrote this paper (Jones 1957), a
rumor forcefully contradicted in my view by Ferenczi's
own clinical diary from this period (Ferenczi 1932/1988),
as well as by descriptions from others who were with Ferenczi
at the time (see Hidas 1993). This pathologizing of Ferenczi,
of course, was only one of many times that a clinician
or patient has been marginalized by those who disapprove
of or won't tolerate discourse about sexual abuse
and incest.
Contemporary
Approaches to Sexual Betrayal
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 et al. 1976).
Since
1980, however, 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. Besides the writers in this
volume, I am referring here -- and I apologize both for
the length of this list and for the many names I have
left off it -- to Briere (1989), Courtois (1988, 1992),
Ehrenberg (1987, 1992), Finkelhor (1984, 1986), Gelinas
(1983), Herman (1981, 1992; Herman and Schatzow 1987),
Hunter (1990a,b,c), Kluft (1990), Levine (1990), Lew (1988),
Lisak (1993, 1994, 1995; Lisak and Luster 1994), Russell
(1983, 1984, 1986), Sgroi (1988, 1989), Shengold (1989),
Simon (1992), and van der Kolk (1987, 1988, 1989, 1991,
1995; van der Kolk and Greenberg, 1987).
The
current legalistic and litigious climate in our country
has unfortunately encouraged some patients and therapists
to look to the legal system for redress of childhood sexual
abuse. In some instances court cases have gone on for
years, and the outcome rarely makes a patient feel truly
better about the abuse experience. In addition, the possibility
of a case coming into the legal system vastly complicates
how we as psychoanalysts understand the word "truth,"
since the psychological truth that an analyst may accept
when working with a troubled patient is quite different
from the legal truth a court of law rightly requires to
find an individual guilty of child molestation.
Since
1990, as any reader of this book knows, serious critiques
have been made of the sexual abuse literature. In particular,
self-help manuals like The Courage to Heal (Bass and Davis
1988) have been denounced for statements like "[if
you] have a feeling that something abusive happened to
you, it probably did" (p. 21) and for compiling
overly generalized lists of symptoms of childhood sexual
abuse. Such criticism does not take into account the climate
in which these manuals were first written, a climate in
which stories of childhood sexual abuse were almost universally
discounted, minimized, and thought to be fantasies and
wish fulfillments (see Wallen 1994).
Nevertheless,
clinicians like Ganaway (1989, 1992), Gardner (1992),
and Prager (1993, cited in Read and Lindsay 1994), academics
like Loftus (1992, 1993a,b; Loftus and Ketcham 1991, 1994)
and Lindsay and Read (1994), and other nonclinician critics
like Carol Tavris (1993) and Frederick Crews (1994/1995)
have all made powerful - though sometimes shrill - arguments
about the questionable nature of repression, the unreliability
of memory, and the ethics of techniques that may lead
patients to conclusions about their history that are dubious
at best. As Dodi Goldman and I noted in a published response
to Crews' articles in The New York Review of Books (Gartner
and Goldman et al. 1995), these watchdogs have done our
field a service in reminding us that some overly zealous,
ideologically driven practitioners have at times shown
poor judgment and most likely done a therapeutic disservice
to their clients as well: "Insufficiently trained
therapists may fail to take into account the complexity
of the intermingling of fantasy and memory and the way
the human mind actively constructs rather than passively
registers perceptions. . . .Therapists who insist, through
a variety of pressuring and suggestive techniques, on
convincing their clients of abuse, are enacting a subtle
form of abuse themselves" (Gartner and Goldman et
al. 1995, p. 42).
On
the other hand, this does not automatically mean that
because a memory has been "recovered" in therapy
it has no historical basis. When the American Psychological
Association appointed a working group to investigate issues
about memories of childhood sexual abuse, it included
psychologists as diverse as Elizabeth Loftus and Christine
Courtois in their beliefs about memory. This entire committee
agreed in its interim conclusions (Alpert et al. 1994)
that, while "most people who were sexually abused
as children remember all or part of what happened to them,
. . .it is possible for memories of abuse that have been
forgotten for a long time to be remembered . . . (and)
it is also possible to construct pseudomemories for events
that never occurred" (p. 2).
I
believe that every contributor to this volume agrees with
that statement.
Repression, Dissociation, and Double-Speak
The terms repression and dissociation are both used to
describe the process by which events in a person's
history are unavailable to the individual's memory.
They are not interchangeable terms, and it is important
to differentiate them with clarity. Repression, a process
first described by Freud (1900), refers to an active mastering
of conflictual material by pushing it out of awareness.
Dissociation, a process discussed by Bromberg (1991, 1993,
1994), Fairbairn (1954), Janet (1898), and Sullivan (1956),
among others, refers by contrast to a passive severing
of connections between one set of mental contents and
another, often before they enter awareness, so that they
dwell side by side without reference to one another. Thus,
good and bad feelings about the same object can coexist
without conflict in dissociated states. Dissociation is
thought to take place as a response to overwhelming trauma,
as a means for the self to maintain some fragile sense
of functioning. It can occur before traumatic events are
verbally encoded, so that they have never gotten out of
the realm of what Stern (1983) calls "unformulated
experience." Unverbalized, unsymbolized, fragmented,
and undigested, dissociated material emerges exactly as
it was in its original traumatizing context.
Repressed
material, therefore, is considered to have had a previous
shape in consciousness, and is thus familiar to the individual
once it reemerges (but note Cohler's [1994] point
that, for Freud, repression of early childhood material
is absolute and can never reenter consciousness). Dissociated
material, on the other hand, breaks through as nearly
the same terrifying experience it was before the disintegrating
self severed the experience's ties to consciousness.
When it is a traumatic relationship that must be dissociated,
as in the case of chronic incest, then there may be a
severe disturbance about relating itself because of terrifying
dissociated experiences (Sands 1994). Such chronic disturbances
in relationships have been detailed throughout the clinical
literature on incest (e.g., Gelinas 1983, Courtois 1988,
Ehrenberg 1992, Gartner 1993, 1994, and Davies and Frawley
1994). For further discussions of repression and dissociation,
see Davies and Frawley (1994), and Davies's and
Stern's papers in this volume).
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