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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