The Trauma Myth: Understanding the True Dynamics of Sexual Abuse | | AlterNet

As a graduate student at Harvard in the mid-1990s, I participated in research studies carried out by the psychology department that began in October 1996 and continued until August 2005 to interview adults who had experience sexual abuse as children and learn what effects the abuse had had on their lives. Although I was sure I knew what I would discover—that the abuse would be remembered as a horrible experience that overwhelmed the people I interviewed with fear when it happened and had always been viewed as a traumatizing occurrence—what I heard in the hundreds of interviews I conducted was quite different. In nearly all the cases, the adults I questioned had not experienced the abuse as traumatic when it occurred and only came to regard it as so years later. And in many of the cases, they had never been questioned about their evolving sense of the abuse and the ongoing impact that it had on their lives, but only about what the traumatic experience had been like at the time. These findings led me to question the progress professionals in the sexual abuse field have made when it comes to understanding and treating child sexual abuse.

Certainly we have advanced to the point that the right things are being said (sexual abuse is common and harmful; it is never the child's fault). Funding in the trauma field has been secured, research conducted, studies and books published, treatment centers established, and public awareness raised through sex-education programs and campaigns in the media. But is any of it translating into actual progress for victims? Do they feel that they're being helped, that they're understood and their needs are being served effectively?

The trauma model's main purpose—one of the primary reasons why mental health professionals welcomed it with such enthusiasm in the 1980s—was to provide an explanation for how and why sexual abuse wreaks such psychological and social havoc in victims. Armed with a better understanding of the impact of abuse, mental health professionals hoped to be better able to help victims cope with and recover from these damaging crimes.

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 level of long-term psychological harm experienced. 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 of their abuse, and mental health professionals still have not reached a consensus as to exactly why or what precisely to do to help them recover.

This state of affairs is far from surprising. How can trauma be the cause of harm if most victims say that the abuse was not traumatic when it happened? A growing number of scholars in the sexual abuse field are coming to agree that understanding how and why sexual abuse damages victims probably has little to do with the actual abuse and a lot to do with what happens in its aftermath. For example, as David Finkelhor concluded in his recent book Childhood Victimization, continuing research efforts that seek to track the consequences of early events through developmental, cognitive, and behavioral pathways may prove more fruitful than continuing the restrictive focus on the severity and nature of event-specific trauma. I believe that the victims themselves have always known this.

Jen was a sixty-five-year-old, divorced, retired administrative assistant. A tall, big-boned redhead with long purple fingernails, she was up front about lots of things. She did not like the coffee I gave her, my office was too cold, and she did not like the color of my hair. We were at the part of the interview when I asked her to rate how traumatic her abuse had been when it occurred. She did not like the questions I asked.

"Nothing personal," she said, "but these questions are kind of dumb. If you are trying to do what you say you're trying to do, and figure out why the abuse screwed me up so badly, why are you asking so many questions about what it was like when it happened? What you need to be focusing on was what it was like later on."

I asked what she meant. "What I mean is that what it was like when it happened and what it is like now are two separate things entirely."

At that point in my career, I did not have a lot of experience interviewing sexual abuse victims. I had, however, a lot of experience interviewing victims of other kinds of horrible experiences (motor vehicle accidents, combat, natural disasters, abductions), and I had asked these subjects to rate how traumatic the events were at the time. No one in these studies had ever said this to me before. And as far as I knew at the time, scholars were not talking how perceptions of the traumatic nature of an abuse experience change over time—how an event not initially perceived as horrible could become so. They certainly talked about how symptoms of trauma (depression, anxiety) might not manifest themselves until long after the abuse, but they were not talking about how perceptions of the abuse itself can change.

I knew I had to consider Jen's words seriously. From that point on, I asked my question in two parts: What was the experience like when it happened? And what is the experience like for you today, looking back on it.

By the end of the study, the data was clear. Although sexual abuse was not a particularly awful experience for many victims when it happened, looking back on it, from their perspective as adults, it was awful—ratings of shock, horror, disgust, and even fear were all high. Obviously, perceptions of abuse when it occurs and when victims look back on it years later are entirely different. In addition, sexual abuse is very different from other kinds of terrible life experiences. For example, getting into a car accident is traumatic both at the time it happens and later when it is recalled. Sexual abuse, however, becomes traumatic later on. Why? What happens in the aftermath of sexual abuse?

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.

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