By Judith L. Herman and Mary R. Harvey
The Harvard Mental Health Letter, Vol. 9, No. 10, April, 1993
Excerpts from http://www.mentalhealth.com/mag1/p5h-mem3.html
. . . a debate has arisen about the proper balance between victims' rights and due process of law. Under the high standard of evidence required by due process, the credibility of testimony based on delayed recall has been challenged. Academic researchers who study normal memory in volunteer subjects have been asked to generalize from laboratory findings to the clinical realm of psychological trauma. They have questioned the veracity of delayed memories of childhood sexual abuse and speculated on the possibility that these memories might be fictions inculcated by naive or manipulative psychotherapists.
The notion that therapists can implant scenarios of horror in the minds of their patients is easily accepted because it appeals to common prejudices. It resonates with popular fears of manipulation by therapists and popular stereotypes of women as irrational, suggestible, or vengeful. It appeals to the common wish to deny or minimize the reality of sexual violence. In actuality, false claims of childhood sexual abuse are demonstrably rare, and false memories of childhood trauma are no doubt equally so. The evidence comes from epidemiological research, investigations of sexual abuse reports, and studies on the nature of traumatic memory.
Several independent large-scale studies have documented the nature and prevalence of sexual assault in the United States. In these studies trained interviewers have obtained detailed information from large community samples of adult women, revealing that rape, incest, and childhood sexual abuse -- defined in accordance with prevailing law -- are common experiences. The best study, by the sociologist Diana Russell, indicates that one girl in three is sexually abused by age 18, one in four before age 14. Most abusers are known and trusted people in a position of authority over the child. Many are family members. This abuse is vastly underreported, because offenders usually succeed in silencing their victims. Probably less than 10% of child sexual abuse cases come to the attention of protective agencies or police.
The consensus of researchers is that false complaints by children are rare, in the range of 2-8% of reported cases. False retractions of true complaints are far more common, especially when the victim is insufficiently protected after disclosure and therefore succumbs to intimidation by the perpetrator or other family members who feel that they must preserve secrecy.
Since most child victims are silenced, disclosures of sexual abuse usually come from adults who report what they remember having undergone earlier. Their stories usually resemble those of child victims who speak out. We know of only one study directly addressing the question of whether these adult memories can be verified. Working with 53 female patients in group therapy, most of whom reported delayed recall after a period of partial or complete amnesia, Judith Herman and Emily Schatzow found that the majority (39, or 74%) were able to obtain independent corroborating evidence for the abuse. In some cases their stories were confirmed by other family members or other victims of the same perpetrator. Some found physical evidence such as pornographic photographs or diaries. In several cases the perpetrators unapologetically admitted their actions, and a few even tried to renew the sexual contact. Five women (9%) found evidence that was strongly suggestive but not conclusive. Six (11%) did not try to confirm their memories. Only three (6%) could not find any supporting evidence. Although more research is needed, these results suggest that delayed recall of sexual abuse is as verifiable as any other form of disclosure.
Traumatic memory is a new field of investigation in which there are many unanswered questions. Clinical experience shows that these memories are formed in an altered state of consciousness induced by terror. The focus of attention is greatly narrowed, the surrounding context falls away, and certain details of imagery and sensation are deeply engraved. Such memories seem to be extremely accurate in some respects; for example, an adult may give a detailed description of the wallpaper in a room in which she was raped, even though she has not seen the room since the age of five. In other respects, such as time sequence, traumatic memories may be fragmentary and vague. But these flaws should not be taken to imply that the remembered events did not occur. As Elizabeth Loflus' own research has shown, even eyewitness accounts of known events often contain many inaccuracies.
Partial or even complete amnesia for childhood trauma is well documented. In a follow-up study of 200 children who had been treated for sexual abuse, Linda Meyer Williams of the Family Violence Research Laboratory at the University of New Hampshire found that one in three did not recall the experiences that had been documented in their hospital records 20 years before. How much is remembered depends on circumstances. In general, the younger the child and the more violent the experience, the greater the likelihood and the severity of amnesia.
Delayed recall of traumatic events after a period of amnesia is also well documented. The most recent example is the well-publicized case of Father James Porter, a Catholic priest who by his own admission molested more than 100 boys and girls in several states. Many of Porter's victims, including the first to come forward, testified that they had recalled the abuse after a period of amnesia. In these cases both the fact of the abuse and the phenomenon of delayed recall are beyond dispute.
The causes of delayed recall are poorly understood. Often it occurs when the survivor is in her twenties or thirties, but we have seen it even later in life. A common precipitant is a change in an intimate relationship. Memories may surface when the survivor begins a sexual relationship, gets married, or has a child, or when this child reaches the age at which the survivor was first abused. Delayed recall may also occur when another victim of the same man discloses abuse, as in the Porter case. Sometimes the trauma is recalled only when the aging perpetrator dies, or falls ill and expects the victim to care for him.
When traumatic memories break into awareness, distress can be overwhelming. Survivors are frightened, ashamed, depressed, and tormented by flashbacks or nightmares. They may feel suicidal or fear they are going crazy. At such times many people seek therapy. In our experience, they are far more likely to see a therapist because they are troubled by new memories than to unearth new memories at the instigation of a therapist. Furthermore, the process of uncovering one's history does not depend on a single memory. New memories must be gradually blended with old ones and alternative explanations weighed until a coherent and largely verifiable account is constructed. No patient is eager to discover that she was violated by people she loved and trusted. In fact, patients tend to cling to their doubts long past the point where most impartial observers would be convinced.
. . . therapists do not have enough power or influence over their patients to impose an elaborate form of mind control. Psychotherapy cannot be compared with coercive interrogation; the power imbalance between patient and therapist is not nearly so extreme. Most psychotherapy is collaborative. Therapists often make suggestions, but patients will respond only when those suggestions resonate with their own feelings and experiences. If a therapist is on the wrong track, most patients simply say so. If the therapist persists in pursuing a false hypothesis, therapy is ineffective, and the patient will usually look elsewhere for help.
. . . In our experience, however, most patients recover their memories without using hypnosis at all, and even those who do use it rarely rely on it as their main source of information. In a review of over 200 cases seen in our trauma program this year, we could find only one in which a patient based her belief that she had been abused solely on a trance experience.
Since research on childhood sexual abuse overwhelmingly supports the authenticity of most survivors' claims, defense lawyers have increasingly had to introduce data and expert testimony from fields that are only marginally relevant -- especially laboratory studies of normal memory. In the most commonly cited of these studies, it is shown that college student volunteers are susceptible to acquiring false memories of fictitious events described in great detail by trusted family members who claim that they were present at the time.
To generalize from these findings to the situation of adult survivors, it would be necessary to make four assumptions: 1) The patient is as suggestible as a motivated student volunteer and trusts her therapist as much as that volunteer trusts a brother or sister. 2) The therapist, unassisted by the patient's family, is capable of planting a wholly inaccurate, scripted scenario in the patient's mind. 3) An adult patient who has not been abused would find the idea of sexual abuse by a trusted caretaker or devoted parent as plausible as a moderately upsetting event that might occur even in the happiest childhood, such as being temporarily lost in a store. 4) False memories inspired by therapists are not just theoretically possible, but probable enough to warrant an especially high degree of skepticism. No evidence supports any of these assumptions, and stringing all four of them together violates the rule of parsimony. Such speculations fail to meet minimum standards of serious social research.
It has taken 20 years for women's organizations to bring the enormity of sexual assault to public attention and establish minimal standards of fairness for victims. As more victims try to hold their abusers accountable, it is natural to expect a backlash. Unfortunately, laboratory research can be exploited when it is taken out of its proper context and used to support a reaction against hard-won social gains. For researchers, a troubling consequence of this debate is that serious investigations of traumatic memory may be compromised. For therapists, the resulting polarization may prevent thoughtful discussion of the clinical issues attending memory work with adult survivors. Victims face the much greater threat of renewed social pressure to remain silent or recant.
Judith Lewis Herman, M.D., is Associate Clinical Professor of Psychiatry at Harvard Medical School and the author of Trauma and Recovery (Basic Books, 1992).