Child Sexual Abuse

Susan Clancy's important book "The Trauma Myth" (New York, Basic Books, 2009) is drawing the critical fire of a number of people who have not given it the careful reading it deserves. Some of these critics have claimed that Clancy argues against any deleterious effects of sexual molestation in childhood--- that she defends pedophiles, and even that she is a pedophile herself or that she blames child victims for the behavior of sexually-exploitative adults.

These statements are nonsense, and I am going to attempt to counter them by devoting today's post to a summary and comments on Clancy's argument in "The Trauma Myth".

"The Trauma Myth" emphasizes repeatedly the clear evidence that childhood experiences of sexual exploitation by adults are associated with a long list of later problems, including mood disorders, anxiety disorders, personality disorders, relationship and sexual problems, eating disorders, self-mutilation, and so on. Because one in five children is reported to have experienced sexual abuse (and probably there are more, unreported, cases), such abuse is responsible for significant numbers of mental health problems. It's important that we learn how to prevent it and to treat its results, not only for the sake of individuals but for the mental health of the whole population. To prevent child sexual abuse and treat problems that result from it, we need to have a real understanding of how these experiences cause bad outcomes. However, much work in this area is based on the assumption that trauma theory, which attributes many mental health problems to the past experience of severe pain and fear, and trauma theory may not provide a good framework for understanding the impact of sexual molestation in childhood.

Clancy is not the first to point out that children's sexual experiences with adults are not necessarily experienced as traumatic (severely painful or terrifying) at the time when they occur. But her interview research with adults who had been molested as children clearly showed a continuum of child experiences, ranging from terror and pain at one end, through puzzlement without distress in the middle, to physical and emotional gratification at the opposite end. In fact, most of her interviewees reported that in childhood, at the time of the event, they were not frightened or in pain. The abuser's actions did not involve force or even penetration of any kind, but were generally limited to rubbing, kissing,or fondling of genitals, nor did most of the abusers threaten the children in any way. Nevertheless, those adults, as well as the ones who had experienced trauma, reported symptoms related to their experiences, and now felt that the sexual event had had a deplorable effect on them.
The question Clancy raises is this: if the abused children did not at the time experience the event as traumatic, how can we explain the connection to their present symptoms? We can't do this in any simple way by means of applying trauma theory. To make trauma theory work in this context, we would have to add to it the concept of repressed memories-- to say, for example, that the adults Clancy interviewed were really terrified and hurt, that they have repressed and can't report that part of the experience, but that in its repressed form the memory still affects their mental health. Taking that approach, however, we would come up against an even more complicated issue: why is it that people who were actually hurt and terrified (according to independent evidence) don't repress what must be a hideous memory? Using the repressed memory concept, then, we find ourselves having to explain why a really terrible experience is remembered with all the emotional factors intact, but a less painful and frightening situation leads to repression of memories of emotion. Although U-shaped functions of this kind are not unknown in psychology, this one does not seem to make much sense.
Clancy concludes from this line of reasoning that trauma theory and the concept of repression are not good ways to explain the most common situations involving childhood sexual abuse and its aftermath in adulthood. Because they are not good ways, they have not done much to help us either prevent or treat the effects of child sexual abuse. We need to explore these matters much more carefully, and, Clancy says we need to make sure that our explanation involves the child's point of view, which has generally been ignored. To understand that children's group and individual characteristics affect the sex abuse situation is a far cry from "blaming" the child.
Clancy makes several points about children's understanding of the world and the ways it can make the child's view of non-painful sexual abuse rather different from an adult's. She stresses the ignorance of children about sexuality and their failure to comprehend what an adult wants or what he or she is doing. Why heavy breathing and a red face, for instance? A child has probably observed these things before, but in quite different contexts. The puzzled conclusion may simply be that this is strange and perhaps it's one of those embarrassing things that you get in trouble for talking about, so best to just keep it to yourself.
Importantly, Clancy also emphasize that there are characteristics of individual children that may make them more likely to be the victims of repeated abuse which they do not report. No, she does not say these children are "seductive"; what she does say is that they are lonely, unsupervised, and grateful for adult attention. They respond to the fascinated attentiveness of the potential abuser as a delightful experience, in sharp contrast with the indifference their caregivers may show. Without experiences of pain or fear, why should they reveal what seems to them like a romance to familiar adults who will probably cause some trouble?
Finally, Clancy says something that is for many readers the unspeakable: that given a kind, careful adult who treats them well, children may enjoy sexual experiences (we are not talking about penetration here, of course). I was reminded of a story I heard from a friend some years ago. She had left her 3-year-old boy with a 13-year-old boy babysitter, and when she came home she became aware that some sort of sex play must have been going on. All she could think of was to give the 3-year-old the old bromide, "if someone touches you and you don't like, just tell them to stop"--- to which the 3-year-old replied enthusiastically, "I liked it! When can he babysit me again?" And there you have it in a nutshell; sexual activity of the right kind is pleasurable for everybody at every age. Sexual predators know that very well, and if we want to stop their exploitation of children, we need to be honest about it too, and not to expect children to "tell on" someone who gives them pleasure.
"The Trauma Myth" is a serious effort to deal with child sexual abuse and its aftermath. I've had space here to give only the highlights of Clancy's argument, but the book contains much more of interest, including a discussion of abuse prevention programs as they now exist. I hope readers will give "The Trauma Myth" the careful attention it deserves.

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