There had been an unprecedented increase in cases where children, sometimes as adults, charge parents and others with sexual abuse. Rumour has it that the District court is full of sex cases and this remains unresearched. It is a situation of extraordinary gravity as I can see families being destroyed by allegations. The consensus among experienced practitioners is that there is a new phenomenon, a moral panic.[1] In my practice, a week never passes without a matter connected to the issue of inappropriate sexual contact arises in harassment, custody and criminal injuries. The cases to which I refer are not those where a rape or assault took place and was investigated then and there while physical evidence was still present. These sexual contacts are alleged to have taken place months or years before. The new cases, their accusers and their families are very different in their presentation, behaviour and attitudes from victims and perpetrators of child sexual abuse whom I assessed thirty years ago.
Whether or not sex abuse had occurred was not an issue for expert advice until serious doubts were raised about the numerous cases have demanded expertise beyond that provided by lawyers who defend cases. Common knowledge on which juries rely depends on untested belief. Expert knowledge comes from scientific research.
This increase in child abuse allegations has been causally linked to a paradigmatic set of beliefs, acceptance of a syndrome, that inappropriate sexual contact inevitably causes harm. By corollary, if this is the case, the argument runs that disturbances in adult life can and should be traced back to abuse. This notion finds support among disturbed persons whose therapists, promote and share their beliefs, citing 'clinical experience' as evidence for this being the case. They argue that the patient often does not know of such abuse because it is repressed. Therapy that can release that repressed memory will be long and costly. Recalling will lead to recovery. Those of us who subscribe to any past life therapies, on which psychoanalysis is one, are unaware that without physical evidence, one cannot argue from effect to cause.
The social movement associated with 'Recovery' is said to have has created the greatest moral panic since Salem.[2] It claims that sexual abuse constitutes a major and ubiquitous evil in society and must at all costs be rooted out. Australia is affected to a lesser degree than the United States. They got the Puritans and we got the convicts and we thank God for that.
The origin of this notion can be been traced back to the work of F Schreiber, alias 'Cornelia Wilbur,' the psychiatrist whose work resulted in the book and film, Sibyl. Its influence has been profound in spite of the fact that Wilbur's patient repudiated this work both privately and publicly and accused Wilbur of making it up for commercial reasons.[3]
During the development of his talking therapy, Freud said that almost all of his adult female patients told him of abuse by their fathers.[4]
For a while, believed that infantile seduction, in current terminology, child molesting was the cause of their ailments then collectively known as hysteria. His colleagues were appalled at the preposterous nature of this claim. Freud came to recognise his role in generating these fantasies and retracted. Jeffrey Masson, in his book 'Assault on Truth' denounced him, claiming that Freud recanted to protect his friend Fleiss, at that time the recipient of an embarrassing sexualised transference from a patient.[5] Some well placed but ideologically driven feminists believe that Masson is right and that Freud was wrong in deciding not to accept at face value the complaints of his women patients against their fathers.
The Recovery movement's three seminal texts, are Herman's 'Trauma and Recovery'[6] Terr's dramatic Unchained Memories'[7] and 'The Courage to Heal',
The attraction of the 'Recovery' paradigm is its explanatory power and this is all laid out in 'Courage to Heal' a million copy best seller by Ellen Bass and Laura Davis, a journalist and as self-styled survivor.[8] All problems of living, all the clinical phenomena associated with borderline personality disorder and other forms of unhappiness are attributed to having been sexually abused and if you cannot remember, it is because you have repressed it and you must uncover the memories. Several million patients and their families are devastated by the consequences of recovered memory therapists, who have themselves become the targets of lawsuits.
Much of the debate is ideologically driven with therapeutic empires research grants and fame at issue. The issue has provided an impetus for research into the science of memory, an area previously in the taken-for-granted sphere of common knowledge. As knowledge about memory and about abuse and its effects grows, expert advice comes to be needed to correct commonplace but mistaken beliefs.
Critics of the repression/recovery paradigm, Loftus,[9] Ofshe[10], Crews[11] and social critic Mark Prendergrast[12] call its assumptions into question. They argue that its conclusions are drawn from 'clinical experience' and so are dangerous, biased and contaminated. They point out that before anyone can draw conclusions about the effects of abuse, the question of whether or not it really occurred must first be answered. They point out that sexual abuse is ill defined and can range from fondling to brutal rape while incorporating consensual but illegal contact.[13] They argue that no experiment can be devised that will differentiate repression, a phenomenon for which there is no evidence, from common or garden forgetting. To advise that recalling help assumes the existence of repression.
The literature that links reports of 'sexual abuse' to present difficulties is underpinned by the ideologically-driven belief is that what the patients calls her memory should not be questioned. They point out that there is no research paper which has linked the development of abnormal personalities solely to demonstrated child sexual abuse. Studies of sexually abused children cannot differentiate the effects of sexual abuse from physical and emotional abuse which generally accompanies it.[14]
The controversy is played out in the New York Review of Books, in learned texts, legal and clinical journals, on the internet and court rooms.
A brief overview of academic memory research that this epidemic has spawned leads me to suggest that every jury a judge needs to get expert advice on the reliability of recall in situations where uncorroborated events in the past are at issue. A systematic forensic evaluation is provides a framework in which truth and falsehood might be debated, identified or substantiated. Evidence for the truth or falsehood of the beliefs lies in their plausibility, their birth and the reasons for their existence the context in which they were developed and disclosed and their developmental history. One cannot ever know what transpired between two individuals a long time ago. However one can often sure that events did not occur as described, because those events would have had high visibility and serious consequences.
Some of the validating and negating judgements have been minutely researched, others are a matter of opinion but most are common sense. Imagine if your sister or daughter suddenly disclosed an inappropriate sexual relationship with your best friend and it was to be denied. The absence of evidence in such cases is as important as supporting evidence in others. All data collected are taken in context with each other. Data includes the genesis, growth, content and disclosure of the allegations, as well as the personalities, characteristics and motives of the alleged perpetrators, child and adult victims and the accusers.
There is no single piece of information that is pathognomonic of child abuse. Confessions have been retracted and have been proved to be false. A discontinuous recovered memory is not inevitably false. The incredible is likely untrue. Allegations that are preposterous will be found to be so on many criteria. It is unsafe for an expert to leave recognising the preposterous to judge or a jury. Juries also fail to recognise that which the psychiatrist sees as manifest hysteria as lay views of hysteria differ from the experts' definition. While a psychiatrist may recognise hysteria by its form, he or she must also submit the proof of the falsehood of hysteria to a court.
First I construct a scale, a semantic differential on the axis of undeniable possible equivocal improbable untrue and preposterous. Then each piece of information is located on this axis.
A psychiatrist can identify a belief as delusional if it is bizarre, its content preposterous, ludicrous. So are X files, yet their contents are accepted by believers of the preposterous who constitute a jury.
When one is interviewing, it is unwise to receive information in any way but in a deadpan manner. The liar is searching the face of the examiner for evidence of disbelief. The liar is unlikely to see a physician as trying to differentiate between a mistake a lie, a delusion and an hysterical belief. The liar is less likely to trust the interviewer than a mistaken person who believes what she is saying.
The goal is to identify and categorise that which the subject calls a memory and to know something of its nature. Much of what passes for memory is not that at all. Memory might be true and false, accurate and inaccurate, corroborated and unsupported, continuous and discontinuous, accurate an inaccurate. 'Memories' can be reconstructions, delusions, or the content of dreams, or of a mystical experience. They can be beliefs based on information from another, elaborations engendered by therapeutic processes or in a trance, oedipal fantasies, plausible explanations, recovered memories, false memories, hysterical beliefs,[15] borrowed scenarios from films and books, dreams and nightmares, unverified conclusions achieved by short-circuiting in panic situations, hysterical shared beliefs, such as having been involved in satanic abuse.[16] or lies.
None of them is true, but by the same token, very little of it is a lie. If there is a variety of psychological explanations for untruths, then the jury should know about the possibilities. If they are not untruths recognisable as such to the teller, then the jury should certainly be told that the teller possibly believes that she is telling the truth.
Out of the above spectrum of false beliefs only lies are not in the psychiatric spectrum. It might be the province of a jury to decide between true or false, and it will do it on its own criteria. An expert's advice will alter the odds offering a number of explanations beyond the truth or lie option.
The characteristics of memory and recall are not common knowledge. Recent memory research demonstrates that normal and well-motivated volunteer subjects are unable to differentiate real events from their childhood from false, deliberately implanted chronicles.[17] Expert knowledge of memory is not good. For example, one study revealed that twenty-five per cent of graduate therapists believe that all forgotten memories are still stored and subject to retrieval. Experimental evidence is to the contrary. Studies of hypnotism, trance-mediumship, multiple personality, hysteria, brain disorders, epilepsy and psychosis reveal that memory associated with these states is qualitatively different from that found in laboratory studies of healthy individuals.[18]
Poorly trained sexual abuse workers who do not have a basic grounding in current research on memory are employed by government-funded heath care institutions and this lends them the authority of the government which funds their work. Twenty-five per cent of graduate therapists believe that all forgotten events are still stored and can be retrieved. All of them genuinely believe in what they are doing so they are less reprehensible but more dangerous.
Hysteria, is something that a layman can understand only on a two dimensional axis, true or false, organic or malingered. The motive of malice is easily understood but hard to demonstrate; the most common reason for adopting false beliefs is that they explain everything. This attraction is obscure, especially when such beliefs lead to massive losses, of freedom, of family. So did the beliefs of Christian martyrs.
A belief that one has been sexually abused is very often delusional and it can be held with delusional intensity. A psychiatrist might recognise characteristics of delusions beyond their falsehood, its inclusion among other bizarre beliefs or in schizophrenia. Delusions that manifest in borderline personality disorder can be transient and elusive. A delusion might coincidentally be true, but nonetheless delusional in the way that it was acquired and held.
The ability to recognise a delusion is the agreed-on province of an expert, but non-bizarre delusional beliefs are routinely accepted by laymen. Areas of inquiry include: Does the belief come in the company of many supporting beliefs and statements? Is the accuser arguing from effect to cause to support it? This is very dangerous indeed and also very informative. Did it arise in the context of a mental disorder? Was it preceded by a perplexity, by a delusional mood or an autochthonous experience? Was it at this or any other time the major and exclusive preoccupation of the believer? Is it shared, by whom, from what time and under what circumstances did the sharer adopt it? How did it come to be shared?
Hysterical beliefs share some of the qualities of a delusion In his classic text, Theory of Collective Behaviour,[19] Smelser defined an hysterical belief as 'one that attributes to an ambiguous element in the environment the power to threaten and destroy.'
There are unverified beliefs about concern the ability of inappropriate sexual touching of children that fit into that category: unverified. Hysterical beliefs are the driving force behind collective action such as occurs in moral panics. This preoccupation with child sexual abuse has all the characteristics of a moral panic.[20] Hysterical beliefs are shared and come about by short circuiting of reason in a panic.
What is plausible to one person might well be preposterous to another. The knowledge of a jury about the nature of the human body, the consequences of rape, sodomy on small children, the behaviour of profoundly abused children, seems to be inadequate. For example: 'My father sodomised me in the bathroom every week from when I was three' is not a statement that I would believe from a person with no medical or surgical history. Many others have. Nor did I believe the adult who accused her father of raping her some five times a week for three years from when she was eight, but so secretly and efficiently that not one in her family of six ever came upon them in action. The jury put the father away. Family photographs revealed a loving close family as did friends.
If someone has detailed recall of events that took place before the age of three or four, it is improbable. A Hollywood presentation refers to a film scripted scenario with details of costume and furniture. I have no more than single scene memories form those ages.
A young woman told me that her mother and father tied her to a four poster bed and regularly raped her with a double edged knife. I found it implausible as no doctor had ever needed to attend and, to explain that, she alleged that her bewildered mother colluded. No one else knew, not her friends, her doctor her school. The corroborating 'medical' evidence cited in this case was that the woman had refused to allow vaginal examination and this was further proof of her having been sexually assaulted in early childhood. The jury bought it and her father went to jail for eleven years, her mother was also punished. There was heavy media involvement and she became a cause celebre of the local feminist lesbian group.
One would imagine that a case where perpetrators had confessed and were willing to plead guilty would mean that they were guilty. Yet false confessions are not rare and the most famous case that of Richard Ingram written up by Lawrence Wright initially in the New Yorker and later as "Remembering Satan.'[21] It was a case of a small religion-obsessed town in the United States where a whole tribe of children and alleged perpetuators confessed to years of ritual satanic abuse. Indeed one went to jail until the verdict could be reversed. The case was deconstructed and invalidated by Richard Ofshe, the cult-busting psychologist called in to assist the prosecutor. Ofshe found that he was able to cause all parties to recall memories of entirely fabricated events which he suggested to them. He uncovered an hysteria reminiscent of the grand confessions of medieval witches to equally improbable events. A review of this case suggests that if these criteria for evaluation had been applied then the memories of abuse might have been deemed improbable to impossible on a number of counts. Prosecutors rarely call in experts who are unlikely to assist them. Richard Ingram learnt later to distinguish his fabricated beliefs from genuine memories having been unable to do so for many years and that required specialised psychotherapy.
Disclosure is triggered by events and circumstances. True disclosures can be triggered in small children by a television program and educational sessions which raise the awareness of all children to 'stranger danger' and the privacy of their bodies. Other 'memories' emerge in the course of other stimuli, a report of huge compensation payment, a conversation about a case, seeing a film, a family fight. I have twice seen a memory surge in police undergoing training in child abuse matters. In one case it was true the perpetrator confessed, in the other, the family was entirely dazed and there was not only no corroboration. Further negative evidence was uncovered but the jury put father away. The victim's compensation tribunal had given her forty thousand dollars .
I argue that memories are even more liable to become contaminated, confused and mistaken than tissue samples in their travels from a crime scene to a laboratory and back to court. I want to know to whom was the disclosure first made and with whom else it was I discussed? Accusations may be preceded by family discussions or therapy. One needs information to trace escalation. The manner, time and context of 'recovery' of memory recovery is of crucial interest. My patients tell me that their sex abuse therapists have helped them remember lots more. This poorly based therapy will cost their employers, the State Governments, millions in compensation if Australia follows the lead of the United States in this kind of litigation..
Most people do not routinely distinguish between that information which they have obtained from observation from that gleaned from other sources. A group discussing rumours and hearsay, without malice or intent contaminates evidence. It is the expert's task to discover this.
False allegations of sexual abuse frequently emerge in custody litigation. Estimates of validity are as low as twenty percent. In family court matters, if one is called for the child, it might be possible to interview the alleged victim, the accuser, to sight disclosure documents and to see the alleged perpetrator as well and observe interactions between that person and the allegedly abused child. If one parent calls you, it will come as no surprise that the other sees you as biased. However this does not preclude the possibility that both might co-operate. They all cooperate at their own risk, as some more willing than others to go for what they see as a lie detector test.
An episode of mental illness can be the vector of sudden recall as can therapy of various types, flotation tank therapy, hypnotherapy as well as the more all past life therapies, from psychoanalysis to counselling and the now notorious 'disclosure therapy' and . 'Survivors of incest' groups generate memories in persons who formerly only suspected themselves to have been victims.
I have seen a full blown delusional mood and autochthonous experience precede the sudden crystallisation of a belief which, on all criteria, fitted the description of a delusion. The young woman suddenly became flooded by never before considered memories of rape in her infancy. She was taken screaming to a psychiatric unit where delayed post traumatic stress disorder was diagnosed and the psychosis evaded discovery.
Well documented cases have occurred during police interrogations, just like other false confessions and certain fundamental Christian prayer meetings associated with the speaking of tongues and fear of the devil have generated cases. Religious hysteria can accompany sexual hysteria as it did in the Middle Ages.
Sudden revelations go into the improbable category still to be evaluated on other protocols. There is one well documented report of a dream bringing back a true memory of a sexual relationship undertaken before puberty with a camp supervisor who freely admitted that it had happened. Dream origins are, in general, suspect.
Recent confessions by teaching priests of having abused large numbers of children generated a great number of 'me too' claims for compensation by well put together and successful young men who had not given the priest's fondling a second thought since they left primary school. They have claimed to have a total preoccupation with these matters since. The police advised them of the offending priest's confession and told them to seek legal action. A large proportion had gone to sex abuse counsellors after they were advised to claim and their familiarity with the jargon of post-traumatic stress disorder and Courage to Heal left me with no doubt of the extent to which unacknowledged coaching had taken place. They seemed to believe what they were saying.
Some well meaning experts seem to believe that total preoccupation with the stressor is an indicator of post traumatic stress disorder, automatically compensable. It is well to remember that traumatic events are not easily discussed. Those who have experienced trauma will go to great lengths to avoid memories of it. The person who is intensely preoccupied with a stressor is probably experiencing litigation anxiety. Each occurs at its worst, nearest its cause and tends towards recovery unless inept therapy intervenes and prolongs it. The expert or counsellor who cites Judith Herman is likely to be ideologically driven.
School records can be consulted as well as medical records and hospital records, especially where abortions were claimed to have been carried out.
Prior sexual history cannot be raised in NSW courts. The defence can find it hard to get therapy reports where the evidentiary gold dust is located. This material can provide evidence of escalation of claims, of impossible scenarios, of the sudden and bizarre onset of memories, of their characteristics and impossibly detailed recall, all of which would enable the expert to understand the kind of mental phenomenon which was involved in the generation of the beliefs involved. The government has loaded the dice by excluding certain evidence at law.
Given the explanatory power of the abuse excuse, one cannot rely on the fact that a number of complainants are saying the same thing about a person. One needs to have a good knowledge of friendship and communication networks.[22]
Expert medical evidence in identifying sexually abused young and inarticulate children has been historically disastrous, involving anal reflexes and 'disclosure therapy.'
One would question the litany of abuse, the borrowed scenario abuse, invoking 'the truth,' elaboration, changes over the time frames, variances and inconsistencies, accompanying affective states affect such as withdrawal, compliance and depression. One would look for evidence of concurrent distress in the form of psychosomatic disorders, fears tension, anxiety sleep disturbances bed wetting, antisocial behaviour, school performance and attendance problems, running away from home, psychopathology, preoccupation and specific dreams, dissociation sexual attitudes, stigmatisation, threats and bribes, attention seeking, shame, guilt, advanced sexual knowledge, identification with the aggressor, seductiveness, pseudo maturity
Virtually every borderline patient I see in the late 1990s makes a complaint of sexual abuse. If their therapists believe them then clinical experience is a dangerous teacher. Borderline psychopathology is rarely recognised by laymen as young and attractive women make appearances on television or in the witness box and present as somehow appealing, perhaps more to men than to women. Borderline psychopathology, formerly called 'malignant hysteria, features heavily in the literature of sexual abuse. This can be diagnosed on behavioural criteria and its characteristics include brief psychotic episodes and perceptual distortions.
The view that borderline personality disorder is the products of sexual and physical abuse in childhood emerged from psychoanalysts and therapists of other persuasions who saw these people frequently for therapy. It is based on clinical experience and is not confirmed by scientific studies.
This is often a mother with a history of having been abused herself, one that might need evaluation. It is from the accuser that we can learn of exposure to suggestive material, of her capacity to believe and select the preposterous, her participation in survivor groups and her motives.
Not all borderlines are malignant. Greed and spite and fantasy production can be part of the everyday lives and can be uncovered by a protocol of questions. There are also fantasists, 'Me too' claimants, groups of hysterical females and mentally retarded persons who raise allegations. Those with empty lives who comprise the Munchausen and, increasingly, the Munchausen by Proxy perpetrators want a ticket for endless sex abuse therapy in the way that empty, rich and lonely people enjoyed psychoanalysis, a relationship with a surrogate friend.
The most common response is denial and it means little unless supported by other negative evidence. Bewilderment is different from denial and may result in soul searching and false confession. "My daughter would not lie, if she says this, I must have done something wrong. Such confessions are typically retracted. sometimes the accused is a known paedophile or has a history of emotional deprivation, intellectual impairment, childhood history of sex abuse, abnormally high urges, impulsivity and narcissism, that is entitlement. Coercive dominating behaviour can be evident as might passivity, substance abuse, poor judgement, impaired sexual interest in age appropriate women and the presence of other deviations, psychosis, immaturity, possession of pornography, career choice and recent rejections. These characteristics would encourage a prosecutor and might disqualify a custody-seeker. Their absence is also of significance in the whole picture.
A false belief might have adverse consequences such as going to jail but this does not influence its holder to let it go. This relates to the explanatory values of that belief. A false confession gives temporary or permanent explanation as to why one might be here being questioned by all these police and authorities and why one is in prison. Students of victimology know about induced guilt.
I have seen an accuser get $40,000 from the Victims Compensation Tribunal even before she brought her father to court. In my view, she was not a disinterested witness. She had spent the money. Yet no caveat was issued to the jury and the judge did not know, nor apparently di the prosecutor. She had undergone sex abuse therapy with counsellor to whom she had given information to the effect that her father had already been convicted. The compensation tribunals have no idea what powerful legitimators of belief they are, so informing a jury that compensation has already been given to an accuser is a double edged sword
In rich families, sex abuse claims provide a means of redistribution of an inheritance to a pariah who would not have achieved it otherwise. .
A recent case in the High Court allows for a situation where an expert can bring certain aspects of a complainant's psychopathology to the attention of a jury if it impinges on reliability beyond common knowledge.[23] Changes to the Evidence Act allow experts to express an view on the ultimate issue. Never has the expert wielded such power and had so little responsibility and so few checks and balances. Expert evidence is out of control, subverting justice, creating victims and passing off unresearched theories as facts on gullible judges and juries. It is time that the courts demanded more from expert evidence, and demanded that witnesses made available their sources of knowledge, the basis on which their views are formed.
[1] Gardner R A. Protocols for the Sex abuse Evaluation. New Jersey: Creative Therapeutics, 1995
[2] Gardner RA. Protocols for the Sex abuse Evaluation. New Jersey: Creative Therapeutics, 1995
[3] Schrieber F. Sibyl. Chicago: Henry Regnery, 1973 cited and explicated in Wassil-Grimm C. Diagnosis for Disaster. Woodstock New York: The Overlook Press, 1995, 176-177.
[4] Schimek JG. Fact and Fantasy in the Seduction Theory: A Historical Review. Journal of the American Psychoanalytic Association 1987;35:937-965.
[5] Masson JM. Assault on Truth: Freud's Suppression of the Seduction Theory. Penguin Books, 1984
[6] Herman J. Trauma and Recovery. New York: Basic Books, 1992
[7] Terr LC. Unchained Memories. New York: HarperCollins, 1994
[8] Bass E, Davis L. The Courage to Heal. New York: Harper & Row, 1988
[9] Loftus E. Creating False Memories. Scientific American 1997;2(77(3)):50-55.
[10] Ofshe R, Watters E. Making Monsters. Berkeley, Los Angeles: University of California Press, 1994
[11] Crews F. The Memory Wars: Freud's Legacy in Dispute. New York: A New York Review Book, 1995
[12] Prendergrast M. Victims of Memory: Sex Abuse Allegations and Shattered Lives. Hinesberg Vermont: Upper Access, 1995
[13] Pope HGJ, Hudson JI. Can Memories of Childhood Sexual Abuse be Repressed? Psychological Medicine 1995;25(1):121-126.
[14] Romans S, Martin J, Anderson J, O'Shea M, Mullen P. Factors that Mediate Between Child Sexual Abuse and Adult Outcome. Psychological Medicine 1995;25(1):127-142.
[15] Smelser NJ. Theory of Collective Behaviour. London: Routledge & Kegan Paul, 1970.
[16] Wright L. Remembering Satan. New York: Alfred A Knopf, 1994
[17] Loftus E. Creating False Memories. Scientific American 1997;2(77(3)):50-55.
[18] Erdelyhi M H. The Recovery of Unconscious Memories: Hypermnesia and Reminiscence. Chicago London: The University of Chicago Press, 1996
[19] Smelser NJ. Theory of Collective Behaviour. London: Routledge & Kegan Paul, 1970
[20] Goode E, Ben-Yahuda N. Moral Panics. Oxford & Cambridge: Blackwell, 1994
[21] Wright L. Remembering Satan. New York: Alfred A Knopf, 1994
[22] Kerckhoff AC, Back KW. The June Bug: A study in hysterical contagion. New York: Appleton Century Crofts, 1968
[23] Farrell v The Queen. High Court of Australia. August 1998 HCA 50.