| The Memory Issue | Autumn 2008 |
Speak, Memory These women and their stories had a powerful impact on me. After my residency, I began working at a storefront women’s clinic. Before long, a colleague and I had collected 15 cases of father–daughter incest. We first published our findings in a women’s studies journal in 1977. In the year before the article was published, the manuscript was passed hand-to-hand like underground literature, and we began receiving letters from women throughout the country. They all wrote, “I thought I was alone.” It was then we realized that we had indeed made a discovery. At that time, the Comprehensive Textbook of Psychiatry estimated the prevalence of incest at one case per million. This estimate proved to be wrong by several orders of magnitude. We now know that sexual abuse of children is common and often has terrible consequences for the abused child. We also know that the most common perpetrators are people the child knows and trusts: teachers, coaches, clergy members, uncles, brothers, stepfathers, and fathers. (The great majority of perpetrators are men.) As the women’s movement encouraged survivors to come forward, and as new research documented the prevalence of such abuse, we entered a period in which these discoveries gained sympathetic attention from the media. Oprah Winfrey set an example by coming out as a survivor of childhood sexual abuse, and she has gone on to do what I regard as some of the best public education on child abuse and violence against women. School-based educational programs were developed to encourage children to tell someone if they were being abused. Today, if a child discloses, there is a much better chance that the person hearing the story will respond in a protective way, rather than shaming and silencing the child. Recently, the many survivors of sexual abuse perpetrated by clergy—not only Roman Catholic but Jewish and Mormon, among others—increased the credibility of victims by coming forward and enduring the rigors of court testimony to share their stories. As long as victims of sexual abuse were shamed into silence, these crimes against children were essentially crimes of impunity. As public awareness of the problem grew, however, many states began to amend their laws to make it easier for child victims and adult survivors to testify in court. In particular, many states extended their statutes of limitations in recognition of the fact that adult survivors might need time to gain an understanding of the harm done to them, either because they might not have initially made the connection between their suffering and the abuse they endured, or because they might have had a period of frank amnesia. And thus began the controversy over memory. A backlash can be expected whenever crimes of impunity suddenly become crimes with possible consequences. We see this in societies emerging from repressive regimes, when perpetrators of political crimes—previously immune as government workers, police officers, spies, or prison guards—are suddenly exposed. As the evidence of their crimes accumulates, they resort to impugning the credibility of their accusers. It is no different with crimes against women and children. As adult survivors of incest started to come forward in court, perpetrators countered that their accusers must have been brainwashed. In this rendering of the story, the accusers had been alienated from their loving families by unscrupulous psychotherapists who had instilled false memories of abuse. In a climate of sympathy for the victims, blaming a third party was generally a more favorable strategy than attacking the victims directly. It also served to patronize and demean the victims, as it implied that they didn’t know their own minds. When allegations of false memories started to appear, the media latched onto this novel angle for a while. We no longer see much in the press about false memories, but at the height of the controversy, the main line of attack was the suggestion that incompetent or biased clinicians were implanting memories in the minds of the vulnerable: children and unstable women. After all, why had the victims not mentioned the crimes earlier? Much was made of the notion that memories of sexual abuse disappeared from consciousness only to be recalled at some later time. The implication was that a memory recalled after a period of amnesia was inherently suspect. In fact, many survivors of childhood sexual abuse dearly wish to forget—but cannot. When these people begin to describe the abuse, they will say something like, “I never forgot, but I was too ashamed to say anything about it. I tried to force myself not to think about it.” Well into adulthood, some victims feel so tormented by their shame that they cannot give voice to what they have always perfectly well remembered. Others may have partial recall. One patient of mine, for example, initially claimed she had no memories. What she meant was that she did not remember the details of physical encounters with her father. She did have clear memories, however, that her father would leave pornography around for her to see, that he would continually tell dirty jokes, and that his lewd interest in her and other young women was apparent in many ways. His behavior was tolerated within the family; he was just being his quirky self. No alarm was raised, and no one sought to protect her. The patient felt alone with her feelings of disgust and humiliation. So in fact, she did have plenty of memories, but she had not yet learned how to make sense of them. As she explored the feelings her memories evoked, she was able to recall more details of specific incidents of abuse. Run Silent, Run Deep A significant minority of victims do seem to have dense amnesia about their abuse for a period of time, only to recall it later, often through struggle and pain. In a study that Emily Schatzow, a lecturer on psychiatry at Harvard Medical School, and I conducted with 53 female outpatients, we found that 28 percent reported a period of severe memory deficit. What seemed to set this group apart is that the abuse began very early, in the preschool years, and ended before adolescence. Also, the degree of amnesia seemed to be related to the level of frank violence that accompanied the abuse: the more violent the abuse, the greater the memory deficit. Two factors may be at work here. First, the memory functions of early childhood differ from those that develop later. Second, traumatic memories are not stored in the same way that ordinary memories are. Both of these factors serve to keep the knowledge of being abused out of the autobiographical narrative that each person ordinarily assembles. In the nineteenth century, Pierre Janet, an early student of trauma, described traumatic memory as an idée fixe. He contrasted this with normal memory, which he described as “the action of telling a story.” A memory is not truly a memory, he said, until it has been recited to oneself and to others and taken its place in our personal narrative. Ordinary memory, Janet held, is fluid, contextual, and autobiographical; it requires a certain amount of verbal processing and is subject to voluntary retrieval. A traumatic memory is static, fragmentary, and nonverbal—one remembers sights, sounds, smells, and tastes—and it is not subject to the usual mechanisms of voluntary recall. It might intrude, unwanted, as a flashback; when sought, it might remain inaccessible. Janet’s description of trauma and memory has held up extraordinarily well to the scrutiny of contemporary research. In the fourth revision of the Diagnostic and Statistical Manual of Mental Disorders, amnesia for all or part of a traumatizing event is recognized as one of the diagnostic criteria for post-traumatic stress disorder. When a person is traumatized, the memory of the trauma is laid down in an altered state of consciousness. For effective retrieval, the person must gain access to that altered state, not only recalling the event, but also reconnecting with the state of feeling that accompanied it. Early in his career, Sigmund Freud used hypnosis to gain that access. In the many wars of the twentieth century, military psychiatrists discovered that hypnosis or the administration of sodium amytal could help shell-shocked soldiers access their memories. Military psychiatrists also found that “the action of telling a story” could bring dramatic relief to traumatized soldiers, often allowing them to return to battle. As the role of early sexual trauma was being rediscovered three decades ago, many clinicians, like military psychiatrists, were eager to get to the core of the problem quickly. Since then, clinicians have become wiser. We have learned not to ask leading questions and to permit victims to deal with their memories at a safe pace. This healing process may help the individual survivor come to terms with a past abusive experience, but it does not address the larger social problem of justice. Memory is not only a personal matter; as we discovered in our consciousness-raising group, it is also a matter of bearing witness. Recently, I conducted a study in which I interviewed survivors about their visions of justice. What they wanted most was acknowledgment, both of what had happened to them and of the harm done. They also wanted the family or the community they had lived in to take some responsibility for the neglect that permitted the abuse to occur, and to make amends. Just about half wanted an apology from the perpetrator, and then only if it was accompanied by genuine empathy and remorse, as rarely as those emotions may occur in abusers. As one survivor put it, “Perpetrators lack empathy, or they wouldn’t commit abuse in the first place.” Interestingly, few of my informants embraced a retributive idea of punishment for its own sake. No one wanted the perpetrator locked up, unless he was considered a recidivist predator. For example, one of my informants had notified the police when she discovered that her niece was being abused, just as she and her sisters had been abused in childhood by the same perpetrator. At that point she mobilized her sisters, and they supported the niece in pressing criminal charges. The perpetrator was convicted and sentenced to prison, where he finally acknowledged the abuse. My informant believed prison was the best place for him because he was still a danger to the community. To this survivor, only the desire to protect others made the ordeal of court testimony worthwhile. Justice Deserved Despite legal reforms, the U.S. justice system continues to be unfriendly to adult survivors and even more stress-filled for child victims. If you wished to design a mechanism for exacerbating symptoms of post-traumatic stress disorder you couldn’t do better than a court of law. The adversarial system, of necessity, places the victim’s credibility under attack. Instead of being able to tell their stories in their own fashion and at their own pace, victims must answer rapid-fire, yes-or-no questions, and instead of having control over exposure to reminders of the trauma, they have the reminders pressed upon them. It takes amazing courage for someone who has grown up with a perpetrator who was both loved and terribly feared, who was viewed as all powerful in the way that a child sees a parent as all powerful, to confront that person in a court of law. More victims would risk such a confrontation, though, if the remedy the court afforded was anything resembling what victims wanted. But punishment of the offender is not what most are seeking. Moreover, there’s little evidence as to the overall effectiveness of punishing and registering sex offenders. Criminal prosecution simply doesn’t work as a prevention strategy. For this reason, it is worth considering some emerging models of community intervention that differ considerably from conventional legal responses. Conceptually, these models draw their inspiration from the restorative justice movement. One of these models, initially developed in a child-protective service in Canada, is called family group conferencing. In this model, all the members of a family are brought together for a formal meeting, each with at least one support person. In this way, an extended social network may be mobilized. Older children are included in the process and may bring a friend. The meeting begins with a full discussion of what happened and an acknowledgment of both the facts of the case and the harm done. Child-protective officials also lay out the requirements for an action plan to remedy the situation. The family group must then devise a plan to protect the child victim from further harm. An agreement is signed, and the respective support systems agree on to how it will be monitored and enforced. In this process, punishment of the perpetrator is beside the point. The victim’s priorities are central, not peripheral, to the outcome, and the victim’s community takes responsibility for protective action. Mobilizing a community response may ultimately do more to develop a culture of protection and safety than prosecutions can accomplish. The primary need, of course, is protection. For children the first line of protection appears to be a mother with the power to take care of them. It has been clear even from our earliest research on incest that a disabled or disempowered mother is one of the biggest risk factors for child sexual abuse. Any policy or intervention that promotes women’s health and enhances the status of women ultimately protects children as well. The same women’s movement that brought this problem to light is also the surest advocate for its solution. Judith Lewis Herman ’68 is a clinical professor of psychiatry at Harvard Medical School and director of training at the Victims of Violence Program at the Cambridge Health Alliance in Massachusetts. Photo: Terry Vine/Stone/Getty Images |
those early days of the women’s movement, many women came forward to disclose sexual violations long kept secret. With a new awareness, I listened to the stories of my first patients, two women whose lives were tormented by memories of incest.
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