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«Return to LEAR'S FEBRUARY 1992 By Heidi Vanderbilt A Chilling Report Do you want to know what incest is? What it really is? No ...»

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While some non-medical rehab programs claim up to a 95 percent "cure" rate, they are misleading in their optimism. Jim Breiling of the National Institutes of Mental Health says Page 25 of 56 that the results of many studies are suspect owing to the unreliability of statements by offenders, many of whom lie. According to one study, a 38 percent dropout of participants can be anticipated in any program. Of those who receive the full course of treatment, 13 percent reoffend during the first year. After that, who knows?

The rare offender who voluntarily seeks help can get trapped in a bind. Therapists are legally required to inform the local police if they hear about a specific child-abuse crime.

Massachusetts therapist Mike Lew cautions his clients at the outset that if they tell him they have offended, he must report them. Even so, the authorities tend to look more favorably on those who turn themselves in than on those who get caught or accused.

Ruth Mathews believes that women may be easier to rehabilitate than men because, as noted, they may feel more empathy for their victims than male offenders do. But she points out that her opinion is based on the women she sees, who have come voluntarily for treatment. A sample of women in prison for sex crimes would probably yield very different results. Child offenders who receive treatment, on the other hand, do much better than adults. They need less long-term help and are less likely to re-offend.

Mental-health providers are key to spotting and treating offenders and their victims. But, says psychologist Mary W. Armsworth, the Houston trauma specialist, "we don't train mental-health providers properly." Incest victims who need psychiatric care are often misdiagnosed. Victims of child sexual abuse who suffer symptoms of post-traumatic stress disorder have been hospitalized for everything from manic depression to schizophrenia and have been subjected to shock treatments, insulin shock, and other inappropriate therapies.

Freud was Wrong Misdiagnosis occurs because the therapist, psychiatrist, or doctor doesn't know what to look for, doesn't consider childhood sexual abuse a possibility, or doesn't believe the patient's account of what has occurred. For almost a century, Freud and his followers have led us astray.

Vienna, Austria. April 21, 1896. Sigmund Freud stands before his colleagues at the Society for Psychiatry and Neurology, reading his paper "The Aetiology of Hysteria." He informs his listeners that mental illness is the result of childhood sexual abuse. The words he uses to describe the abuse are rape, assault, trauma, attack.

He has based his findings—which he has used to formulate what he terms the seduction theory—on the testimony of his patients. These are both women and men who have told him of their childhood abuse, often by their fathers. He has listened to them, understood them, and believed them. He has reason to. As he has written to his friend and colleague Wilhelm Fliess, "My own father was one of these perverts and is responsible for the hysteria of my brother... and those of several younger sisters."

But Freud is soon under attack by his colleagues, many of whom denounce his argument. He retracts the seduction theory. The accounts of incest, he now says, were fabricated by hysterical women who were not assaulted. Like Oedipus, he says, they yearned for intercourse with one parent and wanted to murder the other, and these yearnings produced such a profundity of guilt and conflict that they caused a lifetime of Page 26 of 56 mental illness.

Unlike the seduction theory, for which Freud was ostracized, the Oedipal theory finds favor with the great majority of his colleagues. It becomes the cornerstone, the bible, of all psychoanalysis to come.

Jeffrey Moussaieff Masson, Ph.D., former project director of the Sigmund Freud Archives in Washington, D.C., and a self-described "former psychoanalyst," has written three books detailing first his affection for, then his disaffection from, Freud and his teachings. According to Masson, Freud's reversal of his position represented a monumental loss of moral courage that served to save his professional skin to the detriment of his patients.

In Banished Knowledge: Facing Child-hood Injuries, Alice Miller, Ph.D., like Masson a former Freudian psychoanalyst, argues that Freud suppressed the truth to spare himself and his friends the personal consequences of self-examination. "Freud has firmly locked the doors to our awareness of child abuse and has hidden the keys so carefully that ensuing generations have been unable to find them.

Miller goes on to make a startling revelation about Freud's great friend Wilhelm Fliess.

She writes that many decades after Freud suppressed his data, Wilhelm's son Robert found out that "at the age of two, [Robert] had been sexually abused by his father and that this incident coincided with Freud's renunciation of the truth."

Some scholars have expressed the wish that the seduction theory and the Oedipal theory could work together. But they can't. The seduction theory states that child sexual abuse is the cause of most—or even all—mental illness. The Oedipal theory, on the other hand, states that child sexual abuse almost never happens, that a person's memories are false, and that mental illness and neuroses come from a child's conflicted desires for sex and murder.

Ever since Freud, the Oedipal theory has been used to refute claims of child sexual abuse. In Healing the Incest Wound, Dr. Christine Courtois, the Maryland psychotherapist, writes that "many survivors report that they were medically examined and treated for their various symptoms, but for the most part the symptoms were never attributed to abuse even when the evidence was obvious. Instead, symptoms were most frequently described as psychosomatic or without basis or another diagnosis was given." Some therapists still tell their patients that their memories—no matter how degrading, detailed, or sadistic—are really their wishes. Freud placed the responsibility for the deed and the memory not with the offending adult but with the child victim— and his adherents continue the sham. As Alice Miller writes: "I often hear it said that we owe the discovery of child abuse to psychoanalysis. In fact it is precisely psychoanalysis that has held back and continues to hold back knowledge of child abuse.... Given our present knowledge of child abuse, the Freudian theories have become untenable."

But most people don't know this. To accept that Freud lied means that nearly a century of child rearing, analytic training, law enforcement, and judicial and medical attitudes must be reconsidered. As the matter rests now, the men and women who should be able to identify abuse and help prevent and punish it have never even learned the Page 27 of 56 basics. Our doctors, analysts, and judges have been taught to mistake victim for offender. They allow offenders to remain untreated, free to infect the next generation.

Alice Miller writes that Freud "wrote volume after volume whose style was universally admired and whose contents led humanity into utter confusion." His legacy has been in part to blind us to the prevalence of incest, to make the offenders in our midst invisible.

At the sexual Abuse center of the Family Support Line in Delaware County, Pennsylvania, therapists who work with perpetrators and survivors showed me paintings done by children aged 7 to 12 who had participated in an incest survivors' support group.

Monica, 10, had drawn the outline of an adult, six feet tall, on butcher paper. With the help of her therapist she titled it Diagram of a Perpetrator. She drew in hair, a brain, eyes, ears, nose, mouth, shoulders, big hands, a heart, and a penis. Next to each feature, down each finger, and around the penis, she wrote the things her father had

said to her:

–  –  –

The Courts The family court building at 60 Lafayette Street in lower Manhattan looks like a Darth Vader prison—big, black, square, and ugly. Once inside, you have to wait in a line of irritated people to be searched for weapons by armed guards.

Page 28 of 56 The interior is depressing, monotonous, and confusing. In the six days I spent there, I never could figure out which floor I was supposed to go to or whether I was already there. All the corridors look the same: flesh-colored walls, orange and blue seats made of molded plastic and bolted to one another and to the floor. Drug addicts slump. Babies scream. Once in a while a fight breaks out. All too often I saw small children with bored, baffled, or frightened faces.

Manhattan family court is blessed with social workers who care passionately about their work and the children, with bright and dedicated Legal Aid Society lawyers for those who need them, and with good judges. Each judge hears thousands of cases every year, more than half of which have to do with child abuse—including child sexual abuse, including incest. But even given the high numbers, fewer than 10 percent of the incest cases ever get to court. One reason is the traumatic nature of the process, which can involve weeks of agonizing testimony.

Everyone from the victim to the judge wants to avoid a trial if at all possible. To many critics, it seems that the system is designed to protect the accused, not the accuser.

And this becomes unreasonable, even abusive, when the accuser is a child who must participate and withstand cross-examination as if an adult. New York Family Court Judge Jeffry H. Gallet, for one, does all he can to keep children from having to testify. In his courtroom—or part, as it's known—the child is almost invariably the last witness scheduled in the hope that the case will have resolved itself before that point.

The agencies that intervene to stop the abuse frequently, if unintentionally, maintain it instead. And it is the child victims, those most in need of care and consideration, who receive the worst treatment. A child may be questioned 20 different times by as many different people in perhaps as many different places—hospital emergency rooms, attorneys' offices, police stations, courthouses. The children are exposed to drunks, criminals, and their own parents in handcuffs. I knew one terrified little boy who had to wait for hours on a bench in the courthouse hallway, across from his abuser. This happened to him six times over a period of years.

From the child's perspective the process is a nightmare, and it is almost as arduous for the child's family. Mothers who report that their children have been incestuously abused are often regarded as unreliable or vindictive, particularly if the accusation comes during a custody dispute.

Oliver's parents were divorced when he was just one year old. He lived with his mother in the country and visited his father in the city for holidays. As he grew older it became evident that Oliver didn't like to visit his father. His mother thought it must be normal separation anxiety. When he was five, Oliver told her his "butt hurt." Then he described to her how his father had anal intercourse with him, shared him with friends, and put him in pornographic movies. Oliver's mother reported all this to the county mental-health clinic and a social worker was assigned to the case. "I don't know about her," the social worker told me later. "She just seems so... hysterical."

Eight years ago child-sexual-abuse cases rarely got to court. Today courts across the country brim over with them. In Vulnerable Populations: Evaluation and Treatment of Sexually Abused Children and Adult Survivors, Detective Richard L. Cage of the Child Page 29 of 56 Abuse Sexual Offense Unit of the Montgomery County, Maryland, police department, writes: "Many police and social service personnel are finding themselves bombarded with these cases. Yet there are not enough qualified personnel to investigate cases adequately and deal sensitively with the families and particularly the children who are in a crisis."

In all 50 states, incest, whether specifically called so by statute or covered under other child-sexual-abuse laws, is a felony offense. But its definition varies from state to state, and so does the punishment. What is consistent is that incest per se is harder to prove.

It also carries fewer and lighter penalties than any other form of sexual abuse, due largely to the fact that in many states incest laws were conceived not to protect children but rather to prevent closely related adults from marrying and procreating. In any event, most incest cases, even in states where an incest statute exists, are tried as child sexual abuse or rape, charges that are often easier to prove. Assuming these cases get tried at all.

There are problems from the outset. Many cases never progress beyond the initial complaint, if they even reach that stage. Children refuse to tell, typically out of loyalty to their abuser; they remain silent out of love and fear. Those who do tell usually retract. So do their families. "You find families hiding the abuse, families accepting it, families passing it on," says Philip Caroom, an official in the Maryland judiciary whose docket includes child-sex-abuse cases.

Sandra Butler Smith, a municipal court judge in San Joaquin County, California, and author of Children's Story: Sexually Molested Children in Criminal Court, says that "adults faced with the disclosure of sexual molestation often find reasons for denying belief, but more often, even if the child is believed, have difficulty in perceiving of such a case as a fit subject for a criminal proceeding."

Police investigators and social workers not only must deal with the victim's unwillingness to talk about what happened but with their own beliefs. "Unfortunately, extremely competent investigators find allegations of child sexual abuse very difficult to deal with on a personal level," writes Cage. Just because someone is a cop or a social worker doesn't automatically mean that he or she is a sensitive questioner, able to earn and keep the trust of a frightened and abused child or a distraught parent. Nor do these investigators necessarily know what information is needed, how to get it, or how to organize it into a cohesive case.

In Manhattan each of the ten family court judges starts the year with 500 to 600 unresolved cases of every kind that are held over from the previous year. About 3,500 new cases then come in. Generally, more than half of these involve physical or sexual child abuse. "The implications of these figures are profound," Judge Gallet says.

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