The Phenomenon of Child Abuse Hysteria as a Social Syndrome: The Case for a New Kind of Expert Testimony
Lawrence D. Spiegel*
ABSTRACT: This article provides a foundation for
viewing group hysteria about child sexual abuse as part of a recognizable
social syndrome. Information from sociology and social psychology,
cognitive development, and clinical psychology is combined in a
three-stage process to explain the abuse hysteria phenomenon. These
stages provide a cohesive set of behaviors which constitute a recognizable
social syndrome. This abuse hysteria syndrome has contributed to
over-reporting and sometimes improper prosecution of such cases.
A child abuse hysteria syndrome may be useful in
determining the truthfulness of an abuse allegation. It is suggested
that expert testimony using these concepts can add a generic dimension to
explain the public climate, and can therefore encourage the courts to move
toward a new kind of non-adversarial expert testimony which is more
educative and objective, as opposed to the argumentative and subjective
nature of much testimony offered in adversarial proceedings.
Within recent years we have witnessed an explosion of
media reports, professional articles, educational programs, child
protection services, and legal reforms dealing with child abuse,
especially child sexual abuse. There is little doubt among
professionals in the field that we are experiencing a national
phenomenon. The issue of child abuse, after having been kept in the
shadows for so many years, has finally emerged. Yet it has done so
with such a fury that some have characterized it to be of almost
The term hysteria, as used here, is not used in its traditional or psychological sense.
dictionary definitions characterized hysteria as "an uncontrollable
outburst of emotion or fear, often characterized by irrationality,"
(Random House, 1981). In the psychological realm, the term hysterical
generically refers to an irrational fear or state of anxiety or emotional
shock (Random House, 1981).
When used in its sociological sense however, the term
takes on a broader quality which incorporates and transcends the other
definitions. Since it is being used with respect to a group, an entirely
different dimension is added in that the emotion is now shared by more
than one person. Most basically, the term mass hysteria is closely
associated and often used synonymously with mass suggestion (Freud, 1922;
Tarde, 1903) in the sociological literature. The origins of both these
concepts are attributed to Gustave LeBon as used in his now classic work,
The Psychology of Crowds (1895). Since then, these terms have been
expanded upon by many others. Both terms reference the notion that there
exists within a group the possibility for a contagion of emotional and
irrational thoughts and behavior which causes a circular reaction within
the group. The group then acts on these irrationalities in a homogeneous
manner (McDavid & Harari, 1968).
The current cultural climate regarding child abuse fits
within these broad definitions. It has been fueled by a variety of
and seems to have reached hysterical proportions in a number of instances.
Sensationalist media accounts which quote government figures tell us that
there is an "epidemic" of child abuse. We have been barraged
with attempts to heighten public awareness. Public service announcements
on television, feature newspaper articles, pictures of missing children on
milk cartons, and prime time television movies have all contributed to the
These efforts, along with a multitude of other
innovative approaches, have generated a fever-pitched public response to
"do something" about the problem. These efforts include books
and movies on such topics as "Good Touch, Bad Touch," as well as school
presentations which take the form of puppet shows, lectures, and even
groups of traveling actors, all portraying the dangers of abuse.
The March 10, 1986 issue of Newsweek tells of some even
more novel approaches. In addition to the flood of books and pamphlets
which include titles like It's Okay To Say No, the new offerings now
include board games called Safe City USA and one developed by a former
prosecutor in Illinois titled, Strangers and Dangers. One of the most
popular writers of children's stories, Stan Berenstain, has written The
Berenstain Bears Learn About Strangers. Although the titles don't always
suggest it, the message today goes far beyond the old adage, "don't
talk to strangers" (Kantrowitz & Leslie, 1986).
Indeed, if we note the figures complied by the National
Center on Child Abuse and Neglect, the numbers would justify such extreme
measures. According to these official figures, the number of reports of
child abuse have skyrocketed — from 675,000 reports m 1974 to 1.6 million in
1985, a staggering increase (Besharov, 1985). Not surprisingly, the
professionals have been quick to rally to the cause.
The proliferation of literature has been
interdisciplinary. From the abundance of legal articles which led to the
1974 Child Abuse Prevention and Treatment Act (sponsored by Mondale), to
the fields of social work, psychiatry and psychology, the response has
been reflective of the public climate. Each of those fields have seen the
development of new theories and syndromes seeking to explain, diagnose and
treat child abuse in general, and sexual abuse in particular.
Several authors have produced writings on abuse which
now form the backbone of the child saver movement. Finkelhor (1984),
Goodwin, Sahd, and Rada (1980), Sgroi (1982) and Summit (1983) are just a
few of the many writers developing theories which attempt to define
syndromes of abused children. New tools such as "anatomically
correct" dolls, and other diagnostic aids are being touted as the
cutting edge of the field. All of these professional attempts to address
the issue of child abuse have been spurred by the public passion and,
paradoxically, seem to have contributed to it.
Perhaps the most telling sign that public concern has
reached epidemic proportions has been the abundance of responsive or
backlash literature. These works have not only identified the public
hysteria, but have pointed to the resulting problem of over-reporting.
Many of these authors cite the government figures mentioned previously,
but add a crucial dimension. Though the number of abuse reports has indeed
sky-rocketed, so have the percentage of unfounded reports. These writers now tell us of a second epidemic, that of
false reports, a problem which in their view is as damaging as abuse
itself (Wakefield & Underwager, 1988).
Again, this responsive or backlash literature has been
interdisciplinary and equally vociferous. Legal experts such as Douglas
Besharov, the first director for National Center on Child Abuse and
Neglect, tells us that the percentage of unfounded reports in 1985 reached
65%, as opposed to 35% ten years ago (Besharov, 1985). Practicing
attorneys Gordon (1985) and Herzog (1986) have expressed vigorous concerns
over the growing legal trends which have stretched the rules of evidence
precariously thin. Over the past two years there has also been an
explosion of articles on the problem of false reports. Social work
specialists like Schultz (1985) as well as psychological and psychiatric
experts have responded. Coleman (1986), Green (1986), and Gardner (1987),
among many others, are also warning about the dangers facing the clinician
as a result of the "epidemic" of false reports.
Indeed since the publication of my own book, A Question
Of Innocence, in December of 1986,1 have received numerous letters,
articles, court decisions, books, research projects, etc. I have been
advised of and participated in numerous conferences and symposiums held by
a host of professional associations. I have been called upon to testify as
an expert in both civil and criminal cases of child abuse. I have been
advised of and testified before legislative hearings on both a state and
federal level, and consulted with numerous law firms all over the country.
Most of the authors mentioned earlier have addressed
the false accusation problem for the express purpose of neutralizing the
"expert" testimony of those who testify for the prosecution as
validators as part of the adversarial court proceedings. Their rebuttals,
however, are usually allowed as testimony only to refute points made by
the expert witness for the prosecution. These include efforts on the part
of some authors to neutralize evidence resulting from the use of the
anatomical dolls ( Mclver,1986; White, 1987). In essence, many child abuse
cases are coming down to a battle of experts, psychologists and
psychiatrists refuting one another, usually leaving the judge or jury more
confused than ever.
Coleman (1986) and Green (1986) have responded to the
so-called abuse syndromes, both by methodically picking them apart, and/or
by presenting their own syndromes in an effort to counterbalance them.
credible effort in this regard is the SAID Syndrome by Gordon Blush and
Karol Ross (1986). Still others, such as Schetky and Boverman (1986) and
Schuman (1986), have discussed even broader problems including
competency issues, biased interviews and other "red flag"
indicators. By far, the most comprehensive treatment of the problem of
false accusations which this author has seen is the work by Hollida
Wakefield and Ralph Underwager (1988).
The so called backlash phenomenon and the hysteria it
points to has not escaped the media's attention. Within the past few
years, a grass roots organization called VOCAL, an acronym for Victims Of
Child Abuse Laws, made up of parents who feel they've been victimized by
witch hunt mentality, has over 3,000 members nationally (Besharov, 1986).
In the past year, virtually every network and newspaper, major magazine
and radio station in the United States has covered the problem of false
accusations, and has referred to them as epidemic (Dorschner, 1985).
The inherent paradox, however, and therefore the need
for a more thorough understanding of the social climate, is that along
with endangering innocent people, false reports also endanger children who
need protection, by misdirecting the resources of child protective
services. Just as false alarms to fire or police endanger those facing a
real emergency, false reports take child protective workers away from
those cases where children are truly in danger.
The fact that the media has now not only reported the
zeal of the public to stop abuse, but the backlash as well, is further
substantiation of the confusion and conflict. Every social movement of any
magnitude always creates a reaction. On a segment pf the Phil Donahue
program, Mr. Donahue characterized the prevailing attitude toward the end
of the show, "Show me a man who is accused of child abuse, and I'll
show you a child abuser" (Donahue, 1987). CBS News correspondent,
Bernard Goldberg, summed up the paradox which we are facing. In his
statement on the CBS Evening News, Mr. Goldberg commented that the efforts
to do something about child abuse seem to be "not only overdue, but
overdone as well" (Goldberg, 1987).
The climate of hysteria, as previously defined, and
growing public and political pressures have already impacted the courts.
As a consequence of the need felt by the judicial system to respond to the
public clamor, there have been several changes in the structure of the
legal system itself. Rules of evidence have been significantly relaxed
when it comes to cases of alleged child abuse, seemingly because of the
public outcry. These recent trends should be of particular concern to the
psychological community, since it is psychology as "the science of
human behavior," which is most ethically obliged to evaluate the
phenomenon which has these changes in the courts.
In most states, expert testimony is now guided by three
basic criteria: it must be of more probative value than prejudicial, it
must not invade the province of the fact finder (judge or jury), and it
must be based on accepted scientific principles. Traditionally, expert
testimony in cases of alleged child abuse has become more and more a part
of court proceedings, but has been limited to specific areas, i.e.
evaluation of children, parents, and/or defendant, as well as some limited
testimony on the dynamics of sexual abuse generically. To a lesser degree,
some courts have also permitted experts to offer opinion with respect to
the cognitive capability of child witnesses, usually at a pretrial
competency hearing, out of the presence of the jury (Schuman, 1986).
is especially true of cases which involve very young children, or those
which emanate from divorce and/or custody disputes (Benedek & Schetky,
Most states have now adopted one or more legal reforms,
which directly impact cases of child abuse, especially when the charge is
sexual abuse. In general, in addition to more frequent use of expert
testimony, the rules of evidence have been modified to allow more latitude
for experts. Even in the criminal courts, experts are now allowed to
testify to facts which have not been admitted into evidence. These include
history which may have been taken, hearsay statements and hypotheticals.
Other changes in legal procedures are even more far
reaching. The recent tendency to permit younger and younger children to
testify by relaxing or amending the requirements for competency, and/or
the use of closed circuit television (Spiegel, 1986) are two examples.
Another is the recent tendency of prosecutors to bring cases to criminal
court which in the past might never have been pursued. Even more
disturbing is the stretching of hearsay laws, which now make admissible
certain testimony from parents or professionals and/or the use of proxy
testimony by an adult in the event the child is found not to be competent.
In most cases, however, it is the adversarial process itself which is most
problematic for the expert witness.
For these reasons, the purpose of this preliminary
effort to develop a more generic type of expert testimony is twofold:
first, to add a generic dimension which explains the public climate, and
second, to encourage the courts to move toward a new kind of
non-adversarial expert testimony which is more educative and objective, as
opposed to the argumentative and subjective nature of much testimony
offered in adversarial proceedings. This discussion is therefore designed
to impact the nature of expert testimony both in substance and procedure.
In substance, generic testimony with respect to the
public climate is necessary to give the fact finders the broadest and most
comprehensive view of the problems. If, in fact, it is the weight of
public pressure produced by this group hysteria which has caused the
scales of justice to tilt, then the psychological community needs to
objectively investigate the climate of hysteria more precisely, as an
entity unto itself. This could aid the fact finders and courts in
evaluating whether the recent legal changes are too reactionary. In almost
all of the backlash literature, the problem of the "climate of
hysteria" has been discussed, yet nowhere has it appeared as a
cohesive and comprehensive issue unto itself. Given opportunity for
research and data collection, it could constitute a new kind of expert
testimony — testimony not designed to add to the already troubled battle of
experts, but to offer a broad context to the court to aid all those
involved in developing a more balanced and objective approach.
This article is only a preliminary attempt at a new
perspective which transforms the hysteria phenomenon into a empirically
identifiable syndrome. It must be made clear that this effort is a
theoretical formulation, not a scientifically accepted syndrome and is not
being proffered as such. Perhaps ultimately this may help to balance the
scales of justice and create a deeper understanding of the complexity of
child abuse cases and add another scientific tool for analyzing and
differentiating false reports from true ones.
What is being proposed is an integration of variety of
heretofore separate areas of psychology and sociology in order to develop
a new paradigm which will more adequately define the phenomenon
of "hysteria," or "witch hunt" mentality. Through a
cross-fertilization of disciplines, it is possible to arrive at such a
paradigm. This is accomplished through a three-stage process which
transposes the notion of a "phenomenon" (which implies something
remarkable or extraordinary) into a more defined and scientifically
refined concept of a social syndrome. The term syndrome is used here in
its strictest sense, "a recognizable set of social characteristics or
behaviors" (Random House, 1980), as opposed to the rather vague
concept of a phenomenon, which implies something remarkable or
extraordinary. Naturally, only through ongoing research and testing can an
initial formulation such as this be determined to be scientifically sound
The reality of the current public behaviors toward
child abuse is neither remarkable nor extraordinary, given an appropriate
understanding of the factors from which they have evolved. This
understanding is developed in a three-stage process of combining
information from sociology and social psychology, cognitive development and clinical psychology.
STAGE ONE - Collective Behavior
Both sociology and social psychology refer to the
cultural phenomenon of mass hysteria or mass suggestion as defined
previously in the broad category of collective behavior (Johnson, 1945).
Collective behavior includes riots, mob behavior, lynchings, social
movements, crazes, fads, and rebellions.
In general, the category of collective behavior is
further delineated by the distinction of being either the congregated or
uncongregated variety. The definitions of each are implicit in the terms
used to identify them. The former would involve circumstances in which the
groups of people meet personally in the context of a meeting or rally, as
opposed to the latter category in which those involved do not meet in any
formal setting, but are united indirectly as a function of an event or
Most collective behaviors involve circumstances which
are bizarre or extraordinary and therefore become a popular topic for
study (Light & Keller, 1975). Although incidents of collective behavior
have been extensively researched and written about, controlled studies are
difficult, owing to the nature of the phenomenon. Child abuse hysteria
includes both congregated and uncongregated behavior.
As one might suspect, uncongregated movements can
evolve into congregated ones (Light & Keller, 1975). Some of the more
common examples are the civil rights and women's movements of the past two
decades. The advent of mass media seems to have aided these
transformations. One can only surmise that had there been network news
coverage of the witch trials in Salem, Massachusetts, it may have grown to
a national epidemic. Court rooms all over the country might have been
overflowing with witch trials, as they are now with child abuse
It is the electronic media which has provided the
vehicle to transform uncongregated movements into a congregated mass media
audience. The medium is, in part, the message. (McLuhan, 1968).
make a case for the fact that the current child abuse phenomenon has
resulted from just that. The momentum of the current climate began just
after the much publicized arrests of twenty-four parents in the small town
of Jordan, Minnesota. This was quickly followed by day care scandals in
New York, California, New Jersey and a number of other states.
Less publicized, however, were the eventual outcomes of
many of these cases. In the Minnesota case all of the charges were
eventually dismissed against the parents, and the only person found guilty
was a trash collector, James Rud. Ultimately, it was learned that
Rud had begun the hysteria by "cooperating" with the prosecutor
by giving her the names of those involved in the "sex ring"
which she was certain existed, in a swap for a plea bargain deal for Rud.
Most of the public is still unaware of this. The public is also largely
unaware that the prosecutor, Kathleen Morris, was found guilty of
malfeasance after investigations by the FBI and special task force
appointed by the Attorney General of Minnesota. She was later voted out of
Now, some years after the arrests of seven people in
the McMartin Preschool case in California, we find that charges have been
dismissed against five of the seven defendants. We are told by the defense
council and the former prosecutor of the case, that the accusations of the
children are "patently absurd," and that the initial charge came
from a psychologically disturbed mother who has since committed suicide.
Still, the charges against Raymond Buckey and his mother have not been
dropped and the state of California has spent close to five million
dollars of taxpayers money to date. (CNN News, 1987).
The literature in social psychology and sociology is
replete with historical examples of collective behavior, which, like the
phenomena being discussed here, seem to defy scientific explanation.
Popular writers and journalists, as well as some academicians, have
described these instances as mass hysteria (Brown, 1965).
There are many examples of congregated "mass
hysteria," dating back to the Spanish Inquisition. Most work on the
subject cites other examples such as the Salem Witch Hunts, early
lynchings in the South, religious movements, the civil rights marches, and
the women's movement. The remarkable similarity between the Salem Witch
Hunt in 1692 and the current topic has been addressed by several modern
writers. One of the most notable accounts appeared in the August 1985
issue of Persuasion At Work:
Salem, Massachusetts, 1692. Tituba, a servant girl
steeped in the "black magic" of Barbados, has excited the
imagination of two children, nine-year-old Betty and eleven-year-old
Abigail. The youngsters writhe, scream, and moan on demand before
amazed, frightened adults. The experts arrive from Boston, question the
girls with techniques handed down from the Great Inquisition, and
discover the cause: witches! Townspeople — some strange, most ordinary —
brought before the bewitched children. The girls identify 40 of them as
those who had caused their maladies. With a passion for securing
confessions, zealous prosecutors toss out factual evidence as the
Devil's work. Instead, special evidence is introduced: "I saw him
fly on a stick across the face of the moon." Those of the accused
who deny their guilt are subsequently tied to a stool and dunked beneath
water. If they drown, this is clear evidence of guilt. If they survive, the
Devil is surely responsible and they are promptly hanged. Twenty "witches" so perish.
Jordan, Minnesota, 1984: James Rud, a trash collector
and baby-sitter, has been arrested for sexually molesting two children.
Once in custody, he plea bargains with the prosecutor and, in exchange
for a reduced sentence, describes his involvement in a large child-sex
ring composed of Jordan parents. With no prior investigation, police
arrest the parents and seize the children, placing the latter in the
care of social workers. Once in custody, the children are grilled for
hours by a battery of experts. Therapists strip the children down and
perform physical exams. Doctors stick their fingers in the little girls'
vaginas, asking, "Is this what they did to you, and do you think it
went in the far, and did it bleed? Anatomically correct dolls are given
the the children so they can "role play." Many of the children
are told that if they reveal the truth about their abusing parents, the
families might be reunited. The children start confessing. More experts
come. Citizens who complain about police tactics are arrested, and their
children also seized. In all, 24 adults eventually face charges.
the months pass, the prosecutor fails to come up with any hard evidence.
The hymens of the little girls are all intact. None of the children show
any signs of physical harm. In desperation, the prosecutor turns to some
of the accused and begins plea bargaining. One of them, a police officer,
is offered a new identity, relocation, no jail time, even money in
exchange for testimony against the other adults. Yet he refuses the
offer, demanding a trial. In September, the first couple brought before
the jury is acquitted. The prosecutor begins hinting about the parents'
involvement in ritual murders. In November, Rud admits in a radio
interview that he had lied: there was not sex ring; he made it all up.
The children also recant. Yet the prosecutor is unmoved. The adults are
guilty, she insists; they will never get their children back (Carlson,
In both these circumstances we find all the elements of
group hysteria, including irrational emotions which became contagious and
are self-reinforcing or cause a circular reaction. The fact that one might
question the analogy because "witches do not exist" and child
abusers do, does not really undermine the foundation of the analogy.
Although most of us now think we know witches don't exist, certainly that
was not the case in 1692. Indeed perhaps it is not the case at all.
Since the advent of mass media, there have been many
examples of uncongregated phenomenon. The most familiar examples of
uncongregated events include the panic which ensued during the Halloween
broadcast by Orson Wells of "War of the Worlds" in 1938, and the
paranoia about communism generated by the McCarthy hearings in 1945 (McDavid
& Harari, 1968). Lesser known, but perhaps even more interesting are
some other unique phenomenon. One example follows:
In September of 1944, a woman in the small city of
Mattoon, Illinois, reported that someone had opened her bedroom window and
sprayed her with a sickish-sweet-smelling gas that partially paralyzed
her legs and made her ill. During the ten-day period that followed,
dozens of cases with similar symptoms were reported, and police exerted
full effort to catch the "gasser," who had become known in
newspapers throughout the nation as the phantom anesthetist of Mattoon.
Although the story died away within two weeks, an investigation through
interviews with "victims" and police in Mattoon was carried
out during the subsequent six weeks. On the basis of this evidence, the
episode was attributed entirely to hysteria and a wave of mass
suggestion. Rumor spread rampant, people became apprehensive and
disoriented, and they were gullible and suggestible. Those most
susceptible were women who were below average in educational and
economic level. Following the wave of hysterical suggestion came a
successive wave of "contrasuggestion," with critical public
attitudes toward hysterical suggestion, and low ebbs in prowler reports.
Without mob congregation, a cultish wave had united a collection of
"victims" and subsequently a collection of "critics"
of these victims (Light & Keller, 1975).
In recent years, both the disciplines of sociology and
social psychology have analyzed the phenomena of congregated collective
behavior in more contemporary terms. Several facets of these analyses
represent more scientific attempts to both explain and understand these
occurrences. Most of the research done on collective behavior is, by
necessity, historical and analytical in nature. These events are unique
and so unusual that they are difficult to replicate experimentally. The
most relevant data, therefore, has come from analysis of real events.
important fact upon which most social scientists agree is that there are
certain preconditions which must exist in order for a phenomenon of
collective behavior to occur.
Social ambiguity is perhaps the important construct. Collective behavior is more likely when there is an inherent paradox or
contradiction. For years, child abuse, especially sexual abuse, remained a
secret. It was rarely reported and was not likely to be taken seriously
when it was (Schuman, 1986). This seemed due in part to our Puritan
heritage and embarrassment with sexual matters in general, as well as to
the influence of Freudian psychology which tended to dismiss children's
complaints as fantasies. With the infusion in 1979 of huge amounts of
federal funds into the social service system came the mandatory and
anonymous reporting laws. Yet the conflicting issues are complicated for
America. The desire to do something about child abuse stands in opposition
to our long history of difficulty in dealing with sexual matters and the
privacy of the family. Add to this the confusion created by adversarial
expert testimony and opinion, and we have a true dilemma.
Three other sociological constructs are germane to our
analysis: frustrated social concerns, normlessness, and unanticipated
events. Certainly, after decades of secrecy, there is a frustrated
collective social concern to stop child abuse. Normlessness ensues when
people are caught between conflicting social values. When, for
example, should a neighbor report suspicion of abuse? The conflicting
needs to do something and the regard for privacy, as well as
embarrassment, generates a condition of normlessness. There is no clear
historical norm for such a dilemma. With regard to an unanticipated event,
it is doubtful that anyone in the United States could have anticipated the
news headlines which came from Jordan Minnesota in 1984.
Taken together, these constructs provide a foundation
for understanding collective behavior and the hysteria which has resulted
in so many false reports of abuse. But it is more difficult to explain why
both children and parent(s) often insist that abuse has taken place, even
when it hasn't. In order to provide a sufficient scientific base for
understanding this phenomena, we must now couple the information from
Stage One with some well-known and researched areas of cognitive
psychology in Stage Two.
STAGE TWO - Cognitive Issues
The cognitive capacities of children as witnesses has
been widely discussed by a number of the authors mentioned earlier. Many
authors who have written about false accusations have illustrated how
easily children are led into creating fantastic stories, which they learn
to believe through repeated interrogations. These interrogations employ
the powerful learning variables of repetition and reinforcement, even when
it is not the intention to do so. Often the interviewers are case workers
or law enforcement personnel who do not have sufficient training or skills
to conduct an unbiased interview.
The repeated interrogations are often accompanied by a
process of bureaucratic escalation, in which the accusation itself becomes
more and more defined and often enlarged. This can be deliberate, on the
part of an overzealous worker, or simply be an inadvertent consequence of
the accusation being passed from one division to another. Often the term
"alleged victim" is replaced by the word "victim."
term "subject" is replaced by "perpetrator" and so on.
Hence, one investigator's zeal may spark another's and all serve to
reinforce and solidify the accusation for those who reported it. This is
exactly the circular reaction defined in group hysteria.
The use of so-called diagnostic aids, such as puppets,
anatomical dolls, books, and drawings, can contaminate children's
perceptions even further. When encouraged by a zealous investigator,
because children tend to view these items as playthings (to be associated
with "make believe"), they may conjure up fantastic stories (Wakefield & Underwager, 1988).
controlled studies (Mclver, Wakefield, & Underwager, 1989), it has
been shown that there is no significant difference in the way that abused
and non-abused children interact with the dolls.
Piaget (1926) states that children cannot reliably
discriminate between internal and external stimuli until age eleven or
twelve. Kohlberg (1968) claims that children do not distinguish their own
dreams from external reality until about age five. Yet children as young
as three years of age (Spiegel, 1986) are being asked to testify as
witnesses in criminal proceedings, often sitting on the lap of a parent
who made the accusation. When the cognitive limitations and suggestibility
of children are considered in light of these repeated interrogations,
usually being done by biased adults with few or no interviewing skills, a
terrifying picture emerges.
Hollida Wakefield and Ralph Underwager describe the
position of the science of psychology with regard to the testimony of
children in cases of alleged abuse:
The procedures followed in the interrogations of
children contaminate, confuse, and make statements made by children
unreliable. ... The younger the child, the more powerful the teaching
and learning experience will be. When there is no supporting or
corroboration data or no admission from the alleged perpetrator,
children's statements standing alone must be viewed with great caution
... (Wakefield & Underwager,1988, p.33).
There is no evidence establishing that these
procedures [anatomical dolls, drawings, books, play therapy, puppets]
are reliable or valid techniques in in assessing possible sexual abuse
in children (Underwager & Wakefield, 1989, p. 30).
If we now look at the components of Stage One and Stage
Two together, there is a definable group behavior of an uncongregated and
congregated nature, which, within the definition of terms as used here,
has generated a climate of hysteria with respect to child abuse. It has
also generated a zeal on the part of the authorities to put a stop to
abuse. When these factors are combined with the suggestibility of children
discussed in Stage Two, there is a resulting synergistic effect. These two
stages taken together explain not only how so many cases of abuse are
reported, but also why so many of those involved come to believe that
abuse has occurred, even when it hasn't.
STAGE THREE - The Clinical Component
Thus far, most of the authors who have addressed the
issues discussed in Stage Two have not directly combined them with the
collective behavior constructs discussed in Stage One. Nor have most made
the connection to certain clinical components which often
exist when allegations of abuse are false. There are a variety of
psychiatric and psychological factors which can come into play in cases of
alleged abuse. Some of these are extremely pertinent, and provide a
foundation for differentiating a possible false accusation from a true
one. Often this type of pathology can be triggered by the group hysteria
and suggestibility of children discussed in Stages One and Two. There are
always many possible psychiatric problems when an allegation is false.
Obviously, there is the possibility of true psychotic behavior, if someone
is convinced abuse has taken place when it actually hasn't. For the most
part, only a few of the authors have examined carefully specific clinical
syndromes which may be applicable to cases of alleged child abuse.
There are a few authors who have discussed specific
clinical syndromes which may be applicable to cases of alleged child abuse
(Schuman,1984; Schetky & Boverman, 1985; Blush & Ross, 1987).
These authors have discussed the specific psychopathology found in
accusing parents, and less in depth, the individual pathology which might
be found in the child. So far, this author has found few articles which
expand these formulations to include the application of a lesser known
psychiatric entity, which is perhaps the most appropriate diagnosis in
Kaplan and Kaplan (1981) discuss the psychiatric entity
known as Shared Paranoid Disorder, or Folie a Deux. This is a
diagnosis listed in the Diagnostic Manual of the American Psychiatric
Association III-R as 297.30 (Induced Psychotic Disorder). As stated by
Kaplan and Kaplan. "Folie a Deux provides a useful clinical
perspective ... It is a well defined clinical entity" (p.92). In a frequently
cited article, Gralnick (1942) defined a Folie a Deux as a
"psychiatric entity characterized by the transference of delusional
ideas and/or behavior from one person to one or more others who have been in close association
with the primarily affected patient" (p.232).
This diagnosis can be applicable in cases of alleged
abuse, especially when charges are brought by the custodial parent in
instances of divorce/custody litigation. Yet, it may be applicable in
other cases as well, in that this type of psychiatric entity can be
manifested by a child in interaction with adult interviews, investigators,
etc. Social workers often remove children from the home in cases of alleged abuse, and hence become t
a sort of surrogate parent.
The central dynamic which makes this diagnosis
applicable is that the relationships are characterized by a
dominant/submissive dynamic. The very nature of the relationship of a
child to an adult is that of dependency and submission. Thus, there is a
considerable amount of secondary gain on the part of the child in
adopting the dominant adult's ideas and/or behavior. The child seeks in
this way to gain the approval and love of the adult. These are very
powerful motivators. The only therapeutic intervention which can be made
must include separation of the child from the primarily affected adult(s).
When this is accomplished, the child will lose the delusional effect if it
was a result of such a disorder.
It must be stressed that the existence of such a
clinical disorder is only a possibility. The fact that an accusation, even
a false one, is made does not indicate the presence of a psychiatric entity.
This determination must be made by a qualified professional, after a
careful evaluation of all the parties involved. If, however, such a
diagnosis is made, it can be extremely valuable in assessing the
situation, and can aid in determining the veracity of the charges. Even
then, such a diagnosis should be subjected to a second opinion. Most
importantly, even the presence of such a disorder does not prove that the
accusation is false. The third component must be evaluated along with the
first two stages to obtain a complete picture.
When taken together, the three concepts or stages taken
from the various disciplines provide a compelling argument for a cohesive
set of behaviors which may constitute a recognizable social syndrome.
is characterized by the three stages which interact in a synergistic
fashion thus producing the possible syndrome. The concepts of collective
behavior in Stage One explain the conditions which have contributed to the
public hysteria regarding the problem of child abuse. This contagion may
then predispose both parents and children as well as professionals, to
misinterpret, misconstrue and overreact to the possibility of abuse, and
therefore report what might otherwise have gone unnoticed.
In Stage Two, the cognitive capacities which make
children so suggestible are exploited either consciously or unconsciously
by the reporting adult, social workers and/or investigators and the
allegation is subjected to a process of bureaucratic escalation. The
alleged child victim is subjected to repeated interviews and
interrogations, often by biased or poorly trained
"professionals" and the child, in effect, learns the story.
is then reinforced by the interrogator and the perceptions of the
In the Third Stage there can develop a psychiatric
disorder known as Folie a Deux or shared paranoid disorder in which the
child imitates the accusers' perceptions, ideas and behaviors.
This then is the general scenario of a Child Abuse
Hysteria Syndrome. In certain instances there can be additional facts which add to the predisposition or
motivation to find abuse, especially in divorce and/or custody disputes;
though this does not, by itself, mean that the accusation is false.
This paper is a preliminary effort to identify a
recognizable set of behaviors, which, if verified through further
research, may help determine the veracity of an accusation of child abuse.
The formulation is based on the integration of three heretofore separate
areas of widely accepted scientific principles, and thus constitutes a
presumptive basis for foundation testimony from an expert of a more
generic and neutral variety than currently exists within the adversarial
court system. This attempt to identify a social syndrome is with the hope
that this and similar formulations can ultimately be used as new kind of
Foundation testimony of a generic nature, which is not
biased or adversarial, might encourage the courts to use a team of
appointed experts, who could assist the fact finders in gaining a broad
understanding of the complex issues in a child abuse proceeding. Such a
team with members well versed in applying scientifically sound
formulations could then be applied to the case at bar without the
intrusion of the adversarial process. In this manner, a team could provide
the court with the most objective and non-biased interpretation of the
matter, from a myriad of perspectives. This team, acting almost as a
committee, would subject the case to the various analysis and report their
clinical perspective to the judge or jury.
The guidelines for opinion testimony have been
broadened by rule 702 of the Federal Rules of Evidence, and may permit
opinion testimony of this type if it can assist the trier of fact
(Schuman, 1986). Such opinions by experts are usually governed by the
discretion of the trial judge, but guided by similar principles. Opinions
which can be of value to the fact finder may be acceptable, while opinions
regarding the ultimate issue in the case are rarely permitted. In the past
the expert opinion has been devalued as a consequence of the adversarial
process. Expert opinion from a court-appointed team, however, may be far
more useful, as well as valid.
Generic and broad-based theoretical formulations like
those in this paper, could provide a far greater understanding of the
large picture for the fact finders, just as other clinical tools prove
useful in evaluating specific cases. Such testimony could only be useful,
however, if it is exempt from the adversarial process,
and therefore presented in an unbiased fashion. It is in the spirit that
these preliminary formulations are being presented.
The adversarial system which pits the specific
knowledge and expertise of one mental health professional against another
is not only a waste of money and valuable resources, it often creates a
tunnel vision in the mind of the fact finders and prevents them from
gaining a broad understanding of the complexity of child abuse cases.
time for both the mental health and judicial establishments to recognize
that our obligations transcend merely adding to the confusion through
participation in the adversarial process. Our energies must be devoted not
only to theoretical formulations or clinical opinions, but to aiding the
courts in implementing effective procedures as well.
If any of the preliminary formulations in this paper
turn out to be on sound scientific footing, then we the health
professionals must assume the responsibility of demonstrating their value
to the courts. We cannot afford to allow ourselves to continue to be drawn
into battles of the experts any longer. We must impress upon the
that this approach not only limits our abilities to assist the fact finders,
but compromises the value and objectivity of our input. The time has come
for a court appointed team approach, not only for child abuse proceedings,
but for most areas of family court. We must be responsible not only for
the content of our opinions, but the context in which they are presented
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