Belated Realization of Child Sex Abuse by an Adult

Richard A. Gardner*

ABSTRACT: Many adults, usually women, are claiming that they have recently recalled sexual abuse that had been "repressed" for many years.  This revelation generally occurs after the woman has been in therapy with a therapist who claims particular skills in bringing such memories into conscious awareness.  Many of these allegations, however, are likely to be false and occur as a result of the interaction between angry and sometimes paranoid women and overzealous and often naive therapists who specialize in this type of therapy.  The characteristics of the accusing adults and their supporting therapists are discussed along with the features that are found in false allegations in this setting.
  

Introduction

In recent years we have witnessed a new phenomenon, namely, an adult (usually a woman) claiming that she recently realized — after many years of absolutely no recollection — that she was sexually abused as a child (usually by her father).  First, I wish to emphasize that I believe that some of these accusations are indeed true.  Child sex abuse is a widespread and ancient phenomenon.  Children who are sexually abused grow up and become adults.  Children who are sexually abused may repress their memories of such abuse for many years.  There is no question, however, that some adults are making false accusations and that it is extremely important to develop guidelines for differentiating between true and false accusations.  It is my purpose here to focus on the false accusations, especially with regard to the manifestations that suggest strongly that they are false.

Commonly, the revelation occurs in the office of a therapist who has a reputation for being particularly skilled in bringing such long-repressed memories into conscious awareness.  The moment of revelation is considered to be a turning point in the woman's life, and now all unanswered questions about her psychological health are answered.  Everything now has "fallen into place."  All the years of emotional turmoil, psychiatric treatment (including hospitalizations), wrecked marriages, and other forms of psychological dysfunction are now understood.  It was the sex abuse that occurred during childhood that was the cause of all these years of grief.  Now that the cause is known, the "healing" process can now really begin.  (All previous therapies were a waste of time and money.)  The treatment may take many years and may involve a significant degree of hardship for the nearest of kin, but it will be worth it.  The woman continually extols the brilliance of her new therapist — who saw what others failed to see — and toward whom this woman will have a lifelong debt.

Frequently, the next step is for the woman to remove herself totally from the alleged perpetrator, who is generally a man in declining years.  His initial reaction is often one of astonishment and immediate denial, generally supported by his wife.  The sessions may extend over days, weeks, months, and sometimes even years.  Nothing the father can say will convince his daughter that no sex abuse ever took place.  The father— who previously may have had a reasonably good relationship with his daughter — now finds himself totally rejected and isolated.  His wife, who supports her husband, is also rejected, as well as anyone else who may support the father's position.  The distraught parents feel impotent as every relative whose assistance they wish to enlist is cut off as well and the daughter maintains contact only with those friends and relatives who will support her accusation.

The next step often involves the daughter's appearance on television programs, interviews for newspapers and magazines, and personal presentations to any group willing to listen.  One of the purposes here is to help other women (and there are millions out there) "discover" their own childhood molestations in order that they too might now, for the first time, deal properly and effectively with the effects of their childhood exploitations.  Whereas most women who are sexually molested traditionally feel some shame over their experiences, both for themselves and their families, these women are just the opposite.  If they had the opportunity to appear on "Prime Time" syndicated television, they would seize it.  Clubs of such "victims" and "incest survivors" are formed and pressures placed on legislators to provide public funding for the treatment of such women, which, it is predicted, will require many years in order for them to "heal."  In some cases, we are told, the trauma has been so formidable that these women may require treatment for the rest of their lives.

There is no question that child sex abuse is widespread.  Obviously, there is also no question that the vast majority of sexually abused children become adults.  However, there is no question that most of the women who satisfy the false-accusation criteria described here have never been sexually abused.  These cases satisfy many more of the indicators of the false than the true sex-abuse accusation.  In fact, I have already mentioned two of the indicators of the false accusation — the strong need to bring the abuse to the attention of the public and the belief that all of one's psychological problems are derivatives of the abuse.
  

The Accusers: Why Do They Do This?

Release of Anger

Generally, these are very angry women.  When the problems generating anger are not resolved, anger builds up and presses for release.  Society always provides targets that facilitate such release, and these change with the times.  Various rules and regulations are set up that strictly define which areas of release are acceptable and which are not.  Some of the more common vehicles for release in our society are competition, gossip, worthy and noble causes, sports (both as a spectator and as a participant), family squabbles, and violent themes in books, television, and cinema.  Family members are safe targets for such anger because they are often captive and are less likely to retaliate as strongly as strangers.  In short, they cannot readily escape (especially if they are children and spouses), and they can be relied upon to be less punitive in their retaliatory maneuvers.  The socially sanctioned targets change with the times and place.

In recent years, many women have found that men can serve as useful targets for their hostility.  There is no question that women have been terribly subjugated since the beginning of civilization and that the process is still going on in just about every part of the world.  There is no question that the women's liberation movement is, overall, a constructive force in human progress.  But every movement has its fanatics and zealots, and the women's movement is no exception.  Most women have some justification for feeling angry at men in general.  However, those who believe that the best way to deal with this is to destroy every man in sight are certainly not making constructive use of their anger.  Actually, such women do the women's movement much more harm than good, give it a bad name, and work against its progress.  Such utilization of men as scapegoats is a form of bigotry.  If scapegoatism is to work, it is important that the scapegoat be close by.  And this is an important element in prejudice.  One can be intellectually prejudiced against people who live thousands of miles away, but they are not available as targets for the release of anger.  Accordingly, one must find a scapegoat close by, even in the next house or neighborhood.  Husbands and fathers satisfy this proviso quite well.
  

Sexual Factors

In other cases of false accusations of sexual abuse, a woman may release her anger via the sex-abuse accusation against a separated husband.  Here the adult woman vents this rage on her own father, who, for many women, was once the most important person in their lives and, at the time of the accusation, may still occupy the number one (or possibly the number two) level in the hierarchy of men who have influenced them.  If one looks over the last 15 to 20 years with regard to what has been going on in the field of sex-abuse accusations, it might have been predicted that false sex-abuse accusations toward husbands would spread to fathers.

Contrary to popular opinion, children are capable of having strong sexual urges.  Although there is generally an intensification of such urges around the time of puberty, they are present before that and have the capacity to be intensified — even to adult levels.  Children's sexual urges are generalized, and children have to learn which individuals are "proper" to involve themselves with in the particular environment in which they are raised.

In our society, where the incest taboo is quite strong, little girls have to learn that their fathers are off limits when it comes to the expression and gratification of their sexual feelings.  The suppression and repression of such feelings may produce some clinical and behavioral squelching, but they may press for release nonetheless.  One way of dealing with them is via the mechanism of projection.  In this way the individual is saying, "It is not I who harbor strong sexual desires toward my father; it is he who has strong sexual desires toward me."  The next step is to have the fantasy that these desires were realized in reality.

To call all this an "Oedipus complex" or "Electra complex" adds no new information.  Freud considered these particular desires to be the central element in the development of most psychoneurotic problems.  I am in disagreement with him on this point, but I do agree that these intrafamilial sexual urges do play an important role in our lives.  Of importance here is that such urges may contribute to a child's professing that a parent sexually abused her and later in life, as an adult, claiming that she was sexually abused as a child.
  

Paranoia

The Ubiquity of Paranoia

Paranoia is much more common than is generally appreciated.  Most know that a paranoid is a person who harbors delusions of persecution, that is, the individual believes that he or she is being persecuted by another individual, when there is absolutely no evidence that such is the case.  Most believe that such people are to be found mainly in mental institutions, locked up in closed wards.  This belief is in itself a delusion.  The reality is that for every paranoid who is in a mental hospital, there are probably hundreds on the outside, and many of these people are not even recognized as being mentally ill.  Crichton-Miller, the English psychiatrist, once said (Kolb & Brodie, 1982):

For every fully developed case of paranoia in our mental hospitals, there must be hundreds if not thousands, who suffer from minor degrees of suspicion and mistrust; whose lives are blighted by this barrier to human harmony; and who poison the springs of social life for the community (p. 446).

Sometimes the paranoia may fuel worthy causes, and the individual achieves a certain amount of stability and even social respectability (especially from those who have joined the cause).  The anger is vented toward those who are considered to be contributing to the perpetuation of various social abominations, and sometimes even constructive things come out of these movements.  I am not claiming that all people who devote themselves assiduously to worthy causes are paranoid.  I am only claiming that some of the people who are involved in such movements — those who are the most fanatic and consumed — may very well be paranoid.  The rage that fuels the paranoia is being channeled into a socially constructive venture and good may come of it.

There are others, however, whose paranoia blurs their reality, and they distort significantly the object of their indignation.  They may see the situation as worse than it is, and attribute malevolent motives to those they are trying to reform or otherwise change.  They misconceive events and oversimplify.  Because of their blurred perceptions, their own colleagues may find them progressively less useful to the movement.
  

The Content of Paranoid Delusions

The content of paranoid delusions is not created de novo in the brain of the patient.  Rather, the material is derived from ambient social phenomena that may serve well as a focus for the paranoid's preoccupation.  There are not too many people in our society whose paranoia involves evil spirits, but this was certainly the concern of people in societies where evil spirits were considered to play an important role in the lives of the individuals.  In 1692, in Salem, some of the people who believed that they (or others) were possessed by witches were most likely paranoid.  (I am not claiming that all who believed this were paranoid, only some.)

In the World War II era, Nazi spies were frequently incorporated into the delusion of paranoids.  Although there certainly were Nazi spies in the United States, it is not likely that a network of them devoted themselves to spying on paranoid patients, especially those in mental hospitals.  In contrast, in Germany, Jews were commonly incorporated into the delusions of paranoids, Adolph Hitler being the most famous example.

In my residency days, in the 1950s, many paranoids considered themselves to be persecuted by Russian spies.  Without doubt, the McCarthy hearings contributed to the development of delusions involving impending persecution by Communists.  In reality, there actually were Russian spies in the U.S., and they were given particular attention in the public media.  However, there was no good reason to believe that these spies were as numerous as paranoids believed them to be and that networks of them were devoting themselves 24 hours a day to spy upon these particular patients.  Not surprisingly, since the end of the cold war, fewer paranoids are being persecuted by Russian spies.  But other potential persecutors are not hard to find.  Being followed by the police and FBI are common preoccupations of paranoid people.  Wiretapping is another concern for paranoids, again as a spinoff from a practice that certainly occurs in our society.

I could go on and on and give many examples throughout the history of the human race to demonstrate this point.  What is pertinent here is that sex abuse has become the most recent concern for paranoids, and there is no question that some of the women who are accusing their fathers of having sexually abused them as children are paranoid individuals who have selected from the society the in-vogue scapegoat to serve as the target for the paranoid rage.
  

The Projection Element in Paranoia

Paranoia serves functions other than the release of pent-up anger.  Central to the paranoid mechanism is projection.  Specifically, paranoid individuals project out onto others thoughts and feelings that they themselves have, but they wish to disown.  Because of guilt and other ego-debasing mechanisms, they do not wish to accept that they themselves have particular urges.  Accordingly, by projecting them onto others, they can consider themselves free of these undesirable thoughts and feelings.  Murderous rage is a good example.  Most people would not be willing to accept the fact that they harbor within themselves the kind of murderous rage that causes some people to kill others.  By projecting such anger out onto others, the paranoid can say: "It is not I who wish to kill him; it is he who wishes to kill me."  And this mechanism can relate to sexual feelings as well.  The sexually inhibited person may say: "It is not I who have sexual feelings toward him; it is he who has sexual feelings toward me."  And this is one of the elements that may be operative in the false sex-abuse accusation.
  

The Oversimplification Element in Paranoia

Another element operative in paranoia is oversimplification.  Most problems are complex and the solutions to most of the problems in the world are not easy ones.  A multiplicity of factors is operative in any phenomenon, and problems are not dealt with by simple solutions.  The paranoid solution generally involves an oversimplification of the problem and offers a quick and easy solution.  And this is one of the elements in paranoid prejudice.  Such people are essentially saying, "If we only get rid of those people, all our problems will be solved."  Although history has repeatedly shown that this is not the case, the delusion still persists.

A woman who has suffered with a wide variety of psychological difficulties throughout the course of her life is likely to embrace a simple solution that promises to cure all of her problems.  If she can come to believe that her father's sexual activities with her in early childhood were the cause of all her difficulties, then she has a simple answer and, presumably, a simple solution, or at least the route to a simple solution.  It is for this reason that such women are likely to say, "Now everything is understandable.  Now I understand why I have all these years of grief.  Thank God I met Ms. So-and-so, my brilliant counselor, who has shown me the path to the cure."
  

Resistance to Alteration by Logic and/or Confrontation with Reality

Another characteristic of paranoia is that the belief is not altered by confrontations with reality, no matter how compelling.  Paranoia, after all, is a form of delusion.  And a delusion, by definition, has no basis in reality and is a product of internal psychological processes rather than external realities.  There are strong psychological forces within the individual that compel the person to maintain the belief, no matter how much at variance it may be with reality.  Therefore, those who try to alter the belief of paranoids by logic, argument, and confrontations with reality achieve nothing but frustration and a sense of futility.

Accordingly, when the father, mother, and other family members try to convince the accusing woman that her beliefs are false and that some of the elements in her scenario are absurd and even impossible, their arguments fall on deaf ears.  Or, if she does feel the need to respond, she provides some kind of an explanatory justification that may be as implausible as the original scenario.

At the same time, paranoids are notorious for their avoidance of such confrontations and provide a never-ending stream of justifications for not involving themselves in such conversations.  When they are willing to discuss their accusations, they are often ingenious in providing rationalizations to justify their distortions.  This principle is demonstrated by an anecdote from my residency days.  It is the story about a man who comes to a psychiatrist.  The following interchange takes place:

Psychiatrist: How can I help you?
Patient: Doctor, I'm dead.
Psychiatrist: Let me ask you this.  Can a dead man bleed?
Patient: Of course not.  A dead man can't bleed.
Psychiatrist: (takes a-pin, pricks the man's finger tip, and expresses a drop of blood): What do you think about this (while pointing to the drop of blood on the man's fingertip)?
Patient: (after a long pause) Well, what do you know.  This is the first time in the history of the world that a dead man has bled!

Paranoid women who accuse their fathers of sexually abusing them provide similar rationalizations to support the maintenance of their delusion.  When their mothers try to convince them that the accusation has no basis in reality, they will claim that the mother is only trying to protect the father in order to preserve her marriage.  It is a no-win situation when one tries to change a paranoid's mind regarding the validity of a delusion.
  

Low Self- Esteem in Paranoia

Paranoids basically suffer with deep-seated feelings of insecurity.  This is one of the factors contributing to the need for projection.  People with stronger egos are willing to tolerate socially unacceptable impulses within themselves and have enough compensatory assets to counterbalance personality weaknesses and socially unacceptable thoughts and feelings that they may harbor.  Paranoids do not have the ego-strength to do this.

Not only does this problem contribute to the mechanism of projection — wherein they project out onto others their own inadequacies (or presumed inadequacies) — but this weakness contributes to other problems as well.  One such problem is their inability to admit that they were wrong.  Admitting that one makes mistakes also requires a certain degree of ego-strength.  And this is one of the reasons they are so resistant to logic, arguments, and confrontations that might demonstrate that their thinking is awry.  For a paranoid, such an admission is tantamount to admitting that one is "crazy," and this, of course, is very difficult for anyone to do.

The feelings of low self-worth may also be compensated for by the individual developing the feeling that she is more astute than others regarding the ability to appreciate the significance of information.  In general, paranoids consider themselves quite skillful in detecting innuendo, slights, and trifling disparagements that pass others by.  They pride themselves on their ability to detect the hostility in everyday inadvertencies.  For women who promulgate false sex-abuse accusations against their fathers, they may, in retrospect, pride themselves on their new-found sensitivity to the most subtle manifestations of sexual abuse, manifestations that others were too blind and/or stupid to detect.

In the extreme, this compensatory mechanism for ego enhancement may result in grandiosity and an all pervasive feeling of superiority over others.  This feeling of superiority, then, serves to strengthen the individual against those around them, who inevitably react with hostility to the paranoid's accusations.  A vicious cycle then ensues in which those who disagree and argue with the paranoid unwittingly contribute to the strengthening of the paranoia and its derivative symptoms.
  

The Spread of Paranoia

Paranoia tends to spread and expand.  Whereas the delusions may start with a single individual, they frequently spread to others.  I have already mentioned the phenomenon in which all family members and friends are divided into two categories: those who agree that the sex abuse has taken place and those who do not.  When a sex-abuse accusation is the central mechanism in an adult woman's paranoia, she may consider all individuals who support the father's position to be capable of aiding and abetting his abuse — even at present.  Although, as an adult, she considers herself strong enough to resist any present advances, her children would certainly not be able to protect themselves.

Accordingly, grandchildren, who previously may have had a loving and warm relationship with their grandfather, are now removed entirely from the opportunity to have any contact with him — even by mail and telephone.  Gifts are returned with the excuse that these are likely to be bribes, the purpose of which is to entice the grandchildren into sexual encounters.  And his wife, as one who has openly supported her husband's denials, is considered to be similarly untrustworthy.  Because she "looked the other way" or was "too stupid to see what was going on" when the accuser was molested as a child, the woman now suspects that her mother would be similarly incapable of preventing her husband from perpetrating similar abuses on her own children.

Aunts and uncles who have not come forth to align themselves with the accusing woman are similarly distrusted and viewed as potential facilitators of her father's sexual abuse of her children.  As a result, many of these women go into hiding, move to distant states, and cut off entirely any and all communication with the accused father as well as his extended family and friends.
  

Paranoia and the Legal System

People who are angry to the degree described here often want to wreak vengeance on those whom they believe have abused them.  Our legal system provides a ready and willing vehicle for gratifying this morbid desire.  There are generally two tracks along which such women can operate.  On the civil track, they can ask for damages and payment for their "therapy."  Because the trauma has been "enormous," the amount of money that can provide compensation is generally an amount equal to the total value of the assets of the father.  And because the therapy must be intense and prolonged (no one can predict how long — it may be lifelong), then payment for such treatment is also justified.  In some cases the blackmail element here is easily seen.  I have seen letters written by such women in which their fathers were told that if they did not come forth with the indicated amount of payment, the daughter would consider herself to have no choice but to press criminal charges, with the threat of years of incarceration.

And this brings us to the second track, the criminal track.  Here, too, such women will find willing accomplices in the legal apparatus.  There is a sea of prosecutors and district attorneys who are quite happy to enhance their images in the public eye by bringing 'justice" to these kinds of "perverts."  The public media, as well, are happy to provide these individuals with the notoriety (and future promotions and salary increments) that they crave.  In most states the punishment for sexual abuse of a child is Draconian, far above and beyond the punishments meted out for most other crimes (including murder).  Life sentences for fondling little girls are commonplace, and there are hundreds (and possibly thousands) of individuals who have been convicted of such a crime — some of whom may very well be guilty but many of whom are not.  In either case, their punishments are far beyond what was visualized by the Founding Fathers when they framed the U.S. Constitution, which was designed to protect an accused individual from "cruel and unusual punishment."
  

Conclusion

I do not believe that all adult women who promulgate false sex abuse accusations against their fathers are paranoid.  Although some (and possibly many) of them are, it is too early to know approximately what percentage of these accusers fall into this category.  Some are preparanoid and may be moving along the paranoid track; with the false sex-abuse accusation enhancing movement along that path.  With more knowledge and experience, we will most likely see other types of psychopathology in these women.  All of them, however, probably will have demonstrated significant degrees of psychopathology in the earlier parts of their lives, long antedating the outbreak of the psychopathology associated with the sex-abuse accusation.
  

The Accuser's Search for a "Therapist"

Some women have developed their delusional systems in the course of treatment.  There are others, however, who have not had the opportunity for such therapy, but who have read or heard about the phenomenon of adult women learning in treatment about their childhood sex abuse and thereby found the key to all of their psychological problems.  They, too, decide that they also would like to find out whether they can find this kind of simple solution to their own problems.  This factor, plus the presence of a wide variety of other predisposing forms of psychopathology, result in their searching for a therapist who will help them delve into their past and possibly uncover similar evidences of sex abuse.

Not just any therapist will do, however.  They want someone who specializes in this particular area, one who is well known for her expertise in uncovering this material, which may be very deeply buried in the innermost recesses of the unconscious mind.  (I refer to the therapist as "her" because there are far more female than male therapists who satisfy this proviso.)  These days it is not hard to find a therapist who is a specialist in this area, so ubiquitous is the sex-abuse hysteria.  Especially attractive is the therapist who has the reputation of finding sex abuse in the vast majority, if not all, of the patients who come her way.  Predictably, the therapist will be found; the sex abuse will be uncovered; the prophecy will have been fulfilled; the row of dominoes will begin to tumble — with tragic results for the woman, her father, her children, her friends, and her family network.
  

Who Are The "Therapists"?

Anyone who believes that people who refer to themselves as therapists are psychologically healthy is also suffering with a delusion, just a little less pathological than the delusions discussed thus far.  And anyone who believes that people who are therapists are adequately trained and that most of them know what they are doing is also entertaining a belief that is easily contradicted by reality.  In most (if not all) states, any individual can go into business with the title of "therapist."  One cannot legally say that one is a psychiatrist (a subspecialty of medicine) or that one is a psychologist, or that one is a psychiatric social worker.  Generally, people who practice therapy in the context of these disciplines require a certain amount of prescribed training and state certification.  There are other disciplines as well that may require specific training and certification, e.g., family counselors, psychiatric nurse practitioners, and pastoral counselors.

In addition, there are many therapists who are self-styled and self-trained and who have not progressed along any of the more formal paths.  Most of these people are incompetent and many are dangerous.  But there are also thousands who have trained within the aforementioned disciplines who have little or no competence.  Even within these formal disciplines, there are many schools of thought and a wide variety of therapeutic approaches with only limited scientific validity.  Accordingly, it is predictable that a certain segment of these individuals will also be dangerous, although not as high a percentage as those who have no formal training and monitoring of their activities.

With so many therapists per square inch, it is not surprising that there is significant competition for patients.  It is indeed a buyer's market.  One way for therapists to make a buck — in this competitive arena — is to pander to individuals who are involved in the latest fad of psychiatric disorder.  At this point, sexual abuse is probably number one.  There are probably more sexually abused patients seeking treatment today than ever before in the history of psychiatry.  Accordingly, sex-abuse "experts" are sprouting up in every field, coming out from under every stone, and suddenly appearing from behind every tree.  If someone has money to give away, there will always be someone who will be pleased to take it.  For such people there will always be the exploiters and the psychopathic types, those who have no belief at all that their patients were indeed sexually abused, but who are quite happy to take money from any gullible individual who is willing to give it to them.

Considering the competition in the market place, one can easily find "treatment" no matter how little money one has.  Some of these therapists are so fanatic that they will treat patients for nothing, so noble do they consider to be their cause.  These therapists really believe that most of the patients who come their way have indeed been sexually abused.  Interestingly (but not surprisingly), most of these therapists are women.  Therefore, for simplicity of presentation, I will refer to the therapist as a female, although there are certainly some men who have jumped on the bandwagon as well (especially men in the aforementioned psychopathic category).

Some of these women therapists have actually been sexually abused themselves when younger.  Not having come to terms with their own sexual abuse, and not having worked out whatever residual psychological problems may have resulted for them, they harbor ongoing animosity toward men.  It is not simply their fathers (or their uncles, grandfathers, or whoever else it was who abused them), but all men who must pay for the sins of these individuals.  If they had their way, they would wreak vengeance on all mankind (not womankind).  What better way to wreak vengeance on men than to become a therapist and use one's patients to act out one's morbid hostility.  One can become even more effective in the implementation of this grand plan if one sees sex abuse in just about every patient who comes one's way.  In this way, all men can pay for their depravity.  The possibility that an accused man may be innocent does not cross their minds.

These are the people who are ever waving the banner "children never lie" and are deeply committed to the dictum that if a child claims he or she was sexually abused, it must have happened.  The extension of this is "adult women who profess sexual abuse in childhood also never lie."  The principle is: "If you have a fantasy that it happened, it must have happened.  Otherwise, where else would the fantasy come from?"  In the opinion of these individuals, a fantasy must relate to some external reality.  A fantasy cannot be the result of external suggestion or internal psychological processes.  As long as they follow this principle, they can gratify the pathological motives that operate in their having selected the profession of sex-abuse therapist.

Some of these therapists are overtly paranoid.  They may even have been graduates of a prestigious and well-recognized kind of therapeutic program (e.g., psychiatry, psychology, and social work).  Some have been trained by paranoids, thereby transmitting the pathology down yet another generation.  Such paranoid therapists are particularly attractive to adult women who claim their fathers sexually abused them.  These therapists may not have been sexually abused themselves, or they may have.  In either case, they are paranoids and they will predictably bring preparanoid patients into the paranoid realm and, when already paranoid, make them worse.  What develops is what we refer to in psychiatry as a folie--deux relationship.  This is a disorder in which one party — a more assertive and aggressive individual — inculcates his or her psychopathology into a weaker and more passive individual.  Attempts by family members to convince the accusing woman that her therapist is making her sicker, not better, prove futile.  The bonding between these two women becomes unbreakable.  Even the slightest criticism will not be tolerated.
  

What Do These People Do?

Ignorance and/or Failure to Accept Well-Established Concepts of Memory

In order to understand exactly how these therapists work, it is important to understand the phenomenon of memory.  It is beyond this chapter to discuss the phenomenon of memory in detail.  Therefore the focus will be on the aspects of memory relevant to the adult woman who accuses her father of sex abuse and on the ways that therapists ignore and/or distort well-established principles of human memory.
  

Encoding, Storage, and Retrieval

Memory can be broken into three large categories: encoding, storage and retrieval.  Encoding (registration) refers to the process by which an external stimulus is transmitted into the brain, where it is stored.  Storage (retention) refers to the processes by which the material is retained in the brain.  Retrieval (recall or decoding) refers to the process by which the stored memory is brought into conscious awareness.

The analogy to a camera's making a photograph is applicable here.  When a camera takes a picture, it reproduces on the film (the storage place) a fairly accurate reproduction of what has been transmitted through the lens.  This is not what happens with human beings.  Whereas the camera is indiscriminate and sees everything, the human is selectively attentive to that which the individual wants to see and selectively inattentive to those things that the brain does not wish to register.  A wide variety of psychological mechanisms are operative in determining what will pass through the human eye in a meaningful way.  Most important are our wishes and mechanisms of guilt, shame, and denial.  These modify significantly what will be encoded and then stored in the brain.

Now to carry the analogy further.  The retrieval process can be compared to removal of the photograph from the camera, album, or file.  Generally, the photograph is the same (with the exception of situations in which it might be marred or destroyed, and the likelihood of this increases over time).  But the view that human memories remain fixed in the brain, especially over time, is not consistent with the best research on the subject.  Rather, the already distorted renditions of reality that have been stored are reworked and restructured in the storage compartments of the brain (primarily the hippocampus).

This is an extremely important point.  The memory does not sit there like a rock in a box, unchanged over the years.  Rather, it becomes reworked, reconstructed, and integrated with other memories, each of which is distorted and changed over time.  An important element determining what happens to this memory is what we want to happen to it.  If the memory involves material that makes us uncomfortable, ashamed, or guilty, it is very likely that it will be altered in a direction that will remove these unpleasant thoughts and feelings.  Memories are reconstructed; they are not reproduced.

Furthermore, there is a certain amount of reorganization that takes place in order to give the memory a consistency and logical sequence that it may not otherwise possess.  An example of this phenomenon is what we do with dreams.  Dreams enter conscious awareness in what to us appears to be a disorganized format.  Most often when we relate a dream, we automatically give it a continuity that it does not intrinsically possess.

The retrieval process, separate from the storage process, also involves selective attention and reworking.  Here too we ignore what makes us unhappy and uncomfortable and rework the memory into a format that pleases us.  And this final "memory" may have little if anything to do with the original reality of which it is a derivative.  And it is this final product that we call the memory.  And even this may be altered over time as our views about the original event warrant further modification. Dawes (1991) puts it well: "It is the story that creates the memory, rather than vice versa."

With regard to childhood memories, the distortions may be introduced by parents and other family members.  It is extremely important to appreciate this universal principle.  When an individual talks about an early childhood experience, it is often useful (if possible) to get the parents' input regarding the validity of the child's rendition of the event.  Although the parents' version may not be the "right" one (for the reasons already mentioned), it is likely to be a more accurate reflection of reality.

A common phenomenon is a person's remembering an event that either never occurred, or had occurred at a time when the person was really too young to remember it but still believes that it took place.  What the person is remembering is the parents' version of the event, told at the time or possibly later.  The French psychologist Piaget provided an excellent example of this phenomenon from his own life.  For many years he told about an early memory in which he recalled his nurse foiling an attempt to kidnap him from his carriage when he was two years old.  Years later this nurse, then retired, sent a letter to his parents informing them that there was no such kidnapping attempt and that she had concocted the story in order to impress the parents with her efficiency and vigilance.  Piaget had heard the story so often from his parents that he actually came to believe that he was witness to the event (Toufexis, 1991).

Therapists of the kind described here take many liberties with the aforementioned well-founded principles.  They believe that if an individual has a memory of a childhood sexual experience, it must be true.  They do not believe that our mind can play tricks on us and that we can actually have visual images of things that never happened.  They do not believe in the restructuring of memories over the passage of time.  They believe that memories are like rocks in a box or permanent photographs.  Obviously, such ignoring of well-established scientific principles serves to maintain the folie--deux relationships they have with their patients.
  

Flashbacks

Another area of memory with which therapists take liberties relates to the phenomenon of the "flashback."  A flashback is basically an eruption into conscious awareness of a buried memory that has generally been traumatic.  Usually, the flashback is brought into conscious awareness by some external stimulus that evokes it.  Often, the stimulus has some similarity to the original traumatic event.  An example would be the war veteran who has been traumatized in battle.  Years later, exposure to situations that might be peripherally similar to the original battlefield conditions may evoke visual imagery (and associated thoughts and feelings) of actual battlefield scenes.

An important element in the flashback phenomenon is that there is generally no prolonged period in which the traumatized individual is completely free of flashbacks.  Rather, as time goes on, their frequency diminishes, sometimes even to the point where they will be rare.  The greater the trauma, the longer will be the period of flashbacks and the less the likelihood that they will disappear completely.  Individuals who suffer from flashbacks do not generally have the experience of many years of freedom from them and then their sudden reappearance 15, 20, or 30 years later.  There are just too many environmental stimuli that can potentially evoke the flashback to allow for such a prolonged symptom-free period.

The therapists described here do not subscribe to this well-established principle.  Rather, they believe that a girl who was sexually abused at age three can be completely free of flashbacks for many decades and then, at age 43, for example, can suddenly experience flashbacks about her experiences.  Sexual intercourse with her husband (even after years of marriage) may have served as the evoking stimulus.  Although the woman may have had sexual relations with her husband hundreds of times, and although she may have had multiple sexual experiences with other lovers (past and present), this particular sexual encounter — one that occurred in the course of treatment — now becomes the evoking stimulus for the flashback.  Or, if she is not in treatment, it may have occurred after she read an article about it or learned about a friend who had this experience.  (We see here once again the power of human suggestibility and gullibility.)  In either case, the flashback is considered to be proof of the abuse, and the therapist is likely to point to the phenomenon's inclusion in the DSM-III-R as one of the manifestations of the post-traumatic stress disorder (PTSD), the diagnosis most often applied to people who have been raped and/or sexually traumatized in other ways.
  

Body Memory

A related phenomenon is sometimes referred to as "body memories."  This is a relatively new term, appearing only within the last few years, and it is said to be a kind of flashback in which physical contact (usually of a sexual kind) evokes a flood of memories involving a similar kind of body experience.  The individual then experiences particular physical symptoms, which are presumably identical to those that were experienced at the time of the abuse.

Whereas flashbacks are generally psychological, body memories are considered to be the physical analogy of the flashback.  They are believed to provide even more compelling confirmation that the abuse took place.  The body memory theory has been especially invoked in situations in which the abuse occurred before the age of one or two, the age below which human beings are not considered capable of recall.  The theory is that the mind may not remember the event, but the body is able to.  Accordingly, when an individual alleges that she was sexually abused at the age of four months, it is not her brain that is bringing about the recall, but the body's memory of the event, especially those parts of the body that were directly engaged in the sexual acts.  The theory here is that these organs have some kind of a memory that acts independently of the brain.  It is claimed that certain circumstances may have the effect of "reminding" these latent memory cells about certain past events (especially sexual traumas that the particular organ was subjected to) and they are thereby brought into action and produce the physical sensations that the individual experienced at the time of the original trauma.

This body memory concept is a true testament to the ability of the human being to rationalize the preposterous.  If this theory is true, then we have been wrong all these years when we have believed that memory resides only in the brain.  According to these people, there are also memory cells in those organs involved in sexual activities, e.g., the vagina, the penis, and the anus.  Of course, no one has yet demonstrated these pockets of neurological memory cells in these organs, but this does not dissuade the believers from their conviction for their existence.

Actually, I should be less mocking of these people and should appreciate that they may be on to something that can be a boon to medicine and should be a source of hope for people with Alzheimer's disease, brain tumors, and other degenerative diseases of the brain.  These pockets of memory cells could be transplanted from the genital organs or anus to the brain, thereby restoring the individual to normal memory.  Or, people might be able to be trained to use these cells as satellite brain replacements.  Such brain cells in the genitals could conceivably contribute to a reduction in unwanted pregnancies (please excuse the pun) and sexually transmitted diseases (including AIDS).  Furthermore, an individual might even be trained to think with his or her anus!
  

Accretion

Another relevant principle of memory is that of accretion.  Normally, we forget a vast majority of all things that happen to us.  If we were to continually keep in memory — especially conscious awareness — all the things that occur, we would be driven insane.  There must be a process of repression and suppression.  There must be a process of relegation to the unconscious of the vast majority of memories.  All of us may exhibit the phenomenon of progressive elaboration of a memory after initial recall.  More specifically, a long-forgotten event may be brought into memory by some external evoking stimulus (such as a friend or relative reminding us of the experience).  Initially, we may recall only a small fragment of the event.  However, with further discussion and mental searching, we may be able to retrieve from our memory bank progressively more material about the event.  This is normal.

These therapists will frequently use a fragmentary memory of a presumably long-past sexual encounter as the point of departure for the accretion process.  They will continually encourage their patients to think deeper and harder in order to extract from the storage compartments of their mind ever more detail about the alleged sexual encounter with the father.  When the patient complies with these requests, the elicited "memories" are considered to be verifications of the fact that there was indeed sexual trauma.

What is not considered is the alternative explanation that the progression of provided fantasies has nothing to do with the accretion process but is related to the suggestions of friends, relatives, the therapist, the public media, the ambient sex hysteria, and the wish of the patient to provide such material.  Ostensibly, the process for both true and false accusations is the same.  However, two very different things are going on here.  In the case of the true accusation, the process of accretion is normal and expected.  In the case of the false accusation, the process of accretion results from human fantasy and suggestibility.

These therapists will provide support for their position by pointing to the fact that there are indeed sexually abused women who do indeed exhibit the accretion phenomenon and will — quite honestly and accurately — provide increasing details of actual sexual experiences.  Their critics argue that one can obtain the same results by the process of suggestibility.  This is one of the knottiest problems confronting those who are trying to differentiate between true and false sex-abuse accusations.  In such cases, one must look to other sources of information, information unrelated to the accretion phenomenon, in order to decide whether the accusation is true or false.
  

Commitment to the Concept of a Memory-Free Hiatus

A typical scenario provided by adult women who claim that they were sexually abused as children is one in which they learn, sometime in adult life, that they were sexually abused in childhood, often in infancy.  They usually claim total amnesia for the events until the moment of recent revelation.

There are certain aspects of this hiatus that can provide examiners with important information regarding whether the accusation is true or false.  First, anyone who claims to recall events that occurred before the age of one is probably providing a false accusation.  Most people cannot recall any events in their lives prior to the age of four or so.  There are some who appear to be recalling accurately events that took place when they were three.  Most knowledgeable experts in this area agree that memories dating back to the age of two are more likely to be repetitions of parental renditions that, over the years, have become believed by the child.  These memories would be in the category of those described already by Piaget regarding his memory of his nursemaid protecting him from a kidnapper when he was two years old.  Those who claim memory back to the age of one, in the opinion of most experts, must be fantasizing.

The general consensus is that the child's brain cannot cognitively recall and organize events well enough to provide coherent memories of events during the first year of life.  But the therapists described here have no suspicions about memories of events that took place in the second and third year of life and are even deeply committed to memories that took place in the first year of life.  (They are helped along here by their commitment to the body memory concept.)  This receptivity lessens their credibility when claiming that the sex-abuse accusations are real.

In addition, these therapists have a deep commitment to the concept of the memory-free hiatus, during which time there was absolutely no recall of the sexual events.  In some situations, the hiatus of repression may have credibility; in others it is highly improbable (if not impossible) and lends weight to the conclusion that the accusation is false.  For example, if a woman claims that she was sexually abused throughout her childhood and adolescence, left the home at 18 because of a desire to remove herself from the indignities to which she was being subjected, then remembered nothing of her sexual experience until age 36 when the memories were uncovered in therapy, it is highly unlikely that she was sexually abused.  If one is to believe this scenario, one has to believe that from age 18 to 36 she was completely amnesiac for events that occurred from ages 2 to 18.  Anyone who believes this is as suggestible as the patients being described here.

More possible (although not probable) is the situation in which a woman may have been abused from ages 4 to 7, then repressed the memories of the trauma, and then recalled it in her mid-thirties, with or without "therapy."  Repression at age 6 or 7 of events that occurred over a two-to-three-year period is more credible than repressing memory of events that took place from ages 2 to 18.

Less important than the time span over which the abuse occurred is the age at which the abuse stopped.  It is understandable that one may forget events that took place when one was about 5 (all of us do).  It is less credible that memory experiences taking place throughout the teen years have been completely obliterated, especially if these experiences were viewed as traumatic.  Examiners do well, then, when trying to assess whether such an accusation is true or false, to define as clearly as possible the time frame of the original alleged abuse, the time frame of the hiatal period of alleged amnesia, and the age at which the individual came to the realization that she had been sexually abused.

This leads us to a central problem faced by those asked to ascertain whether an adult's previously repressed accusation of sex abuse is true or false.  The principle is best introduced by two vignettes that demonstrate the extremes on a continuum.  At the one end, for example, is a woman of 25 who was sexually abused between ages 3 and 5 and repressed the memories for 20 years, first recalling them at the age of 25.  Furthermore, if such recollection did not take place in the hands of an overzealous therapist of the kind described above, it may very well be true.

At the other end of the continuum is the 25-year-old woman who claims that she was sexually abused between ages 3 and 21, repressed entirely memories of the abuse for four years, and then realized she had been abused while in treatment with an overzealous therapist.  Under these circumstances, the accusation is likely to be false.  The guidelines, then, are these: the longer the period of abuse, especially abuses that extend into the teen period (and even later), the less the likelihood of its being repressed.  In addition, the shorter the period of repression, especially repressions in which the time frame is completely within the confines of adult life, the greater the likelihood the accusation is false.  In the hands of an overzealous therapist, these criteria for the false accusation are more likely to be satisfied.

Another factor relevant to this hiatal period is the absence of symptoms (as opposed to memory).  If indeed the individual was traumatized during the time frame of the abuse, it is likely that there will not only be memories of the trauma (especially if the trauma was discontinued in the teen period), but residual symptoms that can be directly related to the trauma and not inferred by some great leap of illogical logic.  The greater the freedom from symptoms during this hiatal period, the greater the likelihood the accusation is false.  Therapists often justify the symptom-free hiatus with the argument that even DSM-III-R provides for a delayed-onset type of PTSD.  It is certainly true that DSM-III-R describes a delayed-onset type of PTSD.  However, what they fail to appreciate is that delayed onset is not necessarily synonymous with symptom free. What is being referred to in DSM-III-R is a situation in which, following the trauma, the individual did indeed have symptoms, but they were not great enough and frequent enough to warrant the PTSD diagnosis.  Then, possibly because of other stresses, the individual does warrant the diagnosis.  Vietnam veterans with the delayed-onset type of PTSD have not left the combat zone clean-free of symptoms.  Rather, they do suffer with symptoms prior to the period when the PTSD diagnosis becomes warranted.
  

Multiple Personality Disorder

When I was in medical school and residency training, I was taught that the multiple personality disorder (MPD) was extremely rare.  I saw no such patients in medical school and saw only one patient with MPD throughout the five years of my internship and residency training.  In recent years, many psychiatrists hold that the disorder is much more common than previously realized and that an important etiological factor is childhood trauma that is dealt with by dissociation.  Grinspoon (1992a) provides an excellent definition of dissociation:

Dissociation can be described as a process or experience in which the unity of consciousness is disrupted, normal integrated awareness is disturbed, and mental functions are separated into complexes that operate autonomously.  Connections, continuity, and consistency are lost; the sense of identity changes, groups of memories, feelings, and perceptions are relegated to separate compartments or buried in oblivion from which they may suddenly emerge (p. 1)

People who have devoted themselves to the study of individuals with MPD claim that it is frequently associated with childhood physical and/or sexual abuse and that the dissociative process protects the individual from conscious awareness of the painful thoughts and feeling associated with the abuse.  Not surprisingly, people who feel the need to support a false sex abuse accusation have jumped on the MPD bandwagon.  Now we are taught that it is much more common than we have previously realized and that MPD is the plight of many sexually abused individuals.  Of course, the individual may not realize that he or she is suffering with MPD, but this is not surprising because the disorder involves the process of "dissociation," which, by definition, means that the individual is not consciously aware of what is going on within himself.  (However, the therapist is.)

And this brings us to one of the central problems in psychoanalytic theory and treatment.  The theory is based on the assumption that there are mental processes that are beyond the realm of conscious awareness, i.e., in the unconscious compartment of the mind.  I personally believe that there are unconscious processes, dreams being an excellent example.  One of the problems with psychoanalytic theory is that of demonstrating and/or proving that specific thoughts and feelings are indeed stored in a particular individual's unconscious mind.  Often what is considered to be present in the patient's unconscious mind is present only in the psychoanalyst's conscious mind.  If the patient denies any awareness of such material, the analyst can say, "Of course you don't know about it.  It's in your unconscious."

This presents a no-win situation for the patient as well as anyone who might be dubious about the validity of the analyst's statement.  As a psychoanalyst myself, and as someone who has served for many years on the faculty of a psychoanalytic institute, I am familiar with this problem.  It is one of the reasons why I no longer serve on a psychoanalytic faculty.  Imputing unconscious memories of childhood sex abuse is one recent offshoot of psychoanalytic theory.

Until recently, the controversy within psychiatry regarding the prevalence of MPD was a relatively minor one and was confined to whether it was a very rare or just a rare disorder.  No one paid very much attention.  Now it has become center stage, not because it has gotten more common, but because the childhood trauma factor has enabled overzealous and even fanatic examiners to seize upon this medical-psychiatric disorder to give "scientific credibility" to their allegations.  This is similar to the way the post-traumatic stress disorder has been used for this purpose.

Because there is no "sex abuse syndrome," overzealous examiners have to find other DSM-III-R entities to justify and provide credibility for their allegations.  Abused children who deny they were abused are considered to have been abused but are "dissociating" the thoughts and feelings associated with their trauma.  These children are considered to be individuals who will ultimately become diagnosed as MPD.

Interestingly, many of these people say "disassociating" rather than "dissociating."  Their misspelling of the term is yet another example of their ignorance of the sources from which they are borrowing material.  (So widespread is their misuse of the word that I would not be surprised if theirs becomes standard spelling within the next few years.)  Adults who are not consciously aware of the fact that their psychiatric problems are derived from childhood sexual abuse can be considered to be suffering with MPD and, in the hands of an allegedly skilled therapist, will be able to tease out conscious awareness of their abuse.  Coons (1986) describes in detail this delicate process.

Aldridge-Morris (1989) is critical of the widespread application of the MPD diagnosis, especially as a way of justifying sex abuse.  Aldridge-Morris states "One should only diagnosis multiple personality when there is corroborative evidence that complex and integrated alter egos, with amnesic barriers, existed prior to therapy and emerge without hypnotic intervention by clinicians."  I am in full agreement with Aldridge-Morris.  He recognizes that there are some individuals who indeed suffer with MPD and that this disorder might very well have resulted from early childhood traumas, including sexual.  However, he also holds that it is being overdiagnosed and that one way of differentiating between those who genuinely warrant the diagnosis and those who do not is to use the criterion regarding whether the disorder existed prior to "therapy," especially therapeutic techniques such as hypnotherapy.  The reader who is interested in a sober statement on the dissociative disorders does well to refer to Grinspoon's articles (1992a, 1992b).
  

Hypnotherapy

Many of these therapists have a deep commitment to hypnotherapy, which they believe to be an extremely valuable tool for uncovering repressed material.  Whether hypnotherapy is truly capable of doing this is a point of controversy.  What is less controversial is the fact that there is a strong relationship between hypnotizability and suggestibility.

In order to be hypnotized, one must be suggestible.  Basically, when one goes into what is referred to as a hypnotic trance, one is putting oneself in a dependent position in relationship to another person and demonstrating a willingness to comply with the requests and suggestions made by the hypnotherapist.  This refers to more than the mechanical acts of lying down, shutting one's eyes, and raising and lowering one's arms in compliance with the therapist's suggestions.  These are obviously the most objective and easily observable manifestations of the patient's receptivity.  More subtle, and more difficult to objectify, is the patient's willingness to provide the specific kind of information that the therapist is requesting.  There are many situations in which the patient and therapist together enter into a fantasy world in which the patient provides just the kind of fantasies the therapist is asking for.  These may have absolutely no basis in reality, but are provided because the therapist is asking for them and the patient, for many reasons, wishes to comply with this request.

One of the more dramatic examples of this phenomenon was seen many years ago, when significant attention was given to a book written by a woman named Bridie Murphy.  She claimed that in the skilled hands of a hypnotherapist, she not only was able to regress to the earliest weeks of her life, but could regress back to a previous existence in Ireland many years before her birth.  She had never been to Ireland, but her recounting of a wide variety of experiences that allegedly occurred to her earlier self were convincing with regard to the detail they provided about life in Ireland during that period, which was before she was born.

However, subsequent to the publicity and notoriety that Bridie Murphy enjoyed, it was learned that, as a child, she had an Irish nanny who spent many hours telling her about her experiences in Ireland, experiences that served as a nucleus for the fantasies provided the hypnotherapist.  The book not only served to enhance general belief in the power of hypnotherapy to uncover unconscious memory, but even gave support to the theory of reincarnation.  Accordingly, we are not dealing here merely with the suggestibility of the patient and the suggestibility of the therapist, but the suggestibility of the people who believed all of these preposterous revelations that were allegedly uncovered by hypnotherapy.

Hypnotherapy can play a role in the treatment of some patients for certain specific conditions. It is not, however, any more effective in bringing into conscious awareness unconscious material than simply relaxing in an environment without competing stimuli and trying consciously to recall earlier events.  But of greater importance is the fact that more suggestible people are more easily "hypnotized."  The fact that more suggestible people are more likely to be hypnotized increases the likelihood that these same people are more likely to "remember" childhood sex abuse than those who are not so easily hypnotized.  Accordingly, those who seek hypnotherapy and those who are good candidates for hypnotherapy are also the same people who are more likely to provide fantasies about sex abuses that never took place.
  

Belief in the Child's Capacity to Make Extremely Subtle Differentiations

Most good and devoted fathers undress their children, bathe them, and help them when they go to the bathroom.  Such activities inevitably involve a certain amount of contact with the child's genitals.  When the contact involves the hand of the parent to the genitals of the child, it is extremely difficult — if not impossible — for the child to differentiate between contact that is associated with sexual arousal on the adult's part and contact that is not.  And this is especially the case if the adult is a female.  But even if the adult is a male, there may not be an apparent erection.  But even if the adult's penis was erect, it is not likely that the three-year-old child is going to appreciate the link between that phenomenon and sexual arousal.  Therapists who promulgate false sex-abuse accusations ignore children's inability to appreciate such differentiations and accept as valid the patient's statement that the activity was engaged in with sexual intent on the part of the parent.
  

Belief in Preposterous and Extremely Unlikely Events

One of the hallmarks of the false accusation is the inclusion of preposterous and even impossible events.  One accusing woman stated that she was so embarrassed by the fact that her father had put his finger in her vagina when she was three years old that she did not permit her mother to bathe her thereafter.  Her mother — now the wife of the father she was accusing of having molested her — denied that this was the case and claimed that she had continued to bathe this child up to the age of eight or nine, after which time she could trust her to bathe herself.  The mother claimed, as well, that she certainly would have been concerned about her three-year-old child refusing to be bathed.  Furthermore, the mother pointed out the obvious fact that three-year-old children are not famous for their ability to bathe themselves and no one ever complained about this child's hygiene.

Not surprisingly, the accusing woman's therapist accepted her patient's rendition as completely valid.  Also not considered here was the fact that the insertion of a finger into the vagina of a three-year-old is likely to produce pain and bleeding, so tender are the hymenal and surrounding tissues at that age.  Under these circumstances it is hard to imagine the child's not bringing this to the attention of the mother, either voluntarily or involuntarily.

Another woman claimed that following her "rape" at the age of two-and-a-half, there was extensive bleeding that lasted two or three weeks.  She described herself as literally sopping up large amounts of blood and hiding the blood-stained rags and towels in various parts of the home because her father had threatened her with dire consequences if she ever divulged the sexual activities to the mother.  I will not address myself to the question of whether such extensive loss of blood would have produced fainting, dizziness, and at least some symptoms of anemia.  More important here is the incredibility of the story because if it is true, one has to believe that the mother never once found any of these rags and towels that were saturated with blood.  Two-and-a-half-year-old children are not famous for their ability to hide blood saturated materials in various parts of their home.  Yet, both the mother and the daughter agreed on this point: the blood saturated rags were never found by the mother.

Of course, once again, the therapist believed that the patient's rendition had to be valid because the divulgence was made in the course of a hypnotic trance.  Also ignored is the fact that the insertion of an adult male penis into the vagina of a two-and-a-half-year-old would not only result in pain and bleeding, but lacerations that would require immediate medical attention involving suturing of lacerations, which, because of the age of the child, would usually have to be done under general anesthesia.

In another case, the woman claimed that she was sexually molested by her uncle when she was between ages two and five.  She had gone into therapy suspecting sex abuse, but it was only in treatment that her "brilliant" therapist helped her uncover these memories of this now deeply repressed trauma.  And hypnotherapy (thank God for it) was of invaluable assistance in the uncovering process.  She did not disclose recognition of this abuse until about two years into therapy, at which time she engaged the services of a lawyer and started to move down the legal track.  The uncle consulted an attorney and informed him that during the time frame when his niece was allegedly abused, he was serving in the US. Navy in the South Pacific (from 1942 to 1945).  During this time frame he had not once set foot in the United States.  When the accusing woman learned, through her attorney, that this was the case, she and the therapist quickly came up with the explanation that they had gotten the ages wrong and that it was really ages five to seven.  The delusion had to be changed to justify its perpetuation, but this alteration appeared to be a "minor adjustment" and the case rolled on.

Examiners do well, then, to remember that the greater the number of improbable, preposterous, and even impossible elements included in the scenario, the greater the likelihood that the accusation is false.
  

Failure to Interview the Accused Father

Typically, these therapists show little if any interest in speaking directly with the accused father.  I personally have not yet come across one such case in which the father has been invited to meet with the therapist, and in all those cases that have come my way, the therapist has refused to meet with the father, even when he has beseeched her to do so.  The usual reason for refusing to see the father — a reason provided both by the therapist and the accusing daughter — is, "There was no point in wasting my valuable time on him because he would only deny it anyway."  Such rejection only produces a deepening of the father's sense of helplessness, frustration, and a feeling of impotent rage.  It must be remembered that these therapists are generally angry women, many of whom are on a lifelong vendetta against men.  Anything they can do to hurt men provides them with a sense of morbid gratification.

A truly neutral therapist, a therapist who had a balanced view regarding whether or not the abuse took place, would welcome input from the father in order to get information that might help make the differentiation.  The failure to see the father is a strong statement of the therapist's bias and is one of the hallmarks of the false sex-abuse accusation.
  

The Destruction of the Father-Daughter Psychological Bond

The failure to interview is only the first step in a process that leads to the attenuation and ultimately the destruction of the father-daughter psychological bond.  Most competent therapists appreciate that even if the sex abuse did indeed take place, this in itself is not necessarily a reason to eliminate the father-daughter bond.  And this is especially the case if there has been a reasonably good relationship between the father and the daughter.  This is even more the case if there are grandchildren who themselves have had a good relationship with the alleged abuser.

Instead, such therapists believe that the best way for these women to work through their reactions to the abuse is to remove themselves entirely from their fathers.  In the course of treatment, the woman is taught to hate her father and to view him as a despicable individual who deserves only scorn, rejection, and punishment.  Any positive thing he may have done, either at the time of the alleged abuse or subsequently, is not considered to have any redeeming value.  So heinous has been the crime he has committed that nothing good he may have done in the whole life of the accusing woman can in any way counterbalance the traumatic effects of the abuse.  The therapy, then, fans the flames of hatred that come to consume the patient.  And the hatred then extends to all those who may support the father's position.  This misguided and sadistic approach to the father is also one of the hallmarks of the false sex-abuse accusation.

Commonly, these therapists conduct group therapy.  In some cases, all members of the group are individuals who have been sexually abused as children and they meet in order to provide "support" for one another and to help each other deal with the residual traumatic effects of their abuse.  In other cases, there are individuals who have come to treatment for a variety of problems and have never considered the possibility that their problems the result of childhood sex abuse.  One of the purposes of introducing them into the group is to help them uncover what they have probably repressed and, predictably, with enough group support and encouragement, they inevitably uncover this repressed unconscious material.  This, of course, is another statement of the gullibility of the human being, a gullibility which is necessary for the success of these therapists.

The Assumption that a Sexual Encounter Between an Adult and a Child Is Automatically Psychologically Detrimental

Sexual activities between adults and children are a universal phenomenon, have been practiced all over the world, and exist even to this day to a significant degree in every culture.  Although less common in countries which are part of the Judaeo-Christian ethic, the practice is still highly prevalent in these countries as well.  One can view adult-child sexuality to be related to the subjugation of women which is also an ancient tradition.  Women and children, being weaker than men, have been easily exploited by the more powerful.

However, and this is an extremely important point, such encounters are not necessarily traumatic.  The determinant as to whether the experience will be traumatic is the social attitude toward these encounters.  As Hamlet said: "There is nothing either good or bad, but thinking makes it so."  Elsewhere (Gardner, 1992), I have given examples of societies in which such experiences were not traumatic and, even in our society, not all adult-child sexual encounters are psychological damaging.  Studies of our culture — which do not start with the bias that they must be psychologically damaging — provide clear demonstration of this.  In short, there are many women who have had sexual encounters with their fathers who do not consider them to have affected their lives detrimentally.  There are others, however, who have been seriously damaged by these encounters.  I am not recommending the practice; I am only describing the reality of the world.

Of relevance here is the belief by many of these therapists that a sexual encounter between an adult and a child — no matter how short, no matter how tender, loving, and non-painful — automatically and predictably must be psychologically traumatic to the child.  This belief justifies lengthy, ongoing therapy ("No one knows how long it will take.  It will certainly take many years.")  Obviously, if the therapist did not take this position, then she would not be able to enjoy the financial rewards attendant to this belief.  A derivative of this is the encouragement of lawsuits, the purpose of which is to extract as much money as possible from the father, money which will presumably allow vengeance gratification, but which will also pay for the treatment.
  

The "Enablers"

Alcoholics Anonymous uses the term "enablers" to refer to those individuals with whom alcoholics involve themselves — individuals who contribute to the promulgation of the drinking problem.  They are also referred to as "codependents."  These are people who have a vested interest in the maintenance of the problem because it feeds into their own psychopathology in some morbid way.

Women who promulgate false accusations of sex abuse against their fathers typically surround themselves with enablers.  I have already mentioned the process by which those who support the father are rejected and are removed entirely from the life of the mother and her children.  This is part of the process by which these women acquire their enablers and weed out those who will not provide support.

Often the accusing woman is married to a man who passively goes along with his wife's accusation.  My experience with these men is that they suffer with one or more of the following defects: passivity, limited intelligence, fear of asserting themselves against their wives, defective independent thinking, and shared paranoia.  In some cases they have involved themselves in a folie--deux relationship with their wives.  They know, however, that if they were to actively claim that the sex abuse accusation sounds "hokey," they may very well find themselves divorced.  They have been observers to the quick rejection of all those who even suggest that the father might be innocent, and they fear that they too will quickly be thrown on the garbage heap if they express any doubt about the validity of the accusation.

The accusation may result in a civil war within the family.  All brothers and sisters are required to join one side or the other.  Those who are neutral and want to stay out of it may similarly find themselves rejected.  Only those who come out directly in support of the accusation have any chance of having a relationship with the accuser.  A therapist of the father, who might want to enlist the aid of one of the siblings, is not likely to be successful.  Any sibling on the side of the father is rejected, scorned, or treated as if he or she did not even exist.  Accordingly, that person's assistance cannot be elicited by the therapist to help resolve the family problems.  If the person is on the side of the accusing daughter, it is extremely unlikely that he or she is going to accept an invitation to come to the father's therapist's office for purposes of bringing about rapprochement.  And, not surprisingly, invitations by the father for his daughter to come to another therapist with him — even for the purpose of a consultation — are routinely rejected.  There is only one therapist such women trust and that is the one with whom they have the folie--deux relationship.

Throughout the United States there is a network of groups that provide support for battered and abused women.  Many of these have "underground" divisions which provide protection for women whose husbands would indeed pursue, beat, and even kill them if they were to be found.  There is no doubt that such groups may play an important role for some women who are physically abused by their husbands.  This is especially so because legal and other community services designed to protect such women generally operate at an extremely low level of efficiency.  However, my experience has been that the people who administer such groups are somewhat indiscriminate with regard to the women whom they take under their wings.

My experience also has been that some (I am not saying all) of the women who are active in these groups are so filled with rage that they lose their objectivity with regard to dealing with the husbands of the women they are sheltering, as well as men in general.  Many are fanatic and some are paranoid.  Operating with such a head of rage, they are likely to lose objectivity with regard to discriminating between women who genuinely need their services and those who are using them for other purposes.  Women who promulgate false sex-abuse accusations may very well enter the system in order to go into hiding and gain assistance for relocation in a secret place.  For many such accusing women there is no distance great enough to provide them with safety.  Moving 3000 miles away may not be considered inconvenient if it can provide them with a feeling of some safety.

It is important to appreciate that some (I am not saying all) of the women who organize and administer such protective group networks and "underground railroads" for women, abused children, and other groups seeking safety from persecutors may be operating with the utilization of the reaction formation mechanism.  Their obsession with protecting children may be a thin disguise for their basic desire to harm them.  In one case the worker in such a "shelter" stated: "When these kids come in most of them deny they were sexually abused.  But, after a few days here, after speaking to other kids who were abused, they become more comfortable talking about it, and after a week or so everybody discloses their abuse."

The idea that these children are exhibiting the "keeping-up-with-the-Joneses" phenomenon is not even considered.  Denial of this possibility provides them with an excellent opportunity to vent rage on all the men against whom sex-abuse accusations are made, accusations derived from this setting.  Under the guise of helping and protecting children, they are really setting up a situation that results in their destroying them.  It is not surprising, then, when some of these people are then subsequently brought up on charges of abusing children themselves.  In such cases, the reaction formation mechanisms break down and the basic sadistic impulses reveal themselves.

Of course, the aforementioned therapists and the therapeutic groups that they provide must also be listed among the enablers.  This is especially the case if the groups consist entirely of people who are trying to provide "support" for one another because they have all been sexually abused as children.  The need for such a group belies the underlying weakness of the allegation, which is basically like a house of cards and could be "blown out of the window" by reasonable and healthy individuals.  In many cases, it is so patently absurd that only a retarded or psychotic person would believe it.  Yet, so great is the gullibility and suggestibility of many human beings that even the most preposterous scenarios may gain credibility.

Friends in the neighborhood and supporting relatives should also be added to the list.  Because the accusation is basically weak, the woman needs to surround herself with supporting individuals who will help maintain the delusion.  Adult women who were genuinely abused in childhood do not generally need to surround themselves with such a coterie of supporting individuals.  The presence of the coterie of enablers is one of the hallmarks of the false sex-abuse accusation and is generally not seen in women who have been genuinely abused.
  

The Money/Power Factor

Sex abuse is big business.  There is lots of money to be made by a whole parade of individuals who involve themselves in these cases.  Adult women who accuse their fathers of child sex abuse may very well turn to a lawyer for assistance.  Considering the fact that in the United States there is approximately one practicing lawyer for every 340 people (1991 figures), it is reasonable to say that there are innumerable hungry lawyers who are happy to take money from any client, no matter how absurd the complaint.  I am not claiming that all lawyers are this greedy and indiscriminate with regard to whom they take on as a client; I am only claiming that there are enough such types around to make it quite easy for women in this category to obtain legal assistance.

Then, there are the subgroup of lawyers who are paranoid.  Paranoids gravitate toward the law because, in part, it provides them with compensation for feelings of inadequacy via the utilization of a powerful structure which insures that "justice will be done" and that "wrongs" will be made "right."  Not surprisingly, those paranoid women who find paranoid therapists are also likely to gravitate toward paranoid lawyers.  We then have a folie--deux which will predictably cause the accused father formidable grief.  Paranoia and litigation go hand in hand.  Waving the flag that justice must be done, the three together seek to gain redress in a court of law and thereby obtain "proof' that the abuse did indeed take place.  Because the allegation is basically like a house of cards resting on sand, the need for this external and formidable proof becomes more compelling.

The lawyer, of course, has been enlisted not only to prove in a court of law that the father is guilty but to gain punitive damages and money for the woman's therapy.  And the lawyer, obviously, must also be paid for his or her services.  This is only "just" because it was the father who caused all this trouble in the first place by his indulging himself in animal behavior with an innocent child who was too tender in years to protect herself.  In many of these cases the blackmail element is apparent, especially when the daughter threatens the father that if he does not pay X amount of megabucks, she will press criminal charges and not just keep the case in the civil courts.

When there is money to be made, exploiters will be quick to jump on the bandwagon.  I was involved recently in a case in which an ex-daughter-in-law approached her former father-in-law — a man of affluence — and told him that if he did not provide her with $500,000 (tax free), she would accuse him of sexually abusing his grandchildren (with whom he had a deep relationship).  Thus rebuffed, she reported him to the local child protection services who, predictably, descended upon this man like gangbusters.  Naturally, the "validators" were armed with their anatomical dolls and, predictably, they concluded that all five of his grandchildren were victims of sex abuse.  Although he did not submit to this blackmail, it cost him thousands of dollars in legal fees to exonerate himself.

In recent years, legislators have been besieged by requests for increasingly more money to be allocated to clinics serving people who have been sexually abused.  Most of this money has gone for the evaluation and treatment of children but, considering the increasing number of adult women who are belatedly alleging sex abuse, these clinics are now facing a new "challenge," namely, dealing with yet another segment of the population requiring their services.  It is not very "political" for a legislator to refuse to vote for money for such a worthy cause.  Furthermore, these clinics are easily demonstrating an ever-growing population of abused individuals who are. in desperate need of their services.  When money is allocated only for the treatment of abused people, it is obvious that those who are falsely alleging abuse (those who are lying or delusional) are not likely to be designated as such because if the clinic does so, it will have less justification for demanding funds.

In the last few years, we have seen yet another development — a development that could almost have been predicted — modifications of statutes of limitations.  Traditionally, those who commit criminal acts have enjoyed a certain period beyond which an accuser could no longer gain redress in a court of law.  For example, seven years is a common limitation for initiating accusations of homicide.  And lesser crimes generally involve shorter statutes of limitations.  Obviously, a woman claiming sex abuse 35 years after the alleged crime could not press charges unless there had been some modification of the statutes of limitations.

In many states, recently, such statutes have been changed so that the statute's time frame is not calculated from the actual date of the crime's commission, but from the time the woman first realized she had been abused.  Accordingly, if a woman was allegedly abused at age 3 and at the age of 40 (37 years later), while in hypnotherapy uncovers unconscious material that leads her to the conclusion that she was abused at age 3, she could press charges up to the age of 47 (under a seven-year statute of limitations calculated from the day she appreciated she was sexually abused).

If the accused had murdered his daughter, there would only be a seven-year statute of limitations.  However, because he is accused of committing the abominable crime of sex abuse, the statute of limitations (for him) has been extended to 44 years.  We see here yet another example of how Constitutional safeguards are being ignored in the service of prosecuting individuals who are being accused of sex abuse.

Our founding fathers crafted our Constitution ever mindful of the abominations that those in power have perpetrated upon the weaker and helpless.  Constitutional safeguards, more than anything else, were designed to protect individuals from these depravities.  Statutes of limitation are an excellent example.  Statutes of limitation serve two primary purposes: (1) they protect defendants against irrational and excessive punishments that are likely to be meted out in times of hysteria, and (2) they increase the likelihood that defendants will be able to avail themselves of credible witnesses.  In most states, there is a three-year statute of limitation on most misdemeanors and a five-year statute of limitations on felonies.

Adult women who claim they were sexually abused as children are clamoring for changes in these laws, changes that would calculate the beginning of the period of the accused's vulnerability from the time she first realized she had been sexually abused.  Some of these women have been sexually abused, and some of them have not.  In either case, this change in the statutes would deprive such defendants of a fundamental constitutional right, considered to be one of the cornerstones of the U.S. Constitution.  The modification of these laws would deprive sex-abuse defendants of these safeguards in an atmosphere that is exactly of the kind the founding fathers were trying to protect defendants from, namely, an atmosphere of hysteria in which defendants would be deprived of credible witnesses.

Not surprisingly, most lawyers are in favor of these modifications because they would provide more opportunities for lawsuits, lawsuits that the present statutes of limitation would prohibit.  Because many (if not most) legislators are lawyers who combine private practice with their legislative obligations, it is likely that these modifications will eventually be instituted in most states.  At this point (July 1992), the best information I have is that 21 states have now passed such legislation and many others are in the process of giving serious consideration to these changes.  In short, the trend is sweeping the nation at a very rapid rate, and the likelihood of the trend reversing itself in the near future is extremely small.

There is a question as to whether those states that have introduced these modifications are passing laws that are unconstitutional.  Even murderers are protected by statutes of limitations, generally five to seven years.  Also, murderers today are given shorter prison sentences than sex abusers and are more likely to get out on parole earlier.  This is just one example of the hysteria of our times, hysteria that is prevailing over reason and justice.  I can appreciate the desire of those who have been genuinely abused to take action against those who have victimized them.  However, until we have developed exquisitely sensitive criteria for differentiating between true and false sex-abuse accusations in this category (the guidelines presented here are an initial offering), changes in the statutes of limitations are dangerous.  They open the floodgates for the hysterical false accusers, with tragic consequences for the victims of their false accusations.

Mention has been made of the immunity from lawsuits enjoyed by those who promulgate false allegations of sex abuse.  Such immunity also serves the ends of the money/power structure.  Individuals who falsely accuse cannot be countersued for perjury or libel unless malice can be proven.  Because malice is an internal psychological state which cannot be objectively measured, it is almost impossible to prove malice in such cases.  Although it may be obvious that the motives were indeed malicious, it is very difficult to prove this in a court of law.  Because false accusers cannot be brought up on charges of perjury and libel, that route of redress is not available to the accused.  Such statutes, although passed with the ostensible motive of protecting individuals from being sexually exploited, has the effect of keeping in business the power/money structure that thrives on sex-abuse allegations, whether they be true or false.
  

Concluding Comments

At the time I write this (July 1992) I have the feeling that the phenomenon of belated sex-abuse accusations by adult women is only in the earliest stages of its growth.  The combination of human suggestibility, gullibility, and avarice will predictably fuel this expansion of the phenomenon.  I suspect that there will be many more such accusations in the immediate future.  Recently (1992) the False Memory Syndrome Foundation (a tax-exempt research and educational foundation recently set up by falsely accused parents) conducted a survey.  The following "therapy techniques" were described to have been utilized in bringing about the disclosures:

Satanism expert brought in

Prayer therapy
Primal scream therapy
Sodium amytal
Psychodrama
Meditation
Trance writing
Regression therapy
Nero-linguistic programming
Yoga
Fasting
Massage therapy
Astrology
Channeling
Crystals
Reflexology
Massage therapy

These sources of the disclosure are testament to the conclusion that fanaticism is running rampant here.

The crucial question is: What can be done about this?  I believe that books such as mine may play a role (admittedly small) in bringing to the attention of all concerned parties what is going on.  Perhaps with more appreciation by the public of how its monies are being spent, there will be a tightening up of legislative funding of those clinics that are contributing to the promulgation of this scandal.  I believe that the immunity from being countersued that sex-abuse accusers enjoy has done much more harm than good.  I believe that such laws should be rescinded.  If this is accomplished, then it will be much easier to institute lawsuits against false accusers and this may have the effect of discouraging frivolous accusations.

To the best of my knowledge, there have not been enough lawsuits against the therapists involved in these accusations.  Fortunately, those who operate along traditional professional tracks (such as psychiatry, psychology, and social work) are protected from malpractice suits under the principle that a professional is only expected to practice at the level of competence standard for peers in that same community.  The therapists I have described here are not alone.  In fact, there are thousands of "therapists" who will be willing to come to court and claim validity to the "therapeutic" modalities described here.  I am certain that these therapists can provide a much longer parade of supporters than people like myself.  My hope is that books such as this will contribute to a change in this situation.

A compelling argument against the notion that ongoing traumatic childhood experiences can be totally repressed over many years is provided by the experiences of the Holocaust survivors.  I am convinced that if one were to obtain a list of people who were released from Nazi concentration camps in 1945, and one were to trace these people for interviewing in 1992, it would be a rare person who would have totally forgotten the experience.

I cannot imagine such a person saying, "concentration camp?  What concentration camp?  I have absolutely no memory of the experience" or "I had obliterated entirely any memories of having been in concentration camp" or "the whole experience was totally repressed.  However, in the skillful hands of my therapist I gradually recovered memories of the cattle cars, firing squads, rape of women, gas chambers, and the crematoria."  Possibly, there might be a very small percentage who did indeed repress some of their experiences, but there certainly would not be a flood of people now claiming dramatic "recall" of their childhood traumas.

Furthermore, I am certain that these survivors would not be found to have developed a multiple personality disorder, nor would they suddenly exhibit the signs and symptoms of a posttraumatic stress disorder 30 to 40 years after their release.  And this would be true of other people who were subjected to other forms of prolonged childhood trauma, such as chronic physical illness, physical abuse, wars, earthquakes, and ongoing emotional abuse.

In short, if we are to believe these "victims" and their "therapists," we have to consider childhood sexual traumas to be such a special kind of experience that a whole series of well-accepted psychological principles are inapplicable, and an entirely new set of psychological theories has to be invented to explain its alleged derivative symptoms.  A new set of psychological principles has to be accepted, principles totally at variance with everything we know about childhood trauma, our capacity for repressing it, and its residual manifestations in adult life.  This, then, brings me to a useful dictum:

"The most likely things are most likely."  The evaluator who keeps this obvious wisdom in mind will be in the best position to ascertain whether a sex-abuse accusation is true or false.
  

References

Aldridge-Morris, R. (1989). Multiple Personality: An Exercise in Deception (Hardcover)(Paperback). Hillsdale: Lawrence Erlbaum Associates.

Coons, P. M. (1986). child abuse and multiple personality disorder: Review of the literature and suggestions for treatment. Child Abuse & Neglect, 10, 455462.

Dawes, R. M. (1991). Biases of Retrospection. Issues in Child Abuse Accusations, 3(1), 25-28.

Gardner, R. A. (1992). True and False Accusations of Child Sex Abuse (Currently Out of Print). Cresskill, NJ: Creative Therapeutics.

Grinspoon, L. (1992a). Dissociation and dissociative disorders: Part I. The Harvard Mental Health Letter, 8(9), 14.

Grinspoon, L. (1992b). Dissociation and dissociative disorders: Part II. The Harvard Mental Health Letter, 8(10), 14.

False Memory Syndrome Foundation (1992, May 1). FMS Foundation Newsletter, p. 2.

Kolb, L. C., & Brodie, H. R. H. (1982). Modern Clinical Psychiatry (Out of Print)(Out of Print). Philadelphia: W.B. Saunders Co.

Toufexis, A. (1991, October 28). When can memories be trusted? Time, pp. 86-87.

* Richard A. Gardner is a psychiatrist, author, publisher, and lecturer at 155 County Road, P.O. Box 522, Cresskill, NJ, 07626-0317.  This selection is adapted from his 1992 book, True and False Accusations of Child Sex Abuse: A Guide for Legal and Mental Health Professionals  (Currently Out of Print), Cresskill, NJ: Creative Therapeutics[Back]

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