The Trauma Trap

Frederick Crews writes for the New York Review of Books in 2004:

In the 1980s, as McNally relates, day care workers risked prosecution and imprisonment on the coerced testimony of bewildered and intimidated three-year-olds who were prodded to “remember” nonexistent molestations. Meanwhile, poorly trained social workers, reasoning that signs of sexual curiosity in children must be “behavioral memories” of rape, were charging parents with incest and consigning their stunned offspring to foster homes. And most remarkably, whole communities were frantically attempting to expose envisioned covens of Satan worshipers who were said, largely on the basis of hypnotically unlocked “memories,” to be raising babies for sexual torture, ritual murder, and cannibal feasts around the patio grill.

In the same period many psychotherapists, employing hypnosis, dream analysis, “guided imagery,” “age regression,” and other suggestion-amplifying devices, persuaded their mostly female patients to “remember” having been molested by their fathers or stepfathers through much of their childhood, in some cases with the active participation of their mothers. The “perpetrators” thus fingered were devastated, embittered, and often publicly shamed, and only a minority of their accusers eventually recanted. Many, in fact, fell in with their therapists’ belief that young victims of sexual trauma, instead of consciously recalling what was done to them, are likely to develop multiple personalities. Disintegrating further, those unfortunates were then sent off to costly “dissociative identity” wards, where their fantasies of containing five, a dozen, or even hundreds of inner selves were humored until their insurance coverage expired and they were abandoned in a crazed condition. At the height of the scare, influential traumatologists were opining that “between twenty and fifty percent of psychiatric patients suffer from dissociative disorders”—disorders whose reported incidence plummeted toward zero as soon as some of the quacks who had promoted them began to be sued for malpractice.

What we experienced, McNally shows, was a perfect storm, with forces for mischief converging from every side. The fraudulent 1973 bestseller Sybil had already helped to relaunch the long-dormant fad of multiple personality and to link it to childhood sexual abuse. Beginning in the early 1980s, the maverick Swiss psychoanalyst Alice Miller taught many American readers what Sigmund Freud had once believed, that memories of early abuse are typically repressed and must be therapeutically unlocked if the resultant neuroses are to be cured. Jeffrey Masson’s melodramatic book The Assault on Truth (1984), misrepresenting Freud’s “seduction” patients as self-aware incest victims rather than as the doubters that they remained, fanned the feminist anger that Miller had aroused, encouraging women to believe that molestation by fathers must be pervasive. Self-help manuals such as The Courage to Heal (1988) then equipped scientifically ignorant psychotherapists with open-ended “symptom checklists,” ensuring that their patients would be diagnosed as suffering from buried memories of violation. And all the while, Geraldo Rivera and less cynical alarmists were whipping up fear of murderous devil cults.

* Like Holmes and Pope, McNally finds that no unanswerable evidence has been adduced to prove that anyone, anywhere, has ever repressed or dissociated the memory of any occurrence.

* …the 1990s recovered memory therapy made significant inroads into the practice of North American psychoanalysis. Even today, feminist clinicians bearing diplomas from analytic institutes are probing for missing memories of abuse and vigorously defending that practice in psychoanalytic books and journals. But the American Psychoanalytic Association, representing over 3,000 members, has turned a blind eye to this trend—and one can understand why. The psychoanalytic movement is already embattled, and too much about the historical ties between Freudianism and recovered memory would prove embarrassing if attention were called to it. The elected custodians of Freud’s legacy have no desire to confront his early phase as a self-deceived abuse detecter; or to admit the precedent he set, during that phase and thereafter, in treating dreams, tics, obsessional acts, and agitation in the consulting room as “behavioral memories” of inferrable traumas; or to revisit the grave doubts that have been raised about repression; or to be reminded of the way psychoanalysts, until quite recently, insulted real victims of molestation by telling them that their “screen memories” covered a repressed desire to have sex with their fathers. No longer given to excommunicating dissidents, the tottering Freudian patriarchy has made its peace with “recovered memory psychoanalysis” by pretending that it doesn’t exist.

* This reluctance to challenge the judgment of its therapist members is deeply rooted in the APA’s philosophy. Ever since 1971, when the association gave its blessing to Ph.D. and Psy.D. programs that omitted any scientific training, the APA has guided its course by reference to studies indicating that the intuitive competence of clinicians, not their adherence to one psychological doctrine or another, is what chiefly determines their effectiveness.

* PTSD, like Victorian hysteria and like recovered memory itself, can now be understood as an artifact of its era—a sociopolitical invention of the post-Vietnam years, meant to replace “shell shock” and “combat fatigue” with an enduring affliction that would tacitly indict war itself as a psychological pathogen. However crippling the symptoms associated with it may be for many individuals, the PTSD diagnosis itself has proved to be a modern contagion.

Once certified by the American Psychiatric Association as natural and beyond the sufferer’s control, post-traumatic stress disorder began attracting claimants, both civilian and military, who schooled themselves in its listed symptoms and forged a new identity around remaining uncured. By now, as McNally relates, PTSD compensation is demanded for such complaints as “being fired from a job, one-mile-per-hour fender benders, age discrimination, living within a few miles of an explosion (although unaware that it had happened), and being kissed in public” (p. 281). According to Paula Jones among others, PTSD can even be the outcome of a consensual love affair. In view of such examples, the attempt to subsume forgotten abuse under post-traumatic stress makes more cultural than scientific sense; the same atmosphere of hypersensitivity and victimhood brought both diagnoses to life.

* Attention to the chimerical task of divining a patient’s early traumas is attention subtracted from sensible help in the here and now. The reason why psychotherapists ought to familiarize themselves with actual knowledge about the workings of memory, and why their professional societies should stop waffling and promulgating misinformation about it, is not that good science guarantees good therapy; it is simply that pseudoscience inevitably leads to harm.

About Luke Ford

I've written five books (see Amazon.com). My work has been covered in the New York Times, the Los Angeles Times, and on 60 Minutes. I teach Alexander Technique in Beverly Hills (Alexander90210.com).
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