Wednesday, November 27, 2019

When Others Decide the Effects of Abuse

By David S. Prescott, LICSW, & Kieran McCartan, Ph.D.

A vital study that appeared a few weeks ago has attracted surprisingly little attention. Esme Fuller-Thompson (from the University of Toronto) and her colleagues examined 17,014 survey respondents, including 651 known to have a history of sexual abuse as children. From their findings:

Remarkably, two-thirds [65%] of the childhood sexual-abuse survivors in our sample met the   criteria for complete mental health -- defined as being happy or satisfied with life most days in the past month, having high levels of social and psychological well-being in the past month, and being free of mental illness, suicidal thoughts and substance dependence in the past year. While the prevalence of complete mental health among childhood sexual-abuse survivors is higher than we had expected, it is still substantially less than that found in the general population [77%]. (p. 6)

Not surprisingly, the study found that factors such as social isolation, chronic pain, and substance dependence were impediments to “complete mental health” (a term that describes the study’s goals accurately, but may be conspicuously, even amusingly, absent in the daily life of many readers).

These findings are far from surprising. Many of those working with people who have been traumatized are familiar with post-traumatic growth, with some professionals having experienced it personally. As our colleague Alissa Ackerman has observed, “You are never more than a stone’s throw away from a survivor of abuse.”

On the other hand, these are findings that challenge traditional beliefs about abuse. The familiar refrain of abuse leaving people “scarred for life” can be harmful in its own way, including when those who have been abused hear this from friends, family, therapists, or prosecutors seeking a conviction. The simple fact is that we need a more nuanced approach in understanding abuse. The problem isn’t that all forms of abuse cause inevitable harm. The problem is that abuse poses an unacceptable risk of harm. No one has the right to state categorically how abuse affects others.

What might be most fascinating about this study is its historical context. It has only been 20 years since the 1998 meta-analysis by Rind, Tromovich, and Bauserman was condemned by a US Congress formal resolution and sparked significant controversy. They had produced similar findings, although they framed their study quite differently. From the abstract: “negative effects were neither pervasive nor typically intense, and that men reacted much less negatively than women”. Obviously, how one frames the issues contributes to how they are understood by others.

These lessons in controversy appeared again in 2009, with the publication of Susan Clancy’s book, The Trauma Myth. Clancy, too, experienced substantial push back in the media, and spent considerable time explaining her work. By this time, and in the wake of rejection by the academic community in the US, she had emigrated to Central America.

All these facts and findings suggest that understanding the nuances of harm and trauma can take years of dedicated study and practice to comprehend. Even the most seasoned professionals often find themselves surprised by what they learn in their ongoing practice. The lessons of how research findings are presented are no less significant. How we frame the issues matters, especially regarding sexual abuse where victims offer feel unheard and/or unrecognized by the system. Forcing victims into frames that help us respond to their abuse without necessarily helping them is problematic. We need to hear and respect what victims say about the abuse they have experienced and the way that it has impacted them. Musician Frank Zappa may have expressed it most succinctly when he said that, “The most important thing in art is the frame.” In this case, that means hearing and respecting the voices of those victimized.

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