In the NY Review of Books, Frederick Crews discusses "Remembering Trauma", by Richard McNally (via AL Daily).
McNally's title Remembering Trauma neatly encapsulates the opposing views that, for a whole generation now, have made the study of trauma into psychology's most fiercely contested ground. Are scarring experiences well remembered in the usual sense of the term, or can some of them be remembered only much later, after the grip of a self-protective psychological mechanism has been relaxed? This is the pivotal issue that McNally decisively resolves.
To understand why this issue is so critical we need to go back to the early days of psychoanalysis in the 1890s. The story that Freud told, which became the standard line in psychoanalytic history, was that he was confronted again and again by stories from his neurotic patients of sexual abuse in infancy. At first he assumed that sexual abuse was rampant among the Viennese bourgeousie, but eventually realised with a flash of inspiration that these stories were all fantasies, and represented not memories but inner desires. Thus was psychoanalysis born.
In the 1980s Jeffrey Masson was given access by Anna Freud to the Freud archives in London, including the Freud-Fliess letters (Wilhelm Fliess was a Berlin neurologist who was in regular correspondence with Freud in the 1890s, and shared his passion for cocaine, fame, and bizarre theories). Regrettably for Anna Freud, Masson proved to be insufficiently impressed by the Freud legend, and in 1984 wrote "The Assault on Truth : Freud's Suppression of the Seduction Theory", which argued that Freud had simply chickened out on hearing all these tales of sexual abuse from his patients, realising that such unpalatable truths would not exactly help his struggling career. Masson argues that these tales were, as Freud first thought, actual memories. As the Amazon review puts it:
The Assault on Truth reveals a reality that neither Freud nor his followers could bear to face. Bracing in its honesty, gripping its revelations, this is the book that prompted Masson’s break with the psychoanalytic community–and launched his subsequent brilliant career as an independent thinker and writer.
Brilliant career may be putting it a little strong: after being engaged for a while to feminist Catherine MacKinnon, the guy now lives in New Zealand and writes books about animals. Nevertheless the damage had been done, though in retrospect it's not clear how much blame should be laid at Masson's door for what followed. Soon enough the whole recovered memory movement was in full swing, exemplified by Ellen Bass and Laura Davis's "The Courage to Heal", which suggested that if women felt depressed, unfulfilled, or had difficulty with relationships, they should consider the possibility that they'd been sexually abused as infants. Tens of thousands did, and headed along to therapists who - often through hypnosis - managed to persuade them that yes indeed, they did have memories of abuse, long suppressed, which the therapists managed after prolonged and highly lucrative sessions to drag out of them. Regrettably, once started on this course, and finding simple memory of abuse by fathers didn't quite provide the hoped-for catharsis, the patients would bring up ever more elaborate and implausible scenarios involving mothers, relatives, communities, satanic rituals, alien abductions, not to mention multiple personalities. Thus therapy, breaking away from psychoanalysis but maintaing the core belief in repression of trauma, continued the tradition of generating illnesses to fit its own needs. As Crews states:
[M]any 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.
The whole issue of course also spread out through the Eighties and Nineties into the satanic abuse witch-hunts which saw infant schoolteachers and day care workers imprisoned on ludicrous charges. Crews again:
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.
It would unfortunately be premature to say that those days are behind us, as the recent case of Anver Daud Sheikh highlights. For some US cases, where individuals remain in prison, Dorothy Rabinowitz' "No Crueller Tyrannies" is worth reading.
As the history of the early years of psychoanalysis is studied more closely it's become clear that Freud's founding myth is untenable, and Masson's revisionism simply compounds the mistake. Both these accounts only make sense if the patients' stories of early sexual abuse were freely forthcoming, but this is precisely not the case. Freud's theory of the genesis of neuroses required that the memory of sexual abuse be suppressed. In the strange hydraulic pressure model that Freud used, it was the repression of the abuse which manifested itself in the symptoms of the neurosis. It was of no use whatever to Freud to have patients who remembered being sexually abused. On the contrary, the memories had to be dragged out of them, and Freud is quite clear about this. They will resist, he said. They will strenuously deny that any such thing ever happened. What is required from the therapist is an absolute insistence on the central truth that abuse had occurred, and only when the patient accepted this, after long and wearying sessions, with the therapist using the full weight of his authority, could recovery begin.
In other words, the stories of infantile sexual abuse which Freud elicited, prior to his "breakthrough" understanding, were entirely constructions of the therapeutic situation, as were those elicited by recovered memory therapists more recently. McNally's book provides further evidence of the sand on which these theories are based. When empirical findings are scrutinised, there is no evidence that the required repression of trauma actually exists. As Crews concludes:
Remembering Trauma is neither a polemic nor a sermon, and McNally offers little counsel to psychotherapists beyond warning them against turning moral disapproval of pedophilia into overconfidence that they can infer its existence from behavioral clues observed twenty or thirty years after the fact. But another lesson is implied throughout this important book. 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.