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Article Excerpt
With the high incidence of childhood sexual abuse and the attendant serious negative consequences resulting from it clearly documented, there is a high probability that many mental health counselors will at some point in their career provide treatment to members of this population. Since memory retrieval is an integral part of the treatment protocol when working with such clients, it is imperative that clinicians have a good understanding of the controversy over recovered memories of childhood sexual abuse. This article revisits the controversy, provides a detailed discussion of the issues involved, and offers practice implications for mental health counselors.
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Since the early 1990s there has been a great deal of controversy within the mental health community over the recovery of previously repressed or dissociated memories of childhood sexual abuse. There were a number of factors contributing to the increased interest in this psychological phenomenon, beginning with a tremendous increase in cases where individuals reported the recovery of such forgotten memories after a period of many years. The memories were allegedly repressed or dissociated and subsequently recovered, often when the individual began therapy (Baker, 1998; Courtois, 1999; Loftus & Ketcham, 1994; Lynn & McConkey, 1998; Pendergast, 1995; Pope & Brown, 1996; Whitfield, 1995).
State legislative changes allowing victims to prosecute perpetrators many years after the events had occurred added momentum to the controversy resulting in numerous lawsuits filed against parents. The central component and catalyst for the controversy were claims made by alleged perpetrators that accusations made were false and based on memories often induced, or suggested, by the victims' psychotherapists. Often such claims were substantiated when individuals who had recovered memories in therapy recanted, reporting that they were actually false and implanted by their therapists' suggestion (Magner & Parkinson, 2001; Wakefield & Underwager, 1992).
The major mental health organizations responded by initiating task forces to examine the controversy. This resulted in guidelines for treating clients claiming recovery of memories of childhood sexual abuse during therapy (Courtois, 1999). While the current trend is towards a more balanced perspective and the extreme positions of the past have been modified, there still is disagreement within the mental health community over the veracity of such memories (Brown, 2004; Davies & Dalgleish, 2001).
Given the documented incidence of childhood sexual abuse there is high probability that mental health counselors will encounter clients who present with this problem or who suspect they may have been sexually abused and seek treatment in uncovering memories related to this suspicion. Therefore, it is critical that mental health counselors have a clear understanding of this ongoing controversy and, more importantly, of how to effectively treat clients with such backgrounds. This article presents a discussion of the contributing factors in the longstanding debate. It also provides suggestions for mental health counselors to consider when treating clients who claim to have recovered memories of sexual abuse or who want to retrieve such memories because they believe they were sexually abused.
PREVALENCE AND IMPACT OF CHILDHOOD SEXUAL ABUSE
Numerous studies have substantiated a history of childhood sexual abuse among adults seeking therapeutic services. Finkelhor (1994) noted prevalence rates ranging from 7% to 36% for women and from 3% to 29% for men, while Gorey and Leslie (1997) reported prevalence rates of 22% for women and 9% for men. In a study conducted of U.S. women, Consentino and Collins (1996) reported that 25% to 33% revealed sexual abuse before age 18. Jones and Finkelhor (2001), citing data from the National Child Abuse and Neglect Data System, found a prevalence rate of 32.8%.
More recently, documented evidence of the prevalence of childhood sexual abuse for women revealed a low range of 10.9% to 13% (Oaksford & Frude, 2001; Plant, Miller, & Plant, 2004; Sidebotham, 2000) to a high range of 27.2% to 33% (Boles, Joshi, Grella, & Wellisch, 2005; Feerick & Snow, 2005; Freeman, Parillo, Collier, & Rusek, 2001; Hawke, Jainchill, & DeLeon, 2000). The prevalence rate for men ranged from a low of 4% to 5% (Dunne, Purdie, Cook, Boyle, & Najam, 2003; King, Coxell, & Mezey, 2000) to a high of 9.2% to 11.7% (Boles et al., 2005; Plant et al., 2004).
Further, the long-term negative effects of childhood sexual abuse have been amply documented as follows: development of adult mental disorders (Katerndahl, Burge, & Kellogg, 2005); disordered eating behaviors and clinical eating disorders (Ackard, Neumark-Sztainer, Hannan, French, & Story, 2001; Hund & Espelage, 2005; Johnson, Cohen, Kasen, & Brook, 2002; Romans, Gendall, Martin, & Mullen, 2005); greater marital dissatisfaction (Liang, Willaims, & Diegel, 2006); disturbed interpersonal relationships (DiLillo, 2001); post-traumatic stress disorder (Feerick & Snow, 2005; McDonagh et al., 2005); risk for greater suicidal behavior (Martin, Bergen, Richardson, Roeger, & Allison, 2004; Oates, 2004); adolescent pregnancy and sexual problems (Noll, Trickett, & Putnam, 2003); engaging in high risk sexual behaviors (Cinq-Mars, Wright, Cyr, & McDuff, 2003; Testa, VanZele-Tamsen, & Livingston, 2005); use of illicit drugs and substance use disorders (Hawke, Jainchill, & DeLeon, 2000; Plant et al., 2004; Rodriguez-Srednicki, 2001); alcohol abuse (Dube, Anda, Felitti, Edwards, & Croft, 2002; Horwitz, Widom, McLaughlin, & White, 2001); depression (Hill et al., 2000); childhood onset depression (Hill, Pickles, Rollinson, Davies, & Byatt, 2004); and anxiety (Roberts, O'Connor, Dunn, & Golding, 2004).
Rind, Tromovitch and Bauserman's (1998) meta-analysis on the long-term effects of childhood sexual abuse set off a controversy in the U.S. media that reached the halls of Congress. They concluded that the harmful effects of childhood sexual abuse were greatly overstated by mental health researchers, and indicated that willing encounters should no longer be classified as childhood sexual abuse, but rather, as adult-child sex. Their findings were disputed, severely criticized and found invalid by subsequent reviewers (Dallam et al., 2001; Lilienfeld, 2002; Whittenburg, Tice, Baker, & Lemmey, 2001; Speigel, 2001).
Thus, it is apparent that not only will mental health counselors come into contact with individuals sexually abused in childhood, but also that individuals from this population are in dire need of therapeutic services to address the issues and circumstances surrounding their abuse.
RECOVERED MEMORY CONTROVERSY
The Beginning
The recovered memory controversy began in the late 1980s and early 1990s and centered on whether traumatic experiences, such as childhood sexual abuse, could be completely forgotten and recovered years later. Not only were numerous families split over accusations of sexual abuse but the controversy over the reliability and veracity of such memories also caused a significant split within the mental health profession (Davies & Dalgleish, 2001; Schacter, 1996). Besides the question of whether the mechanism of repression actually existed, issues involved in the hotly debated topic included how memory is formed, encoded and retrieved, the effect of trauma on memory, the accuracy and credibility of memories of childhood sexual abuse, and the role of therapeutic influence on memory retrieval (Davis, 2005; McNally, 2003; Mollon, 2002).
Courtois (1999) indicated there were three issues involved in the recovered memory controversy: "(1) whether trauma can be forgotten and then remembered, (2) the accuracy and credibility of memories of childhood sexual abuse, and (3) the role of therapeutic influence on memories" (p. 31). Brown (2004) agreed but suggested the early debate focused basically on two areas: (1) was it scientifically possible for someone to remember sexual abuse trauma after many years of not knowing and (2) was it possible for someone to develop false beliefs about prior life experiences, specifically about having been sexually abused in childhood, in response to suggestions from therapists, books and other sources.
The False Memory Perspective
The False Memory Syndrome Foundation (FMSF) was founded in 1992 by Pamela and Peter Freyd, after Peter was accused of sexually molesting their daughter Jennifer, a professor of psychology. Its purpose was to assist individuals claiming to be falsely accused of, or charged with sexual abuse. After gathering together a small group of academics who believed that memories of abused were often false and implanted by psychotherapists, the FMSF began a media campaign against what they referred to as recovered memory therapy (Whitfield, 1995).
False memory (FM) advocates took the extreme stance that all denials by alleged perpetrators and any recantations on the part of victims were truthful and to be believed even without investigation, while all abuse memories discussed or recovered during therapy were false, and should not be believed. They claimed that recovered memories were untrue, that substantial numbers of people were falsely accused and that those who say they are survivors have often been misled, or even brainwashed by naive or manipulative therapists, authors, and book publishers. They pointed out that research studies had not found many cases in which sexual abuse events were completely wiped from memory and that most victims remembered all too well, rather than forgot the sexual abuse (McNally, 2003; Pope & Brown, 1996).
According to Davis (2005), "the FMS Foundation and other critics have largely framed the memory wars as a battle between empirical science and therapeutic romanticism" (p. 231). He described it as a polarization between psychiatrists and academic psychologists defining their discipline as one of rigorous scientific observation and methodology against therapeutic practitioners relying heavily on insights gathered from the treatment of individual cases. It was a rejection of the trauma model and the mental mechanisms of repression and dissociation.
Strongly based on Holmes' (1990) research on repression, the FM position argued against the existence of repression, dissociation, and recovered memory. This perspective found support among many mental health professionals (Loftus, 1993; Loftus & Ketcham, 1994; Ofshe & Watters, 1994; Pendergast, 1995; Pope & Hudson, 1995,...
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