The Trauma MythThe Truth about the Sexual Abuse of Children—and Its AftermathSusan A. Clancy Basic Books, $25, 256 pp.
In her new book, Susan A. Clancy offers a powerful and unsettling message about childhood sexual abuse in the United States. The Trauma Myth is a scathing attack on the widely espoused “trauma model” of child sexual abuse, a model that characterizes most abuse as a physically coercive act perpetrated against a terrified victim. Clancy’s research proposes a different template: the seductive manipulation, by a trusted intimate, of a confused and compliant child. She argues that societal emphasis on the relatively rare incidents of violent and sadistic abuse obscures our awareness of the more common, noncoercive type, and tragically shames adult survivors—convinced their violation does not meet the threshold of “real abuse”—into continued silence.
As a graduate-student researcher at Harvard, Clancy conducted over two hundred interviews with adults who had suffered childhood sexual abuse. Her interviews repeatedly and unexpectedly revealed that victims described their abuse as “confusing” rather than terrifying, and recalled it occurring without physical force or threat. Often the abuser was a trusted and familiar person—an older relative, family friend, or authority figure from the community. With sexual contact realized through manipulation rather than violent force, victims seldom experienced trauma at the time of the abuse. Only later, with increased perspective, did they begin to suffer the consequences: anger, anxiety, depression, shame, and often escape into substance abuse. Through her interviews, Clancy realized that the destructive effect of childhood sexual abuse is less the detonation of a traumatic response than the seepage of a kind of psychological radiation sickness, one that disfigures the survivor’s self-image and poisons subsequent relationships.
Clancy’s efforts to communicate this discovery met fierce resistance from fellow academics, mental-health professionals, and survivors invested in the traditional trauma model of abuse. She describes hate e-mails, personal attacks (she was accused of sympathizing with abusers and was even called a pederast herself), and collegial rejection. When she was invited to give a talk at Cambridge Hospital, site of the prestigious Victims of Violence program, not a single person from the program attended. Exploring this antipathy to her findings, Clancy delves into the history of the psychiatric and psychological professions’ response to child sexual abuse—a response highlighted by dismissal and denial until well into the twentieth century. By the 1960s and ’70s, however, the pervasiveness of child abuse and its pernicious effects could no longer be suppressed. At the same time, Vietnam War veterans were displaying the debilitating responses to combat that came to be characterized as post-traumatic stress disorder (PTSD). Pioneering researchers and clinicians in the abuse field, such as Judith Herman in her landmark book Trauma and Recovery, made the persuasive argument that the emotional scars of PTSD closely resembled the psychic wounds inflicted by sexual abuse.
This equation of physical and psychic brutality helped shape the dominant model of child sexual abuse. First-person accounts and self-help books, best exemplified by Ellen Bass and Laura Davis’s The Courage to Heal, embraced this perspective and boosted it in the popular imagination. Supported by the extreme and sensational examples of abuse highlighted in the media, a “trauma industry” developed to promulgate and treat the devastating effects of traumatic sexual abuse. This industry is now funded to the tune of millions of dollars by federal and state grants, private foundations, and for-profit treatment centers.
In speaking up about noncoercive child sexual abuse, Clancy ran head-first into this establishment. Its hostility led her to a rather dark interpretation of our societal investment in the trauma model. In her view, replacing that model with one emphasizing sexual manipulation by trusted authority figures would force us to acknowledge a fundamental breakdown in our most intimate relationships of family and community. Are we willing to do this? Clancy notes that our undue focus on the relatively small number of violent and coercive sexual-abuse episodes (less than 10 percent of the total) has a stifling effect on abuse victims: comparing their more ambiguous experiences to the ghoulish prototypes of children locked in basements or compelled at knifepoint, they question the legitimacy of their pain and castigate themselves for what seems like compliance. Their shame and self-disgust push them away from help and into the shadows—conveniently for the rest of us, Clancy concludes, since silencing them is preferable to facing our own culpability.
It’s a compelling story, and I only wish that Clancy had presented it in a straightforward and temperate manner. But The Trauma Myth gives us its findings with a narrative arc and rhetorical vehemence that rather eerily parallel the book’s themes of hidden abuse and betrayal. Clancy begins her story by presenting herself as an almost hopelessly naive graduate student—an idealistic young scientist who accepts the trauma model unquestioningly, even as she assumes that ultimately her data will carry the day, that scientists and clinicians will readily embrace new findings even when those findings challenge their theories and practices. Such double-barreled naiveté is hard to credit. Would a psychology graduate student at Harvard—one chosen for the sensitive task of interviewing individuals who were abused as children—really have a completely unnuanced view of abuse? As for data carrying the day, graduate students typically need about two weeks to see how science divides up into ego-controlled fiefdoms where reputation, power, and money are based in allegiances to certain ideas, allegiances that frequently place truth at risk.
Yet such is the innocent stance Clancy chooses to write from; and once her narrative shifts to her efforts to communicate her iconoclastic conclusions, her prose rings with outrage, and presentation of data yields to a wrathful skewering of the trauma industry and its “lies about sexual abuse.” In two extensive chapters she details how trauma experts effectively damage and silence victims of sexual abuse. These chapters, while providing important insights into the guilt that torments noncoerced victims, increasingly vilify—and simplify—trauma-oriented mental-health practitioners. Eventually Clancy drops all pretense of giving a measured assessment of the abuse debate. Lining up the good guys on her side—the “famous,” “influential,” and “brilliant” experts whose views support her positions—she condemns opponents as tendentious hacks wasting time and money on the “largely mythical hazards of violent abuse.” The trauma industry, she asserts, teems with practitioners whose “allergy to the truth” both mirrors and enables our society’s failure to “confront the truth” about abuse.
Unfortunately, with all this finger-pointing, whatever truth there may be in Clancy’s words (and I believe there is quite a bit) loses some of its persuasiveness. When she speaks in a direct address to the victims in the last two pages of the book, any sense of her role as a scientist goes out the window; only the advocate remains. This is unfortunate. The data presented in these pages provide an urgent corrective to societal misconceptions about abuse, yet the vehemence of Clancy’s polemic undermines the impact of her message. Given the painful bipartisan breakdown in our national politics and the us-vs.-them tenor of our social discourse on issues from health care to gay marriage to prayer in school, it is lamentable that Clancy’s treatment of a complex and multifaceted problem becomes at times simplistic and Manichean.
Perhaps, in the cacophony of our public dialogue, scientists feel compelled to turn up the volume in order to be heard. Certainly, a book that explodes the “trauma myth” and challenges thousands of practitioners—and millions of dollars spent on treatment—might well attract the attention of Oprah or 20/20 and grab fifteen minutes of media spotlight. In doing so, such passionate partisanship might arguably have a greater impact on our approach to child sexual abuse than a hundred scientific articles. What we lose in the bargain, however, is our commitment to a systematic method of gathering, analyzing, and presenting data in the most objective and dispassionate way possible—a method that not only remains the best protection against the vagaries of our all-too-human scientists, but helps set the rational foundations of civil society itself.
One final and, to me, unsettling point: as far as I can determine, the data presented in The Trauma Myth have not been published in a peer-reviewed scientific journal. It is unusual for a scientist to present data in a book for a general audience that have not been previously vetted and published in a scholarly venue. This anomaly will make an attentive reader worry about Susan Clancy’s trustworthiness as a guide through the controversy raging around childhood sexual abuse. In the end, the author’s stridency does a disservice to her cause, and this is disheartening precisely because the message she conveys is so vitally important. In the age of Fox News, it may be old-fashioned to say this, but I wish Clancy had stuck more closely to her data and let it speak more loudly than her rhetoric. A measure of restraint would improve her account of this insidious form of sexual abuse and its haunting consequences for adult survivors.