Murphy8 refers to the DSM, which is a highly controversial psychiatry book, full of invented diseases rather than discovered diseases (many diseases in the DSM are included on a vote at the APA annual meeting, this is not science). The most fundamental scientific criticism of the DSM concerns the validity and reliability of its diagnoses. This refers, roughly, to whether the disorders it defines are actually real conditions in people in the real world, that can be consistently identified by its criteria. These are long-standing criticisms of the DSM, originally highlighted by the Rosenhan experiment in the 1970s.

Rosenhan's study was done in two parts. The first part involved the use of healthy associates or "pseudopatients" who briefly simulated auditory hallucinations in an attempt to gain admission to 12 different psychiatric hospitals in five different states in various locations in the United States. All were admitted and diagnosed with psychiatric disorders. After admission, the pseudopatients acted normally and told staff that they felt fine and had not experienced any more hallucinations. Hospital staff failed to detect a single pseudopatient, and instead believed that all of the pseudopatients exhibited symptoms of ongoing mental illness. Several were confined for months. All were forced to admit to having a mental illness and agree to take antipsychotic drugs as a condition of their release.

The second part involved asking staff at a psychiatric hospital to detect non-existent "fake" patients. The staff falsely identified large numbers of genuine patients as impostors.

To return to the child sexual issue, I totally agree with the comments of Jin Zhao, randall and Marthijn Uittenbogaard. By not dealing more carefully with it, I believe we are creating a social monster that is worse than the events itself. I believe that the hysteria mood surrounding the whole issue is going to bring us back to the far west era, where people were hanged on simple allegations. Innocent people have already paid for it: remember the McMartin, Fells Acres, Little Rascals, Wee Care Day Nursery, Bryn Estyn cases and many others.

What exactly is the trauma theory? Clancy says that when she began her research at Harvard in 1996, the trauma theory held that “a child will only participate in abuse if forced, threatened, or explicitly coerced” (p. 41). Then she interviewed the adult who were molested as children. She learned they did resist the abuse (p. 41). Clancy concluded that since the abuse wasn't violent, it wasn't traumatic. The trauma doesn't occur until years later when victims realize they were supposed to fight it.

Do therapists agree? As early as 1994, the DSM stated, “For children, sexually traumatic events may include developmentally inappropriate sexual experiences without threatened or actual violence or injury” (p. 424). So based on the DSM, therapists recognize that being molested by an adult can be traumatic for the child even though violence is not actual or threatened. Clancy, on the other hand, says that if the abuse wasn't violent, then it wasn't traumatic for the child. But that the traumatic may occur years later.

Yes, Clancy says “Feminists redefined rape as a crime of violence rather than a sexual act” (p. 92). Then as Federal money began to flow in, more and more professionals were drawn to the child abuse industry (93). Then at the urging of feminists, all the research on the nonharmful nature of sexual abuse was thrown out (p. 94-95.) Still, I was still left with some question.
1. Clancy tested to see whether the abuse was traumatic—that would suggest repression. (p. 18). The incidents weren’t traumatic, so she concluded that victims don’t repress. Should she have tested for other contributing factors?
2. From what she says, an offender molests a child he knows, and the child complies. It’s that easy for offenders? What happened to the grooming process—making the child feel special as the relationship is gradually sexualized?
3. Children are molested and there are no consequence to the child until years later? No sexualized behaviors, unexplained fears, depression---all those signs parents and teachers are supposed to look for?
4. Courtois’s 1988 “Healing the Incest Wound” interviews victims and Cameron’s 2000 “Resolving Childhood Trauma” interviews victims over time. Both draw conclusions other than Clancy’s. Should we therefore rely on Clancy’s conclusions?
5. On a less serious note, Clancy says the book “is based on interviews with adults…who participated in research studies at Harvard” between 1996 and 2005 (vii). Has Harvard “gone green” or are budget cuts forcing researchers to recycle study participants?

If people are not reacting hysterical about the sexual contacts then there is no problem at all.

Calling it trauma and calling the child a surviver is just abuse of words.
The therapists should the ones be prosecuted. They are responsible for the demage in society.

As a pediatrician of many years and decade long member of a committee that heard sexual abuse cases, I think Dr. Clancy is saying something very important by giving child abuse a much needed perspective. Children respond varyingly to what is a wide variety of sexual abuses, and parental/adult responses to it is critical. No doubt many who have been abused do not feel emotionally scarred in any significant way, and adult response, often hysteria, may magnify the child's response to it. (Of course), and you have to emphasize this because many have difficulty holding opposing views of a subject at the same time, this kind of abuse is frequently damaging and life alterating. The point is we need to take it case by case. As is well known in the mental health literature, therapy is not always necessary, or helpful, and sometimes makes things worse. Child abuse is a highly charged emotional subject and as adults we need to be sensible as well as caring in our response to it.

Joseph, I agree with all of your points, inlcuidng those that you noted which were brought foward by Dr. Clancy.

What I most appreciate about today's on- air program and in this comment section is the fact that chldhood sexual abuse is a topic of discussion. Thrity years ago, it was taboo. The introduction of the term "trauma" (which comes from the ancient greek word meaning "injury") to describe childhood sexual abuse in the late 1970's allowed a framework for thinking about a problem for which there was previously no language (it was not spoken about). The word trauma (understood as "injury"), allows a person to consider that there is recovery, that some people's inuries are worse than others, and that some are very resilient (do well in the fact of adversity) and importantly,that some one or something outside of the child caused the injury (bringing in the reality of the perpetrator)

The concept of sexual abuse as a trauma defined as a particular type of event (the injuring kind) may not capture the entirety of the expereince of sexual abuse but it allowed the problem to enter the public domain of discussion. It's not intended to make anyone feel like a "victim." It's a perspective that is supposed to be liberating in the sense that it aknowledges the reality of an event.

Marylene Cloitre
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I agree with Joseph. I was pretty shocked by Dr. Clancy's assertions. Child sexual abuse is a trauma. I think the problem is that society is set up to protect the abusers. We need to quit protecting the abusers. The abusers are the ones that should feel the shame, guilt, and embaressment.

My brother is a victim. I suffered a trauma just going through some of those feelings with him as a child, not knowing at that time that he was being abused. Just seeing him in the state that he was in and feeling empathy for him was traumatic for me. I can't imagine actually be abused and what that feels like. To say that it is more confusing that traumatic is offensive to me and I'm sure it is to many victims as well. I think it is both confusing and traumatic but we should not discount the trauma.

As a survivor of childhood sexual abuse I take issue with many of Dr. Clancy's assertions. Her study (of only 200 subjects) flies in the face of the greater scientific research on the subject and clearly departs from the general scientific consensus. Personally, I find it offensive that her research assumes that abuse isn't frightening, overwhelming and painful. She assumes that society (i.e. the media, public misperception and health professionals) perpetuate many myths about abuse which keep many from treatment. I would say her efforts with this research further hinder her goals and professional/ethical responsibilities as a psychologist. Her findings are by no means definitive.

As much as I disagree with her I think Dr. Clancy is correct on a few points.

1.Survivors of sexual abuse can choose to hold a victim mentality. Much of what the modern Psychologically community endorses doesn't help survivors reclaim that birth right of happiness. We are not an event that happened to us.
2.Our society needs to raise awareness about this issue and increase treatment. Unfortunately, I think her efforts will hinder this by bolstering the perception that abuse isn't a real trauma.
3.We need to make victims of sexual abuse aware that they are not alone, it's NOT their fault, they have nothing to be ashamed of. Victims need to know that it's a crime that they should report.
4.We need to be vocal in addressing this issue to bring an end to sexual abuse. So be vocal wherever and whenever you can! The media, scientific community, political world should hear our voice so we see more healing!

In closing I hope this coverage/discussion to bring us all healing and resolution.

Dr. Clancy's Salon.com Interview:
http://www.salon.com/books/int/2010/01/18/trauma_myth_interview/index.html

Dr Cloitre what are you thoughts?

Thank you for a great discussion on PRI! I agree with Dr. Clancy's position. "Trauma" is not a word that describes the nature of an event, but the nature of an event in relation to the reaction of the people involved in this event. In other words, an event can't be a trauma unless it has traumatic effects on the "victim." Thus the same event can be traumatic to some and benign to some others depending on how these people understand, or in many cases define ("label" or "name") it. In this sense, "victims" are created not simply by the event, but necessarily the "labeling" of the event. I agree with Dr. Clancy that labeling some past events that have been benign to the children (then) involved as "traumatic" and the said children as "victims" of this "trauma" doesn't help the "victims" to move on and live their lives free from the negative effects these events perceived by psychotherapists or activists. Society should leave some space of defining, understanding, forgetting, and forgiving to people involved in these events, instead of imposing the label of "victim" on them and telling them that they should be traumatized according to professional definitions regardless of how they really feel.

I would be happy to answer any questions listeners might have regarding today's discussion.

Sincererly,
Marylene Cloitre