9

DIGGING FOR MEMORIES

It may take considerable digging on the part of the therapist to discover incest as the source of the symptoms being experienced by the client.

—Wendy Maltz and Beverly Holman, Incest and Sexuality: A Guide to Understanding and Healing

Before Jennifer Nagle recovered any memories of her father abusing her, she was exposed to two books, one thin and one fat, on the subject of incest survival and recovery. Jennifer’s school counselor handed her a ten-page pamphlet, published by a rape relief organization, titled “Incest: A Book for Survivors,” and her therapist gave her The Courage to Heal. Despite the 485-page difference in their length, the two books share the core ideas fundamental to the concept of repression and repressed memory therapy:

• Incest and child sexual abuse are epidemic. The rape relief pamphlet states that one in four women and one in six men were sexually abused as children, while The Courage to Heal cites statistics declaring that one of three girls and one of seven boys are sexually abused by the time they reach age eighteen.

• Many symptoms of adult psychopathology—including but not limited to anxiety, panic attacks, depression, sexual dysfunction, relationship difficulties, abusive behaviors, eating disorders, loneliness, and suicide attempts—reflect long-term reactions to childhood sexual abuse.

• A significant percentage of adult survivors completely block out their traumatic memories through the defensive and unconscious mechanism of repression.

• Accessing and accepting the memories as real and valid is a critical step in the recovery process.

• Individual and group therapy can offer healing, resolution, and renewal.

To sum up the central message in a few words: Incest is epidemic, repression is rampant, recovery is possible, and therapy can help.

In this chapter we’ll examine these general themes in detail and then describe the specific techniques used to recover repressed memories. When we use the word “repression,” we are referring to more than “ordinary forgetting,” which is the act of not thinking about an event or experience for a period of time and then having the memory come back to mind. Repression refers to the active banishment into the unconscious of a traumatic event or series of traumas. Repressed memories are typically recovered in therapy, when the patient is exposed to extensive “memory work”—suggestive questioning, guided visualization, age regression, hypnosis, body-memory interpretation, dream analysis, art therapy, rage and grief work, and group therapy.

While we are skeptical about the truth-finding function of these and other aggressive therapeutic techniques, we are not challenging the reality of childhood sexual abuse or traumatic memories. We do not question the trauma of the sexually abused child, nor do we doubt the experiences of men and women who suffer silently with memories of abuse they have never forgotten. We are not expressing reservations about the skills and talents of therapists who work hard, with compassion and great care, to elicit memories that for many years were too painful to put into words.

Many tortured individuals live for years with the dark secret of their abusive past and only find the courage to discuss their childhood traumas in the supportive and empathic environment of therapy. We are not disputing those memories. We are only questioning the memories commonly referred to as “repressed”1—memories that did not exist until someone went looking for them.

GENERAL TENETS

INCEST IS EPIDEMIC

The first and most forcefully stated principle of the incest-survivor movement is that incest occurs much more frequently than any of us ever imagined. Psychiatrist Judith Lewis Herman has referred to incest as a “common and central female experience” while therapist and popular writer E. Sue Blume claims in her book Secret Survivors that “incest is so common as to be epidemic.… At any given time more than three quarters of my clients are women who were molested in childhood by someone they knew.”

Statistics are immediately gathered to fortify these alarming claims of ubiquity. Beverly Engel introduces her book The Right to Innocence: Healing the Trauma of Childhood Sexual Abuse with statistics gathered from three sources: an August 1985 Los Angeles Times survey estimating that nearly 38 million adults were sexually abused as children; Dr. Henry Giaretto’s survey of 250,000 cases referred to the Child Sexual Assault Treatment Program, indicating that one in every three women and one in every seven men are sexually abused by age eighteen; and sociologist Diana Russell’s 1986 study of 930 San Francisco women, 38 percent of whom revealed that they had been molested before the age of eighteen. When nonphysical contact (i.e., genital exposure) was factored in, over half of Russell’s subjects reported abuse.

The statistics are frightening, but in another sense they are meant to be comforting. As Engel writes, “Be reassured. You may have felt isolated with your pain, but you no longer have to be. Many others like you have suffered from the same pain, fear and anger. You are not alone.”

Definitions and expositions of incest quickly follow the statistics. Questions are raised and forcefully answered. As Blume writes:

Must incest involve intercourse? Must incest be overtly genital? Must it involve touch at all? The answer is no.… Incest is not necessarily intercourse. In fact, it does not have to involve touch. There are many other ways that the child’s space or senses can be sexually violated. Incest can occur through words, sounds, or even exposure of the child to sights or acts that are sexual but do not involve her.”

Blume illustrates her discussion with several examples of incestuous abuse: a father hovering outside the bathroom while a child is inside, or barging into the room without knocking; an older brother coercing his sister to undress; a school bus driver ordering a student to sit with him; an uncle showing pornographic pictures to a four-year-old; a father’s jealous possessiveness or suspicion of the young man his daughter dates; a relative’s repeated requests to hear the details of an adolescent’s sexual experiences. The event itself is not considered as important in determining whether incest occurs as the child’s subjective experience—the “way” in which she is treated or touched. Thus, sexual abuse can be inferred from the “way” a priest kisses a child good-bye or the “way” a babysitter handles a child when bathing her.

Bass and Davis, authors of The Courage to Heal, agree that the crucial factor determining whether or not an act is incestuous is the child’s or adolescent’s subjective physical, emotional, or spiritual experience. They also provide examples of nonphysical incestuous activities or “violations of trust”:

Some abuse is not even physical. Your father may have stood in the bathroom doorway, making suggestive remarks or simply leering when you entered to use the toilet. Your uncle may have walked around naked, calling attention to his penis, talking about his sexual exploits, questioning you about your body … There are many ways to be violated sexually. There is also abuse on the psychological level. You had the feeling your stepfather was aware of your physical presence every minute of the day, no matter how quiet and unobtrusive you were. Your neighbor watched your changing body with an intrusive interest. Your father took you out on romantic dates and wrote you love letters.

Beverly Engel offers a personal memory to reinforce the point that it is the child’s level of discomfort, signaled by uneasiness or embarrassment about a specific encounter, that determines whether or not the incident was abusive. The degree of discomfort can be assessed through hindsight, many years later:

On several occasions during my high school years, my mother would get sloppy drunk and would get very sentimental. Sometimes she would plant a big “wet” kiss on my mouth. Now I have reason to believe my mother was unconsciously being sexually seductive.

But—the skeptic in the back of the room raises her hand—isn’t this the adult Beverly reconstructing and analyzing a decades-old memory? Was the adolescent Beverly aware of such feelings as she was being kissed, or soon afterward? Could it be that she was more distressed by the fact that her mother was “sloppy drunk” than by the kiss it self? Were Beverly’s adult interpretations, clarified and refined by years of clinical training and experience with incest survivors, grafted onto an ambiguously disturbing but relatively “harmless” experience?

These skeptical questions apparently miss the point. The adolescent feelings and perceptions aren’t really at issue here, because Beverly was young and immature and thus incapable of adequately assessing and understanding her situation. Only when she grew up and looked back at the past could she understand the meaning of her earlier experiences. And if, in the process of reviewing her memories, she had the feeling that she was abused, then she probably was abused. She doesn’t even have to have the memories.

REPRESSION IS RAMPANT

“Something in the neighborhood of 60 percent of all incest victims don’t remember the sexual abuse for many years after the fact,” proclaims self-help author John Bradshaw in his monthly Lear’s magazine column. While Bradshaw doesn’t cite a source for this statistic, a similar figure is offered by Blume in her book:

It is my experience that fewer than half of the women who experience this trauma later remember or identify it as abuse. Therefore it is not unlikely that more than half of all women are survivors of childhood sexual trauma.… Literally tens of millions of “secret survivors” carry the weight of their hidden history of abuse.

Later in her book Blume announces that “repression in some form is virtually universal among survivors.”

Therapist Renee Fredrickson agrees that the numbers are staggering. At first suspicious of the sheer volume of clients reporting repressed memories of sexual abuse (“I thought that this must be some form of contagious hysteria”) she eventually came to believe that these buried and unearthed memories were accurate representations of the past. As her conviction grew, she searched in the scholarly journals for information on the subject of repression. To her dismay she found only Freudian speculation about patients’ “fantasies” of abuse. “I was forced to rely on my own observations and the clinical experiences of my colleagues to learn about repressed memories.”

It wasn’t long before Fredrickson understood the magnitude of the problem and decided to write a book (Repressed Memories: A Journey to Recovery from Sexual Abuse) in order to help the “millions of people” who have “blocked out frightening episodes of abuse, years of their life, or their entire childhood. They want desperately to find out what happened to them and they need the tools to do so.”

Bass and Davis agree that repression is a common occurrence among survivors. In a chapter entitled “Remembering,” readers are told: “If you don’t remember your abuse, you are not alone. Many women don’t have memories, and some never get memories. This doesn’t mean they weren’t abused.”

Scholars tend to be slightly more circumspect about the numbers, although they agree that repression is a common reaction to trauma. Psychoanalyst Alice Miller offers a generalized, universalized statement about the mind’s ability to store away disturbing thoughts and emotions: “Every childhood’s conflictual experiences remain hidden and locked in darkness, and the key to our understanding of the life that follows is hidden away with them.”

Many psychiatrists, psychologists, and social workers believe that the reality of the “hidden-awayness” known as repression is finally being rediscovered. In a scholarly article frequently cited by trauma therapists (sometimes called traumatists) titled “The Intrusive Past: The Flexibility of Memory and the Engraving of Trauma” authors B. A. van der Kolk and Onno van der Hart provide some history. For nearly a hundred years, the authors contend, psychoanalysis (defined as “the study of repressed wishes and instincts”) “virtually ignored the fact that actual memories may form the nucleus of psychopathology and continue to exert their influence on current experience by means of the process of dissociation.” But in the 1980s and 1990s, psychiatrists are at long last acknowledging

the reality of trauma in people’s lives, and the fact that actual experiences can be so overwhelming that they cannot be integrated into existing mental frameworks, and instead, are dissociated, later to return intrusively as fragmented sensory or motoric experiences.

If memory blocks are protective, as every popular author and scholarly writer seems to agree, why do we expose ourselves to the risks of digging up the buried material? Because the shards and fragments of the past will continue to penetrate our present-day lives, causing piercing pain and grief. Not until we unearth the memory, file down its jagged edges, and carefully slide the smoothed-out pieces into our expanded sense of self will we experience relief and release from the past. As Van der Kolk and Van der Hart explain:

Traumatic memories are the unassimilated scraps of overwhelming experiences, which need to be integrated with existing mental schemes, and be transformed into narrative language. It appears that, in order for this to occur successfully, the traumatized person has to return to the memory often in order to complete it.

Popular writers use looser language and familiar metaphors to make the same point. In his Lear’s column, John Bradshaw describes the need to face our fears: “Avoidance of the facts of our lives only harms us. Help comes when we name our demons and speak plainly even of the most fearsome things.”

These “fearsome things” generally reside in the unconscious mind, a hypothetical location that is given weight and substance by many popular writers. Renee Fredrickson, for example, offers a tangled but intriguing explanation of the workings of the unconscious mind and its ability to function only in the present:

The unconscious always operates in the present tense, and, when a memory is buried in the unconscious, the unconscious preserves it as an ongoing act of abuse in the present reality of the unconscious mind. The cost of repressing a memory is that the mind does not know the abuse ended.… Uncompleted memory fragments will always “come back to haunt you.”

But—the skeptic’s hand rises again—if you have no memories of being abused, how do you know that your present-day problems might be caused by repressed memories or “uncompleted memory fragments”? The proof is in the pudding, as it were. If your life shows the symptoms, then you were in all likelihood abused. If you think you were abused, if you have the feeling you were abused, then you were abused. Don’t let anyone try to talk you out of your reality, the advice continues, because if it feels real, it is real, and that’s all the proof you will ever need.

Skeptics receive a rather thorough bashing in the popular incest-recovery books. Survivors are told not to give any credence to research reports about the prevalence of incest. According to E. Sue Blume, incest research “has been used to hide truths and support lies.… In quantifying human experience, we may lose its richness, if not its truth.” Blume then quotes Judith Lewis Herman, who argues that only clinicians can accurately gauge the extent of the incest problem: “The insight of a skilled clinician cannot be matched by any questionnaire or survey instrument presently available. Subtle forms of emotional damage, which may not be detected in broader sociological studies, are apparent in clinical reports.”

Psychologist John Briere makes a similar point in a recent interview. Responding, perhaps, to critics’ statements that repressed-memory therapy is a temporary fad (or, as social psychologist Richard Ofshe has termed it in his characteristically blunt manner, “one of the century’s most intriguing quackeries”), Briere said: “I’m hoping that because a vast number of survivors have found a voice, no amount of what is now trendy disbelief will silence them. The ‘up side’ of the wide prevalence of sexual abuse is that millions of people know, deep down, that sexual abuse is a real phenomenon.”

It is difficult to escape the intimation (lurking as accusation) that memory researchers and statistic gatherers are not only antisurvivor but antitruth when they question the reality of repressed memories. As Briere’s interview continues, it becomes even more obvious that he believes certain skeptical researchers are deeply committed to the task of proving survivors’ stories false:

I find myself saddened and angered by the fact that people who otherwise show reasonable scientific probity have in this case become invested in trying to prove somehow—without persuasive data—that the memories of hundreds of thousands of survivors are not true.… We’re ultimately talking about human beings in pain, and human beings in pain are not always going to be 100% accurate. We don’t do the same kind of grilling of someone who has a car accident or some other kind of experience. It seems to be especially in the sexual abuse area that we have the greatest difficulty accepting what is told to us.

Why do skeptics have such a difficult time accepting the truth? Because (we’re told) we’re in denial. When psychologist Carol Tavris’s critical essay “Beware the Incest-Survivor Machine” appeared in The New York Times Book Review, therapists and survivors fired off angry letters to the editor, accusing Tavris of being afraid to face the truth. Ellen Bass outlined the reasons for the skeptic’s denial:

It is painful to face the reality that so many children were horribly abused. It is far easier to call it fantasy, manipulation, fabrication; easier to say that someone has been brainwashed into believing he or she was abused than to face the fact that this person—as a child—endured such torments.

In this, at least, skeptics and survivors join hands, for denial affects us all, obscuring the light of truth. Denial is presented as tangible and physical, like an artichoke whose sharp-tipped leaves must be stripped away to reveal the “heart” of truth. How do we peel away our denial?

“Some things have to be believed to be seen,” writes Renee Fredrickson, quoting one of Reader’s Digest’s “Quotable Quotes.” For researchers who follow the scientific method, relying on faith to arrive at facts is simply against the rules. But Fredrickson and other popular writers aren’t particularly interested in dislodging the stubborn skepticism of the science types. Their primary purpose is to help survivors overcome their denial, and the most efficient way to defeat denial is to jump right in and “do” memory work. Once the survivor embarks on memory work—a tool box full of exercises and techniques designed to excavate buried memories—the sheer volume of memories retrieved will conquer denial. As Fredrickson explains:

When you have retrieved enough memories, you will reach critical mass, which is a sense of the overall reality of your repressed memories.… After enough memories, debriefed enough times, you will suddenly know your repressed memories are real. It is the opposite of the maxim that if you tell a lie long enough, you will believe it is real.… if you talk about your repressed memories long enough, you will intuitively know they are real.

RECOVERY IS POSSIBLE

Once a survivor reaches “critical mass,” the road to recovery straightens out, and healing begins. Recovery is a land of triumph and renewal where we become, in Fredrickson’s words, “wiser and more beautiful” than we were before we began the journey. On the road to recovery, the survivor reclaims herself, taking her power back, shedding guilt and self-blame, regaining her lost pride, experiencing new energy and vitality, healing the wounds of her childhood.

Healing must not be confused, however, with the end of a journey or the absence of pain. Recovery is a lifelong process full of painful and bewildering ups and downs, detours and backtracks. Psychologist John Briere tells a story to convey this point about the perennial nature of health and healing:

A survivor I saw a while back ended our consultation by asking me, “Will I ever be cured?” It seemed to me that she was really asking, “Will I ever not hurt?” The sad, weird answer—and what I said to the survivor—was “No, probably you will never not hurt, at least never stop hurting completely. I understand that in your desperation not hurting is the best thing you can think of that could happen for you, but maybe that’s not all of what this [therapy] is about.”

“Then what is it about?” she asked.

“Freedom?” I suggested.

And she smiled.

Freedom. Truth. Justice. The American Way.

Recovery gradually takes on the shine of truth, of the righteous fight, the global battle to end oppression and join hands with all who suffer, not just from sexual abuse but from any kind of fear or prejudice. Survivors are assured that their cause goes beyond their own healing, for by healing themselves, they contribute to the healing of the world. As therapist Mike Lew writes in Victims No Longer: “From where I look it’s all about the same thing. Children. The ocean. Fish. The earth. We either care about them or we don’t.… In short, how can we heal the world unless we heal ourselves?”

You don’t even have to be a victim or survivor to become part of this privileged and empowered group. It does help, however, to be a woman. “Though I was not personally raped, I am a woman. I am the mother of a daughter,” writes Ellen Bass in her introduction to I Never Told Anyone: Writings by Women Survivors of Child Sexual Abuse:

I share in the pain, in the anger, in the healing, and in the creation of a world where children are encouraged and empowered to control their own bodies, to protest, and to ask for help, knowing they will get it. Ultimately, I am sharing in the restoration of a consciousness where the rape of children—as well as the rape of women, of forests, of oceans, of the earth—is a history to be remembered only to assure it will not begin again.

In The Courage to Heal, Bass and Davis make the theme even more explicit and, of course, politically correct:

Although your responsibility toward healing begins with yourself, it does not stop there. Child sexual abuse originates from the same fear, hatred, deprivation, selfishness, and ignorance that lead people to abuse and assault in other ways. These attitudes are woven into the very fabric of our society and oppress on a large scale. We get nuclear waste, inhuman conditions for migrant farm workers, the rampages of the Ku Klux Klan.

The Courage to Heal then goes on to imply that the victims of oppression are the chosen few who can heal not only themselves but the world at large:

Part of your healing is the healing of the earth. If you don’t make it a priority, there is little hope for the world. By and large, it is not the abusers who are going to write letters to our government, imploring them to stop funding slaughter in El Salvador. It’s not the mothers who are too terrified to hear your pain who are going to fight for changes in the legal system to make it easier for children to testify. And how many pedophiles care about toxic waste?

It is you—who know something about both justice and injustice, about abuse and respect, about suffering and about healing—who have the clarity, courage, and compassion to contribute to the quality, and the very continuation, of life.

Perhaps we doubters and disbelievers do have reason for concern, for this kind of warm and fuzzy survivor-speak creates an obvious polarization of the field: an us-versus-them mentality, a self-righteousness that separates and divides, a black-and-white dichotomizing of the world by people who should know better.

Just consider the implications in that one short sentence in The Courage to Heal: “How many pedophiles care about toxic waste?” Is the world so easily reduced to good and evil? A parallel can be drawn with a scene in Arthur Miller’s The Crucible, in which Deputy Governor Dan-forth announces to the bewildered townfolk of Salem, Massachusetts:

But you must understand … that a person is either with this court or he must be counted against it, there be no road between. This is a sharp time, now, a precise time—we live no longer in the dusky afternoon when evil mixed itself with good and befuddled the world. Now, by God’s grace, the shining sun is up, and them that fear not light will surely praise it. I hope you will be one of those.

Miller drew parallels between the Salem witch-hunters and the McCarthyite red-baiters. He feared their shared “parochial snobbery,” born and bred in the belief “that they held in their steady hands the candle that would light the world.” In our zeal to end child sexual abuse and help ease the pain of adult survivors, have we been blinded by the light of what some choose to call the truth? Have we fallen prey to the same misguided and moralistic beliefs that in times past divided the world into purely good and purely evil?

SPECIFIC TECHNIQUES

There is never only one path up the mountain … Techniques for memory recovery are as unlimited as human creativity.

—Renee Fredrickson, Repressed Memories

Having explored the general framework supporting the concept of repressed memory therapy (or simply “memory work”) we come to the specifics: the various and sundry tools used by therapists to unearth buried memories.

THE DIRECT QUESTION

When clients walk into therapy and describe a history of depression, anxiety, suicidal feelings, sexual problems, eating disorders, or various addictions, many therapists automatically suspect sexual abuse as the underlying cause of their problems. What actions should a therapist take regarding her suspicions? The authors of The Courage to Heal suggest a direct approach.

When you work with someone you think may have been abused, ask outright, “Were you sexually abused as a child?” This is a simple and straightforward way to find out what you’re dealing with. It’s also a clear message to your clients that you are available to work with the issue of sexual abuse.

Therapist Karen Olio agrees that the clinician must be experienced in the area of sexual abuse and willing to bring up this sensitive and formerly taboo subject:

Probably the most important factor in the identification of sexual abuse among clients is the clinician’s willingness to consider it as a possibility.… Unfortunately, because of inexperience and ignorance, many therapists do not ask the right questions or recognize the indicators of sexual abuse.… Unless asked directly … survivors may not disclose a history of abuse.

In her book Betrayal of Innocence Susan Forward, a therapist who claims that she has treated more than fifteen hundred incest victims, discusses her method of approaching clients:

You know [she says to them], in my experience, a lot of people who are struggling with many of the same problems you are have often had some kind of really painful things happen to them as kids—maybe they were beaten or molested. And I wonder if anything like that ever happened to you?

Other clinicians profess to know of colleagues who say to their clients, “Your symptoms sound like you’ve been abused when you were a child. What can you tell me about that?” or even “You sound to me like the sort of person who must have been sexually abused. Tell me what that bastard did to you.”

If a client cannot remember any specific incidences of abuse, the therapist is advised to consider the possibility of repressed memories. For repression is not only the method by which memories are banished from consciousness, but an indication in and of itself that abuse exists. “When survivors can’t remember their childhood or have very fuzzy memories, incest must always be considered a possibility,” authors and therapists Maltz and Holman (Incest and Sexuality) advise their clinical colleagues. Psychotherapist Mike Lew echoes the theme: “When an adult tells me that he can’t remember whole chunks of his childhood, I assume the likelihood of some sort of abuse.”

“Vague feelings” are another indication that repressed memories of abuse may be seeping out of the unconscious and into the conscious awareness. “If you have any suspicion at all, if you have any memory, no matter how vague, it probably really happened,” therapist Beverly Engel advises her patients. “It is far more likely that you are blocking the memories, denying it happened.”

Suspicion, apparently, always leads to confirmation. “In fifteen years of practicing as a psychotherapist, I have never worked with a client who initially suspected she was sexually abused but later discovered she had not been,” Engel writes. Bass and Davis confirm the theory:

So far, no one we’ve talked to thought she might have been abused, and then later discovered that she hadn’t been. The progression always goes the other way, from suspicion to confirmation. If you think you were abused and your life shows the symptoms, then you were.

THE SYMPTOM LIST

1. Do you have trouble knowing what you want?

2. Are you afraid to try new experiences?

3. If someone gives you a suggestion, do you feel you ought to follow it?

4. Do you follow other people’s suggestions as if they were orders to be observed?

This diminutive symptom list, published in John Bradshaw’s July 1992 column in Lear’s, is part of a larger checklist titled “An Index of Suspicions” from Bradshaw’s book Homecoming. After presenting these four questions in Lear’s, Bradshaw offers a quick analysis:

If you answered even one of these questions in the affirmative, you can count on some damage having been done to you in your early developmental stage, between the 9th and 18th months of your life, during the period when you began to crawl and explore and follow your innate curiosity wherever it led you.

In his August 1992 column, Bradshaw presents a slightly more specific inventory of traits that he considers “typical of adult victims of incest.” The list includes nine items with an obvious sexual bent (“You have little or no interest in sex,” “You are sexually promiscuous without enjoying it much,” “You displayed unusually precocious sexual behavior before the age of ten,” “You have never to your knowledge had sex with anyone”), with a few questions thrown in about apathetic behaviors, eating disorders, and various physical ailments. For those readers who identify with a majority of these traits but have no memories of incest, a simple exercise is suggested: “Accept the theory that you were sexually abused, live consciously with that idea for six months in context with an awareness of the traits you acknowledge, and see whether any memories come to you.”

If Bradshaw offers the fast food of the symptom list, E. Sue Blume extends an invitation to a gourmet feast. Her menu of symptoms, impressively titled “The Incest Survivors’ Aftereffects Checklist,” includes thirty-four traits or characteristics of incest survivors, most of which include several components, extensions, or, oddly enough, contradictions. For example:

Number 3: Alienation from the body—not at home in own body; failure to heed body signals or take care of one’s body; poor body image; manipulating body size to avoid sexual attention.

Number 5: Wearing a lot of clothing, even in summer; baggy clothes; failure to remove clothing even when appropriate to do so (while swimming, bathing, sleeping); extreme requirement for privacy when using bathroom.

Number 9: Need to be invisible, perfect, or perfectly bad.

Number 32: Aversion to making noise (including during sex, crying, laughing, or other body functions); verbal hypervigilance (careful monitoring of one’s words); quiet-voiced, especially when needing to be heard.

From just this brief sample (the actual list runs on for five paperback pages), consider this: If you have a poor body image, wear baggy clothes, feel the need to be perfect (or perfectly bad), speak softly, and don’t like to make noise while making love, “You could be a survivor of incest.” (The reader, by the way, is given no advice about how to score an item in which one detail fits and the others don’t; presumably even a flickering of recognition invites a check mark.)

Renee Fredrickson offers in her book a checklist of symptoms that highlights “common warning signals of repressed memories.” Sixty-five questions separated into seven categories (“Sexuality,” “Sleep,” “Fears and Attractions,” “Eating Disturbances,” “Body Problems,” “Compulsive Behaviors,” and “Emotional Signals”) focus on fears, preoccupations, and behavior patterns. Some sample symptoms:

• I have had a period of sexual promiscuity in my life.

• I often have nightmares.

• I have difficulty falling or staying asleep.

• Basements terrify me.

• I do some things to excess, and I just don’t know when to quit.

• I identify with abuse victims in the media, and often stories of abuse make me want to cry.

• I startle easily.

• I space out or daydream.

The symptom lists are designed to help survivors recognize the extent of the damage caused by the abuse and its continuing impact on their present life. Bass and Davis (The Courage to Heal) present a total of seventy-four questions organized in seven broad categories: “Self-esteem and Personal Power,” “Feelings,” “Your Body,” “Intimacy,” “Sexuality,” “Children and Parenting,” and “Families of Origin.” The question “Where are you now?” heads each section, the point being that you may have been too busy just surviving to notice the myriad ways in which you were harmed by the abuse. Here, for example, is just a sampling from the fifteen questions in the “Self-Esteem and Personal Power” section:

• Do you feel different from other people?

• Do you have trouble feeling motivated?

• Do you feel you have to be perfect?

• Do you use work or achievements to compensate for inadequate feelings in other parts of your life?

WARNING: The problem with symptom lists is that relatively harmless parts of a “normal” personality become distorted and deviant when viewed through the microscopic lens of incest. Nonpathological aspects of our temperament become symptomatic of a dark and evil secret that we hide even from ourselves. The symptom lists toss out a net that entangles the whole human race. As psychologist Carol Tavris comments:

The same list could be used to identify oneself as someone who loves too much, someone who suffers from self-defeating personality disorder, or a mere human being in the late 20th century. The list is general enough to include everybody at least sometimes. Nobody doesn’t fit it.

A related problem is that the more far-fetched items on the list (the baggy clothes and fear of basements immediately come to mind) are given greater credence and plausibility when grouped with symptoms commonly accepted as aftereffects of sexual abuse (such as an exceptionally strong startle response or hypersexuality in childhood). When normal behaviors and responses are reinterpreted as suggestive of abuse, then any behavior becomes potentially symptomatic; the more items you check off on the symptom lists, the more it looks like you’re a candidate for survivorship. If one symptom doesn’t fit, certainly the next one, or the one after, will.

Blume is remarkably straightforward regarding the underlying purpose of her list. “We have found that the Aftereffects Checklist can serve as a diagnostic device for suggesting sexual victimization when none is remembered” [emphasis added]. How do clients respond to such obvious (and obviously intentional) suggestions? Some undoubtedly persist in their denials that they were not abused, and eventually either the therapist gets back on track or the client terminates therapy. Attorney Dennis Herriot, for example, was severely depressed after his father’s suicide and sought the help of a psychotherapist. But when he tried to talk to the therapist about the problems he was facing, she kept intimating that something else was happening that he either could not or would not face. The mystery of that “something else” haunted Herriot, and his depression deepened. What was wrong with him? His therapist stunned him with her diagnosis: “I don’t know how to tell you this, but you display the same kinds of characteristics as some of my patients who are victims of satanic ritual abuse.” Herriot, who had never alluded in any way to satanism or ritualistic abuse, immediately terminated therapy.

But other clients, perhaps more vulnerable and less self-confident, get caught up in the quest to find those buried memories and put an end to their misery, once and for all. A woman from Oregon who heard about my work with memory distortions and the experimental implantation of false memories, wrote a long letter requesting my help. With her permission, I include a section from her anguished letter:

Three years ago, I began individual therapy to deal with symptoms which included depression and anxiety. Within a few months, my therapist suggested that the cause of my emotional distress could be a history of childhood sexual abuse. Since that time, he has become more and more certain of his diagnosis.… I have no direct memories of this abuse.… The question I can’t get past is how something so terrible could have happened to me without me remembering anything. For the past two years I have done little else but try to remember.… Still, I am left wondering if anything really happened.… The guessing has become unbearable.

What can a therapist do to make the guessing less unbearable? While all the popular books on incest survival and recovery mention different therapy techniques, and several include specific methods for recovering repressed memories, the most specific and detailed advice is offered by Renee Fredrickson in her book Repressed Memories: A Journey to Recovery from Sexual Abuse. Fredrickson, who has a doctorate, has appeared on National Public Radio, Cable News Network, “Oprah,” and numerous other radio and television talk shows to discuss her very specific techniques for uncovering repressed memories. Her book has been widely disseminated to “survivors” by therapists who practice repressed-memory therapy.

Fredrickson includes seven basic techniques designed to excavate buried memories and breathe life into the mummified remains of repressed memories: imagistic work; dream work; journal writing; body work; hypnosis; art therapy; and feelings work. Because these and similar techniques are employed by many clinicians, particularly “memory work” therapists, we’ll examine them in some detail.

IMAGISTIC WORK

Sarah was haunted by a flashback of a child’s body slamming violently into a wall. Because the “memory” was presenting itself as an image, Fredrickson suggested that Sarah try “imagistic work,” a process of describing in great detail every sight and sensation relating to the image and adding, whenever appropriate, subjective interpretations. As Sarah focused in on her internal reality, she began to tell the story evoked by the image, always using the present tense. (Fredrickson explains that imagistic memory is located in the unconscious, where everything takes place in the present tense.)

As one image was added to another, the “memories” created a moving picture of a child—Sarah at age two—with her grandfather in an outhouse. Sarah “sees” her grandfather leading her to the outhouse and latching the door; she watches as he takes out his penis and rubs it between her legs.

“I feel like I’m just making this up,” Sarah says, suddenly interrupting the “slide show” of images.

But Fredrickson urges her client to continue, explaining that “truth or fantasy is not of concern at the beginning of memory retrieval work. What is important is what was in her [Sarah’s] mind and what seemed true at this moment in time.” Sarah obligingly develops the image. She recalls that her grandfather ejaculated on her. Then, holding on to her by one hand, he lowered her into the toilet hole, where her body banged painfully against the side beams.

Sarah’s memory is astonishingly clear and vivid as she recalls bits and pieces of conversation (“He tells me no one cares about me”), sounds (“He laughs a funny little laugh”), smells (“The smell is awful”), emotions (“I’m really scared”). After she emerges from the outhouse, she describes the sensation of being outside again (still speaking in the present tense): “I’m surprised at how sunny and pretty the world looks.”

When Fredrickson summarizes Sarah’s imagistic work, she leaves no doubt that these images represent real memories surfacing from the unconscious.

The images that surface from your unconscious to your conscious mind are fragments of a traumatic memory ready to emerge. These blips flashing across your mind may be mystifying or obscure at first glance, but they are an incomplete scrap from an abuse incident that you have buried. A piece of that incident has broken through and is poking into your conscious mind. Follow it down into your unconscious and you will retrieve a repressed memory.

Nor does Fredrickson leave any doubt that, in her opinion at least, these images represent real memories. Her client, she writes, “had completed the process of imagistic retrieval of an abuse memory.… The memory that had been stalking Sarah’s life was finally fully exposed.”

Fredrickson insists that these images from the unconscious, while often exaggerated or cartoonlike, represent “an accurate slice of the abuse.” But once again she reiterates that the truth doesn’t really matter, at least not at this point in therapy: “Whether what is remembered … is made up or real is of no concern at the beginning of the process; that can be decided at a later date.”

Renee Fredrickson is not alone in suggesting imagistic work as a means of exhuming and resurrecting buried memories. In The Courage to Heal, Bass and Davis include an exercise that relies on a process called “imaginative reconstruction,” allowing the survivor “to piece together things you can’t possibly know about your history or the history of your family”:

Take an event in your family history that you can never actually find out about. It could be your father’s childhood or the circumstances in your mother’s life that kept her from protecting you. Using all the details you do know, create your own story. Ground the experience or event in as much knowledge as you have and then let yourself imagine what actually might have happened.

WARNING: “Create your own story” and “imagine what actually might have happened” are important strategies for the development of fictions. But do they lead to the unearthing of lost or misplaced facts? Cognitive psychologists know that when people engage in exercises in imagination, they begin to have problems differentiating between what is real and what is imagined. And forensic psychologists have concluded that guided imagery promotes a dissociative state similar to that produced by hypnosis; as a result, it may be equally unreliable as a tool for recovering memories.

Thus, in the process of creating our own stories, we run the very serious risk of mistaking imagined events for memories of actual experiences. We end up believing in the stories we tell.

DREAM WORK

The theory is that when we dream, “the channel is open” to the unconscious mind, and all we have to do is look for the symbols and “indicators” of repressed memories. Fredrickson suggests that survivors keep an ongoing written list of memory fragments and “access symbols” (defined in the following list). Using the dream symbol as a focal point, they can then work to retrieve repressed memory fragments. Fredrickson lists six types of “repressed-memory dreams” that contain vital information from the unconscious about buried memories:

• Nightmares. The distinguishing feature of a nightmare is the intensity of fear engendered by the dream. If your nightmares include certain symbols or indicators, they may reveal sexual abuse. These symbols might include rapists, murderers, psychopaths, and stalkers; bedrooms, bathrooms, basements, closets and attics; penises, breasts, and buttocks; bottles, broom handles, and sticks; bloody sacrifices, dismemberment, cannibalism, black-robed figures, and Satan.

• Recurring dreams. These are “an emergency signal from your unconscious” and can either be nightmares or nonthreatening dreams that return over and over again with the same characters, setting, and action.

• Sexual-abuse dreams. These contain a specific, clear-cut act of sexual abuse and are always repressed-memory dreams, according to Fredrickson. The specific act may be rape, oral or anal sex, the abuse of a child or teenager, voyeurism, or bestiality.

• Dreams containing access signals. Such dreams point to the existence of buried memories of abuse. Some common access signals are closed or locked doors, mysterious passageways, anything stored or hidden, a child who cannot communicate or who needs protection, water (especially, frightening water), snakes, or phallic symbols.

• Any dream you have a strong feeling about. Even uninteresting or trivial dreams can contain fragments of repressed memories. If you have a particularly vivid dream that makes a strong impression on your conscious mind, Fredrickson advises that you consider dream work, which involves the following steps:

• Sifting through your dreams for themes or symbols of sexual abuse

• Sharing your feelings, thoughts and interpretations regarding these symbols

• Clarifying the dream by seeking more information, expanding on details, or free-associating

• Identifying the general outlines of the abuse as it has been interpreted and clarified through “dream work.”

Many therapists agree that dream work is a powerful tool. “Conscious thought can be controlled; conscious awareness can be altered by defenses,” writes Blume. “But in sleep realities that are carefully masked during wakefulness can leak out.” And Beverly Engle claims that dreams can be “very revealing, exposing memories you have been unwilling or unable to face during waking hours.” To illustrate her point she tells a story about Judy, who knew all along that her brother had sexually abused her but had a dream one night that her father had also molested her. “She awoke to a terrible pain in her vagina and a flood of memories. Indeed, she realized, the dream was true.”

WARNING: Were these dreams “true,” or did they “come true” as therapist and client worked together to explain away or resolve the client’s fears, anxieties, and uncertainties? Once again, as with exercises in imagination, psychologists are questioning claims that dreams provide a reliable map to reality. Psychologist Brooks Brenneis recently completed an extensive review of the literature on the relationship between dreams and traumatic events. His findings indicate that even when someone dreams about an event that can be corroborated (for example, an actual car accident), the dream often bears little resemblance to the actual event; in fact, the dream clearly portrays the trauma metaphorically. Brenneis concludes:

There is no empirical evidence and very little clinical evidence to substantiate the idea that specific traumatic experience predictably passes untransformed into dream content. Consequently, the idea that a dream may be identical to, or isomorphic with, a traumatic experience is questionable.

Given the fact that dreams often consist of “residue” from the day’s events, it is not surprising that patients involved in therapy and memory work sometimes dream about abuse-related experiences. Therapists’ interpretations of these dreams may reflect their own biases and beliefs, and clients may be too willing to accept their therapists’ interpretations—especially if they have been told by their therapists that their dreams are direct messages from the unconscious about repressed childhood abuse.

JOURNAL WRITING

Fredrickson theorizes that there are five different types of memory: recall memory (the only type that resides in the conscious mind), and imagistic, feeling, acting-out and body memories (all of which are found in the unconscious mind). While imagistic work and dream work utilize imagistic memory (“memory that breaks through to the conscious mind in the form of imagery”) and feeling memory (“the memory of an emotional response to a particular situation”), journal writing accesses acting-out memory, “in which the forgotten incident is spontaneously acted out through some physical action.”

In journal writing the idea is to start with a focal point—a body sensation, image, or symbol from a dream or nightmare—and record in words the images and messages arising from the unconscious. Fredrickson suggests three basic techniques for retrieving repressed memories using the technique of journal writing.

The first technique is that of free association, in which you write whatever comes into your mind, including images, feelings, and body sensations, with no attempt to sort out or categorize. Sorting out is a right-brain process and, according to Fredrickson “will impede the left brain from accessing what you want to know.”

To employ the second technique, you begin with an abusive incident, either real or imagined, and write a story about it. In storytelling, the important point is to write the story as quickly as possible: “The unconscious can be relied on to select traumatic incidents from your own past for most or all of the ‘story,’” Fredrickson writes, “since it is easier to rely on experience rather than imagination when you do something quickly.”

The third technique is the quick list: You jot down your immediate responses to a focal point or prompting question, resisting any urge to think, screen, edit, or organize.

Fredrickson illustrates the “quick list” journal-writing technique with a fascinating case history. On the basis of a few scattered memories and some convincing dreams, Ann believed that she was abused by her grandmother, but the details of the abuse eluded her. Ann’s therapist provided her with pen and paper and asked her to list, without pausing to think or worry about accuracy, five abusive acts her grandmother had committed. Ann immediately jotted down eight very specific items, including a memory of her grandmother hanging her cat, another memory in which her grandmother tried to suffocate her with a pillow, and other memories involving specific sexually abusive acts. After reading the list to her therapist, Ann experienced feelings of grief and shock, but felt comforted by the fact that at least now she knew the “basics” of what had happened to her.

Fredrickson suggests a little trick to make access to the unconscious a little easier: If you write in your journal with your left hand, it will facilitate access to the right brain, the creative, intuitive, synthesizing part of the brain. In his book Homecoming John Bradshaw gives similar advice, urging readers to write with their nondominant hand, a technique that apparently bypasses the controlling, logical side of the brain and “makes it easier to get in touch with the feelings of your inner child.”

WARNING: The technique of journal writing strikes many cognitive psychologists as a potentially “risky exercise,”2 particularly when therapists suggest that their patients strive for a noncritical, stream-of-consciousness flow, writing down whatever comes to mind without stopping to evaluate the content. The possibility that this technique will lead nonabused people to create false memories and beliefs is compounded when journal writing is accompanied by other therapeutic techniques and/or the therapist’s expressed beliefs about memory recovery—for example, telling the client that her current symptoms reflect childhood sexual abuse, that healing depends on recovering memories, or that accurate memories are likely to emerge from journal-writing exercises.

Furthermore, the massive body of scientific literature on the workings of memory contains no evidence that different kinds of memories exist in the unconscious mind. Thus, “imagistic,” “feeling,” “acting-out,” and “body” memories must be viewed as interesting but unprovable theories of how the intuitive and impulsive part of the mind works. The “inner child” is obviously a metaphor (is it really possible to “get in touch” with the “feelings” of a metaphor?), and no evidence exists that writing with the nondominant hand will gain access to this “inner child.” Nor is there any evidence that sorting out, categorizing, or thinking—the cognitive acts of reflecting, reasoning, and analyzing—will impede the accessing of memories from the unconscious.

A final note on the “quick list” technique: Most psychologists would agree that any theory of the mind that suggests doing away with “thinking” should probably be reevaluated.

BODY WORK

The theory behind “body work” is that the body remembers what the mind unconsciously chooses to forget. When a traumatic or abusive event occurs, our minds may react by shutting down and stuffing the memory into the drawers of the unconscious, but our bodies will always remember the feeling of being abused. Through massage therapy or body-manipulation techniques we can access these “body memories” and begin to uncover the truth about our past.

Fredrickson delineates three stages in the process of uncovering memories through body work:

• Energy. The body stores memory as energy; when certain parts of the body are touched or massaged, the blocked energy can be accessed and the memories stimulated.

• Emergence. The stored memory emerges through any of the five senses.

• Resolution. As the memories begin to flow, rage and grief are also released, and the survivor surrenders to the truth about her past.

Body memories apparently can be stimulated through any of the five senses. Some examples of body memories include: the smell of Clorox or new leather, the sight of mouthwash or toothpaste, the sound of a door creaking or pants being unzipped, the taste of alcohol or cigarettes, feelings of sleepiness, tingling sensations, or extreme sensitivity in the lower back, arms, toes, shoulders, or other body parts. When a body memory emerges, the experience can be intensely uncomfortable, as one survivor, quoted in The Courage to Heal, testifies:

I would get body memories that would have no pictures to them at all. I would just start screaming and feel that something was coming out of my body that I had no control over. And I would usually get them right after making love, or in the middle of making love, or right in the middle of a fight. When my passion was aroused in some way, I would remember in my body, although I wouldn’t have a conscious picture, just this screaming coming out of me.

Clinicians cite the intense physiological reactions experienced by clients recalling memories of abuse as impressive evidence of the body’s gift of recall. In a paper published in the Journal of Child Sexual Abuse, clinical psychologist Christine Courtois explains that memories

can return physiologically, through body memories and perceptions. The survivor might retrieve colors, specific visions or images, hear sounds, experience smells, odors, and taste sensations. His or her body might react in pain reminiscent of the abuse and might even evidence physical stigmata as the memory of a particular abuse experience is retrieved and worked through.… Memories might also occur somatically through pain, illness (often without medical diagnosis), nausea, and conversion symptoms such as paralysis and numbing.

E. Sue Blume sums up the general theory of body memories and body work:

The body stores the memories of incest, and I have heard of dramatic uncovering and recovery of feelings and experiences through body work.… This therapy has been around for a long time but never taken seriously by talk therapists. It should be. It can release memories and feelings that talk therapy cannot touch.

WARNING: While it is theoretically possible for unconscious memories to influence behavior and create physical symptoms, no evidence exists to support the claim that muscles and tissues respond in a way that can be interpreted reliably as a concrete episodic memory. Scientists point out that it is impossible to determine whether the symptoms associated with body memories are caused by real, historical memories, by current problems and fixations, or even by chance. As psychologist Martin Seligman explains: “In science we have to set up a null hypothesis to prove something. It has to be shown that it can be disproved in order to achieve scientific credibility.” But the theory of body memories refuses the possibility of a null hypothesis—you can’t prove the theory, and you can’t disprove it either.

HYPNOSIS

According to Fredrickson, hypnosis taps into the unconscious via “imagistic memory,” thus facilitating the retrieval of buried memories of abuse. The most common hypnotic technique used for retrieving repressed memories is “age regression.” Once trance is induced, the therapist encourages the client to move backward in time, stopping at an age that seems significant. The client, now “age regressed,” describes the scenes, images, and feelings that come into her mind, and “abuse memories that are ready to be faced emerge from the unconscious.”

*   *   *

Fredrickson cautions that hypnosis is not a magical truth serum and is effective only if the client is prepared to face “the truth.” Other clinicians extend the warning, even arguing that hypnosis is contraindicated with incest survivors. The misuse and misapplication of hypnosis carries “the potential of harm,” writes Mike Lew in Victims No Longer, arguing that “memories are blocked for a reason,” and questioning “the benefit of dragging out memories before you are ready to deal with them.” Lew is also skeptical about the “quick fix” mentality of memory recovery work:

I don’t think it makes sense to set recovery of specific abuse memories as the primary goal. Doing this gives the misleading impression that if you recover the memories everything will be all right. If you adopt this mistaken notion, you will be deeply disappointed when you discover that there is still much work to be done after the memories are in place.

ADDITIONAL WARNINGS: In a recent paper, psychologists Steven Jay Lynn and Michael Nash point out that

features of the hypnotic context, taken individually and in combination, may conspire to elevate the risk of pseudomemory creation. This observation is reinforced by the 1985 report by the American Medical Association3 and by subsequent research that underscores the fact that hypnosis can increase the confidence of recalled events with little or no change in the level of accuracy.

Repeated questioning “tends to freeze or harden memories, regardless of the historical accuracy of the memories,” Nash and Lynn warn, and the problem is intensified if the therapist believes in the historical accuracy of the memories: “When clinicians communicate that clients’ memories are accurate, clients may place an unwarranted degree of trust in their memories.”

In a paper presented in 1992 at the annual meeting of the American Psychological Association, Nash discussed cases in which hypnotized subjects were age-progressed to seventy or eighty years old and recalled events they had yet to experience. He also described a patient from his own practice who believed he had been abducted by aliens and provided copious details about the high-tech machines the aliens attached to his penis in order to obtain samples of his sperm. “I successfully treated this highly hypnotizable man over a period of three months, using standard uncovering techniques and employing hypnosis on two occasions,” Nash summarized.

About two months into this therapy, his symptoms abated: he was sleeping normally again, his ruminations and flashbacks had resolved, he returned to his usual level of interpersonal engagement, and his productivity at work improved. What we did worked. Nevertheless, let me underscore this: he walked out of my office as utterly convinced that he had been abducted as when he walked in. As a matter of fact he thanked me for helping him “fill in the gaps of my memory.” I suppose I need not tell you how unhappy I was about his particular choice of words.

Nash compared this patient’s abduction story with memories recovered by adult survivors of sexual abuse:

Here we have a stark example of a tenaciously believed-in fantasy which is almost certainly not true, but which, nonetheless, has all the signs of a previously repressed traumatic memory. I work routinely with adult women who have been sexually abused, and I could discern no difference between this patient’s clinical presentation around the trauma and that of my sexually abused patients. Worse yet, the patient seemed to get better as he was able to elaborate on the report of trauma and integrate it into his own view of the world.

In his concluding remarks, Nash advised clinicians to proceed with care and discretion regarding their patient’s traumatic memories, for “in the end we (as clinicians) cannot tell the difference between believed-in fantasy about the past and viable memory of the past. Indeed there may be no structural difference between the two.”

Hypnosis researcher Campbell Perry agreed, suggesting that therapists may be responsible for creating and then validating their clients’ “pseudomemories”:

Any memory that might turn up in age regression might be a fact, a lie, a confabulation, or a pseudomemory caused accidentally by inappropriate suggestions by the hypnotist. Most of the time, an expert can’t even distinguish between these. She or he can only hope to validate with facts one of these possibilities.

In his book Suggestions of Abuse, clinical psychologist and hypnosis expert Michael Yapko emphasizes that formal hypnotic techniques do not have to be used to make a patient susceptible to suggestion. Just being in therapy creates a vulnerability to directly stated or merely implied beliefs and suggestions. Yapko describes an “unthinkable” event that occurred in his own practice.

A woman called me and asked if I would hypnotize her in order to determine whether she had been molested as a child. I asked where she got the idea that she might have been abused. She told me she had called another therapist about her poor self-esteem, and the therapist told her—never even having met her—that she must have been abused and should be hypnotized to find out when and how.

This case, which Yapko insists is not unique, represents in his words “foolishness of the worst sort,” and is “tantamount to professional malpractice.”

ART THERAPY

According to Renee Fredrickson, art therapy accesses two types of unconscious memory—acting-out memory (forgotten memories spontaneously and physically enacted) and imagistic memory (memory that appears in the conscious mind as images). By creating a visual representation, the survivor is able to recreate the memory or memory fragment, or she can use the completed artwork to trigger the recovery of repressed memories.

Fredrickson describes three basic methods of accessing or elaborating memories through artwork:

• Imagistic recall. The client is instructed to select an image as a focal point, draw the image, and then portray whatever she thinks might happen next. Guesswork is often involved. “The key is to draw whatever your best guess is about what happened,” Fredrickson advises.

• Already retrieved memories. The client adds details to an already retrieved memory in an attempt to make it more specific and concrete.

• Interpreting your artwork. In this final stage, the client tries to determine if certain symbols, themes, or objects reappear. Discovering and then interpreting these recurring symbols may help to uncover repressed memories.

Bea, one of Fredrickson’s patients, loved to draw and turned to art therapy as a means of exploring her feelings. Her drawings always featured the same frightening symbols: blood, pentagrams, people dressed in robes, the devil, and “huge penises ripping through young children.” Bea eventually came to believe that she was recreating factual scenes from memory. After staring at a painting of a goat and a small child surrounded by robed figures, she recognized that the scene represented an actual memory: “I painted a memory even before I knew it was a memory!” she exclaimed.

Drawing exercises are often used by therapists to help their patients “generate” memories about childhood sexual abuse. “The simple reconstruction of a bedroom can allow blocked feelings to surface if the client is able to draw what he or she imagines the room to look like,” writes therapist Catherine Roland. “The bed may engender feelings of which the client is not yet aware, especially if the abuse took place in or near the bedroom.” “Probing questions” can then be used to uncover the family’s general attitude toward sexual activities, and specific references to the details in the artwork will help the client “begin to explore the deeper nuances of suspicion and fear.”

WARNING: While drawing pictures might access blocked feelings, is it wise to use those feelings to explore “the deeper nuances of suspicion and fear”? Where, we have to ask, will those nuances lead? If memories are triggered by a client’s drawings or visual representations, the therapist has no reliable way of determining whether these memories are accurate or inaccurate. Once again, caution is advised.

FEELINGS WORK

Feelings work is designed to tap into “feeling memory,” which Fredrickson defines as the memory of an emotional response to a particular situation. The memory itself may be repressed, but the orphaned feelings haunt the mind, restlessly seeking their memory “home.” Thus, feelings of being abused exist without the matching memories, and the survivor is deeply affected by intense emotions and sensations that seem unconnected to any present-day reality. If a survivor says, “I think I was sexually abused, but it’s just a feeling,” she is experiencing a feeling memory.

Survivors experience many feelings, of course, but two are considered universal and form the basis of “feelings work”: grief and rage. If a survivor can get in touch with her emotions, the theory goes, she can begin the painful process of releasing them; when the feelings begin to emerge, the repressed memories often come with them. Fredrickson explains how structured grief work proceeds:

You curl up or lie down and begin a slow, relaxed breathing. Whenever you feel any sense of sadness, try to express a noise with the feeling. Slowly, over time, the grief will start to build. Grief usually comes in waves, so do not be discouraged if it fades, for it will surely return. As each wave of grief is felt, let yourself moan, cry out, or sob. As the grief deepens, the related memories may also begin to surface.

Grief work often turns into rage work (and vice versa). The purpose of rage work is to focus the survivor’s anger, resentment, and hostility where they belong: on the perpetrator. Clinicians suggest a variety of techniques for rage work, including whacking the floor, the walls, an old sofa, or a pile of cushions with a tennis racket, rubber hose, rolled-up towel or newspaper, or an “encounter bat” (a soft foam-rubber club); stomping on old egg cartons or aluminum cans; practicing karate kicks; shredding a phone book with your bare hands; or simply screaming as loud and as long as you can.

In The Courage to Heal, a survivor describes the emotional release experienced during her rage work:

Doing the actual rage work wasn’t scary. In fact, it was very exciting. It’s such a safe environment with so much love, you have the feeling you can do or say anything. It’s okay if you bash in your stepfather’s face with a rubber hose. I remember thinking, “This isn’t so bad. This isn’t going to kill anybody.” Every once in a while I’d stop, look around the room, and think, “No way, that didn’t come from me!” I had totally shredded a Denver phone book, just obliterated it, and still more to come. I’d have to catch my breath or blow my nose, and I remember looking at the devastation and thinking, “My God! That was all inside!” I was flabbergasted at how much rage there was.

WARNING: Because there is no evidence that feelings work leads to the recovery of real, historical memories, as opposed to imagined, invented, or fabricated memories, it seems prudent to repeat psychoanalyst Alice Miller’s conclusions regarding the “goal” of therapy: “When the patient has truly emotionally worked through the history of his childhood and thus regained his sense of being alive—then the goal of the analysis has been reached.”

After that goal is reached, Miller continues, it is the patient’s responsibility to make his own life decisions. “It is not the task of the analyst to ‘socialize’ him, or ‘to bring him up’ (not even politically, for every form of bringing up denies his autonomy), nor to make ‘friendships possible for him’—all that is his own affair.”

Therapy is, or used to be, about helping people become responsible human beings. But some therapists argue that with its emphasis on venting emotions, therapy has the potential to become abusive. Psychologist Margaret Singer puts the problem in perspective:

In the end, if therapy works well, the patient ends up more autonomous, more responsible, more mature and more in charge of her life. But today patients are expected to display emotions in a way the therapist approves of. Many patients tell me they were urged by their therapist to be in a continuous rage. So how could therapy help them become more mature, and more independent, functioning citizens? I feel very embarrassed that a healing profession could have strayed so far from the standards of care and practice that demand, “Do not harm the patient.”

GROUP THERAPY

Group therapy is considered a powerful adjunct to individual therapy and a crucial part of the recovery process. Mike Lew stresses the benefits of community and solidarity that accrue in groups where other incest survivors can “listen to what you’re saying,” “believe you,” and “know that you’re telling the truth about the abuse and its effects, because they have had similar experiences.”

Listening, believing, and knowing the truth act as the rock salt that allows the survivor’s memories to gel, eventually taking solid shape. “Your memories, which for so long have seemed unreal, gain substance each time you share them with others,” Fredrickson advises survivors.

Group therapy is also considered an effective method for accelerating the memory-retrieval process. A “chaining” of recollections and feelings occurs, as one member of the group after another identifies and then connects with the memories vocalized by the others. As Bass and Davis counsel: “If you’re still fuzzy about what’s happening to you, hearing other women’s stories can stimulate your memories. Their words can loosen buried feelings.”

In her book Trauma and Recovery, Judith Lewis Herman extols the memory-stimulating function of the group process, claiming that it virtually guarantees the recovery of memories:

The cohesion that develops in a trauma-focused group enables participants to embark upon the tasks of remembrance and mourning. The group provides a powerful stimulus for the recovery of traumatic memories. As each group member reconstructs her own narrative, the details of her story almost inevitably evoke new recollections in each of the listeners. In the incest survivor groups, virtually every member who has defined a goal of recovering memories has been able to do so. Women who feel stymied by amnesia are encouraged to tell as much of their story as they do remember. Invariably the group offers a fresh emotional perspective that provides a bridge to new memories.

WARNING: While many psychologists and psychiatrists consider the stimulation and triggering of associated memories to be an important function of group therapy, they warn that the chaining process can suddenly spiral out of control. Psychiatrist Paul McHugh warns that it is particularly dangerous to mix people who have memories of abuse with people who believe they may have been abused but have no memories. The pressures of such “mixed” groups can lead to the creation of pseudomemories—as one survivor, who eventually recovered memories of being molested on the changing table when she was twelve months, attests: “There was a lot of peer pressure in the group. You weren’t well accepted unless you were coming up with a lot of memories.”

Psychologist Christine Courtois believes that group therapy can be a valuable source of “safety, support, and understanding,” but counsels that a therapist should be available to “carefully monitor and pace the group process so that members are not continuously emotionally overwhelmed.” Judith Lewis Herman agrees that the memories may come so fast that it is necessary “to slow the process down in order to keep it within the limits of the individual’s and the group’s tolerance.”

The primary focus of any trauma-based group, Herman concludes, should be on the task of establishing safety:

If this focus is lost, group members can easily frighten each other with both the horrors of their past experiences and the dangers in their present lives. An incest survivor describes how hearing other group members’ stories made her feel worse: “My expectation going into the group was that seeing a number of women who had shared a similar experience would make it easier. My most poignant anguish in the group was the realization that it didn’t make it easier—it only multiplied the horror.”

CONFRONTATIONS

Once the repressed memories have been retrieved, the survivor is told she has a choice: She can either continue with therapy, working to resolve her grief and rage in a private, noncombative way, or she can choose to stand up to the abuse (and stand up for herself) by confronting her abusers. The decision to confront is never promoted as easy or risk-free. Most incest-survival authors warn that confrontations should be considered only if and when the survivor is fully prepared and well along the road to recovery. Furthermore, the survivor is assured that confrontation is a choice that one can choose not to make. As Mike Lew writes in his sensitive chapter on confrontation, “Confronting the perpetrator is a difficult and complex issue … a highly individual, personal decision. For some people it is a logical next step in recovery; for others it could be a dangerous and self-destructive act.”

But there is also much talk in these books about the healing power of speaking the truth. “Telling the people in your family how you were hurt is the most expedient form of healing. Now you are finally free to speak the truth,” writes Fredrickson. Not only are you “free” to speak the truth, but you have the right to do so. “Everyone has a right to tell the truth about her life,” write Bass and Davis at the beginning of their chapter titled “Disclosures and Confrontations.”

When we speak the truth, we gain a sense of “empowerment,” which Fredrickson defines as “spiritual, physical, and emotional strength.” Confrontation is presented as a rite of passage, a painful but momentous step in the metamorphosis from victim to survivor. “Confronting the abuser … is the ultimate reclaiming of power for the survivor; it declares that she is not silenced, is not controlled,” writes E. Sue Blume. “To confront is an opportunity to declare, ‘I know what you did, and you had no right.’”

Specific advice on preparing for the confrontation is sometimes offered in the incest-recovery literature. Support systems must be shored up, motivations and expectations carefully analyzed, and rehearsals undertaken. The survivor can begin by telling her story to her supporters—her therapist, group members, friends, spouse, or lover. She can explore her feelings by writing letters and asking her friends and therapists for feedback. She can create fantasy pictures of the confrontation, in which she imagines herself as strong, confident, and completely in control. Or she can engage in role-play or psychodrama, rehearsing with her therapist or group members various confrontational scenarios.

Then, when she is fully prepared, she can “tell the truth” to her family. In the actual confrontation, she should always avoid expressing doubts or uncertainties, stating clearly what she knows to be true and specifically describing how she has been affected by the abuse. “Avoid being tentative about your repressed memories,” Fredrickson advises. “Do not just tell them; express them as truth. If months or years down the road, you find you are mistaken about the details, you can always apologize and set the record straight.”

Survivors should expect protestations of innocence and expressions of outrage when they confront their abusers. “Be prepared to encounter denial,” Mike Lew writes.

Don’t let the situation turn into an argument or a debate. Don’t allow a perpetrator to talk you out of your memories. Remember that she has lied to you before. Stick to your guns and don’t get involved in an exercise in frustration.

If the abuser continues to disavow and repudiate the survivor’s story, it may be time to bring up the subject of repression. “You may want to suggest that the abuser has repressed all memory of the abuse,” Fredrickson counsels. But at all costs survivors should avoid a reality war. It is not the survivor’s job to convince or convert her perpetrator. The sole purpose of disclosure and confrontation is to free yourself, to take back your power, to prove to yourself that you will not be frightened or controlled any longer, and thus to guarantee that you will never be a victim again. Confrontation, in Lew’s words, is “an act of self-respect.”

The Courage to Heal offers several dramatic examples of successful confrontations:

Twenty years ago, a woman went to her grandfather’s funeral and told each person at the grave site what he had done to her. In Santa Cruz, California, volunteers from Women Against Rape go with rape survivors to confront the rapist in his workplace. There they are, ten or twenty women surrounding a man, giving tangible support to the survivor, as she names what he has done to her.… One survivor told us the story of a woman who exposed her brother on his wedding day. She wrote down exactly what he’d done to her and made copies. Standing in the receiving line, she handed everyone a sealed envelope, saying “These are some of my feelings about the wedding. Please read it when you get home.”

WARNING: The effect of deathbed, receiving-line, or one-on-one confrontations extends beyond the accused, who may or may not be guilty as charged. The damage to the survivor must also be considered. What if “months or years down the road,” the survivor discovers that she was, indeed, “mistaken about details”? The promise that she can “always apologize and set the record straight” denies the disastrous impact of the accusation on the lives of everyone involved. Families are torn apart, relationships are irrevocably altered, and lives are destroyed.

A thirty-five-year-old woman told her mother, a widow who was dying of cancer, that she had recovered memories of being sexually abused by both parents. Two days later the accused mother drove her car off a cliff and killed herself. She left a note behind explaining that she had “nothing left to live for.” Who can gauge the long-term effects of this confrontation and its aftermath on this woman who now believes her memories are false?

SUING THE PERPETRATOR

The Courage to Heal includes a five-page section written by Mary Williams, an attorney who represents adult survivors. Williams briefly describes recent changes in the statute of limitations, citing California’s enactment of a three-year statute for civil actions based on childhood sexual abuse when the abuser was a family member. Under the new statute, victims can choose to bring suit up until their twenty-first birthday. When delayed-discovery laws are applied to the new statute, survivors have three years from the date of discovery to file suit. Thus, if a survivor repressed the memory of abuse and as a result was unaware of the alleged injury for many years or even decades, she would be granted three years from the date of discovery (presumably somewhere in the midst of therapy) to initiate a lawsuit. (Since The Courage to Heal was published in 1988, over twenty states have revised their statutes of limitations regarding childhood sexual abuse.)

An entire page in The Courage to Heal is devoted to the subject of “Getting Money.” Williams discusses the potential range of settlements (“I have had settlements ranging from $20,000 to nearly $100,000”) and includes a footnote indicating that average settlement amounts will most likely rise in the future.4 The possibility of tapping into homeowner’s insurance policies for damages caused by “negligence” is also reviewed.

In a final section, a cost/benefit analysis of lawsuits is presented. While “there’s often a feeling of letdown and disappointment” after the case is settled and “emotional reconstruction still has to be done,” the benefits of suing are alleged to be substantial:

In my experience, nearly every client who has undertaken this kind of suit has experienced growth, therapeutic strengthening, and an increased sense of personal power and self-esteem as a result of the litigation.… A lot of my clients also feel a tremendous sense of relief and victory. They get strong by suing. They step out of the fantasy that it didn’t happen or that their parents really loved and cared for them in a healthy way. It produces a beneficial separation that can be a rite of passage for the survivor.

A list of lawyers specializing in adult-survivor lawsuits, complete with addresses and phone numbers, is included at the end of the section.

In Secret Survivors, E. Sue Blume includes a two-page section titled “Suing Perpetrators,” in which she praises the ideological benefits of lawsuits, which offer survivors “an opportunity for some validation from the system that abandoned them; a positive outcome is the system’s acknowledgment that yes, something happened, and yes, he had no right.” Blume also reviews the practical reasons for suing. Settlements can be used to help pay for “large medical and psychotherapy expenses for women whose earning ability (low because of their gender) is reduced by the damage done by the abuse.”

And so we have reached the logical late-twentieth-century ending to the strange and mystifying problem of repressed memories of sexual abuse. When all else fails (or, preferably, before all else fails), hire a lawyer and sue for damages.

SOME FINAL WORDS OF CAUTION

Buried in the middle of Renee Fredrickson’s book is one small sentence containing twenty-one words of caution. We would like to repeat this cautionary advice here, believing that its truth should be balanced against the oft-repeated claim that “getting your memories back is the most healing process of all.”

Neither you nor your therapist want to accept a false reality as truth, for that is the very essence of madness.

If only we had a surefire way to separate false realities from the truth. But we don’t, and in most cases involving “repressed” memories, we never will. Belief is at the root of the problem. If we believe something is true, it becomes our truth, and there is little anyone can say that will shake our faith in our own reality.

Therapists, unfortunately, are no better equipped than the rest of us to discern the genuine light of truth. Perhaps it would be worthwhile to repeat here psychologist Michael Nash’s conclusions regarding the ability of clinicians to distinguish between fantasy and reality: “In the end we (as clinicians) cannot tell the difference between believed-in fantasy about the past and viable memory of the past. Indeed there may be no structural difference between the two.”