The Truth About the

Sexual Abuse of Children

and Its Aftermath



MYT H Susan A. Clancy, Ph.D.













Susan A. Clancy, Ph.D.


A Member of the Perseus Books Group

New York

Copyright © 2009 by Susan A. Clancy

Published by

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Designed by Pauline Brown

Library of Congress Cataloging-in-Publication Data

Clancy, Susan A.

The trauma myth : the truth about the sexual abuse of children—and

its aftermath / Susan A. Clancy.

p. cm.

Includes bibliographical references and index.

ISBN 978-0-465-01688-4 (alk. paper)

1. Child sexual abuse. 2. Sexually abused children. I. Title.

HV6570.C66 2009



10 9 8 7 6 5 4 3 2 1







What Was It Like When It Happened?



The Truth About Sexual Abuse



The Politics of Sexual Abuse



Why the Trauma Myth Damages Victims



How the Trauma Myth Silences Victims










on interviews with adults, all of whom were victims of

sexual abuse as children, who participated in research

studies at Harvard University between October 1996

and August 2005. During the process of writing, my

first priority was to protect the confidentiality of the

victims discussed in this book. For many it was the first

time they had spoken out about the sexual crimes against

them. It was also very important to me to portray the

reality of sexual abuse, the personality of the people

who were abused, the complex interpersonal dynamics

they faced both at the time of the abuse and in the aftermath,

and the multitude of ways these crimes affect

them throughout the course of their lives. In my attempt


to reconcile both goals, I have opted to change the

names of all the victims featured in this book and to

either omit or modify any clearly identifying characteristics

(such as age, birth date, place of residence, and

specific occupation). That being said, the quotes throughout

this book are taken verbatim from the actual victims’

transcribed interviews. In this way I hope to

respect and protect subject confidentiality while still

accurately characterizing the humanity of these victims

and the heartbreaking complexity of the crimes

they experienced.




FALL 1996


steady job as a tax advisor, a wife of twenty years (his

high school sweetheart), and three kids whose photos

dangle from his key chain. Once a week he coaches a

junior high school basketball team and at least twice

a month he brings his family to church. Every March

they all go to Sarasota, Florida, where Frank’s invested

with his brother in a time-share near the beach. On the

outside Frank has it all—family, financial security, and

good health—but on the inside he feels differently.

When Frank Girard was nine years old, something

bad happened to him, something that he believes fundamentally

damaged him, that powerfully and permanently

changed how he felt about himself, who he is, his


abilities, and his rights to success and happiness. For

over three decades he has kept what happened a secret;

he has hidden it completely from his wife, his family,

and his friends and, as much as possible, from himself.

At the root of Frank’s silence is shame. He suspects

that what happened was his fault, that he brought it on

himself, and as a consequence there “must be something

wrong” with him—that it happened because he

was in some way “aberrant.” Not surprisingly, he does

not want anyone to know, least of all the people that he

is close to and who love him.

Despite Frank’s efforts not to talk about what happened

to him as a child, recent circumstances have

made keeping silent increasingly difficult. He’s been experiencing

significant problems both at work and in

his marriage—problems that he believes link back to

his childhood experiences—and he suspects that resolving

these problems will require reaching out for

some kind of professional help or support.

• • •

ON A COLD, RAINY EVENING in October, Frank took

the subway home from work, and he saw a copy of the

Boston Globe on the empty seat next to him. As he idly

skimmed the pages, an ad jumped out at him. The ad



read, “Were you sexually abused as a child? Please call

Susan for more information regarding a research study

on memory in the Department of Psychology at Harvard

University.” Frank read the ad twice. Although his

final destination was supposed to be Alewife Station,

when the train screeched to a halt at Harvard Square,

he got off. Fifteen minutes later he was outside the door

of my office, soaking wet. Could he be part of the research

study? Could it be now?

After more than three decades of silence, Frank

was ready to talk.

• • •


University, just beginning the research project on sexual

abuse that Frank read about in the paper. What

Frank had to say to me was shocking. Beginning when

he was nine years old, over a six-month period, he had

sexual experiences with a middle-aged man who was a

friend of Frank’s family.

This was not the shocking part. Researchers in the

sexual abuse field know that sexual abuse is common—

that adults all too frequently exploit children for sexual

purposes. What shocked me was how Frank said he reacted

to the sexual abuse when it was happening to



him. What gradually emerged, accompanied by long

pauses, frequent sighs, half-finished sentences, and

eventually tears, was that when the abuse was happening,

Frank did not mind it. As a child, he loved this

man, and he liked the attention this man gave to him.

And sometimes what they were doing felt good. Occasionally

he gave Frank baseball cards after the touching,

and Frank looked forward to receiving them.

When the man moved out of town, Frank felt upset.

He missed him, the time they had spent together, and

the attention he had received.

While I listened to Frank describe his reactions to

the abuse, I understood why he felt ashamed and guilty

about what had happened—why he felt “aberrant.”

Considering what I was taught and believed about sexual

abuse, he was.

For over three decades, first the experts and then

our communities have understood sexual abuse as a

terrible experience for the child when it happens—as

something invariably done against the will of a frightened

child. But for Frank, when the sexual abuse was

happening, it felt different.

Before Frank walked out the door of my office, he

asked me a question. Since I was a researcher at Harvard

and “studied these kinds of things,” maybe I could help.



I told him I’d be happy to try.

For the first time in two hours, he looked me directly

in the eyes. “What I told you . . . how common is this?”

At first I was relieved. This was a question I

thought I could easily answer. I began, “Frank, childhood

sexual abuse is very common. Approximately one

in five children—”

But Frank interrupted me.

No, not the sexual abuse part, I know kids get

abusedfor Christ’s sakes it’s in the papers all the

time. . . . What I am asking is if other kids react to it

like I did . . . you know, do what I did?”

Frank was referring to the fact that the childhood

sexual experiences he had were not forced—because he

had loved the man and enjoyed the time they spent together,

Frank did not in any way fight or resist the sex.

I had no idea how to answer his question. At the time,

based on everything I knew about sexual abuse, everything

I studied and was taught by professionals, I was

sure Frank was an unusual victim, but I did not want to

have to say this to him. I strongly suspected it was

something he did not want to know.

So I decided to equivocate.

I said, “Frank, the field of sexual abuse research is

relatively new. Maybe what you did—how you reacted



to it—is common; after all, you were a kid, you cared

about him, and you couldn’t fully understand what you

were doing, what he was asking from you, or what the

consequences might be. Only time and more research

will tell if your experience was common or not.”

He seemed satisfied with the answer. But I felt terrible

for not being totally straightforward with him.

• • •


countless hours studying sexual abuse, reading and

rereading research from the fields of psychology, psychiatry,

law, criminology, and sociology, meeting with

representative experts, and speaking with victims of

sexual abuse—male and female, young and old, rich and

poor—I do not feel bad anymore. As it turns out, I was

telling the truth.

Today, despite their best intentions, some professionals

in the sexual abuse field have developed and fostered

major misconceptions among the general public

about this terrible crime—what it really is and how victims

react to it. In their well-meaning efforts to raise

awareness that sexual abuse is damaging and is never

the child’s fault, they have chosen to emphasize characteristics

and dynamics of abuse (such as trauma, fear,



violence, force, and threats) that do not characterize the

experiences that most victims have. As a consequence

of this misplaced emphasis, professionals ignore and the

public misunderstands the concerns, worries, and fears

of millions of victims—people like Frank. These are

instead overlooked, minimized, and denied.

In the current cultural climate, telling the truth

about sexual abuse—directly addressing what actually

happens and how victims react to it—is difficult. Many

professionals and victims’ advocates in the sexual abuse

field worry that doing so will result in society’s blaming

the victims or questioning the harm sexual abuse causes.

But these worries are unfounded. Sexual abuse, as I will

discuss at length in this book, is never the victims’ fault,

and it most certainly damages them, but not for the reasons

many of us have been led to believe.

It is often said that advocacy is best aided by truth.

In this case, not only will facing the truth about sexual

abuse set victims free from the chains of guilt, shame,

and secrecy that bind them, but it will help criminal

and legal authorities better identify and punish the perpetrators,

mental health professionals develop more

effective treatments, and parents better protect their

children from becoming future victims of these vile

and, to date, outrageously common crimes.




CHILD SEXUAL ABUSE—a term mental health, legal,

and criminal professionals commonly use to describe

sexual experiences between adults and children—

is astonishingly common. According to epidemiological

data, based on randomly sampled, representative populations

from the United States, gathered and analyzed

using advanced and sophisticated social science research

methods (by researchers with no apparent political

or financial agenda), about one in ten men and about

one in five women in the United States today has had a

sexual experience (ranging from genital touching to

oral-genital contact to anal or vaginal intercourse) as a

child with an adult (someone over eighteen).1 This translates

into about forty-five million Americans. (Because


people interviewed by researchers might not admit

they were abused, many agree that these numbers are

likely conservative).2

We have many explanations for the frequency of

this crime. Some sociologists talk about societal deficits

in information about sexual behavior. Mental health

professionals talk about the need for more research and

funding for child maltreatment prevention. Many feminists

highlight women’s subjugation in a patriarchal society.

Religious conservatives have argued that sexual

abuse is an inevitable side effect of an increasingly sexually

liberal society, while some religious liberals posit

that it stems from the sexual repression of priests. More

than a few people I have bumped into have seemed to

believe it results from the world’s becoming increasingly

immoral, from the irretrievable break down of

social norms. An older woman sitting next to me on the

bus recently summed up this perspective: “This generation

is going to hell in a handbasket.”

Explicit or implicit in these explanations is the underlying

assumption that there is something unique

about the present, that something specific about today’s

time and culture allows so much abuse to occur. But

this is not the case. According to the same body of



solid data I mentioned earlier, analysis of abuse rates

by generational cohorts indicate that high rates of sexual

abuse have been fairly constant over the last century.

3 It was common when our great-grandparents

were alive, and unless we do something drastically different,

it will be common when our children’s children

are born.

Not only is sexual abuse common, but no one is

safe. Prevalence rates do not vary much across socio -

economic strata: Rich kids get abused just as often as

poor kids, black kids as often as white, college grads

as often as high school dropouts.4 To makes these findings

less abstract, go to any playground in any city or

town in America and pick out five kids. Odds are one of

them has already had a sexual experience with an adult

or will have one before he or she hits puberty.

This “equal-opportunity” nature of sexual abuse

has a lot to do with the fact that the vast majority of

abusers (about 90 percent of them) are men we know

and trust—family members, friends, teachers, sports

coaches, camp counselors, piano teachers, rabbis, and

priests.5 The notion that most sexual abusers are weird

and sick strangers (the “bogey man theory”) is plain

wrong.6 Your average abuser is not a stranger or some



convicted criminal staking out your house: It is someone

you know, someone you respect and trust, and

someone you’ll most likely be happy to let in.

Not only is sexual abuse common, but it is damaging

to those who experience it. Adults who were sexually

abused as children (compared to people who were

not) report a startling range of problems, including,

but not limited to, mood disorders (like depression),

anxiety disorders (like posttraumatic stress disorder),

personality disorders, relationship and sexual problems,

eating disorders, self-mutilation, alcohol and drug

abuse, and even psychosis.7 Although no specific pattern

of signs or symptoms exists—not every victim is

affected in the same way to the same degree—analysis

of data from both clinical and nonclinical samples reveals

strong and consistent associations between the

experience of early sexual contact with an adult and a

host of adverse adult outcomes. The most conservative

synopsis of the situation would be that sexual abuse is

a significant risk factor for a wide range of adult psychological

problems and disorders.8

Not surprisingly, health professionals in the fields

of psychology and psychiatry have devoted an intense

amount of time and effort to helping victims cope with,



and recover from, the psychological problems they report

in the aftermath of sexual abuse.

In the same way as physicians approach the treatment

of medical problems, mental health professionals

believe that the best way to help patients suffering from

psychological problems is to establish the root cause—

the precise mechanism behind the problems. By establishing

the precise nature of the cause, they can better

treat it. So what is the precise nature of the psychological

pain and problems victims report in the aftermath

of sexual abuse?

The answer might sound like a no-brainer: If you

experience psychological distress after sexual abuse,

then the sexual abuse must be the cause. But it is not

actually that simple. What, specifically, about the abuse

has triggered the distress? Does it have to do with objective

characteristics of the abuse (for example, how

many times it happened or whether penetration was

involved)? Does it have to do with subjective characteristics

about the abuse (how painful, frightening, or shocking

it was)? Perhaps it has less to do with the actual

abuse and more to do with, say, the particular child (how

old he or she was and how genetically predisposed to

long-term psychological problems) or the environment



the abuse occurred in (one characterized by poverty,

physical abuse, or neglect). Maybe it has to do with

the cognitive or social consequences of the abuse

(how the victim’s family or health professionals handled

it or how the victim understood or conceptualized

it later on in life). There are numerous ways to understand

how and why sexual abuse damages victims. For

decades, however, the main focus has centered on one—

the incident itself.

The theory developed in the late 1970s, which sexual

abuse experts accepted widely in the 1980s and

today remains almost uncontested in the fields of psychiatry

and psychology, is referred to as the traumatic

stress (or traumatogenic) perspective.9 In a nutshell,

the idea is that sexual abuse damages victims not due to

the particular nature of the victim, the environment,

or the consequences of abuse but to the abuse experience

itself. Sexual abuse damages victims, the theory

goes, because it is a traumatic experience for the child

when it happens.

Now, the word “trauma” means different things to

different people. My cousin returned from service in

Iraq and reported that getting shot at in the desert was

traumatic. A friend ran over a frog while she was mowing

the lawn and told me that seeing the animal die in



front of her was traumatic. My colleague tells people

that quitting smoking has been traumatic. A student

just walked into my office and told me that studying for

his exam has been traumatic. However, the way professionals

in psychology define a traumatic event is clear:

It is either objectively life threatening when it occurs

(like getting shot at) or subjectively results in the same

kind of intense fear, horror, or helplessness that objectively

life-threatening events arouse.10 According to

the dominant theoretical framework, sexual abuse, like

other traumatic experiences, damages victims because

it is a frightening, horrifying, overwhelming, or painful

event when it happens.11

The exact manner in which professionals believe

that trauma results in long-lasting harm is complicated.

Basically, the experience of psychological trauma

causes extreme, unnaturally high levels of neurobiological

arousal in the victim, arousal so extreme that it

becomes toxic: It destabilizes the victims’ neurobiology,

leading to long-term emotional, behavioral, and cognitive

dysfunction and, in some cases, even to brain damage.

In other words, trauma can set off a chain reaction

in the nervous system that influences levels of hormones

and neurotransmitters and can impact the brain. Traumatized

brains may have dysregulated systems poorly



equipped to handle subsequent psychosocial stressors.

In short, traumatic events produce profound and lasting

changes in physiological arousal, emotion, cognition,

and memory.

The traumatogenic model encompasses three basic

assumptions. First, as I have already discussed, trauma

is the central concept used to explain the long-term

effects of child sexual abuse.12 Second, the pathway

through which the trauma of sexual abuse affects wellbeing

is direct; that is, the emotional disturbance induced

by the trauma of sexual abuse persists across

long stretches of time. Thus, although victims report

different negative outcomes in adulthood as a result of

sexual abuse, all are symptoms of a lingering psychological

disorder, the etiology of which is traced directly

to the original sexual experience. As Lenore Terr, one

of the foremost experts on the harmful effects of childhood

sexual abuse, explains,

Like childhood rheumatic fever, which causes a

number of conditions in adulthood ranging

from mitral stenosis to subacute bacterial endocarditis

to massive heart failure, childhood

psychic trauma leads to a number of mental

changes that eventually account for some adult



character problems, certain kinds of psychotic

thinking, much dissociation, extremes of passivity,

self-mutilative episodes and a variety of

depressive and anxiety disturbances. Even

though heart failure and subacute bacterial endocarditis

in adulthood look very different from

one another and demand specific treatment,

their original cause—“the childhood rheumatic

fever”—gives an organizational pattern to the

physician’s entire approach. Every good internist

knows how to obtain and assess a history

of rheumatic fever. Thus just as rheumatic

fever causes lots of problems, childhood sexual

abuse causes lots of problems.13

The third assumption embedded in the traumatogenic

framework is that child sexual abuse experiences

fall on a continuum of severity that describes the level

of stress induced and predicts the extent to which the

child will suffer long-term negative consequences.14

(The more traumatic the abuse was when it happened,

the more acute the long-term negative outcome.) Put

another way, the degree of traumatic stress experienced

during the sexual experience best accounts for

variation in long-term adverse effects. As Judith Herman,



a psychiatrist at Harvard Medical School, states in her

influential book Trauma and Recovery, “There is a simple,

direct relationship between the severity of the trauma

and its psychological impact.” Accordingly, if a victim

today reports psychological problems in the aftermath

(as they usually do), the assumption is that the sexual

abuse, when it happened, was a horrific experience—it

was frightening, shocking, and overwhelming.15

Although increasingly many professionals and researchers

in the sexual abuse field acknowledge that

other factors not specifically related to the abuse might

have something to do with harmful consequences, the

main emphasis of much of the research has been firmly

on the abuse. For at least three decades, the notion that

the effects of sexual abuse flow from their traumatic

character remains largely unchallenged.16 Any sexual

contact between children and adults is understood to be

invariably awful for the child—an experience characterized

by force, oppression, fear, and helplessness.

Not surprisingly, the trauma theory of sexual abuse

has had a profound effect on how professionals talk

about and describe sexual abuse. By far the most popular

conception of the effects of adult-child sexual contact

envisions the experience as the presentation of a

noxious stimulus to a child, one that immediately pro-



duces adverse emotional responses. If you Google

child sexual abuse,” as hundreds of thousands of

people do every year, the American Academy of Child

and Adolescent Psychiatry website is among the first

returned for public access. The main page concerning

child sexual abuse clearly states, “No child is psychologically

prepared to cope with repeated sexual stimulation.

Even a two or three year old . . . will develop

problems resulting from the inability to cope with the


Today, sexual abuse is very rarely described without

the word “trauma” or without the implication that

the experience involved fear and violence. Treatment

centers are referred to as trauma centers. Sexual acts

against children are described as “sexual assaults” or

violent encounters.” In the words of Lenore Terr,

child sexual abuse is a “horrible external event in childhood

. . . rendering the young person temporarily helpless

and breaking past ordinary coping and defensive

operations.”18 Another tremendously influential researcher,

Denise Gelinas, states, “There is little doubt

that abuse constitutes a major trauma for the child,

one which confuses and profoundly threatens. . . . The

most predominant reported affect is fear.”19 Judith Herman

writes, “At the moment of trauma, the victim is



rendered helpless by overwhelming force. . . . The common

denominator of trauma is intense fear, helplessness,

loss of control and threat of annihilation.”20

Sexual abuse, according to the standard diagnostic

system used by physicians and psychologists (the DSM

IV), exists in the same category of traumatic events as

combat, rape, and natural disasters. As a consequence,

many researchers studying the psychological impact of

sexual abuse do not even bother to ask victims detailed

questions as to whether the experience was traumatic

when it happened; they just assume it was. Like rape or

combat, sexual abuse automatically “counts” as a traumatic

experience. If a victim of sexual abuse reports

psychological damage in the aftermath, it is automatically

assumed that the damage is a function of the degree

of trauma the victim experienced during the abuse.

In fact, the assumption of trauma is so inculcated into

most professionals that if a victim does not report the

abuse as a horrific experience when it happened, they

often assume that the wrong questions were asked or

the victim is misremembering the actual events.21

Naturally, what professionals specializing in sexual

abuse and trauma believe, research, and write about is

communicated to the general public. The trauma conceptualization

of sexual abuse has, in the words of the



medical historian Ben Shepard, been “vectored into society”

and impacted enormously how it is presented in

the media and subsequently understood by all of us.22

Books about sexual abuse targeting victims typically

open with such passages as,

It is about the silence of nights spent holding in

screams, holding back tears, holding in one’s

very self.23

If you are reading this book it is because you remember

the terrible and frightening experience

of being sexually abused.24

Why don’t victims share their secrets? Because

of the cycle of rape, shame, and unshared, unshareable


The Courage to Heal, first published in 1988 with a

twentieth anniversary edition still selling well, perfectly

exemplifies this trauma positioning. It is, without

a doubt, the book most widely read by victims and cited

by professionals. Continual references to trauma occur

throughout this five-hundred-page tome, with words

such as “blood,” “rape,” “sodomy,” “terror,” and “pain”





used to describe the sexual abuse. Victims who read it

are continually told that even if they feel otherwise,

what happened to them was done against their will. According

to the authors, the abuse was forced upon

them; they were “utterly helpless” and “raped against

their will.”26

For thirty years the topic of sexual abuse has resulted

in a steady stream of activism, public concern,

and media attention having to do with topics such as

abuse in day care centers, recovered memories of sexual

abuse, celebrity abuse experiences both as victims

and as abusers, and most recently the sex scandal in the

Roman Catholic Church. To highlight the influential

place the trauma model has in our understanding of

sexual abuse, virtually every commentator shares the

view that the sexual abuse was horrific when it happened

and, as a consequence, profoundly damaging to

the victim. Not surprisingly, when we read about sexual

abuse in the news, watch a feature about it on TV, or

witness it in the movies, it is almost always in the context

of lurid, sensational stories having to do with subjects

like the rape of choir boys by pale, wet-eyed

Catholic priests, Internet stalkers luring young children

for sex through their e-mails, international sex

trafficking of young Latinos and Brazilians, and the

rape of infants in day care centers. In Mystic River, an

Academy Award–winning movie based on a book of

the same title, strangers kidnap a young boy and sexually

abuse him in a basement (this is a movie often

shown at “kickoff ” events when communities raise

awareness about sexual abuse). Indeed, available

cultural scripts foster and support the notion in our

culture that sexual abuse involves fear, force, and


• • •


never thought to question the trauma conceptualization

of sexual abuse. Why would I? First of all, it made

sense. To me, as for most of us, sexual abuse is a painful

topic to think about. The idea that adults use children

for sexual purposes is, quite frankly, morally and physically

revolting. I assumed child victims would feel the

same way.

Second, experts in my field had taught me to think

this way about trauma. The trauma theory anchored

the vast majority of research on sexual abuse. Why

would I question it? I was repeatedly assured that psychology

was a science. And the cardinal rule of science

is simple: Believe only what the facts justify.



Science concerns the pursuit of truth. The pursuit

of truth requires clear thinking, solid reasoning, logic,

honesty, rigorous argument, and especially evidence.

After years of having the importance of establishing

one’s beliefs on objective evidence drilled into me by

people in my field, I assumed that an endorsed theory

would be just that. It never once occurred to me to

think otherwise. I trusted my field and its adherence

to the scientific process.

On top of it all, not only were experts in the field

telling me that sexual abuse is traumatic for the victims

and that this trauma relates directly to the long-term

psychological damage so many report, but they were

telling me it was so traumatic that some victims would

repress memories of their experiences until later in life.

The levels of stress the victims experienced while being

abused were suspected to be so high that they severely

compromised an area of the brain called the

hippocampus, which is responsible for processing and

storing memories. As a consequence, the victims would

be unable to remember what had happened to them. According

to this perspective, victims sometimes report

forgetting what happened to them and then remembering

years later because the abuse was extremely traumatic

when it happened.27



Although Sigmund Freud and his close friend and

collaborator Josef Breuer first developed this concept

of repression over a hundred years ago,28 it only exploded

into our cultural awareness in the early 1990s.

All over the country, people began to talk about sexual

abuse and to “recover” memories of their own. Celebrities

came out on national TV to share their stories;

nursery schools were shut down due to reports of sexual

abuse; the FBI had to start an investigation about

alleged recovered memories involving not just ordinary

sexual abuse but sexual abuse involving satanic cults.

Many professionals in the field of sexual abuse endorsed

the concept of repression, but some, including

members of my department, did not. Skeptics like Daniel

Schacter, at the time the head of my department and

one of the world’s most influential memory researchers,

and Richard McNally, my advisor and a renowned expert

in posttraumatic stress disorder, noted that according

to a large body of laboratory and real-world data, traumatic

experiences are usually remembered all too well;

that is, emotional arousal at the time of an event’s occurrence

actually fosters the consolidation and subsequent

accessibility of one’s memory of it.29 So why, if

sexual abuse was traumatic, would victims forget it?

Further, why were only sexual abuse victims repressing



and recovering their memories? Why did victims of

other types of traumatic events (like combat or prison

camp confinement) not do it as well? Experts in the

trauma field, such as Judith Herman, Bessel van der

Kolk, and Lenore Terr, explained that there was something

unique about the trauma sexual abuse victims experienced.

30 However, what specifically that something

might be was not particularly well specified.

• • •

WHEN A PROJECT EMERGED that would address this issue,

that would allow me to interview sexual abuse victims

and collect data on just how traumatic the sexual

abuse was, I jumped at the chance. It seemed so simple.

All I had to do was find sexual abuse victims, ask them

questions about what the experience was like when it

happened, and then test the hypothesis that the more

traumatic the sexual abuse was when it happened,

(1) the more psychological damage victims would report

in the aftermath, and (2) the more likely they

would be to repress their memories. Both hypotheses

made sense: I just needed to collect the data. In fact,

they were so straightforward I was surprised the research

had not already been completed and reported.



Before the study began, other graduate students

asked me if I was worried about engaging in this kind

of research. Did I not think it would be painful to talk

to victims, to listen to their stories? Did I not want to

pick something less difficult to do with my time? But I

was naïve. I did not think so. Everything I had already

done as a graduate student was psychologically painful

(interviewing schizophrenics, the suicidal, and alcoholics),

so how could this be any worse? Comparatively,

I felt optimistic. After all the years of research, it seemed

like our field was never going to cure schizophrenia, depression

treatments did not always work, and getting

alcoholics with a genetic marker for alcoholism to stop

drinking was proving extremely difficult. This project

was different. Based on what I had read, I felt that over

the previous twenty years, the field had made progress

for victims of sexual abuse, that for the first time in

history, social and professional attention had been seriously

mobilized toward this important topic. So I was

thrilled to be part of it. I was certain that research like

this was really going to help us solve problems and answer

questions for victims.

My biggest concern was finding sexual abuse victims

who would agree to come in and talk with me. It



was not going to be pleasant for them—they were going

to have to answer detailed and personal questions

about their experiences—and I certainly did not have

much to offer them in return for their time.

Many scholars in the sexual abuse field told me that

the best way to find subjects would be to look for them

in the offices of psychotherapists specializing in the

treatment of sexual abuse. It would be easy to locate

victims that way.

But here was the problem. According to data, most

people who are sexually abused do not go to therapy to

talk about what happened to them. By choosing to interview

only victims in therapy, I would be using a biased


I decided to cut down on the bias by running an ad

in a medium where as many people as possible from the

general population would see it. I decided to run ads in

the Boston Globe (and eventually other major newspapers

in the greater Boston area).

My concerns about finding sexual abuse victims

willing to talk to me turned out to be unwarranted.

When I came into work the day I first ran the ad, I already

had over fifty messages waiting for me. It turned

out I would have no trouble connecting with brave and

generous sexual abuse victims in the general popula-



tion who would participate in research studies about

their experiences.

Over a ten-year period, more than two hundred

men and women participated in this and similar research

projects pertaining to sexual abuse with me and

with my colleagues at Harvard University (my sample

comprised approximately 65 percent women, 35 percent

men). Every single one of them was sexually

touched as a child by an adult. By legal, professional,

societal, and Harvard standards, they clearly met the

criteria for victims of sexual abuse. Among the sample

was the CEO of an Internet start-up that had just gone

public (he was worth $62 million), a minor-league baseball

player, a parolee who had just been released from a

five-year prison stint for drug trafficking, a heroin

addict in withdrawal who shook throughout our discussions,

a stunning runway model, two Ivy League computer

geeks working on a NASA-funded research study,

an artist working on her first gallery show opening in

New York, a woman living with her dog out of her

Dodge Bronco, a dowager from the Back Bay whose

husband had just left her for a man after fifty years of

marriage, a litigation attorney who brought his own

consent form for me to sign, a teenager with a lip piercing

and a large tattoo on the back of her neck who was



contemplating emancipation from her foster family, and

more. They were a diverse group, but they shared two

very important characteristics.

The first I expected: Almost every victim I spoke

with reported that their childhood sexual experiences

had damaged them. As the sexual abuse research I was

familiar with predicted, they commonly experienced

symptoms of psychological disorders (for example, depression

and posttraumatic stress disorder). Although

not all met criteria for actual psychological disorders,

most reported multiple adverse effects from the abuse.

They believed that what happened to them had negatively

affected their lives and their relationships with

others. In addition, forgetting sexual abuse (alleged repression)

was not uncommon: I had no trouble finding

people in the general population who reported periods

during which they did not remember their sexual abuse.

The second commonality between the victims I did

not expect. In striking contrast to the assumptions of

the traumatogenic model, whatever was causing the

psychological and cognitive damage these victims reported

had nothing to do with trauma; very few victims

reported any fear, shock, force, or violence at the time

the abuse occurred.





What Was It Like

When It Happened?

I wondered why would anyone

want to touch me there. . . . It didn’t seem right,

but I wasn’t sure why.”




my initial advertisement ran in the paper. According

to my voice mailbox, she called at 5:15 in the morning.

When I connected with her, she said she was not sure

she met the criteria for the study.

Okay,” I said. “Were you sexually abused as a


I’m not sure,” she said.

Not sure? (How could you be not sure? I wondered.)

I rephrased the question. “Did an adult, someone

older than eighteen, have sexual contact with you before

you reached puberty?” Without hesitation, she said

yes. After we discussed the details of her abuse and

the research study, she agreed to participate, and we

scheduled a time for her to come to my office to be


Erin showed up for her interview early, carrying a

latte from Starbucks, looking like a movie star. She was

tall and thin, with long, shiny, blond hair, wearing a

beautiful, fitted, cream pantsuit, crocodile-skin threeinch

heels, a Cartier watch, and diamond studs. She had

perfectly sculpted eyebrows. I was acutely aware that I

had just rolled out of bed and was wearing the exact

same beige sweatshirt and Gap relaxed-fit jeans I had

worn the day before.

Erin briskly shook my hand, sat down, crossed

her long legs, took out a leather eyeglass case from her

Coach satchel bag, carefully removed a tiny pair of

gold-wire-rimmed spectacles, rested them elegantly at

the end of her refined nose, and began to carefully read

the consent form I handed to her. She appeared calm

and totally composed.

Erin had a couple of questions regarding subject

confidentiality; it was very important to her that no one

ever know she had participated. I stressed how the information

she gave me might be used in scientific papers

or books, but that all identifying features, like her

real name, age, and occupation, would be changed so



that no one would be able to identify her. In addition,

she was not thrilled about the tape recorder. Was it

really necessary? I thought it was. I would be transcribing

these interviews, and I wanted to make sure

that what these victims said to me was thoroughly and

accurately recorded.

After she signed the consent form with her own

fountain pen, I offered her some Munchkins I had

brought with me from Dunkin’ Donuts. She declined

politely and looked at her watch. “We have one hour

and forty-nine minutes left. Shall we begin?”

I turned on the tape recorder.

I collected background data about Erin. She was

single and twenty-eight years old. She grew up in a

wealthy suburb of Boston. She had one younger sister,

and her parents divorced when she was very young.

She had attended an exclusive private school, gone to

an Ivy League college where she majored in finance,

worked on Wall Street as a financial analyst, and received

her MBA from a top-ranked business school. For

the past two years she had worked for a Boston consulting

group and traveled on business three days a week.

In her own words, “In essence, I live out of my suitcase.”

She had no children, was not religious, was physically

healthy, and had never gone to see a psychologist.



It was time to begin talking about the actual abuse.

I explained to her that as per the interview protocol, I

would start by collecting information concerning the

objective characteristics of the abuse: what kind of

abuse had occurred, who the perpetrator was, how old

she was at the time, and how many times it happened.

She nodded but warned me that this might be difficult

for her as she had never told anyone about the abuse before.

This took me by surprise. I wondered why. I also

wondered why she wanted to open up after so many

years of silence. She seemed to sense my confusion because,

without my having to ask, she told me that she

thought “it might feel good to talk about it after all

these years” and the fact that she “didn’t know me” and

wouldn’t have to ever see me again” made “participating

in this research study appealing.”

Considering she said she had never talked about the

abuse before, the interview went smoothly. She understood

all the questions and answered them succinctly

and clearly with no hint of emotional distress. And the

information she provided me with, so far, was what I expected

to hear. The perpetrator was an adult family

member; she was nine when it happened; it involved genital

touching (“He asked me to masturbate him”), digital

penetration (“He would stick his fingers inside me”), and



oral genital contact (“He would ask me to perform fellatio”);

and it happened between five and ten times over a

period of six months. Based on the objective characteristics

of the abuse experiences (the who, what, and when),

she fit the standard profile of an abuse victim to a tee.

But the rest of the interview did not go so well.

I asked Erin to talk about the subjective characteristics

of the abuse: what the sexual abuse was like for

her when it was happening, how she reacted to it, how

she felt about it, and what she did. It was in this part of

the interview that I would be collecting the data at the

heart of the study—data about how traumatic the abuse

was for the victim. According to the interview protocol,

I would begin by asking Erin to quantitatively rate, on

a five-point scale, questions related to how traumatic

the abuse was when it happened (five was very much so;

one, not at all).

Okay, can you rate how frightened you were?”


Yes, frightened.”

Umm. You mean at the time of the abuse?”

Yes, at the time of the abuse.”

Not very . . . maybe a two?”

Can you rate how painful it was for you . . . on the

same five-point scale?”



Painful? Not at all. No, not painful. A one.”

Can you tell me how shocked you were?”

Well, it was surprising at first, so maybe a three?”

What about overwhelmed? Did you feel overwhelmed

when it was happening?”

Hmm. No, I would not say overwhelmed. A one

and a half maybe?”

Okay—so overall, how traumatic would you say

the experience was when it happened?”

Hmm . . . at the time it happened?”


About a two.”

Considering that Erin definitely met criteria as a

sexual abuse victim, and considering my indoctrination

into the theory that sexual abuse was invariably a

traumatic experience for the child victim, I wondered

how her ratings of trauma could be so low. I was supposed

to stick to my standardized questions and not to

deviate too much from the interview protocol. But what

I was hearing just did not make sense. I figured I’d go

off the interview and consider Erin to be a pilot subject

who could help me make sure my interview questions

made sense.

Erin,” I said. “You were sexually abused as a nineyear-

old, multiple times, by someone you trusted. . . .



Why wasn’t it more traumatic for you when it was


She looked directly at me with her clear, icy-blue

eyes. “Because I did not understand what was going on.”

What do you mean?” I said.

What I mean is that I did not understand what sex

was. I did not understand what he was asking me to do.

I did not know why he would want me to do that, to

touch him there, to put that in my mouth. I did not

know anything, at all, about sexual matters. I supposed

I had led a sheltered life. He said it was normal and I

chose to believe him.”

Okay, I thought to myself. But even if she did not

understand exactly what was going on, surely she

could tell it was wrong, right? That this should not be


I could tell by the way he was acting that this was

something I wasn’t supposed to talk about—and once

the front door opened while we were doing it, he

jumped up really fast so I could tell we were doing

something wrong.”

But if she knew it was wrong, why did she not stop

it? Say no? Why did it happen so many times? I paused

for a moment and then asked, “Why do you think you

didn’t tell anyone?”



For the first time she did not answer. She closed her

eyes, put her long fingers on her forehead, and began

massaging her eyebrows. After a while she leaned down

and began fishing in her big leather purse.

Do you need something?” I asked.

No,” she said. “I’m fine. Totally fine.”

I could not see her face, but I could hear some muffled

sniffles. I reached across and handed her the

Kleenex box on my desk. After she wiped her eyes and

blew her nose and made a brief visit to the ladies room,

she seemed different—less distant, more relaxed. She

ate a donut.

Look, it’s complicated. I knew him. He was part of

the family. . . . If it was a stranger, I guess I would have

said no, just run away. But it was not a stranger. I loved

him. I trusted him. It did not occur to me that he would

want to do something like that. . . . On top of it, he was

an adult, and I was always being told to listen to adults,

to do what they ask. . . . I didn’t want to say no, to say

no to something he would ask. And why would I be defying

him? I couldn’t even explain it. . . . It did not occur

to me that he would do something to harm me. . . . I

made a decision. I did a kind of cost-benefit analysis,

although I could not of course have understood it in



those terms. What would happen, the cost of saying

yes? I was not sure, maybe get into some kind of trouble?

Cost of saying no—having to defy him or stand

up to an adult. That would have been difficult to do.

And the benefits? If I did it—this thing I didn’t really

understand—I would be making him happy. . . .

Whatever it was clearly it was something that he

wanted. . . . I wanted to do what he wanted. . . . I guess

you could say I was eager to please.”

As a nine-year-old, Erin faced a complicated decision,

one in which, from her perspective as a child,

there was no clearly correct choice. In the absence of

necessary information (for example, what sex was and

why his behavior was wrong, what the long-term consequences

might be for her or for him if anyone found

out), she made the best choice she could.

At the end of the interview, Erin said she was glad

she made time to come in, that it felt cathartic to talk

about the sexual abuse and “finally get it off her chest.”

I felt differently. Nothing went as I had expected.

What Erin told me made no sense. It was a terrible experience

for me even to hear about the details of her

abuse—shocking, revolting, heartbreaking—so why was

it not more terrible for her when it actually happened?



At first I assumed that Erin was an unusual victim—

that I had picked the wrong subject to be my first interview.

This turned out not to be the case.

• • •

SAMUEL WAS A SIX-FOOT-PLUS, extremely attractive,

African American policeman. In his late forties and divorced

with adult children, he was the next participant

in my study.

Like Erin, Samuel clearly met criteria for sexual


I went to this bible camp as a kid. . . . In the

neighborhood I come from, there was not much

to do in the summer except for get in trouble so

my mother sent me there. I was maybe nine or

ten. . . . They didn’t like for us to go to the bathroom

alone so usually one of the counselors

would go with you. He was maybe in his twenties.

His name was John and we thought he was

pretty cool with us kids, so we liked him more

than the other ones. I had to pee but I didn’t

want to pee in front of him so I went into the

stall. When I came out he said he had to check

me to make sure I had cleaned myself properly.



I didn’t know what he was talking about but he

told me to take down my pants and show him. . . .

He said that it wasn’t clean, that I had made a

mess on myself, and he said he was going to

clean it with his mouth. . . . Then he said that he

had to go to the bathroom and then I had to check

if he was clean . . . I had to put it in my mouth to

check. . . . He made me keep it in his mouth for a

while. I don’t think he came—ejaculated if you

know what I mean—but I am not sure. He did

this a number of times over the rest of the summer.

Sometimes I had to clean him with a tissue

and my hand, sometimes in my mouth.

Based on the objective characteristics, Samuel was a

normal” sexual abuse victim. He was abused by someone

he knew, the abuse involved oral sex, and he was

about ten. But again, when it came to the part of the interview

when we discussed the subjective characteristics

of the abuse, I was in for a surprise. Samuel, like

Erin, did not report that the abuse, when it happened,

was particularly traumatic.

Did it hurt?”

Oh, no. No, I would not say it hurt.”

Were you scared?”



No, not at all. Maybe a little weirded out. . . .

Confused is a better word.”

Where you shocked or horrified?”

No, that’s too strong to put it. Maybe surprised?”

Can you tell me what the abuse was like for you

when it happened?”

I would say . . . complicated. Let’s see. . . . It is hard

to explain. . . . I guess to be totally honest, I didn’t

really understand what was going on. I was a pretty innocent

kid. . . . I didn’t actually know what a blow job

was. . . . Actually, what was going through my mind is

why would he want me to kiss him [there].”

So are you saying that you did not understand

what was going on? You didn’t understand that it was

sexual in nature?”

I didn’t understand. . . . I mean, if I had to tell

someone I would not be able to describe what it was we

were doing. . . . I could kind of sense it was wrong—by

the way he was reacting—like trying to be quiet and

telling me we shouldn’t talk about it. . . . Also, it didn’t

hurt or anything. . . . So there were no bells going off,

no alarms going whoop whoop whoop this is wrong.”

• • •




forty-six-year-old homemaker. Her three kids played in

the kitchen area at the entrance of the lab while I interviewed


When I was six my father died and we moved to

my . . . grandparents’ home. They lived in an

old farmhouse in Connecticut. . . . I was pretty

lonely there. . . . We used to live in a city. . . . Now

I was on this five-acre farm in the middle of

nowhere but I loved my grandparents. I did;

I was close to them. . . . My mother was very close

to her mother. They were always together, but

my grandfather and I, we were . . . inseparable. . . .

At the time he was like my best friend—my only

close friend. . . . We lived there for about two

years and I spent a lot of time with my grandfather

and he wasn’t that well—he couldn’t get

around too good, so a lot of the time . . . he

spent in the TV room that was off the porch. . . .

Well, here comes the hard part. . . . Sometimes

when I was watching TV I’d sit on his lap . . .

and sometimes when I was on his lap he would

put his hands on me . . . up my skirt . . . under

my underwear . . . and, well, he’d feel me . . . my



vagina area. . . . It was maybe off and on for a

year or so. . . . Sometimes he would push himself

up against me, rub my crotch against his and he

would be breathing really hard. . . . Sometimes I

would feel wetness; my panties would be sticky.

Carole was a little younger than most victims but

certainly well within the common age range. Like Erin

and Samuel, from an objective perspective, she was

clearly abused—an adult engaged in sexual activities

with her when she was young. But from a subjective

perspective, as a child, she did not see it as abuse. She

trusted the perpetrator, and what he was doing did not

hurt. She had no idea what sex was. While she could

sense it was wrong, she was not quite sure. She figured

the best course of action was just to go along with

what was being done to her.

I’ll tell you, I didn’t like it, what he was doing, but I

just didn’t really understand. . . . I guess I just thought

of it as something we did on Grandpa’s lap when we

watched TV.”

• • •

THESE INITIAL PARTICIPANTS’ stories ended up being remarkably

consistent with what other victims who par-



ticipated told me over the following years. In fact, less

than 10 percent of the participants reported experiencing

their abuse as traumatic, terrifying, overwhelming,

life-threatening, or shocking at the time it happened.

And why was it not traumatic? Usually the perpetrator

was someone they knew, admired, loved, and

trusted—not, as one victim put it, “a freak wearing a

hockey mask and carrying a knife.” In addition, what

this person asked them to do did not hurt—it almost always

involved touching or kissing of the genitals—and

it was not accompanied by force or aggression.

As Kristin, a twenty-seven-year-old architecture

student, described it, “One night I woke up and he [her

new stepfather] was kneeling next to my bed. He said

he liked to watch me sleep. He told me I was beautiful.

That it was nice to see me sleeping so peacefully. Stuff

like that. Then I think what happened the first time is

that he took my hand and put it on him. On his penis.

He moved it up and down and then after a while he was

breathing heavy and then I felt some wetness on my

hand. Then he told me that I was such a good girl, that

I made him feel good.”

Tom, a high school guidance counselor, said, “There

was nothing violent about it; there was nothing coerced

with threat, you know, like ‘I’ll kill you’ or ‘I’ll tell your



parents’ or something like that. It was all verrrrry subtle.

And subtle in the sense that I didn’t even know it

was wrong.”

Initially, from my perspective as a researcher and

academic, it did not matter that they knew, liked, or

trusted the perpetrator. It did not matter that no force

or aggression was used. The experiences were still horrible,

and listening to the details filled me with fear,

shock, and revulsion. As an adult I understood that the

events occurring were sexual in nature, very wrong,

and an egregious violation of a child’s rights. But I was

forced to confront, over and over again, the perspective

of the child being abused. I had to get out of my own

head and into theirs (as children) and see that their reactions

to these experiences were different. Victims

said that since they did not understand what the perpetrator

was doing or asking them to do, they had no way

to process or make sense of sexually toned encounters.

The word used by 92 percent of the victims when

asked to describe how they were feeling? Confusion.

Some randomly sampled victims in my study described

the experience as follows:

It was weird; I had no way to describe it.



He had his pants down; I think he had no underwear

on. It just didn’t make any sense to me.

It didn’t hurt me, and I was too young to think

of it as sexual. . . . The experience just did not

fit into my notions of right and wrong.

Although they were confused, most of the victims

who spoke with me (about 85 percent) said that they

could sense that something about the situation was

wrong. Again, some of the victims who spoke with me

described it as follows:

I knew it wasn’t right for him to have fingers up

underneath my panties. . . . I knew in my little

mind it was wrong.

Oh, I knew there was something wrong, but I

just didn’t know what to call it really.

At some point he said I shouldn’t tell anyone because

this was something special between him

and me and that it was very normal. I believed

him. It didn’t feel normal, but it didn’t feel bad



either. Basically when it was happening I had no

idea what was going on.

Many of the victims said they sensed that what was

happening was wrong because of the way the perpetrator

was acting. They told me,

I only knew it was wrong because he told me

not to tell my mother and he would be real

quiet; he’d tell me not to make any noise.

By the way he was acting, I could kind of figure

out that it was something we weren’t supposed

to be doing.

Everything I knew dictated that the abuse should be a

horrible experience, that the child should be traumatized

at the time it was happening—overwhelmed with

fear, shock, and horror. But the sexual abuse described

by the victims I spoke with was much different. It was

not a black-and-white situation. It was complicated,

subtle. A trusted person had asked each of these children

to do something he or she did not fully understand.

Although they could often sense it was wrong,

they were not sure why.



So what did they do? In stark contrast to everything

I had come to believe about sexual abuse, they did

not fight it. It was not done against their will. They

went along—did what was asked of them. In their own

words, they “participated,” “consented,” and “allowed

it.” In fact, of those who sensed the behavior was wrong,

only 5 percent tried to stop it—by saying no, running

away, or telling a parent. Why? The trauma theory

holds that a child will only participate in abuse if

forced, threatened, or explicitly coerced. This was true

in a very small minority of cases. Most of the victims I

spoke with had very different motivations. According

to them, they did not resist the abuse for three reasons.

First of all, they told me that when they were children,

adults often asked them to do things they did not

really understand or want to do. Accepting confusing,

unpleasant things is, for better or worse, an inevitable

part of life as a child. As Dave, an accountant, put it, “I

would say I had no idea what was going on. What he

was doing just made no sense. . . . But I think as a kid

so much of what happens to you is weird and confusing

that this just sort of joined the ranks with the rest of

the stuff. . . . Basically I was the sort of kid who just

learned to accept what they are told by adults and not

complain much.” In the words of Maria, a mother of



two teenagers who was undergoing treatment for

breast cancer, “He was my doctor and it seemed like

every time I had to see him he did things that were

weird and sort of hurt. Let me just say that this hurt

much less than the shot he gave me on my shoulder.

That had about a million needles sticking out of it.”

Second, not only are kids routinely asked to do

things they do not understand or like, but they are told

to listen to adults—especially adults in positions of authority.

As Bob, a construction worker, put it, “I was

brought up in the kind of family that you listen to adults.

You do what they say and you don’t ask too many questions.”

It never occurred to me to say no to anything a

teacher asked me to do,” noted Joy, a therapist. In the

words of Robert, an attorney specializing in medical

malpractice, “He was a priest. You listen to priests. I

told my father I didn’t want to go, that I didn’t want to

spend time with him and he [said,] ‘Just shut up. . . . Be

happy such a person even wants to give you attention.’”

Resisting the abuse would require children to challenge

authority, something they are told not to do.

Many reported being very concerned about the negative

consequences of saying no to the perpetrator:

He might be upset with me. I didn’t want that.



I didn’t want to hurt his feelings. He was really

nice most of the time.

I don’t know why, I can’t explain it, but it would

be totally embarrassing to say no . . . and not

really to have a reason why I was saying no to

this person.

It didn’t exactly feel normal, but there was no

way I was going to say no. He was my teacher. I

didn’t want to end up getting sent to the principal’s

office for disrespect.

In short, these victims felt they could resist, but

doing so would require questioning authority, and

they did not feel comfortable with that, especially

when they could not clearly articulate why they would

be resisting.

Now add this third factor to further complicate

matters: The abusers often conferred “rewards” on their

victims for saying yes. These ranged from concrete rewards

like gifts (“He took me to Penny’s and would buy

me something afterwards,” “I liked ice cream a lot and

he gave me ice cream”) to abstract but powerful reinforcements

like love and attention (“He told me I would



[do it] if I loved him and I wanted him to know I loved

him,” “As a kid I never got much attention and at least

this was attention,” “Back then I was looking for any

kind of love or approval I could get,” “I remember

thinking this person would like me more if I did it. . . .

I wanted so much for him to like me, to want to be

around me”). Although I did not specifically ask victims

about dysfunctional family backgrounds or childhood

neglect, many reported often being left alone as children:

Both of my parents were busy,” or “I came from

single-parent home. My dad left and my mom had to

work hard to make the ends meet. I hardly ever saw her.”

More than a few volunteered that they felt neglected as

children: “I could sense it was wrong, but the thing is I

think I needed some attention,” or “I was so lonely a lot

of the time, didn’t have brothers and sisters . . . and he,

well, I guess you could say was around for me . . . took

me places, bought me things.”

Some subjects—in no cases victims of penetration—

reported that they responded sexually to what happened

to them, that sometimes it felt good (“I didn’t

understand it, but I guess my body did”; “It was confusing,

but I liked it. It felt good”; “It was the first context

in which I had sexual pleasure”). One subject, who was

sexually victimized by his camp counselor, was quite



clear that, at the time, he enjoyed it: “I used to look forward

to him sneaking into my bunk. It felt good. What

he was doing felt good. It was the first time I developed

erections. When he stopped . . . I thought he was doing it

to someone else. . . . I was mad at him.” Another man told

me that during his abuse (by a priest), he had his first

orgasm: “I was, what, maybe twelve? I had no idea what

was going on. . . . I knew it was wrong, but I also knew it

felt good. Totally fucked up, if you know what I mean.”

Sometimes, heartbreakingly, the benefits extended

to a better life for the victim, as in the case of a man

(one of the 5 percent of victims whose abuse involved

intercourse) who told me, “Well sometimes it hurt, but

it was a hell of a lot better than having to go back to

social services.” Even worse, for some victims the better

life extended to others:

He made my mom happy and I didn’t want to

interfere with that.

He paid the bills, bought us a car. . . . Whatever

it was it seemed like a small price to pay in return.

In short, even though many victims sensed that what

was happening was wrong, they found it very difficult to



say no. Considering the abuse from their perspective, this

began to make sense to me. They were not quite sure

why it was wrong. The perpetrator was someone they

had been told to listen to. On top of all that, the victims

often benefited from saying yes. It was an extremely

complicated situation for these children—one, from their

perspective, with no clearly correct choice. So they made

the best choice they could: They consented. And we cannot

fault them for making this choice. Considering that

they faced confusing circumstances armed with inadequate

information, it was actually quite rational.1

As I learned more, I felt a growing sense of anxiety.

With support from research grants and from my

advisors in the psychology department, I had invested

a lot of time, energy, and money into this project. But

clearly I must have done something wrong. Despite my

best efforts, I must have found a very unusual group of

sexual abuse victims.





The Truth About

Sexual Abuse

HARVARD UNIVERSITY and affiliated institutions

(Harvard Medical School, Cambridge Hospital,

McLean Hospital) are well known worldwide as centers

for trauma research. It is not difficult to find people to

discuss your findings with, and psychologists, psychiatrists,

clinical social workers, and graduate students

were more than willing to give me their input when I

came to them with my results.

Their most common reaction? Precisely what I suspected:

There must be something unusual about the

victims. I must have a sampling problem.

What kind of problem specifically? Perhaps the victims

who responded to my ad, agreed to participate,

and showed up for the interview had experienced less


severe abuse compared to most victims in the population.

According to a clinical psychologist who treated

patients at Cambridge Hospital’s Victims of Violence

Program (one of the nation’s preeminent treatment

programs for adult victims of childhood sexual abuse),

if I looked at the objective characteristics of what happened

to my victims, I might find that those who participated

in my study had experienced, in her own

words, more “benign” abuse compared to most other

victims in the general population.

To determine whether the victims who participated

in my research study experienced more benign abuse

than most, I needed to track down all the national probability

studies that existed on the objective characteristics

of sexual abuse. According to all of them, I had to

disagree with the clinical psychologist who specialized

in treating victims of sexual abuse. There was nothing

particularly benign or unusual about the abuse the subjects

who participated in my study had endured. In

terms of the objective characteristics of the abuse,

their experiences mirrored those of the general population

of people who are sexually abused. Abusers are

almost always someone the children and their families

know, the type of abuse reported usually involves kissing

and genital touching, force or violence is rarely in-



volved, and injuries (minor or severe) occur in less than

10 percent of cases. What happened to the victims in

my research study was remarkably consistent with national

sample studies of victims in the United States.1

• • •

PLAYING DEVILS ADVOCATE, I supposed I could see why

a therapist who specialized in treating victims of sexual

abuse who seek therapy would assume that the victims

participating in my study had experienced abuse that

was relatively benign. Some research shows that, on average,

victims who seek treatment (or who are referred

to treatment) report abuse more severe than the norm

(for example, the abuse more likely involved force or violence

or required medical attention).2 Thus, reversing

this psychologist’s explanation, I realized that it was

probably the victims she saw in the office who reported

unusual abuse, not the people participating in my research


The head of Cambridge Hospital’s psychiatry department

at the time had another explanation for me. If

there was nothing unusual about the abuse the people I

interviewed experienced, then perhaps something unusual

about the victims as children caused them not to

be traumatized. Were they younger or older than most



victims? Based on national studies, the average age of

sexual abuse is about ten, with most of the abuse occurring

before age twelve and about one-third occurring

before age nine. This was true of my sample. He

then suggested that maybe I had managed to find a particularly

resilient sample of victims, people who for

whatever reason were “tougher” or “less sensitive” to

disturbing social interactions than most victims. This

explanation made no sense. How resilient could they

be? Almost every single one of them reported that

these experiences had damaged them: symptoms of

post-traumatic stress disorder (PTSD), major depression,

drug and alcohol abuse, and sexual problems (ranging

from lack of interest to inability to orgasm to hypersexuality)

were extremely common. Of my sample, 75 percent

reported self-esteem problems; 50 percent reported

feeling cut off from others or alienated because of the

abuse; and almost 90 percent reported difficulties in relationships.

Many victims said the abuse had multiple

negative aftereffects. Comments like this were common:

It created a whole bunch of issues for me surrounding

trust, intimacy, control and food, and

other people. It’s affected all my life. There’s

nothing untouched.



What happened to me changed me. It affected

how well I can trust other people . . . how I feel

about myself and my self-esteem. There is a level

of shame . . . how can I put it? Self-loathing?

That is always there after all these years. I can’t

think of any area of my life that has not been


These victims had been affected in the same way as

most others reported being damaged. They were not

particularly resilient. In fact, any rational person in the

field would assume that the abuse must have been very

traumatic when it happened. It was simply my asking

about that dimension of the experience that revealed

that it hadn’t necessarily been so.

The next set of explanations for my data were directed

less at the subjects who participated in the study

and more at me. Were the diagnostic interviews and

questionnaires I used to assess psychological damage—

for example, the existence of disorders such as depression

and PTSD—valid? Yes, they were. I used only

instruments widely accepted in the field.3 Was I properly

trained in diagnostic interviewing? Yes, I was. I

had been trained by experts at the National Institute of

Mental Health and passed my diagnostic training



classes at Harvard with no problems at all. Were the

questions I used to assess how traumatic the sexual

abuse was when it happened misleading or biased?

According to my advisor and colleagues at Harvard, they

were not. In the event that we were all out of touch

with reality, I consulted the CEO of a large, globalmarketing

research company that did polling for outlets

like Time magazine about whether the questions made

sense. He deemed them clear and straightforward.

At a brown-bag departmental lunch where graduate

students, faculty, and researchers got together to

discuss their data, another explanation emerged. Many

of the lunch participants came from the field of cognitive

psychology and specialized in memory functioning.

Perhaps victims were not reporting their abuse as traumatic

because they were not remembering it correctly.

Perhaps the retrospective nature of the study rendered

it vulnerable to inaccurate recollections.

This was possible, I reasoned. As the head of Harvard’s

Department of Psychology explains in his beautifully

written book Searching for Memory, our memory

systems are quite fallible. Memories are subject to decay

and distortion over time.4 The details of early childhood

experiences can be difficult to remember cor-



rectly, and most of the victims in the study were recalling

events that had happened decades before.5

But there were problems with this explanation.

Experts in the field had specifically advised me to collect

data on populations of adults. Why? Because kids

rarely report abuse (more on this later), and those who

do often experience abuse severer than the norm. Further,

I had no proof the victims were remembering

incorrectly. Neither did anyone else. In addition, retrospective

research is the most common type of research

done in the trauma field. In fact, the diagnosis of posttraumatic

stress disorder is based on patients’ memories

of past experiences.6 If my data were going to be

explained away as subject to inaccurate memory recall,

then trauma professionals would have to explain away

most of the research conducted in the field. Finally,

even if this inaccurate memory theory was correct and

my victims were misremembering what had happened,

they should be remembering it as more traumatic than

it actually was. Research shows that people have a tendency

to let current psychological states bias their

memories of past events. The worse you feel at the

time someone asks you about a previous event in your

life, the worse you remember the past event to be.7 If



the people I interviewed were psychologically distressed

at the time I spoke with them (which they definitely

were), one might expect them to, if anything, remember

the abuse as worse than it actually was.

Increasingly eager to understand my data, I invited

an internationally recognized expert on psychological

trauma8 to give a talk as part of a series on PTSD that

I was organizing for postdoctoral research fellows at

Harvard Medical School. I asked him my million-dollar

question: Why are my sexual abuse victims not remembering

their experience as traumatic? Seemingly unfazed

by the question, he answered without skipping a

beat. It had to do with dissociation, a theoretical defense

mechanism of the mind (similar to repression)

that kicks in to help victims mute or escape the psychological

and physical pain they are experiencing. In plain

English, as a consequence of dissociation, victims “space

out,” their minds “drift out of their bodies,” they lull

themselves into a sort of “minitrance”—all ways to distance

themselves from the reality of the situation they

are confronting.9 In short, according to this trauma expert,

the victims who spoke to me did not report any

trauma because the abuse was so traumatic that they

had dissociated when it was happening and as a consequence

could not remember it correctly.



Others in the audience nodded solemnly as he explained

his conclusions; they seemed satisfied with this

explanation. But I did not feel the same way. In fact, I

felt a little sick. Maybe he and other scholars who endorsed

this theory were right. Perhaps sexual abuse

was so traumatic when it happened that victims dissociated

and thus “forgot” the pain. The theory sounded intriguing

(it was exactly the kind of theory that made

me want to be a psychologist in the first place), but the

victims had a different explanation, a simpler one. They

made it very clear to me that the abuse was not traumatic

for them when it was happening because they had

not understood what was going on.

• • •


to as Occam’s razor. When deciding between two competing

explanations for data, you should choose the

simpler, more parsimonious one. The idea is that there

can be any number of explanations for phenomena

you are trying to understand, so when confronted with

multiple competing hypotheses, select the one that introduces

the fewest assumptions and postulates the

fewest entities. In other words, all things being equal,

the simplest solution is usually the best.10 Given the



choice between a complicated, theoretical, unconscious

defense mechanism and victims’ explanations, according

to Occam’s razor, I should listen to the victims.

They said they did not understand what was happening

to them. And if they did not get it, on what basis

would they be traumatized? On what basis would they

dissociate or repress feelings of terror? Where would

the feeling of terror be coming from?

What’s more, science, as I had been taught, is about

developing theories that can be falsified; hypothetically,

data could emerge that would actually disprove

them.11 Yet, it seemed the assumption that sexual abuse

is traumatic was itself “unfalsifiable.” Anything a victim

said that ran counter to the trauma theory professionals

in the trauma field reinterpreted to support it

instead. The theory could not be proven wrong. It appeared

victims could say nothing that would make experts

believe them.

• • •

ON THE TRAIN COMING HOME from the panel on PTSD,

I finally realized that there might not be anything

wrong with me or my research methods and that I was

correct to believe what the victims who participated in

my research study remembered and told me.



I did not question that sexual abuse is related to adult

psychological damage. Thirty years of solid research indicated

that this was the case. Nor did I question that

traumatic experiences, in general, could cause long-term

psychological damage. There was neurobiological research

to support this as well. I did question, however,

whether sexual abuse was usually a traumatic experience

when it happened. I needed to go back to the books. This

time, rather than focusing exclusively on what experts

had to say, it was time to focus on what victims had to say.

What was sexual abuse usually like when it happened?

Given the wide acceptance of the trauma assumption

about sexual abuse, one might suppose that thousands

of studies had asked victims this question. I

discovered that this is not the case. As one researcher

puts it, “The systematic exploration of the subjective

experience of minors involved in sexual contact with

adults, contacts of either positive or negative quality,

has generally been absent from the literature.”12 After

weeks on Medline and Psychinfo (the two most widely

used databases in the fields of psychiatry and psychology),

I found approximately twenty published studies

conducted within the last one hundred years that asked

victims specifically to describe what their abuse was

like when it happened.



In his 1938 study of married women, the cognitive

psychologist Lewis Terman asked if respondents had

had a sexual experience before age fifteen that shocked

or greatly disgusted them, and 32 percent said yes. In

another sample of married women, 24.6 reported “sex

shock.”13 In Alfred Kinsey’s seminal study published in

Sexual Behavior in the Human Female in 1953, he reported

that 80 percent of his sample said they had been

emotionally upset or frightened by their contact with

adults.14 In 1956, Judson Landis presented data from

seventy-three children of “sex deviates” referred to a

clinic in San Francisco for treatment; 33 percent of

girls were frightened at the time of the abuse, 26 percent

of boys.15 In 1991 Paul Okami, one of the few researchers

who asked victims specific questions about

how they felt at the time of the abuse, found that many

victims reported ambivalent responses. For example,

reactions ranged from fear to confusion and shame to

interest and excitement, and often the same victim reported

multiple emotions simultaneously. Among those

who rated the experience as 100 percent negative (about

40 percent of Okami’s sample), force or violence was

present in only 14.3 percent of these cases. Further, the

most common reasons endorsed for why the experience

was negative had nothing to do with fear or shock but



resulted from the fact that “something was done to me

that I didn’t like or didn’t understand” or “the experience

confused me and made me anxious because I

couldn’t tell if it was right or wrong.”16 In a 1983 study

of victims surveyed in a college sample in West Virginia,

about 15 percent reported fear.17 In a 1999 national

sample study, 30 percent of victims reported that

the abuse was frightening when it happened.18 In 2006

a team of researchers out of Holland’s University of

Maastricht asked sexual abuse victims who had “recovered”

memories of their sexual abuse to retrospectively

rate the emotions they felt during their abuse experiences.

Some 85 percent of their sample “failed to appreciate

their abuse as traumatic at the time it occurred.”19

Rather than asking victims to rate aspects of trauma,

many studies had them classify their abuse experiences

based on broad categories such as predominately positive

(usually consisting of words such as “pleasant,”

sexy,” and “exciting”), predominantly negative (consisting

of words such as “shameful,” “frightening,”

shocking,” and “embarrassing”), or neutral. To note

some of these studies here, psychologist Carney Landis

found that 56 percent of victims in his sample considered

the abuse unpleasant or extremely unpleasant, but

only in rare cases was it traumatic.”20 In 1965, John



Gagnon reanalyzed data from Kinsey’s original study

and found that victims could be classified into two categories:

those who found the experience to be mostly

negative and those who found it to be mostly neutral or

positive. The majority reported that they reacted negatively

to the abuse.21 In David Finkelhor’s widely cited

study of sexual abuse victims in Boston, victims rated

their experience on a five-point scale (from positive to

negative). The average rating was a three. He concluded

that “contrary to the stereotype, most victims

readily acknowledge the positive as well as the negative

elements of their experience.”22 In Diane Russell’s seminal

book The Secret Trauma, women in San Francisco

rated their abuse experiences on a five-point scale in

terms of how “upset” they had been: 33 percent of the

sample reported being extremely upset.23 In another

retrospective survey, researchers reported that the

most common reaction at the time of the abuse was

unpleasant confusion” and “embarrassment.”24

While the methodology of these studies differed

wildly in terms of the questions asked and how the

data were analyzed, the takeaway is fairly consistent.

Sexual abuse, for many victims, is not a traumatic experience

when it happens. While most report sexual abuse

as a negative experience, the word “negative” is simply



not synonymous with terror, horror, fear, or pain. As

clinical psychologist Eve Carlson reminds researchers,

to be classified as traumatic, an abuse experience either

has to involve the threat of death, serous injury, or

harm or at least produce the kind of overwhelming fear

and helplessness responses that such threats do.25

Indeed, further to the research I’ve highlighted

above, David Finkelhor, the director of the tremendously

influential Center for Child Victimization and a

well-known sexual abuse researcher at the University

of New Hampshire, states,

The conceptualization that has won the most

support is the idea that the impact of sexual

abuse constitutes a form of posttraumatic stress

disorder . . . but the theory behind PTSD does

not readily adapt to the experience of sexual

abuse. The classic PTSD theory says the symptoms

result from “an overwhelming event resulting

in helplessness in the face of intolerable

danger: anxiety and instinctual arousal. . . . This

theory is well suited to traumas such a war

shock and rape and probably to sexual abuse

that occurs under violent circumstances. However,

much sexual abuse does not occur under



conditions of danger, threat and violence. . . .

Abuse experiences may be degrading, humiliating

and stigmatizing but not necessarily frightening

or threatening to bodily integrity. . . .

Sexual abuse cannot be subsumed or explained

within the framework of Post Traumatic Stress


Margaret Hagan, a professor at Boston University,

concurs: “The absence of clear trauma, violence or

threat and fear in so many cases should prohibit the imposition

of the trauma model in cases where it does not

fit.” She goes on to note, “That the research leads to no

does not, however, lead researchers to accept no as an

answer to questions about the validity of the trauma


Indeed, many professionals interested in sexual

abuse are quick to explain away what the victims in

studies have to say. In The Secret Trauma, Diane Russell

explains why so few of her victims report trauma similarly

to Bessel van der Kolk, by endorsing defenses of

denial, dissociation, and repression.28 Others simply ignore

what victims have to say. In one of the most

widely cited papers in the sexual abuse field, Kathleen

Kendall-Tacket and her colleagues at the University of



New Hampshire’s influential Family Research Center,

after reviewing the overall results of forty-five studies

that do not support trauma as a useful model for most

cases of child abuse, nevertheless stress that the study

of sexual abuse victims “has important relevance to

other theory and research concerning how children

process trauma . . . how trauma expresses itself at various

developmental stages, [and] its role in the development

of later pathology.”29 Today, experts either

implicitly or explicitly rely on stress and trauma models.

The logical failure of these models appears entirely

irrelevant to the strength with which they continue to

be held.

• • •

WHAT I DISCOVERED as I explored this body of research

reassured me. But considering all the evidence that existed

indicating that sexual abuse was not a traumatic

experience, why is the trauma model so dominant, so

entrenched in the study of this sexual crime?

One explanation comes from the field of child development,

specifically from researchers who study

how average children understand and react to sexual

information. Such researchers believe that professionals

in the sexual abuse field suffer from an adultcentric



bias; they try to understand sexual abuse experiences using

an adult framework rather than a child-generated

framework. In their excellent book Treatment and Prevention

of Childhood Sexual Abuse: A Child-Generated Model,

child clinical psychologists Sandra Burkhardt and Anthony

Rotatori elaborate on this idea: “Due to the

morally reprehensible nature of child sexual abuse, researchers

have an understandable tendency to project

their adult fears, repulsion and horror onto child victims,

to assume they react like they do when faced with sexual

situations.” Their anger is barely contained: “Amid the

adult posturing, children’s views are seldom heard,” and

other researchers agree.30 In a controversial chapter titled

The Professional Response to Child Sexual Abuse,”

the authors, all respected professionals in the sexual

abuse field, conclude, “It is amazing that well-meaning

professionals acting in children’s interests have chosen

to all but ignore children’s experience of these actions.”31

As philosophers of science have written, although

scientists are supposed to base their theories on data,

this is not always easy to do. We all tend to be deductivists,

not inductivists, in our approach to the world.

We do not simply gather data and draw raw, unbiased

conclusions; rather, we have prior information and

theories that guide data gathering and interpretation.



Karl Popper clarifies this position: “The belief that we

can start with pure observations alone, without anything

in the nature of a theory, is absurd. . . . Observation

is always selective. . . . For the animal a point of view is

provided by its needs, the tasks of the moment and its

expectations; for the scientist by his theoretical interest,

the special problem under investigation, his conjectures

and anticipations and the theories which he

accepts as a kind of background; his frame of reference,

his horizon of expectations.”32

Sexual abuse is what psychologist Steven Pinker

calls a “dangerous topic”—one that arouses painful and

intense emotions in people who are forced to think

about it. In the grip of such emotions, it is difficult for

many people (even trained scientists) to think clearly.33

Our “horizon of expectations” is likely subject to

strong influence by the moral and even psychological

revulsion many of us feel when we think about adults

using innocent children for sexual purposes. We project

these feelings onto the victims and assume they see the

world in the same way.

As the field of child cognition shows us, beginning

at least with Jean Piaget in the mid-twentieth century,

this is unfair to the child. Children do not think and

reason like adults; rather, their thinking and reasoning



about themselves, other people, and the world around

them unfold over time and through experience.34When

it comes to sex, they do not understand the full meaning

of sexual activities and behavior until late in childhood,

usually just prior to the early stages of adolescence.

Until then, children have only a dim sense of adult sexuality.

Due to their age and level of development, they

are cognitively unable to grasp the meaning of sexual

encounters. They cannot understand sex or sexually

toned encounters like adults can.35 As David Finkelhor

puts it, “What may seem like a horrible violation of social

taboos from an adult perspective need not be so to a

child. A sexual experience with an adult may be something

unusual, vaguely unpleasant, even traumatic at

the moment, but not a horror story.”36 In short, because

children have a very amorphous idea about what is sexual,

they are likely not to recognize sexual action and

intention on the part of others or to interpret them as

something else. Jon Conte and Lucy Berliner, an expert

in sexual abuse working out of the Sexual Assault Center

at Seattle’s Harborview Medical Center, clearly

support this point. In a paper titled “The Process of

Victimization: The Victims’ Perspective,” they note that

the majority of sexual abuse victims they studied did

not know they were being sexually abused at the time



the abuse was happening. No differently from the subjects

who spoke with me, the victims made such statements

as “I didn’t know there was anything wrong

with it, because I didn’t know it was abuse until later. I

thought he was showing me affection.”37

A few years ago, researchers at a prominent Seattle

clinic for sexual abuse victims interviewed children

whose abuse had come to the attention of mental health

officials (and therefore was more likely to represent extreme

cases). They asked these children to describe

what had happened in their own words. Their heartbreaking

responses confirm what I have explored above.

Kids do not get it. Here are some of their comments:

He had a tail. . . . It grew. . . . He tried to put it

in me.

My brother does bad things. . . . He does naughty

things to me. . . . He does something but I don’t

know what it is [child points at her vagina].

My brother stuck his tail in my bottom and he

asked me to suck on it. It’s supposed to be a secret.

I don’t like how it tastes, but I didn’t want

my brother mad at me.38



As I discussed earlier, although child victims often

exhibit a lack of knowledge about the exact nature of the

experiences they are confronted with, many can sense

that they are wrong. Here is how Ross Cheit, a Brown

University professor who was sexually abused in the late

1960s, described it: “The concept of trauma never felt

right to me. It never fit my story. . . . There were no

threats. I never sensed danger. I didn’t fear him. He was

nice to me. Something didn’t add up—and it slowly

started bothering me more and more. . . . I knew I had

been ‘had,’ so to speak, but I couldn’t understand it.”39

Twenty years ago, Leda Cosmides was one of the

first to postulate that humans have a naturally evolved

mental mechanism devoted to detecting cheaters, a kind

of built-in way to detect when people are lying to or

betraying us. According to her theory, the ability to

reason rapidly and accurately about social contracts

may have conferred some evolutionary advantage to

our species; it was important for survival and reproductive

fitness.40 Subsequent research not only supports

the idea that such an evolutionary adaptive cheating detector

exists in humans but suggests that we show evidence

of it early on in life. As anyone who has spent

much time with a young child can attest, the cry of

That’s not fair!” is often heard and is quite accurate. As



a species, we appear to be highly attuned to betrayals,

even when we cannot define them exactly. A child can

often sense that abuse is wrong because the perpetrator

communicates in some way that what is happening is

bad (by warning the child not to tell anyone, making

sure the abuse is done covertly, or reacting with fear if

anyone sees them together).

Children’s knowledge of sex is a function of their

level of cognitive development. If we can accept that,

then we should be able to accept that their behavior is

as well. Initially, I was shocked at how often victims

told me that they participated in the abuse, that they

went along with it, and that they did not fight it or report

it. But the historical literature clearly delved into

this phenomenon in great detail.

As far back as 1907, Karl Abraham noted that sexual

abuse victims seem to fall into two separate categories.

The first group he labeled “accidental victims.” The

abuse is violent, it is usually conducted by a stranger,

and the victim is clearly aware that it is wrong. He or

she reacts strongly and negatively to the offense and

promptly reports it. Today, rather than “accidental” I

might label this kind of abuse as “traumatic.”

The second group Abraham labeled “participant

victims.” In this category, the abuse is not violent, and



the victim knows the perpetrator, does not understand

what is happening, often has more than one experience

with the abuser, keeps the abuse a secret, and sometimes

receives some reward from the offender.41 Based

on a review of the research, the participant victim is, by

far, the more common type.42 In 1977 Judith Herman

and Linda Hirschman published a clinical study of fifteen

adult women molested by their fathers as children.

While the authors were 100 percent clear that the experiences

were wrong, damaging, and criminal in nature,

they were also quite clear that while “most of the

study participants endured the sexual contact,” in exchange

they received special treatment from the father

and a sense of power and gratification in displacing the

mother.” The authors theorized that the fact that such

experiences occurred was a function of “emotional deprivation”

in the victims’ histories.43

According to experts in child cognition, it should

not be surprising that young people “allow” abuse. Not

only do children not understand the full meaning or

consequences of their actions, but they are conditioned

biologically and psychologically to want and need very

basic things: love, attention, positive feedback, and

rewards. And this is precisely what perpetrators are offering

them.44 As Lucy Berliner eloquently notes, “A



common method of coercion used by perpetrators involves

the exploitation of child’s normal need to feel

loved, valued and cared for by parents. Children who do

not have these needs met may be susceptible to the interest

shown them by sexual offenders.”45 As one of the

victims she studied put it, “I think it happened because

I was so needy, because I didn’t have anything.”46

Consider Maya Angelou’s description of her own

account with sexual abuse in I Know Why the Caged Bird

Sings. With heartbreaking honesty, she describes her

childhood longing for affection, which led her to seek

the attention of her mother’s boyfriend. “I began to feel

lonely for Mr. Freeman and the encasement of his big

arms. Before, my world had been Bailey, food, Momma,

the store, reading books and Uncle Willie. Now, for the

first time it included physical contact.”

Mr. Freeman took advantage of her attention.

I went over to him and sat quickly on his lap. At first,

Mr. Freeman sat still, not holding me or anything, then

I felt a soft lump under my thigh begin to move. It

twitched against me and started to harden. Then he

pulled me to his chest. . . . All the time he pushed me

around on his lap, then suddenly he stood up and I

slipped down to the floor. He ran to the bathroom.” She

clearly portrays the immense gulf in intention and



understanding between adult and child: “He smelled of

cola dust and grease and he was so close I buried my

face in his shirt and listened to his heart, it was beating

just for me…”47

Children comply, and to expect them to do otherwise

is simply unrealistic.

Way back in 1956, Judson Landis described a situation

in which an adult friend of the family abused a

young girl. In a “dazed and shocked” state, she went

along with it. Not only did he pass no judgment on her,

but he understood. In his own words, “It is not hard to

understand. The man was a good family friend, and

previous experiences had conditioned the girl to have

accepting attitudes. Only a child of exceedingly alert

judgment and quick perceptions, leading to action,

would have been able to evaluate the approach and repel

it immediately.”48 Many modern-day child psychologists

would agree. It certainly would be expecting a lot

from a child to expect him or her to resist under such


The onus of responsibility for these crimes is 100

percent on the perpetrator. Unlike the child, the perpetrator

fully understands what is going on, he knows

that it is wrong (at least by societal standards, if not his



own), and he decides to do it anyway. Although it is

rarely articulated in such blunt terms, he decides that

his own sexual needs and desires are more important

than propriety, rules, regulations, common morality, or

a child’s well-being.

Further, the fact that children cannot understand or

react appropriately to sex is why, from a legal standpoint,

children cannot technically consent to having

sex with adults. For consent to truly occur, two conditions

must prevail: A child must know what he or she is

consenting to and have the freedom to say yes or no. So,

in a court of law, children cannot consent. The problem

is that most people do not live in a courtroom. We live in

the real world, and in the real world, from the perspective

of child victims, they do consent. They rarely resist,

run, scream for help, or report the perpetrator. As

adults we cannot fault them for making the choice

they do.

Many of us, especially parents, might not want to

have to consider that our children might be confused

about and susceptible to sexual advances from adults.

We might react with denial (impossible!) or outrage

(how can you say such a thing!). But for our children’s

sake, we need to get past both reactions. Perpetrators



are well aware of children’s vulnerability; they are well

aware that children will not get it, that they can offer

confused, innocent kids certain things in exchange for

sex. As a small but consistent (and very frightening)

body of evidence shows, perpetrators specifically seek

out and woo children who might be particularly vulnerable

to abuse—for example, those who lack parental supervision

or seem emotionally or physically neglected.49

• • •


sexual abuse was usually forceful or violent, something

clearly done against the will of a terrified child. I also

believed that this was why so many victims were psychologically

damaged later in life and why many repressed

or otherwise forgot about their abuse for long

periods. Years later, I have emerged with an entirely

different perspective. Obviously there is something

very wrong with the traumatic stress conceptualization

of sexual abuse that has been so dominant in the field.

Carl Sagan, a man who knew how to make science

accessible to just about everyone, said that scientists often

make mistakes, but this is to be expected and embraced.

Science has a built-in fact-checking mechanism.



No matter how enthusiastic scientists are, no matter

how strongly a theory has been embedded in the cultural

zeitgeist, we should always be prepared to discard

it in the face of strong and substantial contradictory

evidence. Science is ultimately about the pursuit of

truth, and this is how more robust theories come

about.50 I believed in my scientific ideals and decided to

publish my research.





The Politics of

Sexual Abuse

WHEN I FIRST BEGAN my graduate work at Harvard,

a respected psychiatrist at Harvard Medical

School gave me some advice. He told me that I

should avoid studying sexual abuse. It was just too

controversial, too sensitive, and too politicized. He said

that advocacy would always outweigh truth and emotions

would always override data. At the time I nodded

solemnly, wondering what he was getting at. Once I

published my research, it made perfect sense.

All hell broke loose. I was bombarded with accusations

that I was hurting victims even more than they

already had been and that I was a friend of pedophiles.

I was also vilified by many in my own scientific community.

Some colleagues and graduate students stopped

talking to me. A well-meaning professor told me to

pick another research topic because I was going to rule

myself out of a job in academia. Some felt my research

had a political agenda, one biased against victims. I was

invited to give a talk about my research at Cambridge

Hospital—home of the tremendously influential sexual

abuse treatment program Victims of Violence. No one

from the program showed up.

Unfortunately, when people heard “not traumatic

when it happens,” they translated my words to mean “it

doesn’t harm victims later on.” Even worse, some assumed

I was blaming victims for their abuse. Such reactions

made no sense. I never once questioned whether

sexual abuse hurt victims. In fact, I spent years listening

to heartbreaking stories about how these childhood

experiences left a lasting imprint on their lives, relationships,

and sense of self. I had never suggested that

sexual abuse was not a crime; from my perspective,

there was no doubt it was a reprehensible one. And as I

discussed in chapter 2, I could not have been clearer

that victims are not at fault. In direct contrast to what

many believed, the point of my research was not to

minimize the harm abuse causes but to question our as-



sumptions about what the cause of this harm really is.

But my explanations fell on deaf ears.

Did I not know, a reporter asked me at the time,

that for suggesting sexual abuse is often not a horrific

experience for victims, that many comply with the perpetrator’s

requests and rarely resist the abuse when it

happens, I would be crucified? The implication seemed

to be that I was naïve. Perhaps I was. I had been so focused

on why a popular scientific theory was wrong

that I overlooked a perhaps more important question:

Why did so many well-trained and dedicated professionals

appear to think it was right?

How and why did the trauma model emerge as the

central interpretive paradigm for understanding the

long-term effects of childhood sexual abuse? According

to scholars like Ian Hacking, Joseph Davis, and

Allan Young, answering this question would require a

social constructionist approach. I would have to abandon

the idea that scientific knowledge exists a priori, in

a pure state, just waiting to be discovered by unbiased

professionals committed to truth. Instead, I would have

to accept that scientific theories often emerge through a

complex and interactive process, one negotiated by professionals

whose discovery and interpretation of data

are inevitably influenced by the social, cultural, and



political frameworks in which they are embedded.1 As

Ian Hacking explains, the basic idea of a social constructionist

approach is to challenge the “taken for

grantedness” of an existing theory, to “unmask it” and

show its “extratheoretical function.”2

In short, it was time to stop focusing on the fact the

trauma theory was wrong. Instead, I needed to focus on

the social, cultural, and political forces that gave rise to

it and the purposes the theory served for those who

promoted and legitimized it.

As I discussed in the introduction, the trauma conceptualization

of child sexual abuse emerged in the

early 1980s. What professional theories and approaches

to child sexual abuse had existed before then? Having

come of age during a time when most professionals in

the mental health field acknowledged that sexual abuse

is a common and harmful form of victimization, I was

shocked by what I found in the historical literature leading

up to this point. For most of the twentieth century,

many mental health professionals believed otherwise.

Sexual abuse, especially as conducted by people victims

know, was considered uncommon. In the words of

one widely read scholar, Karin Meiselman, sexual abuse

qualified as a relatively rare event, much more rare

than most other forms of stigmatized sexual behavior.”3



Clinicians apparently came across few cases. Charles

Wahl reported in 1960 that “it is quite a rare thing to

encounter an actual, verifiable clinical example.”4 As recently

as 1975, a standard psychiatry textbook estimated

the frequency as one case per million.5 As no

large-scale studies on the prevalence of sexual abuse

even existed until Kinsey’s work in the late 1950s, and

this research clearly indicated that sexual abuse was

not uncommon, it is difficult to understand where these

assumptions came from. Some believe it had a lot to do

with Sigmund Freud and his influence on the field of


During the late 1800s Freud found himself confronted

with a number of patients who reported that as

children they had had sexual interactions with adults,

almost always family members. Initially Freud believed

his patients. Not only that, in 1896, with the publication

of his classic paper “The Aetiology of Hysteria,” he

proposed that the sexual abuse they experienced had

caused the neurosis (loosely defined, psychological distress

and problems) that brought them to his office in

the first place.6

But Freud quickly changed his mind. In an 1897

letter to his confidant Wilhelm Fliess, he explained, “It

was hardly credible that perverted acts against children



were so general.”7 For reasons widely (and acrimoniously)

debated by scholars in the mental health field,

he subsequently concluded that his patients had actually

fabricated the abuse experiences they reported.8

According to his revised theory, his patients’ psychological

symptoms and problems did not stem from actual

childhood sexual experiences but from “fantasies”

of them: “I was driven to realize in the end that these

reports were untrue and so came to understand that the

hysterical symptoms are derived from phantasies and

not from real occurrences.”9What motivated his patients

to engage in such fabrication? According to Freud, they

had “failed to resolve the Oedipal situation”—to transfer

their sexual desire from their parents onto more

socially acceptable sources.10

Many scholars argue that the legacy of Freud’s inquiry

into the topic of sexual abuse has been a tenacious

prejudice held by many professionals in the field

that victims lie about their sexual abuse.11 For example,

consider John Henry Wigmore’s Treatise on Evidence,

one of the most widely read and cited legal texts in the

country. He specifically warns that “women and girls

are predisposed to bring false accusations against men

of good character” and that “these accusations might

convince unsuspecting judges and juries.” He therefore



recommends that “any female complainant should be examined

by a psychiatrist to determine her credibility.”12

Although some health professionals acknowledged

that sexual abuse existed and was perhaps more common

than many thought, they were quick to dismiss the

cases as harmless to the victims; the majority of sexual

abuse offenses were deemed slight and short-lived.

Why? For one main reason: because, as I discussed in

chapter 2, victims reported that force or violence were

rarely involved and that it was rare for any medically

significant physical trauma to occur. As John Gagnon,

one of the foremost experts, put it in 1965, “The bulk

of sexual abuse cases will be minimal in character. . . .

The amount of damage—if any, is limited.”13 A text

coauthored by C. Henry Kempe, a world-renowned

child abuse expert, argued in 1978 that “most sexual

molestation appears to do little harm to normal children.”

14 The consensus among most professionals was

that the majority of these offenses were essentially

nuisance experiences” and rarely involved the use or

threat of physical force.15 As the scholar Philip Jenkins

puts it, “The perception of child molestation was as innocuous

as the modern image is threatening.”16

The belief that sexual abuse did not harm victims

was so widespread that for most of the twentieth century,



the term sexual abuse did not even exist. When cases of

adults having sex with children emerged in the criminal

and court systems, they were often referred to as

sexual offenses” against children.17

In the event an abuse victim reported that they had

been damaged psychologically, it was posited that this

damage probably preexisted the abuse, that the victim

already has a disposition to neurosis or psychosis in

later life.”18 In some cases, experts even suspected that

any psychological problems victims reported might relate

to why they were abused in the first place. Why?

Again, for the exact same reasons I discussed in chapter

2: because victims reported that they were often complicit

in the abuse in the sense that they did not resist it

when it happened or report it in the aftermath. Although,

as discussed earlier, there are excellent reasons

for why this is the case—specifically, because children

are developmentally unable to understand or react appropriately

to sexually toned encounters—professionals

at the time came to another conclusion entirely. They

interpreted victims’ compliance as evidence that the

abuse was, in some ways, the child’s fault. As an example

of this flawed thinking, Karl Abraham, the influential

follower of Freud who was one of the first to note

(correctly) that abused children rarely resist the sexual



acts perpetrated against them, concluded, based on his

observations, that there must be something wrong

with them, that they were preinclined toward their own

violation, that they “yielded” to the sexual assault. “The

victim herself unconsciously also may tempt the offender.

. . . We sometimes find this seductive inclination

even in young girls, in their being flirtatious . . . thus

exposing themselves more or less unconsciously to sexual

attacks.”19 Lauretta Bender, a famous American

child psychiatrist and one of the earliest to research

adult-child sexual encounters, found that all the victims

she interviewed were “unusually attractive” children

who made seductive overtures to the psychiatrists. She

referred to them as “sex delinquents” and went on to

note that “it is not remarkable that frequently we considered

the possibility that the child might have been

the actual seducer rather than the one being seduced.”20

Echoing the victim-blaming theme, a book on sex education

widely read in 1970 stated, “There is the incontrovertible

fact, very hard for some of us to accept, that

in certain cases it is not the man who inaugurates the

trouble. The novel Lolita . . . describes what may well

happen. A girl of 12 or so is largely endowed with a

good deal of sexual desire and also can take pride in

her ‘conquests.’” The author goes on to suggest that



she is the temptress and not the man.”21 In fact, between

1930 and 1970, the literature was rife with case

studies of “seductive children” or “pathologically

needy” children.22 In short, based on their observation

that children rarely resist the sexual abuse, professionals

concluded that the acts were, in some way, the children’s

fault. As Benjamin Karpman opined in 1954,

Generally the fact that a particular girl is the victim is

not accident: there is something in her background,

personality or family situation that predisposes her


Consider that only forty years earlier, an elevenyear-

old girl was brought before a juvenile court for

having sexual intercourse with a sixty-year-old man

who introduced himself to her in a park. The man was

acquitted, as the jury refused to send him to prison “for

a girl like that.” Based on the transcripts of the trial, it

is clear that she was considered the offender; she had

caused the incident, and any possible harm that she

might have suffered was trivial compared to her moral

depravity.24 The professional conclusion for most of the

twentieth century was consistent and clear. When victims

reported sexual abuse, reactions included disbelief,

blame, and minimization. As one scholar, Erna Olafson,

summarized, “For most of the 20th century, when



child victims were not viewed as liars, they were labeled

as sex delinquents. When a man sexually assaulted

a child, it was the victim, not the offender, who was

blamed and held accountable for this crime.”25

Professional assumptions about child sexual abuse

began to change in the 1960s. Initially members of the

child-protection movement led these changes. In 1962,

Dr. C. Henry Kempe published “The Battered-Child

Syndrome,” a report of a nationwide survey dealing

with the symptoms of young children who had been repeatedly

physically injured by their caregivers, in the

prestigious Journal of the American Medical Association.

In an editorial accompanying the article, he urged doctors

to report suspected abuse and suggested that more

children might die from battery at the hands of parents

or guardians than from diseases like leukemia, cystic fibrosis,

or muscular dystrophy.26 This paper attracted

massive national attention concerning the physical

abuse of children (and between 1963 and 1968, every

state passed a law requiring the reporting of child abuse).

It also spurred research on all forms of child abuse, including


According to the results of two federally funded

studies commissioned to study the topic in the late 1960s,

sexual abuse was common; a much higher presentation



of abuse existed than thought. In fact, Vincent De

Francis, the author of one of the studies, extrapolating

from the number of cases found, suggested that the results

shattered a commonly held opinion” that sexual

abuse was uncommon. He also noted that most offenses

were committed not by “stranger perverts” but by

adults familiar to the child. Not only was such abuse

common, in stunning contrast to what most professionals

believed, he theorized that “the hazards and longterm

damage” to abused children were “grave and

comparable to the damage inflicted in child battering.”

He called for a coordinated attack on this problem.28

Around the same time, a second group, feminists,

emerged to champion the issue of child sexual abuse.

In The Dialectic of Sex, a cofounder of the New York

Radical Feminists, Shulamith Firestone, urged feminists

to make the issue of child sexual abuse part of

their analysis and to “think of children’s liberation

from male oppression as being linked to women’s liberation,”

to consider it part of the broader subjugation of

women in a male-dominated society.29

Regarding professional assumptions of infrequency,

harmlessness, and victim accountability, feminists were

outraged. In a tremendously influential paper titled the



Freudian Cover-up,” Florence Rush, a leading feminist

at the time, wrote,

What can the consequences of such thinking

be? It categorically assigns a real experience to

fantasy, or harmless reality at best, while the

known offender—the one concrete reality—is

ignored. . . . The victim is trapped within a web

of adult conjecture and is offered not protection,

but treatment under some speculative ailment,

while the offender—Uncle Willie, the grocery

clerk, the dentist or the child’s father—is permitted

to further indulge his predilection for little

girls. The child’s experience is as terrifying

as the worst horror of a Kafkaesque nightmare:

her story is not believed, she is declared ill, and

worse, she is left at the mercy and “benevolence”

of psychiatrically oriented “child experts.”30

Indeed, feminists indicted mental health professionals

not only for suppressing evidence of the maltreatment

of children by men (a “conspiracy of silence”

existed) but for male-biased blame shifting.31 According

to feminists, their theories, “surrounded by scientific



aura,”32 allowed for the systematic suppression and concealment

of the sexual exploitation of children.

On April 17, 1971, Florence Rush took the podium

at the New York Radical Feminists’ first conference on

rape to address not adult rape but child molestation.

During the talk she quoted from past research on sexual

abuse and argued that almost all the existing studies

on the subject needed to be discarded; they were

biased and flawed, conducted by men committed to

covering up and continuing their sexual aggression

against girls. At the end of her address, she cried out

to a wildly supportive audience that a new approach to

sexual abuse was necessary, “a new attitude—one that

acknowledges the harm that sexual abuse causes and

does not blame the victims.”33

Regarding such an approach, family systems therapists

during the 1970s championed what they called an

ecological model for understanding child sexual abuse.

While they agreed with feminists that child victims

were not to blame, they did acknowledge findings indicating

that children were often complicit in the abuse.

This behavior was understood to be part of a dysfunctional

interpersonal dynamics displayed by the entire

family (including a colluding wife). The abuse, accord-



ing to a family systems approach, occurred because it

satisfied mutual dysfunctional needs within the family.34

Feminists rejected this approach outright. As part

of their agenda, they rejected any focus on the victims’

behavior, regarding it as diluting the focus on the offenders’

behavior. In short, according to feminists, the

offender is always 100 percent culpable for his behavior;

they attacked any research or theory that suggested

otherwise (for example, research emphasizing the fact

that children sometimes comply and/or rarely resist

their abuse) as negatively biased.35 One feminist summarized,

It is important not to forget who is the fucker

and who is the fuckee.”36

The feminists involved in this crusade had an interesting

challenge to overcome: how to explain the fact

that victims themselves said that they rarely resisted

the abuse, that they often participated, and that most

chose not to report what happened and kept silent about

their experiences? The feminist solution was to conceptualize

sexual abuse as a violent crime, to treat sexual

abuse the same way they treated rape. As Judith Herman

explains in her widely acclaimed book Trauma and Recovery,

The feminist movement offered a new language

for understanding the impact of sexual assault. . . .



Feminists redefined rape as a crime of violence rather

than a sexual act.”37 As Herman herself says, this “simplistic

formulation” was advanced to counter the view

that rape or the sexual abuse of children was in any

way the victims’ fault. Feminists also defined rape as a

method of male political control, enforcing the subordination

of women through terror. In short, rape was

the feminist movement’s initial paradigm from which to

establish views about the sexual abuse of children. As

Susan Brownmiller stated in Against Our Will, “The unholy

silence that shrouds the inter-family sexual abuse

of children and prevents a realistic appraisal of its true

incidence and meaning is rooted in the same patriarchal

philosophy of sexual private property that shaped and

determined historic male attitudes toward rape.”38 Both

rape and sexual abuse were considered a function of

the inferior status of women (and female children) in a

male-dominated society. Framing sexual abuse as a violent

crime rendered all characteristics of the victim and

the victim’s circumstances, except vulnerability, irrelevant.

In no sense are victims implicated in the production

of the crimes against them. In no sense are

offenders excused from their offences. Blame for both

rape and sexual abuse has everything to do with the offender

and the patriarchal society that created him.



• • •

IS SEXUAL ABUSE REALLY in the same category of crime

as violent rape? According to what victims have said,

not really. It is far more complex and multifaceted. But

as sociologist Joel Best has noted, such “domain expansion”

has important rhetorical benefits, allowing “claims

makers” to build new claims on an established foundation,

to delay controversy over peripheral issues, and

to galvanize professional and societal attention to the


Public and professional attention soon followed.

From the mid-1970s on, the topic of sexual abuse was

put squarely on the agenda of both the child-protection

and the feminist movements. Federal money began to

flow in, child abuse and neglect demonstrations became

more common, research grants were awarded, and child

welfare organizations’ efforts (such as establishing

child abuse hotlines) increased. Such initiatives drew an

increasing number of professionals into the child abuse

and protection “industry.” A new journal called Child

Abuse and Neglect was launched in 1976 and became an

important outlet for articles on sexual abuse. Media attention

followed. In 1977, an explosive article titled

Incest: Sexual Abuse Begins at Home” by Ellen Weber

was widely cited and broadly distributed.40 The article



captured and popularized the growing professional

conviction that sexual abuse was rampant in American

society, that it occurs in families of every social, economical,

and ethnic background, and that the topic had

been virtually ignored despite the fact that “many professionals”

had seen a correlation between sexual abuse

and a multitude of adult psychological symptoms and

disorders. Between 1978 and 1982 at least a dozen

highly publicized books appeared on the subject of sexual

abuse—about half of which were first-person accounts

by victims.41 In addition to books, there were

many films, major network-television documentaries,

and newspaper articles on the subject. Survey results

indicate that by 1980, most Americans reported having

seen a media discussion of the problem.42

The professional and societal attention that sexual

abuse garnered was unprecedented. It not only represented

a massive quantitative increase from the past but

collectively signaled a complete and total break from

the theoretical orientation that characterized earlier attention.

It was a new perspective oriented toward harm

and victim innocence, one that developed not as a rational

response to any solid data but because of politics.

In fact, at the urging of feminists, all existing scientific

research on the nonharmful nature of sexual



abuse or on participant victims was either discarded or

ignored, thrown out not on methodological but on

moral grounds. It was assumed to be “biased against

victims” and even “conducted by male professionals

committed to the systematic denial and suppression of

sexual abuse.” The body of research that subsequently

emerged to take its place effectively erased the past.

The new emphasis was squarely on violence, force, and

psychological harm.43

The first wave of research, conducted between the

mid-1970s and mid-1980s, involved demonstrating just

how damaging sexual abuse was. What occurred was a

cataloguing stage” of all the psychological symptoms

and problems victims reported in the aftermath. They

were numerous, ranging from mood disorders to relationship

and sexual problems, to eating disorders, selfmutilation,

and alcohol and drug abuse, to psychosis.

These long lists of symptoms were used to justify more

professional interest, research funding, and insurance

coverage for treatment. In keeping with the new perspective,

these studies implied that sexual abuse directly

caused these problems, but, as psychologists

themselves often noted, this could not yet be proven.

According to two influential researchers at the time,

Angela Brown and David Finkelhor, although victims



reported a wide variety of effects, including depression,

anxiety, feelings of isolation and stigmatization, poor

self-esteem, a tendency toward revictimization, difficulty

in trusting others, substance abuse, and forms of

sexual maladjustment, it could not be demonstrated

that the abuse was their immediate source.44

One of the first axioms that statistics students learn

is that correlation does not imply causation. Childhood

sexual abuse (A) and psychological problems (B) were

found to be related. Feminists, child-protection advocates,

and many professionals were assuming that A

causes B. However, as professionals in the past had believed,

it was possible that B causes A. Alternatively, it

was also possible that some other factor (C) that was

not being explored (say, for example, childhood neglect

or family dysfunction) was causally related to both.

Feminists, child-protection advocates, and other

constituencies committed to helping victims wanted,

ideally, to find a direct relationship between abuse and

psychological problems. That way, it could be conclusively

proven that sexual abuse is harmful, and in stark

contrast to professionals’ past beliefs, the victim was in

no way to blame. This could be accomplished if the

precise cause of the harm (the “mechanism” driving

the damage) could be clearly identified. Just as doctors



know that the damage caused by a stab wound is primarily

related to something external to the victim—the

sharp tip of a knife ripping into skin and muscle tissue—

sexual abuse victims’ advocates wanted to find an

external cause of the psychological pain and damage

victims of sexual abuse reported in the aftermath.

By the early 1980s, a possible mechanism had been

identified, one that, if correct, could decisively prove

both that sexual abuse damages victims and that it is

never their fault. It would enable the field to progress

beyond a study of mere symptoms to actually conceptualizing

the impact of sexual abuse and developing

treatments to help victims cope later on in life. That

mechanism was called “psychological trauma.”

Ten years before, mental health professionals had

initiated systematic, large-scale studies of the psychological

aftereffects of exposure to combat. This was a

result, in large part, of Vietnam veterans’ accounts of

psychological problems and symptoms experienced

upon their return to civilian life. Antiwar psychiatrists

and veteran’s advocacy groups theorized that this

psychological distress was related to trauma—the

overwhelming fear, horror, and helplessness veterans

experienced when confronted by the life-threatening

experiences they faced in battle.45



During this period, for reasons beautifully outlined

in Allan Young’s book The Harmony of Illusions, professional

interest in the long-term effects of traumatic experiences

grew exponentially.46 An entirely new and

well-funded field of research, trauma studies, subsequently

emerged and became enormously popular. New

scientific societies like the International Society for the

Study of Posttraumatic Stress were born, and scientific

publications like the Journal of Traumatic Stress were released

to meet the increasing interest in the long-term

impact of exposure to life-threatening experiences.

During this period, professionals in the trauma

field discovered that the pattern of psychological

symptoms and problems that veterans reported in the

aftermath of combat exposure appeared to be the same

as those reported by victims of other kinds of horrible

experiences—including rape, natural disasters, concentration

camp confinement. The traumatogenic

theory was subsequently born, and the argument was

quickly accepted that exposure to any event that induced

high levels of psychological trauma could directly

cause psychological damage (even though this

damage might not manifest itself until a later time).

A new diagnosis of posttraumatic stress disorder

(PTSD) entered the psychiatric diagnostic system



(DSM-III) in 1980. An individual could meet the criteria

for the PTSD diagnosis by reporting a certain constellation

of psychological symptoms and problems

following exposure to a traumatic event, one that was

life threatening or provoked the same intense emotions

that life-threatening events do.

The professional ratification of PTSD, a traumatic

stress model for understanding psychological harm,

was a watershed moment for feminists, child-protection

workers, and other advocates for sexual abuse victims.

If sexual abuse was a traumatic experience when it happened,

a solid theoretical framework existed to explain

many of the problems victims reported in the aftermath.

Finally, after more than half a century of professionals

believing otherwise, it could be proven that

sexual abuse directly harms victims, that neither the

psychological damage that victims report in the aftermath

nor the fact that the abuse occurred in the first

place has anything to do with the victims.

The problem, of course, was that initially the link

between the PTSD diagnosis and sexual abuse was by

no means obvious. The theory behind PTSD did not

readily adapt to the experience of sexual abuse as described

by victims. The classic PTSD theory states

that symptoms stem from an overwhelming event that



results in helplessness in the face of intolerable danger,

anxiety, and/or arousal.47 It is a theory well suited

to trauma such as war shock and rape and to the (rare)

occurrences of sexual abuse that take place under violent

circumstances. Furthermore, sexual abuse is less

an event and more a situation, relationship, or process,

one that often continues for a period of time.48

For these reasons, this approach met with criticism

from some professionals who insisted that the conceptualization

of trauma in the PTSD model did not comport

with the experiences of sexual abuse victims. In

the words of one representative critic, “The circumstances

in the prototypal sexual abuse case do not fit

the definition of trauma—exposure to a discreet overwhelming

event. . . . Most abuse involves the subtle

manipulation over time of children by adults they knew

and trusted—the trauma model fits in cases of rape by

strangers, but for ‘normal’ abuse it doesn’t really apply.”49

It did not seem to matter much. Beginning with the

work of Denise Gelinas in 1983, articles and books began

to articulate the harm of sexual abuse as a form of

posttraumatic stress—as a direct function of the

trauma victims experienced during the abuse.50 From

then on, adult-child sexual encounters were understood



as psychologically traumatic for the child in nearly

every case.

Framing sexual abuse as a traumatic event and conceptualizing

the harm of sexual abuse as a form of

posttraumatic stress disorder conferred clear advantages

on sexual abuse victims’ advocates. Here was a

unified model—accompanied by an associated biology

that encompassed a very wide range of distresses, disabilities,

and life problems as trauma aftereffects—that

could be applied to sexual abuse. One very appealing

feature of a traumatic stress model was the unequaled

etiological significance it placed on “outside” (external

to psyche) trauma; the model located the onus of

pathology almost entirely outside the victims. Thus, it

supported the victims’ innocence by shifting the focus

from their own emotional reactions to, or interpretations

of, the sexual contact to the contact itself.

Another very appealing aspect of the model was

that negative outcomes for the child (like drug addiction)

were now understood as coping responses to the

abuse, as the “habitual vestiges of painfully learned

childhood survival skills.”51 Even guilt and shame, feelings

adult victims often report, could now be conceptualized

as self-protective coping defenses—not “normal”



reactions to the abuse but symptoms of an underlying


In short, by constructing the trauma model, clinicians

and researchers were able to reconcile a psychiatric

science with a collective story of a blameless and

harmed victim. As formulated, the trauma model supported

victims’ innocence by locating harm in the conditions

of the experience itself. As Joseph Davis, a

sociologist at the University of Virginia, puts it in Accounts

of Innocence, a major appeal of the trauma model

was that “it supported the unequivocal moral blame of

the offender, including his responsibility for the child’s

passivity and silence, by locating the cause of pathology

in his complete domination. It helped to depathologize

and destigmatize the adult survivor’s symptoms

and experiences by explaining them as necessary coping

responses.”52 In short, the traumatic stress model

did powerful moral and explanatory work; it preserved

and encoded victims’ innocence.

By the late 1980s the link between sexual abuse and

PTSD had been cemented. And since PTSD was a diagnosable

psychiatric condition with set criteria, a large

branch of the mental health profession became more

interested in child sexual abuse. By this time, the topic



had become totally absorbed into the field of trauma

studies. It has been there ever since.

This trauma conceptualization helped not only to

engage professionals but most certainly to galvanize

larger public attention to the topic of sexual abuse. In

his fascinating book The Culture of Fear, Barry Glassner

writes, “If an expert hopes to alchemize a homespun

theory into conventional wisdom he must be bold. His

best chances of doing so are to engage the public’s

emotions, for emotion is the enemy of rational argument.”

53 And, as emotions go, one of them—fear—is

more potent than others. As Richard Nixon supposedly

once said, “People react to fear, not love. They don’t

teach that in Sunday school, but it’s true.” Consider the

fear-inducing implications of the trauma model. As

many as 20 percent of our nation’s children were “being

raped in large numbers,” “forced against their will

into terrifying acts”—acts so horrific that most victims

were “psychologically scarred for life.”

Cognitive psychologists who study fear can offer

excellent explanations of the kinds of things people

tend to be particularly afraid of. For example, negative

events we cannot control (like being in a plane crash)

are much more of a source of fear than those we can



control (like having a car accident). Generally speaking,

we are also more afraid of negative events we can easily

imagine (like our house burning down) than of those

that are harder to envisage (like a pipe breaking in our

basement and our house flooding). We are also more

afraid of ones that are immediate (like a terrorist attack)

than of those that involve a gradual process (like

our arteries slowly clogging with fat). The truth is, in

all cases, we are far more likely to suffer harm from

the latter examples, but they’re still not as scary. Given

a fixed probability of a frightening event’s occurring

(like a child being sexually abused), most of us are

much more likely to get worked up if it is presented as

one that we cannot control, that we can easily imagine,

and that happens all at once.54 The trauma model of

sexual abuse is thus particularly well designed to trigger

our fear—certainly much more so than the truth

that sexual abuse is often a gradual process in which a

confused child is manipulated by someone he or she

trusts into performing sex acts the child does not fully

understand. Barry Glassner emphasizes that immense

power and money await those who tap into our fears.

Perhaps immense power and money weren’t the goal in

this instance, but once the trauma model was adopted, a

sea change occurred in professional and cultural beliefs



and attitudes toward sexual abuse. People started to

care about the subject; they accepted it as common and

harmful to victims. We now understood that it is never

the victim’s fault. The topic of sexual abuse moved

from virtual obscurity into the limelight of public and

professional awareness.

Today, there are thousands of articles under the descriptor

of child sexual abuse. Combined with numerous

books, conference papers, professional seminars,

and so on, the response to child sexual abuse has been

overwhelming. Sexual abuse prevention programs have

been incorporated into most educational curricula. Reporting

laws have been passed in every state. A tremendously

influential, federally funded National Center on

Child Abuse and Neglect exists. There are hundreds of

thousands of professionals—in fields ranging from

psychiatry to law, from education to social work—who

specialize in sexual abuse and conduct research on

causes, consequences, and prevention. Roper polls indicate

that 92 percent of the country reports that sexual

abuse is something we are very concerned about. Millions

of federal and private dollars have been, and are

being, put into designing sexual abuse treatment and

prevention programs. These developments show that

the harsh reality of child sexual abuse has at last been



recognized and that a broad coalition has been formed

to address the problem.

Social movements, according to experts David

Snow and Robert Benford, “frame and assign meaning

to and interpret relevant events and conditions in ways

that are intended to mobilize potential adherents and

constituents, to garner bystander support and to demobilize

antagonists.”55 By framing sexual abuse as traumatic,

child welfare advocates, feminists, and mental

health professionals accomplished all of the above.

During the 1980s and 1990s, not only did the idea of

trauma become attached to a movement (raising attention

to the prevalence and harmfulness of sexual abuse),

but it may have been the horse that pulled the cart—the

idea of trauma proved harm, preserved victim innocence,

and helped galvanize professional and social attention

to the topic. As Judith Herman states in the

opening of Trauma and Recovery, “Without the context

of a political movement, it has never been possible to

advance the study of psychological trauma.”56

Certainly, professionals and movement advocates

have a lot of be proud of. Indeed, the trauma model enabled

victim’s advocacy groups in the 1970s to accomplish

an important goal: to raise societal attention to

the existence and harmfulness of sexual abuse. It was



instrumental in transforming such abuse from a backwater

social issue to the forefront of social, political,

medical, and legal attention. Since it brought an end to

denial, minimization, and victim blame, it seems logical

to assume that, from their perspective, victims agree

that all this societal and professional attention has

proved beneficial to them. As the authors of The Courage

to Heal explicitly state, “The climate for survivors of

child sexual abuse is much different today than it was in

the past.”57 Given the assumption that victims themselves

report progress, it is understandable that advocates

do not want to see, hear, or collect any data that

might rock the boat.

• • •

A FEW YEARS AGO, I gave a talk on my research at an academic

conference. The purpose of my lecture was

clear: We need to modify the trauma model and our cultural

and professional perceptions of what happens during

and after a case of sexual abuse. The trauma model

is not a good fit for the reality of such violations. The

audience sat silent and stony as I explained my perspective.

At the end, a therapist specializing in sexual

abuse cases asked me a question. She wanted to know

why professionals needed to think about sexual abuse



in a different way. Even if I was right and sexual abuse

was not a traumatic event at the time it occurred, what

was wrong with continuing to believe what we all believe

about it?

Today, I am not surprised by this reaction. I realize

that many people committed to helping victims of sexual

abuse do not really care about the truth surrounding

the actual event. The trauma theory’s inaccuracy

does not matter to them. We do not live in a scientific

lab; we live in the real world. And in the real world,

based on the paucity of inquiry into the topic, most

people associate our current thinking about sexual

abuse with progress for victims. Given that assumption,

who would want to risk even the hint of a return to a

time when sexual abuse was ignored, when victims

were blamed for any sex crimes against them, and when

perpetrators got off the hook and went on to defile

more innocent children? I understand why we cling to

the trauma model. Any data that runs counter to it

might threaten the progress victims’ rights advocates

fought so hard to achieve.

The reason the truth matters—the reason advocacy

is, in fact, best based on truth—is that our lies about

sexual abuse are not helping victims. As I discuss in the

next two chapters, based on what victims have to say,



professionals in the mental health field have not made

much progress for them. Unfortunately, the current climate

for survivors does not appear to be much different

today than it was in the past. Today, victims still feel ignored,

they still rarely speak out about the crimes

against them, and when they do, they are still disbelieved

and blamed.





Why the Trauma Myth

Damages Victims


abuse field made when it comes to understanding

and treating child sexual abuse? Certainly we have

advanced to the point that some of the right things are

being said (sexual abuse is common and harmful; it is

never the child’s fault). Funding in the trauma field has

been secured, research conducted, studies and books

published, treatment centers established, and public

awareness raised through sex-education programs and

campaigns in the media. But is any of it translating into

actual progress for victims? According to a report from

the U.S. Department of Justice, sexual victimization

costs victims and their families an estimated $1.5 billion

in medical expenses and $23 billion total annually.1 Do

they feel that they’re being helped, that they’re understood

and their needs are being served effectively? The

paucity of inquiry into the topic leads to the conclusion

that many professionals do not think to ask.2

The trauma model’s main purpose—one of the primary

reasons why mental health professionals welcomed

it with such enthusiasm in the 1980s (despite

there being so little data to support it)—was to provide

an explanation for how and why sexual abuse wreaks

such psychological and social havoc in victims. Armed

with such an explanation, committed mental health

professionals hoped to be better able to help victims

cope with and recover from these damaging crimes.

The problem is that today, after more than twentyfive

years, predictions based on the trauma model have

not proved accurate. Characteristics of the sexual

abuse experience related to trauma (like how frightening

it was, whether penetration or force was involved,

and how many times it happened) do not do a good job

of forecasting the significance of the victim’s psychological

harm in the aftermath.3 There appears to be no

direct, linear relationship between the severity of the

abuse and the psychosocial difficulties victims experience

in adulthood.4 Worst of all, we have developed no

clearly effective treatments for sexual abuse victims:



They continue to suffer from psychological and social

problems in the aftermath, and mental health professionals

still have not reached a consensus as to exactly

why or what precisely to do to help them recover.5 It is

thus not surprising that recently some medical health

professionals have begun to ask what “twenty years of

passionate rhetoric about trauma” has actually accomplished

for victims.6

This state of affairs, I would argue, is far from surprising.

How can trauma be the cause of harm if most

victims say that the abuse was not traumatic when it

happened? Indeed, professionals should have paid more

attention to what victims had to say from the beginning.

A growing number of scholars in the sexual abuse

field are coming to agree that understanding how and

why sexual abuse damages victims probably has little

to do with the actual abuse and a lot to do with what

happens in its aftermath. For example, as David Finkelhor

concluded in his recent book Childhood Victimization,

continuing research efforts that seek to track the

consequences of early events through developmental,

cognitive, and behavioral pathways may prove more fruitful

than continuing the restrictive focus on the severity

and nature of event-specific trauma.7 I believe that the

victims themselves have always known this.



• • •

JEN WAS A SIXTY-FIVE-YEAR-OLD, divorced, retired administrative

assistant. A tall, big-boned redhead with

long purple fingernails, she was up front about lots of

things. She did not like the coffee I gave her, my office

was too cold (and then too hot when I turned the heat

on), and she did not like the color of my hair. We were

at the part of the interview when I asked her to rate

how traumatic the abuse was when it happened. She did

not like the questions I asked.

Nothing personal,” she said, “but these are kind of

dumb. If you are trying to do what you say you’re trying

to do, and figure out why the abuse screwed me up

so badly, why are you asking so many questions about

what it was like when it happened? What you need to

be focusing on was what it was like later on.”

I asked what she meant. She clicked her tongue

impatiently. “What I mean is that what it was like when

it happened and what it is like now are two separate

things entirely.”

At that point in my career, I did not have a lot of

experience interviewing sexual abuse victims. I had,

however, a lot of experience interviewing victims of

other kinds of horrible experiences (motor vehicle accidents,

combat, natural disasters, abductions), and I had



asked these subjects to rate how traumatic the events

were at the time. No one in these studies had ever said

this to me before. And, as far as I knew at the time,

scholars were not talking about how perceptions of the

traumatic nature of an abuse experience change over

time—how an event not initially perceived as horrible

could become so. They certainly talked about how

symptoms of trauma (depression, anxiety) might not

manifest themselves until long after the abuse, but they

were not talking about how perceptions of the abuse itself

can change.8

I knew I had to consider Jen’s words seriously.

From that point on, I asked my question into two parts:

What was the experience like when it happened? And

what is the experience like for you today, looking back

on it?

By the end of the study, the data were clear. Although

sexual abuse was not a particularly awful experience

for the victims when it happened, looking back

on it, from their perspective as adults, it was awful—

ratings of shock, horror, disgust, and even fear were all

high. Obviously, perceptions of abuse when it occurs

and when victims look back on it years later are entirely

different. In addition, sexual abuse is very different

from other kinds of terrible life experiences. For



example, getting into a car accident is traumatic both at

the time it happens and later when it is recalled (although,

as memory researchers are well aware, we may

distort or misremember some aspects of this experience

over time). Sexual abuse, however, becomes traumatic

later on. Why? What happens in the aftermath

of sexual abuse? I had ample opportunity to explore

this question with victims.

As I discussed at length in chapter 2, according to

victims, they did not experience the abuse as awful

when it happened because most simply did not understand

clearly the meaning or significance of the sexual

behaviors they were engaging in. That being said, at

some point later on in life, they do. Over time, the

cloak of innocence lifted,” as one victim described it.

Victims reconceptualized the formerly “confusing and

weird experiences” and understood them for what they

were—sexual in nature and clearly wrong. Only at this

point—when the sexual abuse is fully apprehended—

does it begin to damage victims.


When Anne, a twenty-eight-year-old mother of two,

was eight years old, her mother started working outside

the home. Between 3 P.M. when Anne got home



from school and 6 P.M. when her mom came home from

work, a neighbor and friend of her mother’s named

Frank would babysit. Frank sexually abused Anne.

Sometimes, when Anne was sitting in his lap, he would

put his fingers inside my panties and feel me up . . .

and while this was going on he would thrust himself up

against my butt and he would be breathing heavy.”

When it was happening, Anne said she did not like

what he was doing but was “definately not traumatized.”

And she was no different from most of the victims who

spoke to me. “I knew it was something I shouldn’t talk

about with my mother, but not really exactly totally

sure why.” Anne did know that “he was very complimentary

of me, about what a princess I was, how beautiful,

how lucky my mother was. . . . I didn’t get much

attention in those days and it was nice to hear these

things.” After about eight months of intermittent

abuse, Frank left town, and Anne said she “just didn’t

think much about it again.” But then something changed.

Anne reconceptualized her abuse—she figured out

the meaning of these previously ambiguous experiences:

I remember this like it was yesterday. . . . I was

in eighth grade and my friend Jennie was over and she

had seen her brother and his girlfriend making out and

she was reenacting them rolling around on the ground



and moaning and it was then [that] I remembered

what happened; it reminded me of what happened. . . . I

realized, totally all of a sudden, that what had happened

to me was sexual—that I had basically been having

sexual experiences with my babysitter when I was a

kid.” It took Anne six years to cognitively reconceptualize

what happened to her and understand that it was


For Jamie, it took five years. Her abuse occurred

between the ages of eight and ten on Wednesday afternoons

during her weekly piano lessons. The perpetrator

was her piano teacher, Mr. Anderson. Sometimes

while she played he would touch her thighs and “crotch”

and his own genitals. She did not like what he was doing

and was very uncomfortable, but she did not “really

get” what was going on. Because he told her repeatedly

how beautiful she was, “Whatever it was, I thought

maybe it was my fault, like I was encouraging it.” After

she quit piano (“not because of the abuse but because I

got forced to take the cello”), she says, she “just didn’t

think much about what happened.”

About four years later, the police called. “It turned

out that he had done the same thing to another girl in

town; she was older than me, and she told someone and

they pressed charges. . . . And, oh God, what happened



next, it was . . . I had to go to the police station and I

had to sit in this room with the other girl and my

mother and my father and there was . . . this really

scary woman who just kept asking me questions. . . .

Did he do this? Did he do that? When did he do it? . . .

So I guess then I knew it was abuse.”

Here is how Sam, who was sexually abused in the

school bathroom by a teacher on two occasions when

he was about nine, described the point when he understood

the meaning of what had happened to him in

childhood: “When I was about twelve and started to

get erections . . . masturbating . . . I realized then what

happened was about him getting off on me.” Beth, molested

by a friend’s father when she was seven, recalled,

They were showing us pictures of stuff in health

class. I think I was in ninth grade, and I saw one of the

pictures and I realized . . . that had happened to me and

it was sex. . . . It was wrong.”

• • •

REGARDING THIS PROCESS of reconceptualization, I am

not the first person in the sexual abuse field to note

that sexual abuse victims may fail to understand the exact

nature or meaning of their experiences until later

on in life. Back in 1979 David Finkelhor wrote,



Children may not understand the meaning of

the sexual acts they are engaged in, but then at

a later time in life suddenly realized that this behavior

was inappropriate. Either the children

learned more about sex, or they found out that

such things did not happen in their friend’s

families. . . . At that point the sexual meaning of

all the previous activity becomes clear to them.

Thus, it is our impression that even when a

young child at first fails to recognize the inappropriate

sexual context of some behavior, the

meaning of that behavior does become clear at

some subsequent point in most cases.9

Lucy Berliner and Jon Conte in their 1990 study

noted that a majority of the children they interviewed

reported not knowing initially that they were being

sexually abused. Berliner and Conte quoted victims as

saying such things as “I was led to believe it was a

teaching process” and “I didn’t know there was anything

wrong with it, because I didn’t know it was abuse

until later. I thought he was showing me affection.”10

More recently, two cognitive psychologists, Michelle

Epstein and Bette Bottoms, specifically hypothesized

that due to the confusing and secretive nature of the



abuse, many victims may fail to understand the meaning

of the sexual acts committed (and subsequently

forget them for periods), but then, at a later point, come

to “relabel” the experiences as “traumatic.”11 I believe I

am, however, the first to highlight this “relabeling” as

characterizing most cases of sexual abuse—to posit

that due to the nature of most sexual crimes against

children (not painful or forceful) and the age of most

victims (under twelve), the majority will fail to understand

the exact nature or meaning of these experiences

until some point later on in life.

In my study—no differently from other research—

the exact amount of time it took for victims to reconceptualize

what had happened to them varied. It

depended on the individual victims, on how old they

were when abused, what educational and life experiences

had taught them about sex, and what kinds of

cues had triggered their thinking about what had happened

and recognizing it as abuse. Victims described

the point of realization in different ways: “A light went

on.” “It was like, aha!” “I said, ‘Oh my God.’” For more

than a few it was “like a bomb went off. . . . Holy shit! I

was abused!” For many, the realization was a “long,

drawn-out process” that slowly built up to a new perception

of the abuse. One thing did not vary: only at



this point—when victims understood the abuse as such,

once they had reconceptualized these formerly ambiguous

and confusing events—did the experience become

psychologically traumatic and begin to exert its negative

effects. And, in stark contrast to our collective understandings

of abuse, these effects do not appear to be

immediate and direct, and they have nothing to do with

any “emotional overload” at the time of the abuse (fear

for physical safety on the victim’s part). Rather, they

are indirect, part of a process, and they have to do with

the negative ways in which victims come to feel about

other people and themselves. First and foremost, they

feel betrayed.


When they discover that they have been abused, victims

most frequently report feelings of betrayal. As

Cheryl, a forty-three-year-old high school teacher on

maternity leave with triplets, put it, “I realized that I

trusted him, what he was doing, and I should not have.

He knew he was doing something wrong, and he knew

I didn’t know. . . . It was all an elaborate game of sexual

betrayal.” As Neil, an AIDS activist working for a hospital

in Boston, said, “I realized that it wasn’t just what

he did to me physically. At that moment [of discovery],



I lost my father. He was no longer someone who loved

and took care of me. I was just being used by him for

his personal gratification.”

Sexual abuse victims often feel betrayed for good

reason: They were betrayed.12 The abuse is intentional

on the part of perpetrators. Someone the child knew violated

social norms. Although the perpetrator may have

an explanation—he was lonely, his wife would not sleep

with him, he was drunk, and so forth—in almost all

cases he is still very aware that what he is doing is

wrong. As Morton Bard and Dawn Sangrey, two researchers

specializing in interpersonal crimes, note,

The victims have been deliberately violated by another

person. The crime was not an accident. . . . It is the direct

result of the conscious malicious intention of another

human being.”13

For the victims who spoke to me, the degree of the

betrayal was a function of two main variables. First, it

depended on how close the victim felt to the perpetrator,

on how much he or she trusted, cared about, or

loved him. Here is how Martha, an art director for an

ad agency, described the point of reconceptualization:

The day I realized what happened, I had to

think about the experience in terms of how



much this man meant to me in my life. . . . What

he did didn’t hurt me physically at all; what hurt

me is psychological, that I realized how important

he was to me. I thought he was awesome, a

wonderful man. . . . I really admired and looked

up to him. . . . My whole relationship, my memory,

my past really shifted, from just ‘those

things he did at night’ to complete betrayal. It

was heartbreaking really. . . . I couldn’t stop

crying. I was stupid enough to think he cared

about me; I thought he was wonderful, a good


The second variable related to the degree of betrayal

victims in my study subsequently felt was the degree

to which the victim believed he or she had been

emotionally manipulated by the perpetrator or “taken

in” by the situation. In those cases in which the abuse

was traumatic when it happened (it involved force, violence,

or pain), victims subsequently felt less betrayal.

Since in these cases the children clearly understood the

wrongness of the situation, any sense of betrayal arose

immediately. And, because the children understood

they were being victimized, the abuse was unlikely to

happen again (or if it did, the child remained well



aware of his or her victimization). Thus, victims did

not have to undergo long periods in which they unknowingly

fell prey to, as one subject told me, the perpetrator’s

elaborate games of sexual betrayal.” As

Tom, a neurosurgeon, put it, “For two years, while it

was happening I felt good about him. I believed him, all

his lies and let him do whatever he wanted. It makes me

sick to think about how much I trusted him, how much,

for how long he took advantage of that.” In other words,

the degree of betrayal victims felt in the aftermath

was an inverse function of how traumatic the abuse

was when it happened: the less traumatic it was, the

more betrayal victims reported.

As a consequence, many told me, this betrayal

forced them to rethink the past—to question some of

their fundamental assumptions about being loved and

protected. For many victims, a former sense of security

is shattered; many report feeling a new sense of interpersonal

insecurity and vulnerability.14 As Maria told

me, “The day I understood what happened to me, I

completely lost my own sense of security. The childhood

I imagined I had—the safety that enveloped me—

was shattered. The people who were supposed to be

looking out for my well-being [and] taking care of me

were not.”



These feelings of insecurity and vulnerability are

not confined to the perpetrator and the event. They have

global and pervasive repercussions; they extend far beyond

the actual abuse situation. Many experience a profound

breakdown of trust, not just in the perpetrator

but in other people. Comments like this are common:

This taught me that I can’t trust anyone, that

even the most honest and caring people are

probably just in it for themselves.

I always think that they’re lying, that nobody

really loves me—that they’re just using me in

some way.

This betrayal affects not only victims’ feelings of

security and trust in others but also their self-worth.

They feel that since they must not have been loved, perhaps

they were not worth loving. As Charles, a history

professor, explained to me, “You learn that who you are

and what you might want or need just does not matter.”

For many, the fact that someone they loved and trusted

had abused them led them to think that this person believed

they deserved or warranted such treatment. As



Elinor, a freelance photographer for outlets such as National

Geographic, put it, “What did he see in me? What

was it about me and not my sisters? He could have

come after any of us; we were all there. . . . I think

there was something about me, maybe because I was

too needy?”

Considering the degree and extent of the betrayal

victims felt, I expected anger at the perpetrator to be a

common reaction. Yet only 5 percent spontaneously reported

feeling angry at their abuser. Why would the

victim of a crime punishable in almost any court system

in the world not be angry at the perpetrator? According

to victims, it is because they turned the anger

inward. Most, to a shocking extent, blamed themselves.


According to philosophers, psychiatrists, and intellectuals

from Aristotle to William James, from Shelley Taylor

to Brendan Maher, from Sigmund Freud to Donald

Spence, when bad things happen to people—like discovering

they were sexually abused by an adult they

trusted—it is human nature to want to engage in a

search for meaning, to understand why the event occurred

and what its implications for one’s life are.15 The



nineteenth-century memory researcher Frederick Bart -

lett may have been the first to name this search: he

called it “effort after meaning.”16

As psychologists Ronnie Janoff-Bulman and Camille

Wortman explain, a built-in need to “believe in a just

world”—where people get what they deserve and deserve

what they get—may motivate this process.17

Other researchers agree. As Melvin Lerner and Carolyn

Simmons assert, “It seems obvious that most

people cannot afford, for the sake of their own sanity, to

believe in a world governed by a schedule of random

reinforcements.”18 If something bad happens to us, we

tend to believe that there must have been a reason. And

if we can find the reason, we will be less vulnerable in

the future, better able to predict and control what happens

to us.19

As victims struggle to make sense of their experiences,

they engage in an attribution process: they scan

through all the possible explanations they can generate

to come up with the one that they believe fits best. Traditionally

defined, attributions are individual causal explanations

for why events occur.20

If a victim asks, why did someone I trusted abuse

me? there are, of course, endless possible answers. For

example, he was screwed up or drunk, or I was in the



wrong place at the wrong time. The famous attributional

theorist, Martin Seligman, would refer to this

category of answers as “external explanations for negative

events.”21 It assigns responsibility for the event to

someone or something else. But almost all the victims

I’ve spoken with, to some degree, endorse an “internal”

explanation. They see the abuse as their fault—caused

by their own characteristics or behavior. Note some of

the comments here:

What did I do? What signal did I send that

made him do that to me?

Well, once I realized I got fu––ed with by the

prick. . . . Then I was thinking that I had something

to do with it; maybe it was my fault.

I just feel used. Dirty. I think part of it was that

he knew I was gay and he just targeted me . . .

like maybe I brought it on . . . like it was my


I asked victims who was to blame for the abuse—

them, the perpetrator, or both. Almost 80 percent felt

both were at fault. While almost all could acknowledge



that the perpetrator was responsible, they also thought

they had done something wrong too.

Particularly heartbreaking about this guilt is its

pervasiveness. Victims feel that whatever it was about

them that caused the abuse was not confined to the specific

situation they were in (for example, “It happened

because at that time in my life I did not understand

sex”); instead, as attributional theorists would say, it is

global and stable (it extends to other situations across

time). In other words, victims do not just feel like they

did something wrong regarding the abuse; they feel like

there is something wrong with them as individuals,

that whatever in them caused the abuse is characterological

or traitlike. As Samantha, a veterinarian in her

forties molested by her stepfather between the ages of

seven and nine, explained, “I think it happened because

I was damaged. . . . This is why he sought me out; this

is why I responded the way I did. I know what he did

was wrong, but I cannot escape the feeling that there is

something wrong with me.” As Suzie, a twenty-eightyear-

old columnist for a popular teen magazine, put it,

People can tell me it was not my fault but in my heart

of hearts, you know what I think? Bad things happen

to bad people.”



I am certainly not the first to discover that sexual abuse

victims often feel at fault for what happened. Since at

least Lauretta Bender and Abram Blau’s work in 1937,

clinicians and researchers have been reporting that guilt

is a common aftereffect of sexual abuse and that selfblame

is invariably its legacy.22 As Denise Gelinas states,

Guilt plays an essential role in their everyday functioning,

self-identity, and estimation of what they are

legitimately entitled to in relationships. . . . Victims almost

invariably express guilt about the occurrence of

the experience and usually blame themselves.”23 In the

words of Irving Kaufman and his associates, “Guilt is a

universal clinical finding.”24 Researchers rarely articulate,

however, a consistent explanation for why victims

feel so guilty. If, as trauma researchers have stressed for

the last twenty-five years, sexual abuse is something

done to a victim against his or her will, why would so

many victims feel at fault? Some professionals are content

to let this remain a mystery.25 Others proffer such

explanations as that perpetrators explicitly told victims

that the abuse was their fault,26 or perhaps victims want

to feel like it was their fault because they feel loyal to

their abusers,27 or they prefer feeling guilty over believing

they were totally helpless and had no control over their



environment.28 Regarding this latter explanation,

David Spiegel, a tremendously influential sexual abuse

researcher, notes that most victims “blame themselves

inappropriately for situations over which they had no

control. Oddly, it is less painful to think you brought a

tragedy upon yourself than to face your vulnerability to

mistreatment.”29 Judith Herman offers another explanation

entirely: The guilt victims report may actually be a

symptom of a new psychiatric disorder she calls complex

posttraumatic stress disorder (PTSD) (one caused

by prolonged exposure to interpersonal trauma).30

None of these explanations even comes close to

matching the one most victims give. I’ve found that victims

have a pretty clear reason, one that has nothing to

do with anything the perpetrator told them, anything

they unconsciously want to believe, or any irrational or

psychiatrically disordered thinking on their part. Ironically,

many of us find their answer too “politically incorrect”

to address or discuss.31 Victims say they feel

guilty because the abuse was not done against their

will. From their perspective, they feel that they allowed

it to happen.

Here is how Sheila, a third-grade teacher, put it: “I

have been in therapy for this for a long time and it is

still difficult for me to come to terms with what hap-



pened and to accept that it is not my fault. . . . The way

I understand abuse is that it is something done to you

against your will. But the way it happened to me, I

guess I allowed it. So in that way I very much feel like it

was my fault.”

Stephen, an English professor at a liberal arts college,

said, “Yeah the guy was a cocksucker—in more

ways than one, and I know it was technically his fault . . .

but I still feel involved. I was involved. I let it happen.

I could have said no; I was thinking at the time maybe I

should say no, but I didn’t. I let it happen.”

Here is how Chris, a twenty-eight-year-old electrician

from Dorchester, Massachusetts, reflected on his

experience: “What am I going to say to someone? I

gave this guy blow jobs twelve times? I think that is going

to make me look worse than him.”

Of course, as we all know, children do not have

enough information to understand or respond appropriately

to the sexual situations they are put in.32 To reiterate

an earlier point, for this reason sexual abuse

is never, under any circumstances, the child’s fault.

Legally, you cannot consent if you do not have enough

information to make an informed decision. But when it

comes to the victims’ experience of sexual abuse, what

is technically, legally correct is irrelevant. Rather, it is



important to see the issue from the victims’ perspective

at the time the abuse happened. They feel that they consented.

As child developmental psychologists can remind

us, when it comes to sexual abuse we need to get

rid of our adultcentric bias.

Some victims feel so guilty, so complicit, that they

are not even sure they were abused. Sarah, a twentythree-

year-old, heavily tattooed bartender in a trendy

section of Boston, wondered, “Can it technically be

abuse if I let it happen? You know that expression,

about how you can’t rape the willing?” Albert, a corporate

lawyer, said, “I am not sure that technically it can

be called abuse if I didn’t fight it. Plus, I took what he

gave me. I didn’t take them [Star Wars action figures]

and throw them back in his face.” Britney, a twentyeight-

year-old freelance reporter, explained, “For it to

be abuse I think it has to be done against the person’s

will. The way it happened to me was more like something

I would say I allowed.” Related to this, it was not

uncommon during my initial screening interviews for

victims to ask me, “Do I count?” or “Do I meet the criteria”

as a sexual abuse victim. At the beginning of this

research project, I found these questions perplexing.

How could these people not be sure? From my perspective

as an observer, it was so clear that they were. By



the end of the project I understood. They were not

sure they “counted” as victims because they thought

what happened was (either all or partially) their fault.

I have found that the degree of guilt victims feel in

the aftermath of sexual abuse is indeed strongly related

to the degree of trauma experienced during the abuse

when it happened. Specifically, the less traumatic (forceful,

frightening, threatening) the abuse was while it occurred,

the more guilt and self-blame the victims report

later on. Those victims whose abuse involved force or

violence usually report the least guilt.33 In such cases,

the victims know it was not their fault. One of the victims

I spoke with summarized this quite well: “I was

bleeding. I screamed when it was happening. He ran

away. I got rushed to the hospital. It was pretty clear to

me that he had done something wrong, that it was definitely

not my fault.” As another victim put it, “I wish it

was violent. That it did leave marks or scars. Then at

least I would have known that it was bad, something

bad was being done to me. Then I would have stopped

it. . . . I would feel less guilt. . . . I might not be feeling

so shitty today.”

Victims who report no trauma at all during the

abuse (for example, those who loved the perpetrator,

enjoyed the attention, or occasionally welcomed the



contact) feel extremely guilty. Consider the following

comments from victims I spoke with:

I responded. . . . My body responded. . . . He

could see that; I could not hide it. Yes, I am saying

it—a few times it felt good. For that reason

I can never tell anyone. How can it be abuse if

you got off on it?

I did not get much attention at that age. My father

was not there and my mother worked

around the clock to support us. I was a lonely

child. I was deprived [of ] attention. This was

attention and I was desperate for someone to be

with. I am filled with self-loathing that I allowed

it, that I was pathetic enough to think

that was love.

I would have to do this and then he would take

me to this store around the corner. Buy me

stuff . . . comic books, candy, firecrackers, and

so on. . . . As a kid it was very exciting. . . . I

guess I knew it was wrong, but God I loved

that store. In that way I feel like I was a sick




Does recognizing their “sexual illiteracy”—their lack of

understanding of what was going on at the time—not

help relieve the sense of guilt and complicity victims

feel? Unfortunately, it did not help the victims I spoke

with feel better about what happened. Although aware

that, as children, they were confused, they felt that this

confusion itself was abnormal. They thought that they

should have known or that they should have acted differently.

Indeed, many victims suffer from “perceptions

of avoidability”—the belief that they could have avoided

what happened—and that other children could have

and did. The degree to which victims believe they could

have avoided their abuse predicts self-blame more than

anything else.34Why? Tragically, part of the reason relates

directly to the trauma myth of sexual abuse.

As researchers who study attribution processes are

well aware, when people search for the meaning of experiences

and events, when we mentally scan through

the possible reasons for the negative things that have

happened to us, the list of explanations is not infinite.

According to a process called abductive reasoning, in

our search for answers, the set of explanations we can

generate is limited to the set we are aware of.35

Today, most adult victims’ knowledge about sexual

abuse, about what it is like when it happens and how



children react at the time, is a function of what they

hear, read, and see in the media—the culturally available,

standard scripts about this crime. Because of the

trauma myth, according to these scripts sexual abuse

usually involves fear, force, and threat. The experience is

portrayed as terrible for the victims. They are frightened

when it happens. They try to resist the abuse.

Whatever happens clearly happens against their will.

Books, films, and websites repeatedly assure victims

that they had no control, that they were utterly helpless.

Words like “rape,” “assault,” and “violation” are

commonly used to conceptualize the experience.36

No professionals explicitly discuss with victims or

highlight the real dynamics of sexual abuse—that victims

rarely resist it, often care about the perpetrators,

and often receive “benefits” for participating, like praise,

attention, and gifts. In fact, this kind of information

may actually be suppressed. The preface of a bestselling

book, Secret Survivors, opens, “This is a book

about the aftereffects of sexual abuse. It is not about

what sexual abuse is, but what sexual abuse does.”37 It

appears to be an article of faith among professionals

that you should not talk about aspects of sexual abuse

that run counter to the trauma model at all. Florence

Rush notes that during her psychotherapy training,



she was specifically told not to deal directly with the issue

of consent in treatment because the victims “feel

too guilty and ashamed.”38 A wildly popular book written

for professionals by Judith Herman echoes this sentiment:

She warns professionals not to talk about the

issue of consent as doing so will likely to make the victims

feel revictimized again.”39 Karin Meiselman, in

her influential book for professionals, tells therapists

that although the patient can explore his or her guilty

feelings in therapy, “the therapist will not endorse expressions

of guilt.”40 In The Courage to Heal, the most

widely read book about sexual abuse, the authors go to

extremes to assure victims that what happened to them

was against their will. On page 121 a victim in therapy

blames herself because at age twelve she said no to the

perpetrator, and he stopped. “Why couldn’t I have done

that right away, at four, when he started?” the victim

chastises herself. “I did have the power to stop him.”

But the authors are quick to remind any victim reading

the book feelingly similarly, “Abusers don’t stop because

you say no. . . . You have less control than you think.”41

Because of the trauma myth, I am aware of no public

information campaigns that say, “Kids don’t know

enough to say no.” There are no books telling victims,

You let it happen, and it’s okay. This is normal. You



were too good to know bad.” I know of no newspaper

stories in which the victim comes forth after years to

press charges and explicitly says, “I would have done it

earlier, but I just didn’t understand I was abused until

now.” Today, as a function of the mental health field’s

relentless emphasis on trauma, force, and violence and

the subsequent embargo on any real-world, practical

information about the reality of sexual abuse, most victims’

experiences slip under the radar—their stories

are ignored, dismissed, overlooked, or denied by the

very people who purport to be trying to help them.

What is the consequence? For victims, it is significant.

They naturally compare what happened to them

with the depictions of abuse in cultural scripts. As

James, a nurse, told me, “What happened to me was different

from other kids. I . . . well . . . it’s hard to say out

loud, but basically I let it happen.” There is something

wrong with me. Arnie, a self-employed computer programmer,

said, “The fact that other kids were traumatized

when it happens, pretty much confirmed that

there is something seriously wrong with me.” As Denise,

a bathing-suit model, noted, “I wasn’t afraid. Sometimes

I liked it. Obviously something’s screwed up with

me.” I am alone. I think Karen’s comments best summarize

this perspective: “I know sexual abuse is common,



but probably not the kind that happened to me.” Claudia

explained, “My abuse did not involve such force and

violence. I basically let it happen . . . so it wasn’t classical


The trauma conceptualization results not only in

victims’ negative feelings of guilt and isolation not being

neutralized but in their being exacerbated; victims

feel worse. The fact that their abuse bears little resemblance

to what, apparently, happens to all other victims

reinforces their sense that they did something “wrong”

or, perhaps even worse, that there is something wrong

with them. They are different from most victims. Consider

the irony: After professionals have worked tirelessly

for over thirty years to raise awareness that

sexual abuse is common and never the victim’s fault, actual

victims still feel alone and guilty.

Given the degree of betrayal, guilt, and isolation

victims feel, it is not surprising that they also commonly

report shame.


Shame, as most researchers and clinicians in the field

can attest, is a recurrent theme in the context of sexually

abused people.42 It is an awful emotion, one in

which the self is viewed as incompetent and as an object



of ridicule, contempt, and disgust. Individuals feeling

shame often view themselves as damaged and unworthy.

43 Guilt, at least, can be productive as it sometimes

motivates changes in behavior. But shame is overwhelming.

Unfortunately, most victims use the word

shame” to describe how their abuse makes them feel as

adults. As one victim summed it up, “I think the heart

of the damage is shame. It eats away at me. It has

eroded my sense of self-esteem and my confidence, my

ability to love and feel loved. The abuse stopped when I

was twelve; the shame remained my whole life.”

I cannot offer a clear theoretical model as to exactly

how and why sexual abuse damages victims. It is beyond

the scope of my research. I can say with great

confidence, however, that based on what victims have to

say, the trauma theory needs to go. It is not a good fit

for most cases of sexual abuse. First, and most obviously,

sexual abuse, for most victims, is not traumatic

experience when it happens. Second, clearly the harm

sexual abuse causes is not direct and immediate; before

it begins to damage victims, it has to be understood

(“reconceptualized”) and that often occurs many years

after the actual abuse. Third, the cause of the damage

appears to have nothing to do with any objective characteristics

of the abuse vis-à-vis trauma and everything



to do with the aftermath—specifically, with how victims

come to feel about themselves and others and how these

feelings influence their emotions, cognition, and behavior.

44 As expressed by Jonathan, a middle-aged English

professor at a community college, “The abuse, when it

happened, was so quiet I didn’t even hear it. Now the

echoes of what happened keep me awake at night.”

A growing body of data indicates that feelings of

betrayal, shame, guilt, and self-blame are potent predictors

of psychopathological symptoms and disorders

like depression, low self-esteem, and PTSD in the aftermath

of sexual abuse.45 They are much better predictors

of psychological distress and dysfunction in

victims than anything having to do with the trauma of

the abuse when it happened. These feelings rarely exist

without other similar emotions, such as self-loathing,

disgust, self-doubt, sadness, and hopelessness. It does

not take a rocket scientist to determine that people

plagued by these emotions have a very hard time feeling

good about themselves or others on a day-to-day

basis. This makes it difficult for them to function well in

the world: to build close and supportive relationships,

to develop the self-esteem necessary for sustained ambition,

or to enjoy activities or interactions with other

people. Nor it is surprising that such negative emotions



might set off a pattern of conduct that confirms and reinforces

these feelings—for example, avoidant and isolative

behaviors or acceptance of poor treatment from

others (like abusive relationships). And rather than imparting

experiential wisdom to victims, each negative

experience may serve to reinforce the already entrenched

feelings of inferiority they suffer from.

Further support for the perspective that what damages

most victims has little to do with any trauma they

experience during the abuse and a lot to do with the

shame, guilt, and isolation they feel later on in life

comes from the fact that in the handful of studies that

have specifically tested it, therapeutic techniques involving

cognitive retraining—identifying victims’ irrational

beliefs (for example, that the abuse was their

fault) and then helping them to modify these beliefs (for

example, by providing convincing information about

why it was not their fault)—have shown solid promise

in improving the lives of victims in the aftermath of

sexual abuse.46

• • •

I THINK THE BEST SUPPORT for this perspective comes

from the actual victims themselves. I asked them what

someone could say to them that might make them feel



better about what happened. Invariably they had the

same two requests: variants of “I would like to know

that this happened to other people” and “I would like to

know it was not my fault.” Their answers are the tragic

legacy of the trauma model that has for so long emphasized

aspects of sexual abuse that do not pertain to

most victims’ experiences.

By systematically avoiding these truths about sexual

abuse, professionals have failed to communicate to

victims that what happened to them is common and

that they are not at fault. Victims still feel alone. They

still report guilt, isolation, and shame, feelings so potent

and pervasive that they may actually be at the root

of the psychological harm the trauma model was supposed

to address.

Today, victims need to hear the truth. This requires

us all to highlight publicly the true dynamics of

sexual abuse—to expose the painful reality that most

victims care for and trust the perpetrator (before, and

sometimes during and after, they are abused), that they

do not really understand the nature of what is being

asked of them, that they feel they are receiving love

and attention, that it does not hurt and sometimes feels

good, and that, for all these reasons, participation is




Once exposed to the truth about how victims feel

and behave during sexual abuse, victims need to hear,

loudly and clearly, why they were not at fault. We cannot

accomplish this with platitudes or blanket statements

like “You were not to blame” or “It was done against

your will.” They consented not because they were

forced to but because they did not understand enough

not to. And victims need to know that this is normal.

Although they made an error of judgment—ideally

they should have said no; they should have resisted—

we must reassure victims that given their age and level

of cognitive and physical development, this error of

judgment was understandable.47

In short, in order to help victims feel less stigmatized

in the aftermath of sexual abuse, we must all

communicate that they were helpless victims—not, as

the trauma model portrays them, literally helpless but

metaphorically helpless, victims of their own level of


This information needs to be highlighted in the

form of prevention campaigns, books, websites, and

other culturally accessible outlets. Until that happens,

victims will continue to feel alone, guilty, and ashamed.

Professionals may fear that raising attention to children’s

participation in abuse will elicit in others a ten-



dency to condemn victims, but I think we better get

past this. Victims are already condemning themselves.

Here is the tragic paradox. If the victim’s cognitive interpretation

of the event guides the process of psychological

adaptation after sexual abuse, then the trauma

theory is not only wrong but actually backwards. The

less traumatic sexual abuse was when it happened,

the more betrayal, guilt, isolation, and shame victims

will feel and the more psychological distress and dysfunction

victims they may experience in the aftermath.

And because it is backwards, the trauma model is not

just failing to help victims; it is actually causing some

of the harm it was supposed explain by simultaneously

exacerbating the victim’s damaging beliefs (“It was my

fault,” “I am alone,” “There is something wrong with

me”) and suppressing the information that would neutralize






How the Trauma Myth

Silences Victims

IT IS OFTEN SAID THAT ADVOCACY is best aided by truth.

Rarely articulated is the reason why. I have explained

that by mischaracterizing sexual abuse, by portraying it

as a traumatic experience for the child when it happens,

not only have we overlooked the root cause of psychological

harm, but we are inadvertently supplementing

it. A further consequence of this mischaracterization?

We are silencing victims (and thus actually contributing

to the existence of the very crimes we seek to end).

Thirty years ago—prior to the adoption of the

trauma conceptualization of sexual abuse—back when

many professionals denied the existence of sexual

abuse or blamed victims, feminists bemoaned the fact

that a “conspiracy of silence” forced most victims to

bear the burden of their secret alone. As Florence Rush

put it, “Concealment is the victim’s only recourse. . . .

Sexual abuse is thus the best kept secret in the world.”1

Since then, the pendulum of professional beliefs has

swung widely. Today sexual abuse is widely accepted as

common and never the victim’s fault. But not much

has changed regarding victims’ decision to speak out

about their abuse. According to a large and consistent

body of data, most victims may either delay or refrain

from disclosing entirely.2 Less than 10 percent of actual

crimes ever get reported.3 Consider the results from the

National Health and Social Life Survey, the largest and

most methodologically sound national study on sexual

abuse. Prior to their interviews with researchers, only

22 percent of victims randomly sampled in the general

population had disclosed their sexual abuse.4

Less than half of the victims I have spoken with

over the last decade had talked about their abuse prior

to their interviews with me. Initially I found this extremely

hard to understand. Why would a victim of

crime, never mind a crime that damaged him or her,

choose to keep silent about what happened?

I was certainly not the first to ask this question.

Why so few victims speak out is the topic of much debate.

One widely accepted theory holds that it is be-



cause as children they were warned not to—the perpetrator

threatened that harm would come to them or the

people they cared about if they spoke out.5 In The

Courage to Heal, the most widely read book for sexual

abuse victims, the authors note, “Abusers say things like

I’ll kill you if you tell.’”6 The author of Secret Survivors,

another popular book written for victims, tells

readers that victims rarely speak out because they are

terrified by the possible physical harm that can come

to themselves and others.”7 Another influential sexual

abuse researcher writes that in most cases (of the people

she studied), the victims were “threatened with the

most dreadful consequences if they told.” As an example,

she cites a victim named Maggie whose father told

her that if she told anyone he would have her shot.8

This argument does not fit the data well. In the literature

on disclosure, a factor that consistently emerges

as predictive of whether victims will in fact report their

abuse is trauma. In the cases in which the victim is

frightened or terrified when the abuse happens, when

force, violence, or actual physical rape occurs, the victim

is much more likely to speak out.9 If the source of

silence is fear of physical harm, why would the very

crimes that actually involve physical harm be the ones

victims choose to disclose? It does not make sense.



According to what victims say, this is because the

argument is wrong. As children, they do not speak out

because they do not know they should; they fail to fully

understand the meaning or significance of the activities

they are being asked to engage in. As I discussed in

chapter 2, many can sense that there is something

wrong with these activities, but they are not sure what.

As one victim put it to me, “As a kid it was like a double

bind. I didn’t know enough to justify saying no to

someone like him, but I did know enough to know I

probably shouldn’t tell anyone. . . . I was stuck in the


As adults, victims say they do not disclose for different

reasons. Later in life, as I discussed in chapter 4,

they do come to understand that what happened was

wrong and that they should have spoken out (and most

certainly should not have participated). But since they

remained silent and did participate, as adults, they feel

tremendously ashamed and guilty. Many subjects told

me that they feared these feelings might be confirmed

if they told others—that they would be blamed. John,

a carpenter who had sex with a teacher when he was a

boy, said, “What am I supposed to say? The truth? I

masturbated the guy after school and then he would

give me five dollars? People are going to think I am



more f––ed up than him . . . a prostitute.” Most also expressed

concern that they might not be believed. As

Claire, a twenty-four-year-old woman abused at age

eight by a well-known pediatrician at a children’s hospital,

said, “Who is going to believe me? The man is a

hero to so many people; he is successful, important. . . .

Who am I? A waitress . . . with a GED and a drinking

problem.” Almost all worry that telling will have negative

consequences for their lives:

My family will treat me differently.

It will definitely be very embarrassing and affect

how other people view me.

If anyone at work found out . . . what would that

do to my partner track at the firm?

Plagued by persistent and pervasive feelings of

guilt, isolation, shame, and aberration, most victims

choose to hide what happened rather than risk having

others confirm or exacerbate the stigma they already

feel. Victims are afraid to speak out—afraid not for

their physical, but for their psychological, well-being. In

the words of Ross Cheit, a Brown University professor



who publicly came out about his abuse, “For all this talk

about us being a nation at war with child abuse, and for

all the media hype . . . the fact remains that it is still extremely

difficult to come forward with allegations of

sexual abuse.”10

These feelings make no sense,” a colleague told

me recently. “Why would a victim feel like he or she

wouldn’t be believed or might be blamed if for the last

twenty-five years we have as a society been inundated

with information about how common sexual abuse is

and how it is never the victim’s fault?” It is a good

question, and I think there is a good answer. As I hope

to have made clear, we as a society have been “inundated”

with information about sexual abuse, but it is

about a specific type of sexual abuse, one that involves

trauma. Professionals rarely discuss or highlight explicitly

the type of nontraumatic abuse most victims

experience—one in which victims are confused and

trusting, do not resist, and care for and love the perpetrators.

As a consequence, most people in the general

population do not know this sort of abuse exists. This

is why victims still fear disbelief and blame.

Failure to disclose has terrible consequences for

victims. As two influential clinicians emphasize, “There

is no agony like bearing an untold story inside you.”11



The famous psychologist James Pennebaker’s research

clearly illuminates the importance of emotional expression

as well. In short, he says, describing horrible experiences

may be essential for psychological well-being.

Victims need to be able to talk about what happened—

it may be critical to their overcoming the psychological

pain they suffer in the aftermath.12What’s more, disclosure

is a prerequisite for access to mental health services

and may inform the eventual success or failure of


Instead of talking, however, victims report engaging

in two common coping mechanisms: avoidance

(trying not to think about the abuse) and suppression

(trying to forget about it).14 And we need to keep in

mind that suppression differs from repression in that it

is voluntary and conscious on the victim’s part (he or

she is actively trying to forget something unpleasant),

whereas repression is believed to happen automatically

and unconsciously.15 Whether either avoidance or suppression

is actually beneficial is unclear. While some research

indicates that avoidance is related to better

psychological health in victims, other studies show that

people who were able to forget their memories totally

for a period were actually less well adjusted than those

who always remembered their abuse histories.16 In most



cases, however, neither avoidance nor suppression is

possible; the memories are always there. In the words

of some victims,

What happened, it’s like a dark shadow, always

hanging just above my head.

The memory eats away at me like a cancer.

You have to live with it. Like a small nasty pet

you have had for years.17

The inability to avoid thinking about abuse makes

sense. Data indicate that two factors render memories

difficult to forget: they are negatively valenced (they

make the person remembering feel bad), or environmental

cues exist to trigger the memory (reminders of

the experience exist).18 In cases of sexual abuse, both

conditions are usually met. Obviously, the memory

arouses negative feeling