Rind, Tromovitch and Bauserman: A Meta-Analytic Examination of Assumed Properties of Child Sexual Abuse… (abstract):

“Many lay persons and professionals believe that child sexual abuse (CSA) causes intense harm, regardless of gender, pervasively in the general population. The authors examined this belief by reviewing 59 studies based on college samples. Meta-analyses revealed that students with CSA were, on average, slightly less well adjusted than controls. However, this poorer adjustment could not be attributed to CSA because family environment (FE) was consistently confounded with CSA, FE explained considerably more adjustment variance than CSA, and CSA-adjustment relations generally became nonsignificant when studies controlled for FE. Self-reported reactions to and effects from CSA indicated that negative effects were neither pervasive nor typically intense, and that men reacted much less negatively than women. The college data were completely consistent with data from national samples. Basic beliefs about CSA in the general population were not supported.”

This 1998 study in Psychological Monitor was so scientifically-correct-politically-incorrect that it unleashed a firestorm, which can be followed online for your edification. A Congressional resolution condemned the research and was decried by eminent social psychologist Carol Tavris here (“Congress and clinicians may feel a spasm of righteousness by condemning scientific findings they dislike, but their actions will do little or nothing to reduce the actual abuse of children”) and here (‘Perhaps the researchers’ most inflammatory finding, however, was that not all experiences of child-adult sexual contact have equally emotional consequences nor can they be lumped together as “abuse.” Being molested at the age of 5 is not comparable to choosing to have sex at 15. Indeed, the researchers found that two-thirds of males who, as children or teenagers, had had sexual experiences with adults did not react negatively.’) The latter is a point I have made repeatedly about the zeal with which inexperienced overzealous clinicians label anything untoward in their patients’ early experiences — real or suggested — as abuse and avow it qualifies the patient for the wastebasket diagnosis of PTSD and explains most of their adult psychological distress, with disastrous clinical consequences for treatment. Tavris: “The article by Rind and his colleagues, however, has upset two powerful constituencies: religious fundamentalists and other conservatives who think this research endorses pedophilia and homosexuality, and psychotherapists who believe that all sexual experiences in childhood inevitably cause lifelong psychological harm.” [Are you getting bored with this repeated tirade from me? I make it over and over again; it is one of my pet peeves in behavioral science… — FmH]

More recently, in Mind Games: Psychological Warfare Between Therapists and Scientists, Tavris has continued to evoke controversy by expanding on her observations of a rift between scientists and clinicians within psychology . She makes a related point, again one with which I resonate — that the unregulated nature of calling oneself a “psychotherapist” and the public’s confusion between that term and the term “psychologist” wreaks havoc:

For the public, however, the word “psychologist” has only one meaning: psychotherapist. It is true that clinical psychologists practice therapy, but many psychologists are not clinicians, and most therapists are not clinical psychologists. The word “psychotherapist” is completely unregulated. It includes people who have advanced training in psychology, along with those who get a “certification” in some therapeutic specialty; clinical social workers; marriage, family, and child counselors; psychoanalysts and psychiatrists; and countless others who have no training in anything. Starting tomorrow, I could package and market my own highly effective approach, Chocolate Immersion Therapy, and offer a weekend workshop to train neophytes ($395, chocolate included). I could carry out any kind of unvalidated, cockamamie therapy I wanted, and I would not be guilty of a single crime. Unless I described myself as a psychologist. Chronicle of Higher Education

Part of the problem is that society increasingly turns for advice to “mental health professionals” without understanding that they have come by their pronouncements by the same fallible mix of selective experience, prejudice, doctrinaire adherence to a particular theoretical school or treatment philosophy, and confirmation bias (selectively noticing and valuing evidence in accord with one’s assumptions and discounting or ignoring that in conflict) that operates in other fields. Tavris lists a number of important “widely accepted claims promulgated by therapists are based on subjective clinical opinions and have been resoundingly disproved by empirical research conducted by psychological scientists”:

• Low self-esteem causes aggressiveness, drug use, prejudice, and low achievement.

• Abused children almost inevitably become abusive parents, causing a “cycle of abuse.”

• Therapy is beneficial for most survivors of disasters, especially if intervention is rapid.

• Memory works like a tape recorder, clicking on at the moment of birth; memories can be accurately retrieved through hypnosis, dream analysis, or other therapeutic methods.

• Traumatic experiences, particularly of a sexual nature, are typically “repressed” from memory, or split off from consciousness through “dissociation.”

• The way that parents treat a child in the first five years (three years) (one year) (five minutes) of life is crucial to the child’s later intellectual and emotional success.
  

The increasing split between systematically thinking intellectually rigorous psychological science and pseudoscientific psychotherapeutic hysteria played out in epidemic form in the ’80’s with the “repressed memory”, “multiple personality disorder”, and “rampant sexual abuse of children in daycare centers” furors, all of which have turned out to be spurious. I would also add the “Satanic ritual abuse” folly to that list; maybe Tavris considers that too ridiculous to dignify with discussion.

All three epidemics were fomented and perpetuated by the mistaken beliefs of psychotherapists: that “children never lie about sexual abuse”; that childhood trauma causes the personality to “split” into several or even thousands of identities; that if you don’t remember being sexually abused in childhood, that’s evidence that you were; that it is possible to be raped by your father every day for 16 years and to “repress” the memory until it is “uncovered” in therapy; that hypnosis, dream analysis, and free association of fantasies are reliable methods of “uncovering” accurate memories. (On the contrary, such techniques have been shown to increase confabulation, imagination, and memory errors, while inflating the belief that the retrieved memories are accurate.) The epidemics began to subside as a result of the painstaking research of psychological scientists.

Tavris finds the roots of the increasing divergence in the training of psychotherapists outside academic institutions. I have long made the point that the public is not aware that their mental health is at the mercy of market forces unwilling to pay for necessarily more expensive practitioners who come from adequate training backgrounds. She largely ignores these market forces as the context for the crisis — although commenting that there are “too many economic and institutional supports for (the schism)” — but otherwise nicely defines it. She is not naive about the promise of science with a capital ‘S’ but clearly articulates its value in psychology:

It is not that I believe that science gives us ultimate truths about human behavior, while clinical insight is always foolish and wrong. Rather, I worry that when psychotherapists fail to keep up with basic research on matters on which they are advising their clients; when they fail to learn which methods are most appropriate for which disorders, and which might be harmful; when they fail to understand their own biases of perception and do not learn how to correct them; when they fail to test their own ideas empirically before running off to promote new therapies or wild claims — then their clients and the larger public pay the price of their ignorance.

That last phrase deserves to be underscored — ” their clients and the larger public pay the price of their ignorance.” Moreover, the pity is that they never realize it.

She goes on:

The scientific method is designed to help investigators overcome the most entrenched human cognitive habit: the confirmation bias, the tendency to notice and remember evidence that confirms our beliefs or decisions, and to ignore, dismiss, or forget evidence that is discrepant. That’s why we are all inclined to stick to a hypothesis we believe in. Science is one way of forcing us, kicking and screaming if necessary, to modify our views. Most scientists regard a central, if not defining, characteristic of the scientific method to be what Karl Popper called “the principle of falsifiability”: For a theory to be scientific, it must be falsifiable — you can’t show me just those observations that confirm it, but also those that might show it to be wrong, false. If you can twist any result of your research into a confirmation of your hypothesis, you aren’t thinking scientifically. For that reason, many of Freud’s notions were unfalsifiable. If analysts saw evidence of “castration anxiety” in their male patients, that confirmed Freud’s theory of its universality; if analysts didn’t see it, Freud wrote, they lacked observational skills and were just too blind or stubborn to see it. With that way of thinking, there is no way to disconfirm the belief in castration anxiety.

Yet many psychotherapists perpetuate ideas based only on confirming cases — the people they see in therapy — and do not consider the disconfirming cases. The popular belief in “the cycle of abuse” rests on cases of abusive parents who turn up in jail or therapy and who report that they were themselves victims of abuse as children.

Essentially, many inadequately-trained therapists may lack a necessary skepticism the scientific method teaches and which is imbued only by rigorous training to overcome quite ingrained and natural biases of thought.

The clinicians’ defense is that the way they benefit clients is by helping them make sense of their life experience. In a sort of nihilistic way, the “narrative truth” in which they enlist their patients is different, sophisticated clinicians know, than “historical truth”, but it works. Therapists are not detectives bound to a legalistic standard of evidence-based proof, they argue. But, in a narrow sense the real world does intrude, and the “truth” of what has been discovered in psychotherapy does come into play in legal proceedings. In a broader sense, Tavris wants us to understand that this is not just some irrelevant internal dispute between factions of an academic discipline.

“Much has been written about America’s scientific illiteracy, but social-scientific illiteracy is just as widespread and in some ways even more pernicious. People can deny evolution or fail to learn basic physics, but such ignorance rarely affects their personal lives. The scientific illiteracy of psychotherapists has torn up families, sent innocent defendants to prison, cost people their jobs and custody of their children, and promoted worthless, even harmful, therapies. A public unable to critically assess psychotherapists’ claims and methods for scientific credibility will be vulnerable to whatever hysterical epidemic comes along next. And in our psychologically oriented culture, there will be many nexts. Some will be benign; some will merely cost money; and some will cost lives.”

By the way, the president of the American Psychological Association, aghast at Tavris’ upbraiding of the profession, has circulated a sputtering, ineffective letter of response which I cannot find online but will point to when I can. He attempts a refutation by claiming that many psychologists are both scientists and clinicians, and that academic psychologists as well as psychotherapists consult on media and public policy issues. He pedantically lectures Tavris on supposed logical fallacies in her argument but, IMHO, ends up hoist by his own petard.