Friday, December 12, 2014

Who's Most at Risk for Sexual Assault?

After writing my previous post, I began thinking about the hidden epidemic of sexual abuse and assault, that has been going on for hundreds or perhaps thousands of years. It's not happening on college campuses. It's happening in people's homes. The time period of life when people are at highest risk for being sexually abused or raped is before the age of 18. The most common perpetrators of sexual abuse and assault are parents.

For official statistics on child abuse, the federal government is the best source:

According to government statistics, child abuse is in decline. However, it is difficult and perhaps impossible to gain accurate statistics on child sexual abuse, because many of these cases never come to the attention of authorities.

A large percentage--although not the majority--of patients I've seen over the past 13 years in private practice were sexually abused as children. Many of them have been men. Altogether they far outnumber the patients I've seen who have been raped in adulthood.

Seemingly paradoxically, people who were sexually abused in childhood are at higher risk for being raped in adulthood, probably for a variety of reasons. They may be more likely to abuse drugs and alcohol, putting them at higher risk. They may have low self-esteem and poor self-care--rapists target such individuals. Some who were sexually abused by parents may have difficulty picking up on warning signs, because they are used to being in an environment of constant danger and/or abuse--they don't identify perpetrators as people to avoid because they are used to being in the company of similar individuals.

Society was in denial about the prevalence of child sexual abuse for a very long time. When Sigmund Freud began investigating the phenomenon of "hysteria" among women approximately 100 years ago, he came across evidence of widespread sexual abuse. He suppressed this information because he didn't think anyone would believe it and he was afraid controversy would distract from his theories about the unconscious and the development of human personality. This was a grave ethical mistake that led to disastrous trends in the field of psychoanalysis. In the early 1980s, a psychoanalytic researcher named Jeffrey Masson discovered that Freud had deliberately suppressed evidence of child sexual abuse. He wrote a book, "The Assault on Truth." Sadly, what happened next was a national panic about child sexual abuse in which many innocent people were persecuted. The most famous case involved a preschool in which it was alleged that there was an organized child sex abuse ring. After extensive investigations and prosecutions, the allegations were determined to be bogus and to have been essentially manufactured by police and prosecutors who asked young children leading questions.

 It's interesting how society has a tendency to swing between extremes of denial and panic when it comes to the issues of rape and sexual abuse.

Friday, December 5, 2014

Hard to Believe

I've been following news stories about what some have called a rape epidemic on college campuses. Most recently, I read the Rolling Stone article about the University of Virginia, and today, what seems to be a partial retraction of the story. Rolling Stone now states that the main subject of and source for the article, a young woman identified only by a first name, may not be credible.

I'm not sure how the retraction could come as a surprise to anyone who read the article. The story described how the victim was thrown on a glass coffee table that shattered, continued to lie on the shattered glass while being raped, but did not seek medical attention afterward. She left the fraternity house without anyone apparently noticing a bleeding woman with pieces of glass stuck in her back walking across campus.

From a psychological standpoint, the Rolling Stone debacle raises many interesting questions. Why would someone lie about being the victim of a crime, and why would so many people believe a story that seems suspicious? In fact, there are many psychological disorders that cause people to tell stories that aren't true. Individuals with Histrionic Personality Disorder constantly seek attention and often embellish stories to gain attention. This is considered a fairly severe disorder, but, as with many personality disorders, the individual may, to the superficial observer, appear to be totally normal. People with Borderline Personality Disorder may have delusions, and people with psychotic disorders, needless to say, have difficulty distinguishing between the real and the unreal.

There are also reasons to lie that have nothing to do with psychology, such as the desire to file a lawsuit for monetary gain, or a desire to gain attention for reasons such as publicity that could help one's career.

I think many people assume that college students' emotional disorders are generally limited to depression, anxiety disorders, substance abuse and eating disorders. But there's no reason to believe college students' mental health is any better than that of the general population. In fact, many serious  mental disorders first appear in late adolescence and early adulthood. Emotionally disturbed people are probably far more likely to attend college now than 40 years ago, because better treatments today allow them to function. People who decades ago might have spent months or even years in psychiatric facilities are now able, in some cases, to take medication or receive therapy that allow them to go to college and work.

What's even more interesting is why Rolling Stone, a major publication, violated basic rules of journalism in reporting and publishing the story. I was a journalist in my first career in the 1980s. I never would have written an extensive story about crime based on the account of one victim. My editors would have nixed such an article. I have seen interviews on TV and read other magazine articles, about campus rapes, that seem to avoid basic questions. It's interesting for me, having had two professions, to compare the way that a therapist would talk to someone who reported being raped and the way a journalist is supposed to interview that person. As a therapist, I listen to a person's story and try to understand his or her point of view. When I was a journalist, I had to assure myself of the source's credibility because the story would be distributed to tens of thousands of readers, not simply recounted to me in a private office.

The assumption that anyone who is telling a story about being victimized is telling the truth is naive at best. As a psychotherapist, I need to determine both the emotional meaning of someone's trauma and also the basic facts. Journalists should focus on the facts and let people like me do my job.