What Haunts Victims of Child Abuse? The memory, study results

For generations, our society has vacillated over how best to heal those who have experienced horrific childhood experiences.

Should these memories be dug up, lest their destructive power pass? Should they be gently molded into something less painful? Or should they remain untouched?

Researchers from King’s College London and the City University of New York investigated this mystery by conducting an unusual experiment.

Researchers repeatedly surveyed a group of 1,196 American adults over a 15-year period about their levels of anxiety and depression. Unbeknownst to the subjects, 665 of them were chosen because court records showed they had suffered abuse, such as physical abuse, sexual abuse, or neglect, before the age of 12.

However, not all of them told the researchers that they had been abused – and that made a big difference.

According to the study, published last week in JAMA Psychiatry, the 492 adults who reported being abused and had court records showing the abuse had significantly higher levels of depression and anxiety than a control group with no documented history of abuse. The 252 subjects who reported being abused without court records reflecting it also had higher scores.

But the 173 subjects who did not say they had been abused, despite court records showing it had, experienced no more stress than the general population.

The results suggest that the way people frame and interpret events in their early childhood strongly influences their mental health as adults, said Dr. Andrea Danese, Professor of Child and Adolescent Psychiatry at King’s College London and one of the study’s co-authors.

“It’s about the almost stoic message that what matters is what you make of the experience,” he said. “If you can change the way you interpret the experience when you’re feeling more in control in the moment, then that’s something that can improve mental health over the longer term.”

In a 2019 meta-analysis of 16 child abuse studies, Drs. Danese and colleagues find that 52 percent of people with a history of child abuse did not report it in interviews with researchers, and 56 percent of those who did report it did not have a documented history of abuse.

This discrepancy could be partly due to problems with measurement — court records may not contain the full history of abuse — and could also be because self-reporting of abuse is influenced by a person’s level of anxiety and depression, said Dr. Danish.

“There are many reasons people forget these experiences in some way, and other reasons others may misinterpret some of these experiences as neglect or abuse,” he said.

But even taking those caveats into account, it’s notable, he said, that adults who had a documented history of abuse but didn’t report it — because they had no memory of the events, interpreted them differently, or chose to disassociate those memories with the Sharing with interviewers – seemed healthier.

“If the meaning you give to those experiences isn’t central to how you remember your childhood, so you don’t feel like you need to share it, you’re more likely to have one over time have better mental health,” he said.

Traumatic childhood experiences have been the subject of some of the fiercest controversies in psychiatry. Sigmund Freud posited early in his career that many of his patients’ behaviors were indicative of childhood sexual abuse, but later backtracked and attributed them to unconscious desires.

In the 1980s and 1990s, therapists used techniques such as hypnosis and age regression to help clients uncover memories of child abuse. These methods were sidelined under a barrage of criticism from mainstream psychiatry.

Recently, many Americans have adopted traumatic memory management therapies that have been shown to be effective in treating post-traumatic stress disorder. Experts are increasingly advocating the screening of patients for adverse childhood experiences as an important step in managing physical and mental health.

The new findings in JAMA Psychiatry suggest that therapy aimed at relieving depression and anxiety by trying to track down repressed memories is ineffective, said Dr. Danese, who works in the Department of Psychiatry, Psychology and Neuroscience at King’s College.

However, he warned against interpreting the study’s results as advocating avoiding distressing memories that could make them “more scary” in the long run. Instead, they point to the promise of therapies aimed at “reorganizing” and moderating memories.

“It’s not about erasing the memory, it’s about having the memory and having more control over it so that the memory seems less scary,” he said.

Memory has always been a challenge in child protection, as many abuse cases involve children under the age of three, where lasting memories begin to form, said David Finkelhor, director of the Crimes Against Children Research Center at the University of New Hampshire was not involved in the study.

When treating people with a history of abuse, doctors have to rely on patchy, incomplete and changing reports, he said. “All we have are their memories, so we don’t have a choice,” he said.

He cautioned against concluding that forgotten abuse has no lasting effects. Early abuse can arise from what he termed “residues”—difficulty modulating emotions, feelings of worthlessness, or, in the case of victims of sexual abuse, an urge to provide sexual gratification to others.

Elizabeth Loftus, a psychologist at the University of California, Irvine and a prominent skeptic about the reliability of memories of abuse, noted that the study falls short of another conclusion that might be supported by the data: Forgetting about abuse might be a healthy response.

“You could have said, ‘People who don’t remember in some way are better off, and maybe you don’t want to manipulate them,'” she said. “They don’t say that, and that’s of great interest to me.”

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