Society's Denial

The internet and popular press often print articles denying that dissociative identity disorder exists or minimizing the harm of child sexual abuse. Research in peer reviewed journals prints the opposite.

This page looks at the backlash against survivors of abuse speaking out, and the evidence ignored by the a minority of academics or professionals opposing dissociative identity disorder as a diagnosis caused by childhood trauma, or those who claim child sexual abuse is not extremely harmful to children and to the adults those children later become.

Evidence of distorted or misleading reports about DID and Dissociation[edit]

Media distortions and exploiting those with DID and Child Sexual Abuse Survivors[edit]

Publications and Interactions with the Media

The media and the public have long had a fascination with DID. When doing a story, media reporters commonly seek out a diagnosed individual to provide the human interest aspect of the story. Thus, clinicians working with DID patients may be approached by the media, often with the request that the clinician provide a DID patient to be interviewed. Appearances by patients in public settings with or without their therapists—especially when patients are encouraged to demonstrate DID phenomena such as switching—may consciously or unconsciously exploit the patients and can interfere with ongoing therapy. Therefore, it is generally advisable for a therapist to actively discourage patients from going public with their condition or history and to fully explore patients’ fantasies and motivations about public disclosure of this type. It is helpful to provide education that, in general, patients who have made themselves known to the media have had very negative experiences, often winding up feeling additionally exploited, violated, and traumatized."

Guidelines for Treating Dissociative Identity Disorder in Adults (2011), International Society for the Study of Trauma and Dissociation^[1]

Media interviewing and campaigning for "parents" or "families" but not for children or adult survivors[edit]

The 1992 launch of the False Memory Syndrome Foundation , and their attempt to develop a new psychiatric diagnosis, which they called False Memory Syndrome (FMS), was led by Peter and Pamela Freyd, after their daughter Jennifer began to speak out about memories of her father's sexual abuse of her. The organization engaged heavily with the media, despite the rarely reported fact that husband and wife Peter and Pamela were also step-brother and step-sister to one another, growing up in the same house together.

No symptoms or diagnostic criteria found for "false memory syndrome", despite the vast media interest[edit]

A Conversation with Pamela Freyd Co-Founder And Executive Director, False Memory Syndrome Foundation, Inc. By David Calof, of Treating Abuse Today (TAT)

TAT: I find I'm still left wanting to know how to tell if my patient has false memory syndrome. What's the test? How do I determine if my patient is suffering from this syndrome?

Freyd: What are the tests if some body is suffering from " repressed memory syndrome?"

TAT: Well, I can give you several symptom clusters - dissociative, cognitive, affective, somatic effects they're well documented. But, I'm asking you the question. You're telling me, David, as a clinician: you must be aware of the possibility your patients may have false memory syndrome. Okay, how should I be aware of that? How am I going to know? How do I test for it?

Freyd: David, I'm going to ask Dr. Paul McHugh to talk to you because he is a clinician and I have stated from the beginning that I am not.

TAT: I appreciate that, Pamela. But here's my issue with you not knowing. If I was talking to the Executive Director of the Muscular Dystrophy Association, who presumably is also not a clinician, I'll bet he or she could give me the signs and symptoms of muscular dystrophy. But in the case of false memory syndrome, so far no one seems to be able to say."

Conversation With Pamela Freyd, Ph.D. Co-Founder And Executive Director, False Memory Syndrome Foundation, Inc., Part I Treating Abuse Today, 3(4), p26-33. Calof, David L. ^[2]

After viewing a PBS Frontline documentary in April, 1995, that was biased in favor of "FMS" claims, William Freyd wrote the following letter Frontline:

Peter Freyd is my brother. Pamela Freyd is both my stepsister and sister-in-law. Jennifer and Gwendolyn are my nieces. There is no doubt in my mind that there was severe abuse in the home of Peter and Pam, while they were raising their daughters. Peter said (on your show, "Divided Memories") that his humor was ribald. Those of us who had to endure it, remember it as abusive at best and viciously sadistic at worst. The False Memory Syndrome Foundation is a fraud designed to deny a reality that Peter and Pam have spent most of their lives trying to escape. There is no such thing as a False Memory Syndrome. It is not, by any normal standard, a Foundation. Neither Pam nor Peter have any significant mental health expertise. That the False Memory Syndrome Foundation has been able to excite so much media attention has been a great surprise to those of us who would like to admire and respect the objectivity and motives of people in the media. Neither Peter's mother (who was also mine), nor his daughters, nor I have wanted anything to do with Peter and Pam for periods of time ranging up to more than two decades. We do not understand why you would "buy" such an obviously flawed story. "But buy it you did, based on the severely biased presentation you made of the memory issue that Peter and Pam created to deny their own difficult reality. I would advance the idea that "Divided Memories" hurt victims, helped abusers and confused the public. I wonder why you thought these results would be in the public interest that Public Broadcasting is funded to support. The letter is signed, William Freyd Now please understand that, above all else, this is not about blaming, because if this letter is true, it means that this situation is probably a continuation of victimization and abuse that started in the past."

Freyd, William. (1993). "Divided Memories: Letters to PBS and Frontline" in Moving Forward, Vol. III, No. 3 http://movingforward.org/v3n3-cheit.html

Memory and Abuse: Remembering and Healing the Effects of Trauma Charles L. Whitfield Health Communications 1995 ^[3]

Professional skepticism of DID and dissociative disorders: limited awareness during training[edit]

As an undergraduate student in psychology, I was taught that multiple personalities were a very rare and bizarre disorder. That is all that I was taught on the subject. Then, many years later, I came to know someone with this supposedly rare disorder, then someone else, and then someone. It soon became apparent that what I had been taught was simply not true. Not only was I meeting people with multiplicity; these individuals entering my life were normal human beings with much to offer. They were simply people who had endured more than their share of pain in this life and were struggling to make endured more than their share of pain in this life and were struggling to make sense of it.” The Dissociative Identity Disorder Sourcebook, Deborah Bray Haddock, 2001 ^[4]:xv

Misdiagnosis: hidden disorders

DID and dissociative disorders are not rare conditions. Clinical studies have found that generally between 1% and 5% of patients in psychiatric programs may meet diagnostic criteria for DID. Many of the patients in these studies had not previously been clinically diagnosed with a dissociative disorder. The difficulties in diagnosing DID result primarily from lack of education among clinicians about dissociation, dissociative disorders and the effects of psychological trauma, as well as from clinician bias. Most clinicians have been taught (or assume) that DID is a rare disorder with a florid, dramatic presentation. Instead of showing visibly distinct alternate identities,the typical DID patient presents a polysymptomatic mixture of dissociative and posttraumatic stress disorder (PTSD) symptoms that are embedded in a matrix of ostensibly non-trauma-related symptoms (e.g., depression, panic attacks, substance abuse, somatoform symptoms, eating-disordered symptoms). The prominence of these latter, highly familiar symptoms often leads clinicians to diagnose only these comorbid conditions. When this happens, the undiagnosed DID patient may undergo a long and frequently unsuccessful treatment for these other conditions....

Assessment for dissociation should be conducted as a part of every diagnostic interview, given the fact that dissociative disorders are at least as common as many other psychiatric disorders that are routinely considered in psychiatric evaluations. At a minimum, the patient should be asked about episodes of amnesia, fugue, depersonalization, derealization, identity confusion, and identity alteration. Additional useful areas of inquiry include questions about spontaneous age regressions; autohypnotic experiences; hearing voices; passive-influence symptoms such as “made” thoughts, emotions, or behaviors (i.e., those that do not feel attributable to the self); and somatoform dissociative symptoms such as bodily sensations related to strong emotions and past trauma. Clinicians should also be alert to behavioral manifestations of dissociation, such as posture, presentation of self, dress, fixed gaze, eye fluttering, fluctuations in style of speech, interpersonal relatedness, skill level, and sophistication of cognition.

Guidelines for Treating Dissociative Identity Disorder in Adults, Third Revision, International Society for the Study of Trauma and Dissociation (2011) ^[1]:191-192

Bipolar, affective, psychotic, seizure, and borderline personality disorders are among the common false negative diagnoses of patients with DID and DDNOS. False negative diagnoses of DID readily occur when the assessment interview does not include questions about dissociation and trauma or focuses on more evident comorbid conditions, and when evaluators have failed to attend to critical process issues such developing a sufficient sense of alliance and trust."
Guidelines for Treating Dissociative Identity Disorder in Adults, Third Revision, International Society for the Study of Trauma and Dissociation (2011) ^[1]:193

The less you know, the more you doubt[edit]

In 1994 a study involving a large national survey showed that mental health professionals were least skepticial about the diagnosis of DID (then called Multiple personality disorder - MPD) as their knowledge increased. The survey, now 20 years old shows that 24% of mental health professionals were then extremely or moderately skeptical about the diagnosis (which has been described in the DSM manual continually since it's first publication). This was peer-reviewed and published in a general psychiatry journal rather than a specialist trauma or dissociation journal. The abstract of the study states:

Three studies were conducted to investigate the nature of mental health professionals' skepticism regarding multiple personality disorder (MPD). An initial pilot study was conducted to develop a psychometrically sound survey instrument. In Study 2, the results of a national survey of 207 mental health professionals supported the hypothesis that skepticism and knowledge about MPD are inversely related, r = –.33, p < .01, although the strength of this relationship varied among professions. Moderate to extreme skepticism was expressed by 24% of the sample. Results from Study 3 supported the hypotheses that MPD is diagnosed with less accuracy than is schizophrenia and that misdiagnosis of MPD is predicted by skepticism about MPD. Findings are related to literature pertaining to mental health professionals' skepticism about MPD and consequential effects on treatment."
Mental health professionals' skepticism about multiple personality disorder. By Hayes, Jeffrey A.; Mitchell, Jeffrey C. ^[5]

Four years later (1998) different researchers published a paper on the same topic in the same peer-reviewed journal, this time looking at it from the example of a case which could be interpreted either as DID or as a person intentionally mimicking the symptoms. This much larger survey (425 mental health professionals) showed an overwhelming majority of psychologists believed the diagnosis of DID (then called MPD) was valid but rare and almost 50% had encountered a client with it. Significantly less believed they had encountered a client faking (feigning) the disorder. (Note: Feigning any medical or physical illness intentionally is described under the diagnosis of "Factitious disorder" in the DSM). The abstract reads:

If you saw a patient who appeared to have more than one personality, what diagnosis would you make? And how would you vary your clinical approach? Data from 425 respondents indicated that the majority of psychologists believed multiple personality disorder (MPD) to be a valid but rare clinical diagnosis. Respondents cited extreme child abuse as the foremost cause of MPD. Approximately one-half of all respondents believed that they had encountered a client with MPD, whereas less than one-third believed that they had encountered a client who feigned MPD.
Professional skepticism of multiple personality disorder. Professional Psychology: Research and Practice, Cormier, Jane F.; Thelen, Mark H., 1998 ^[6]

Majority opinion: opposing sociocognitive/iatrogenic theories of DID and dissociative disorders[edit]

"Challenging conventional wisdom" is the title of one published article which presents a non-trauma basis for DID, establishing that those against the trauma-dissociation model are in a minority. The article provides no suggestions for helping people with DID heal.

Sociocognitive and iatrogenic theories of DID explained[edit]

• The trauma-dissociation etiology of DID and dissociative disorders shows that these disorders are caused by trauma.
• The sociocognitive theory states that social/cultural suggestion causes DID - people who are easily led develop DID as a result of hearing about the symptoms via popular books, films or media/journalism. Suggests that fantasy/suggestion created DID, not trauma. No explanation is given for the origins of DID being in France, or the consistent reports dating from the 16th, 17th, 18th, 19th and 20th centuries. No explanation is offered about why DID is found in Japan, China or Turkey despite the lack of media being translated into languages there. No explanation exists for those diagnosed who have never had therapy or who did not know what DID is.
• The iatrogenic theory states that medical mistreatment and/or malpractice causes DID. No medication has been shown to do this so blame is put on the mental health services: usually therapists. This theory accuses therapists of either "bad therapy" or exploiting patients by convincing them they have DID when they do not, presumably for financial gain. No court case has found a therapist guilty of malpractice but some insurers have settled out of court, especially over issues like failing to get informed consent in writing. No explanation is given for therapists working with those with DID on behalf of non-profits or on very low sliding scale rates. No research describes how to treat this type of DID, should it be found to exist. Usually patients are portrayed as weak, passive and helpless - which suggests a single identity and role (rather than multiple ones) and ignores the common role of "protector" parts.

Research into different theories of the cause of DID[edit]

1. A recent review in Psychological Bulletin by 2012) found strong support for the etiological relationship of trauma and dissociation. These included several large meta-analyses, some of which focused on patients with DID... In addition, Dalenberg et al. (2012) tested eight different predictions of the trauma versus the fantasy (sociocognitive/iatrogenic) model of dissociation. On each, careful of reviews of the literature, including meta-analyses, on memory, suggestibility, and neurobiology, among others, Dalenberg et al. (2012) found minimal scientific evidence to support the fantasy model. Further, reviews have shown that there are no research studies in the literature in any population studied to support the iatrogenic/sociocognitive etiology of DID promulgated by Dr Paris (Brown et al., 1999; Loewenstein, 2007).... "

Disinformation about dissociation: Dr Joel Paris's notions about dissociative identity disorder. Bethany Brand, Richard J Loewenstein, and David Spiegel Journal of Nervous and Mental Disease (2013) ^[7]

2. "In 1989 Richard Kluft, well known in the field of treating dissociative disorders and trauma, published a paper describing how therapists could recover when overwhelmed by their work with people with DID (then called MPD). "he (Kluft, 1984) indicated that the therapist's empathic capacities could be taxed... it is grueling to remain in empathic rapport with a patient who maintains he or she has been severely, traumatized, and many a therapist consciously or unconsciously beats a retreat from the intensity of the treatment process." (here Kluft supports the trauma basis of DID). Kluft gives four common reactions of therapists:

• "skeptically derealizing the patient's account...the patient is implicitly or explicitly requested to prove his or her allegations or recollections, or to doubt them or discount them." (inconsistent with iatrogenic)
• "the assumption that the patient has been so badly injured that his or her needs must be met in special and tangible ways" (consistent with patients as survivors of severe trauma)
• "the patient's situation needs tangible redress rather than therapy; i.e., the therapist must become an advocate rather than a healer" (inconsistent with sociocognitive and iatrogenic theories)
• lastly "the therapist may... experience counteridentification, and become engulfed in the patient's misery, ultimately, experiencing posttraumatic stress" (inconsistent with sociocognitive and iatrogenic, known as secondary or vicarious traumatization this can only result from patients with DID sharing horrific experiences of trauma with the therapist, rather than therapists being the ones suggesting the trauma.

He also quotes research from Coons (1986) about the resistances of DID patients in therapy, which guves many qualities inconsistent with patients being described as suggestible or easily led (iatrogenic and sociocognitive theories): "stubbornness (54%), sexual acting out (46%), secretiveness (46%), manipulativeness (46%), continuous crises (46%)... excessive dependency on the therapist (31%), suicidal threats (31%)... refusal of hypnosis (23%)..." (Note that sexual acting out is also common in survivors of sexual abuse, giving further weight to the trauma-dissociation model.)"

The Rehabilitation of Therapists Overwhelmed by Their Work with MPD Patients, Journal: Dissociation http://hdl.handle.net/1794/1498^[8]

Growing amount of research into DID[edit]

...Joel Paris, MD... suggests that DID is merely a ‘‘fad’’ and that there is no credible evidence to connect traumatic experiences with the development of DID. We refute several of the claims made by Dr Paris.

Our biggest concern as non-North American researchers is that Dr Paris does not reference a single international study related to dissociative disorders and DID...his speculation that DID is not diagnosed outside clinics that specialize in treating dissociation is not consistent with current data. DID and dissociative disorders have been reliably found in general psychiatric hospitals; psychiatric emergency departments; and private practices in countries including England, the Netherlands, Turkey, Puerto Rico, Northern Ireland, Germany, Finland, China, and Australia, among many others... Epidemiological general population studies indicate that 1.1% to 1.5% meet diagnostic criteria for DID; and 8.6% to 18.3%, for any DSM-IV dissociative disorder... international literature on DID and dissociative disorders has been widely published in mainstream journals of psychiatry and psychopathology and is inconsistent with Dr Paris’s conclusions."

Growing Not Dwindling International Research on the Worldwide Phenomenon of Dissociative Disorders, Psychology Bulletin (2013) ^[9]

Quoting media and biographies instead of research. Using single cases to distort facts[edit]

Dr Paris devotes a whole section of his article to challenging a single case of reported DID, published in the popular press by a journalist (i.e., Nathan, 2011; Schreiber, 1973). This degree of attention to a single popular press case is out of place in a serious academic review and also ignores another work in the same popular press genre that came to the opposite conclusion about that case (Suraci, 2011). Given the scientific topic under discussion, it would have been preferable for Dr Paris to base his thesis on peer-reviewed, empirical-driven, scientific data rather than on a journalistic investigation in the popular press. He insistently refers to seven popular books or sensational press releases in his attempts to sustain some of his arguments.
Growing Not Dwindling International Research on the Worldwide Phenomenon of Dissociative Disorders, Psychology Bulletin (2013) ^[9]

Ignoring historical reports from well known scientists[edit]

Dr Charles Myers, a Consulting Psychologist to the British Armies in the First World War, recognized dissociative symptoms including dissociative amnesia, dissociative motor problems and loss of physical sensations were a direct result of functional dissociation occurring within traumatized soldiers during World War I. Writing for the famous The Lancet journal he stated:

In my early experience of shell shock I came to lay great stress on disturbances of personality, and I regarded the amnesia and the bodily disorder, mutism, tremor, incoordination, or spasmodic movement, so commonly observed in cases seen soon after their onset, as the expression of this change of personality, due. like it, to some functional dissociation."

Dr Myers goes on to describe dissociation resulting in apparent personality changes, using the terms "ultra-emotional personality" and "normal personality", an updated version of this understanding is known as the structural dissociation model - it is the most frequently model in understanding dissociative identity disorder (DID), and applies to other trauma conditions including PTSD and Complex PTSD. Complex PTSD has also been termed "Enduring Personality Change After Catastrophic Events" (EPCACE), consistent with Myers' description.

LIMITS OF DISSOCIATION.

Cases frequently occur in which the sudden recovery of lost memory is accompanied not merely by the restoration of speech, not merely by the cessation of spasmodic movements, but also by a marked change in the entire facies of the patient. He not only (as he states) feels, but he also looks, another person. His pupils, pulse-rate, and skin colour regain their normal condition. We may consider their previous abnormal state as due to the persistence of emotional expression, either uncontrolled by, because dissociated from, the normal personality, or belonging to an "ultra- emotional" personality which held sway owing to dissociation of the normal personality.

The study of shell shock, Dr C. S. Myers, M.D., SC.D., F.R.S., Lieutenant-Colonel, R.A.M.C. (T.C.). The Lancet (1919) ^[10]:52

Dr Myers kept a detailed diary with medical observations on his work on shell shock, including documentation of amnesia caused by traumatic war experiences. He wrote that 'shell shock' itself was a misleading term because the physical cause of the exploding shell was not the cause of the symptoms and that dissociative symptoms, including amnesia and personality alterations were already recognized outside war. His War Diary states:

mental disorders from 'shell shock' are mainly due to 'dissociation'," and included anxieties, fugues, alternations of personality and amnesia as dissociative symptoms."(p29)

"A shell, then may play no part whatever in the causation of 'shell shock': excessive emotion, e.g. sudden horror or fear - indeed any 'psychical trauma' or 'inadjustable experience'- is sufficient."(p26)

...conditions were experienced outside war, they had "been previously recognized in civil life as occurring in industrial and railway accidents; to them the 'traumatic neurasthenia' and 'traumatic hysteria' have been applied."(p37)

Shell Shock in France, 1914-1918: Based on a War Diary Kept by C.S. Myers, 1940. University Press ^[11]:29

Disinformation: False claims, basic errors and lack of scholarship[edit]

The epidemiological, laboratory, neurobiological, psychophysiological, and psychometric research on dissociative disorders is abundant and impressive. For whatever reasons, this research is inadequately represented in Dr Paris’s article...

...Dr Joel Paris’s... claim that dissociative identity disorder (DID) is a ‘‘medical fad’’ is simply wrong, and he provides no substantive evidence to support his claim. From the mistaken identification of Pierre Janet as a psychiatrist in the first line (Janet was the most famous psychologist of his day), it is replete with errors, false claims, and lack of scholarship and just plainly ignores the published literature. Dr Paris provided a highly biased article that is based on opinion rather than on science.

His review of the literature is extremely selective. Of 48 references, Dr Paris cites exactly 7 peer-reviewed articles published from 2000 onward (7/48 references equals 14%) and only 8 peer-reviewed, data-driven articles from before 2000 (8/48 equals 16%). Rather than relying on the recent peer-reviewed, scientific literature, Paris relied almost entirely on the non-peer-reviewed books, including a popular press book written by a journalist whose methods and conclusions have been strongly challenged. He claims that interest and research in DID have waned, yet he fails to cite the multitude of studies that have been conducted about it. In fact, Dalenberg et al. (2007) documented evidence of the exact opposite pattern described by Paris: ‘‘A search of the PILOTS database offered by the National Center for Posttraumatic Stress Disorder for articles on dissociation reveals 64 studies in 1985-1989, 236 published in 1990-1994, 426 published in 1995-1999 and 477 in the last 5-year block (2000-2004) (p.401) Dr Paris seems unaware of the breadth and depth of research about dissociation yet made sweeping generalizations about it. For example, he fails to review the neurobiological and clinical research that has led to the addition of a dissociative subtype of posttraumatic stress disorder (PTSD) in the DSM-5. He fails to cite cutting-edge research on dissociation including a recent study by 2012) in Biological Psychiatry that sound evidence of the dissociative subtype of PTSD in about 14.4% of 25,018 individuals in a World Health Organization sample involving 16 countries. The dissociative subtype was associated with male sex, a history of exposure to previous traumatic events and childhood adversities, subsequent onset of PTSD in childhood, ... and suicidality. Despite failing to review this and other relevant research, Dr Paris made the claim that ‘‘Neither the theory behind the diagnosis nor the methods of treatment are consistent with the current preference for biological theories’’ (p. 1078). Furthermore, he fails to cite any research that has been done by researchers outside North America."

"Dr Paris makes claims that are far afield from what can be scientifically substantiated by current research. For example, he states that 'the treatment recommended [for DID] was never shown to be successful' (p. 1078). Dr Paris ignores studies that have found treatment of DID is associated with improvements in a range of outcomes, including substantially reduced dissociation, PTSD, depression, general distress, suicidality, and self-destructive behaviors, among others..." " this level of scholarship would not be considered acceptable in the discussion of the psychotic disorders, mood disorders, personality disorders, or any other disorder in psychiatry. It is time that the same minimum standard of scholarship by provided for discussion of the dissociative disorders. In summary, disagreement is healthy for our field. However, Dr Paris’s article does not provide scholarly criticism based upon peer reviewed research, scientific data, or accurate discussion of the history of psychiatry. His point of view is incorrect and outmoded. It is the so-called false-memory, iatrogenesis model of the dissociative disorders that is the fallen fad, buried under the weight of rigorous data that contradict it. Dissociative disorders have not risen and fallen. These existed before the fields of psychiatry and psychology did."

Disinformation about dissociation: Dr Joel Paris's notions about dissociative identity disorder. Journal of Nervous and Mental Disease (2013) ^[7]

Professionals stigmatizing patients[edit]

...in addition, by trivializing a psychiatric disorder that research shows affects 1% to 3%... articles such as that of Dr Paris add to the burden of stigma for these highly traumatized patients with serious psychiatric illness."
Disinformation about dissociation: Dr Joel Paris's notions about dissociative identity disorder. Journal of Nervous and Mental Disease (2013)^[7]

Evidence of the harm of child sexual abuse[edit]

Dr Paris also opines that there is only a ‘‘weak link’’ between child abuse and psychopathology, quoting an article published 17 years ago. Current research illustrates a very different picture."

Persons with early abusive experiences demonstrate increased illnesses (Green and Kimerling, 2004), impaired work functioning (Lee and Tolman, 2006), serious interpersonal difficulties (Van der Kolk and d’Andrea, 2010), and a high risk for traumatic revictimization (Rich et al., 2004). The Adverse Childhood Experiences Study... provided retrospective and prospective data from more than 17,000 individuals on the effects of traumatic experiences during the first 18 years of life. This large study demonstrated the enduring, strongly proportionate, and frequently profound relationship between adverse childhood experiences and emotional states, health risks, disease burdens, sexual behavior, disability, and health care costs, even decades later (Felitti and Anda, 2010). Specifically, child sexual abuse (CSA) has been related in various epidemiological studies to the subsequent onset of a variety of psychiatric disorders... Molnar et al. (2001), using data from the National Comorbidity Survey, found that CSA was associated with 14 psychiatric disorders among women and 5 among men, even after controlling for other childhood adversities. Dinwiddie et al. (2000), using a large database of Australian twins (N = 5,995), found that individuals reporting CSA were much more likely to receive a psychiatric diagnosis and more likely to report suicide attempts than were those who were not sexually abused. In a population based sample of 1,411 female adult twins... When the twin pairs were discordant for the CSA, the abused twin was at a higher risk for developing a psychiatric disorder... In fact, stringently documented international research has made it almost impossible not to appreciate what happens psychologically to children who grow up being abused by the adults who were supposed to protect them (Kezelman and Stavropoulos, 2012; Middleton, 2013a, 2013b)."

Growing Not Dwindling International Research on the Worldwide Phenomenon of Dissociative Disorders, Psychology Bulletin (2013) ^[9]

Evidence of distorted or misleading information about child sexual abuse[edit]

Professionals with pro-pedophile views[edit]

PAIDIKA: Is choosing paedophilia for you a responsible choice for the individuals?

RALPH UNDERWAGER: Certainly it is responsible. What I have been struck by as I have come to know more about and understand people who choose paedophilia is that they let themselves be too much defined by other people. That is usually an essentially negative definition. Paedophiles spend a lot of time and energy defending their choice. I don’t think that a paedophile needs to do that. Paedophiles can boldly and courageously affirm what they choose. They can say that what they want is to find the best way to love. I am also a theologian and as a theologian, I believe it is God’s will that there be closeness and intimacy, unity of the flesh, between people. A paedophile can say: “This closeness is possible for me within the choices that I’ve made.” Paedophiles are too defensive. They go around saying, “You people out there are saying that what I choose is bad, that it’s no good. You’re putting me in prison, you’re doing all these terrible things to me. I have to define my love as being in some way or other illicit.” What I think is that paedophiles can make the assertion that the pursuit of intimacy and love is what they choose. With boldness, they can say, “I believe this is in fact part of God’s will.” They have the right to make these statements for themselves as personal choices. Now whether or not they can persuade other people they are right is another matter (laughs).

Dr Ralph Underwager (psychiatrist, now deceased), Interview in June 1991 by “Paidika,” Resigned from the False Memory Syndrome Foundation's Scientific Advisory Board after the interview became public. Frequently paid as an expert witness in the defense of those accused of child sexual abuse

Michael B. First and Allen Frances (2011) stated that hebephilia (an attraction to barely pubescent adolescents typically in the 11-14-year-old range^[12]:4) was "normal", they referenced three small studies between 23 and 41 years old (dated between 1970 and 1989) to support this dubious assertion. They wrote:

It is fallacious to assert that having sexual urges involving pubescent youngsters is sufficient for a diagnosis of a mental disorder. Having such urges is normal; acting on them is a serious crime, not a mental disorder. The risks of the DSM-5 proposals are magnified because they emerge against the background of a push toward the increased diagnosis of hebephilia in SVP [sexually violent predator] cases."
Allen Frances & Michael B. First, Hebephilia Is Not a Mental Disorder in DSM-IV-TR and Should Not Become One in DSM-5, Journal of American Academy of Psychiatry and the Law, 2011 http://www.jaapl.org/content/39/1/78.long

Professionals and academics[edit]

One of the central questions surrounding the debate on memories of CSA is how often false or repressed memories actually occur. The APA working group (Alpert et al., 1996) and other experts (e.g., Loftus, 1993a) noted that no reliable method can distinguish between accurate and inaccurate memories. Therefore, no one can determine the prevalence of false or repressed memories. Nevertheless, six texts (30%) implied that false memories occur frequently (see Table 1). Of these, three included the opinionated suggestion that a "witch hunt" may be occurring in which innocent parents are routinely accused of, and then severely punished for, CSA. Two texts suggested that false memories of CSA must occur because an entire support group (the FMSF) has been formed for falsely accused parents. These authors apparently failed to consider that some members of the FMSF may actually have sexually assaulted children but are motivated to appear innocent."
"The portrayal of child sexual assault in introductory psychology textbooks." Journal: Teaching of Psychology ^[13]

Expert Witnesses for the Defense: The profits of defending sex offenders[edit]

Elizabeth F. Loftus[edit]

A number of very vocal academics have made very large numbers of court appearances which use their research of that of others to testify as "expert witnesses" in the defense of (alleged) child abusers and (alleged) sex offenders. Some of these "expert witnesses" have never testified on behalf of the prosecution, and only for the defense. Self-styled "false memory expert" Dr Elizabeth F. Loftus stated in her book "Witness for the Defense: The Accused, the Eyewitness and the Expert who puts Memory on trial" that by 1991 she had testified in defense in over 100 cases, including the first case brought against serial killer Ted Bundy (1976), a case of kidnapping. She describes how Bundy did not meet her stereotypee: "On the other side of the table, close enough for me to reach across and touch him, sat Ted Bundy. He’s adorable, I thought, surprised at my first impression, because I’d pictured him in my mind as brooding, dark, intense disdain. ^[14]:83 Bundy was found guilty and subsequently charged with the further crimes.

Dr. Luis Rosell, Dr. Allen Frances and Dr. Stephen Hart[edit]

Rosell, Frances and Hart all testified in 2012 in support of convicted child sex offender Bradley Hutchroft, the legal document states that:

Hutchcroft previously "admitted that after he reached the age of eighteen, he had thirty-six total sexual contacts with victims under the age of eighteen"^[12]:3 and had pleased guilty to 2 child sex offences in return for another 6 charges to be dropped.^[12]:1-2 Hutchcroft had "multiple violations of his probation, culminating in a conviction in 2006 for assault with intent to commit sexual abuse in the third degree" and he had "pleaded guilty to sexual abuse in the fourth degree" with a 15-year-old. Hutchcroft's work release from prison was revoked after 3 months following "several rule infractions including accessing pornography at the local library and having contact with a fourteen-year-old."

Despite this, Dr Luis Rosell, Dr Allen Frances and Dr Stephen Hart "All offered opinions that Hutchcroft did not suffer from a mental abnormality and was not likely to reoffend"^[12]:5. Dr. Frances stated "people are expected to have sex when they become sexually mature. While it is a crime to act on the sexual impulse directed at a thirteen-year-old... the impulse itself should not be considered a mental abnormality." The court instead agreed with the state's expert witness Dr Anna Salter, and classified him as a "sexually violent predator", meaning he was to be kept in a secure psychiatric institution after the end of his jail sentence. In the original trial, Dr. Salter’s opinion was that Hutchcroft suffered from hebephilia, and "technically meets the definition of pedophilia... his victims are usually thirteen years old."

IN THE COURT OF APPEALS OF IOWA No. 2-798 / 11-1838 Filed October 31, 2012 IN RE THE DETENTION OF BRADLEY HUTCHCROFT, Appeal from the Iowa District Court for Dubuque County, Michael Shubatt, Judge

http://statecasefiles.justia.com/documents/iowa/court-of-appeals/2-798-11-1838.pdf IN THE COURT OF APPEALS OF IOWA No. 2-798 / 11-1838 Filed October 31, 2012 IN RE THE DETENTION OF BRADLEY HUTCHCROFT, Appeal from the Iowa District Court for Dubuque County, Michael Shubatt, Judge^[12]

Misuse of the term "false memory"[edit]

We propose that use of the term “false memory” to describe errors in memory for details directly contributes to removing the social context of abuse from research on memory for trauma. As the term “false memories” has increasingly been used to describe errors in details, the scientific weight of the term has increased. In turn, we see that the term “false memories” is treated as a construct supported by scientific fact, whereas other terms associated with questions about the veracity of abuse memories have been treated as suspect. For example, “recovered memories” often appears in quotations, whereas “false memories” does not (Campbell, 2003).The quotation marks suggest that one term is questioned, whereas the other is accepted as fact. Accepting “false memories” of abuse as fact reflects the subtle assimilation of the term into the cognitive literature, where the term is used increasingly to describe intrusions of semantically related words into lists of related words. The term, rooted in the controversy over the accuracy of abuse memories recalled during psychotherapy (Schacter, 1999), implies generalization of errors in details to memory for abuse—experienced largely by women and children (Campbell, 2003)."
What's in a Name for Memory Errors? Implications and Ethical Issues Arising From the Use of the Term “False Memory” for Errors in Memory for Details, Journal: Ethics & Behavior^[15]

In the specific case of the use of the term “false memory” to describe errors in details in laboratory tasks (e.g., in word-learning tasks), the media and public are set up all too easily to interpret such research as relevant to “false memories” of abuse because the term is used in the public domain to refer to contested memories of abuse. Because the term “false memory” is inextricably tied in the public to a social movement that questions the veracity of memories for childhood sexual abuse, the use of the term in scientific research that evaluates memory errors for details (not whole events) must be evaluated in this light. "
What's in a Name for Memory Errors? Implications and Ethical Issues Arising From the Use of the Term “False Memory” for Errors in Memory for Details, Journal: Ethics & Behavior^[15]

The myth that divorce often causes false child sexual abuse allegations[edit]

Coverage of high-profile cases in the respected print media tends to reflect the attitudes of a handful of very vocal, self-styled ‘experts.” They have fueled the widespread public perception that false allegations of child sexual abuse are appearing with increased frequency in custody cases. Despite scientific evidence to the contrary, this belief has been adopted by many in the legal profession and by a sizeable segment of the mental health community.

The purpose of this book is to challenge these misconceptions. Sex abuse allegations that occur during custody disputes are frequently presumed to be false because they have arisen during or just before a custody case, regardless of the evidence. Because of this presumption on the part of private professionals and public officials, when children who suffer incest become the subjects of custody disputes, often their outcries are not believed and they are not protected. Custody of such children is likely to be given to the very adults accused of molesting them."

The Hostage Child: Sex Abuse Allegations in Custody Disputes, Leora N. Rosen, Michelle Etlin^[16]:x

While many experts insisted that children seldom lie about sexual abuse, others claimed that young children often failed to distinguish between fact and fiction and might be susceptible to suggestion and pressure on the part of investigators... Were these parents intentionally coaching their children to lie in order to punish a hated ex-spouse or to gain advantage in a divorce settlement? There were many professionals—lawyers, judges, clinicians, psychiatrists—who became convinced that this was the case. Articles in respectable publications like Time and Newsweek cited statistics indicating that fictitious allegations made by divorcing parents were on the rise, and lawyers were quoted describing sex abuse allegations as the ‘atom bomb of custody disputes.’

There were also parents—predominantly mothers—who found evidence suggesting a good possibility that their children had been sexually molested by ex-spouses. Sometimes a child’s disclosures or physical or psychological symptoms led a mother to seek medical or psychological advice. Often the suggestion that abuse had occurred came not from the mother but from a doctor or a psychologist. Initial shock and disbelief on the part of these mothers was followed with the hope and expectation that the proper authorities, to whom suspicion of abuse was reported, would conduct appropriate investigations and take the steps necessary to protect their children. Rapidly they found that the systems response was very different from what they had expected. As protective mothers in cases against fathers, these women were automatically labeled vindictive, malicious, and paranoid, regardless of evidence to the contrary... the end result was almost always the same—returning or delivering the child to the alleged molester. Could this really be happening in America?

The Hostage Child: Sex Abuse Allegations in Custody Disputes, Leora N. Rosen, Michelle Etlin^[16]:x

Evidence that horrific trauma can be forgotten - repressed memory and recovered memory[edit]

Extensive evidence from of memory loss with no physical cause, followed by the return of the traumatic memories, was documented by Dr Charles C. Myers and others treating soldiers experiencing combat, with detailed reports from at least 70 years ago.

Amnesia, which is a loss of memory, is a symptom of many different trauma and/or dissociative disorders, including PTSD, Dissociative Fugue, Dissociative Disorder Not Otherwise Specified and Dissociative Identity Disorder. Amnesia can affect both implicit and explicit memory."
The Impact of Early Life Trauma on Health and Disease: The Hidden Epidemic, Ruth A. Lanius, Eric Vermetten, Clare Pain ^[17]

Repressed memories (also known as recovered memories) refer to a period of amnesia after trauma, followed by the return of the traumatic memory/memories. This amnesia after trauma has been well documented for over 100 years, particularly during World War I which involved large numbers of soldiers suffering from psychological trauma without physical injuries, and some of these traumatized soldiers had both amnesia and dissociative symptoms, including dissociative stupor, motor problems and loss of physical sensations. The soldiers' trauma was independently witnessed and reported by other soldiers (unlike cases of sexual abuse, which is rarely witnessed). Dr Charles S. Myers described cases of what he termed "shell shock", examining the apparent lack of suggestion of their symptoms.

3. In childhood certain spasmodic movements were temporarily induced by a severe fright. Of this the soldier has lost - all memory. Sudden fear in the trenches revives this disordered movement, which persists for many weeks. The influence of suggestion is here less sure. But even if suggestion can explain the origin it cannot account for the long persistence of the movement, which may even continue during sleep. But if (as is usual) it ceases during

sleep can it be supposed that each morning on waking the patient receives a fresh suggestion ?? Do we not gain a clearer insight into the condition by regarding the movement as a dissociated emotional expression inherent in the waking personality of the patient, especially when this view leads us to cure the disorder by reviving in the patient the memory of the original trouble, and thus helping to restore his normal personality ?? 4. A soldier in previous good health is buried owing to a shell explosion. After a period of stupor or confusion (perhaps preceding, accompanying, or following excitement, depression, or fugue), he " comes round " mute and amnesic, but he has clearly not quite returned to his normal self. Here there is no evidence of suggestion, but it is possible that suggestion may have influenced the patient when the state of confusion or stupor was passing away. By means of hypnosis memories of a patient’s thoughts or environment during confusion or stupor may often be recovered. Hypnotic investigation may therefore serve to clear up this point. Yet even if loss of speech had been suggested during recovery from confusion or stupor, suggestion is impotent to explain such a patient’s loss of memory. The soldier may confess to having felt some previous fear, but what man has not at some time had that experience in the trenches?? There is often no evidence of any mental conflict before or after burial. But he may have been unconsciously repressing some tendency to action. Here hypnosis may again prove of use in revealing the presence of such past conflict or inhibition. It cannot be said that mutism and amnesia are obvious measures of escape from the firing line ; and amnesia can only be called a defence mechanism in the sense that, like stupor, it safeguards the patient from suffering further emotion. In such cases, may we not suppose that the shock of an excessive emotion (or ? commotion) is adequate to produce an abnormal, stuporose, or confused personality, on emergence from which the memories of events

The study of shell shock, Dr C. S. Myers, M.D., SC.D., F.R.S., Lieutenant-Colonel, R.A.M.C. (T.C.). The Lancet (1919) ^[10]:52

Hypeː leave the child sex offender alone! "witch-hunts" "moral panics"[edit]

Certain inflammatory terms appear regularly in popular press and online, and attempt to portray people reported as child sex offenders as "victims", and to justify not prosecuting child sex offenders and in some cases not seeking out sex offenders.

• What is wrong about looking for and prosecuting criminals?
• moral panic? Panic seems to be coming from those supporting the accused. What is wrong with panicking about child sex offenders escaping justice, and being allowed to continue offending? This isn't about moral standards, it is about criminal offences.
• What is different about sex offences - particularly child sex offences - that means law enforcement should not investigate, prosecute or lure offenders, for example, officers posing as young children in chatrooms? Surely for other frauds - especially financial fraud - monitoring and instant investigation is not in depute?
• Why do older sex offenders - especially those who have multiple victims - get sympathy and pity as if the offender is the victim?
• Why does more evidence appear to be demanded for sex offences than other types of offences?

For all this talk about us being a nation at war with child abuse, and for all the media hype about witch-hunts and false allegations — and don't ever let anyone use the word witch-hunts about this; there were no witches — the fact remains that in 1994, it is extremely difficult to come forward with allegations of sexual abuse. And the external forces of denial are almost overwhelming. If a case as verified as mine meets with denial, I dread to think about the experience of people who don't have the kind of corroboration that I do. And I really worry that we're getting close to a point where it's going to be impossible to prosecute child molesters, because we don't believe children, and now we don't believe adults.
Paper presented at the Mississippi Statewide Conference on Child Abuse and Neglect", Ross E. Cheit ^[18]

...in another article, Loftus writes, "We live in a strange and precarious time that resembles at its heart the hysteria and superstitious fervor of the witch trials." She took rifle lessons and to this day keeps the firing instruction sheets and targets posted above her desk. In 1996, when Psychology Today interviewed her, she burst into tears twice within the first twenty minutes, labileLabile effect - "Affective expression characterized by rapid and abrupt changes unrelated to external stimuli." {{Rp|22}}"inability to difficulty in describing or being aware of one's emotions or moods; elaboration of fantasies associated with depression, substance abuse and posttraumatic stress disorder"{{Rp|22}} People with alexithymia are incapable of soothing themselves when under stress.{{Rp|259}}"Reduced impulse to act and to think, associated with indifference about consequences of action." {{Rp|21}}"Inability to speak because of a mental definciency or an episode of dementia." {{Rp|22}}Altered states of consciousness / alter identity. :Exchangeable terms include parts, states, identities, selves, or ego states. An [[alter]] is present only in those with [[Dissociative Identity Disorder]], where the parts of the [[personality]] are highly [[dissociated]] and isolated. No [[alter]], including the host [[alter]], is a complete [[personality]], even though an [[alter]] might feel as if they are. {{Rp|55-67}} [[Alter]]s are psychodynamically interacting parts, each with their own separate centers of subjectivity, identity, autonomy, and sense of personal history. {{Rp|55}} An individual with [[Dissociative Identity Disorder]] may have few or many [[alter|alters]], which include a variety of ages, cross gender, animal or objects, with coconsciousness (see coconsciousness) at varying degrees, and [[communication]] can be limited to one direction. (one way amnesia) {{Rp|301}}, lubricated, theatrical, still whip smart, talking about the blurry boundaries between fact and fiction while she herself lived in another blurry boundary, between conviction and compulsion, passion and hyperbole. "The witch hunts," she said, but the analogy is wrong, and provides us with perhaps a more accurate window into Loftus's stretched psyche than into our own times, for the witch hunts were predicated on utter nonsense, and the abuse scandals were predicated on something all too real, which Loftus seemed to forget: Women are abused. Memories do matter. Talking to her, feeling her high-flying energy the zeal that burns up the center of her life, you have to wonder, why. You are forced to ask the very kind of question Loftus most abhors: did something bad happen to her? For she herself seems driven by dissociated demons, and so I ask. What happened to you? Turns out, a lot."
refers to Dr. Elizabeth F. Loftus, Opening Skinner's Box: Great Psychological Experiments of the Twentieth Century” ^[19]

Quotes about society's denial of child abuse[edit]

Today, acknowledgement of the prevalence and harms of child sexual abuse is counterbalanced with cautionary tales about children and women who, under pressure from social workers and therapists, produce false allegations of ‘paedophile rings’, ‘cult abuse’ and ‘ritual abuse’. Child protection investigations or legal cases involving allegations of organised child sexual abuse are regularly invoked to illustrate the dangers of ‘false memories’, ‘moral panic’ and ‘community hysteria’. These cautionary tales effectively delimit the bounds of acceptable knowledge in relation to sexual abuse. They are circulated by those who locate themselves firmly within those bounds, characterising those beyond as ideologues and conspiracy theorists.

However firmly these boundaries have been drawn, they have been persistently transgressed by substantiated disclosures of organised abuse their have led to child protection interventions and prosecutions. Throughout the 1990s, in a sustained effort to redraw these boundaries, investigations and prosecutions for organised abuse were widely labelled ‘miscarriages of justice’ and workers and therapists confronted with incidents of organised abuse were accused of fabricating or exaggerating the available evidence. These accusations have faded over time as evidence of organised abuse has accumulated, while investigatory procedures have become more standardised and less vulnerable to discrediting attacks. However, as the opening quotes to this introduction illustrate, the contemporary situation in relation to organised abuse is one of considerable ambiguity in which journalists and academics claim that organised abuse is a discredited ‘moral panic’ even as cases are being investigated and prosecuted.”

Michael Salter, Organised Sexual Abuse (2013)^[20]:1-2

I feel that some people have a hard time with the truths around us, not only the sexual abuse by priests, but all bad things. I call it chosen ignorance. This modified form of ignorance is found in people who, if confronted with certain truths realize that they have to accept them and thereby acknowledge evil, and that scares them. Opening up and letting the truth in might knock them off their perceived center. It is too hard, period.” Charles L. Bailey Jr., In the Shadow of the Cross^[21]

The knowledge of horrible events periodically intrudes into public awareness but is rarely retained for long. Denial, repression, and dissociation operate on a social as well as an individual level. Clinicians know the privileged moment of insight when repressed ideas, feelings, and memories surface into consciousness. These moments occur in the history of societies as well as in the history of individuals. [For example] In the 1970s, the speakouts of the women's liberation movement brought to public awareness the widespread crimes of violence. Victims who had been silenced began to reveal their secrets. As a psychiatric resident, I heard numerous stories of sexual and domestic violence from my patients." Trauma and Recovery. Judith Lewis Herman ^[22]:2

The FMSF [False Memory Syndrome Foundation] is the only organization in the world that has attacked the reality of multiple personality in an organized, systematic fashion. FMSF Professional and Advisory Board Members publish most of the articles and letters to editors of psychiatry journals hostile to multiple personality disorder.” Dr Colin A. Ross, The CIA Doctors: Human Rights Violations by American Psychiatrists (2006) ^[23]

Some readers may find it a curious or even unscientific endeavour to craft a criminological model of organised abuse based on the testimony of survivors. One of the standard objections to qualitative research is that participants may lie or fantasise in interview, it has been suggested that adults who report severe child sexual abuse are particularly prone to such confabulation. Whilst all forms of research, whether qualitative or quantitative, may be impacted upon by memory error or false reporting, there is no evidence that qualitative research is particularly vulnerable to this, nor is there any evidence that a fantasy— or lie—prone individual would be particularly likely to volunteer for research into child sexual abuse. Research has consistently found that child abuse histories, including severe and sadistic abuse, are accurate and can be corroborated (Ross 2009, Otnow et al. 1997, Chu et al. 1999). Survivors of child abuse may struggle with amnesia and other forms of memory disturbance but the notion that they are particularly prone to suggestion and confabulation has yet to find a scientific basis. It is interesting to note that questions about the veracity of eyewitness evidence appear to be asked far more frequently in relation to sexual abuse and rape than in relation to other crimes. The research on which this book is based has been conducted with an ethical commitment to taking the lives and voices of survivors of organised abuse seriously.” Michael Salter, Organised Sexual Abuse (2013)^[20]:1-2

In the 1980s, research on post traumatic stress disorder in Vietnam veterans was regarded as important, noble, and useful. When the same researchers looked at the same problem in children who had been sexually abused, a tremendous controversy ensued a controversy that persists to this day. There were those who disputed the extent and severity of the sexual abuse that had been uncovered.” Sexual Anorexia: Overcoming Sexual Self-Hatred, Patrick J. Carnes ^[24]

Lack of awareness or false information: Questions to ask people[edit]

References[edit]

1. ^ ^{a b c} International Society for the Study of Trauma and Dissociation. Guidelines for Treating Dissociative Identity Disorder in Adults, Third Revision. Journal of Trauma & Dissociation, volume 12, issue 2, 28 February 2011, page 115–187. (doi:10.1080/152947)
2. ^ Calof, David L.. Conversation With Pamela Freyd, Ph.D. Co-Founder And Executive Director, False Memory Syndrome Foundation, Inc., Part I. Treating Abuse Today, volume III, issue 3.
3. ^ Freyd, William. Divided Memories: Letters to PBS and Frontline. In Memory and Abuse: Remembering and Healing the Effects of Trauma. Whitfield, Charles L. (1995). . Moving Forward, volume III, issue 3.
4. ^ Haddock, Deborah Bray (2001). . .
5. ^ Hayes, Jeffrey A.; Mitchell, Jeffrey C. (1994). Mental health professionals' skepticism about multiple personality disorder.. Professional Psychology: Research and Practice, volume 25, issue 4, page 410-41.
6. ^ Cormier, Jane F.; Thelen, Mark H. (1998). Professional skepticism of multiple personality disorder. Professional Psychology: Research and Practice, volume 29, issue 2, page 163-167.
7. ^ ^{a b c} Brand, Bethany; Loewenstein, Richard J., Spiegel, David (2013). [www.researchgate.net/publication/236090406_Disinformation_About_Dissociation_Dr_Joel_Paris's_Notions_About_Dissociative_Identity_Disorder Disinformation about dissociation: Dr Joel Paris's notions about dissociative identity disorder. Letters to the Editor..] Journal of Nervous & Mental Disease, volume 201, issue 4, page 354–356. (doi:10.1097/NMD.0b013e318288d2ee)
8. ^ Kluft, Richard P.. The Rehabilitation of Therapists Overwhelmed by Their Work with MPD Patients. Dissociation, volume 2, issue 4, page 243-249.
9. ^ ^{a b c} Martınez-Taboas, A; Dorahy, M., Sar, V., Middleton, W., Krüger, C. (2013). Growing Not Dwindling.. Psychology Bulletin, volume 201, issue 4.
10. ^ ^{a b} Myers, Dr. C. S.. [http://www.onnovdhart.nl/articles/MyersSTUDYOFSHELLSHOCK1919.pdf The Study of Shell Shock BEING A CONSIDERATION OF UNSETTLED POINTS NEEDING INVESTIGATION.] The Lancet, volume 193, issue 4976, 11 January 1919.
11. ^ Myers, Charles Samuel (1940). ''Shell Shock in France, 1914-1918: Based on a War Diary Kept by C.S. Myers.
12. ^ ^{a b c d e} Frances, Allen; First, Michael B. (2011). Hebephilia Is Not a Mental Disorder in DSM-IV-TR and Should Not Become One in DSM-5. Journal of American Academy of Psychiatry and the Law, volume 39, issue 1, page 78-85.
13. ^ Letourneau, E. J.; Lewis, T. C. (1999). The portrayal of child sexual assault in introductory psychology textbooks. Teaching of Psychology, volume 26, issue 4, page 253-258. (doi:10.1207/S15328023TOP260402)
14. ^ Loftus, Elizabeth (1991) (coauthors: Ketcham, Katherine). Witness for the Defense: The Accused, the Eyewitness and the Expert who puts memory on trial. 0-312-08455-2.
15. ^ ^{a b} DePrince, Anne P.; Allard, Carolyn B., Oh, Hannah, Freyd, Jennifer J. (2004). [dynamic.uoregon.edu/jjf/articles/daof04.pdf‎ What’s in a Name for Memory Errors? Implications and Ethical Issues Arising From the Use of the Term “False Memory” for Errors in Memory for Details.] Ethics & Behavior, volume 14, issue 3, page 201-233.
16. ^ ^{a b} Rosen, Leora N. (1996) (coauthors: Etlin, Michelle). The Hostage Child: Sex Abuse Allegations in Custody Disputes. .
17. ^ Lanius, Ruth A., Vermetten, Eric, Pain, Clare (Eds) (2010). The Impact of Early Life Trauma on Health and Disease: The Hidden Epidemic. .
18. ^ Cheit, Ross E.. as quoted in "Betrayal Trauma: The Logic of Forgetting Childhood Abuse" Jennifer J. Freyd 1998, 29 April 1994.
19. ^ Slater, Lauren (2005). Opening Skinner's Box: Great Psychological Experiments of the Twentieth Century. .
20. ^ ^{a b} Salter, Michael (2013). . .
21. ^ Bailey, Charles L. Jr. (2007). In The Shadow of the Cross: The True Account Of My Childhood Sexual and Ritual Abuse At the Hands of A Roman Catholic Priest. books.google.com/books?=059584944X.
22. ^ Herman, Judith Lewis (1992). Trauma and Recovery. .
23. ^ Ross, Colin A. (2006). The CIA Doctors: Human Rights Violations by American Psychiatrists. .
24. ^ Carnes, Patrick J. (1997). Sexual Anorexia: Overcoming Sexual Self-Hatred Carnes. .