Essay:Some thoughts on "The Trauma Myth" by Susan Clancy

This post and a response by another user are proposed to a reader for further reflection and developing MAP perspective on Susan Clancy's findings in her "The Trauma Myth" book.

Original post appeared on Boychat

Post by talix

Some thoughts on "The Trauma Myth" by Susan Clancy

The Methodology

Throughout the book she makes references to many studies. But the focus of the book is a study she conducted based on interviews with "more then two hundred" CSA victims over 10 years recruited via newspaper ads in the Boston area (p. 21).* She admits that much of the available research on CSA is based on clinical referrals, and she wanted to avoid this method because most CSA victims never seek therapy.

This is of course still a convenience sample. It's limited to people who responded to an ad recruiting CSA victims. Still, she seems to have found a group decidedly different then what a clinical referral methodology would find. Over half her victims had told nobody about the abuse, and most had never sought psychiatric help.

One notable detail I did notice is that compared to the (more representative) Rind studies, her subjects were fairly young at the time the abuse started. She claims the average age of abuse was 10, most happened before 12, and 1/3 happened before 9 (p. 50). In Felson (2019), a representative study, 88% of cases involved a minor over age 12. That is a pretty big difference.

* Annoyingly, unless I missed it she never did a formal academic paper based on this dataset. So there isn't much in the way of demographic information or rigorous quantifiable measures in the book. We kind of have to take her at her word on the interpretation of her data much of the time.

An note on pro-c vs Illegalism

She claims that "almost every" subject in her study reported negative effects from the abuse (p. 50). Now I would point out that most of her subjects where very young at the time of the abuse, so I don't think it's fair to extrapolate her results to the 13+ demographic. And I'll note the lack of quantifiable measures in her claim. Lastly, this is a convenience sample that may be primed towards this reaction. Still, I think this raises a point that warrants emphasizing: regardless of how much of the damage from child abuse is from the abuse vs. from societal reactions, right now the damage from societal reactions - at least for young children - is apparently very real. Some of the impacts she retells from seemingly willing children are pretty bad. So don't do it.

The Trauma Myth

The book's first thesis centers around the prevailing theory that child sexual abuse is "traumatic". Here by trauma she specifically means it's formal definition in psychology:

"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." (p. 7)

She asserts that only 5% of her subjects had an experience that could be described as traumatic. For most of them, at the time of abuse, the strongest emotion felt was just confusion or misunderstanding. A large proportion of her subjects were active participants in the abuse. Some claimed they even enjoyed it at the time. She claims that the conception of CSA as widely or inherently traumatic is deeply flawed and does not match the available data. She works through a variety of possible theories for why her methodology might have been flawed, and eventually dismisses all of them.

The theory of "reconceptualization"

For the subset of CSA victims who did not experience traumatic abuse, she builds a paradigm based on a concept of "reconceptualization". The theory is that at the time of the abuse, the child generally does not even understand what is happening. Sometimes they enjoy the physical pleasure, sometimes they are ambivalent about it, sometimes they don't like it. But rarely do they feel strongly. The leading emotion seems to be just confusion.

It's not until years later that they identify the activity as abuse. Clancy suggests that for many subjects this was almost a singular moment for them, typically centered around some point when they realize the sexual nature of the activities -- like during a sex ed class or when talking about sex with a friend. This moment she labels as the point of "reconceptualization". She claims it is typically met with two strong emotions:

First, betrayal. Upon realizing how the abuse was sexual in nature, the child feels that they were taken advantage of by the adult. They come to question all the ways the perpetrator might have been nice to them, and attribute it all to using the kid for sexual gratification. She suggests this often causes long term trust issues and troubles future relationships.

Second is guilt. The child feels guilt that they should have stopped the sexual relationship earlier. Somehow they feel responsible for allowing it to continue. They feel they are responsible for having done something wrong.

Some implications of this model

This concept of reconceptuatlization really only makes sense if the child does not know what is going on in the first place. If the child knows the sexual nature of the activity, then it's unclear to me how this model of harm could apply. So logically it seems that for a child to be vulnerable to this type of harm they would have to either have not had any sex education or be too young to have understood it.

For example, I had a decently comprehensive sex education at around age 10 which I was old enough to understand. So it would seem that from that age on I would no longer have been vulnerable to this type of harm from CSA. And certainly by age 14 (assuming the child is not seriously mentally disabled) they would probably know what sex is by gossip if nothing else. So this model of CSA harm would seem compatible with an age of consent of maybe 12 or so, provided it was coupled with good sex education.

In a way she even alludes to this herself. She defines informed consent (something that I will note few others in academia will bother to properly do) as:

"A child must know what he or she is consenting to and have the freedom to say yes or no." (p. 73)

It's totally plausible to me that a child of age 10 would be capable of this type of consent. And it seems unlikely to me that a child of 14 would be incapable of this type of consent (barring blatantly coercive circumstances). So again, this feels to me almost like a tacit endorsement of an age of consent set at early adolescence, maybe with some caveats to protect against highly coercive conditions.

Comparisons with the Rind data

First off, most of her subjects were way younger then the Rind datasets. As as mentioned before, the concept of "reconceptualization" does not make much sense for teenagers. So this is a bit of an apples to oranges comparison.

Still, Rind did have some data on interactions with a child under 12 and it was not as universally damming as Clancy's dataset was. 72% of girls and 34% of boys had a negative recall. Particularly for boys, that's a far cry from Clancy's "almost every". Frankly, I know people who had sexual interactions under 12 that don't fit this paradigm of reconceptualization. So I don't know where the break was between Rind and Clancy, but it would seem there is one.

One key figure that sticks out to me is that the reconceptuatlization theory suggests that perceptions of the encounter should get markedly worse with time. Yet the Rind studies suggest the opposite: perceptions of the abuse tend to mellow out and drift toward "neutral" over time. Another possible explanation is that the Clancy dataset is a convenience sample, so it's possible something about the sampling methodology selects for negative perceptions.

In one way though, Clancy's theory also does jive uncomfortably with the Rind data. She notes that over half her subjects were hesitant to describe the experience as "abuse" because they felt they where complicit in the encounter. Well, around half the subjects in Felson (2019) also described the interaction as "not abuse". Yet Clancy asserts that nearly all her subjects where negatively affected by the experience despite this. So that raises the possibility that the perception of the experience by the minor as "not abusive" in Felson (2019) does not necessarily indicate the interaction was not harmful.

Interestingly, Clancy her self does cite Bruce Rind several times in her footnotes. She also explicitly talks about Rind (1998) when talking about how any dissent in CSA academia is roundly shut down. She even defends Rind (1998)'s methodology and statistical validity. Most strikingly, she quietly admits in the end notes that Rind (1998) contradicts her claim that CSA is widely harmful to children (p. 208).

The still unexplained

While her paradigm of reconceptualization for the most part makes much more sense to me then the traumatic model, there is one piece of the puzzle she still does not explain. What the hell actually happens that triggers this reconceptualization? What is it that all of a sudden caused the abuse to go from being benign to awful? She sort of implies that the trigger is the process of realizing that the abuse was sexual in nature, and that sex is something special. But she never really delves into that process.

Take the feelings of betrayal: why is it that the child suddenly perceives that the abuser must have "used" them? Is it not possible that the abuser both cared about the victim, and enjoyed sexual activity with them? Perhaps the perpetrator assumed this was alright because the child appeared to be enjoying it too? This is how most adult relationships work after all. What causes the victim to all of a sudden assume the abuser must not have cared about them?

Or the feelings of guilt. Guilt for what? What changed about how they saw the interaction that makes them feel guilty about it all of a sudden? Why do they assume they did something wrong?

The unmentioned possible explanation

She doesn't say it, but I'm guessing given this forums demographic most readers have by now a possible answer. The victim reconceptualised the interaction as abuse because they were told it was abuse. I can't prove this answer, but I have to admit it does sort of fit the data. They assumed betrayal because abusers can't possibly care about their victims. It's abuse after all, by definition, and only a monster of an adult would do that. The victim assumed guilt because they knew what they were complicit in was "wrong". Clancy even uses the phrase "violated social norms" when describing the abuse at one point (p. 123).

She insists that the proper treatment for these victims is to explain to them they are victims, and that their willful participation does not disprove that. They were too young to stop this abuse, and thus are not responsible for it. What was done to them was wrong, and the fact that they enjoyed it does not change that.

I can't help but wonder if - particularly for those who were active participants in and at the time enjoyed the "abuse" - there is another treatment route: tell the "victim" that it's okay if they enjoyed it. That it's alright that they did something sexual at a young age and liked it. That they don't need to feel guilty about that. That it's possible the perpetrator really did both care about them and derive sexual gratification from doing things with them. That they don't have to be a "victim" if they don't feel they were.

I'll be honest: sexual activity with pre-pubescent children scares me. I'm putting a lot of faith in the older partner to be careful and well intentioned with a vulnerable younger partner. Based on some of the case studies Clancy mentions, to me it very much seemed like this did not happen a lot of the time. Still though, I can't help but ask: perhaps part of the hang up isn't that the victim didn't understand that the interaction was sexual and thus "special" (by which I mostly mean sordid), but rather that we as a society insist sex must be something "special".

Response from another user

Good point on her using a “convenience sample” that focused mainly on young (prepubescent) children. To me, there’s a real reason why minor attractions are segregated into nepiophilia, pedophilia, hebephilia or ephebophilia. There are marked differences in the minor understanding (ability to consent) between these classifications that certainly have a major bearing on how the minor is affected by relationships. As you noted, using open ads to find participants was better than focusing on clinical cases only since it opened a door to those who didn’t find it “traumatic” enough to seek help. By doing so, she in affect opened another door into the complex world of minor-adult relationships (a different angle on the issue). As a result, she was able to conclude that most young children were not “traumatized” based on not having experience life-threatening situations resulting in immediate negative psychological reactions. Rind in turn was able to open even more doors (new angles) leading him to find that many (if not most) pubescent minors (mainly males) had positive experiences.

It's amazing how often people debate a topic based on their definition of the terms and end up talking (yelling) past one another. In addition to the industry definition for trauma noted in your report, Dr Clancy also noted “Assumption is that the sexual abuse, when it happened, was a horrific experience – it was frightening, shocking, and overwhelming (p. 9).” This then begs the question of what about CSA is harmful to minors. The simple word “harm” seems to be open to interpretation, with many researchers struggling to find a common definition so they can compare their results with others. So, what is the harm? There’s no doubt that many are harmed and deserve our respect and empathy. But what about the rest?

After proposing the concept of “reconceptuatlization,” Dr Clancy notes “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 (p.120)” This seems to fit the mold of what many PTSD therapists have come to know as “moral injury.” As this can affect soldiers in later years after they process what they have done / seen on the battlefield, it too can affect adults later on years after their sexual encounter with an adult as a child.

Some say that minors can’t consent because their minds have not developed, nor do they have the experience base necessary, so they can determine what is right or wrong, and in turn what to do about it. Dr Clancy notes “We live in the real world, and in the real world, from the perspective of child victims, they do consent. (p. 72)” Kids are probably a lot more world savvy than we give them credit, which is why we let them ride their bicycles on city streets with so many distracted drivers all around. The key, in so many ways, is to relate to the kids as they perceive the world, and above all, to seek what is best for them versus ourselves.

So, what are “social norms” and why do they mean so much to us? Dr Clancy notes how many feel guilty for whatever they did to cause the “abuse” to happen. To feel guilty, they must perceive that whatever happened was “bad,” and therefore there must be something “wrong” with them to cause the “bad” to happen. Then they are told that they aren’t to blame, but instead they were victims of some sinister plot on the part of others. Granted, there are many cases where kids are raped or coerced into having sexual relationships with adults. But as we have seen from research, this is not always the case. Society, it seems, determines what is “bad” in our minds, as well as giving us a path out of self-hatred by shifting our emotions from sadness to hatred. This of course, it a gross generalizations, since the world is never really that simplistic. It’s not completely off the mark, though, so a questioning attitude across the board is certainly in order. A little more focus on emotional intelligence is important to achieve a safe world where that can happen (i.e., stop the hysteria pandemic in its tracks).

Dr Clancy notes that it takes a “social constructionist” approach to crack this nut. She then hit the nail on the head of why we seem to be stuck in narrow band of universal understanding (a prisoner) when she noted “(we) 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. Insta, (we) would have to accept that scientific theories often emerge through a complex and interactive process, on negotiated by the professionals whose discovery and interpretation of the data are inevitable influenced by the social, cultural, and political frameworks in which they are embedded.” Unfortunately, Dr Clancy met with great resentment (attacks) by her peers and academia superiors for daring to challenge the sacred trauma myth, and in turn further victimize many in our society (i.e., those who make a living or achieve recognition for championing such theories). So where is Dr Clancy today? Turns out, like many who dare to challenge “social norms” like Allyn Walker, she had to find a new academic home where she could dare say what some called “heresy.” She now lives and works in Nicaragua (Susan A. Clancy | INCAE).