Mistakes Were Made - Carol Tavris [55]
Clinicians who believe in repression, therefore, see it everywhere, even where no one else does. But if everything you observe in your clinical experience is evidence to support your beliefs, what would you consider counterevidence? What if your client has no memory of abuse not because she is repressing, but because it never happened? What could ever break you out of the closed loop? To guard against the bias of our own direct observations, scientists invented the control group: the group that isn’t getting the new therapeutic method, the people who aren’t getting the new drug. Most people understand the importance of control groups in the study of a new drug’s effectiveness, because without a control group, you can’t say if people’s positive response is due to the drug or to a placebo effect, the general expectation that the drug will help them. For instance, one study of women who had complained of sexual problems found that 41 percent said that their libido returned when they took Viagra. So, however, did 43 percent of the control group who took a sugar pill.18 (This study showed conclusively that the organ most involved in sexual excitement is the brain.)
Obviously, if you are a psychotherapist, you can’t randomly put some of your clients on a waiting list and give others your serious attention; the former will find another therapist pronto. But if you are not trained to be aware of the benevolent-dolphin problem, and if you are absolutely, positively convinced that your views are right and your clinical skills unassailable, you can make serious errors. A clinical social worker explained why she had decided to remove a child from her mother’s custody: The mother had been physically abused as a child, and “we all know,” the social worker said to the judge, that that is a major risk factor for the mother’s abuse of her own child one day. This assumption of the cycle of abuse came from observations of confirming cases: abusive parents, in jail or in therapy, reporting that they were severely beaten or sexually abused by their own parents. What is missing are the disconfirming cases: the abused children who do not grow up to become abusive parents. They are invisible to social workers and other mental-health professionals because, by definition, they don’t end up in prison or treatment. Research psychologists who have done longitudinal studies, following children over time, have found that while being physically abused as a child is associated with an increased chance of becoming an abusive parent, the great majority of abused children—nearly 70 percent—do not repeat their parents’ cruelties. 19 If you are doing therapy with a victim of parental abuse or with an abusive parent, this information may not be relevant to you. But if you are in a position to make predictions that will affect whether, say, a parent should lose custody, it most surely is.
Similarly, suppose you are doing therapy with children who have been sexually molested. They touch your heart, and you take careful note of their symptoms: They are fearful, wet the bed, want to sleep with a night-light, have nightmares, masturbate, or expose their genitals to other children. After a while, you will probably become pretty confident of your ability to determine whether a child has been abused, using those symptoms as a checklist to guide you. You may give a very young child anatomically correct