Child Abuse: Memory is What Haunts Victims

A recent study has found that the memory of childhood abuse is what haunts victims. People who did not remember the event or interpret it differently had better mental health.

Highlights:

Child abuse is any form of maltreatment by an adult, which is violent or threatening to the child and ranges from physical, sexual, emotional, and medical abuse to neglect
A review explored how people who have forgotten about the event or interpreted the event differently have better mental health
The solution is not to avoid the memory, it is to ‘re-organize’ the events with the help of therapy to make the event less scary

Child abuse is a sensitive topic and for years, our society has tried to understand what might be the best way to heal people who have endured horrific events as children.

Should these memories be awakened, releasing their devastating power? Should they be shaped gently into something less painful? Or should they be left alone?

An interesting experiment was carried out by researchers from King's College London and the City University of New York to explore this problem.

Over 15 years, researchers interviewed 1,196 American adults about their degrees of anxiety and despair. Unknown to the subjects, 665 of them were chosen because court records revealed they had been subjected to mistreatment such as physical abuse, sexual abuse, or neglect before the age of 12.

However, not all of them told researchers that they had been mistreated – and this was associated with a significant difference.

According to the study, 492 adults who reported having been mistreated and had court records proving the abuse had considerably greater levels of despair and anxiety than a control group with no documented history of abuse (). Higher levels were also found in the 252 participants who reported being abused but did not have any court records to back it up.

However, the 173 participants who did not disclose being abused despite court records proving it occurred experienced no greater distress than the general population.

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‘A new study explores how the memory of childhood abuse can impact the mental health of survivors as adults. #abuse’

The Interpretation of Childhood Abuse Shapes Mental Health as Adults

“The findings suggest how people frame and interpret events in their early childhood powerfully shapes their mental health as adults”, said Dr. Andrea Danese, a professor of child and adolescent psychiatry at King’s College London and one of the study’s joint authors.
“It goes back to almost the stoic message, that it’s what you make of the experience,” he said. “If you can change how you interpret the experience if you feel more in control at present, then that is something that can improve mental health in the longer term.”

Dr. Danese and colleagues discovered that 52% of those with records of childhood abuse did not disclose it in interviews with researchers, while 56% of those who claimed it had no documented history of abuse in a meta-analysis of 16 studies of childhood maltreatment published in 2019 ().

“This discrepancy could be partly because of problems in measurement — court records may not have all abuse history — and may also reflect that self-reporting of abuse is influenced by a person’s levels of anxiety and depression”, Dr. Danese said.

“There are many reasons why people may, in some ways, forget those experiences, and other reasons why others might misinterpret some of the experiences as being neglect or abuse,” he said.

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People Who Had No Memory of the Abuse Seem to be Mentally Healthier

Even with these caveats, he noted that those who had a documented history of abuse but did not report it — either because they had no memory of the incidents, interpreted them differently, or decided not to share those memories with interviewers – appeared to be healthier.

“If the meaning you give to these experiences is not central to how you remember your childhood so you don’t feel like you need to report it, then you are more likely to have better mental health over time,” he said.

Some of psychiatry's most heated debates have centered on traumatic childhood experiences. Sigmund Freud hypothesized early in his career that many of his patients' behaviors showed a history of childhood sexual abuse, but eventually reversed his position and attributed them to hidden impulses.

Therapists employed treatments like hypnosis and age regression to assist clients uncover memories of childhood abuse in the 1980s and 1990s. Those practices faded in the face of widespread criticism from conventional psychiatry.

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Encouraging Therapy of Child Abuse Survivors for Their Physical and Mental Health

Many Americans have recently adopted therapies aimed to handle traumatic memories, which are useful in the treatment of post-traumatic stress disorder. Experts are increasingly advocating screening patients for traumatic childhood experiences as a key step in providing physical and mental health care.

“The new findings suggest therapy that seeks to alleviate depression and anxiety by trying to unearth repressed memories is ineffective”, said Dr. Danese, who works at the Institute of Psychiatry, Psychology & Neuroscience at King’s College London.

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The Aim is not to Delete the Memory, But Make it Less Scary

But he cautioned that the results of the study should not be interpreted as endorsing the avoidance of distressing memories, which could make them “scarier” in the long term. Instead, they point to the promise of therapies that seek to “reorganize” and moderate memories.

“It’s not about deleting the memory, but having the memory and being more in control of that so that the memory feels less scary,” he said.

“Memory has always posed a challenge in the field of child protection because many abuse cases involve children below the age of 3 when lasting memories begin to form”, said David Finkelhor, the director of the Crimes Against Children Research Center at the University of New Hampshire.

In treating people with histories of having been abused, he said, clinicians must rely on sketchy, incomplete, and changing accounts. “All we have is their memories, so it’s not like we have a choice,” he said.

He cautioned against assuming that forgotten mistreatment has no lasting impact. Early abuse may manifest as "residues" – trouble modulating emotions, feelings of worthlessness, or, in the case of sexual abuse victims, the need to bring sexual enjoyment to others.

According to Elizabeth Loftus, a psychologist at the University of California, Irvine, and a vocal skeptic of the reliability of abuse memories, the study falls short of another conclusion that could be supported by the data: forgetting about abuse may be a healthy response.

“They could have said, people who don’t remember in some ways are better off, and maybe you don’t want to tamper with them,” she said. “They don’t say that, and that, to me, is of great interest.”

References:

Associations Between Objective and Subjective Experiences of Childhood Maltreatment and the Course of Emotional Disorders in Adulthood - (https://pubmed.ncbi.nlm.nih.gov/37405795/)
Agreement Between Prospective and Retrospective Measures of Childhood Maltreatment - (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6551848/)

Source-Medindia