Mental health articles

THE PERIOD PRIOR TO FREUD
During the last 100 years, Freud has probably had a greater impact than any other
person upon the professional knowledge base of child sexual abuse. While his
influence fundamentally framed the profession’s conceptualization of child sexual
abuse prior to the 1960s, it continues to be felt even today. For this reason, the social
context of the environment to which Freud was exposed is important to explore.
Child sexual abuse simply was not acknowledged prior to the late 1800s. While it
would be reassuring to believe that child sexual abuse did not exist, it of course did. It
simply was not labeled as such. Indeed, child sexual abuse has been documented
throughout history, with Biblical references to child sexual abuse (Rush, 1980), and
more extensive records of abuse in the Roman and Greek civilizations (Gray-Fow,
1987). Even in colonial America, records suggest that child abuse, including child
sexual abuse, was widespread (deMause, 1988). DeMause, in The History of
Childhood (1974), a classic analysis ofchildhoods in previous historical eras, states:
The history of childhood is a nightmare from which we have only begun to awaken. The
further back in history one goes, the lower the level of child care, and the more likely
children are to be killed, abandoned, beaten, terrorized, and sexually abused. (p. 1)
This statement suggests that sexual abuse is certainly not a recent phenomenon-only
its recognition.
Until the mid-1800s, then, sexual abuse was generally recognized only by its
victims (Summit, 1989). Even then, the extreme belief in the ownership of children
quite possibly influenced the victim’s perception of whether abuse had occurred.
Professionals also largely ignored the possibility that abuse had occurred. When
faced with psychological trauma in victims of sexual abuse, professionals were
likely to treat the victims pejoratively and to label them hysterical.
At the time, hysterical women were the target of contempt and indignation on the part of
the physicians, the best of whom regarded the illness as a matter of simulation (manipulation)
or “imagination.” In the past, thinking it a particular disorder of the womb, they
had treated it by extirpation of the clitoris …fo r some believed [it] would cure the
wandering womb by “putting it in its place.” (Brandcraft & Stolorow, 1984, p. 94)
The first important work on child sexual abuse may be that of the Frenchman,
Ampoise Tardieu (Cunningham, 1988). In 1862, as a forensic-medical expert, he
documented 515 cases of sexual offenses, 420 of which were committed on children
under the age of 15. During an 11-year period, he cited more than 11,000 cases of
completed or attempted rape, 80% of which involved child victims (Masson, 1984).
These cases, to be defined as assault, had to present with legal evidence of rape,
including tearing of the hymen (Cunningham, 1988). Much of his work focused on
how child sexual assault victims may not present with the requisite physical
evidence. To a lesser extent, he acknowledged and wrote of the possible psychological effects of such sexual assaults and was the first professional to write
of sexual abuse as a social problem.
Jean Martin Charcot, described by Masson (1984) as “France’s most illustrious
neurologist, defender of hypnosis, and physician of hysteria” (p. 14), was also
influential in the views of child sexual abuse during this era. While Charcot did
recognize that the sexual offenses occurred, he did not share the same compassionate
view of the victims as Tardieu. Charcot’s principal emphasis appeared to be on
influencing officials to view offenders as mentally ill instead of “vicious” (Cunningham,
1988, p. 347), and he not only suggested that offenders were often “honest family” men
(p. 347), but that up to 80% of accusations against them were false.
Another writer on child sexual abuse, Alfred Binet, suggested that all offenders
had experienced a critical incident in childhood (Cunningham, 1988). Although he
did not state that this critical incident was a history of child sexual abuse, he did
make this connection in case studies. Binet also forwarded the idea that children
were suggestible and that this suggestibility was related to situational and individual
characteristics. His influence was especially felt in the courts, in which suggestibility
came to be associated with pathology, thus offering a “rationale for disbelieving the
testimony of children, especially those involved in sex crimes” (p. 349).
Other French authors, including Fournier, Bourdin, and Brouardel, also
documented cases of rape. Regrettably, the works of these authors were fraught with
misconceptions (Masson, 1984). Fournier was a proponent of the offender, whom he
often considered “an excellent and perfectly honorable man” (Fournier, as cited by
Masson, 1984, p. 43), and believed that children’s assaults were “imaginary” (p, 44).
Brouardel also believed that children lied about the sexual assault and that the
genesis of these false accusations was hysteria. Bourdin reinforced the view that not
only were victims lying, but that they also took pleasure in their lies because of “evil
instincts” and “evil passions” (p. 48).