Memory haunts victims of child abuse, says study – 07/14/2023 – Equilibrium

For generations, our society has hesitated about the best way to heal people who experienced terrible things in childhood.

Should these memories be unearthed, allowing their destructive power to dissipate? Should they be delicately molded into something less painful? Or should they be left untouched?

Researchers at King’s College London and the City University of New York examined this conundrum by conducting an unusual experiment.

Researchers interviewed a group of 1,196 American adults repeatedly over 15 years about their levels of anxiety and depression. Unbeknownst to the participants, 665 of them were selected because court records showed they had been abused or ill-treated before age 12.

But not all of them told the researchers they had been abused — and that was linked to a big difference.

The 492 adults who reported being mistreated and who had court records proving abuse had significantly higher levels of depression and anxiety than a control group with no documented history of abuse. The study was published last week in JAMA Psychiatry. The 252 individuals who reported being abused, with no court record about it, also had higher levels of psychological problems.

But the 173 subjects who did not report being abused, despite court records showing that they were, did not experience any more distress than the general population.

The findings suggest that how people view and interpret events in their early childhood powerfully shape their mental health as adults, says Andrea Danese, professor of child and adolescent psychiatry at King’s College London and one of the study’s authors.

“It almost goes back to the Stoic message, that it’s how you frame the experience,” he says. “If you can change the way you interpret the experience, if you feel more in control now, that can improve long-term mental health.”

In a meta-analysis of 16 studies on child maltreatment published in 2019, Danese and colleagues found that 52% of people with a record of child abuse did not report it in researcher interviews, and 56% of those who did did not have a history of child abuse. documented abuse.

This discrepancy could be due in part to measurement issues — court records may not have the entire history of abuse — and it could also reflect that a person’s account of abuse is influenced by a person’s levels of anxiety and depression, says Danese.

“There are many reasons why people might, to some extent, forget these experiences, and other reasons why other people might misinterpret some of the experiences as being neglect or abuse,” he points out.

Even considering these caveats, he says, it’s notable that adults who had a documented history of abuse but didn’t report it —because they had no memory of the events, interpreted them differently, or chose not to share those memories with interviewers—seemed more healthy.

“If the meaning you give to these experiences isn’t central to how you remember your childhood, so you don’t need to mention them, then you’re more likely to have better mental health over time,” he said. he.

Traumatic childhood experiences have been the subject of some of the fiercest battles in psychiatry. Sigmund Freud postulated early in his career that many of his patients’ behaviors indicated a history of childhood sexual abuse, but later backtracked, attributing them to subconscious desires.

In the 1980s and 1990s, therapists used techniques such as hypnosis and age regression to help clients uncover memories of childhood abuse. These methods retreated under a barrage of criticism from mainstream psychiatry.

Recently, many Americans have embraced therapies designed to manage traumatic memories that have been shown to be effective in treating post-traumatic stress disorder. Experts increasingly advocate screening patients for adverse childhood experiences as an important step in managing both physical and mental health.

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

But he cautions that the study results should not be interpreted as an endorsement of running away from distressing memories, which could make them “scarier” in the long run. Instead, they point to the promise of therapies that seek to “reorganize” and moderate memories.

“It’s not about deleting the memory, it’s about having the memory and having more control over it so it feels less scary,” says Danese.

Memory has always posed a challenge in the field of child protection, because many abuse cases involve children as young as 3, when lasting memories begin to form, says David Finkelhor, director of the Crimes Against Children Research Center at the University of New Hampshire, which was not part of the study.

When treating people with a history of abuse, he points out, doctors have to rely on vague, incomplete and changing reports. “All we have are their memories, so we don’t have a choice,” he says.

He cautions against concluding that forgotten maltreatment has no lasting effect. Early abuse can arise through what he described as “residuals” — difficulty modulating emotions, feelings of worthlessness or, in the case of victims of sexual abuse, the desire to provide sexual gratification to others.

Elizabeth Loftus, a psychologist at the University of California, Irvine, who doesn’t have much confidence in memories of abuse, notes that the study doesn’t reach another conclusion that could be supported by the data: forgetting abuse can be a healthy response.

“They could have said that people who don’t remember are somehow better off, and maybe you shouldn’t mess with them,” he says. “They don’t say that, and to me it’s of great interest.”

Translated by Luiz Roberto M. Gonçalves