Uncovering the epidemic of child sexual abuse
Discovering that all types of trauma–from war and political terror to domestic violence and rape–lead to similar psychological symptoms
Helping establish the diagnosis of Post-Traumatic Stress Disorder
Introducing the concept of Complex PTSD
Psychiatrist Judith Herman noticed something strange. Back in the 1970s, at a time when the incidence of child sexual abuse was purported to be one in a million, Dr. Herman’s female patients kept claiming they were victims of incest. After consulting with a colleague, Lisa Hirschman, who noticed the same thing, the two women wondered, “What’s going on here? Is this an epidemic? If so, why isn’t anyone saying anything about it?” This prompted Herman and Hirschman to publish a paper about incest in a women’s studies journal. After that, women all over to the country contacted the authors to share their own experiences of incest. Wanting to alert the world to a silent epidemic, Herman eventually felt compelled to publish Father-Daughter Incest, a seminal book in the recognition of widespread child sexual abuse.
After Father-Daughter Incest was published in 1981, Herman began work at Harvard Medical School’s Cambridge Hospital. There, she met Mary Harvey, a colleague who had just finished a study of the nation’s rape crisis centers. Together, the women established the hospital’s Victims of Violence program, which serves the needs of rape victims, as well as victims of other types of violence.
Around the same time that Herman was working with incest and rape victims, she met Bessel van der Kolk, who worked with combat veterans. The two soon realized that the psychological effects of war were like those of rape. Intrigued, Herman and van der Kolk formed a study group with survivors of many different types of trauma, including veterans, prisoners of war, battered wives, and abused children. Through this group, the two began to see that the psychological effects of all types of trauma are predictably similar, leading to the diagnosis of Post-Traumatic Stress Disorder. They also noticed a link between child abuse and the development of Borderline Personality Disorder.
Armed with new information, Herman decided to write a book that would “unify a diverse body of knowledge and develop concepts that would apply equally to the experiences of war and political violence, the traditional sphere of men, and to the experiences of domestic and sexual life, the traditional sphere of women.” The result of this effort was the seminal Trauma and Recovery: The Aftermath of Violence—From Domestic Abuse to Political Terror.
Since its publication in 1992, Trauma and Recovery has changed the way people think about psychological trauma. In addition to introducing the concept of Complex PTSD, Herman’s book explores “the ways in which people are formed and deformed by relationships of dominance and subordination” and shows how such relationships are always maintained through violence and terror.
According to Herman, because traumatic disorders are “afflictions of the powerless,” survivors must be empowered again in order to heal. This means that, in a therapeutic relationship, the survivor is in charge of his or her own recovery, while the therapist acts as “an ally, a witness, and a consultant.”
Quotes gathered from Mapping Trauma and Its Wake (ed. Charles Figley)