From the Introduction to Betrayed As Boys (1999),
Richard Gartner, Ph.D.
In 1988, I started treating the first man I specifically conceptualized as having been sexually abused in boyhood. I had been in practice for more than fifteen years, as a dynamically oriented psychotherapist, as a systems-oriented family therapist, and finally as an interpersonal psychoanalyst. In retrospect, I realize that patient, whom I call Patrick in my clinical descriptions later in this book, was certainly not the first man I treated who had a history of childhood sexual betrayal. He was not even the first to tell me about inappropriate or unwanted premature sexual experiences with older friends, relatives, or caretakers. I was, however, a product of my own training and a prevailing conventional wisdom among clinicians that such stories should be treated cautiously because of the likelihood that they emerged from patients’ fantasy lives and wish fulfillments. So, while I had not doubted my patients’ stories, I also had not encoded them as descriptions of sexual abuse. Nor had I thought about patterns of behavior common in men with histories of childhood sexual betrayal.
My work with Patrick proved to be a watershed for me. As he slowly began to recall horrifying stories of sexual abuse in early childhood, I was forced to rethink how to understand them. If they were entirely fantasies, then Patrick was floridly psychotic, which I did not believe. But if his stories were even partly true, then he had been the victim of grievous crimes perpetrated by his father and brother. As time went on, the picture became fuller as his sister confirmed that she too had been sexually abused by their father. My doubts about Patrick’s stories dissipated. Instead, I began to think about how his adult symptoms of recurrent depression, night terrors about a stranger breaking into his room, obsessive but impersonal sexual fantasies, long-term isolation, and difficulties in interpersonal relationships all made sense in the context of chronic sexual abuse in early childhood.
In time, I educated myself about the literature on childhood sexual abuse, which focuses mainly on women. As I sought help from colleagues, my interest in sexually abused men grew, and I began to get referrals of other men (and women) with similar histories. More referrals came when I started a group for these men after I could not find one in New York City for Patrick.
Once I began to work with men who defined themselves as having been sexually abused, I started to think about other patients differently. I was more likely to inquire into their early sexual histories. Interestingly, more patients told me about inappropriately sexual childhood histories without my ever asking. My receptivity about the subject had in some way been communicated to them.
When a patient I had treated for several years during and after my psychoanalytic training returned to see me after an absence of some five years, I was especially struck by how much my thinking had been transformed. He reminded me that just before he stopped treatment he had asked whether I thought he might have had a history of boyhood sexual abuse, even though he had no actual memories of it. Confused about how to explore this possibility in the absence of memories, I had given an equivocal response. He now told me that shortly thereafter he stopped the treatment “in despair.”
Yet I now realized how limited my thinking had been. This man’s symptom picture, which included obsessive and compulsive sexuality, masochism, cross-dressing, and severe interpersonal isolation and distrust, was certainly consonant with a history of childhood sexual abuse. Nevertheless, I had never thought in such terms during his earlier treatment. Nor had it ever been brought up by any of the four excellent teachers and supervisors to whom I had presented my work with him while in training.
My work with this man in his second treatment sequence did not reveal overt childhood sexual abuse. Nevertheless, the incestuous sexuality and abusiveness he witnessed in his extended family came to the forefront as inappropriately stimulating. From this, I came to see him as having suffered a covert sexual betrayal as a boy.
This is the kind of pattern I was now able to recognize and work with in my male patients. Sexual abuse is certainly not a universal experience for boys, nor is it the explanation in every case for complex symptomatic pictures like those I describe in this book. It is, however, far more often present in boys’ histories than any of us would like to believe.
Incest and the sexual abuse of children have long been taboo and misunderstood subjects in the popular culture and in the clinical literature. Sexual victimization of all children has chronically been denied in our society. The sexual victimization of boys, however, is even more universally minimized, underestimated, and ridiculed than the abuse of girls, for reasons I will discuss throughout this book, but especially in Chapters 2 and 3.
Perhaps these social views of male sexual victimization have started to change as stories about boys’ sexual victimization gain greater currency in the popular press. I will discuss in Chapter 2 the well-publicized cases of two women brought up on child rape charges for their sexual involvement with boys. Scandals have also been widely reported about extrafamilial victimization of boys by men in church, scouting, Internet, child care, and sports venues. I refer here to such stories as:
the sexual abuse of young boys by Catholic priests and seminarians in such diverse locations as Maryland, California, and Texas, leading to numerous guilty pleas and successful civil suits (New York Times, December 2, 1993, p. A18; New York Times, October 21, 1995, section I, p. 10; New York Times, July 25, 1997, pp. A1, A10)
the multiple successful suits against the Boy Scouts of America brought by former scouts and their families because of sexual abuse by scoutmasters (Boyle, 1994);
∑the criminal convictions and financial settlements in Newfoundland and Ontario during the 1980s and early 1990s following the revelation of sexual, emotional, and physical abuse by Christian Brothers of hundreds of boys confined to training schools (Henton and McCann, 1995);
the male nanny who pled guilty to abusing a twelve-year-old boy in Armonk, New York, while already on probation for abusing a nine-year-old boy in Greenwich, Connecticut (New York Times, September 26, 1996, p. B6);
the guilty plea of a Canadian hockey coach accused of molesting several young hockey players, followed by the further accusation by National Hockey League player Sheldon Kennedy that he too had been abused by this coach as a teenager (New York Times, January 4, 1997, p. I34, and January 16, 1997, p. A10), in turn followed by the arrest and subsequent conviction of Toronto Maple Leaf Garden employees who lured at least twenty-four boys into exchanging sex for hockey tickets, hockey sticks, and player autographs (New York Times, February 20, 1997, p. B19); and
the controversy when a teenage boy accused of sexually assaulting and murdering an eleven-year-old boy was revealed to have been himself abused by an adult man he met in an America On-Line chat room (New York Times, October 3, 1997, p. B6).
Interestingly, in each of these stories the victimizer came from outside the family. This does reflect some research findings that most abused boys suffer from extrafamilial victimization. Incestuous abuse of boys is virtually never reported in the press, however, even though its prevalence is also well-documented, as we will see in Chapter 1. Indeed, denial of the extent of childhood incest has been almost universal in our society. There is a deep cultural taboo against accepting how common it is. To believe in the widespread incidence of incest is to question the sanctity of the family, where children are thought to be protected from harm.
The pervasiveness of the denial of childhood sexual betrayal, especially the sexual abuse of boys, was illuminated for me several years ago. I was invited to an international conference to give a paper about the treatment of sexually abused men. Just as I was leaving for the foreign city that was hosting the meeting, the conference program arrived. My paper was not listed in it. Surprised, I called the program chair when I arrived. He did not remember me or my paper. At that moment, I felt the sense of unreality that patients have told me they experience in the face of their family’s denial of ongoing sexual abuse. Flustered and confused after a day-long flight, I momentarily wondered if I was mistaken about the initial request to read my paper. I grounded myself when I realized that the conference chair’s letter of invitation was in my hand as I spoke to him. He apologized and found a place for me on a panel at the meeting, albeit one on which none of the other papers related to mine. The addition of my paper to the program was announced once at the conference opening, but was not listed on any of the notices posted around the meeting rooms until I insisted. At the panel itself, the moderator, an American scholar and psychoanalyst, permitted the speaker before me to go on for fifteen minutes beyond his allotted twenty-five. Seven minutes after I began to talk about the experiences of sexually abused men, however, this moderator handed me a note that read “Can you wrap this up? We’re supposed to be having a coffee break now.” Luckily, several colleagues in the audience protested that they wanted to hear my paper.
These events were not directed at me personally. At first, I thought my experience arose from the overall disorganization of the conference itself. Now, however, I realize that hearing about boyhood sexual abuse is intolerable to many of us. Our unconscious reactions affect how we feel, how we act, and how we enact.
Stories of childhood sexual abuse have been central to acrimonious debates as long as psychological treatment itself has existed. This started when Freud’s early work on hysteria (Breuer and Freud, 1893-1895; Freud, 1896) was followed by his retreat from the so-called seduction theory. Later, there was a notorious dispute between him and his closest and most gifted student, Sandor Ferenczi, after Ferenczi (1933) wrote a paper, “Confusion of Tongues between Adults and the Child,” that cogently described how sexual trauma affects a child in later life. In the decades that followed, childhood incest and other childhood sexual betrayals were relegated to the realm of fantasy throughout the psychoanalytic, psychiatric, and psychological literatures. As recently as 1976, a leading psychiatric textbook claimed that actual incest between father and daughter occurred only once in a million cases (Freedman, Kaplan, and Sadock, 1976).
Since 1980, however, the pendulum has been swinging away from the fantasy theory about sexual betrayal, and a rich literature has emerged in both the psychoanalytic and trauma-based arenas of sexual abuse work. This literature, in turn, has stimulated new controversy. In particular, criticism has been made by those who felt too easy credence was given to patients’ vague memories or to therapists’ feelings that abuse took place.
It is indeed possible both for memories of abuse that have been long forgotten to be remembered and for adults to construct pseudomemories for events that never occurred (Alpert et al., 1994; see also Lindsay and Read, 1994). I have elsewhere edited a book that considers this complex controversy about memories of sexual betrayal (Gartner, 1997c). In this book, unless otherwise noted, I accept the patient’s memory as basically true, though not necessarily representing a point-to-point, literal, videotape-like recollection. Such recall is rare when any adult remembers what happened at a developmentally early stage of life. Instead, I believe the essence of my patients’ stories, which usually means that severe boundary violations took place, some of a specifically and explicitly sexual nature, and that frequently the abusers were trusted parents and caretakers (see Hedges, 1994).
This is a book about what happens to boys who grow up in pernicious circumstances, often in a family where incestuous boundary violations repeatedly recur. It is also about the psychotherapeutic treatment of these boys when they become men who at last must face their abusive histories. Finally, it is about the inner experience of therapists who try to draw on their skill and inner resources as they evolve in very complex treatment situations.