Welcome to the doll house

There have always been scapegoats - the Christians, the Jews and the Catholics. In our own agnostic age, we have fixed on child sexual abusers, who are mercilessly pursued, whether guilty or - as so often transpires - innocent. Imagine you are a five-year-old child whose father is suspected of child abuse. You might well find yourself having the following conversation.

Therapist: Would you tell Ernie?

Child: No.

Therapist: Ah, come on Please tell Ernie. Please tell meI You whisper it to ErnieI Did anybody ever touch you right there? (pointing to the vagina of a girl doll).

Child: No.

Therapist: Did anybody touch your bum?

Child: No...

Therapist: Would you tell Bert?

Child: They didn't touch me.

Therapist: Who didn't touch you?

Child: Not my teacher. Nobody.

Therapist: Did any big people, any adult, touch your bum there?

Child: No.

This is an extract from a tape-recorded session. The dolls used have grossly enlarged sexual organs, both primary and secondary: the child is encouraged to play with them and any touching of these parts is thought to reveal that she has been sexually abused. The constant questioning, in which "`No'' is never taken for an answer, breaks the child down, inducing her finally to give a false reply, particularly as sessions can last as long as six hours. In one of the first British cases (in the Orkneys) the children were detained for weeks with no access to their parents and were offered bribes to lie. To extract "the truth'', hypnosis or sedative drugs may be given: it is known that neither technique helps people to recover real memories, but it does make them extremely suggestible. All these methods (except the dolls) are also practised on adolescents and adults who have sought therapy for psychiatric problems.

The current dogma is as follows. People who have suffered sexual abuse as children develop psychiatric symptoms as adults, as well as many minor defects. Indeed a list of the latter is used as a test for whether someone has been sexually abused: it includes such items as taking an excessive number of baths, difficulty with eye contact, and excessive day dreaming. It seems doubtful whether anyone, however sane, could take this test without being declared sexually abused. Like the doll test, the questionnaire has never been validated and is therefore useless.

It seems unlikely that those who deny having been sexually abused are lying. Taking their cue from that disgraceful old rogue, Sigmund Freud, the abuser hunters have cunningly declared that in their case the memory has been repressed. They therefore feel justified in hammering away at these recalcitrant people, telling them they have repressed their memory, and making constant suggestions, until the patient's imagination is triggered and a false memory is produced. The therapists believe their patients will never recover until they remember and abreact to incidents of abuse. Only a very strong patient could resist the pressure: many confabulate such incidents and come to believe they actually happened.

This whole approach defies everything that is known about memory and trauma, as Mark Pendergrast notes in Victims of Memory, his cogently argued book. First, there is no evidence for repression, despite many attempts to discover it. Moreover, unless there is concussion, a severe trauma, like recovering the bodies after the Lockerbie disaster, tends to prey upon the mind and is difficult to forget or to ignore. Second, it has repeatedly been shown that people are highly suggestible and confuse memory with what they are told later. Third, recent evidence suggests that the best way to deal with trauma - even the loss of a spouse - is not to abreact, but to distract oneself and to try not to dwell upon it. Indeed, the methods used by the therapists seem carefully calculated to make their patients worse. Lengthy cross-examinations about sex are likely to disturb young children and even adults, while encouraging abreaction is probably the surest way to damage those who have been abused - and indeed those who have not.

Discovering false memories of abuse can damage the innocent. It breaks up families and in the United States there are 57 known cases of innocent victims who have been sent to jail.

There is evidence that neither sexual abuse nor other forms of childhood trauma damage the adult personality. A Howard League working party concluded that serious long-term emotional problems were uncommon and one of the most eminent workers in the field of clinical psychology, wrote: "The major traumas of childhood may have some influence on adult personality, but the influence is barely detectable.'' None of this implies that real sexual abuse is to be condoned, even if it is difficult to draw a line. Perhaps the guiding rule should be to limit physical interchanges to those that please the child.

When people hear the words "child sexual abuse'', they probably visualise intercourse with a child. But most cases do not involve that. Indeed one therapist includes in her list of abusive parental activities letting the child sleep in the same bed, being seen in the nude, hugging a child too long and so on: in America you kiss your child in the supermarket at your peril.

Apart from increasing the apparent frequency of child abuse by widening its definition, the therapists have thought up another wheeze. They have declared that the only cause of multiple personality disorder (MPD) is having been abused as a child. Until about 1970 there had been only about 100 diagnosed cases of MPD worldwide, now there are at least tens of thousands, mainly in America. The increase was produced by sensational books and films, abetted by the American Psychiatric Association which added this disorder to its list of recognised mental illnesses in 1980. Because health insurance companies pay only for recognised illnesses, it enabled anybody who could pass as a "multiple" to have therapy: the new illness was of course extremely lucrative for therapists specialising in it.

As a matter of fact, psychotherapists are having a hard time at present, though perhaps not as hard as that of their patients. The American Department of Health is considering reducing their federal funding on the grounds that they do no good. The president of the American Psychology Association has requested them not to criticise one another, as it gives psychology a bad name. Victims of Memory is one of the best of a series of recent books taking psychotherapy apart. It is thorough, well written and highly readable. It will appeal to the general public and, although it will undoubtedly infuriate them, it should be compulsory reading for all psychotherapists.

Stuart Sutherland is emeritus professor of experimental psychology, University of Sussex.