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For generations, our society has struggled with the best way to heal people who have experienced terrible things in childhood.
Should we exhume these memories to let their destructive power dissipate? Should they be gently molded into something less painful? Or should they be left untouched?
Researchers from King’s College London and the City University of New York have examined this conundrum by conducting an unusual experiment.
Researchers surveyed a group of 1,196 American adults repeatedly for 15 years about their levels of anxiety and depression. Unbeknownst to the subjects, 665 of them had been selected because court records showed they had suffered abuse such as physical abuse, sexual abuse or neglect before the age of 12.
However, not all of them told the researchers they had been abused – and that was linked to a big difference.
According to the study, the 492 adults who reported being abused and who had court records proving the abuse had significantly higher levels of depression and anxiety than a control group with no documented history of abuse. published last week in JAMA Psychiatry. The 252 subjects who said they had been abused without a criminal record to reflect it also had higher levels.
But the 173 subjects who did not report being abused, despite court records showing it happened, had no more distress than the general population.
The findings suggest how people frame and interpret events in their early childhood powerfully shape their mental health in adulthood, said Dr Andrea Danese, professor of child and adolescent psychiatry at King’s College London. and one of the study’s co-authors.
“It almost comes down to the stoic message, that this is what you experience,” he said. “If you can change the way you interpret experience, if you feel more in control right now, then that’s something that can improve longer-term mental health.”
In a meta-analysis Of 16 studies of child abuse published in 2019, Dr. Danese and colleagues found that 52% of people with a history of child abuse did not report it in interviews with researchers, and 56% of those who had reported had no documented history of abuse.
This discrepancy could be partly due to measurement issues – court records may not have all of the history of abuse – and may also reflect that self-reporting of abuse is influenced by levels of anxiety and a person’s depression, said Dr. Danese.
“There are many reasons why people may in some ways forget these experiences, and other reasons why others may misinterpret some of these experiences as neglect or abuse,” he said. he declared.
But even heeding those caveats, he said, it was notable that adults who had a documented history of abuse but hadn’t reported it — because they had no recollection events, interpreted them differently, or chose not to share those memories with investigators. – seemed in better health.
“If the meaning you give to those experiences is not central to how you remember your childhood and you don’t feel compelled to report it, then you are more likely to have better mental health. over time,” he said.
Traumatic childhood experiences have been the subject of some of the fiercest battles in psychiatry. Sigmund Freud posited early in his career that many of his patients’ behaviors indicated a history of childhood sexual abuse, but later backtracked, attributing them to unconscious 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 have receded under a deluge of criticism from mainstream psychiatry.
Recently, many Americans have embraced therapies designed to manage traumatic memories, which have been shown to be effective in treating post-traumatic stress disorder. Experts increasingly advocate screening patients for negative childhood experiences as an important step in providing physical and mental health treatment.
New findings from JAMA Psychiatry suggest therapy that seeks to relieve depression and anxiety by trying to unearth repressed memories is ineffective, said Dr Danese, who works at the Institute of Psychiatry, Psychology and Neuroscience. from King’s College London.
But he cautioned that the study results should not be interpreted as endorsing the avoidance of 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 erasing the memory, it’s about having the memory and being more in control so that the memory is less scary,” he said.
Memory has always posed a challenge in the field of child protection, as many abuse cases involve children under the age of 3, when lasting memories begin to form, said David Finkelhor, director of the University of New Hampshire Crimes Against Children Research Center. , who did not participate in the study.
In treating people with histories of abuse, he said, clinicians must rely on sketchy, incomplete and changing accounts. “All we have are their memories, so it’s not like we have a choice,” he said.
He cautioned against concluding that forgotten abuse has no lingering effect. Early abuse can show up through what he described as “residue” – difficulty modulating emotions, feelings of worthlessness or, in the case of victims of sexual abuse, the urge to provide sexual gratification. to others.
Elizabeth Loftus, a psychologist at the University of California at Irvine and a prominent skeptic the reliability of memories of abusenoted that the study stops short of another conclusion that might be supported by the data: forgetting the abuse might be a healthy response.
“They could have said, people who don’t remember a certain way are better off, and maybe you don’t want to alter them,” she said. “They don’t say that, and that, to me, is of great interest.”
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