Latest / System Speak: Complex Trauma and Dissociation / Guest: Warwick Middleton

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Guest: Warwick Middleton · System Speak: Complex Trauma and Dissociation

• 0:08
  Speaker 1: Over:
• 0:11
  Speaker 2: Welcome to the System Speak Podcast, a podcast about Dissociative Identity Disorder. If you are new to the podcast, we recommend starting at the beginning episodes and listen in order to hear our story and what we have learned through this endeavor. Current episodes may be more applicable to long time listeners and are likely to contain more advanced topics, emotional or other triggering content, and or reference earlier episodes that provide more context to what we are currently learning and experiencing. As always, please care for yourself during and after listening to the podcast. Thank you.
• 1:02
  Hello. This is doctor E. And today, I'm interviewing professor Warwick Middleton. Professor Middleton has had substantive ongoing involvement with research, writing, teaching, including workshops and seminar presentations, supervision, and conference convening. He has made substantial and ongoing contributions to the bereavement and trauma literatures and was with Doctor.
• 1:29
  Jeremy Butler, author of the first published series in the Australian scientific literature detailing the abuse histories and clinical phenomenology of patients fulfilling diagnostic criteria for dissociative identity disorder. He was the first researcher to publish systematic research into ongoing incestuous abuse during adulthood. He is a fellow and past president of the ISSTD, is a co chair of the ISSTD membership committee, and vice chair of the ISSTD Scientific Committee. Professor Middleton chairs the Canon Institute. In 1996, he was a principal architect in establishing Australia's First dedicated unit treating dissociative disorders, the Trauma and Dissociation Unit at Belmont Hospital.
• 2:22
  He has authored many papers and book chapters and has been the co editor of two books based on journal Special Issues. He holds professorial appointments at the University of Queensland, the Trauma University, the University of New England, and the University of Canterbury. Welcome, Doctor. Middleton. I know that you were studying originally, bereavement and getting your doctorate.
• 2:48
  And through those cases, first, we're introduced to trauma. Can you tell me how you got involved with treating trauma patients after that?
• 2:59
  Speaker 1: What I was seeing with severely abused patients is a spectrum of the broader trauma area. And one becomes aware that in order order to survive and in order for dissociation to work, one has to somewhat dissociate the fact that one dissociates. And dissociation is is a disruption in the normally integrated processes of identity consciousness, memory, and motor control, and emotional response. It's it's a way of shutting off channels of recording and in a way that protects a a traumatized child in the in the longer term from having to deal with something that they're incapable of dealing incapable of dealing with. And that usually involves ongoing abuse by someone who is also their primary attachment object and caregiver.
• 4:02
  So there's there's this inbuilt contradiction that the person who most likely is your abuser is also the person to whom you lie for attachment and protection. So it's nothing nothing very nothing very unusual about the process of dissociation. It it actually makes a whole lot of psychological sense to realize that, of course, you know, in somebody who doesn't have a developed sense of identity when their trauma starts, that identity is going to be part of the dissociative process. And where trauma starts early, before there is stable identity, then the compartmentalization of trauma, which is in which, say, in an adult is a compartment between a traumatized and a nontraumatized part in a child takes on the persona of different identity states, some of whom are daddy's special little girl and some of whom know the extent of the abuse and only surface at times of the abuse and so compartmentalize memories of trauma. I, early on, decided that the most productive way in which to further the establishment of the field in Australia was to do a detailed phenomenological study of a representative and substantial number of individuals who satisfied diagnostic criteria for DID.
• 5:41
  And over a period of five years, I and a colleague, Jeremy Butler, collected fine grained data on the phenomenology and abuse histories of 62 individuals seen in Brisbane, selected for no other reason than that I had legitimate clinical contact or he had legitimate clinical contact with these individuals. Of the series, I had contact with 57, and he had contact with five such individuals. And the core the core findings of that study, was published in 1998, so we're getting back over two decades now, was that the abuse history and phenomenology of individuals who satisfied diagnostic criteria for DID in Brisbane, Australia was pretty well identical to the phenomenology and abuse histories of individuals in series who had been described in North America. So going forward, the next step was to establish an inpatient unit that attempted to address the particular issues of individuals with dissociative disorders, and that was how I became involved in being the principal architect of the establishment of the Trauma and Dissociation Unit at Belmont Hospital. And we celebrated with a conference in Brisbane back in 09/2017, the twentieth anniversary of the establishment of that unit.
• 7:22
  Over time, and it was apparent in the first published series, I became focused on the issue in my research and writing on those particular individuals with DID, and they all have DID who have been subjected to ongoing incestuous abuse during adulthood. If one looked at the literature of of even recent years, one could be forgiven for thinking that apart from the odd case study and anecdotal references that there was no systematic research whatsoever on the fate of a significant proportion of individuals with DID for whom the abuse essentially never ended. And one of the paradoxes of researching this field where one has to show due care and never go beyond the verifiable data, that the the individuals in this spectrum are people who very much resemble the large group now of individuals who have been the subject of of of articles in the in the popular press about that same phenomena. And I probably, somewhat paradoxically, have Fritz Joseph Fritzl to thank for stimulating press interest in the phenomena. So as you're aware, Joseph Fritzl had sexually abused his daughter Elizabeth for thirty one years, and for twenty four of that, he had her imprisoned in a homemade dungeon under his residence in Austria.
• 9:13
  And the apart from the fact that he actually created a dungeon, the the core elements of his abuse was very similar to multiple other reported cases. And in 02/2013, I reported in the international literature an analysis of 51 such, individuals or groups of individuals reported in the world press who had subjected children, usually daughters, to this sort of ongoing abuse. Obviously, press reports tend to be somewhat sensationalized and usually fairly short, so we don't get the fine grained collection of data that one sees in a in a systematic scientific series. But what it did, it allowed me to to actually identify from unequivocal cases that were verified by court reports and police statements a phenomena that one could then examine more closely in a series of clinical cases, which I published again later that year, which was a series of 10 such individuals seen in Brisbane, who had essentially identical abuse histories to the sorts of people that were the subject of verified court reports. And if one looks way back to the published series in 1998 that I was involved in in putting together, it was apparent back then that at least one in eight patients with DID had this sort of history.
• 10:53
  They were victims of abuse that never ended. There used to be this assumption, of course, that somehow bad as incest was that it tended to end with at least if not before puberty, at least with puberty where abusers and fathers, etcetera, became worried about pregnancy and individuals became older and stronger and managed to leave the family environment or or, something happened that that that brought the abuse to an end. But it's very apparent that for a significant proportion and I would say now looking having having seen many, many more such cases that the one in eight figure of people with DID who have this sort of background is, if anything, you know, a tad on the conservative side. So if you look at if you look at published figures for the, you know, population incidence of, you know, DID in the adult population, we the median of published series is somewhere in the order of 1.1. And if you've if one was to assume and if congruent with my published research, that that something in the order of one in eight of these were subjected to ongoing incest during adulthood, we actually end up with with the challenging figure that about one in seven hundred of the adult population have this sort of background where the abuse is ongoing.
• 12:24
  And, of course, in among the groups that I have seen, one sees, you know, examples where where the abuse has literally, by one or other family members and and associated organized abusers where sexual abuse has continued for half a century. And that was also borne out in the published, press reports where where the where there were press reports documenting cases where ongoing incest had occurred for over forty years. And, of course, when it was originally published, Joseph Fritzsall's case led people to wonder whether there was something unusual about Austria than than you know, we had Adolf Hitler coming from Austria. We had Joseph Fritzl coming from Austria. And, of course, there were a couple of other high profile cases of severe abuse associated with with Austria.
• 13:25
  And, of course, very shortly, it became very apparent that every country that where there's a reasonable court system that we have similar such cases. And, as soon, there were British fritzels and and Scottish fritzels and American fritzels and Australian fritzels and and so on and so forth. In 02/2012, I published an updated, series of of such cases. And as time's gone on, one just sees the such a case cases in the popular literature continue to accumulate. And while while the some become the subject of books and where there is more detailed description of their dissociation.
• 14:07
  You know, the brief press reports usually don't have an opportunity to delve into any of the complexities of their dissociative conditions. One of the things that I've found is that every single person that I've ever seen who has this sort of history has DID. It's almost like if you're going to survive and you haven't suicided, you need to be severely dissociative in order to live with and somehow survive that sort of ongoing abuse.
• 14:38
  Speaker 2: What is the difference in the dynamic between the abuser and the child and the abuser and the adolescent or the abuser and the adult?
• 14:47
  Speaker 1: When when one looks at abuse that continues into adulthood, one has, you know, a strong usually a strong attachment despite the fact that, you know, at one level some parts of an individual are very aware that they're being abused. They're all they're also as as as we as a species mammalian species strongly attached to our primary attachment figures, and if the only attachment figures are abusers, then there is a deep ambivalence about, you know, acting definitively against someone who is both your strongest attachment figure and also your principal abuser. So disent disentangling oneself from that sort of abuse scenario, yes, it happens, and and and therapy is an important very important component of that. But one one actually does see individuals who they never reach escape velocity. You know?
• 15:46
  Yes. They're they're deeply traumatized by it and and deeply shamed. And the the the the principal mechanisms by which abuses keep their victims in this sort of role is via use of shame, fear, and conditioning. Shame is that, you know, that the the child victim really wanted this or wanted it or elicited it, that they're really a slut. Or combined with no one will believe you and and and, you know, if you tell anyone, I will kill you or you will go to hell, and all mixed in at times with, you know, you're my special person, and I love you, and you're my little princess.
• 16:45
  And and one what became apparent when getting that form of extreme abuse that in in the series of people that I've seen, that it 's very apparent that one or both of the parents seemingly from what the victim could pick up had themselves had been quite traumatized. And in the published series that I mentioned of 10, at least half felt that their their father or stepfather had dissociative identity disorder themselves, and most were aware that their father had come from an abusive background. And with mothers, we saw not dissimilar pattern where where they also had an abuse history and a tendency to be dissociative themselves. So when you're surrounded by, you know, generations of people who were traumatized and dissociative and, you know, where where the abusive culture is so ingrained, it becomes, you know, a very challenging thing. There was a case that came to light in New South Wales just just in in the last half decade or so, and that that was a family known as the cult family where, literally, they were documented, you know, four generations of this extended family where every generation was abused.
• 18:12
  And where when they when authorities finally sort of moved on a sort of a rural conclave at Kuta Mundra, and you said, in bush, you know, they found, you know, 10 children. And of the of the 10 these are young children that needed to be put in care. Of the ten, nine nine had parents who were related to each other. So there were nine of the 10 were incestuously fathered children, and they were the fourth generation of a family where the insisters went back and back and back. Now one has to be extremely careful in making generalizations, lest one assume that every person who's been traumatized is automatically an abuser.
• 18:56
  But it does it does point to the a reality that when you're dealing with the extreme end of the spectrum, that abusers tend to coerce or force their abused offspring to also abuse their own offspring. That it brings with it, you know, strong feelings of shame and a strong tendency to maintain silence. So even even though you get egregious, you know, abuses, yes, some will sort of finally take out some sort of aggravated violence order to keep keep their abuser away. But but it's actually very rare that they will initiate, you know, court proceedings that would have their father jailed. A rare exception was one in Northern New South Wales around which whose court matter became prominent a couple of years ago where a father and a mother were both jailed and where, you know, two sisters gave evidence of severe sadistic abuse.
• 20:04
  And that's when you're dealing with this spectrum, sadism, the use of weapons, knives, guns, death threats are commonplace. And one looks into the families, one sees and these are verified examples where, you know, the close family members and close associates seem to die by unnatural means, homicide, suicide at sort of alarming rates. And we and while I said before that, you know, we've we're looking at rough figures, you know, that are where the DID incorporates ongoing incest during adulthood of, you know, one in seven hundred, that could be an underestimate of the number affected. Because when one looks at the group that have survived, that they most of them have survived serious suicide attempts. Most of them have been seriously physically assaulted and carry scars and internal injuries from those sort of assaults.
• 21:07
  And a number of them have had inducements to suicide by their abusers. So it's very apparent that quite a number of people in that spectrum are already dead, so they never get included in the figure. Of course, that keeps the issue hidden, that these people die by suicide or other natural causes or misadventure, and no one looks at the is able to look at the overall picture and actually demonstrate all of the causal links. The fact that society has large numbers of people who are in positions of authority and who abuse children or and or who use their institution to cover up such abuse was really brought into graphic relief by the Australian World Commission into the institutional responses to child sexual abuse, which concluded late in 02/2017 and which was the most comprehensive national inquiry into such abuse in human history. Yet, even then, that that inquiry focused on institutions, particularly churches, and of the churches that were represented among those victims most frequently was the Catholic church, where of all of the victims of institutional abuse that gave evidence of the Australian Royal Commission, no less than 40% of them were victims of clergy abuse or other other church officials within the Catholic church.
• 22:51
  No no faith group really remained unaffected. And and I might also add that when one looks at professional groups, one finds examples of prominent abusers who outwardly appear eminently respectable and persuasive and powerful, who nevertheless have abused people who are vulnerable, including those who are children. And that includes, you know, people in the mental health professions, people in sporting professions, people who are in the scouting movement, who run orphanages, etcetera. You know, the salutary message of recent years is that, you know, that abusers don't usually declare themselves, and they use positions of authority to cover their tracks or to intimidate their victims or to organise access to victims. And I guess one of the features of recent years as we have become a digitally interconnected community is that we've just seen graphic examples of the way child abuse is organised by the encrypted sites of on Internet on the Internet to swap, you know, at times live video feeds of of children being abused.
• 24:16
  And we've seen multiple large, you know, encrypted rings of child abusers being uncovered in various law enforcement probes, one in which was the probe by the FBI into Playpen, which came to light in 02/2015. And Playpen was a site that allowed for the connection between child sex abusers online, and and the number of members of that site when it was when it was published was in the order of 215,000 members. So the one is abuse and and numerous numerous there are numerous examples of people from prominent professions right across from politicians through to university professors to members of the FBI, Justice Department, police, child protection agency workers, etcetera, etcetera, that the message is that that within all of those groups, we find prominent examples of people who have been using their position to have access or cover for the abuse of children. So one one one becomes, I guess, appropriately cautious about just taking things on face value. And an ex I guess the prime example of this would be the ongoing series of abuse scandals involving the Catholic church where country by country, we have seen dramatic and evolving evidence of the extent of abuse in in prominent archdiocese that that stretch back for fifty or more years in entire countries, where it becomes apparent that that the senior hierarchy of the church have covered up for pedophile abusers and moved them around from diocese to diocese, and where there has been destruction of evidence.
• 26:28
  And it sort of got to the point where we're seeing now that fairly frequently in the process, it's not like the old days where some there is some polite inquiry into the church. These days, law enforcement arrive with search warrants and and take away documents from from the administration of prominent bishops. And when we look at places like The Netherlands, we find that, you know, that the majority of the bishops in the entire country are credibly involved in the cover up or knowledge of child sexual abuse that was not reported. And we've seen these prominent examples in Holland, Germany, Ireland, The US, Australia, etcetera, where we get the predictable, you know, expressions of regret and and need for more openness. And we're now right for the first time in human history, really, where where the Catholic church, in terms of the number of its senior members who have been charged or facing trial or have been convicted of serious crimes is unprecedented.
• 27:42
  Where, you know, a person who's you know, was third in line in the power and succession of the pope, you know, is is has been committed to trial. And there's prominent bishop in France I should say cardinal in France. There's there's there's a cardinal, McCarrick, in The US whose issues have prompted, you know, a senior bishop to call on the pope to repent and to resign. We just know never seen that sort of public attention to to our institutions in in the history of humanity, really. I mean, the church has been around two thousand years.
• 28:19
  And, yes, we've been through the reformation five hundred years ago, but this this is actually this is actually, if anything, more dramatic in terms of, you know, of the way in which we run our institutions. And I might add within psychiatry, we have seen much more of a trend to put any allegations within about sexual boundary violations or abuse prominently within the hands of police rather than or registration authorities rather than attempting any sort of in house inquiry. They've proven to be demonstrably unhelpful and and unusually embarrassing in terms of their results. So that's an overview of some of the issues.
• 29:16
  Speaker 2: How do we help people if it's so pervasive and so extensive?
• 29:21
  Speaker 1: Well, I guess there are two major prongs to that. One is one is society itself, you know, benefits from being encouraged to be open, that the bravery of individuals who are able to finally tell their truth needs to be acknowledged and supported. And at the same time, you know, we we need to be aware that that, you know, this sort of abuse has massive impacts on the causation of mental illness and social problems such as, you know, alcoholism, drug abuse, sexually transmitted disease, not to mention smoking, heart disease, etcetera. In fact, the more traumatised one is, the more types of trauma one has growing up, the more likely one is to develop mental illness or physical illness, to have a teenage pregnancy, or to to develop lung disease from smoking, or cardiovascular disease from alcohol and drugs, etcetera. None of these things, you know there's not just a unilateral sort of unidirectional result from abuse.
• 30:37
  It filters through and from generation to generation, as I've sort of mentioned, it can continue to impact. At the individual level, obviously, we need to be aware, health professionals need to be aware of trauma spectrum disorders, including post traumatic stress disorder, dissociative identity disorder, somatisation disorder, so called borderline personality disorder, etcetera. In fact, when we look when we look at, you know, all of the literature that's looked at the abuse histories of people who present to mental health centres or mental health outpatient departments, we find that approximately two thirds come with significant history of childhood, physical, and or sexual abuse. And when we add in abuse and neglect, emotional abuse and neglect, I should say, you know, the figure comes up to around eighty percent. Now that's not to say that everybody that presents in any way to a mental health facility has a condition caused by abuse, but nevertheless it's it's in it's undeniable that the more abuse one has, the more likely it is that one's going to end up with major mental health issues and major physical issues.
• 32:03
  Yes, there are other factors that cause mental illness, and just as there are other factors that cause physical illness. As a I mean, one thing you asked about, you know, what do we do? I I think there was something very valuable about the Australian Royal Commission. It and as as one is aware, there are there have been a number of royal commissions or similar commissions national commissions launched in various parts of the world, And none of them have done it anything like as well as the Australian World Commission. I see the British Commission, you know, into historical child abuse is largely been, you know, a lengthy and messy process that has yet to get any real traction and where they've been through multiple different commissioners.
• 32:49
  The Australian Commission started with the Run World Commissioner and Assistant Commissioners and went through the entire five year process with the same team intact. And very early on, they made a central, I guess, anchor point of their commission's work was respect for the dignity of abuse survivors. Survivors didn't give evidence in a way where they were put on trial or where they were cross examined. They were supported in large numbers in a very empathic and sympathetic environment to be able to tell their story to someone in authority. And, yes, there were public hearings which looked in-depth at a range of institutions and were which gave findings that that could be generalized to multiple institutions.
• 33:50
  So there was an in-depth look at let's say, certain schools or certain sporting bodies or certain church groups or certain church policies, etcetera. And that was balanced by a whole lot of individuals, over 8,000, in fact, who gave individual testimony about their own sexual abuse within institutional settings that involved both abuse and the cover up of the abuse. Now it became very apparent to the royal commissioners that a large proportion of those who gave evidence about being sexually abused by institutions or representatives of institutions were also abused by members of their family. And it's very apparent that ninety percent plus sexual child sexual abuse that happens within society doesn't happen particularly within institutions, but within that other untouched organisation, if you want to put it that way, you know, the family where ninety percent of child sexual abuse occurs within family groupings. And when you get to the extreme ends of DID, one finds almost universally, as I found in my published studies, is that when you get ongoing incest into adulthood, almost invariably the abuse within the family extends to incorporate some form of organized abuse, whether it be associated with the church, whether it be a father's workmates, whether it be multigenerational family and orientation, or whether it be some form of a cult.
• 35:41
  There seems to be a natural human tendency to organize, whether one collects stamps, rides motorcycles, or abuses children. And we see that hence, when we have an Internet connected society, we just see graphic evidence of organizational abuse on scales hitherto unimaginable.
• 36:03
  Speaker 2: Organizational abuse, even using that term, broadens the scope of different kinds of ritual abuse to include those other examples that you gave.
• 36:15
  Speaker 1: Yeah. I'm glad you mentioned the term ritual abuse. I guess in the in the prime minister's public apology and his speech that that that came with it, our prime minister of the time last year, Scott Morrison, made reference to ritual occurring within abuse. And, undoubtedly, ritual is incorporated in in some childhood sexual and other abuse, and the sorts of rituals that that one that one encounters. You know, one sees examples of things that involve, you know, religious symbols.
• 36:58
  It's it's I guess, you get occasions where other symbols like satanic symbols, in a verified way, you know, have been incorporated into significant crimes. That is not to say that that as yet that there is significant hard evidence of some sort of multigenerational satanic worldwide organization that sort of murders babies and and eats them, etcetera. But those sorts of stories have circulated and have been circulating in various forms, probably for hundreds of years, but sort of got to prominence again in the eighties. And hence, when I was researching ongoing incest during adulthood, I was very careful to not go beyond the data And that before I published systematic research onto individuals within the spectrum that I had assessed in detail, I published verified accounts and analysis of such individuals who had been widely reported in the world press. So that made it that that gave a solid foundation to then being able to say, yes, this exist this form of severe abuse exists.
• 38:24
  It is widespread. And what one sees clinically is very consistent with what is reported in the popular press and which appears in court reports and police statements. That did not happen with with allegations that appeared in in the nineteen eighties about alleged, you know, satanic ritual abuse, you know, where there were accounts of sort of cannibalism and, you know, babies being murdered in large numbers and and etcetera. That's not to say that at times that, you know, some disturbed individuals, and there are disturbed individuals who have, and it's verified, used some form of reference to satanic symbols just as they have used Christian symbols incorporated into their abuse. And I have patients where, you know, they've been abused by priests where, you know, the abuse, I guess, is fairly mainstream for this sort of spectrum, but where, you know, on occasions, there were some elements of, you know, Christian ritual incorporated into the abuse.
• 39:37
  So one, you know, one needs to keep an open mind, but, you know, one does not need one's brain to fall out. And, you know, from very early on in in, you know, the modern dissociative disorder slash conflict complex trauma field, you know, there have been many individuals who have cautioned about going beyond the verifiable data. We also need to not report things that do happen and which are provable and verifiable because we just choose not to look. I'm I'm I do find it interesting that that it took so long for systematic research into ongoing incestuous abuse during adulthood to actually be published. Up until 02/2013, you know, the only references to it in the literature was the on anecdotal the auto anecdotal reference and the odd single case study, sometimes as a, you know, autobiographical or biographical book written by a journalist or with a journalist.
• 40:44
  And that was that was the extent of it.
• 40:47
  Speaker 2: What has changed that's made it more accessible or possible culturally or as a society to listen to these accounts or to confirm data and actually publish it so that it's available to more people? What what has changed?
• 41:08
  Speaker 1: I I think we've reached a tipping point. The if you if you look at the last hundred odd years, at various times, a few individuals have tripped over and reported on the reasonably widespread nature of of severe child abuse. In fact, it even goes back further than that. You know, if we one looks at, you know, some of the French pathologists, you know, who were seeing the results of child child abuse and, you know, French morgues, you know, back in the mid eighteen hundreds, it was apparent that that that severe abuse occurs within society. And as we kind of know, Freud was the first person to actually publish an account of the etiology of what was called hysteria being, you know, child sexual abuse occurring at an early age and usually involving a close family member.
• 42:13
  And within a very short period of time from from publicly proclaiming his theory about the etiology of hysteria, he was already, by September 1897, reworking his theory and and and denying it. That by February by by 2400, he had renounced his so called seduction theory and replaced it with a theory of edible fantasy and hysterical mendacity. So we got back to sort of a sort of a scenario where women are fantasizers and children can't be relied upon to tell the truth, and that people within the spectrum of hysteria or what would also encompass what became known as borderline personality disorder, you know, were prone to make wild and extravagant claims and were not to be believed. And, you know, the disempowering of women or the projection of women as lacking power, being unclean, being down the totem order in in religious observance, and in power structures, you know, was well ingrained. And, yes, over subsequent years here and there, a study by a single individual did shine briefly a little light, but it did not capture was never captured as a widespread phenomenon until until, you know, the late seventies, you know, feminism reached something of a critical point that coincided with the issues of returning Vietnam Veterans with post traumatic stress disorder.
• 44:00
  But even then, there was even then when incest became finally acknowledged as a widespread phenomena, there was a backlash. I might point out that when when I started psychiatry in 1980, the most prominently used comprehensive textbook in psychiatry was the comprehensive textbook of Friedman, Kaplan, and Saddock. And in a small section buried in the back of the book, there was a page and a bit on incest, which quoted no no study more recent than 1955 on the prevalence, and it came up with a result that that on the quote quoted prevalence that was some incest was a vanishingly rare phenomena where where, you know, one woman in about a million was subjected to incest. And, like, within six years of that published epidemiological studies indicated that child sexual abuse in some form was occurring in over a third of women and that something like sixteen percent of the female populate adult population came with a history of some form of childhood incest. And of that sixteen, something like four and a half percent involved a father or stepfather.
• 45:25
  So, you know, the order of magnitude from one in a million to a 60,000 per million as victims of incest gives some indication of just the extent of of the nonfocus and the denial of society even in relatively recent times. And, you know, going back to that period, it was the period where I was just finishing just finished training in psychiatry. And and if incest was vanishingly rare, you can imagine how rare DID was, which was a condition that's particularly associated with severe incest.
• 46:02
  Speaker 2: So do you think that trauma is being reported or disclosed more? And so you're saying that it's often a kind of a comorbidity kind of thing or that it's being misdiagnosed as other things?
• 46:23
  Speaker 1: Well, I think it's being reported far, far more frequently now. That was what I was saying about the tipping point. We know while I said there was a backlash, and that was that was sort of backlash that encompassed, you know, polarizations and and and professional disputes about the validity of recovered memories. And as you know, in about 1992, an organization formed the False Memory Syndrome Foundation, formed by Pamela and Peter Fried with Ralph Wunderwager and her leader, Wakefield, in Philadelphia. And it gained prominence by by being a focal point for people accused of incestuously abusing children and who proclaimed that they were innocent.
• 47:08
  And I'm not saying that there that there weren't significant numbers who have been falsely accused, just as there are people accuse falsely accused of all sorts of crimes. But it also it also became apparent that that this organization made a focus of essentially, you know, encouraging people to sue therapists to try and essentially outlaw therapy and to attack the foundations of the diagnosis of DID by putting forward some entity which was never never been scientifically defined in terms of any operation criteria, that of the false memory syndrome, but it gained a lot of national and international press at the time. And that organization sort of continued but became much less prominent over the last half decade. They don't no longer publish a newsletter. They have a scientific advisory committee, but a large proportion of the people that are named on their website are actually now deceased.
• 48:17
  And in that intervening period, we've seen this massive change in the way in which institutions are now seen, those that should normally be the bastions of of of moral authority and putting forth as the highest priority the welfare of children, to find that, in fact, they've just horribly let down children decade after decade and have covered their tracks or tried to. And we've seen so many examples in so many countries that it's no longer credible to say, you know, that that the fantasizing about abuse is is an alternative to the reality that, you know, our mainstream churches and our family, so called nuclear family, are major contributors to child sexual abuse and to the causation of complex trauma, including dissociative identity disorder and the whole range of trauma spectrum disorders. And that includes, as I said, you things like drug and alcohol addiction and abuse, sexual difficulties and disorders, sleeping disorders, eating disorders, know, proneness to depressive disorders, etcetera.
• 49:41
  Speaker 2: You were one of the first researchers to really link the dissociative disorders to trauma and to research those trauma histories specifically, and that you have been so careful to stay within the confines of the data itself and research and approaching it that way so that it did get more traction and got a greater reception so that more people could learn about this. But you've also really done a lot to advocate and empower survivors through the way that you present it. So for example, I wanna read with your permission a quote from a presentation I saw you give actually in 02/2011. And here's what you said that I have never forgotten and has and it just really blew my mind. But it said you said, far more is right with them than what's wrong with them, and what's wrong with them was not caused by them.
• 50:51
  Speaker 1: Yes. That's right.
• 50:54
  Speaker 2: It's a powerful statement. It's a heavy statement, and it's really very straightforward and very simple and maybe even very obvious. But I think it's it's a it's a point that's not often said out loud by researchers or by those who are discussing survivors as if they are not in the room. It was good. Just thank you for that.
• 51:22
  That was it was a powerful statement, and I've shared it frequently.
• 51:26
  Speaker 1: Yeah. My colleague, professor Jennifer Fried, and I might add that Jennifer, just by way of orientation, is the daughter of Peter and Pamela Fried. Jennifer Jennifer has gone on to a distinguished career as an academic psychologist and is the for the long term editor of the Journal of Trauma and Association. Jenna Jennifer has, you know, written a lot about institutional betrayal. And one of the points she makes about abuses is, you know, the standard the standard response from from the abuser is to deny and loudly attack and to switch the the the focus from the victim to the offender so that they become the victim and the victim is now portrayed as somebody who is attacking them and they're the innocent victim of an attack.
• 52:29
  I don't I don't probably don't have to to labor the point, but when one looks at that as a strategy, one one sees certain parallels within the political process in your country at the moment where where loud denial and loud attack sort of seem to dominate the airways on a daily basis.
• 52:48
  Speaker 2: I very much appreciate you talking to me today, and I want to honor your time, so I know our hour is almost up. Is there anything you want to add before we finish?
• 52:58
  Speaker 1: Absolutely. You you've very generously sort of attributed to me a role in the field, and and it is true that that, you know, I have been involved for many years in Australia in terms of the sort of things I mentioned before in terms of publishing, setting up a model of treatment, in terms of contributing to and collaborating with a number of organisations and in trying to put together foundational research that provided a reference point for the emerging field in Australia. But I would I would very much emphasize that that the modern disability field had its formation in in in more senior colleagues in The US particularly, and within that group and I try I won't try and list them all by name, but but I should I should I should give prominent examples to those who very early on were prominent in in doing systematic research and in publishing in this area, and they include Richard Cloughed, who who was the editor for a decade of the journal Dissociation, who's a past president of our society, and who has treated more people with DID than anyone in the history of the world, Frank Putnam and Colin Ross, both of whom published major textbooks on the diagnosis and treatment of what was then called multiple personality disorder in 1989 and a veritable large grouping of of other colleagues who, today's early years and subsequently contributed to the foundation of a field.
• 54:53
  And that field is actually a strong field, and it's and it's it's growing healthily. I I look forward to, being in The US in in March 2019, this year, for for the, International Society for the Study of Trauma and Dissociation annual conference, which will be in Times Square, New York. And it's bringing researchers and presenters from all over the world. It's it's and it's nice that I have so many colleagues within Australia who were part of that organization. And my colleague, Martin Dorahee, who's who I've collaborated with more than anyone else, succeeded me as a president of the International Society for the Study of Trauma and Dissociation and is a prominent presenter and and has made a major focus of his research the issue of shame.
• 55:57
  And I could talk a lot more about shame, but it's a core component of why and how abusers have kept their victims silent.
• 56:09
  Speaker 2: I know a little bit of the shame from Patricia De Jong's work. What is your perspective on shame?
• 56:17
  Speaker 1: It's it's one of those emotions that it's not something attached to what you do, but it's what is done to you. And it's it's a bit like having indelible tar sort of embedded in your skin. And it's used very effectively by abusers who manipulate the natural, normal sexual responsiveness that everybody has and turns that into an instrument of projecting blame and shame onto the victim, which they know in turn, at the one level, ties the victim to them and another level makes it incredibly difficult for that person to break free of that dynamic and and to speak forcefully. The person one of the people, I think, who speaks beautifully about shame is Marilyn Van Derber, who was the 1958 Miss America and who did recover memories of her incestuous abuse that had been inaccessible. And she was at the time, obviously, highly dissociative and who has gone on to, you know, a a very effective career where she speaks a lot about about confronting shame and being able to you know, shame shame shame is someone else's problem, you know, once you get to be able to talk about what happened to you, you know, someone else has a difficulty with it.
• 57:46
  It's their problem. It's not your problem. You're talking about something that somebody did to you that who really wanted to keep you silent. I did send a recording. That was just my take on on the loss of innocence.
• 58:01
  Speaker 2: Well, thank you.
• 58:02
  Speaker 1: Okay. You take care, Emma.
• 58:04
  Speaker 2: Thank you. Thank you for listening. Your support really helps us feel less alone while we sort through all of this and learn together. Maybe it will help you in some ways too. You can connect with us on Patreon by going to our website at www.systemspeak.org.
• 58:30
  If there's anything we've learned, it's that connection brings healing. We look forward to connecting with you!