The Courage to Heal
Encyclopedia
The Courage to Heal: A Guide for Women Survivors of Child Sexual Abuse (first published in 1988) is a popular self-help
book written by Ellen Bass and Laura Davis that discusses the impact of child sexual abuse
and how to address it. The primary thrust of the book is that individuals (mainly women) with a vague set of symptoms have been abused. The book also states that in some cases the memories of the abuse have been forgotten
but are responsible for the individual's current problems. A variety of techniques are proposed to help these individuals heal, involving confronting their alleged abusers, adopting an identity as a "survivor", overcoming the associated trauma
and in cases where there is no memory of any abuse, recovering the memories. The book was a bestseller in North America and Europe.
The book has been criticized for creating false memories
of abuse, its authors being unqualified and for creating an industry which has isolated and separated family members despite having no positive proof the abuse occurred. Bass and Davis have also been criticized for leaping to unwarranted, implausible conclusions with significant consequences and for scientific errors found in the first edition that were not corrected in subsequent reprintings.
survivor. Bass and Davis attributed efforts to confront incest and child sexual abuse to the Women's liberation movement
. While working with students, Bass and Davis came to believe that the stories of some students were trying to convey painful memories of incest. From this idea, the two developed methods to assist students in recovering memories of abuse in childhood.
Neither Bass nor Davis have any training in psychotherapy
or science
, and they state that nothing in the book is based on any psychological theories. They have defended their lack of training with the claim that a PhD is not necessary "to listen carefully and compassionately to another human being"; neither author has ever acknowledged the errors they have made in their descriptions of memory and trauma. Despite their complete lack of knowledge about the workings of memories, the scientific approach or information and lack of qualifications, Bass and Davis still define themselves as healers and experts in the area of child sexual abuse, due to leading workshops with victims.
The third edition featured an afterword called "Honoring the Truth: A Response to the Backlash", which was added to respond to and rebut negative reactions to the book. The section has been characterized as an effort to dismiss all research contradicting the book as being part of a backlash against victims of incest.
The book was written as a response to the authors' frequent encounters with women who were the victims of sexual abuse during their childhood and adolescence, and is predicated on the belief that extreme childhood trauma, of which sexual abuse is one, is spontaneously repressed
. The authors suggest that people experiencing dysfunction in their lives (including a wide-ranging set of problems such as depression, anxiety
, alcoholism
, drug addiction, dysfunction
al relationships, dissociative identity disorder
, self-injury and suicidal
thoughts) or feel there was something traumatic in their childhood should investigate these feelings; Bass and Davis also present what they believe is a path to healing from the trauma of alleged childhood abuse. The latest edition features language more inclusive of male sexual abuse victims.
The original edition of the book contained an influential chapter discussing satanic ritual abuse
(though satanic ritual abuse is now considered a moral panic
, the case specifically discussed in The Courage to Heal is that of Judith Spencer, which has since been discredited) and the discredited autobiography Michelle Remembers
- citing the latter approvingly along with other alleged survivor stories of satanic ritual abuse. Subsequent editions renamed the phenomenon "sadistic ritual abuse". The Courage to Heal was part of the vision that childhood sexual abuse could be discovered with no corroborating evidence beyond a vague set of symptoms.
The basic errors regarding the science of memory have never been corrected between editions; in the third edition, the book stated that for a small number of women their symptoms may have originated in emotional rather than sexual abuse.
, these therapists lacked appreciation of the risks of seeing incest behind any symptom, or even a lack of symptoms and did not consider that other factors besides incest may have caused sexual problems in their clients. The book was a bestseller in North America and Europe, and has been described as "the bible of the 'survivors' movement". Discussing the book in relation to their discussion of narratives of incest, professors of English Janice Doane and Devon Hodges believe the book's popularity is due to it offering "an enormously enabling fantasy that by the same token refuses a complex analysis of the very means of recovery, writing, that it so confidently touts" and for promising to completely make sense of the reader's lives through the simple process of writing.
, psychology
or any form of treatment for mental illness, with critics stating that as a result they are not qualified to write such a book. This lack of training may have resulted in Bass, Davis and others who adopted their approach leaping to conclusions that caused considerable harm, irrespective of their intentions. Bass and Davis also never acknowledged that their basic claims of how memory works were flawed or outright wrong. Paul R. McHugh
, professor of psychiatry at Johns Hopkins University
and award-winning researcher in the field of memory
describes the book as the "bible of incompetent therapists". A report for the Australia
n branch of the False Memory Syndrome Foundation
(FMSF) found the book was linked to nearly 50% of the cases in which a false allegation of child sexual abuse
was made based on recovered memories and a 2005 report by the Health Services Commissioner to the Minister for Health of Australia stated that some respondents from families where there were accusations of child sexual abuse
called for the book to be banned, believing the book promotes the practice of recovered memory therapy
. Frederick C. Crews has criticized the book for appealing not to women who have always remembered abuse, but rather being aimed at those who struggle to convince themselves they were abused as children in the absence of previously-existing memories, and that the author's claim to promote self-esteem
are actually based "on a shattering of their readers' prior sense of identity and trust".
Elizabeth Loftus
, an award-winning researcher on memory, stated that the book was certainly very comforting to individuals living with memories of abuse, but questioned the effect it would have on people who do not have such memories, and suggested The Courage to Heal may be one of many sources of false memories for some individuals. Loftus also stated that "All roads on the search for popular writings inevitably lead to [the book]". The Courage to Heal encourages the use of strategies such as guided imagery to access and attempting to elaborate details and emotions and discouraging individuals from questioning the memories recovered.
According to psychologist Bryan Tully, the philosophy of the authors regarding memories of abuse, or lack thereof, is that:
Professors of English Doane and Hodges note that the book was widely condemned for its use of checklists to determine if the reader was abused, describing the complaints made against the book as being as formulaic as the stories it engenders (in part due to things like the "notorious") and only criticizing parts of the book. Doane and Hodges also state that the use of "you" throughout the book blinds Davis and Bass to their shaping of the identity of the reader and their story.
branch of the FMSF criticizes the 20th anniversary edition, claiming "No book did more to spread false memory syndrome" (though the existence of false memory syndrome, a belief that memories can be created through inappropriate therapy techniques, is itself debated). The book was described as vicious, and filled with factual errors about the FMSF and the nature of memory, though the anniversary edition is described as better, without the outrageous features of earlier publications and that in the new edition, the FMSF is not mentioned in the book's index. The book is still dedicated to recovering memories, and does not warn the reader of the doubts scientists have about its premises. The book still contains a section on satanic ritual abuse
, without noting the FBI
's report that concluded there was no evidence for the phenomenon.
The Third Edition of the book, published in 1994, offers a whole chapter titled "Honoring the Truth," in which the authors respond to the book’s critics. The FMSF criticized the chapter about their organization as filled with factual errors and written by a man who had no known credentials and no scientific publications
in the relevant fields; the discussion of the FMSF was removed from the 20th anniversary edition.
Self-help
Self-help, or self-improvement, is a self-guided improvement—economically, intellectually, or emotionally—often with a substantial psychological basis. There are many different self-help movements and each has its own focus, techniques, associated beliefs, proponents and in some cases, leaders...
book written by Ellen Bass and Laura Davis that discusses the impact of child sexual abuse
Child sexual abuse
Child sexual abuse is a form of child abuse in which an adult or older adolescent uses a child for sexual stimulation. Forms of child sexual abuse include asking or pressuring a child to engage in sexual activities , indecent exposure with intent to gratify their own sexual desires or to...
and how to address it. The primary thrust of the book is that individuals (mainly women) with a vague set of symptoms have been abused. The book also states that in some cases the memories of the abuse have been forgotten
Repressed memory
Repressed memory is a hypothetical concept used to describe a significant memory, usually of a traumatic nature, that has become unavailable for recall; also called motivated forgetting in which a subject blocks out painful or traumatic times in one's life...
but are responsible for the individual's current problems. A variety of techniques are proposed to help these individuals heal, involving confronting their alleged abusers, adopting an identity as a "survivor", overcoming the associated trauma
Psychological trauma
Psychological trauma is a type of damage to the psyche that occurs as a result of a traumatic event...
and in cases where there is no memory of any abuse, recovering the memories. The book was a bestseller in North America and Europe.
The book has been criticized for creating false memories
Confabulation
Confabulation is the process in which a memory is remembered falsely. Confabulations are indicative of a complicated and intricate process that can be led astray at any given point during encoding, storage, or recall of a memory. Two distinct types of confabulation are often distinguished...
of abuse, its authors being unqualified and for creating an industry which has isolated and separated family members despite having no positive proof the abuse occurred. Bass and Davis have also been criticized for leaping to unwarranted, implausible conclusions with significant consequences and for scientific errors found in the first edition that were not corrected in subsequent reprintings.
Authors
The Courage to Heal is written by feminist activists Ellen Bass, a poet and creative writing teacher, and her student Laura Davis, an author, writing teacher and incestIncest
Incest is sexual intercourse between close relatives that is usually illegal in the jurisdiction where it takes place and/or is conventionally considered a taboo. The term may apply to sexual activities between: individuals of close "blood relationship"; members of the same household; step...
survivor. Bass and Davis attributed efforts to confront incest and child sexual abuse to the Women's liberation movement
Feminism
Feminism is a collection of movements aimed at defining, establishing, and defending equal political, economic, and social rights and equal opportunities for women. Its concepts overlap with those of women's rights...
. While working with students, Bass and Davis came to believe that the stories of some students were trying to convey painful memories of incest. From this idea, the two developed methods to assist students in recovering memories of abuse in childhood.
Neither Bass nor Davis have any training in psychotherapy
Psychotherapy
Psychotherapy is a general term referring to any form of therapeutic interaction or treatment contracted between a trained professional and a client or patient; family, couple or group...
or science
Science
Science is a systematic enterprise that builds and organizes knowledge in the form of testable explanations and predictions about the universe...
, and they state that nothing in the book is based on any psychological theories. They have defended their lack of training with the claim that a PhD is not necessary "to listen carefully and compassionately to another human being"; neither author has ever acknowledged the errors they have made in their descriptions of memory and trauma. Despite their complete lack of knowledge about the workings of memories, the scientific approach or information and lack of qualifications, Bass and Davis still define themselves as healers and experts in the area of child sexual abuse, due to leading workshops with victims.
Overview
The 2008 edition is divided into the following sections:- Taking Stock
- The Healing Process
- Changing Patterns
- For Supporters of Survivors
- Courageous Women
- Resource Guide
The third edition featured an afterword called "Honoring the Truth: A Response to the Backlash", which was added to respond to and rebut negative reactions to the book. The section has been characterized as an effort to dismiss all research contradicting the book as being part of a backlash against victims of incest.
The book was written as a response to the authors' frequent encounters with women who were the victims of sexual abuse during their childhood and adolescence, and is predicated on the belief that extreme childhood trauma, of which sexual abuse is one, is spontaneously repressed
Repressed memory
Repressed memory is a hypothetical concept used to describe a significant memory, usually of a traumatic nature, that has become unavailable for recall; also called motivated forgetting in which a subject blocks out painful or traumatic times in one's life...
. The authors suggest that people experiencing dysfunction in their lives (including a wide-ranging set of problems such as depression, anxiety
Anxiety
Anxiety is a psychological and physiological state characterized by somatic, emotional, cognitive, and behavioral components. The root meaning of the word anxiety is 'to vex or trouble'; in either presence or absence of psychological stress, anxiety can create feelings of fear, worry, uneasiness,...
, alcoholism
Alcoholism
Alcoholism is a broad term for problems with alcohol, and is generally used to mean compulsive and uncontrolled consumption of alcoholic beverages, usually to the detriment of the drinker's health, personal relationships, and social standing...
, drug addiction, dysfunction
Dysfunction
Dysfunction can refer to:* Abnormality * Dysfunctional family* Sexual dysfunction* Dysfunction , an album by the rock band Staind...
al relationships, dissociative identity disorder
Dissociative identity disorder
Dissociative identity disorder is a psychiatric diagnosis and describes a condition in which a person displays multiple distinct identities , each with its own pattern of perceiving and interacting with the environment....
, self-injury and suicidal
Suicide
Suicide is the act of intentionally causing one's own death. Suicide is often committed out of despair or attributed to some underlying mental disorder, such as depression, bipolar disorder, schizophrenia, alcoholism, or drug abuse...
thoughts) or feel there was something traumatic in their childhood should investigate these feelings; Bass and Davis also present what they believe is a path to healing from the trauma of alleged childhood abuse. The latest edition features language more inclusive of male sexual abuse victims.
The original edition of the book contained an influential chapter discussing satanic ritual abuse
Satanic ritual abuse
Satanic ritual abuse refers to the abuse of a person or animal in a ritual setting or manner...
(though satanic ritual abuse is now considered a moral panic
Moral panic
A moral panic is the intensity of feeling expressed in a population about an issue that appears to threaten the social order. According to Stanley Cohen, author of Folk Devils and Moral Panics and credited creator of the term, a moral panic occurs when "[a] condition, episode, person or group of...
, the case specifically discussed in The Courage to Heal is that of Judith Spencer, which has since been discredited) and the discredited autobiography Michelle Remembers
Michelle Remembers
Michelle Remembers is a book published in 1980 co-written by Canadian psychiatrist Lawrence Pazder and his psychiatric patient Michelle Smith. A best-seller, Michelle Remembers was the first book written on the subject of satanic ritual abuse and is an important part of the controversies beginning...
- citing the latter approvingly along with other alleged survivor stories of satanic ritual abuse. Subsequent editions renamed the phenomenon "sadistic ritual abuse". The Courage to Heal was part of the vision that childhood sexual abuse could be discovered with no corroborating evidence beyond a vague set of symptoms.
The basic errors regarding the science of memory have never been corrected between editions; in the third edition, the book stated that for a small number of women their symptoms may have originated in emotional rather than sexual abuse.
Reception
A large number of therapists, between a quarter and a third, adopted the approach advocated in the book. Lacking training in research and awareness of the confirmation biasConfirmation bias
Confirmation bias is a tendency for people to favor information that confirms their preconceptions or hypotheses regardless of whether the information is true.David Perkins, a geneticist, coined the term "myside bias" referring to a preference for "my" side of an issue...
, these therapists lacked appreciation of the risks of seeing incest behind any symptom, or even a lack of symptoms and did not consider that other factors besides incest may have caused sexual problems in their clients. The book was a bestseller in North America and Europe, and has been described as "the bible of the 'survivors' movement". Discussing the book in relation to their discussion of narratives of incest, professors of English Janice Doane and Devon Hodges believe the book's popularity is due to it offering "an enormously enabling fantasy that by the same token refuses a complex analysis of the very means of recovery, writing, that it so confidently touts" and for promising to completely make sense of the reader's lives through the simple process of writing.
Criticisms
Bass and Davis have no formal training in psychiatryPsychiatry
Psychiatry is the medical specialty devoted to the study and treatment of mental disorders. These mental disorders include various affective, behavioural, cognitive and perceptual abnormalities...
, psychology
Psychology
Psychology is the study of the mind and behavior. Its immediate goal is to understand individuals and groups by both establishing general principles and researching specific cases. For many, the ultimate goal of psychology is to benefit society...
or any form of treatment for mental illness, with critics stating that as a result they are not qualified to write such a book. This lack of training may have resulted in Bass, Davis and others who adopted their approach leaping to conclusions that caused considerable harm, irrespective of their intentions. Bass and Davis also never acknowledged that their basic claims of how memory works were flawed or outright wrong. Paul R. McHugh
Paul R. McHugh
Paul Rodney McHugh is an American psychiatrist, researcher, and educator. He is University Distinguished Professor of Psychiatry at the Johns Hopkins University School of Medicine and the author, co-author, or editor of seven books within his field.- Education :McHugh was born in Lawrence,...
, professor of psychiatry at Johns Hopkins University
Johns Hopkins University
The Johns Hopkins University, commonly referred to as Johns Hopkins, JHU, or simply Hopkins, is a private research university based in Baltimore, Maryland, United States...
and award-winning researcher in the field of memory
Memory
In psychology, memory is an organism's ability to store, retain, and recall information and experiences. Traditional studies of memory began in the fields of philosophy, including techniques of artificially enhancing memory....
describes the book as the "bible of incompetent therapists". A report for the Australia
Australia
Australia , officially the Commonwealth of Australia, is a country in the Southern Hemisphere comprising the mainland of the Australian continent, the island of Tasmania, and numerous smaller islands in the Indian and Pacific Oceans. It is the world's sixth-largest country by total area...
n branch of the False Memory Syndrome Foundation
False Memory Syndrome Foundation
The False Memory Syndrome Foundation is a nonprofit organization founded in 1992 by Pamela and Peter Freyd, after being accused by their adult daughter Jennifer Freyd of sexual abuse when she was a child...
(FMSF) found the book was linked to nearly 50% of the cases in which a false allegation of child sexual abuse
False allegation of child sexual abuse
A false allegation of child sexual abuse is an accusation that a person committed one or more acts of child sexual abuse when in reality there was no perpetration of abuse by the accused person as alleged. Such accusations can be brought by the alleged victim , or by another person on the alleged...
was made based on recovered memories and a 2005 report by the Health Services Commissioner to the Minister for Health of Australia stated that some respondents from families where there were accusations of child sexual abuse
Child sexual abuse
Child sexual abuse is a form of child abuse in which an adult or older adolescent uses a child for sexual stimulation. Forms of child sexual abuse include asking or pressuring a child to engage in sexual activities , indecent exposure with intent to gratify their own sexual desires or to...
called for the book to be banned, believing the book promotes the practice of recovered memory therapy
Recovered memory therapy
Recovered-memory therapy is a term coined by affiliates of the False Memory Syndrome Foundation in the early 1990s, to refer what they described as a range of psychotherapy methods based on recalling memories of abuse that had previously been forgotten by the patient...
. Frederick C. Crews has criticized the book for appealing not to women who have always remembered abuse, but rather being aimed at those who struggle to convince themselves they were abused as children in the absence of previously-existing memories, and that the author's claim to promote self-esteem
Self-esteem
Self-esteem is a term in psychology to reflect a person's overall evaluation or appraisal of his or her own worth. Self-esteem encompasses beliefs and emotions such as triumph, despair, pride and shame: some would distinguish how 'the self-concept is what we think about the self; self-esteem, the...
are actually based "on a shattering of their readers' prior sense of identity and trust".
Elizabeth Loftus
Elizabeth Loftus
Elizabeth F. Loftus is an American psychologist and expert on human memory. She has conducted extensive research on the misinformation effect and the nature of false memories. Loftus has been recognized throughout the world for her work, receiving numerous awards and honorary degrees...
, an award-winning researcher on memory, stated that the book was certainly very comforting to individuals living with memories of abuse, but questioned the effect it would have on people who do not have such memories, and suggested The Courage to Heal may be one of many sources of false memories for some individuals. Loftus also stated that "All roads on the search for popular writings inevitably lead to [the book]". The Courage to Heal encourages the use of strategies such as guided imagery to access and attempting to elaborate details and emotions and discouraging individuals from questioning the memories recovered.
According to psychologist Bryan Tully, the philosophy of the authors regarding memories of abuse, or lack thereof, is that:
Professors of English Doane and Hodges note that the book was widely condemned for its use of checklists to determine if the reader was abused, describing the complaints made against the book as being as formulaic as the stories it engenders (in part due to things like the "notorious") and only criticizing parts of the book. Doane and Hodges also state that the use of "you" throughout the book blinds Davis and Bass to their shaping of the identity of the reader and their story.
Relationship to the False Memory Syndrome Foundation
A 2009 newsletter from the AmericanUnited States
The United States of America is a federal constitutional republic comprising fifty states and a federal district...
branch of the FMSF criticizes the 20th anniversary edition, claiming "No book did more to spread false memory syndrome" (though the existence of false memory syndrome, a belief that memories can be created through inappropriate therapy techniques, is itself debated). The book was described as vicious, and filled with factual errors about the FMSF and the nature of memory, though the anniversary edition is described as better, without the outrageous features of earlier publications and that in the new edition, the FMSF is not mentioned in the book's index. The book is still dedicated to recovering memories, and does not warn the reader of the doubts scientists have about its premises. The book still contains a section on satanic ritual abuse
Satanic ritual abuse
Satanic ritual abuse refers to the abuse of a person or animal in a ritual setting or manner...
, without noting the FBI
Federal Bureau of Investigation
The Federal Bureau of Investigation is an agency of the United States Department of Justice that serves as both a federal criminal investigative body and an internal intelligence agency . The FBI has investigative jurisdiction over violations of more than 200 categories of federal crime...
's report that concluded there was no evidence for the phenomenon.
The Third Edition of the book, published in 1994, offers a whole chapter titled "Honoring the Truth," in which the authors respond to the book’s critics. The FMSF criticized the chapter about their organization as filled with factual errors and written by a man who had no known credentials and no scientific publications
Scientific journal
In academic publishing, a scientific journal is a periodical publication intended to further the progress of science, usually by reporting new research. There are thousands of scientific journals in publication, and many more have been published at various points in the past...
in the relevant fields; the discussion of the FMSF was removed from the 20th anniversary edition.
See also
- AmnesiaAmnesiaAmnesia is a condition in which one's memory is lost. The causes of amnesia have traditionally been divided into categories. Memory appears to be stored in several parts of the limbic system of the brain, and any condition that interferes with the function of this system can cause amnesia...
- Dissociation
- The Freudian CoverupThe Freudian CoverupThe Freudian Cover-up is a theory first popularized by social worker Florence Rush in the 1970s which asserts that Sigmund Freud intentionally ignored evidence that his patients were victims of sexual abuse . The theory argues that in developing his theory of infant sexuality, he misinterpreted his...
- Memory inhibitionMemory inhibitionIn psychology, memory inhibition is the ability not to remember irrelevant information. Memory inhibition is a critical component of an effective memory system. For example, imagine if, when a person tried to remember where he had parked his car, every place he had ever parked his car came to mind;...