From an
href="http://www.washingtonpost.com/wp-dyn/content/article/2007/11/20/AR2007112001777.html">article
in the Washington Post:
Afterward, she stayed strong. She wasn't
going to make the classic victim's mistake of blaming herself for
provoking the attack.
Mo, writing at
href="http://scienceblogs.com/neurophilosophy/2007/11/mdma_for_ptsd.php">Neurophilosophy,
commented at length upon an article about the use of
href="http://en.wikipedia.org/wiki/Mdma">MDMA (
href="http://www.erowid.org/chemicals/mdma/mdma.shtml" rel="tag">Ecstasy)
in the treatment of
href="http://en.wikipedia.org/wiki/Posttraumatic_stress_disorder">PTSD.
The post, and the article, raise a great many issues, all
eminently bloggable. But there is one part (the one quoted
above) in the article that I want to address in particular.
The article starts with a case story, to add human interest.
It is a case of a woman who was raped, who went on to develop
posttraumatic stress disorder.
To make a long story short, she tries various treatments, none of them
works, until she finally enrolls in an experiment. She is
given MDMA and has some improvement.
But let's back up a bit. The author includes a comment, an
aside, really, about how the patient "wasn't going to make the classic
victim's mistake of blaming herself..."
My question is this: would it necessarily be a mistake for the victim
to blame herself?
Intuition might indicate that it is a
mistake. Blaming the victim, while common, is something that
most traditional Western humanists find offensive. But
psychology is a tricky thing, especially when trying to help persons
who have been traumatized. Every issue that arises must be
dealt with carefully. It can't be done by a cookbook
approach, because each case is unique.
Even so, there are some general principles. One is that it
often is helpful to examine the issue of blame. It is my
opinion that this should be done nonjudgmentally.
If, in the course of psychotherapy, a crime victim expresses self-blame,
it may be tempting to rush in an try to "correct" the "mistake."
However, I would recommend a slower, thoughtful approach.
First, it is helpful to keep in mind that there are three possible ways
to attribute blame: blame the victim, blame the perpetrator, and/or
blame society at large. It is possible for someone to blame
one, two, or all three.
This is the key point: the victim's initial attribution of blame serves
a purpose. When a person is traumatized, that
person often will try to make sense of what happened. The
explanatory narrative is an initial attempt at healing. While
such initial attempts can lead a person to becoming stuck, in general
it is not good practice to encourage the person to discard that defense
without first understanding the individual's purpose for selecting that
defense.
Remember that psychotherapy can hurt people. One of the ways
it can hurt people, is by tearing down a defense without putting
something as good (or, preferably, better) in its place.
My preference is to choose a good time -- timing is very important in
psychotherapy -- and say that there are three ways people can attribute
blame, clarify the possibilities, and encourage the person to evaluate
the pros and cons of each possibility. This is done in a
nonjudgmental, nondirective manner. The point is to help the
individual understand his or her own thoughts and feelings.
If a person assigns blame in a way that seems to impede the healing
process, it may be helpful to point that out.
In this process, it is important to maintain clarity between blame and
criminal culpability. In one's private thoughts, blame can be
ascribed in various ways for various purposes. But the
assignment of criminal responsibility is entirely different.
In summary, it is important to avoid the assumption that there is only
one right way for the victim to undergo a healing process.
Often, the choice of an initial defense serves a purpose.
Sometimes, that initial choice is made with a kind of wisdom.
The wisdom of that choice may be obscure at first.
If the therapist starts out with the assumption that the
victims initial choice is a mistake, it could lead to a setback in the
course of treatment.
Note: the concept used in this post was contained in a paper I read in
the late 1980's. The researchers set out to test the
hypothesis that self-blame led to a worse prognosis for victims of
sexual assault. They were not able to substantiate the
hypothesis.
I spend about a half hour on Medline trying to find that paper, but was
unable to do so. If anyone out there remembers that paper, I
would appreciate it if someone could post the reference in a comment
here.
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First, it sounds to me like the scope of your statements is jumping around between applicability to the individual abuse victim and to abuse victims as a whole. While it may be inconclusive across the group whether self-blame leads to a worse prognosis, I expect that it nevertheless does hold for many individuals. That the latter is not so seems impossible, given that many victims do not really start to recover until, years later, they stop blaming themselves.
Second, you say: "Often, the choice of an initial defense serves a purpose. Sometimes, that initial choice is made with a kind of wisdom. The wisdom of that choice may be obscure at first."
With all due respect, that is a total crock. "Wisdom" is not the appropriate term here. It is well known that people frequently make poor choices when faced with an emotionally charged situation.
I'll grant that self-blame does serve a purpose, but it is this: The victim has the ability to act on self-blame, whereas often they are unable to act on blame assigned to either the assailant or to the conditions that contributed to the assailant's behavior. It's an unconscious attempt to avoid feeling powerless that, while possibly useful in the short-term during which the assailant could be more dangerous if impugned, is counterproductive in the long-term. However, if someone is in therapy, then by definition they are in a position to accuse the assailant.
I would love to get my hands on a copy of this study. Were there no other studies that arrived at a similar conclusion? Over a twenty year interval? If not, that in itself is quite suspect.
What was it that Milton Ericksson said, when he was asked what his theory on psychotherapy amounted to? Something along the lines of "I develop a new theory for each client"? I think it's correct that self-blame may have some kind of value to the individual. However, when that value is no longer taken, then it is time to stop blaming, and do something else, instead.
Most victims, of course, never have the luxury of being able to question their abuser, such that they can understand the motivation for the victimization, and seek resolution. In the absence of that avenue of release, it is not surprising that a victim chooses to examine his/her own conduct, being the only thing that (s)he has any control over, going forward.
Of course, not knowing what it was that triggered the behaviour of the abuser, it is quite possible that a victim starts to shut down on a whole bunch of stuff, just on the offchance that this is what caused the abuse. That's an endless game, which victims should be discouraged from playing, I think.
Matt
"Classic Victim's Mistake" (?)
Sounds like a pretty good name for a band to me
I have trouble with this one. Firstly, I must admit I am really uncomfortable with the idea of letting a rape victim believe it was their fault for any amount of time. A family member was raped, so there's my bias.
That aside, it seems to me that blaming the victim, or a victm blaming oneself is indeed a defense mechanism. There is a lot humans don't have control over, and assigning "If I only..." or "If they only..." reasons for things that happens makes people feel they have control over the situation.
People want to feel like they can affect things beyond their control, and just like four leaf clovers, homeopathy, and the fad of the month, this is one more mechanism.
Off-topic: LED lighting for Buckingham Palace