Kavanaugh exposed: Sexual assault as masculine theater

And the answer to the oft-asked question, "If it was so bad, why didn't she report it?"

Calvin Klein ad glorifying group rape

He unzipped his pants, whipped out his penis and thrust it in her face. "Kiss it!" cried others in the dorm room, jeering and taunting. She pushed him away, inadvertently touching his dangling member. Word of the escapade spread rapidly through the university grapevine, humorous for some and unsettling for others. 

The mushrooming allegations against Supreme Court nominee Brett Kavanaugh share a common denominator: Each took place in full view of other men. These were not furtive attempts to gratify lust. They were (if true) proud demonstrations of male entitlement and power.

As I have written about previously, multiple-offender rape is a distinct type of sexual violence. It is a form of cultural theater, in which the victim serves as a dramatic prop through which men publicly demonstrate their heterosexual masculinity to each other.

In weighing reactions to the Kavanaugh allegations, it is instructive to contrast the two disparate scripts of so-called “gang rape” that I found in a study of media coverage of high-profile cases. When the actors are men of color, we see a Feral Beasts narrative that taps into a deep reservoir of racial fears to cast the offenders as amoral savages viciously ravishing innocent victims. In contrast, with high-status men such as Kavanaugh, a Good Guys script trivializes the event as merely a youthful and isolated indiscretion.

Group rape prelude, DC Comics

But group rape is no youthful mistake. It is functional behavior. It serves a purpose. Masculinity is a fragile identity that must be earned and then repeatedly proven. The public humiliation of females (and in some cases weaker or feminine men) is one dramatic method for publicly demonstrating hegemonic masculinity. Ritualistic conquest of the feminine “other” serves to visibly prove heterosexual masculinity and celebrate gendered power while simultaneously cementing male social bonds through mutual complicity in taboo acts. 

And what better object of display than the penis itself, the instrument of maleness brandished as a weapon to denigrate a drunken woman and establish her gendered powerlessness.

This misogynist performance art is not randomly distributed. As I discussed in my earliest analysis of this phenomenon – an in-depth exploration of an incident in which a group of high school athletes in Long Island, New York sexually assaulted younger male teammates – subcultures that germinate the seeds of group rape share a preoccupation with masculinity, or the extrusion of all things feminine.

Historically, masculinist social norms have thrived in all-male settings such as fraternities, military forces, street gangs, police departments, rock groups, and aggressive sports teams. So it is no coincidence that Judge Kavanaugh came of age in just such an all-male, misogynist milieu.

There were the lascivious Friday morning announcements, usually delivered by a senior:

Kavanaugh (far left) and teammates brag in yearbook about "Renate,"
an unwitting girl from a nearby Catholic girls' school

“After the [football] game, there will be a mixer. Girls from Holy Cross, Holy Child and Visitation ... will ... be ... available.” 

To facilitate this sexual availability, Georgetown boys were in the habit of getting girls “blind drunk” on a concoction of “jungle juice”; to them, girls were nothing but “meat,” one girl recalled. The sexual abuse of girls was so rampant that more than 1,000 alumnae of Holton-Arms, the girls’ school down the road, have signed a letter in support of former alumnae Christine Blasey (Ford), saying her account of Kavanaugh’s attempted rape is entirely consistent with the experiences they too had “heard and lived.”

Most recently, attorney Michael Avenatti (of Stormy Daniels fame) is claiming to possess “significant evidence” from a reputable source of multiple house parties in which Kavanaugh, his buddy Mark Judge, and others would ply vulnerable girls with alcohol in order to pull “trains,” or gang-rape them. Avenatti is not the most desirable source for a bombshell claim like this; he is "a relentless self-promoter" who is obviously thrusting himself into the center of the controversy for his own self-aggrandizement. However, Judge’s ex-girlfriend confirms that Judge told her he participated in at least one such train, lending some support for Avenatti's allegation.

UPDATE 9/26/18 0900:  Avenetti has just released a sworn declaration by his client, Julie Swetnick, claiming she was gang raped at a house party attended by Kavanaugh and his friend Mark Judge. She says she confided in at least two people at the time. (She subsequently told MSNBC that she reported the assault to police.) She also claimed she attended other house parties at which the two were among a group of males who may have drugged girls in order to take advantage of them. She says that Kavanaugh was a "mean drunk" who was verbally and physically abusive to girls, engaging in behaviors "designed to demean, humiliate and embarrass them."

An assortment of other people -- both male and female -- have come forward publicly to describe Kavanaugh as a heavy drinker in high school and college who became belligerent when intoxicated. A woman going by the pseudonym "Elizabeth" has described an incident in which an inebriated Kavanaugh became "obnoxious and crude" with her, to the merriment of his football buddies, causing her to flee a party and avoid him thereafter. Additionally, Kavanaugh got into at least one bar fight in which he allegedly threw his drink on a man; his friend was taken into police custody for hitting the man with a glass. 

The reporting penalty

Kavanaugh supporters – including the man who nominated him – have retorted by asking why neither Dr. Blasey nor Deborah Ramirez (the victim of the Yale University penis-dangling incident) reported these offenses when they happened. This is a common question. It comes up all the time at sexual assault trials in which I serve as an expert consultant.

But it is the wrong question.

The correct question is: Why in the world do any (albeit few) young women opt to report sexual assault, when the deck is stacked against them and reporting will most likely compound their suffering?

Overall, only about one out of every three or four sexual assaults is reported to police. The reporting rates are thought to be even lower – as low as 10 percent – for acquaintance rapes of teenage girls and young women. Coming forward is extraordinarily courageous. But from my vantage point in the trenches, I often find myself wondering whether it is perhaps foolhardy as well, stemming from a skewed calculus of the relative risks and benefits. Because at every step – from the police station to the courtroom and beyond – reporting has unintended negative effects on privacy, social and family relations, and even on one’s very sense of self.

As the victim who is brave (or foolhardy) enough to come forward quickly learns, being on the receiving end of gendered power means that you don't control the discourse.

The “lying bitches” unit

First, there is the police problem. Police departments are precisely the type of hypermasculine milieu in which misogynist attitudes have traditionally flourished, and walking into a police station can be like entering the lion’s den.

Multiple surveys reveal that police to this day remain highly suspicious of rape claimants, erroneously believing that large numbers – up to 80 percent – are lying. [After the Judiciary Committee hearing on Sept. 27, a police officer in Jonesboro, Arkansas took to social media to publicly proclaim Dr. Blasey a liar, citing the ludicrous 80 percent statistic.] As an extreme example of police hostility, a former detective in Philadelphia’s rape unit reportedly called it the “lying bitches unit.” Accordingly, he was in the habit of miscoding rape reports as noncriminal offenses, thereby preventing them from being counted, much less prosecuted. (Such data machinations have the added advantages of bolstering police crime-solving rates while artificially lowering a community’s overall crime rates.)

Police and prosecutorial recalcitrance remains a major barrier to successful prosecution. In one county in Pennsylvania, for instance, at least 85 people, include 44 teenagers, have reported rapes to police in the past three years, yet charges were filed in just two of those cases, resulting in only one conviction. In a new report, the U.S. Police Executive Research Forum warns that high rates of downgrading or “unfounding” of rape allegations is a red flag; journalists have exposed such systematic practices in several large U.S. cities, including St. Louis, New Orleans, Cleveland, Baltimore, and New York City.

Deer on wall of shed where Amber Wyatt was raped (police evidence photo)

I was involved in one such case recently, in which a rape allegation mysteriously vanished. The 16-year-old victim, "Jessica," had promptly reported a credible sexual assault by an older classmate. Despite collecting physical evidence – both from Jessica's body and from a used condom left at the scene – police did not even bother to question the perpetrator, dismissing the rape as a “he-said, she-said” situation. It wasn’t until the assailant went on to commit at least three further sexual assaults that he was finally brought to justice. Naturally, that happened in a different jurisdiction.

Reporter Elizabeth Bruenig spent three years investigating the appalling case of another 16-year-old girl, a cheerleader from her hometown who was viciously raped while intoxicated by two athletes at a high school party. Like 16-year-old Jessica, Amber Wyatt had also promptly reported the assault to police. Physical evidence, including vaginal and anal tearing and one of the boys' semen inside her, corroborated her account. Yet no one was ever prosecuted. Her hometown turned against her, and she became a pariah. 

Outside of the U.S., meanwhile, police in some locales put the onus on victims to prove that their histories are unblemished before a case may proceed. In London, police are demanding unfettered access to vast quantities of highly personal records such as health data, school records and social media accounts, data that are not routinely collected from suspects. 

This intense scrutiny hints at the greater peril a woman faces at the next, more adversarial stage. Even when police investigate diligently and prosecutors determine there is enough credible evidence to file charges, the courtroom remains inescapably dangerous for the rape victim, a site of potential revictimization and compounding of the initial trauma. 

The "real" rapist of the public imagination

In criminal trials, a claim of rape is measured against the popular stereotype of a “real rape.” Real rapists are strangers to their victims. They wield knives or guns. They use physical force, and inflict physical injury. In reality, the proportion of such rapes is small. An estimated 90 percent of assailants know their victims. Typically, there is no weapon (other than alcohol), and the victim does not suffer visible injuries. The rape may be an impulsive crime of opportunity. Or, a victim may be targeted because she is easy prey due to such vulnerabilities as intoxication, social or physical isolation, naivety, or a desire to fit in with the popular crowd.

Acquaintance rape is essentially a confidence trick. The rapist exploits the victim’s psyche to gain her trust. The victim is taken by surprise. Girls are trained from a young age to be polite and compliant. So when caught off guard, fighting back aggressively against someone they know (and trusted up until that very moment) does not come naturally. But any dearth of physical resistance will be deployed against them later, in court. 

In other words, with the benefit of 20/20 hindsight, the victim in the prototypical acquaintance rape has just about always done things “wrong.” Maybe she drank too much. Maybe she flirted. Most likely, she made a poor choice – such as trusting the wrong guy or getting in the wrong car – that put her in a vulnerable position. Perhaps she did not physically resist to the degree that many men – with their different gender socialization – believe that a "real" victim would. Maybe her character is flawed, as evidenced by her sexual history or her mental health.

It is especially unreasonable to expect a 15- or 16-year-old girl to have the instincts (which are born out of experience) to anticipate that something bad is going to happen, and the skills necessary to extricate herself in time to avoid the assault. Perhaps it is no coincidence that girls in this age range are at especially heightened risk for victimization.


The requirement of a perfect victim is a very high bar. Invariably, case-specific factors can be found to cast aspersions on the victim's reputation or decision-making, thereby diminishing her credibility and recasting the incident so that the suspect is recast as victim. Unless there are multiple victims (and sometimes not even then), it is very difficult for the prosecution to prevail. Often, in the cases I observe, the accused is acquitted, perhaps using the defense of an honest (mis)belief that he had consent.

He walks out of the courtroom smiling, his invincibility shield intact. For her, the nightmares continue.

Shame

It is not just the rest of the world who judges the victim and finds her lacking. The victim is her own worst critic, nagged by a profound sense of shame and self-blame. Why did she trust him? Why did she get drunk? Why didn’t she fight harder? Why? Why? Why?

In a candid account of her own sexual assault victimization and failure to report, Atlantic contributor Caitlin Flanagan writes about the intense self-loathing an attempted “date rape” unleashed in her:

“In my mind, it was not an example of male aggression used against a girl to extract sex from her. In my mind, it was an example of how undesirable I was. It was proof that I was not the kind of girl you took to parties, or the kind of girl you wanted to get to know. I was the kind of girl you took to a deserted parking lot and tried to make give you sex. Telling someone would not be revealing what he had done; it would be revealing how deserving I was of that kind of treatment.” 

Although under normal circumstances it is the powerful who get to shape the dominant narrative and dictate who is to be believed, the Kavanaugh debacle is encouraging silenced voices to speak up – and to be believed by many. Flanagan believes Dr. Blasey. And so do most other women, if we are being honest. We’ve all been there. We’ve all been assaulted or harassed or denigrated. We’ve been made to feel small. We’ve blamed ourselves for male transgressions. We’ve witnessed these same things happening to other girls and women.

This is why Dr. Blasey’s story resonates among women, and presents such a potent threat for Kavanaugh and his base of support.

False allegations

Among his defenders, in contrast, Kavanaugh’s unwavering denial of wrongdoing is posited as evidence of innocence. But denial is only natural for an accused. If it proved innocence, the prisons would be empty. Denial proves lack of acceptance of responsibility, and nothing more.

In truth, contrary to the beliefs of many police officers and others in the general public, it is quite rare for women to fabricate allegations of sexual assault. Research has consistently found that only a tiny fraction of rape reports – perhaps 5 or 6 percent – are false, and these generally follow predictable and detectable patterns.

Protesters at Kavanaugh's alma mater, Yale University

The allegations against Kavanaugh do not fit the profiles of false reports. Dr. Blasey and Ms. Ramirez did not engage in “regret sex” with Kavanaugh. They have no personal vendettas. They are not mentally unstable or criminal fraudsters. Both are respected, middle-aged, professional women who have come forward quite reluctantly, imperiling their valued privacy and the safety of their families. If they were lying, we would expect exaggerated claims made with greater certitude. We wouldn’t expect Dr. Blasey to take and pass a polygraph exam. Even the small details point to veracity: Mark Judge jumping onto the bed with Kavanaugh and Blasey; the manner in which Kavanaugh zipped his pants after exposing his penis to Ramirez; both women's admitted gaps in memory for some peripheral details. Real crimes are clumsy and messy and awkward, just like these.

Mercy

We are witnessing a wave of ignominious "himpathy" for Kavanaugh. Defenders of this powerful man lament that no man is safe, if a youthful indiscretion or two can come roaring back decades later and “destroy a good man’s career.” 

But let’s tease that apart a bit. First and foremost, the implication that all young men are rapists is horrendously defamatory of the male gender.

And while forgiving youthful transgressions sounds merciful, why is himpathetic compassion not equal opportunity? Why aren't these same individuals lobbying to end sex offender registries that impose lifelong societal exile on teenage boys and young men, often for one-off mistakes? Why aren’t they advocating on behalf of the forgotten boys (and girls) from disadvantaged backgrounds who languish in prison for decades (as chronicled by attorney Bryan Stevenson in his poignant Just Mercy)?

Kavanaugh snubs Fred Guttenberg,
father of a 14-year-old Parkland school shooting victim

Unlike some of his detractors, I am not especially worried about Kavanaugh coaching girls’ basketball. He may inadvertently communicate sexist attitudes. But, as I’ve explained here, his sexual assaults were not the product of sexual deviance. They were the efforts of a privileged male to prove his masculine dominance to his peers.

So the issue isn’t Kavanaugh's risk for sexual reoffense. It’s whether he is ethically and morally fit to serve on our nation’s highest court.

Kavanaugh has repeatedly called for "fairness" in the confirmation process. But is he himself someone who will exercise his authority fairly and on behalf of all citizens, including women? Is he someone who demonstrates fairness and empathy for those with less privilege?

We don’t have to look back into ancient history for clues to the answer. Judge Kavanaugh was a member of a three-judge panel that twice flouted U.S. Supreme Court recognition of the rights of Guantanamo detainees to seek federal court review of their detentions, suggesting he is no friend to the disenfranchised. And as he hides behind good deeds like volunteering at a soup kitchen, he callously turns his back and refuses to shake the proffered hand of a Parkland slaughter victim's father.

So, the question of fairness becomes, fairness to whom? Only to him, or to society writ large? If Kavanaugh is hurriedly ushered onto our nation's highest court, what message will that transmit – especially to today's youth on the cusp of adulthood – about fairness, and about the true status of girls and women in 21st-century America?

The Trauma Myth, Revisited

The Trauma Myth may be one of the most misunderstood books of the past decade. Based on its regrettable title, pedophiles erroneously believe it minimizes the harm of child sexual abuse; in the opposite corner, some misguided anti-abuse crusaders have demonized the Harvard-trained author as a pedophile apologist. As guest blogger Jon Brandt explains in this review -- first published in the Summer 2016 issue of The Forum, the newsletter of the Association for the Treatment of Sexual Abusers (ATSA) -- both fans and detractors of Susan Clancy have gotten the courageous researcher all wrong.

The Trauma Myth

by Susan Clancy

Book review by Jon Brandt, MSW, LICSW*

As a former child protection social worker, and now working with both victims and offenders, I was drawn to The Trauma Myth because of both the title, and subtitle: “The Truth About the Sexual Abuse of Children – and its aftermath.” When I first read Susan Clancy’s book, in 2010, nearly every page confirmed my professional experience with victims. I’m offering this review some six years after the book's publication because I believe most experienced professionals will agree that Clancy’s thesis is not just well-researched, but articulate and luminously persuasive.

Dr. Clancy is a Harvard-trained experimental psychologist. Her expertise is not in the field of sexual abuse; it is in the field of memory. This information is important in understanding how Clancy endeavored to interview adults who had been victims of childhood sexual abuse (CSA) – in part, to further understand the role of memory in how adults recalled traumatic experiences. Clancy acknowledges that her career had a rocky start – not only investigating adult memories of childhood sexual abuse, but to understand why some people seemed to believe in alien abductions. Clancy writes about the challenge of having to reconcile her research with two deep concerns: first, she had to abandon some of what she had been taught about the ‘trauma’ of sexual abuse, and second, she had to try to save her reputation and career.

After Clancy interviewed more than 200 Boston-area adult victims of CSA, she came to recognize that most victims’ memories were consistent with previous research – the vast majority of victims knew, liked, and/or trusted their abusers. And she confirmed another finding – that most CSA was tricked and manipulated, not the product of threats, force, pain, or injury. Even young children intuitively understand that when an older person inflicts pain, injury, or fear (elements of trauma), something is very wrong. But when sexual violations occur in the absence of violence and in the presence of trust, most victims reported being confused by the encounter, rather than traumatized. Less than one in ten adults that Clancy interviewed described being sexually abused as “traumatic.” Clancy considered that perhaps CSA is so traumatic that adults had repressed their memories, but that hypothesis ran counter to research that: (1) discredits repressed memories and (2) indicates that the more powerful life experiences are to an individual, the more the events are both strongly embedded and vividly recalled. Clancy goes on to articulately detail how children are indeed harmed by sexual abuse – in the aftermath.

Dr. Clancy has expressed some regret about the title of her book, but does not back-peddle from her findings – that CSA is not universally traumatic. She asserts that many professionals don’t really understand how, why, and when CSA is harmful, and imputing trauma when it’s not present might actually introduce secondary harm. Clancy expresses that children clearly do not have the developmental capabilities to understand interpersonal sex, that acceding to sexual touching is not the same as sexual consent, and that naïve cooperation is not complicity. In the absence of veritable trauma, the harm of CSA comes not from sexual touching, per se, but from relationship violations – a sense of betrayal, shame, and misplaced blame. Clancy explains that as a CSA victim begins to sexually and socially mature, and comes to understand what motivated their abuser, they feel duped and exploited. As victims try to reconcile how and why someone of trust would use them for sexual purposes, the ‘harm’ evolves. Clancy’s message is clear: if we don’t talk to kids about sex, we leave them vulnerable; if we don’t listen to kids who have been sexually abused, we re-victimize them; when we truly listen to child victims, we empower them to guide their own recovery – that helps to turn victims into survivors.

Dr. Clancy uses the controversies around her book to illustrate how difficult it is for professionals to navigate the nuances of CSA, and that it is incumbent on adults to protect children until they are mature enough to navigate the world of interpersonal sex. Clancy acknowledges that she was perhaps naïve in believing that rigorous science would protect the integrity of her research. What she was not prepared for was that CSA is virtually unspeakable – so abhorrent that, even among the educated, it was difficult to separate legitimate research from prevailing public opinion, or simply the politics of sex.

In 1998, psychologist, Bruce Rind and colleagues published an article on CSA in the American Psychological Association journal Psychological Bulletin. It was peer-reviewed, sound research, but so contrary to conventional beliefs of CSA that it resulted in an Act of Congress condemning his work. In 1981, Professor Alfred Kadushin (one of my graduate school advisors at the University of Wisconsin) published a book titled Child Abuse, an Interactional Event. He spent the rest of his career explaining that he was not blaming children for being abused.

The truth is, there has never been any time in history that sex could be separated from politics, or that science hasn’t waged an uphill battle against public opinion. The Socratic Method, or the applications of logic and scrutiny to understanding complex problems, is a predecessor of the Scientific Method, and one of the most important legacies of Socrates. It is ironic that Socrates could not survive the politics of his own time – he was condemned to death as a heretic. Nearly two millennia later, perhaps Galileo had taken note of the fate of Socrates. When Galileo found himself charged with heresy, to avoid being executed, he recanted his theory of the heliocentric solar system, and lived out his life under house arrest. It took another 350 years for the Catholic Church to acknowledge that Galileo had been right all along.

Susan Clancy wasn’t charged with heresy, at least not formally, but by her own admission, after a firestorm of controversy over The Trauma Myth, she fled the US to work in Nicaragua for several years. If Clancy was flattered by a favorable book review in the NY Times, she must have been horrified by a book review by NAMBLA [the North American Man/Boy Love Association]. Clancy’s book, and her story, are a testimony to professional courage in the face of deeply held, widespread, long-standing beliefs about the sexual abuse of children. Apparently, Clancy no longer writes or teaches about sexual abuse, based on a Google search, but she is still professionally active in research and education about the functions of memory.

There is so much right about The Trauma Myth that I am hesitant to be critical, but I think Clancy missed the mark on a few points. In my experience, some victims of CSA have the internal constitution to avoid both the trauma and the harm of sexual abuse. Other victims seem to have the resiliency and tenacity, with or without professional help, to truly earn the moniker of ‘survivor.’ Clancy views CSA as dichotomous – if there is a victim, there is an offender, who must be punished. If Clancy understood offending with the same verve, complexity, and nuances with which she understands victims, I think she would forgo the black and white, victim-offender paradigm in favor of the complex dynamics of offending, and the range of uniquely tailored interventions that serve victims, offenders, and their families. With a focus on the etiology and aftermath of CSA, it might not be obvious that Clancy was also advocating for both more prevention and better public policies.

The Trauma Myth is well researched, with endnotes in APA format. With just over 200 pages, and still professionally sound, it is easy reading. Most individuals are likely to approach the book with the same skepticism with which Clancy pursued her research. In the end, I think most professionals are likely to agree with many conclusions that Dr. Clancy found unassailable: that the popular, one-dimensional understanding of ‘trauma’ caused by child sexual abuse is largely a myth – a vestige of the 20th century.

*Jon Brandt is a clinical social worker who specializes in the evaluation, treatment and supervision to sexual offenders. His previous guest posts have reported on the link between pornography and contact sex offending and on an ongoing legal challenge to Minnesota's civil commitment of sex offenders. Many thanks to the editors of The Forum for granting me permission to post Mr. Brandt's review. The original review can be found HERE.

Efficacy of sex offender treatment still up in the air

Sex offender group treatment, Larned State Hospital, Kansas

"Did he complete treatment?"

That is a front-burner question for judges and jurors in sexually violent predator trials. Understandably, before they decide to release someone who has been convicted of sexually molesting a child, they want reassurance that he is sincerely remorseful and has acquired the tools to turn his life around. In short, they want a certificate of rehabilitation attesting to his low risk.

But does formal sex offender treatment really lower risk?

A systematic review found no scientifically rigorous studies that establish a link between treatment completion and a reduced risk of reoffending among men who have sexually abused children.

This isn't altogether fresh news. We knew from earlier research reviews that:

• Any effect of treatment was modest, at best
• Treatment works best for the tiny minority of very high-risk offenders, while possibly aggravating risk for the broad majority of men at lower risk of recidivism 
• Older offenders, due mainly to their very low risk, derive no tangible benefits from treatment

But considering both the prevalence and the harm of child sexual abuse, there is surprisingly little high-quality research on effective interventions. Partly, this is because of the lock-'em-up-and-throw-away-the-key mentality of policy makers. And partly it is because of the ethical difficulties in implementing random-design procedures, a hallmark of the scientific method, because men assigned to a control group would be denied treatment that could reduce their risk and in some cases shorten their prison terms.

Patient at "treatment program" in Minnesota

Scouring research databases, a six-member, international research team was able to locate only three well-designed experimental studies. These included one with adults, one with adolescents and one with children. In only the study with adolescents was treatment shown to reduce recidivism. That project used multisystemic therapy, a very promising approach that integrates the family and larger community in the treatment. 

Even broadening the search to include observational studies that lacked experimental designs, the research team found only five studies with a low enough risk of research bias to be deemed reliable. None of the five observational studies demonstrated that formal treatment -- primarily cognitive behavioral therapy with relapse prevention -- impacts sexual reoffending.

High-bias studies, in which the study design introduced a high probability of unreliable findings, were excluded. An example of such research bias would be a study in which treated and untreated offenders differed on a variable known to affect risk. When subjects are  not randomly assigned to treatment or control groups, any observed differences between groups may be due to factors outside of the treatment itself.

Treatment in most formal sex offender programs is cognitive behavioral, and relies primarily on manual-based group therapy. For example, group exercises challenge distorted thinking, denial and minimization.

The research team found no  minimally adequate studies whatsoever on the efficacy of pharmacological treatment with antiandrogen drugs, more popularly known as "chemical castration." They found this omission "particularly striking," in light of the prominence of this method in public debates. 

Can treatment cause harm?

Given "the overall unimpressive treatment effects" that were found, the researchers cautioned clinicians working with sex offenders to consider the potential negative effects of treatment:

"Journeymen" by Ricky Romain (reproduced with permission)

"Under certain circumstances, with some people and some interventions, treatment could increase the risk of sexual reoffending. For instance, prolonged or intense interventions for offenders at low risk of relapse, or grouping low risk offenders with those at high risk for reoffending, could result in adverse outcomes."

They especially cautioned against unnecessary treatment of children. With recidivism risk very low among untreated children, treatment may lead to "unjustified stigmatization and could negatively affect the child’s development…. If these children are subjected to excessively intense or inappropriate therapy, this could increase the risk for future antisocial behavior."

The team was headed up by prominent researcher and professor Niklas Långström and included Canadian researcher R. Karl Hanson, psychologist Pia Enebrink, forensic psychiatrist Eva-Marie Laurén and researchers Jonas Lindblom and Sophie Werkö. The research was commissioned and partially funded by the Swedish government.

The Convention on the Protection of Children against Sexual Exploitation and Sexual Abuse, ratified by 27 countries so far, mandates effective treatment to sexual abusers of children, individuals at higher risk of committing such offences, and children with sexual behavior problems.

This mandate is a bit of a problem, given the inconclusive evidence that the dominant treatment approach works.

Manualized, one-size-fits-all approach

My own belief is that the one-size-fits-all approach of manualized group therapy, driven in part by a shortage of highly qualified and talented clinicians in bureaucratic institutions, can never meet the needs of a heterogeneous population of offenders. Indeed, in the hands of poorly trained technicians, much of what passes for "treatment" is actually punishment in disguise. As anthropology professor Dany Lacombe noted in her insightful ethnographic study,  sex offender treatment can paradoxically cement deviance through its obsessional fixation on sex. As an 18-year-old patient told Lacombe:

"They want to hear that I always have fantasies and that I have more bad ones than good ones. But I don't have bad ones that often. I make up the bad ones. I make them really bad because they won’t leave me alone." 

"Contained" by Ricky Romain (with artist permission)

Genuine treatment, as we all should remember from our graduate school training, is all about the empathic relationship -- not the technique. Indeed, although more and more psychologists have internalized the insurance industry's mantra that cognitive-behavioral therapy (CBT) is the "evidence-based" treatment of choice for a variety of conditions, this is not actually true. For example, in a new randomized clinical trial published in the American Journal of Psychiatry, psychodynamic therapy performed just as well in the treatment of depression.

The research team cautioned that their failure to find significant effects of treatment should not be interpreted to mean that treatment as currently implemented is ineffective. The low base rates of recidivism among sex offenders make it difficult to find treatment effects without very large sample sizes and long follow-up periods, they point out.

Additionally, an early study out of California provided some evidence that it was not the formal completion of treatment per se that reduced risk but, rather, the internalization of treatment messages and a desire to change -- something that is harder to measure. 

The research team issued a call for large-scale, multinational randomized controlled trials. In the meantime, in the absence of solid proof that manualized cognitive-behavioral group therapy works as intended, they recommend a shift to more individualized assessment and treatment.

That's a solid, and very welcome, recommendation.

The study is: "Preventing sexual abusers of children from reoffending: Systematic review of medical and psychological interventions" by Niklas Långström, Pia Enebrink, Eva-Marie Laurén, Jonas Lindblom, Sophie Werkö and R Karl Hanson. It is freely available online from the British Medical Journal (HERE). 

Subscribers: View the conversation and add your comment by scrolling to the bottom of the original blog post (HERE). 

8-year prison term in long-running Ayres saga

The up-and-down case of a child psychiatrist who sexually molested boys sent to him by the courts for counseling has finally concluded -- at least for now. William Ayres, 81, pleaded no contest to molesting five boys and was sentenced this week to eight years in prison.

The case has been slogging through the courts for as long as this blog has been around, in large part due to disputes over Ayres's competency. Ayres is suspected of molesting dozens of boys over a period of several decades, but many cases were beyond the statute of limitations.

The case had all of the elements of high drama: A once-respected child psychiatrist accused of molesting vulnerable boys sent to him by the courts. Allegations that prosecutors turned a blind eye. Pressure from victim's rights lobbyists. And, of special interest to this blog's readers, a bevy of mental health experts presenting contradictory evidence.

After a jury trial on the issue of competency ended in a deadlock in 2011, both sides stipulated that Ayres was incompetent due to dementia. He spent about nine months at Napa State Hospital -- where defendants in Northern California are sent for competency restoration treatment -- before the hospital decided that he was faking dementia in an elaborate ruse to avoid trial. He was finally found competent to stand trial after a four-day court hearing late last year.

At his sentencing hearing, victims -- now adults, some with children of their own -- spoke of the traumatic effects of being victimized by someone in a position of trust. As evidence that the former head of the American Academy of Child and Adolescent Psychiatry knew the damage he was inflicting, one former victim even read an excerpt from a journal article Ayres co-authored entitled "Practice Parameters for the Forensic Evaluation of Children and Adolescents Who May Have Been Physically or Sexually Abused."

Victims and their family members burst into applause when Ayres was sentenced, hugging and rejoicing over their victory in a lengthy and uphill struggle for justice, according to a news report in the San Mateo County Times.

But the fight may not be quite over yet: Ayres' attorney warned in court that the wheelchair-bound octogenarian may seek to withdraw his no contest pleas.

My prior blog posts on this case include: 

• Ayres case: Final act in long-running competency drama? Notorious psychiatrist found fit for trial on molestation charges (Nov. 24, 2012)
• Psychiatrist accused of faking dementia to thwart retrial (Aug. 5, 2012)
• Professionals behaving badly: Mistrial in psychiatrist molestation case (July 27, 2009)
• Lesson to abusers: Target socially disempowered (April 23, 2007)

Military sexual assault scandal unearths "illegal" psychiatric diagnoses

If you haven't been following the sexual assault scandals in the U.S. military, tune in: It’s yet another arena where bogus psychiatric diagnoses are playing a sordid role.

Women soldiers who report sexual assault are diagnosed with psychiatric conditions such as borderline personality disorder or bipolar disorder that get them drummed out. Not only are their careers ruined, but they are denied benefits and sometimes must even repay any bonuses they got for enlisting.

Because the symptoms of these "preexisting" disorders overlap with the emotional sequelae of trauma -- anger, fear, depression, anxiety, avoidance -- it can be hard to tell the difference.

Women in every branch of the U.S. military are being disproportionately discharged with personality disorders, according to an investigative series, Twice Betrayed, in the San Antonio (Texas) Express-News. The Air Force has the widest disparity: Women make up 20 percent of the force, but 35 percent of personality discharges.

Sometimes, as in one case featured in the Express-News series, military psychologists and psychiatrists are being influenced by officers in the accused's or accuser's chain of command to view accusers as mentally unstable and/or sexually promiscuous.

In a report on "illegal" psychiatric diagnoses, the Vietnam Veterans of America say that in addition to rape victims, many combat soldiers with organic brain trauma or posttraumatic stress disorder continue to be drummed out of the military with bogus personality disorders and adjustment disorders that block their disability benefits, despite Congressional efforts to crack down on this abuse (for example, by requiring that the diagnoses be issued by psychiatrists or PhD-level psychologists).

It was a bit incongruous to find myself sitting in an Air Force courtroom, consulting on a sexual assault case, when the news broke that the chief of the Air Force's Sexual Assault Prevention and Response program had been arrested for sexually assaulting a female stranger in a parking lot.Talk about the fox guarding the hen coop.

That bizarre twist came on the heels of a headline-grabbing survey documenting skyrocketing rates of sexual assault in the military: An estimated 26,000 soldiers were sexually assaulted in 2012, up from 19,000 the year before. Women in the military face about twice the risk of sexual assault as civilian women (one in three versus about one in six). And only a tiny fraction of assaults -- 3,374 last year-- are reported.

That's likely due to the fact that women who do report rape are shunned, disbelieved, and retaliated against, and their assailants are rarely punished. The seven-month investigation by Karisa King of the San Antonio Express-News found that only about 10 percent (302 of 2,900) of the accused were court martialed, with only 177 sentenced to confinement. (The airman in my case was one of those rare few, but then again he was a low-level airman, not an officer. And it probably didn't help his case that all of these scandals were busting out that very week.)

It’s no coincidence that the San Antonio paper ran the series: Outside that city sits the sprawling Lackland base, the Air Force's basic training center for enlisted personnel. In an unfolding investigation there, at least 33 training instructors are suspected of sexually assaulting 63 or more trainees.

If this latest scandal isn't enough to convince people of the link between sexual violence and a climate of hostile masculinity (as researchers such as Neil Malamuth have been arguing for decades), I don't know what is. On the other hand, if psychologists in the sex offender treatment industry got their hands on these training officers, they'd probably label them with some fictional disorder like "paraphilia not otherwise specified (nonconsent)" that decontextualized their behaviors beyond recognition. 

Consulting in a military court martial one week and a sexually violent predator civil commitment hearing the next, I can't help but notice how mental illness strikes in clusters, afflicting sexual assault victims in one setting and offenders in the other. The clue that situational exigency is in play is that in neither case is the diagnosis about helping the supposed sufferer. It's all about punishment, with diagnosis as the weapon.

I highly recommend the series, Twice Betrayed. An in-depth report by the The Vietnam Veterans of America on the misuse of psychiatric diagnoses in the military, Casting Troops Aside, is HERE.

Special offer on groundbreaking group rape text

The Handbook on the Study of Multiple Perpetrator Rape: A multidisciplinary response to an international problem

Photo credit: Sajjad Hussain

Two current events, on opposite sides of the globe, signal encouraging changes -- dare I say even a tipping point -- in public attitudes toward sexual violence:

1. The giant waves of protest sweeping India in response to the vicious gang rape of a young woman (who died from her injuries) on a public bus in New Delhi. Protesters, spurred on by social media, are demanding that authorities address gender violence in a country in which police and prosecutors have often turned a blind eye to rampant violence against women, including rape, sexual harassment, dowry murders and honor attacks. As Shalini Nataraj of the Global Fund for Women notes in an op-ed in the San Francisco Chronicle,  what is remarkable is that "people of all backgrounds are coming out into the streets, they are bringing their young children, they are demanding accountability from their government for this culture of violence that goes unpunished. People in India today are talking about rape."

2. The uproar over a sexual assault by members of the high school football team in Steubenville, Ohio against an unconscious girl, and alleged attempts by local authorities to cover it up. After a tenacious crime blogger posted deleted tweets and was (unsuccessfully) sued by a young athlete, the New York Times published an excellent, in-depth piece. Now, in an unprecedented development, the underground hacker group Anonymous has entered the fray, digging up and publishing incriminating tweets and videos (including the disturbing one below, featuring an athlete who has not been arrested) and demanding more aggressive prosecution.

These are precisely the types of cases that I analyzed for an upcoming chapter in the first-ever book on multiple-perpetrator rape, due out next month. My analysis focuses on the subtexts pertaining to masculinity, social status and race that are embedded in media coverage of high-profile cases. But although some of the two dozen cases that I analyzed generated widespread public outrage, it typically focused narrowly on the perpetrators and, at times, their immediate communities. The current international uproar is qualitatively different, in that people are connecting the dots between patriarchal power and sexual victimization.

Given this current level of public interest, next month's publication date for The Handbook on the Study of Multiple Perpetrator Rape is timely. I just finished reviewing the galley proofs and found the book to be a highly informative compilation, written from an international and multi-disciplinary perspective.

From the publisher's promotional blurb:

"The contributions to this collection are written by leading academics and practitioners from a variety of disciplines who bring together research and practice on multiple perpetrator rape by presenting new data from a strong theoretical and contextual base. This book will be a key text for students and academics studying multiple perpetrator rape and an essential reference tool for professionals working in the field, including police officers, educationalists, forensic psychologists, youth workers, probation staff, lawyers, judges and policy makers."

Ad glorifying group rape; my web page with more examples is HERE.

Co-editors Miranda A. H. Horvath and Jessica Woodhams are phenomenal researchers who head an international consortium (of which I am proud to be a part) that focuses on the understudied problem of group rape. Horvath, who has published extensively on sexual violence and violence against women, is the David Jenkins Chair in Forensic and Legal Medicine at Middlesex University, where she is also deputy director of Forensic Psychological Services. Woodhams is a forensic psychologist who teaches forensic psychology at the University of Birmingham, UK and has also published extensively on sex offending.

Chapters include:

• Multiple perpetrator rape as an international phenomenon by Teresa Da Silva, Leigh Harkins and Jessica Woodhams
• Masculinity, status, and power: implicit messages in Western media discourse on high-profile multiple perpetrator rape cases by Karen Franklin
• Variations in multiple perpetrator rape characteristics relative to group size: Comparing duo and larger group MPR offences by Mackenzie Lambine
• Group sexual offending: comparing adolescent female with adolescent male offenders by Jan Hendriks, Miriam Wijkman and Catrien Bijleveld
• Busting the ‘gang-rape’ myth: girls’ victimisation and agency in gang-associated rape and peer-on-peer exploitation by Carlene Firmin
• Streamlining: understanding gang rape in South Africa by Rachel Jewkes and Yandisa Sikweyiya
• Multiple perpetrator rape during war by Elisabeth J. Wood
• Leadership and role-taking in multiple perpetrator rape by Louise Porter
• Offender aggression and violence in multiple perpetrator rape by Jessica Woodhams
• Multiple perpetrator rape victimization: how it differs and why it matters by Sarah Ullman
• Multiple perpetrator rape in the courtroom by Miranda A. H. Horvath and Jacqueline M. Gray
• Issues concerning treatment of adolescent multiple perpetrator rape offenders by Talia Etgar
• Girls and gangs: preventing multiple perpetrator rape by James Densley, Allen Davis and Nick Mason

This is the fourth volume in the book series Issues in Forensic Psychology, edited by Richard Shuker of the therapeutic prison community HMP Grendon in the UK. The series aims to provide analysis and debate on current issues of relevance to forensic psychology and associated fields. Routledge anticipates issuing the paperback in 2014.

To take advantage of a 20 percent pre-publication discount (until February 28), visit the book's web page and use the discount code CRIMHPR12 when placing your order. The same url can also be used to recommend the book to your institution's librarian.

Groundbreaking research: One out of every 10 rape convictions wrong?

As a young man, Michael Jones pleaded guilty to back-to-back attempted molestations of two girl strangers. However, he adamantly maintained his innocence while in prison and on parole. He said his lawyer had coerced him into pleading guilty by threatening him with life in prison if he went to trial. Michael was one of a handful of Black people in a rural white community; both of the little girls were white. He was identified when police brought him to the station and showed him to the girls. There was no lineup procedure with foils; he was the only choice the girls were given. On the basis of his two convictions, government evaluators diagnosed Michael with pedophilia and recommended civil commitment.

As a teenager, Paul Smith tried to molest a younger boy. He was arrested at the scene and confessed. He disputed only one point in the victim’s statement: that he had threatened the younger boy with a gun. Police searched his home and found no gun. Pre-conviction polygraph testing indicated he was being truthful when he denied having a gun. Over the ensuing years, however, clinicians in sex offender treatment programs hammered at him to admit that he had used a gun. Government evaluators said Paul’s “denial” and “minimization” of his gun use influenced their recommendation for civil commitment.

In cases such as these, I am consistently struck by the naïveté of clinicians and forensic evaluators alike, who accept police reports and especially victim accounts as the gospel truth. From my former career as a criminal investigator, I can attest to the fact that even impartial observers with no conscious motivation to distort are never 100 percent accurate in describing events they have witnessed. As Daniel Schachter so clearly articulates in Seven Sins of Memory, distortion is the nature of the human animal. It is even more likely to occur in situations involving high levels of stress, fear and emotionality.

So I was happy to see that the issue of false convictions for sex offenses is getting some much-needed and long-overdue attention. Or, let me qualify that: Happy about the empirical research, but less than thrilled with a theoretical article on the psychological dynamics underlying false accusations. Let me take those up one at a time.

Dredging old cases for DNA matches

The most methodologically rigorous study to date, released in June, suggests that somewhere between 8 and 18 percent of men convicted of sexual assault may be innocent. The federally funded research project randomly sampled convictions in Virginia between 1973 and 1987, before DNA testing was widely available, and compared preserved physical evidence with the DNA profiles of convicted men.

After poring through more than half a million cases, researchers found 422 sexual assault cases in which DNA evidence was preserved. In 8 percent (33) of those cases, the DNA evidence was exculpatory and supported exoneration. Because many of the DNA comparisons were inconclusive, this amounted to 18 percent of the cases in which it was possible to make a definitive determination one way or the other based on DNA analysis. (The data and the analyses are complex and not without flaws, so I recommend reading the study itself before relying on these numbers.) Noted the researchers:

"Even our most conservative estimate suggests that 8 percent (or more) of sexual assault convictions in a 15-year period may have been wrongful. That means hundreds, if not more than a thousand, convicted offenders may have been wrongfully convicted. That also means hundreds (if not more) victims have not received the just result, as previously believed. Therefore, whether the true rate of potential wrongful conviction is 8 percent or 15 percent in sexual assaults in Virginia between 1973 and 1987 is not as important as the finding that these results require a strong and coordinated policy response."

Bennett Barbour. Photo credit: 

Joe Mahoney, Times-Dispatch

Unfortunately, the researchers ran out of money before they could do more exhaustive analyses of the cases in which innocence was suggested. In the project’s wake, the government is battling with false confession activists who want access to the data, reports the Richmond (Virginia) Times-Dispatch. Police and prosecutors want to restrict access; exoneration activists argue that people have a right to know when their DNA does not match that collected in the crime for which they were convicted.

The project has led to the exoneration of at least four men. Putting a face to them is Bennett S. Barbour, who served a prison sentence for a 1978 rape. He had moved and did not receive the 2010 letter notifying him that the DNA specimen cleared him and matched a convicted rapist instead. A volunteer lawyer finally tracked him down and broke the good news by phone 18 months later.

Research into wrongful convictions has pinpointed several leading causes. These include:

Top sources of wrongful convictions. The Innocence Project

• False witness testimony (including mistaken identification and lying codefendants) 
• Faulty forensic evidence (especially comparisons of hair and bite marks) 
• False confessions 
• Police being influenced by prior knowledge of a suspect 
• Brief jury deliberations 

These problems are compounded by racial bias both in the criminal justice system and in society more broadly. African American men make up far more than their share of those who were convicted and later exonerated based on DNA evidence.

False accusations: A role for psychology?

Flat-out false accusations of rape -- like that depicted in To Kill A Mockingbird -- are rarely the cause of exonerations. But they do occur. Now, a prominent forensic psychology professor and his student propose 11 pathways to false allegations, and suggest that psychology could play a role in helping to sort reliable from unreliable reports. Write Jessica Engle and William O'Donohue in the Journal of Forensic Psychology Practice:

"[W]e suggest that some psychological disorders may increase the likelihood of believing a sexual assault occurred when it did not. Additionally, some psychological disorders may be related to an increase in motivation to fabricate an allegation of sexual assault in an effort to achieve what may be believed are the positive consequences of a false report…. [P]sychological evaluations may inform forensic evaluators of psychological processes by which a person may either intentionally or unintentionally file a false allegation of sexual assault."

The motivational and information processing pathways they propose lean heavily on psychiatric disorders -- including antisocial personality disorder, borderline personality disorder, histrionic personality disorder, psychotic disorders and intellectual disability -- as causes of false allegations. For example, here’s how they suggest that a histrionic personality style could lead to a false allegation:

"[A] person who is histrionic may, after a co-worker complements her clothing and accidentally bumps into her during the day, construe these actions as intentional communications of sexual interest. This misperception can lead her to feel that if the individual had touched her chest while bumping into her, it was an intentional action of unwanted assault. Thus, a pathway to false allegations of sexual assault may be through individuals with a diagnosis of histrionic personality disorder who for reasons of attention and misinterpretation may knowingly or unknowingly make a false allegation of sexual assault."

Okay, I’m not saying that people don’t lie, or make mistakes. Other research suggests that anywhere from 2 to 10 percent of all sexual assault reports may be false. But some of the examples provided in this article stretch credulity, and reek of sexism. I don’t know too many women, histrionic or not, who don't know the difference between an innocent compliment and a sexual assault.

A classification system based largely on pathologizing women runs the risk of reifying the mythology of so-called “rape myths,” in which only “good,” virtuous women can be raped. It seems especially problematic to disbelieve women with psychiatric problems when -- as the authors acknowledge -- they are the ones most likely to be sexually victimized.

More broadly, it is improper for clinicians to wade into the waters of truth-telling or lie detection. We weren’t there, and we don’t know what happened. It's problematic enough when we use character traits to predict the future. Stating that people (read: women) with this or that disorder are more likely to be lying or distorting reality opens the door for yet more improper use of psychiatric diagnosis in court.

Rather, as suggested by the Virginia data, we need to be skeptical at all times, and to keep our minds open to competing hypotheses based not on psychiatric stereotyping, but on the individual case facts. Maybe an assault happened, maybe it didn’t. Maybe the witnesses have their facts straight, maybe they don’t. Maybe the person who was convicted is the real culprit, and maybe he isn’t.

It’s clear that false convictions and false allegations are two separate beasts. And if that’s not complicated enough, there are true cases that are falsely recanted! For example, in a recent Welsh case, “Sarah” was repeatedly raped and forced into prostitution by her husband. When she recanted her report, she was convicted for perverting justice.

So, did Michael Jones (top of post) try to molest the two little girls? Maybe. Maybe not. The point is that we will never know for sure, and we should embrace -- rather than avoid -- that uncertainty. Present the competing scenarios, and analyze the case both ways, so that the trier of fact has all of the information.

The complexities in understanding sexual assault patterns are mind-boggling, and can make your head spin. False convictions, false accusations, false retractions. And then there's the other end of the spectrum: A vast proportion of sexual assaults – probably somewhere between 85 and 95 percent – are still going unreported altogether. And when victims do come forward, prosecution is rare, and convictions even rarer.

It's one gigantic mess, all around.

The U.S. Department of justice Study is: Post-Conviction DNA Testing and Wrongful Conviction by John Roman, Kelly Walsh, Pamela Lachman and Jennifer Yahner.