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Secret survivors: Uncovering incest and its aftereffects in women
566
Book reviews
Children of Chemically Dependent Parents: Multiperspectives
thy M. Rivinus. BrunnerfMazel,
From the Cutting Edge. Edited by Timo-
New York, 199 1. 364 pp. $40.95.
The editor, Timothy M. Rivinus, M.D., writes that the objectives of this book are to critically review information learned by clinicians and researchers concerning children of substance-abusing parents (COSAPs), focus attention on issues related to the plight ofthe younger children of addicted parents, and to integrate the basic signs, clinical and research findings with public policy and public health prevention efforts. This book, which generally reads as a textbook, is divided into four parts covering academic. diagnostic, treatment, and public-policy issues. An excellent review concerning the biological aspects of children of alcoholic parents and a historical and contemporary overview of research on children of chemically dependent parents are found in early chapters. A very interesting chapter focuses on resiliency factors in young children of substance-abusing parents. Clinicians will find a very useful summary of the development of the social movement involving children of alcoholics (COA), which includes adult children of alcoholics (ACA or ACOA), and a discussion ofthe reasons traditional psychological theories had previously made recognition of ACOAs difficult. This discussion highlights the reasons that psychoanalysis and developmental psychology historically neglected children of chemically dependent parents. The biopsychosociat aspects of deniaf contributing to this problem and the factors leading to a greater understanding of the traumatic effects of growing up in substance-abusing families are reviewed. The first half of this book ends with chapters reviewing the diagnostic criteria for codependency with an expanded section describing the interface between narcissism and codependence and a proposal concerning a new diagnostic category-chronic trauma disorder of childhood. The second half of the book addresses issues related to treatment and public policy. One chapter describes the usefulness of a short-term psychoeducational group for ACOAs, which often facilitates a more productive engagement with the recovery process. A chapter summarizes the findings of a longterm study of a treatment program for substance-abusing adolescent girls and their families. Another chapter provides a five-stage treatment model conceptualization for ACOAs with a very good summary of treatment issues that need to be addressed. These discussions are supplemented by a chapter that emphasizes the impact of famity addiction on young children and summarizes pertinent treatment issues. The treatment section concludes with a description of a study and discussion which address the issue of COSAPs who themselves work as substance abuse counselors, The three chapters addressing public policy issues identify developments in the field ofaddiction medicine, issues for future service and research for COSAPs and the epidemic proportions of COSAP issues. The editor is generally able to accomplish his objectives for writing this book. This book is particularly useful for providing clinicians with a very useful overview of working with children of chemically dependent parents and better unde~~ndi~~g of the self-help movement. The strengths of this book include the clear writing, cohesive organization of chapters, and clinical relevance. This book is a very useful addition to the field of substance abuse treatment. JEFFREY L. METZNER,M.D.
The Kemp ~rffti~~nulCefzter,for the Prfventim und Treatment qf Child Abuse und Neglect University qf CO Health Scitwcrs Center 1205 Oneida Denvm CO 80220, UX4 Secret Survivors: Uncovering Incest and its Aftereffects in Women. E. Sue Blume. John Wiley & Sons,
New York, 1990. 320 pp. $19.95. Secret Survivors is a thought-provoking contribution to sexual abuse literature. Written for women who have experienced incest, it is delightfully free of psychological jargon. After a review of theory and research on effects of incest, Blume illustmtes with incest survivors’ own words, demonstrating themes of
Book reviews
56-l
powerlessness, violation, secrets, and the psychological defenses utilized. She includes practical suggestions for dealing with aftereffects as well as resources for the adult survivor. One of this book’s assets is Blume’s redefinition of incest as sexual acts by any person in authority whom the child feels she cannot refuse. These sexual acts need not involve touching, but can be exposure to sexual words, sounds or acts, or placing the child in an adult role to satisfy the adult’s emotional needs. Blume argues that damage is more from the violation of trust experienced by the child than from the severity of the act. It is refreshing to see a definition of incest based on the internal experience of the victim and not merely on law or theory. This is but one example of Blume’s survivor advocate position. Another contribution of Secret Survivors is Blume’s focus on the “secret.” The child’s trust often ensures that she will not fight back or tell others. The child protects the secret, usually blaming herself for “cooperating,” and often repressing the entire experience. As adults, these women experience a variety of seemingly unrelated psychological symptoms that Blume argues are clusters of aftereffects. Blume thoughtfully discusses this hidden population’s impact on psychotherapy and research and presents the Incest Survivors’ After-effects Checklist, which is potentially both clinically and empirically useful. Blume critically reviews psychiatric diagnoses assigned to women who display the aftereffects of incest. These diagnoses reflect the traditional perspective of the aftereffects as disorders, which perpetuates viewing these women as weak and ignores their strength in surviving. Blume prefers the concept of “Post-Incest Syndrome,” which combines aspects of both trauma theory and bereavement theory with the specifics of sexual abuse. Secret Survivors is helpful for survivors and is an eye-opening guide for clinicians. Blume estimates that half the women who seek therapy have survived incest, whether they consciously remember it or not. If her estimate is correct, psychotherapists need to be aware of the aftereffects that manifest in their clients’ behavior. Secret Survivors is an invaluable contribution to the growing movement among helping professionals to hear the voice of the survivor. DEBRA K. PETERS
University ofsouthern Mississippi Department of Psychology S.S. Box 5025 Hattiesburg, MS 39406-5025, USA
on Children’s Testimony. Edited by S. J. Ceci, D. F. Ross, and M. P. Toglia. SpringerVerlag, New York, 1989. 259 pp. Aus $68.00.
Perspectives
This is not, in the main, a book about children’s actual abilities as eyewitnesses. That was the concern of the earlier volume compiled by the same editors: Children’s Eyewitness Memory (Springer-Verlag, New York, 1987). Instead, the first 6 of the 11 chapters in this book are reports of research on adults’ perceptions of children’s abilities and credibility as eyewitnesses. These include a study of the perceptions of “mock jurors” asked to evaluate children’s videotaped reports of a recent stressful experience (chapter by Goodman et al.), a study of the interaction between speech style and ascribed eyewitness age where a verdict has to be reached on the basis of transcribed evidence (chapter by Nigro et al.), and a study of the beliefs and impressions of practicing criminal attorneys based on their experience of child witnesses testifying in court (chapter by Leippe et al.). With the exception ofthe chapter by Leippe et al., which shows how prosecuting and defense attorneys may place different emphases on the abilities of the child witness as a matter of tactics, these studies would be of limited interest taken in isolation. One reason for this is that the conclusions of any one of these studies seem highly dependent on the methods used in that study. The usefulness of this section of the book becomes apparent however when the studies are compared. It then becomes clear that the child witness’s perceived credibility depends on a complex interaction between factors such as the type of case in question and the fluency, confidence, and possible motivations of the child. As Dunning notes in Chapter 11 of the book, following the evidence from Leippe et al., practicing criminal attorneys apparently use their awareness of these factors
Book reviews
Children of Chemically Dependent Parents: Multiperspectives
thy M. Rivinus. BrunnerfMazel,
From the Cutting Edge. Edited by Timo-
New York, 199 1. 364 pp. $40.95.
The editor, Timothy M. Rivinus, M.D., writes that the objectives of this book are to critically review information learned by clinicians and researchers concerning children of substance-abusing parents (COSAPs), focus attention on issues related to the plight ofthe younger children of addicted parents, and to integrate the basic signs, clinical and research findings with public policy and public health prevention efforts. This book, which generally reads as a textbook, is divided into four parts covering academic. diagnostic, treatment, and public-policy issues. An excellent review concerning the biological aspects of children of alcoholic parents and a historical and contemporary overview of research on children of chemically dependent parents are found in early chapters. A very interesting chapter focuses on resiliency factors in young children of substance-abusing parents. Clinicians will find a very useful summary of the development of the social movement involving children of alcoholics (COA), which includes adult children of alcoholics (ACA or ACOA), and a discussion ofthe reasons traditional psychological theories had previously made recognition of ACOAs difficult. This discussion highlights the reasons that psychoanalysis and developmental psychology historically neglected children of chemically dependent parents. The biopsychosociat aspects of deniaf contributing to this problem and the factors leading to a greater understanding of the traumatic effects of growing up in substance-abusing families are reviewed. The first half of this book ends with chapters reviewing the diagnostic criteria for codependency with an expanded section describing the interface between narcissism and codependence and a proposal concerning a new diagnostic category-chronic trauma disorder of childhood. The second half of the book addresses issues related to treatment and public policy. One chapter describes the usefulness of a short-term psychoeducational group for ACOAs, which often facilitates a more productive engagement with the recovery process. A chapter summarizes the findings of a longterm study of a treatment program for substance-abusing adolescent girls and their families. Another chapter provides a five-stage treatment model conceptualization for ACOAs with a very good summary of treatment issues that need to be addressed. These discussions are supplemented by a chapter that emphasizes the impact of famity addiction on young children and summarizes pertinent treatment issues. The treatment section concludes with a description of a study and discussion which address the issue of COSAPs who themselves work as substance abuse counselors, The three chapters addressing public policy issues identify developments in the field ofaddiction medicine, issues for future service and research for COSAPs and the epidemic proportions of COSAP issues. The editor is generally able to accomplish his objectives for writing this book. This book is particularly useful for providing clinicians with a very useful overview of working with children of chemically dependent parents and better unde~~ndi~~g of the self-help movement. The strengths of this book include the clear writing, cohesive organization of chapters, and clinical relevance. This book is a very useful addition to the field of substance abuse treatment. JEFFREY L. METZNER,M.D.
The Kemp ~rffti~~nulCefzter,for the Prfventim und Treatment qf Child Abuse und Neglect University qf CO Health Scitwcrs Center 1205 Oneida Denvm CO 80220, UX4 Secret Survivors: Uncovering Incest and its Aftereffects in Women. E. Sue Blume. John Wiley & Sons,
New York, 1990. 320 pp. $19.95. Secret Survivors is a thought-provoking contribution to sexual abuse literature. Written for women who have experienced incest, it is delightfully free of psychological jargon. After a review of theory and research on effects of incest, Blume illustmtes with incest survivors’ own words, demonstrating themes of
Book reviews
56-l
powerlessness, violation, secrets, and the psychological defenses utilized. She includes practical suggestions for dealing with aftereffects as well as resources for the adult survivor. One of this book’s assets is Blume’s redefinition of incest as sexual acts by any person in authority whom the child feels she cannot refuse. These sexual acts need not involve touching, but can be exposure to sexual words, sounds or acts, or placing the child in an adult role to satisfy the adult’s emotional needs. Blume argues that damage is more from the violation of trust experienced by the child than from the severity of the act. It is refreshing to see a definition of incest based on the internal experience of the victim and not merely on law or theory. This is but one example of Blume’s survivor advocate position. Another contribution of Secret Survivors is Blume’s focus on the “secret.” The child’s trust often ensures that she will not fight back or tell others. The child protects the secret, usually blaming herself for “cooperating,” and often repressing the entire experience. As adults, these women experience a variety of seemingly unrelated psychological symptoms that Blume argues are clusters of aftereffects. Blume thoughtfully discusses this hidden population’s impact on psychotherapy and research and presents the Incest Survivors’ After-effects Checklist, which is potentially both clinically and empirically useful. Blume critically reviews psychiatric diagnoses assigned to women who display the aftereffects of incest. These diagnoses reflect the traditional perspective of the aftereffects as disorders, which perpetuates viewing these women as weak and ignores their strength in surviving. Blume prefers the concept of “Post-Incest Syndrome,” which combines aspects of both trauma theory and bereavement theory with the specifics of sexual abuse. Secret Survivors is helpful for survivors and is an eye-opening guide for clinicians. Blume estimates that half the women who seek therapy have survived incest, whether they consciously remember it or not. If her estimate is correct, psychotherapists need to be aware of the aftereffects that manifest in their clients’ behavior. Secret Survivors is an invaluable contribution to the growing movement among helping professionals to hear the voice of the survivor. DEBRA K. PETERS
University ofsouthern Mississippi Department of Psychology S.S. Box 5025 Hattiesburg, MS 39406-5025, USA
on Children’s Testimony. Edited by S. J. Ceci, D. F. Ross, and M. P. Toglia. SpringerVerlag, New York, 1989. 259 pp. Aus $68.00.
Perspectives
This is not, in the main, a book about children’s actual abilities as eyewitnesses. That was the concern of the earlier volume compiled by the same editors: Children’s Eyewitness Memory (Springer-Verlag, New York, 1987). Instead, the first 6 of the 11 chapters in this book are reports of research on adults’ perceptions of children’s abilities and credibility as eyewitnesses. These include a study of the perceptions of “mock jurors” asked to evaluate children’s videotaped reports of a recent stressful experience (chapter by Goodman et al.), a study of the interaction between speech style and ascribed eyewitness age where a verdict has to be reached on the basis of transcribed evidence (chapter by Nigro et al.), and a study of the beliefs and impressions of practicing criminal attorneys based on their experience of child witnesses testifying in court (chapter by Leippe et al.). With the exception ofthe chapter by Leippe et al., which shows how prosecuting and defense attorneys may place different emphases on the abilities of the child witness as a matter of tactics, these studies would be of limited interest taken in isolation. One reason for this is that the conclusions of any one of these studies seem highly dependent on the methods used in that study. The usefulness of this section of the book becomes apparent however when the studies are compared. It then becomes clear that the child witness’s perceived credibility depends on a complex interaction between factors such as the type of case in question and the fluency, confidence, and possible motivations of the child. As Dunning notes in Chapter 11 of the book, following the evidence from Leippe et al., practicing criminal attorneys apparently use their awareness of these factors