Bad Men Do What Good Men Dream: A Forensic Psychiatrist Illuminates the Darker Side of Human Behavior (24 page)

The country has been slow to awaken to the horrors of child abuse. However, the death of 6-year-old Lisa Steinberg at the hands of her adoptive parents became indelibly etched in the minds of Americans. As millions of spectators watched on television, Hedda Nussbaum accused her common-law husband, disbarred lawyer and cocaine addict Joel Steinberg, of striking Lisa with fatal blows. Pounded into unconsciousness, Lisa was left lying on the floor of the couple’s middle-class, Greenwich Village apartment for 12 hours. While Steinberg went out to dinner, she remained unconscious, with water and undigested food from a recent meal oozing out of the side of her mouth. Nussbaum was unable to find the psychological strength to do anything about the situation. When Steinberg returned, Nussbaum informed him that Lisa could not be revived. Steinberg insisted that he and Hedda freebase cocaine before calling for help. Steinberg reportedly tortured Lisa and Hedda Nussbaum for years. In court, Steinberg received a sentence of 8 to 25 years for manslaughter. The charges against Nussbaum were dropped as the result of a successful battered-woman syndrome defense. Steinberg was released in June 2004 after serving 17 years of his sentence.

Then there was Susan Smith, who drowned her children by strapping them into safety seats in her car and driving it into a lake. She first received national attention by reporting that a passing carjacker had abducted the children. Smith went on television, tearfully begged for the return of the children. She showed home videos of them and herself, looking for all the world like a devoted mother gamboling on the floor with her two happy toddlers. Friends described her as a loving mother. Later, she confessed to killing the children. She let it be known that because she was severely depressed she had intended to kill herself along with them, but at the last minute had changed her mind and let the children go alone to their watery deaths. She received a life sentence for the murder of her two sons. During the trial, the dark underside of a small southern town was exposed—the lies, the adultery, the incest, and the human failures.

There is little in the psychiatric literature or in the experience of most forensic psychiatrists to indicate that mothers kill their children in a cold-hearted, calculating manner. Most often, the killings are formed in a state of fear, panic, dissociation, depression, or psychosis. Susan Smith was sexually abused as an adolescent, but it is unlikely that she would have developed MPD at that age. Instead, she had a history of deep depression and had attempted suicide twice as a teenager. No psychiatric diagnosis can explain everything about this unfathomable human tragedy. Perhaps F. Scott Fitzgerald came closest to the truth about such situations in
The Crack
-
Up
: “In a real dark night of the soul, it is always three o’clock in the morning.” Every parent, except for the few saints among us, has now and then caught a terrifying glimpse of that darkness.

Incestuous abuse accounts for a large proportion of all child abuse. Its true dimensions are unknown, but by extrapolating from a 1986 landmark study—itself skewed toward underreporting—an estimated 60,000 per million, or 6%, of women in the United States may have been abused by close blood relatives (including stepparents) before they reached the age of 18. In 75% of cases, the incest abuse victim is a daughter and the perpetrator is her father. Therefore, as many as 45,000 per million women may have been incestuously exploited by their own fathers.

Male incest survivors have been underestimated, and, until recently, their plight has been denied and ignored. One such survivor was Dr. Richard Berendzen, who made national headlines when he resigned as president of American University in Washington, D.C., after having been caught making bizarre, obscene phone calls to women about having sex with children. His own sexual abuse at the hands of his mother was later described in his book,
Come Here: A Man Overcomes the Tragic Aftermath of Childhood Sexual Abuse
. At least 20% of sexual abuse against boys is directly perpetrated by women. It has been estimated that approximately 5% of women are pedophiles; that is, they have sexual desires directed toward children. Other perpetrators include babysitters, mentally disturbed mothers, mothers who enable men to abuse their sons, teachers, mentors, neighbors, and family friends.

Almost all parents at one time or another experience angry or violent feelings toward their children, but most do not act them out in an abusive manner. Similarly, some parents experience sexual feelings toward their children. Many do not act them out. Others do. Child abuse, more than any other destructive act, reflects the theme and title of this book: that bad men (and women) do what good men (and women) only (occasionally) dream.

Reaping the Whirlwind of Child Abuse

Children of abuse become future abusers. This does not occur in every instance, of course, because there are many who are determined never to repeat the abuse of their own childhoods. Surprisingly, studies show that 70% to 90% of abused children do not abuse their children as parents. But the fact is that the vast majority of abusers were themselves abused as children. What is it that perpetuates the cycle of abuse? Abused children model their behavior after that of the abusing parent by means of a psychological mechanism called
identification with the aggressor.
By becoming like the abusing parent, the child seeks to transform his or her helpless and terrifying dependency on an unloving parent or caretaker into power over others who take on the dreaded position of victim. This process of identification is facilitated by the child’s perception that he or she is blameworthy and that the parent is always right. Many abused children internalize the identification with the abusing parent and direct it at themselves. This often results in physical complaints (somatization), depression, self-mutilation, or destructive lifestyles. One of my patients who had been severely abused as a 9-year-old child did not develop M PD, but later blamed himself for everything that went wrong with his life—an orgy of negative omnipotence. Instead of feeling anger at others when it was clearly appropriate to do so, he turned the anger on himself, flagellating himself, as it were, with merciless blame. Although he was aware of his persecutory side, he was unaware of carrying around within himself the abusive parent. Long-term psychotherapy enabled him to gain control of his self-inflicted abuse.

The wind is sown with abuse of children, and the whirlwind is reaped when those former children abuse the next generation. The cycle of sowing and reaping the child abuse whirlwind seems endless and full of despair. For the abused child, the consequences can be enormous, depending on the type, severity, and frequency of abuse. These consequences affect every important aspect of a person’s life—physical health, psychological health, and basic life choices of career, marriage, and lifestyle. Childhood abuse and neglect increase the likelihood of that person’s arrest as a juvenile by 53%, as an adult by 38%, and for a violent crime by 38%. As adults, females tend to remain victims of abuse, whereas males tend to become abusers. The ability to make proper, adaptive life decisions and to sustain careers, good personal relationships, and stability in the community can all be severely damaged by child abuse.

The human condition gives rise to fundamental fears in us, such as helplessness, loss, physical-mental deterioration, and extinction. Although individuals may vary widely in their perceptions of and reactions to these existential fears, and although the hurly-burly of our lives may distract our attention from them for a while, these fears are inevitable. In children who have been psychologically, sexually, or physically traumatized at a time in their lives when they are most vulnerable, these primal fears become greatly heightened. For many abused people, whether in childhood or after they become adults, their life contains little pleasure and even less joy. In attempts to master their terror, some of these traumatized children grow into adults who, in turn, victimize other children. Often, they sexualize the abuse in efforts to deny or to rationalize the painful origins of their behavior. W.H. Auden wrote in his poem “September 1, 1939,”

I and the public know
What all schoolchildren learn, Those to whom evil is done Do evil in return.

One of the highly psychologically damaging varieties of childhood abuse comes as a consequence of parents or caregivers who alternate between loving and abusing the child. Not all child abusers reject their children. Some child abusers love their children but, because of intense ambivalence, simultaneously hate them. Parents with poor parenting skills who were abused themselves or who become intoxicated with alcohol or drugs may harm children that they otherwise love. Children become totally bewildered by these utterly conflicting behaviors, further fostering the tendency to split off or dissociate the memories of their abuse.

Child abusers deal with the child as though he or she has no individual identity, and exploit the child exclusively for their own gratification. This kind of abuse is referred to as
soul murder
. Soul murder deprives the child of a personal identity and of the ability to experience joy in life. It is characterized by sometimes brutal, sometimes subtle acts of abuse against children that makes them act like whipped dogs—bonding them emotionally to their abuser because they can turn to no one else. The end product of the abuse is a tragic psychic and spiritual annihilation of the child’s core self.

Soul murder is the defining kind of child abuse that we find in the background of most people who have M PD. As suggested earlier, 97% of people with M PD were abused during childhood. Of the remaining 3% of MPD patients, some appear to have the innate ability to dissociate, and others present with M PD symptoms after encountering lifethreatening experiences such as a near drowning.

In the vast majority of cases, then, M PD develops as a way for people to cope with severe child abuse. When the child cannot assimilate the contradictory images of a loving parent or caretaker and the fact of being sexually or physically abused, the child feels helpless and unable to escape. A bewildering mind warp occurs. A young child tends to view self and others in all-or-nothing, good-and-bad terms. The idea that fair and foul can be mixed together is totally foreign to the mind of a child of 7 or 8. The abused child, overwhelmed with the terror, horror, and pain of the abuse, as well as with the inability to comprehend it, often copes psychologically by leaving the scene of the assault. Children do this by various means. Some M PD patients, for instance, describe autohypnotically focusing on an object or on a stream of light to mentally transport themselves to a favorite peaceful place such as the seashore or a pleasant wooded spot. When they are so transported, another part of the personality is left behind to personally experience the physical and emotional pain of abuse—and, not incidentally, to be the receptacle of the bad memory. Other patients dissociate from the abuse experience by mentally floating to the ceiling or to a corner of the room and watching the abuse from there, as if it were happening to someone else. By such mental mechanisms, the immense physical and psychological pain of abuse is temporarily escaped.

Memories of abuse couple with the intense feeling states of extreme fear, terror, and helplessness. These feelings are split off from consciousness by the psychological mechanism of dissociation. Dissociation can be thought of as a “horizontal” separation, in which the memory and the intense emotional trauma are split from one another. Thus disconnected and defused, like dynamite sticks from their fuses, the traumatic memories and feelings can be stored safely out of awareness, unless an external or internal trigger reconnects and ignites them. Severe psychological trauma may predispose persons to dissociate. By contrast, repression is a “vertical” separation mechanism that banishes unacceptable ideas, fantasies, feelings, impulses, or memories from consciousness, or that keeps in the unconscious dangerous thoughts and feelings that have never been consciously recognized or felt. Psychological conflict is often a precursor of repression. Repressed material is not subject to voluntary recall, although repressed memories may sometimes emerge in disguised form. Suppression, the conscious, temporary setting aside of a painful memory, may be a way-station to permanent, unconscious removal of the memory through repression. All of these
psychological defense mechanisms
, as they are called by therapists, work together to keep painful memories, feelings, and conflicts out of a person’s awareness. These active mental defenses must be distinguished from ordinary forgetting. Our minds simply do not retain the day-to-day massive influx of data and information flooding into our brains every second. The vast volume of this influx is dumped. It is simply a myth that our brains record everything that has ever happened to us.

As with a piece of flotsam that is carried down a river, snags on the river bank, and gradually sinks into the mud, childhood memories and associated feelings of abuse become separated—dissociate—and are carried downstream and become buried in the back channels of the mind. It is not until some abuse survivors are in their 30s and 40s, and in therapy for depression, anxiety, or other personality disorders, that they are able to unearth or recall their abuse. For some, like Saul on the road to Damascus, revelation will come in a single blinding moment. In abuse sufferers, a stunning flashback is often triggered by a seemingly innocuous event, as in the following case:

One lazy summer afternoon, a patient was lying on her living room couch and looking quietly at a picture on the wall. In one corner of the picture, she noticed some shrubbery at the edge of a lake. In a horrifying instant, she recalled having been sexually abused by her father on the farm where they lived. It had happened when she had accompanied her father on a walk through the farm’s wooded area. Stunned, she recalled that her father had attempted sexual intercourse with her behind some bushes near the farm’s lake. Paralyzed by the flood of terror that accompanied her newly found memory of the abuse, she lay motionless on the couch for hours.