The Abused and the Abuser

Victim–Perpetrator Dynamics

Warwick Middleton, Adah Sachs, Martin J. Dorahy, Warwick Middleton, Adah Sachs, Martin J. Dorahy

• Publisher: Routledge
• Year: 2019
• Print ISBN: 9781032073392
• eBook ISBN: 9781351213967
• Edition: 1
• Topic: Psychology
• Subtopic: Mental Health in Psychology
• Index: Psychology

Severe abuse often occurs in settings where the grouping, whether based around a family or a community organisation or institution, outwardly appears to be very respectable. The nature of attachment dynamics allied with threat, discrediting, the manipulation of the victim's dissociative defences, long-term conditioning and the endless invoking of shame mean that sexual, physical and emotional abuse may, in some instances, be essentially unending. Even when separation from the long-term abuser is attempted, it may initially be extremely difficult to achieve, and there are some individuals who never achieve this parting. Even when the abuser is dead, the intrapsychic nature of the enduring attachment experienced by their victim remains complicated and difficult to resolve.

This volume includes multiple perspectives from highly experienced clinicians, researchers and writers on the nature of the relationship between the abused and their abuser(s). No less than five of this international grouping of authors have been president of the International Society for the Study of Trauma and Dissociation, the world's oldest international trauma society. This book, which opens with a highly original clinical paper on 'weaponized sex' by Richard Kluft, one of the foremost pioneers of the modern dissociative disorders field, concludes with a gripping historical perspective written by Jeffrey Masson as he reengages with issues that first brought him to worldwide prominence in the 1980s. Between these two pieces, the contributors, all highly acclaimed for their clinical, theoretical or research work, present original, cutting edge work on this complex subject.

This book was originally published as a double special issue of the Journal of Trauma and Dissociation.

ARTICLE

Weaponized sex: Defensive pseudo-erotic aggression in the service of safety

Richard P. Kluft, MD, PhD

ABSTRACT

Problematic sexual behaviors are frequently encountered in the treatment of patients suffering Dissociative Identity Disorder and related forms of dissociative disorders. These may include unfortunate patterns of ready acquiescence or submission to overtly or potentially aggressive or sexual approaches/encounters, subtle and/or overt seductive signaling and behaviors, and even overt sexually provocative patterns of verbalizations and actions. This paper discusses the possibility that in some instances, sexual behavior has become weaponized; that is, deployed in circumstances under which assertiveness and/or aggression or other self-protective measures might be expected, probably because such behaviors were not within the range of the possible or were not understood as potentially successful for some victims of trauma. Clinical manifestations are described and discussed. An animal model in which sexual behaviors substitute for aggressive behaviors is described. A speculative hypothesis is offered, postulating that in some cases, such patterns in traumatized humans might represent an epigenetic response to exogenous trauma. Exploration of this model may lead to improved understandings and approaches to trauma victims who manifest such behavior, hopefully destigmatizing them further, facilitating reduction of their shame and guilt, and supporting their recoveries. Clinical interventions are suggested.

Introduction

Patients suffering Dissociative Identity Disorder (DID) and allied conditions frequently manifest problematic sexual behaviors. These may persist in the face of DID patients’ clear (but usually rapidly rationalized, denied, and/or dissociated) appreciations of their deleterious consequences. Ranging from mild to quite severe, they may remain refractory to the advices, injunctions, and insights of concerned others and/or mental health professionals. They include disorders of diminished desire and/or aversion; conflicted gender and sexual identities (Stoller, 1973); activities ordinarily classified as perversions (Brenner, 1996); and/or powerfully driven pressures to enact particular sexual scenarios and/or actualize pressures to activate particular patterns of sexual behaviors under particular circumstances (often accompanied with claims that such scenarios/practices are necessary, undertaken without misgivings or conflicts, and in some instances, experienced as immensely pleasurable and satisfying).

Here I will discuss the powerful pressures experienced by a small minority of dissociative women to engage others in sexual activities, even at the cost of disrupting their adult lives and/or their psychotherapeutic encounters. My perspectives are drawn from the study and treatment of women with DID. Some perspectives advanced here are admittedly speculative, presented as food for thought at a moment in time when biological aspects of trauma and the trauma response are subjects of increasing interest.

Novel contributions to the understanding of complex phenomena are merely new chapters in a long, long book, much of which remains to be written. This “chapter” both looks back over 44 years of clinical experience and forward toward developments in branches of molecular biology still in their infancy.

I have spent over four decades working with victims of sexually-exploitive therapists, clergy, and similar figures of authority. I have also worked with offenders. This body of experience has convinced me that the highly censored and politically correct vagueness customary in discussing such situations, the understandable emphasis on the unwanted consequences to the victim, and the unfortunately perfunctory attention paid to the second party apart from condemnation, together contribute to an unfortunate overall failure to communicate the complexity, urgency, and intensity of what might have transpired within the context of the clinical encounter.

Professionals who respond to sexual provocations, however extreme, are indisputably in the wrong. But too often the rapid attribution of blame preempts potentially informative study of what transpired in the minds and actions of both individuals and the occurrences within the relational dyad antecedent to, during, and subsequent to boundary violations. Neither an avoidance of the potentially prurient, militant defense of the victim, nor passionate excoriation of the perpetrator promotes nuanced understanding.

Antecedents to such transgressions are studied by psychoanalysts (e.g., Celenza, 2007; Gabbard, 1995; Gabbard & Lester, 1995). However, among traumatologists, similar explorations of the relational contexts of such incidents are often derailed by strident sexual politics. Recently I presented the same clinical material to psychoanalytic and trauma meetings only months apart. The former group was receptive, but among the latter some rapidly adopted a hostile attitude, accusing me of misogyny quite early in my presentation.

Withholding detailed descriptions to appease those who find them odious squanders educational opportunities advantageous to the welfare of actual and potential victims of exploitation. Three examples follow.

First, assuming the desirability of reducing mental health professionals’ misunderstanding and/or making inappropriate responses to such provocations, and of enhancing their sensitivity to such behaviors, from subtle to extreme, it seems wise to provide them with anticipatory socialization and desensitization, reducing the likelihood of dysfunctional therapist behaviors. In 1971, before my residency group was either taught the rudiments of sex therapy or assigned actual sex therapy patients, we were required to spend two full days watching and discussing tapes of incredibly intimate and detailed sexual acts of all varieties in order to deprive these acts of their potentials for prurience, shock, and arousal. Thereafter, we could view and/or listen to clinical material involving such activities with minimal countertransferential arousal/distress responses.

Second, clinicians’ failures to explore these materials openly may increase the likelihood that their first intense and overt exposures to such provocations may find them unprepared, vulnerable to becoming over-stimulated, deskilled, and overwhelmed.

Third, an aversion to exploring these situations denies the clinician the vicarious opportunity to learn from others how to see such situations begin to emerge, anticipate the likely next steps, and nip them in the bud. Luborsky’s symptom context studies (Luborsky & Auerbach, 1969; Luborsky & Mintz, 1974) demonstrated that the triggers for symptoms emerging in sessions can usually be found in a transferential reference within the several hundred words antecedent to the onset of the symptoms. I use this method to identify and interdict as many of these episodes as possible.

Given that the small minority of patients to whom I refer often express an inability to control their sexual behaviors, I will characterize such circumstances, and ask if we can attempt to understand driven, compulsive, dysfunctional sexual enactments as determined, in some instances, at least in part, by more or less involuntary neuropsychobiological phenomena. Finally, I will share what I have learned about the psychotherapeutic management of unwanted sexual provocations in the consulting room.

Preliminary considerations

My interest in the driven dysfunctional sexuality of DID patients began with a patient who reported abuses so similar to those described in Sybil (Schrieber, 1973) that I assumed she had read the book, notwithstanding her denial. Astonishingly, both parents confirmed her allegations. Her mother assured me that she had been psychotic when she mistreated her daughter. Now she knew she suffered paranoid schizophrenia and took her medication conscientiously. Her father explained he had not intervened because raising children was “the women’s work.”

Perhaps preoccupied by processing the acknowledged maternal brutality, our work had not addressed her claims of sexual abuse by a male relative, or perhaps I overlooked relevant indicators. One evening I did not recognize the individual sitting in my waiting room, wearing a clinging, low-cut “little black dress.” Assuming she was someone else’s patient, I had turned to leave the room before she called out, “Afraid of me, Doc? I don’t bite!”

Thus began my first encounter with a flagrant, over the top sexually aggressively alter presenting me with a confrontational, provocative, and challenging seductive relational field. I had never understood why my patient had been fired from a series of demanding jobs. Soon it became clear she had repeatedly seduced her immediate supervisors so flamboyantly that her resignation was demanded.

I had been taught that if a person incessantly repeats a behavior, however dysfunctional, something within that person was driven to bring these recurrences about; that is, at some level (conscious, unconscious, or both) the person “wanted” such outcomes, or was compelled to repeat problematic behaviors in the service of mastery. Yet when I tried to interpret such understandings to my first traumatized dissociative patients, anger, mortification, self-harm, suicidal impulses, and even suicide attempts/overdosing to drive away pain, were not uncommon. I rapidly arrived at the then-controversial conclusion that such lines of thinking situated both blame and shame within the victim in a rather simple-minded and unproductive manner (Kluft, 2016).

In 1973–1974, there was much to learn, but little guidance or precedent.

The literatures of trauma and dissociation had yet to flower. In desperation, I began to study revictimization. It would be years before the burgeoning literature of feminist thinkers and the contributions of early explorers of therapist/patient sexual exploitation (e.g., Gartrell, Herman, Olarte, Feldstein, & Localio, 1987; Herman, 1981; Pope & Bouhoutsos, 1986) would become available. My early efforts taught me only that such situations were best approached by applying the empathic and interpretive perspectives of Kohut (1971, 1977), with attention to selfobject transferences.

In studying a cohort of men and women who had experienced therapist–patient sexual exploitation, I found that all proved to be victims of parent–child incest and suffered diagnosable dissociative disorders (Kluft, 1989, 1990). Of course, the unlikely conjunction of these three factors was a sampling artifact due to my referral streams at the time rather than a firm basis for more general understanding.

I was forced to reconsider the role of classical Oedipal dynamics. Had Oedipal triumph fixated these male and female patients into a repetitive pattern of seducing/accepting seduction by authority figures, such as therapists, physicians, clergymen, and the like? Clinical experience demonstrated diverse rather than uniform dynamics at play. Pope and Bouhoutsos (1986) published a complex list of dynamic formulations, to which I added some others (Kluft, 1989; 1990; see also Celenza, 2007; Gabbard & Lester, 2005). Even when my patients’ sexualized behaviors demonstrated profound commonalities, their underlying unconscious dynamics showed surprising diversity. My conclusion was that their vulnerability to revictimization resided largely in the persistence of instrumental behaviors that had served these patients well within the contexts of their abusive childhoods, but contributed to recursive cycles of dysfunctional and life-disrupting actions in their adult lives.

The more I worked with traumatized patients the less erotic their expressed sexuality appeared to be. They rarely demonstrated either erotic desire or responsiveness as these terms are normally understood. This contributed to my describing “the sitting duck syndrome” (Kluft, 1989, 1990), the perversion of many aspects of normal coping and relatedness, including sexuality, into patterns designed to maximize safety and minimize damage and distress in dangerous and abusive environments.

It was helpful to understand their “sexual” issues as instrumental, as tactical and strategic enactments in the service of trauma-perverted concepts of safety. But what optimized damage control in environments in which at any second they might become the helpless targets of aggression, sexualized, or otherwise, sabotaged them and diminished their safety in other settings. What created primary gain in abusive settings occasioned substantial secondary loss in others, resulting in ongoing vulnerability to revictimization, compromised object relations, and a diminished quality of life.

The concept of such weaponized sex/instrumental pseudo-erotic behavior as other than genuinely erotic may be easier to grasp when compared with a different but more familiar form of aggressive nonerotic sexual behavior, rape. Rape involves the enactment of sexual behaviors driven by self-gratifying destructive aggression enacted in the service of power, domination, and sadism rather than in the service of mutual affection and shared erotic engagement.

Weaponized sex encompasses a wide and sophisticated array of strategies that utilize sexual behaviors or the implication of possible imminent sexual behaviors to seek safety, to cope with a threatening interpersonal world (and sometimes a world of internalized object relations as well) in which strong unambivalent committed attachments are not firmly established. In weaponized sex, processes and interactions that at first glance appear flagrantly sexual have minimal erotic significance or meaning. Nonetheless, these behaviors (and usually the insistence that they are erotic) are profoundly valued and clung to with desperation as coping and survival strategies.

Clinical encounters with weaponized sex/instrumental pseudo-eroticism

A professional woman from a conservative religious background believed that having angry feelings made a person evil; she deemed this emotion completely unacceptable. After many years of therapy, angry affect began to emerge. Shortly thereafter, she went into an altered state during session, exposed her breasts, and struggled to force my hands upon them. Despite my best countermeasures, this behavior recurred in over a dozen consecutive sessions, always both disremembered and denied. We slowly came to understand that these behaviors expressed both (1) the emergence of an intolerable wish to murder me (her abusive father in the transference); (2) her reenacting defending herself against her homicidal impulses and her father’s/my possible reactions to them by offering herself sexually; and (3) erotic feelings toward me. She had dissociated several efforts to kill her brutal father, after which he had nearly beaten her to death. In her contemporary life, this pattern was demonstrated in rapid acquiescence to sexual approaches by powerful men, and in smiling and beginning to unbutton her blouse if a powerful man began to express anger toward her. She never had consensual sex with a lover, but she had become sexually involved with many of the men under whom she had trained or worked, all such experiences banished from memory by amnesia.

My efforts to share my findings about such situations did not fare well in the heated gender-sensitive atmosphere of the 1990s. I was attacked for “blaming” the patients and “excusing” various perpetrators. Few besides my recovered and recovering patients were ready to consider that working with these episodes actually generated non-shaming and effective clinical interventions that restored the health, dignity, and functionality of victimized women, often even allowing them to lay claim to their healthy sexuality for the first time in their lives.

Hence, the importance of providing colleagues with sufficiently detailed illustrations to facilitate the process of bringing the study of this matter out of the shadows and subjecting it to the circumspect thought and study it deserves. Left inadequately characterized and censored beyond recognition under the aegis of political correctness, this important topic can neither be understood nor explored in a meaningful and reasonably objective manner.

Vignette 1

My adolescent friends and I spent years infatuated with one particularly beautiful young woman who would walk along “our” beach, oblivious to us. She became involved with any number of “biker types,” but took no notice of us college/professional students. Naturally, we called her “The Girl from Ipanema” after a line from Jobin’s song: “Every day when she walks to the sea, She looks straight ahead, not at me”(Jobim, de Moraes, & Gimbel, 1964).

Flash forward 25 years. A new patient was referred by a senior and respected colleague. He ended our conversation w...

Table of contents

• Cover
• Half Title
• Title Page
• Copyright Page
• Table of Contents
• Citation Information
• Notes on Contributors
• Introduction – The abused and the abuser: Victim–perpetrator dynamics
• 1 Weaponized sex: Defensive pseudo-erotic aggression in the service of safety
• 2 Extreme adaptations in extreme and chronic circumstances: The application of “weaponized sex” to those exposed to ongoing incestuous abuse
• 3 Conflicts between motivational systems related to attachment trauma: Key to understanding the intra-family relationship between abused children and their abusers
• 4 Through the lens of attachment relationship: Stable DID, active DID and other trauma-based mental disorders
• 5 Dying for love: An attachment problem with some perpetrator introjects
• 6 Predicting a dissociative disorder from type of childhood maltreatment and abuser–abused relational tie
• 7 Victim–perpetrator dynamics through the lens of betrayal trauma theory
• 8 Shame as a compromise for humiliation and rage in the internal representation of abuse by loved ones: Processes, motivations, and the role of dissociation
• 9 Knowing and not knowing: A frequent human arrangement
• 10 Mother–child incest, psychosis, and the dynamics of relatedness
• 11 Dissociation in families experiencing intimate partner violence
• 12 Organized abuse in adulthood: Survivor and professional perspectives
• 13 Treatment strategies for programming and ritual abuse
• 14 Issues in consultation for treatments with distressed activated abuser/protector self-states in dissociative identity disorder
• 15 Robert Fliess, Wilhelm Fliess, Sándor Ferenczi, Ernest Jones, and Sigmund Freud
• End note – A personal perspective: The response to child abuse then and now
• Index