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Can of Worms not so easily dismissed

I have re-read the Can of Worms leaflet[1]. In particular I note that the authors repeatedly point to the conjecture that there is a causal link between sexual abuse in childhood and conduct disorder in adulthood, the disorder being in some cases sufficiently severe to attract diagnoses such as PTSD, borderline and anti-social personality disorders. It is important not to underestimate the weight and authority which underpin this thinking. Although not explicitly cited in [1], and although it is far from chronologically the first to introduce the idea of a causal link, material such as "Scars that won't heal..." by Martin H. Teicher[2] is often ultimately cited as clinical evidence of the existence of this link. In particular, rather than simply re-cycle anecdotal material from patients, he studies the problem at the experimental level with brain scans and suchlike. So far as I know, Teicher is widely regarded and is not, at least currently, thought of as being completely self-deluding in the Meadow tradition. Therefore let us be warned that Can of Worms cannot be trivially brushed aside as completely lacking in factual underpinning: it carries Teicher's authority.

Nevertheless, "Scars that won't heal...", even though it is superficially a convincing read, is frustratingly vague about how Teicher determined whether his experimental subjects had actually been abused or not. One cannot help conjecturing ultimately that it is based on only the anecdotes of the patient, which defeats the object of the experiment. Also, looking at [2] he is a believer, albeit somewhat skeptical, in the highly contentious notions of dissociated identity disturbance and multiple personality disorder. Teicher and his associates were also doing their work around the time of the USA mass panic over child abuse. His funding sources may be influential. Finally, Teicher and Nelson completely ignore a feature of borderline behaviour that is extremely visible to the family and friends of the patient: pseudologia fantatistica, which is the posh name for making false assertions including allegations of abuse or inflating one's own credentials. (This is beautifully described in a short article[3] which manages to get Judge Couwenberg, Prince Charles and Jeffery Archer into one paragraph of an article that mentions borderline personality disorder and false allegations yet does not mention Princess Diana[5]!) I suggest we keep a watch on Teicher thinking as an indicant of future problems and especially on his critics [who they? --ed], whose comments may help devalue Can of Worms.

Back in this country I find a striking parallel between Sarah Nelson's evangelical conversion (2006) of the Scottish Executive to Can-of-Worms thinking, and the less highly-publicized Heather Castillo's[4] evangelical attempts at the conversion (of the Essex, Suffolk and Cambridgeshire Strategic Health Authority?) via the East Suffolk Advocacy Network tot he same view. Both evangelists take as their starting point totally literal commitment to can-of-worms thinking, and then convert the purse-string-holders to the same view, thereby releasing funds to further the cause and ostensibly help the adults. It is a potent and very attractive cocktail for the audience.

[1] http://www.wellontheweb.org/well/files/can_of_worms.pdf Nelson S et al: Yes you can!
[2] http://www.annafoundation.org/stwh.pdf Teicher M: SCARS THAT WON'T HEAL: THE NEUROBIOLOGY OF CHILD ABUSE
[3] http://www.jaapl.org/cgi/content/full/33/3/342 Dike, C C et al Pathological Lying Revisited.
[4] e.g. http://society.guardian.co.uk/mentalhealth/comment/0,8146,1372862,00.html Guardian Newspapers: A Safe Haven
[5] e.g. http://www.hallmemoirs.com/specific_groups/342.shtml Diana, Princess of Wales and BPD.

 


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