Do Memories of Abuse Hurt More Than Actual Abuse?

When it comes to the integrity of our physical body, objective facts tend to matter more than subjective memories. If your finger got amputated in a bad accident when you were a child, you’d grow up without a finger, regardless of whether (and how) you remember the event. But what about our psychological integrity? Do facts matter more than stories with regard to our internal architecture as well? Does what actually happened matter more than what we remember happening?

In the absence of evidence, we may entertain several contradictory yet equally feasible hypotheses with regard to this question. One may suggest that facts will carry the day regardless of subjective experience. If you were in fact abused as a child, then you will experience negative psychological and behavioral effects regardless of whether or not you can actually remember the abuse. If the integrity of the psychological system is hurt in real time, future consequences will ensue, regardless of whatever subjective meanings are assigned to the event.

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An alternative hypothesis may just as well posit that in the absence of memory, psychological events don’t really exist. This approach may advance the notion that the internal architecture is different than the physiological one in that the subject and the subjective are its "matter." Psychological outcomes have psychological roots. Whether or not you actually have been abused matters less than whether you have a memory, a subjective experience of abuse.

A third hypothesis may argue that a combination of early objective events and subsequent subjective memories will affect future outcomes the most. In such a view, objective events leave a mark whether they are remembered or not, yet that mark may be augmented or attenuated by how it plays in memory. If something bad was done to you, and you remember that something bad was done to you, then you will suffer more adverse consequences than if something happened that isn’t remembered or something is remembered that hasn’t happened. 

Now, for the purpose of this discussion, let’s set aside the moral aspect of child abuse—the patently obvious acknowledgment that mistreating a child is an immoral act regardless of whether it is remembered or leaves a mark down the road. Let’s also leave out the clear understanding that if memories of abuse end up being detrimental to mental health, these are much more likely to occur in people who have actually been abused, which would be another argument, for those who need it, as to why children should not be abused in the first place.

Having set these considerations aside for now, we may return to the original question: When it comes to the adverse effects of child abuse and maltreatment, what matters more, the objective events, the subjective memories, or the synergy of both? Who’s to say? Well, this is why we have science, our go-to method of refereeing between competing claims based on empirical evidence.

A new study by psychologists Andrea Danese of King’s College London and Cathy Spatz Widom of City University of New York attempted to answer this question. Examining official records from juvenile and adult criminal courts, the researchers identified a group of participants (n= 908) who were maltreated in childhood between 1967 and 1971, and then matched them on the basis of age, sex, race/ethnicity, and social class with a comparison group of like participants without official records of maltreatment (n= 667).

The researchers then traced, located, and interviewed members of both the maltreated and comparison groups twenty-some years later. The 2-hour in-person interviews included assessment of retrospective reports of childhood physical abuse, sexual abuse, and neglect, as well as assessment of current and lifetime psychopathology. Overall, 1,196 members (76 percent) of the original sample were interviewed. Approximately half were female (48.7 percent) and about two-thirds were white (62.9 percent). The mean age of the sample at the time of the follow-up interview was 28.7 years. There were no significant gender, ethnicity, or age differences between the abuse-verified and comparison groups.

The researchers then compared four sub-groups within this sample: those who had an objective record of abuse but no memory of it; those who didn’t have a record but reported memories of abuse; those who had both a record and a memory; and those who had neither. Comparisons focused on how these groups fared in terms of their mental health outcomes, particularly internalizing (e.g., depression, dysthymia, generalized anxiety, or PTSD) and externalizing disorders (e.g., , alcohol or drug abuse, and/or dependence).

The analysis yielded a clear pattern: subjective memory, rather than objective fact, carried the day. In other words, the data appear to suggest that whether you have been abused is less important to your future adjustment than whether you have subjective memories of abuse.

The authors write: “We found that risk of psychopathology is concentrated among individuals with subjective rather than objective measures of childhood maltreatment… The risk of psychopathology linked to objective experiences of childhood maltreatment, even for severe cases of maltreatment identified through official court records, is minimal in the absence of a subjective appraisal. In contrast, the risk of psychopathology linked to subjective experiences of childhood maltreatment is high, whether or not subjective appraisal is consistent with objective measures. The findings were remarkably invariant across different types of maltreatment and psychopathology and across genders and races… These results suggest that psychopathology emerges as a function of subjective rather than objective experience of childhood maltreatment.”

To be sure, one study, however well designed, is insufficient to determine truth. In particular, a study like this one, which was neither longitudinal nor experimental, cannot establish causality. The fact that subjective memories of childhood maltreatment correlated with psychological problems does not mean that the memories caused the problems. Subjective memories of abuse may be the result, rather than the cause, of psychopathological processes. It is also possible that some extraneous unmeasured variable (such as, say, negative attentional focus or neuroticism) facilitates both subjective recollections and psychological problems. These findings also raise intriguing questions about what causes some abused children, but not others, to remember their abuse, and what may cause some adults to develop memories of abuse in the absence of actual such events.

At the same time, these findings do align well with old insights from the arts (as in Shakespeare’s Hamlet: “Why, then, ’tis none to you, for there is nothing either good or bad, but thinking makes it so.”), from psychotherapy lore—which holds that our subjective thoughts and self-narratives shape our commerce with the world—and from cutting-edge cognitive science, such as the work of the psychologist Daniel Kahneman, who found that our moment-to-moment "experiencing self" differs from our retrospective "remembering self," and that our wellbeing is tied more to the latter than the former.

If this finding is replicated and holds, the potential implications are intriguing. For example, if all you need in order to suffer is a self-constructed, subjective story of abuse, then protecting children from actual abuse may not sufficiently protect them from future harm. At the same time, the findings invoke thorny moral questions. For example, if we know that objective harm was done to you as a child, and we also know that knowing about that harm will cause you further harm down the road, do we have a moral responsibility to shelter you from that knowledge? Is the objective truth a higher value than one’s subjective mental health?

Discuss.