Question:
Re: Peter Barach, MD’s response to this question on 11-8. Sorry about not being able to put his entire quote in, but this is my first time ever writing in a newsgroup and I was unable to find the question in the topic history. (And didn’t know how to do it any other way.) Responding to a previous question, Dr. Barach, head of the International Society for the Study of Dissociation, quoted my book, Secret Survivors. He criticizing the book for saying that a list of symptoms "proves" that anyone is a survivor, and went on to say that this is part of the greater problem: therapists "pushing" clients to see things there way, or pushing for (possiubly nonexistant) incest memories. I am deeply distressed by this misrepresentation of my work, and I wonder if those who say that this is my position have ever read the book. To anyone troubled by feeling pressured for memories by their therapist, please know that this is never ok. Even if you know for sure you are a survivor of sexual abuse, it is my firm belief–stated often in the book–that you should be allowed to remember things at your own pace; what is not remembered is not remembered for a reason. As a survivor, whatever you have done to get through, to get here, deserves to be honored–must be honored. And if you do not identify as a survivor, even if you might be, what you deal with must be up to you; the true goal of all therapies must be personal empowerment, which means that your journey is yours and no one else’s beliefs or values (which includes, by the way, a therapist’s belief that you were NOT abused if your were!) should be imposed on you. As to the claim that I state that my book or Checklist "proves" that anyone is a survivor, I never say anything close; it "indicates" who "may" be a survivor. As to how I, or any therapist, "knows," this hunch is based on the experience of knowing the real experts–survivors themselves. Of course I may be wrong. If you can, try to tell the therapist when you think she or he is imposing or pushing anything, as it is a problem in the relationship that needs to be addressed. But you might want to check with yourself to see whether it is really an untrue thing that is being imposed on you, or just something you don’t want to deal with (but that might be true). The compromise that the writer of "how do therapists know" came to–that each would keep an open mind–sounds like a good one, for any circumstance.–E. Sue Blume, CSW, Box 7167, Garden City, NY. 11530.
Response:
Re: Peter Barach, MD’s response to this question on 11-8.
(I’m a PhD, not an MD) Responding to a previous question, Dr. Barach, head of the International Society for the Study of Dissociation, quoted my book, Secret Survivors. He criticizing the book for saying that a list of symptoms "proves" that anyone is a survivor
Perhaps I was not clear, or perhaps you misunderstood what I wrote. This is what I posted: "There is no such thing as a set of symptoms that proves someone is a "secret survivor," as E. Sue Blume described people who believed they were abused but don’t recall it." I am quoting the term "secret survivor" from her book, but I am not saying that Ms. Blume’s book offers to PROVE who a secret survivor is. If my post left anyone with the impression that I said Ms. Blume offers a checklist PROVING who is a secret survivor, I hereby want to correct that impression. I went on to write: "Sometimes therapists have hunches about things like this, as well as about other things concerning patients, but these hunches may or may not be accurate and IMO should not be offered by the therapist repeatedly with the intent of persuading the client to see things the therapist’s way." I think Ms. Blume and I are in agreement on this point, judging by her post in response to mine. As to the claim that I state that my book or Checklist "proves" that anyone is a survivor, I never say anything close; it "indicates" who "may" be a survivor.
I did not make this claim, as the above quotation from my post explains. I do continue to doubt that any checklist can even indicate who *may* be a "secret survivor" with any degree of validity. The problem with such checklists is typically that they include many symptoms that have a high base rate–statistical jargon meaning that those symptoms have a high frequency in the general population. The longer the checklist, the more likely it is to misidentify non-abused people as secret survivors because every person reading the checklist is likely to have a few of those high base-rate symptoms. In the absence of any scientific study of a checklist’s validity, the validity should be assumed to be not different than zero; that’s a basic position within the science of tests and measurements. I’m not saying that such a checklist could not be developed, only that none of the existing ones has any science supporting its utility. As to how I, or any therapist, "knows," – Hide quoted text — Show quoted text – this hunch is based on the experience of knowing the real experts–survivors themselves. Of course I may be wrong. If you can, try to tell the therapist when you think she or he is imposing or pushing anything, as it is a problem in the relationship that needs to be addressed. But you might want to check with yourself to see whether it is really an untrue thing that is being imposed on you, or just something you don’t want to deal with (but that might be true). The compromise that the writer of "how do therapists know" came to–that each would keep an open mind–sounds like a good one, for any circumstance.–E. Sue Blume, CSW, Box 7167, Garden City, NY. 11530.
– Clinical Psychologist President, International Society for the Study of Dissociation My office: 5851 Pearl Road, Suite 305 Cleveland, OH 44130 Phone: Voice: 440-845-9011, press 6; Fax: 440-845-9013 ISSD office: 60 Revere Drive, Suite 500 Northbrook, IL 60062 Phone: Voice: 847-480-0899 Fax: 847-480-9282 Opinions posted here are my own and not necessarily those of ISSD
Response:
Re: Peter Barach, MD’s response to this question on 11-8. (I’m a PhD, not an MD)
just for the edification of the newsgroup, allow me to clear this up: MD: mentally deficient or medical disappointment PhD: piled high and deep. [humor intentional/nothing personal] Now that I’ve unceremoniously butted in and derailed the real discussion for a moment, I have a question…. Is there any current research or has there been any on some of the medical and psych `things’ around DID? Things like higher than normal esp, heart/brain wave/bp/eye color changes? I can’t help but think this is a valuable opportunity to study the mind. Some of the people who are victims of SRA or mc are said to be able to read minds. If they can do it, isn’t it a fair assumption that we can do it somehow? How did my wife’s good friend (one country away) *know* she was in trouble? And the similarities in groups of people with DID and groups of SOs (caretaking, abandonment)? Peripheral stuff. How many people can `go off’ at the same time (not r*tual related). While I’m prattling on, what’s up with brain studies showing activity (PET?) in different sections in multiples, as opposed to SPDs? Thanks for your time!
Response:
hi again…At the risk of sidewinding this newsgroup into a debate on a limited topic, I am responding to Peter Barach’s reponse to my response to his response (oh, phew!!) to "How Do Therapists Know?"
Hi, Sue. Sorry for butting in but I like talking about this stuff and since it’s not my field, I rarely find anyone who’ll talk about it with me. (My tendency to bore readers to somnolence may also be a contributing factor. 
FWIW, I don’t think that Peter was talking about your checklist. He seemed to be talking about checklists in general. I know that I’m not talking about your specific checklist bc I haven’t seen it. I’m talking about checklists and other screening or diagnostic devices in general. snip The is nothing that PROVES this, but I never say there is. Yet the Checklist has been effective in describing the profile of many survivors of remembered and hidden incest; feedback I have gotten for the past 15 years is consistant: "I was ALL OVER the Checklist." And it has also been effective in uncovering hidden abuse. Actually, the Checklist didn’t start out to do that; it was simply an accumulation of characteristics of the post incest experience (consistant with many similar lists that are scientifically accepted, like the characteristics of PTSD.) I came to see that it was a diagnostic tool only after survivors told me it was.
Is it a diagnostic tool or a screening tool? I think that screening tools are designed to have a high sensitivity rate (ideally, all ppl who have been abused will meet the cut off) but are less concerned about specificity (only ppl who have been abused will meet the cut off). That is, if, in a sample of 100, 5 people have been abused, a good screening tool would pick up all five but it would probably also pick up, e.g., 10 other ppl who hadn’t been abused. I think the DES (dissociative experiences scale) is a screening test. (Someone please correct me if I’m wrong.) It picks up almost all ppl with DID but it also picks up lots of other ppl. OTOH, specificity (only ppl who have been abused will meet the cut off) is important in a diagnostic tool. Ideally, it would pick up everyone who was abused and no one who wasn’t. Of course, in the real world, ppl who design tests have to trade one against the other. Many who had not remembered their abuse–and even Dr. B must admit that this is very common (research shows it too)– frequently told me that shortly after they read the Checklist they remembered being abused. (I saw this often with my own eyes, too.) In other words, it is SURVIVORS, not therapists, who have established this.
I agree that not everyone remembers their abuse. However, this doesn’t seem like a legitimate way to validate any screening or diagnostic instrument. How many ppl who were abused met the cut-off? How did you verify the abuse? How many ppl who weren’t abused met the cut-off? How did you verify that they weren’t abused? If your checklist is going to be used as either a diagnostic or screening tool, I think ppl need to have some idea of its specificity and sensitivity rates at various cut-offs. I wouldn’t want to use a screening or diagnostic device without such information. I wouldn’t know what the results meant. E.g., If the checklist indicates that I may have been abused, I don’t see how it’s helpful. I’d guess that most ppl reading self-help books about abuse probably thought that already. How does the checklist help them determine if they were abused? If they score below a certain level, does it mean that they weren’t abused? If not, what does a high score on the checklist indicate that a low score doesn’t? I’m not trying to suggest that your checklist is unhelpful. I’ve never seen it. I’d just like to understand what various scores on it indicate and with what degree of accuracy. I’d like to understand how it’s helpful to ppl. – Hide quoted text — Show quoted text – I do continue to doubt that any checklist can even indicate who *may* be a "secret survivor" with any degree of validity. The problem with such checklists is typically that they include many symptoms that have a high base rate–statistical jargon meaning that those symptoms have a high frequency in the general population. The longer the checklist, the more likely it is to misidentify non-abused people as secret survivors because every person reading the checklist is likely to have a few of those high base-rate symptoms. Sorry, this is exactly the opposite of the truth. I repeatedly state–in both the book and the Checklist handout– that ANYONE can have a FEW of the items on the list (and anyone with any abuse or alcoholism in their childhood is likely to have even more items), but that is necessary that one have the MAJORITY of the items in order for incest to be suspected. Ergo, the longer the checklist, the more likely someone will NOT have enough of the items for incest to be suggested. This is EXACTLY the kind of reaction that makes me challenge whether a critic is familiar with my work, because I go so far out of my way to say this, and criticism is virtually always based on exactly the point Dr. B makes.
I think you misunderstood. The problem Peter is talking about (I hope <s, someone – Peter, astri, stats ppl – please lmk if I’ve misunderstood) is that IF your checklist includes items that are true for many ppl, including many abuse survivors (e.g., anxiety when meeting ppl, headaches, folding your towels in thirds <g, being triggered by h*gs <g, discussing Jello <g, r*pe fantasies for women, etc., etc., etc.), it will tend to have many false positives (or ppl who weren’t abused but who meet the cut-off bc they share some of the characteristics common for ppl who were). If I were designing a *diagnostic* tool for prior abuse, I’d want to exclude most items that were endorsed by many ppl who weren’t abused. (Which would assume that one could correctly identify those groups.) This would be esp true if the base rate for child abuse within the population that would use the test was low. (If it were possible to determine that.) << In the absence of any scientific study of a checklist’s validity, the validity should be assumed to be not different than zero; It is true that no one has studied the entire list in that way (though several people have studied portions of it),
Cool. 
Do you have any cites to those studies? which may currently be because thanks to the False Memory Syndrome backlash these lists have been denegrated to the point of hostility and are now generally dismissed by many–but this is not the case among survivors, and who would know better?
It is too bad that the FMSF has made dealing with abuse issues so difficult. 
~~~ I think everyone here would agree with that. I think the problem isn’t with the lists, per se. It’s if ppl use the lists to identify themselves (or others) as having probably been abused. FWIW, I’m a survivor. I don’t think I’m any more (or less) credible than most other ppl I know. My memory is fallible. My perception is inaccurate. I’m human. (You probably have no appreciation of the angst I experienced in typing that last sentence. But I survived! Wait. Is that good or bad? <g Sorry, I thought a little humor at my expense might lighten up the discussion a bit. <s) AFAIK, the only way to determine whether any of the abuse I remember or wonder about actually occurred is to obtain independent corroboration of it. This is a real pain bc it means that I’ll never know for sure whether some of it occurred or not, how often the stuff that I do know occurred sometimes actually occurred, etc. I suppose I’m fortunate to have obtained such corroboration of most of my abuse. However, I think that most ppl will always have doubts about the accuracy of at least some of their memories. It’s hard to live with that uncertainty. My concern with checklists (or using symptoms as an indication that abuse was likely) is that some ppl will use them as a way to avoid dealing with that uncertainty. It sounds like you wouldn’t want that, either. Anectotal information is not irrelevant; it is how we develop the theories that we decide are important enought to research more scientifically.
Right. It can help decide which items to include in the initial design of diagnostic or screening tools. However, if that tool is to be useful, it needs to be validated, imo. The individual items on it need to be validated and it needs to be validated in its entirety. And, many, many of the individual items on the list have been researched and are found to exist more often among survivors than the general population.
I’m not an expert on test design. However, just bc something is more common among ppl who have been abused than among ppl who haven’t, doesn’t mean that the item should be included, imo. E.g., if 6% of the population was abused and if item A is endorsed by 50% of the ppl who were abused but only 20% of the ppl who weren’t, it still might not be a good item to include on a diagnostic instrument, imo. If you took 100 ppl in the above example, 3 of the ppl endorsing the item would have been abused (6 x .5) whereas 19 of the ppl endorsing the item would not have been abused (94 x .2). If a diagnostic checklist included many such items (e.g., items A – J), it would probably incorrectly identify many ppl as having been abused when they weren’t. That would be esp true if, e.g., those items were correlated so that if ppl endorsed A they would also tend to endorse B – H. – Hide quoted text — Show quoted text – Ok, now that we’ve taken up so much of readers’ valuable time with this, please accept my invitation to decide for yourselves. I have always made the Checklist available at no charge; get one for yourselves. (See my signature for instructions.) And please forgive me for what may be perceived as a defensive posture on all of this, but for a
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Response:
hi again…At the risk of sidewinding this newsgroup into a debate on a limited topic, I am responding to Peter Barach’s reponse to my response to his response (oh, phew!!) to "How Do Therapists Know?" Dr. Barach says: << There is no such thing as a set of symptoms that proves someone is a "secret survivor," as E. Sue Blume described people who believed they were abused but don’t recall it." Yes, that is true. The is nothing that PROVES this, but I never say there is. Yet the Checklist has been effective in describing the profile of many survivors of remembered and hidden incest; feedback I have gotten for the past 15 years is consistant: "I was ALL OVER the Checklist." And it has also beeneffective in uncovering hidden abuse. Actually, the Checklist didn’t start out to do that; it was simply an accumulation of characteristics of the post incest experience (consistant with many similar lists that are scientifically accepted, like the characteristics of PTSD.) I came to see that it was a diagnostic tool only after survivors told me it was. Many who had not remembered their abuse–and even Dr. B must admit that this is very common (research shows it too)– frequently told me that shortly after they read the Checklist they remembered being abused. (I saw this often with my own eyes, too.) In other words, it is SURVIVORS, not therapists, who have established this. << The longer the checklist, the more likely it is to misidentify non-abused people as secret survivors because every person reading the checklist is likely to have a few of those high base-rate symptoms. Sorry, this is exactly the opposite of the truth. I repeatedly state–in both the book and the Checklist handout– that ANYONE can have a FEW of the items on the list (and anyone with any abuse or alcoholism in their childhood is likely to have even more items), but that is necessary that one have the MAJORITY of the items in order for incest to be suspected. Ergo, the longer the checklist, the more likely someone will NOT have enough of the items for incest to be suggested. This is EXACTLY the kind of reaction that makes me challenge whether a critic is familiar with my work, because I go so far out of my way to say this, and criticism is virtually always based on exactly the point Dr. B makes. << In the absence of any scientific study of a checklist’s validity, the validity should be assumed to be not different than zero; It is true that no one has studied the entire list in that way (though several people have studied portions of it), which may currently be because thanks to the False Memory Syndrome backlash these lists have been denegrated to the point of hostility and are now generally dismissed by many–but this is not the case among survivors, and who would know better? Anectotal information is not irrelevant; it is how we develop the theories that we decide are important enought to research more scientifically. And, many, many of the individual items on the list have been researched and are found to exist more often among survivors than the general population. Ok, now that we’ve taken up so much of readers’ valuable time with this, please accept my invitation to decide for yourselves. I have always made the Checklist available at no charge; get one for yourselves. (See my signature for instructions.) And please forgive me for what may be perceived as a defensive posture on all of this, but for a number of years my work has taken a beating by many people who have misrepresented it badly, yet I know how many people have felt helped by the work. The Checklist is not something I created to impose on people; it was compiled from information provided by survivors, and, in that way, it came from survivors, not me. As I say to survivors who have been victimized by the current fad of dismissing incest memories as "false memories," ( because it has threatened their already fragile belief in their own memories), don’t let anyone decide your truth for you. E. Sue Blume, CSW, DCSW author, Secret Survivors To contact, or to obtain no charge copy of "The Incest Survivor’s Aftereffects Checklist" (for business sized SASE) PO Box 7167 Garden City, (LI), NY 11530
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Is there any current research or has there been any on some of the medical and psych `things’ around DID? Things like higher than normal esp, heart/brain wave/bp/eye color changes? I can’t help but think this is a valuable opportunity to study the mind.
There has been no research on the eye color changes that a few people have reported witnessing when alters "switch"; I myself have never seen this–but I’m nearsighted so maybe I missed it… There have been a number of studies on other physiological changes, especially changes in EEG and PET scans that are associated with different alters and cannot be duplicated by people asked to simulate DID. There are other studies confined to a few subjects that lack control groups, but are quite interesting. E.g., studies showing variations in thyroid function tests among alters (study was conducted by Marlene Hunter), studies showing different eyeglass refractions needed by different alters. The most recent studies of physiological phenomena associated with DID that I’m aware of have been done by Ellert Nijenhuis, who has looked at PET scans. I don’t think his data his been published yet. Peter — Clinical Psychologist President, International Society for the Study of Dissociation (1998-1999) My office: 5851 Pearl Road, Suite 305 Cleveland, OH 44130 Phone: Voice: 440-845-9011, press 6; Fax: 440-845-9013 ISSD office: 60 Revere Drive, Suite 500 Northbrook, IL 60062 Phone: Voice: 847-480-0899 Fax: 847-480-9282 Opinions posted here are my own and not necessarily those of ISSD
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Hi Itchy! I had read in the newby rules that you could write anything under a spoiler, even unsplatted words. I would always get tired of splatting (because it interrupts my train of thought) and thought it didn’t matter since it was under a spoiler, but I guess spoilers don’t help with the search engine thing. Thanks for reminding me (and whoever else) of this other reason for splats. I’ll just go back through after I’m finished and splat stuff. Thanks Sasha
– Hide quoted text — Show quoted text – x-no-archive: yes Could you please ’splat’ words which will draw flames, trolls and unsolicited garbage to this ng. Example…False, F*als, Memory, M*mory, etc. Basically any word which could be put into a search engine and then this ng would come up. We are a support group and not like other ng’s. Here we try to honor each persons feeling and sometimes we get unsolicited junk and spammers which can be very disturbing to some. Thank you Peace Itchy and Crew — "If I have a choice, I’d rather not. If asked nicely, I might." Itchy – Rock On!
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I agree 100% with e’s comments on the issue of sensitivity vs. specificity in the use of screening tools, and the need to have validity data so that people who give themselves such a checklist will know what the risk is of the checklist making a false positive identification of themselves as a "maybe a survivor." e obviously knows plenty about test design, and she explains it more clearly than most statisticians!
Thank you, Peter, on behalf of my psych testing prof and Anastasi who wrote the (now very ancient) textbook I used as an undergrad. <s They were excellent teachers. Thanks for helping educate the public and Ts about this and many other things. (A "very well said" on your letter to the editor of the Dallas Observer.) FWIW, I don’t think my Ts would agree that I explain this stuff clearly. When I tried explaining it to them (in response to their using a variety of checklist generally known as "clinical judgment" <g), their eyes glazed over. I think I may have caused a few major dissociative episodes. <g Or at least PTSD symptoms. <g It did not help strengthen our therapeutic alliance. (I think they usually said something about "resistant", "avoidance", and "denial", at which point I dissociated. I think they may even have interpreted my explanation as an indication that I’d completely lost it. <G ("I wonder if she knows what she’s talking about? Who cares? This stuff is so boring and arcane that only a complete looney – [notice the use of technical jargon <g] – would ever care about it. Then to actually expect anyone else to care enough to listen, or even pretend to. I know she’s paying me but there’s a limit on what I can be expected to tolerate here. Maybe I’ll save your post as some indication that I’m not completely out to lunch in case I ever discuss this with my T again. <g (Don’t worry, I’d never try to pass your post off as a clinical judgment about my sanity. It’s been good talking to you. take care, e — For info about this service, see http://www.twwells.com/anon/ or e-mail:
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I agree 100% with e’s comments on the issue of sensitivity vs. specificity in the use of screening tools, and the need to have validity data so that people who give themselves such a checklist will know what the risk is of the checklist making a false positive identification of themselves as a "maybe a survivor." e obviously knows plenty about test design, and she explains it more clearly than most statisticians! Other forms of "validation" for such checklists run the risk of circular reasoning. For example, just because people read a checklist, tally up a large number of items, and then say to themselves, "Yes, I must be a survivor who has forgotten my abuse!", the checklist should not be held forth as valid solely on the basis that women recognize themselves to be survivors as a result of taking it. Yes, as e states, the DES is a screening tool. Most people with DID get high scores on it, but it also misidentifies some people as having DID when in fact they do not. There are better tools when a diagnosis is required, and there is some research by Niels Waller and associates that describes how people with DID can be identified more accurately on the DES by a complicated procedure involving (non-statisticians, please tune out!) the Bayesian probabilities of responses to a subset of DES items. None of the above is meant to denigrate the experiences of anyone who is trying to come to terms with his or her childhood, abusive or not. The responsibility for determining what happened/didn’t happen rests 100% with the person who is looking into his/her own childhood and trying to make sense of things. — Clinical Psychologist President, International Society for the Study of Dissociation My office: 5851 Pearl Road, Suite 305 Cleveland, OH 44130 Phone: Voice: 440-845-9011, press 6; Fax: 440-845-9013 ISSD office: 60 Revere Drive, Suite 500 Northbrook, IL 60062 Phone: Voice: 847-480-0899 Fax: 847-480-9282 Opinions posted here are my own and not necessarily those of ISSD
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I had vowed to not make thisk forum a therapist’s debate, because it is for real people, as it were, and I didn’t want to intrude. But since my Cheklist is still the target of–well, not debate, exactly, but criticism, there are a few points I want to make. First, though, I see whre Peter commends "e" for her knowledge of E. Sue Blume, CSW, DCSW author, Secret Survivors To contact, or to obtain no charge copy of "The Incest Survivor’s Aftereffects Checklist" (for business sized SASE) PO Box 7167 Garden City, (LI), NY 11530
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– Hide quoted text — Show quoted text – Is there any current research or has there been any on some of the medical and psych `things’ around DID? Things like higher than normal esp, heart/brain wave/bp/eye color changes? I can’t help but think this is a valuable opportunity to study the mind. There has been no research on the eye color changes that a few people have reported witnessing when alters "switch"; I myself have never seen this–but I’m nearsighted so maybe I missed it… There have been a number of studies on other physiological changes, especially changes in EEG and PET scans that are associated with different alters and cannot be duplicated by people asked to simulate DID. There are other studies confined to a few subjects that lack control groups, but are quite interesting. E.g., studies showing variations in thyroid function tests among alters (study was conducted by Marlene Hunter), studies showing different eyeglass refractions needed by different alters. The most recent studies of physiological phenomena associated with DID that I’m aware of have been done by Ellert Nijenhuis, who has looked at PET scans. I don’t think his data his been published yet. Peter
I think all of this falls into the category of ’some’, as in ’some multiple systems have an ISH, some don’t', ’some indicate physiological changes in the body and some don’t', etc. My system has been documented to have _some_ physiological changes with switching, but definitely nothing like eye color change (of course we all had blue eyes any way so that wouldn’t make sense to change:). Our changes were along the line of BP, temp., respirations, brain waves (that one really freaked the neuro out *hee hee* cause he wasn’t expecting it, we had the test done for another reason and happened to switch twice during it so we ended up with three separate patterns:), heart beat pattern (some of us had a heart murmur and some didn’t, unfortunately it seems to be something ‘I’ had so the body has it now) Another thing we have documented is differing MMPIs. (I just love messing with peoples minds *grin*) Took it in the hosp once in 1981; it was so totally invalid that they decided I was too depressed and had me re-take it before I left (it was invalid in ways that they couldn’t even explain:), those results were also invalid (in a different way) so they gave up. Then when I got into t’pist school I took classes on administering it and got to take it again. As a different insider did school stuff this one was _very_ different from the last one. So I took it again just for fun, only someone else took it, and it was yet again different. I brought this up in one of the classes (without mentioning multiplicity) and the instructor was fairly certain that this didn’t make sense in a normal way. His explanation was: test familiarity interferred with the results, I was intentionally trying to mess with the test, or there was something very wrong with me. But as for the ‘typical’ kinds of differences a multiple exhibits, we had none of them. Looking at the body the only way our t’pist could tell we were switching was by looking at our eyes (they ‘did something’, I think that was a technical term:) and then listening to our voice once we had switched. There was no other external sign (like facial expression or whatever). Rainbow Colors (Jill) — The colors blend, the edges soften. Swirling and mixing we are becoming white light.
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Sorry–previous entry was sent prematurely. Here we go again: I had vowed to not make this a therapist’s debate, since this forum is for real people, and I didn’t want to intrude. However, since my Checklist is still the topic of — well, not debate exactly, because some of the folks who have e-mailed me have not passed their comments on to this site–but criticism, I felt the need to respond. First, Peter thanks "e" for her knowledge of research, (<< I agree 100% with e’s comments on the issue of sensitivity vs. specificity in the use of screening tools, )
…but I can’t find her original comments anywhere and would like to read them. Second, I fear there is a danger in making this a debate about scientific validity, removed from the actual testimony of survivors. I will say something that will get me bashed here, but what the heck: Research, like horoscopes and the bible, can be twisted to prove any point. Look at the lies that research used to tell about incest (and women, and gays, and…) We cannot remove this debate from the experiences that real survivors have had with the list. Indeed, we should never steralize the voices of any population that we are studying in that way. It is true, the validity of the Checklist has not been scientifically established. But can you then make the jump, that this means that it is INVALID? Which leads me to my next point: … << that people who give themselves such a checklist will know what the risk is of the checklist making a false positive identification of themselves as a "maybe a survivor.
Let’s look at that for a moment. As I stated in a recent e-mail to Peter, "I don’t know about you, but my experience is that survivors kick and scream for a long time against the fact of their victimization, and that no one WANTS this to be the explanation for their problems! As Alice Miller asks (badly paraphrasing here) why would anyone make up what they fight so hard to not accept? Anyway, if the list doesn’t apply, (or even if it does but the reader isn’t ready for what comes up) what I have seen is that people simply put it away, or lose it. The question must be asked, what draws these people to checklists and books anyway?" My experience working with and knowing survivors tells me that survivors would do anything to make their incest NOT be true; they would rather be crazy, or even dead, sometimes, than face that someone they loved and trusted would do such a horrible thing to them. So where is this presumed epidemic of people reading a two sided piece of paper and erroneously thinking, "hey, maybe that happened to me!" Is it more likely that someone who is not a survivor will falsely believe they are, or that someone who was abused will falsely believe that they were not? It also interests me that suddenly the criticism that I say that anyone with even a few items may be a survivor is no longer the point, since I established that this was a–how shall I say–false accusation. Is the point of criticizing this work really, for everyone, a concern for science? For its first 15 years, when it was out there among survivors and therapists, these issues were not a major concern. You might be interested to know that they were first raised by the F*Sers. I do not wish to suggest that everyone with a challenge to it is a bad guy; but are we sure that a concern for science is all that is behind this debate? Finally, I still have never received an answer from Peter about whether he has read SECRET SURVIVORS. But here is what one author who HAD, said, when analyzing my work in light of a Backlash author’s criticism of recovered memory, in an article which was very conservative and supportive of many of those claims: "The[re] are some of the symptoms that Schacter felt are vague and could be applied to other areas. However, in these and in the aftereffects checklist in her book, it is explained that often the symptoms occur in clusters with survivors showing many of the symptoms, not just one isolated symptom such as depression. Other aftereffects listed which comply more with the scientific community as far as specificity are as follows: Blocking out early years, persons, places, or events, night terrors, alienation from your body, intolerance to being touched, self- injury, sexual acting out, promiscuity, inhibited sex desire, difficulty with water hitting face, gag reflex, inappropriate clothing (i.e. extremely baggy or skimpy), discomfort using public bathrooms, and a history of older partners. This would go along with Schacter’s theory of a history of problems." ("Debate of Memory Repressionof Child Sexual Abuse," by Myra Marple, on Greendoor Resolutions P.L.L.C. site) I certainly never put out the checklist as diagnostic–it never occurred to me that it would be–until the reactions of survivors told me it was. Are we all–therapists and survivors–better served by a debate on scientific methods, or a real commitment to hear what survivors are saying, and to honor them in their journey? -Thanks for your time, folks. E. Sue Blume E. Sue Blume, CSW, DCSW author, Secret Survivors To contact, or to obtain no charge copy of "The Incest Survivor’s Aftereffects Checklist" (for business sized SASE) PO Box 7167 Garden City, (LI), NY 11530
Response:
Sue, Peter and anyone else writing, quoting this discussion of checklists, validity, etc and are using well recognized trigger words here… please, please remember to use the conventions of splatting and/or spoilering to keep trigger reactions through unexpected exposure, minimal. It would be very much appreciated. Sierra of TN
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IMO any reasonable therapist would welcome questions and comments from a client about the methods being used by the therapist, and it would be disrespectful to "glaze over" simply because the comments came from a client–the therapist ought to get some consultation to understand the comments if they are not comprehensible. Most therapists would also explore why the client brought the information in at that particular time in treatment, but it would be disrespectful of the client in the extreme to simply chalk up client’s comments to "resistance and denial" without a joint exploration of the meaning and timing of those comments. — Clinical Psychologist President, International Society for the Study of Dissociation My office: 5851 Pearl Road, Suite 305 Cleveland, OH 44130 Phone: Voice: 440-845-9011, press 6; Fax: 440-845-9013 ISSD office: 60 Revere Drive, Suite 500 Northbrook, IL 60062 Phone: Voice: 847-480-0899 Fax: 847-480-9282 Opinions posted here are my own and not necessarily those of ISSD
Response:
Hi. :) Since you didn’t see my other post, I wanted to make it clear that my comments didn’t specifically address your checklist. I’ve never seen your checklist. It addressed checklists in general. spoilered for discussion of accuracy of memories (Does this need to be spoilered?) ` ` ` ` ` ` ` ` ` ` ` ` ` ` Sorry–previous entry was sent prematurely. Here we go again: I had vowed to not make this a therapist’s debate, since this forum is for real people, and I didn’t want to intrude.
FWIW, I think talking about this is important for me and at least some other survivors. If someone wants to try to figure out how accurate their abuse memories or suspicions are likely to be (i.e., what is the actual truth vs. the psychological truth), it is important to understand the probabilities of a checklist giving an accurate result, incorrectly "finding" that one was abused when one wasn’t (i.e., false positives), and incorrectly "finding" that one wasn’t abused when one was (i.e., false negatives), imo. I think that both psychological truth and historical accuracy are important to most ppl who may have been abused (and most other ppl). I don’t think that one can necessarily come to terms with one by resolving the other. Ime, it is helpful to distinguish the two when dealing with memory – any memory but esp traumatic and abuse memories. My concern is that some ppl will use a checklist, therapy, or other tools to resolve the pain of not knowing historical truth instead of acknowledging and coming to terms with the impossibility of having certainty about it or instead of mistakenly equating psychological truth with historical accuracy. I think that is a serious problem that some checklists and therapies tend to overlook. I think it is a very difficult problem to resolve bc many survivors (and other ppl) have a hard time separating the two, in any event. It is even more difficult bc many survivors (esp but other ppl, too) were never sufficiently helped (or weren’t allowed) to express either. So questioning one tends to be equated with questioning the other. However, since my Checklist is still the topic of — well, not debate exactly, because some of the folks who have e-mailed me have not passed their comments on to this site–
I wish that they would. I don’t think it’s helpful to anyone, including survivors, to make discussions of relevant information inaccessible, to talk about ppl or their problems without giving them the opportunity to hear and respond. I’m not suggesting that anyone be privy to everything that is said about any topic, including the person or group of ppl being talked about. However, it bothers me when ppl, esp ppl who are purportedly acting on behalf of the ppl being discussed (e.g., Ts wrt survivors) behave as if certain nonconfidential aspects of a discussion were somehow not legitimate or proper to discuss with the ultimate "beneficiaries" of the discussion. It seems very condescending and invalidating to me. I don’t know if that’s why ppl emailed you instead of posting here or why you are concerned about intruding with a "professional’ topic on a "survivors’" group. I hope not. Bc that, imo, is silencing survivors and not listening to their concerns about topics that concern them. but criticism, I felt the need to respond. First, Peter thanks "e" for her knowledge of research, (<< I agree 100% with e’s comments on the issue of sensitivity vs. specificity in the use of screening tools, ) …but I can’t find her original comments anywhere and would like to read them.
I’d be happy to send them to you if you email me so that I can send them anonymously. (You’ll automatically get an anon email addy if you email me or anyone else with a twwells addy.) Second, I fear there is a danger in making this a debate about scientific validity, removed from the actual testimony of survivors.
Why is this either/or instead of both/and? Fwiw, this strikes me as the kind of elitism and paternalistic thinking/behavior ("let’s not talk about this in front of the kids, they might actually understand and want some input" that I find difficult to deal with as a client. (Transference hereby acknowledged. <g) I will say something that will get me bashed here, but what the heck: Research, like horoscopes and the bible, can be twisted to prove any point.
Do you think that’s what ppl are doing by talking about sensitivity and specificity (the risks of false positives *and* false negatives)? If so, could you explain how? TIA. Look at the lies that research used to tell about incest (and women, and gays, and…)
Knowing how an instrument is validated allows ppl to question the biases in that instrument, imo. It generally helps uncover the limitations and possible distortions, not hide them. We cannot remove this debate from the experiences that real survivors have had with the list.
How is validation removing anything from the experience ppl have had with a list? It seems to me that it is quantifying some of those experiences in ways that are helpful to ppl using any list. Indeed, we should never steralize the voices of any population that we are studying in that way. It is true, the validity of the Checklist has not been scientifically established. But can you then make the jump, that this means that it is INVALID?
Again, this isn’t my field but I think you may be using validity in a nontechnical sense. Maybe the misunderstanding is that some ppl are using the term in it’s technical (wrt psych testing) sense and others aren’t? Which leads me to my next point: … << that people who give themselves such a checklist will know what the risk is of the checklist making a false positive identification of themselves as a "maybe a survivor. Let’s look at that for a moment. As I stated in a recent e-mail to Peter, "I don’t know about you, but my experience is that survivors kick and scream for a long time against the fact of their victimization, and that no one WANTS this to be the explanation for their problems!
I’m not sure that *no* *one* wants abuse to be the explanation for their problems. Furthermore, many ppl want an explanation – almost any explanation, including abuse – for their problems. Uncertainty can be very painful. As Alice Miller asks (badly paraphrasing here) why would anyone make up what they fight so hard to not accept? Anyway, if the list doesn’t apply, (or even if it does but the reader isn’t ready for what comes up) what I have seen is that people simply put it away, or lose it.
How do you know that ppl who weren’t abused (i.e., false positives) put the list away or ignore its findings? How do you know that someone who is a false negative doesn’t use that as an excuse to avoid dealing with trying to come to terms with the historical accuracy and psychological truth of their abuse? Both those problems concern me. I don’t think you’re addressing them here. The question must be asked, what draws these people to checklists and books anyway?"
I’d hope a search for psychological truth. I.e., I’d hope that they’d use the checklist much as they’d use flipping a coin to make a decision; they base the decision not on the actual outcome of the coin toss but on their reaction to the result. However, I think many ppl use them as a way to find historical accuracy, as a way to avoid the pain of living with doubt and uncertainty. My experience working with and knowing survivors tells me that survivors would do anything to make their incest NOT be true; they would rather be crazy, or even dead, sometimes, than face that someone they loved and trusted would do such a horrible thing to them. So where is this presumed epidemic of people reading a two sided piece of paper and erroneously thinking, "hey, maybe that happened to me!" Is it more likely that someone who is not a survivor will falsely believe they are, or that someone who was abused will falsely believe that they were not?
FWIW, I’d like to know the actual probabilities of both. Without that information, I wouldn’t know what the results meant. It also interests me that suddenly the criticism that I say that anyone with even a few items may be a survivor
I don’t think anyone here suggested that. is no longer the point, since I established that this was a–how shall I say–false accusation. Is the point of criticizing this work really, for everyone, a concern for science? For its first 15 years, when it was out there among survivors and therapists, these issues were not a major concern. You might be interested to know that they were first raised by the F*Sers. I do not wish to suggest that everyone with a challenge to it is a bad guy; but are we sure that a concern for science is all that is behind this debate?
Epistemology is important to me. FWIW, I’ve recently posted about how that aspect of my abuse was worse for me than the physical or s*xual aspects. I’ve known Peter (as a participant at asd) for a few years. I have never known him to discount ppls’ memories or to promote, in any way, the idea that ppl can’t recover accurate abuse memories. I think his position has always been fairly close to mine (and some other ppls’ here): all memory is potentially inaccurate. A T should remain neutral wrt the veracity of any memory, whether it’s recovered or not, whether it’s traumatic or not, whether it’s good or bad, or whether it supports or undermines a T’s beliefs or suspicions. – Hide quoted text — Show quoted text -Finally, I still have never received an answer from Peter about whether he has read SECRET SURVIVORS. But here is what one author who HAD, said, when analyzing my work in light of a Backlash author’s criticism of recovered memory, in an article which was very conservative and supportive of many of those claims: "The[re] are some of the symptoms that Schacter felt are
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One comment, fwiw: When I first began tpy (with the right T) I started to realize that some things I ~definitely~ remember ~were~, in fact, ab*se (I had never called them that or thought of them as that, even though I can now clearly see that’s what they were). My first reaction was to go to the library and read every book I could find about ab*se and dissociation. It took me a lot of work in tpy before I understood that I was hiding from my feelings by focussing on the knowledge I was filling my head with. That’s not to say that knowledge and facts and scientific data aren’t important, but for some of us, "staying in the head" is just another way of staying away from the memories and feelings, and can be counterproductive to healing and recovery. I’ve been finding this discussion very informative, but I hope no one gets so focussed on distilling every definition down to its absolute purest meaning that they lose sight of the most important work of recovery, which is feelings work (IMO). Ceq * Sent from RemarQ http://www.remarq.com The Internet’s Discussion Network * The fastest and easiest way to search and participate in Usenet – Free!
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hi Ceq, for me to be in the head is a way to achieve a partial understanding without overwhelm. that understanding gives me one tool for orienting in the wilderness. iv’e developped a bunchof tools over the years. and there are years in my life when being the head has kept head and body alive. and the feelings are right there whenever it is possible to enter them. so i have alot of respect for being in the head. niniane
Hi niniane, I agree with you that being in the head can be a very useful coping strategy. I hope no one thought I meant that it is bad to gain knowledge. I believe there are times when we can only do what we can handle at that stage of our recovery. I did want to make the point, though, that recovery can start to go much quicker when you allow yourself to go into the feelings more. For me, filling my head with knowledge was an avoidance tactic. It enabled me to keep a distance from my feelings. It isn’t easy, but doing the "feeling work" is proving to be very productive. I should point out that I am DDNOS, not DID. My comments would probably not be helpful to all of asd. Ceq – Hide quoted text — Show quoted text – One comment, fwiw: When I first began tpy (with the right T) I started to realize that some things I ~definitely~ remember ~were~, in fact, ab*se (I had never called them that or thought of them as that, even though I can now clearly see that’s what they were). My first reaction was to go to the library and read every book I could find about ab*se and dissociation. It took me a lot of work in tpy before I understood that I was hiding from my feelings by focussing on the knowledge I was filling my head with. That’s not to say that knowledge and facts and scientific data aren’t important, but for some of us, "staying in the head" is just another way of staying away from the memories and feelings, and can be counterproductive to healing and recovery. I’ve been finding this discussion very informative, but I hope no one gets so focussed on distilling every definition down to its absolute purest meaning that they lose sight of the most important work of recovery, which is feelings work (IMO). Ceq * Sent from RemarQ http://www.remarq.com The Internet’s Discussion Network * The fastest and easiest way to search and participate in Usenet – Free! — For info about this service, see http://www.twwells.com/anon/ or e-mail: message
* Sent from RemarQ http://www.remarq.com The Internet’s Discussion Network * The fastest and easiest way to search and participate in Usenet – Free!
Response:
(I don’t do "splats," but let the reader beware if he or she is bothered by discussions of checklists) . . . . . . . . . . . . . . . In response to Ms. Blume’s unanswered question to me: Yes, I have read her book. However, I’m not going to engage in a discussion of the book in this venue, because I think it’s way outside the realm of a.s.d. IMO Ms. Blume is welcome to her opinions based on professional and or clinical experience, but my gripe was with the claim that an unvalidated checklist devised by her or anyone else "may identify" who is a survivor of unremembered abuse. It might, but it might not, and it should not be assumed to be capable of identifying anything unless there is data to back it up. While not intending to discount survivors, I wanted to point out (as e did, too) that testimonials from people who say the checklist worked for them do not address the lack of information about people for whom the checklist led to an incorrect conclusion (either false positive or false negative). Emotional appeals, such as "Well, who would want to believe they were abused if they weren’t?" aren’t particularly persuasive. I have seen people who arrived at the conclusion that certain abuses took place when there was clear and convincing evidence that what they remembered (or believed to have been true) was impossible. (…and to be fair, I’ll say that I have run across situations where people either suspected they were abused but didn’t remember it, or believed they weren’t and also didn’t remember it, in which clear corroboration of abuse was located). — Clinical Psychologist President, International Society for the Study of Dissociation My office: 5851 Pearl Road, Suite 305 Cleveland, OH 44130 Phone: Voice: 440-845-9011, press 6; Fax: 440-845-9013 ISSD office: 60 Revere Drive, Suite 500 Northbrook, IL 60062 Phone: Voice: 847-480-0899 Fax: 847-480-9282 Opinions posted here are my own and not necessarily those of ISSD
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