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“Dr. Laura” – The Mental Health Demon

Media personality “Dr. Laura” Schlessinger once wrote a commentary Evil Among Us in March 1999, and discussed it on her radio show. This was her response to a research study about child sexual abuse, conducted by a scholar named Rind, and published by the American Psychological Association. “Dr. Laura” stirred up fans, who contacted politicians, who started talking about congressional hearings, and eventually did pass a resolution condemning child sexual abuse. The controversy over the article was very heated (see Wikipedia’s history for some insight), and serves as a good historical reminder of the (ir)responsibilities associated with media and political figures who comment on “science” as they see it.

The Rind Study

This article was written by a psychologist named Rind and several colleagues, and appeared in a 1998 issue of Psychology Bulletin. It basically was a statistical review of almost 60 studies covering 40 years of research on the results of sexual abuse. Much of the research was based on college students and their self-reports of their own experiences of abuse as a child. The conclusions of the study were basically as follows:

  • college students who reported experiences of childhood sexual abuse reported more problems overall in their families
  • 33% of men and 72% of women who experienced child sexual abuse reported negative reactions, and showed the signs of psychological maladjustment you would expect to see after a trauma
  • 29% of men and 18% of women who experienced child sexual abuse reported neutral reactions, and said they were neither helped nor harmed by their sexual experiences before the age of 18 with adults
  • 37% of men and 11% of women who experienced child sexual abuse rejected the label of “sexual abuse” for their sexual experiences before the age of 16 with adults, rated the experience as a positive one, and in fact showed few of the signs of psychological maladjustment that you would expect after a trauma
  • college students who labeled the sexual contact as consensual showed fewer signs of maladjustment than those who reported the sexual contact was physically forced upon them
  • women tend to report feeling more distress and suffering from more emotional problems as a result of the abuse than men

While I will openly admit my dislike for “Dr. Laura” and her views, her comments on this issue have a greater significance. When pseudo-scientific media figures like “Dr. Laura” misrepresent themselves, their knowledge, and the meaning of psychological research for the general public, and do so in what certainly appears to be a willing and planned manner, I believe that psychologists, as a profession, should act to correct the error. With that in mind, I offer the following.

What is a Pedophile?

First, “Dr. Laura” told her readers and listeners that “a person no longer has a psychological disorder simply because he molests children. To be diagnosed as disordered, he [the pedophile] must feel anxious about the molestation, or be impaired in his work or social relationships. Thus, the APA has left room for the psychologically ‘normal’ pedophile… So let me ask a question of psychologists and psychiatrists of the world: If pedophilia is not a mental disorder, then what is it?”

She implied that if you were “successful” and didn’t feel bad about molesting children, you were not a pedophile. Toward the end of the article, she published a letter from an attorney who commented on “the silver lining to the removal of pedophilia” from the list of mental disorders. Although “Dr. Laura” told readers and listeners, “I’ve done my homework,” she did not correct this simple error in her article. Despite “Dr. Laura’s” statements otherwise, Pedophilia was not removed from the list of mental disorders. Put this into medical terms. Suppose a medical doctor says that a client who has a broken bone can be diagnosed with a compound fracture only if other conditions are also met. “Dr. Laura” responds with, “So it’s normal for you to have a broken bone. If a broken bone isn’t a sign of a problem, then what is it?” Imagine she then follows up with a letter from an attorney saying that there is some benefit to no longer treating broken bones. You get the picture.

“Dr. Laura” distorted the facts, and showed a very poor understanding of the nature of diagnoses in general for someone who claimed to be a therapist.

Pedophilia is a mental disorder, and there is no “normal pedophile” as “Dr. Laura” meant it. The diagnosis of pedophilia describes a “core” group of people who engage in sexual relationships with children for a specific group of reasons.

  • Take a borderline-mentally-retarded 19 year old man who has sex with his willing 16 year old girlfriend. Legally, this is statutory rape. While he may be guilty of “sexual abuse” of a child as his girlfriend is underage, he likely does not feel guilty, and his social impairments are not related to the reasons for his sexual involvement with a minor. He is not a pedophile.
  • Take a 60 year old happily married man with a history of pedophilic impulses that he restrained until a recent stroke damaged his pre-frontal cortex, grossly impaired his decision-making and impulse control, and led to the abuse of a neighbor’s child. He did sexually abuse a child, and likely feels incredible guilt, but his impairment is not related to the reasons for his sexual involvement with a child. He is not a pedophile (please note the text at Kook Kamp is a selective quoting and omission of this text here, and that while I do wear glasses I do not have as much hair as the picture shows).
  • Take a third man who admits to abusing 20 children, and shows an impaired ability to form mature social relations with adults, sexual or otherwise. He likely shows some anxiety over his actions and a deeper awareness of a psychological and emotional inadequacy, but an inability to control his attraction to children and his sexual impulses toward them for any long period of time. He feels a need for a kind of power that a relationship with a child provides, power needs that are not met in relationships with adults. He has a limited insight into the reasons for his actions. He likely has dissociated from many of his experiences, and while he admits to abusing 20 children, he may well have abused another 80 children, but has suppressed his memories of these events. He is a pedophile.

The reasons for the behavior of these three men, the direction of their treatment, and the prognosis in each case is vastly different. This level of understanding should be clear to any professional with mental health training. Although she has always represented herself otherwise, “Dr. Laura” has no mental health training. She is not a psychologist, psychiatrist, medical doctor, or similar mental health professional. Her degree is in physiology, and she obtained a license as a marital and family counselor, which lapsed long before she became popular, without any graduate training in the area. She has no professional grounding to refer to herself as a “licensed counselor” or “therapist.” She lacks the training, as shown in her critique of the article noted below, to understand its methodology and findings.

Are Pedophilia and Homosexuality the Same Thing?

Second, “Dr. Laura” equated pedophilia with homosexuality, and commented that “deviance became redefined as diversity” and that pedophilia will be accepted as a “lifestyle choice.” “Dr. Laura” is one of the most prejudice and homophobic media personalities. The misdiagnosis of homosexuality as a mental disorder and the harm it has caused have been addressed well enough elsewhere. The American Psychological Association, American Medical Association, and American Psychiatric Association have all made public statements that homosexuality is not a disorder. Homosexuals have rewarding relationships with adult members of their own sex, and are not attracted to children.

Statistically, the majority of reported molestation cases involve an adult man and a female child. “Dr. Laura’s” equation of homosexuality and pedophilia is no more accurate that an equation of heterosexuality and pedophilia.

Does “Dr. Laura” Understand Science?

Third, “Dr. Laura’s” critique of the article itself was misleading and erroneous on a number of counts. “Dr. Laura” criticized the study by noting that the authors conducted a meta-analysis. “Meta-analysis means you don’t do any of your own work,” she explained for her readers and listeners. This kind of study requires reviewing other studies, rating the quality of each study, and combining the statistical results to understand what the studies all mean together. While not a perfect methodology, it has its strengths. In short, three poorly-designed studies with a small number of participants “outnumber” a single well-designed study with a large sample of participants if you simply “do a head count” and total the “for” and “against” results. However, statistically combining them allows for the larger and better designed study to carry more “weight” in a meta-analysis, and this is the reason this technique was developed. It involves a highly sophisticated understanding of statistics and methodology, and involves quite a bit of “work.” Not having published academic work of her own, “Dr. Laura” likely does not understand this.

“Dr. Laura” said, “Of the 59 studies included in the analysis, over 60% of the data is drawn from one single study done over 40 years ago.” The analysis did include one study, the oldest they included in fact, that was published in 1956 and reported on public exhibitionism and its effects on children. This study was only one of 59 studies, and was not even the largest study in their analysis, and so it is unclear how “60%” of their results came from this study. Her criticism, again, was factually false.

Child Sexual Abuse Has No Effect
“Dr. Laura” took issue with the researchers’ findings that family variables could not be sufficiently separated from child sexual abuse, and so the poorer adjustment seen in sexually abused students could not be attributed to the sexual abuse alone. “Dr. Laura” argued that the researchers had concluded that child sexual abuse had no impact on abused people, and again falsely stated the researchers’ conclusions.

What common sense and research tell us is that when a child is abused and the family is quick to protect the child, end the abuse, and focus on recovery, the effects are much less devastating and people who were abused recover fairly well from it. When the family is slow to protect the child, does not end the abuse, and does not focus on recovery, the effects are more devastating and longer lasting. College students and their families drawn from the general population are, by definition, normal. Finding that adults from normal and adaptive families reported significantly fewer problems after a traumatic event, and that adults from dysfunctional families reported significantly more difficulties after a traumatic event is hardly surprising. But in a family where violence, substance abuse, physical abuse, and neglect may all have occurred, how can sexual abuse be proven to be the most devastating form of abuse among the many types of abuse? The authors stated in their article that they could not separate the effects of child sexual abuse from the effects of all these other negative variables.

“Dr. Laura” also claimed the study was based on self-report data. That means that people who were abused reported on the effects of their abuse, and answered questions about their adjustment and functioning themselves. She commented, “That’s a brilliant way to do research, right? You have a lot of objectivity there.” Sarcasm aside, there is some truth to her comment. Of course, when it suited her, she ignored this issue and published individuals’ letters and viewpoints at the end of her article.

Children Can’t Consent to Sex
What the article did show is that non-consensual sex with children and teens is more harmful than consensual sex. “Dr. Laura” again missed the point by arguing that children can not consent to sex at all, and ignored the researchers’ distinction that sexual activity in which a teen or child resisted and was physically overpowered by the assailant was more harmful, and sexual activity in which the teen or child expresses some interest in experiencing was less harmful. The article also pointed out that we should reconsider labeling others’ experiences for them, against their own conclusions. When an individual labels a childhood sexual experience as something other than abuse, rushing to tell them they are wrong, and forcing them to label their experience as abusive may induce a trauma where the individual saw none before. If the individual says that they have recovered from the experience of abuse, we can believe them in the majority of cases, according to this study.

Sexual Abuse Is Beneficial
“Dr. Laura” went on to tell her listeners and readers, “the authors clearly state that ‘two thirds of sexually abused men and more than one fourth of sexually abused women reported neutral or positive reactions…’ That sure sounds to me as though they found not only no harm, but benefits!” In actuality, the authors stated that only 11% of females and 37% of men reported that their experiences were positive. This is not to say that sexual abuse of children is harmless, good, and a sign of “normal” behavior, and the authors of the study did state quite clearly that their research was not a basis to change our laws or social values. Again, “Dr. Laura” distorted the truth as she stirred up her listeners and readers.

The Attack on APA

Fourth, “Dr. Laura” told her readers and listeners, “When the Conservative News Service asked the APA about their apparent reluctance to condemn this supposed misuse of the data, their representative said, ‘We can’t tell other organizations what to say.’ But, it’s clear they have no such reticence in trying to silence me.” She also noted that NAMBLA, a pedophilic organization, had used the results of the article and that APA should disavow this. What she neglected to mention were her attacks on APA. In her attacks, “Dr. Laura” argued that APA showed a poor commitment “to protect children and … families” and said that they had published only 2.8 journal articles on average over the previous nine years in this area. I found this interesting, as in the previous nine years I had read more than 25.2 articles on child abuse prevention, child resiliency, community programs, and effective parenting… but perhaps “Dr. Laura” and I were reading different things. Again, she clearly distorted the facts for her own purposes as she prompted her readers and listeners to feel outraged and contact their senators and representatives.

It’s Not Science
“Dr. Laura” also criticized APA on the grounds that they had published a scientific article but reported that they did not “endorse” the findings. She stated, “I just don’t get it-if it’s ‘science’ then why aren’t they endorsing it? And if it isn’t ‘science,’ why did they publish it?” The answer is simple to most people. The study is a scientific study that must be presented to the body of professionals in the field. APA does not endorse the conclusions, any more than your local television station “endorses” the actions of a criminal when they report on the crime, or “endorses” the truth of allegations against someone when they report on a high profile lawsuit. This is generally how differing points of view are disseminated, critiqued, and either accepted or rejected by the academic and scientific community. Not being a member of either, “Dr. Laura” would not know this.

Conclusions about “Dr. Laura’s” Understanding of Science

This is in many ways a simple case of a pseudo-scientist media person showing the appropriate use of the prefix “pseudo” in her description. She misrepresented her credentials, misstated the data and conclusions of the article, and provided factually incorrect information in her ranting and raving on the whole process. She clearly stepped beyond her training and area of expertise, and was “whipping the public into a frenzy” as a result. Why would some one do this?

There are many reasons why someone with a frail sense of self and a deep underlying sense of inadequacy would turn this outward onto others, and take a “holier than thou” approach to life, self-righteously pointing out problems in everyone else, ignoring and denying her own, and deflecting all efforts to reflect on who she is and why she acts this way. Is “Dr. Laura” one of these people? Only her therapist could say. One thing is for sure, maintaining that kind of defense to hide your own flaws is probably even more important than the ratings and publicity.