Dr. Laura

When The APA Monitor, the American Psychological Association's newsletter, included an article "APA Defends Stance Against Sexual Abuse of Children" in July, 1999, I was not surprised. I had already been given the "Dr. Laura" commentary Evil Among Us by one of my clients, who was very upset about the issue and Dr. Laura's comments.

Dr. Laura attempts to interpret a "meta-analysis" of the literature on child sexual abuse for the public. 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 was based on college students and their 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 signs of psychological maladjustment 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 little sign of psychological maladjustment 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 tells us 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 implies that if you are "successful" and don't feel bad about molesting children, you are not a pedophile. Toward the end of the article, she publishes a letter from an attorney who comments on "the silver lining to the removal of pedophilia from the DSM IV." Although she claims, "I've done my homework," she does not correct this simple error in her article. Despite Dr. Laura's implications, Pedophilia has not been removed from the DSM IV as a mental disorder.

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's distortion of the facts is self-serving, and shows a very poor understanding of the nature of diagnoses in general.

Pedophilia is a mental disorder, and there is no "normal pedophile" as Dr. Laura means 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, 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.

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 represents herself otherwise, Dr. Laura does not have 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 has now lapsed, 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 equates pedophilia with homosexuality, and comments that "deviance became redefined as diversity" and that pedophilia will soon be accepted as a "lifestyle choice." Dr. Laura is one of the most prejudice and homophobic media personalities around today. 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.

Can Dr. Laura Critique the Research?

Third, Dr. Laura's critique of the article itself is misleading and erroneous on a number of counts.

Dr. Laura and her followers criticize the study by noting that the authors conducted a meta-analysis. "Meta-analysis means you don't do any of your own work," Dr. Laura tells us. This kind of study requires reviewing other studies, rating the quality of the 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 subjects "outnumber" a single well-designed study with a large sample of subjects 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 says, "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 does include one study, the oldest they include in fact, that was published in 1956 and reported on public exhibitionism and it's 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 come from this study. This criticism is, thus, factually false.

Child Sexual Abuse Has No Effect
Dr. Laura takes 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. Although Dr. Laura earlier criticized this entire approach to research, she now argues that this means that the researchers have denied that child sexual abuse has any impact on abused people. Dr. Laura again draws false conclusions.

What common sense and research tell you are 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 report significantly fewer problems after a traumatic event, and that adults from dysfunctional families report significantly more difficulties after a traumatic event is hardly surprising. But in a family where violence, substance abuse, physical abuse, and neglect all occurred, by what rationale or research is sexual abuse proven to be so much more devastating than the other four forms of abuse? The authors stated in their article that they can not separate the effects of child sexual abuse from the effects of all these other negative variables in some families. Does Dr. Laura believe that she can?

Dr. Laura also points out that the study is based on self-report data. That means that people who were abused reported on the effects of their abuse, and completed questions about their current functioning themselves. She comments, "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 suits her, she ignores this, and publishes 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 misses the point by arguing that children can not consent to sex at all. She misses the researchers' distinction that sexual activity in which a teen or child resists and is physically overpowered by the assailant is more harmful, and sexual activity in which the teen or child expresses some interest in experiencing is less harmful. The article also points 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 goes on to say, "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 state 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. The authors of the study do state quite clearly that their research is not a basis to change our laws or social values. Again, Dr. Laura distorts the truth.

The Attack on APA

Fourth, Dr. Laura offers, "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 notes that NAMBLA, a pedophilic organization has used the results of the article, and APA should disavow this. What she neglects to mention is her attack on APA.

Dr. Laura argues that APA has shown a poor commitment "to protect children and … families" and says that they have published only 2.8 journal articles on average over the last nine years in this area. I personally have read more than 25.2 articles on child abuse prevention, child resiliency, community programs, and effective parenting in the last nine years, and would like to think Dr. Laura has as well. Again, she clearly distorts the facts for her own purposes.

It's Not Science
She also criticizes APA on the grounds that they have published a scientific article but report that they do not "endorse" the findings. She states, "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 contributor to either, Dr. Laura would not know this.

Conclusions

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 has 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 has stepped beyond her training and area of expertise, and is "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 everyone else's problems, 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.