The Phenomenon of Child Abuse Hysteria as a Social Syndrome: The Case for a New Kind of Expert Testimony

Lawrence D. Spiegel*

ABSTRACT: This article provides a foundation for viewing group hysteria about child sexual abuse as part of a recognizable social syndrome.  Information from sociology and social psychology, cognitive development, and clinical psychology is combined in a three-stage process to explain the abuse hysteria phenomenon.  These stages provide a cohesive set of behaviors which constitute a recognizable social syndrome.  This abuse hysteria syndrome has contributed to over-reporting and sometimes improper prosecution of such cases.

A child abuse hysteria syndrome may be useful in determining the truthfulness of an abuse allegation.  It is suggested that expert testimony using these concepts can add a generic dimension to explain the public climate, and can therefore encourage the courts to move toward a new kind of non-adversarial expert testimony which is more educative and objective, as opposed to the argumentative and subjective nature of much testimony offered in adversarial proceedings.

Within recent years we have witnessed an explosion of media reports, professional articles, educational programs, child protection services, and legal reforms dealing with child abuse, especially child sexual abuse.  There is little doubt among professionals in the field that we are experiencing a national phenomenon.  The issue of child abuse, after having been kept in the shadows for so many years, has finally emerged.  Yet it has done so with such a fury that some have characterized it to be of almost hysterical proportions.

The term hysteria, as used here, is not used in its traditional or psychological sense.  Traditionally, dictionary definitions characterized hysteria as "an uncontrollable outburst of emotion or fear, often characterized by irrationality," (Random House, 1981).  In the psychological realm, the term hysterical generically refers to an irrational fear or state of anxiety or emotional shock (Random House, 1981).

When used in its sociological sense however, the term takes on a broader quality which incorporates and transcends the other definitions.  Since it is being used with respect to a group, an entirely different dimension is added in that the emotion is now shared by more than one person.  Most basically, the term mass hysteria is closely associated and often used synonymously with mass suggestion (Freud, 1922; Tarde, 1903) in the sociological literature.  The origins of both these concepts are attributed to Gustave LeBon as used in his now classic work, The Psychology of Crowds (1895).  Since then, these terms have been expanded upon by many others.  Both terms reference the notion that there exists within a group the possibility for a contagion of emotional and irrational thoughts and behavior which causes a circular reaction within the group.  The group then acts on these irrationalities in a homogeneous manner (McDavid & Harari, 1968).

The current cultural climate regarding child abuse fits within these broad definitions.  It has been fueled by a variety of things and seems to have reached hysterical proportions in a number of instances.  Sensationalist media accounts which quote government figures tell us that there is an "epidemic" of child abuse.  We have been barraged with attempts to heighten public awareness.  Public service announcements on television, feature newspaper articles, pictures of missing children on milk cartons, and prime time television movies have all contributed to the contagion.

These efforts, along with a multitude of other innovative approaches, have generated a fever-pitched public response to "do something" about the problem.  These efforts include books and movies on such topics as "Good Touch, Bad Touch," as well as school presentations which take the form of puppet shows, lectures, and even groups of traveling actors, all portraying the dangers of abuse.

The March 10, 1986 issue of Newsweek tells of some even more novel approaches.  In addition to the flood of books and pamphlets which include titles like It's Okay To Say No, the new offerings now include board games called Safe City USA and one developed by a former prosecutor in Illinois titled, Strangers and Dangers.  One of the most popular writers of children's stories, Stan Berenstain, has written The Berenstain Bears Learn About Strangers.  Although the titles don't always suggest it, the message today goes far beyond the old adage, "don't talk to strangers" (Kantrowitz & Leslie, 1986).

Indeed, if we note the figures complied by the National Center on Child Abuse and Neglect, the numbers would justify such extreme measures.  According to these official figures, the number of reports of child abuse have skyrocketed from 675,000 reports m 1974 to 1.6 million in 1985, a staggering increase (Besharov, 1985).  Not surprisingly, the professionals have been quick to rally to the cause.

The proliferation of literature has been interdisciplinary.  From the abundance of legal articles which led to the 1974 Child Abuse Prevention and Treatment Act (sponsored by Mondale), to the fields of social work, psychiatry and psychology, the response has been reflective of the public climate.  Each of those fields have seen the development of new theories and syndromes seeking to explain, diagnose and treat child abuse in general, and sexual abuse in particular.

Several authors have produced writings on abuse which now form the backbone of the child saver movement.  Finkelhor (1984), Goodwin, Sahd, and Rada (1980), Sgroi (1982) and Summit (1983) are just a few of the many writers developing theories which attempt to define syndromes of abused children.  New tools such as "anatomically correct" dolls, and other diagnostic aids are being touted as the cutting edge of the field.  All of these professional attempts to address the issue of child abuse have been spurred by the public passion and, paradoxically, seem to have contributed to it.

Perhaps the most telling sign that public concern has reached epidemic proportions has been the abundance of responsive or backlash literature.  These works have not only identified the public hysteria, but have pointed to the resulting problem of over-reporting.  Many of these authors cite the government figures mentioned previously, but add a crucial dimension.  Though the number of abuse reports has indeed sky-rocketed, so have the percentage of unfounded reports.  These writers now tell us of a second epidemic, that of false reports, a problem which in their view is as damaging as abuse itself (Wakefield & Underwager, 1988).

Again, this responsive or backlash literature has been interdisciplinary and equally vociferous.  Legal experts such as Douglas Besharov, the first director for National Center on Child Abuse and Neglect, tells us that the percentage of unfounded reports in 1985 reached 65%, as opposed to 35% ten years ago (Besharov, 1985).  Practicing attorneys Gordon (1985) and Herzog (1986) have expressed vigorous concerns over the growing legal trends which have stretched the rules of evidence precariously thin.  Over the past two years there has also been an explosion of articles on the problem of false reports.  Social work specialists like Schultz (1985) as well as psychological and psychiatric experts have responded.  Coleman (1986), Green (1986), and Gardner (1987), among many others, are also warning about the dangers facing the clinician as a result of the "epidemic" of false reports.

Indeed since the publication of my own book, A Question Of Innocence, in December of 1986,1 have received numerous letters, articles, court decisions, books, research projects, etc.  I have been advised of and participated in numerous conferences and symposiums held by a host of professional associations.  I have been called upon to testify as an expert in both civil and criminal cases of child abuse.  I have been advised of and testified before legislative hearings on both a state and federal level, and consulted with numerous law firms all over the country.

Most of the authors mentioned earlier have addressed the false accusation problem for the express purpose of neutralizing the "expert" testimony of those who testify for the prosecution as validators as part of the adversarial court proceedings.  Their rebuttals, however, are usually allowed as testimony only to refute points made by the expert witness for the prosecution.  These include efforts on the part of some authors to neutralize evidence resulting from the use of the anatomical dolls ( Mclver,1986; White, 1987).  In essence, many child abuse cases are coming down to a battle of experts, psychologists and psychiatrists refuting one another, usually leaving the judge or jury more confused than ever.

Coleman (1986) and Green (1986) have responded to the so-called abuse syndromes, both by methodically picking them apart, and/or by presenting their own syndromes in an effort to counterbalance them.  A credible effort in this regard is the SAID Syndrome by Gordon Blush and Karol Ross (1986).  Still others, such as Schetky and Boverman (1986) and Schuman (1986), have discussed even broader problems including competency issues, biased interviews and other "red flag" indicators.  By far, the most comprehensive treatment of the problem of false accusations which this author has seen is the work by Hollida Wakefield and Ralph Underwager (1988).

The so called backlash phenomenon and the hysteria it points to has not escaped the media's attention.  Within the past few years, a grass roots organization called VOCAL, an acronym for Victims Of Child Abuse Laws, made up of parents who feel they've been victimized by witch hunt mentality, has over 3,000 members nationally (Besharov, 1986).  In the past year, virtually every network and newspaper, major magazine and radio station in the United States has covered the problem of false accusations, and has referred to them as epidemic (Dorschner, 1985).

The inherent paradox, however, and therefore the need for a more thorough understanding of the social climate, is that along with endangering innocent people, false reports also endanger children who need protection, by misdirecting the resources of child protective services.  Just as false alarms to fire or police endanger those facing a real emergency, false reports take child protective workers away from those cases where children are truly in danger.

The fact that the media has now not only reported the zeal of the public to stop abuse, but the backlash as well, is further substantiation of the confusion and conflict.  Every social movement of any magnitude always creates a reaction.  On a segment pf the Phil Donahue program, Mr. Donahue characterized the prevailing attitude toward the end of the show, "Show me a man who is accused of child abuse, and I'll show you a child abuser" (Donahue, 1987).  CBS News correspondent, Bernard Goldberg, summed up the paradox which we are facing.  In his statement on the CBS Evening News, Mr. Goldberg commented that the efforts to do something about child abuse seem to be "not only overdue, but overdone as well" (Goldberg, 1987).

The climate of hysteria, as previously defined, and growing public and political pressures have already impacted the courts.  As a consequence of the need felt by the judicial system to respond to the public clamor, there have been several changes in the structure of the legal system itself.  Rules of evidence have been significantly relaxed when it comes to cases of alleged child abuse, seemingly because of the public outcry.  These recent trends should be of particular concern to the psychological community, since it is psychology as "the science of human behavior," which is most ethically obliged to evaluate the phenomenon which has these changes in the courts.

In most states, expert testimony is now guided by three basic criteria: it must be of more probative value than prejudicial, it must not invade the province of the fact finder (judge or jury), and it must be based on accepted scientific principles.  Traditionally, expert testimony in cases of alleged child abuse has become more and more a part of court proceedings, but has been limited to specific areas, i.e. evaluation of children, parents, and/or defendant, as well as some limited testimony on the dynamics of sexual abuse generically.  To a lesser degree, some courts have also permitted experts to offer opinion with respect to the cognitive capability of child witnesses, usually at a pretrial competency hearing, out of the presence of the jury (Schuman, 1986).  This is especially true of cases which involve very young children, or those which emanate from divorce and/or custody disputes (Benedek & Schetky, 1984).

Most states have now adopted one or more legal reforms, which directly impact cases of child abuse, especially when the charge is sexual abuse.  In general, in addition to more frequent use of expert testimony, the rules of evidence have been modified to allow more latitude for experts.  Even in the criminal courts, experts are now allowed to testify to facts which have not been admitted into evidence.  These include history which may have been taken, hearsay statements and hypotheticals.

Other changes in legal procedures are even more far reaching.  The recent tendency to permit younger and younger children to testify by relaxing or amending the requirements for competency, and/or the use of closed circuit television (Spiegel, 1986) are two examples.  Another is the recent tendency of prosecutors to bring cases to criminal court which in the past might never have been pursued.  Even more disturbing is the stretching of hearsay laws, which now make admissible certain testimony from parents or professionals and/or the use of proxy testimony by an adult in the event the child is found not to be competent.  In most cases, however, it is the adversarial process itself which is most problematic for the expert witness.

For these reasons, the purpose of this preliminary effort to develop a more generic type of expert testimony is twofold: first, to add a generic dimension which explains the public climate, and second, to encourage the courts to move toward a new kind of non-adversarial expert testimony which is more educative and objective, as opposed to the argumentative and subjective nature of much testimony offered in adversarial proceedings.  This discussion is therefore designed to impact the nature of expert testimony both in substance and procedure.

In substance, generic testimony with respect to the public climate is necessary to give the fact finders the broadest and most comprehensive view of the problems.  If, in fact, it is the weight of public pressure produced by this group hysteria which has caused the scales of justice to tilt, then the psychological community needs to objectively investigate the climate of hysteria more precisely, as an entity unto itself.  This could aid the fact finders and courts in evaluating whether the recent legal changes are too reactionary.  In almost all of the backlash literature, the problem of the "climate of hysteria" has been discussed, yet nowhere has it appeared as a cohesive and comprehensive issue unto itself.  Given opportunity for research and data collection, it could constitute a new kind of expert testimony testimony not designed to add to the already troubled battle of experts, but to offer a broad context to the court to aid all those involved in developing a more balanced and objective approach.

This article is only a preliminary attempt at a new perspective which transforms the hysteria phenomenon into a empirically identifiable syndrome.  It must be made clear that this effort is a theoretical formulation, not a scientifically accepted syndrome and is not being proffered as such.  Perhaps ultimately this may help to balance the scales of justice and create a deeper understanding of the complexity of child abuse cases and add another scientific tool for analyzing and differentiating false reports from true ones.

What is being proposed is an integration of variety of heretofore separate areas of psychology and sociology in order to develop a new paradigm which will more adequately define the phenomenon of "hysteria," or "witch hunt" mentality.  Through a cross-fertilization of disciplines, it is possible to arrive at such a paradigm.  This is accomplished through a three-stage process which transposes the notion of a "phenomenon" (which implies something remarkable or extraordinary) into a more defined and scientifically refined concept of a social syndrome.  The term syndrome is used here in its strictest sense, "a recognizable set of social characteristics or behaviors" (Random House, 1980), as opposed to the rather vague concept of a phenomenon, which implies something remarkable or extraordinary.  Naturally, only through ongoing research and testing can an initial formulation such as this be determined to be scientifically sound and acceptable.

The reality of the current public behaviors toward child abuse is neither remarkable nor extraordinary, given an appropriate understanding of the factors from which they have evolved.  This understanding is developed in a three-stage process of combining information from sociology and social psychology, cognitive development and clinical psychology.

STAGE ONE - Collective Behavior

Both sociology and social psychology refer to the cultural phenomenon of mass hysteria or mass suggestion as defined previously in the broad category of collective behavior (Johnson, 1945).  Collective behavior includes riots, mob behavior, lynchings, social movements, crazes, fads, and rebellions.

In general, the category of collective behavior is further delineated by the distinction of being either the congregated or uncongregated variety.  The definitions of each are implicit in the terms used to identify them.  The former would involve circumstances in which the groups of people meet personally in the context of a meeting or rally, as opposed to the latter category in which those involved do not meet in any formal setting, but are united indirectly as a function of an event or phenomenon.

Most collective behaviors involve circumstances which are bizarre or extraordinary and therefore become a popular topic for study (Light & Keller, 1975).  Although incidents of collective behavior have been extensively researched and written about, controlled studies are difficult, owing to the nature of the phenomenon.  Child abuse hysteria includes both congregated and uncongregated behavior.

As one might suspect, uncongregated movements can evolve into congregated ones (Light & Keller, 1975).  Some of the more common examples are the civil rights and women's movements of the past two decades.  The advent of mass media seems to have aided these transformations.  One can only surmise that had there been network news coverage of the witch trials in Salem, Massachusetts, it may have grown to a national epidemic.  Court rooms all over the country might have been overflowing with witch trials, as they are now with child abuse proceedings.

It is the electronic media which has provided the vehicle to transform uncongregated movements into a congregated mass media audience.  The medium is, in part, the message. (McLuhan, 1968).  One could make a case for the fact that the current child abuse phenomenon has resulted from just that.  The momentum of the current climate began just after the much publicized arrests of twenty-four parents in the small town of Jordan, Minnesota.  This was quickly followed by day care scandals in New York, California, New Jersey and a number of other states.

Less publicized, however, were the eventual outcomes of many of these cases.  In the Minnesota case all of the charges were eventually dismissed against the parents, and the only person found guilty was a trash collector, James Rud.  Ultimately, it was learned that Rud had begun the hysteria by "cooperating" with the prosecutor by giving her the names of those involved in the "sex ring" which she was certain existed, in a swap for a plea bargain deal for Rud.  Most of the public is still unaware of this.  The public is also largely unaware that the prosecutor, Kathleen Morris, was found guilty of malfeasance after investigations by the FBI and special task force appointed by the Attorney General of Minnesota.  She was later voted out of office.

Now, some years after the arrests of seven people in the McMartin Preschool case in California, we find that charges have been dismissed against five of the seven defendants.  We are told by the defense council and the former prosecutor of the case, that the accusations of the children are "patently absurd," and that the initial charge came from a psychologically disturbed mother who has since committed suicide.  Still, the charges against Raymond Buckey and his mother have not been dropped and the state of California has spent close to five million dollars of taxpayers money to date. (CNN News, 1987).

The literature in social psychology and sociology is replete with historical examples of collective behavior, which, like the phenomena being discussed here, seem to defy scientific explanation.  Popular writers and journalists, as well as some academicians, have described these instances as mass hysteria (Brown, 1965).

There are many examples of congregated "mass hysteria," dating back to the Spanish Inquisition.  Most work on the subject cites other examples such as the Salem Witch Hunts, early lynchings in the South, religious movements, the civil rights marches, and the women's movement.  The remarkable similarity between the Salem Witch Hunt in 1692 and the current topic has been addressed by several modern writers.  One of the most notable accounts appeared in the August 1985 issue of Persuasion At Work:

Salem, Massachusetts, 1692. Tituba, a servant girl steeped in the "black magic" of Barbados, has excited the imagination of two children, nine-year-old Betty and eleven-year-old Abigail.  The youngsters writhe, scream, and moan on demand before amazed, frightened adults.  The experts arrive from Boston, question the girls with techniques handed down from the Great Inquisition, and discover the cause: witches! Townspeople some strange, most ordinary are brought before the bewitched children.  The girls identify 40 of them as those who had caused their maladies.  With a passion for securing confessions, zealous prosecutors toss out factual evidence as the Devil's work.  Instead, special evidence is introduced: "I saw him fly on a stick across the face of the moon."  Those of the accused who deny their guilt are subsequently tied to a stool and dunked beneath water.  If they drown, this is clear evidence of guilt.  If they survive, the Devil is surely responsible and they are promptly hanged.  Twenty "witches" so perish.

Jordan, Minnesota, 1984: James Rud, a trash collector and baby-sitter, has been arrested for sexually molesting two children.  Once in custody, he plea bargains with the prosecutor and, in exchange for a reduced sentence, describes his involvement in a large child-sex ring composed of Jordan parents.  With no prior investigation, police arrest the parents and seize the children, placing the latter in the care of social workers.  Once in custody, the children are grilled for hours by a battery of experts.  Therapists strip the children down and perform physical exams.  Doctors stick their fingers in the little girls' vaginas, asking, "Is this what they did to you, and do you think it went in the far, and did it bleed?  Anatomically correct dolls are given the the children so they can "role play."  Many of the children are told that if they reveal the truth about their abusing parents, the families might be reunited.  The children start confessing.  More experts come.  Citizens who complain about police tactics are arrested, and their children also seized.  In all, 24 adults eventually face charges.  Yet as the months pass, the prosecutor fails to come up with any hard evidence.  The hymens of the little girls are all intact.  None of the children show any signs of physical harm.  In desperation, the prosecutor turns to some of the accused and begins plea bargaining.  One of them, a police officer, is offered a new identity, relocation, no jail time, even money in exchange for testimony against the other adults.  Yet he refuses the offer, demanding a trial.  In September, the first couple brought before the jury is acquitted.  The prosecutor begins hinting about the parents' involvement in ritual murders.  In November, Rud admits in a radio interview that he had lied: there was not sex ring; he made it all up.  The children also recant.  Yet the prosecutor is unmoved.  The adults are guilty, she insists; they will never get their children back (Carlson, 1985).

In both these circumstances we find all the elements of group hysteria, including irrational emotions which became contagious and are self-reinforcing or cause a circular reaction.  The fact that one might question the analogy because "witches do not exist" and child abusers do, does not really undermine the foundation of the analogy.  Although most of us now think we know witches don't exist, certainly that was not the case in 1692.  Indeed perhaps it is not the case at all.

Since the advent of mass media, there have been many examples of uncongregated phenomenon.  The most familiar examples of uncongregated events include the panic which ensued during the Halloween broadcast by Orson Wells of "War of the Worlds" in 1938, and the paranoia about communism generated by the McCarthy hearings in 1945 (McDavid & Harari, 1968).  Lesser known, but perhaps even more interesting are some other unique phenomenon. One example follows:

In September of 1944, a woman in the small city of Mattoon, Illinois, reported that someone had opened her bedroom window and sprayed her with a sickish-sweet-smelling gas that partially paralyzed her legs and made her ill.  During the ten-day period that followed, dozens of cases with similar symptoms were reported, and police exerted full effort to catch the "gasser," who had become known in newspapers throughout the nation as the phantom anesthetist of Mattoon.  Although the story died away within two weeks, an investigation through interviews with "victims" and police in Mattoon was carried out during the subsequent six weeks.  On the basis of this evidence, the episode was attributed entirely to hysteria and a wave of mass suggestion.  Rumor spread rampant, people became apprehensive and disoriented, and they were gullible and suggestible.  Those most susceptible were women who were below average in educational and economic level.  Following the wave of hysterical suggestion came a successive wave of "contrasuggestion," with critical public attitudes toward hysterical suggestion, and low ebbs in prowler reports.  Without mob congregation, a cultish wave had united a collection of "victims" and subsequently a collection of "critics" of these victims (Light & Keller, 1975).

In recent years, both the disciplines of sociology and social psychology have analyzed the phenomena of congregated collective behavior in more contemporary terms.  Several facets of these analyses represent more scientific attempts to both explain and understand these occurrences.  Most of the research done on collective behavior is, by necessity, historical and analytical in nature.  These events are unique and so unusual that they are difficult to replicate experimentally.  The most relevant data, therefore, has come from analysis of real events.  One important fact upon which most social scientists agree is that there are certain preconditions which must exist in order for a phenomenon of collective behavior to occur.

Social ambiguity is perhaps the important construct.  Collective behavior is more likely when there is an inherent paradox or contradiction.  For years, child abuse, especially sexual abuse, remained a secret.  It was rarely reported and was not likely to be taken seriously when it was (Schuman, 1986).  This seemed due in part to our Puritan heritage and embarrassment with sexual matters in general, as well as to the influence of Freudian psychology which tended to dismiss children's complaints as fantasies.  With the infusion in 1979 of huge amounts of federal funds into the social service system came the mandatory and anonymous reporting laws.  Yet the conflicting issues are complicated for America.  The desire to do something about child abuse stands in opposition to our long history of difficulty in dealing with sexual matters and the privacy of the family.  Add to this the confusion created by adversarial expert testimony and opinion, and we have a true dilemma.

Three other sociological constructs are germane to our analysis: frustrated social concerns, normlessness, and unanticipated events.  Certainly, after decades of secrecy, there is a frustrated collective social concern to stop child abuse.  Normlessness ensues when people are caught between conflicting social values.  When, for example, should a neighbor report suspicion of abuse?  The conflicting needs to do something and the regard for privacy, as well as embarrassment, generates a condition of normlessness.  There is no clear historical norm for such a dilemma.  With regard to an unanticipated event, it is doubtful that anyone in the United States could have anticipated the news headlines which came from Jordan Minnesota in 1984.

Taken together, these constructs provide a foundation for understanding collective behavior and the hysteria which has resulted in so many false reports of abuse.  But it is more difficult to explain why both children and parent(s) often insist that abuse has taken place, even when it hasn't.  In order to provide a sufficient scientific base for understanding this phenomena, we must now couple the information from Stage One with some well-known and researched areas of cognitive psychology in Stage Two.

STAGE TWO - Cognitive Issues

The cognitive capacities of children as witnesses has been widely discussed by a number of the authors mentioned earlier.  Many authors who have written about false accusations have illustrated how easily children are led into creating fantastic stories, which they learn to believe through repeated interrogations.  These interrogations employ the powerful learning variables of repetition and reinforcement, even when it is not the intention to do so.  Often the interviewers are case workers or law enforcement personnel who do not have sufficient training or skills to conduct an unbiased interview.

The repeated interrogations are often accompanied by a process of bureaucratic escalation, in which the accusation itself becomes more and more defined and often enlarged.  This can be deliberate, on the part of an overzealous worker, or simply be an inadvertent consequence of the accusation being passed from one division to another.  Often the term "alleged victim" is replaced by the word "victim."  The term "subject" is replaced by "perpetrator" and so on.  Hence, one investigator's zeal may spark another's and all serve to reinforce and solidify the accusation for those who reported it.  This is exactly the circular reaction defined in group hysteria.

The use of so-called diagnostic aids, such as puppets, anatomical dolls, books, and drawings, can contaminate children's perceptions even further.  When encouraged by a zealous investigator, because children tend to view these items as playthings (to be associated with "make believe"), they may conjure up fantastic stories (Wakefield & Underwager, 1988).  Yet, in controlled studies (Mclver, Wakefield, & Underwager, 1989), it has been shown that there is no significant difference in the way that abused and non-abused children interact with the dolls.

Piaget (1926) states that children cannot reliably discriminate between internal and external stimuli until age eleven or twelve.  Kohlberg (1968) claims that children do not distinguish their own dreams from external reality until about age five.  Yet children as young as three years of age (Spiegel, 1986) are being asked to testify as witnesses in criminal proceedings, often sitting on the lap of a parent who made the accusation.  When the cognitive limitations and suggestibility of children are considered in light of these repeated interrogations, usually being done by biased adults with few or no interviewing skills, a terrifying picture emerges.

Hollida Wakefield and Ralph Underwager describe the position of the science of psychology with regard to the testimony of children in cases of alleged abuse:

The procedures followed in the interrogations of children contaminate, confuse, and make statements made by children unreliable. ... The younger the child, the more powerful the teaching and learning experience will be.  When there is no supporting or corroboration data or no admission from the alleged perpetrator, children's statements standing alone must be viewed with great caution ... (Wakefield & Underwager,1988, p.33).

There is no evidence establishing that these procedures [anatomical dolls, drawings, books, play therapy, puppets] are reliable or valid techniques in in assessing possible sexual abuse in children (Underwager & Wakefield, 1989, p. 30).

If we now look at the components of Stage One and Stage Two together, there is a definable group behavior of an uncongregated and congregated nature, which, within the definition of terms as used here, has generated a climate of hysteria with respect to child abuse.  It has also generated a zeal on the part of the authorities to put a stop to abuse.  When these factors are combined with the suggestibility of children discussed in Stage Two, there is a resulting synergistic effect.  These two stages taken together explain not only how so many cases of abuse are reported, but also why so many of those involved come to believe that abuse has occurred, even when it hasn't.

STAGE THREE - The Clinical Component

Thus far, most of the authors who have addressed the issues discussed in Stage Two have not directly combined them with the collective behavior constructs discussed in Stage One.  Nor have most made the connection to certain clinical components which often exist when allegations of abuse are false.  There are a variety of psychiatric and psychological factors which can come into play in cases of alleged abuse.  Some of these are extremely pertinent, and provide a foundation for differentiating a possible false accusation from a true one.  Often this type of pathology can be triggered by the group hysteria and suggestibility of children discussed in Stages One and Two.  There are always many possible psychiatric problems when an allegation is false.  Obviously, there is the possibility of true psychotic behavior, if someone is convinced abuse has taken place when it actually hasn't.  For the most part, only a few of the authors have examined carefully specific clinical syndromes which may be applicable to cases of alleged child abuse.

There are a few authors who have discussed specific clinical syndromes which may be applicable to cases of alleged child abuse (Schuman,1984; Schetky & Boverman, 1985; Blush & Ross, 1987).  These authors have discussed the specific psychopathology found in accusing parents, and less in depth, the individual pathology which might be found in the child.  So far, this author has found few articles which expand these formulations to include the application of a lesser known psychiatric entity, which is perhaps the most appropriate diagnosis in these cases.

Kaplan and Kaplan (1981) discuss the psychiatric entity known as Shared Paranoid Disorder, or Folie a Deux.  This is a clinical diagnosis listed in the Diagnostic Manual of the American Psychiatric Association III-R as 297.30 (Induced Psychotic Disorder).  As stated by Kaplan and Kaplan. "Folie a Deux provides a useful clinical perspective ... It is a well defined clinical entity" (p.92). In a frequently cited article, Gralnick (1942) defined a Folie a Deux as a "psychiatric entity characterized by the transference of delusional ideas and/or behavior from one person to one or more others who have been in close association with the primarily affected patient" (p.232).

This diagnosis can be applicable in cases of alleged abuse, especially when charges are brought by the custodial parent in instances of divorce/custody litigation.  Yet, it may be applicable in other cases as well, in that this type of psychiatric entity can be manifested by a child in interaction with adult interviews, investigators, etc.  Social workers often remove children from the home in cases of alleged abuse, and hence become t a sort of surrogate parent.

The central dynamic which makes this diagnosis applicable is that the relationships are characterized by a dominant/submissive dynamic.  The very nature of the relationship of a child to an adult is that of dependency and submission.  Thus, there is a considerable amount of secondary gain on the part of the child in adopting the dominant adult's ideas and/or behavior.  The child seeks in this way to gain the approval and love of the adult.  These are very powerful motivators.  The only therapeutic intervention which can be made must include separation of the child from the primarily affected adult(s).  When this is accomplished, the child will lose the delusional effect if it was a result of such a disorder.

It must be stressed that the existence of such a clinical disorder is only a possibility.  The fact that an accusation, even a false one, is made does not indicate the presence of a psychiatric entity.  This determination must be made by a qualified professional, after a careful evaluation of all the parties involved.  If, however, such a diagnosis is made, it can be extremely valuable in assessing the situation, and can aid in determining the veracity of the charges.  Even then, such a diagnosis should be subjected to a second opinion.  Most importantly, even the presence of such a disorder does not prove that the accusation is false.  The third component must be evaluated along with the first two stages to obtain a complete picture.

When taken together, the three concepts or stages taken from the various disciplines provide a compelling argument for a cohesive set of behaviors which may constitute a recognizable social syndrome.  It is characterized by the three stages which interact in a synergistic fashion thus producing the possible syndrome.  The concepts of collective behavior in Stage One explain the conditions which have contributed to the public hysteria regarding the problem of child abuse.  This contagion may then predispose both parents and children as well as professionals, to misinterpret, misconstrue and overreact to the possibility of abuse, and therefore report what might otherwise have gone unnoticed.

In Stage Two, the cognitive capacities which make children so suggestible are exploited either consciously or unconsciously by the reporting adult, social workers and/or investigators and the allegation is subjected to a process of bureaucratic escalation.  The alleged child victim is subjected to repeated interviews and interrogations, often by biased or poorly trained "professionals" and the child, in effect, learns the story.  This is then reinforced by the interrogator and the perceptions of the reporting adult.

In the Third Stage there can develop a psychiatric disorder known as Folie a Deux or shared paranoid disorder in which the child imitates the accusers' perceptions, ideas and behaviors.

This then is the general scenario of a Child Abuse Hysteria Syndrome. In certain instances there can be additional facts which add to the predisposition or motivation to find abuse, especially in divorce and/or custody disputes; though this does not, by itself, mean that the accusation is false.


This paper is a preliminary effort to identify a recognizable set of behaviors, which, if verified through further research, may help determine the veracity of an accusation of child abuse.  The formulation is based on the integration of three heretofore separate areas of widely accepted scientific principles, and thus constitutes a presumptive basis for foundation testimony from an expert of a more generic and neutral variety than currently exists within the adversarial court system.  This attempt to identify a social syndrome is with the hope that this and similar formulations can ultimately be used as new kind of expert testimony.

Foundation testimony of a generic nature, which is not biased or adversarial, might encourage the courts to use a team of appointed experts, who could assist the fact finders in gaining a broad understanding of the complex issues in a child abuse proceeding.  Such a team with members well versed in applying scientifically sound formulations could then be applied to the case at bar without the intrusion of the adversarial process.  In this manner, a team could provide the court with the most objective and non-biased interpretation of the matter, from a myriad of perspectives.  This team, acting almost as a committee, would subject the case to the various analysis and report their clinical perspective to the judge or jury.

The guidelines for opinion testimony have been broadened by rule 702 of the Federal Rules of Evidence, and may permit opinion testimony of this type if it can assist the trier of fact (Schuman, 1986).  Such opinions by experts are usually governed by the discretion of the trial judge, but guided by similar principles.  Opinions which can be of value to the fact finder may be acceptable, while opinions regarding the ultimate issue in the case are rarely permitted.  In the past the expert opinion has been devalued as a consequence of the adversarial process.  Expert opinion from a court-appointed team, however, may be far more useful, as well as valid.

Generic and broad-based theoretical formulations like those in this paper, could provide a far greater understanding of the large picture for the fact finders, just as other clinical tools prove useful in evaluating specific cases.  Such testimony could only be useful, however, if it is exempt from the adversarial process, and therefore presented in an unbiased fashion.  It is in the spirit that these preliminary formulations are being presented.

The adversarial system which pits the specific knowledge and expertise of one mental health professional against another is not only a waste of money and valuable resources, it often creates a tunnel vision in the mind of the fact finders and prevents them from gaining a broad understanding of the complexity of child abuse cases.  It's time for both the mental health and judicial establishments to recognize that our obligations transcend merely adding to the confusion through participation in the adversarial process.  Our energies must be devoted not only to theoretical formulations or clinical opinions, but to aiding the courts in implementing effective procedures as well.

If any of the preliminary formulations in this paper turn out to be on sound scientific footing, then we the health professionals must assume the responsibility of demonstrating their value to the courts.  We cannot afford to allow ourselves to continue to be drawn into battles of the experts any longer.  We must impress upon the judiciary that this approach not only limits our abilities to assist the fact finders, but compromises the value and objectivity of our input.  The time has come for a court appointed team approach, not only for child abuse proceedings, but for most areas of family court.  We must be responsible not only for the content of our opinions, but the context in which they are presented as well.


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* Lawrence D. Spiegel is a psychologist and can be contacted at 40 Baldwin Road, Parsippany, NJ 07054.

This article was presented as the keynote address at St. Joseph Hospital Children and Youth Center Conference; November 4, 1988.  [Back]

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