The Courage to Heal
|The Courage to Heal|
The 2008 20th anniversary re-issue.
|Author||Ellen Bass and Laura Davis|
|Publication date||1988 (original); 2008 (reissue)|
|Dewey Decimal||616.85/8369 22|
|LC Classification||HQ72.U53 B37 2008|
The Courage to Heal: A Guide for Women Survivors of Child Sexual Abuse (first published in 1988) is a popular self-help book written by poet Ellen Bass and Laura Davis that discusses the impact of child sexual abuse. It is based on their experience working with people who have been abused. The primary theme of the book is that individuals (mainly women) who have a vague set of symptoms can be defined as having been abused. The book also states that in some cases the memories of the abuse have been forgotten but are responsible for the individual's current problems. The authors propose a variety of techniques to help these individuals heal. These include confronting their alleged abusers, adopting an identity as a "survivor", overcoming the associated trauma and in cases where there is no memory of any abuse, recovering the memories. The book was a bestseller in North America and Europe.
The aim of the book is to provide a healing experience by means of explanations, practical suggestions, descriptions, and first-hand accounts. The premise underlying the book is that healing is possible. Key points include: the victim is not at fault, the victim is not alone as there are many victims, healing is possible, and the healing process is predictable. The authors consider such topics as effects of child sexual abuse, means of coping, the healing process, and ways of changing patterns. The book includes stories, which resulted from the sexual abuse workshops for survivors and interviews with women who have experienced childhood sexual abuse.
The book has been criticized for creating in children false memories of abuse. Its authors lack of qualifications and for creating an industry which has isolated and separated family members despite having no positive proof the abuse occurred. Bass and Davis have also been criticized for leaping to unwarranted, implausible conclusions with significant consequences and for scientific errors found in the first edition that were not corrected in subsequent reprintings. Bass and Davis responded to the controversy surrounding the book by writing "Honoring the Truth: A Response to the Backlash", a new chapter included the 1994 edition of the book.
The Courage to Heal is written by feminist activists Ellen Bass, a poet and creative writing teacher, and her student Laura Davis, an author, writing teacher and incest survivor. Bass is also a counselor and group facilitator who has been working with survivors of child sexual abuse and their supporters for years. Both authors have had first-hand experience with sexual abuse; Bass is the partner of a survivor of child sexual abuse and Davis is a survivor who participated in one of Bass' groups. Bass and Davis attributed efforts to confront incest and child sexual abuse to the Women's liberation movement. While working with students, Bass and Davis came to believe that the stories of some students were trying to convey painful memories of incest. From this idea, the two developed methods to assist students in recovering memories of abuse in childhood.
Neither Bass nor Davis have any training in psychotherapy or science, and they state that nothing in the book is based on any psychological theories. They have defended their lack of training with the claim that a PhD is not necessary "to listen carefully and compassionately to another human being"; neither author has ever acknowledged the errors they have made in their descriptions of memory and trauma. Despite their complete lack of knowledge about the workings of memories, the scientific approach or information and lack of qualifications, Bass and Davis still define themselves as healers and experts in the area of child sexual abuse, due to leading workshops with victims.
The 2008 edition is divided into the following sections:
- Taking Stock
- The Healing Process
- Changing Patterns
- For Supporters of Survivors
- Courageous Women
- Resource Guide
The third edition featured an afterword called "Honoring the Truth: A Response to the Backlash", which was added to respond to and rebut negative reactions to the book. The section has been characterized as an effort to dismiss all research contradicting the book as being part of a backlash against victims of incest, and was removed from the 20th anniversary edition.
The book was written as a response to the authors' frequent encounters with women who were the victims of sexual abuse during their childhood and adolescence, and is predicated on the belief that extreme childhood trauma, of which sexual abuse is one, is spontaneously repressed. The authors suggest that people experiencing dysfunction in their lives (including a wide-ranging set of problems such as depression, anxiety, alcoholism, drug addiction, dysfunctional relationships, dissociative identity disorder, self-injury and suicidal thoughts) or feel there was something traumatic in their childhood should investigate these feelings; Bass and Davis also present what they believe is a path to healing from the trauma of alleged childhood abuse. The latest edition features language more inclusive of male sexual abuse victims.
The original edition of the book contained an influential chapter discussing satanic ritual abuse (though satanic ritual abuse is now considered a moral panic, the case specifically discussed in The Courage to Heal is that of Judith Spencer, which has since been discredited) and the discredited autobiography Michelle Remembers - citing the latter approvingly along with other alleged survivor stories of satanic ritual abuse. Subsequent editions renamed the phenomenon "sadistic ritual abuse". The Courage to Heal was part of the vision that childhood sexual abuse could be discovered with no corroborating evidence beyond a vague set of symptoms.
The basic errors regarding the science of memory have never been corrected between editions; in the third edition, the book stated that for a small number of women their symptoms may have originated in emotional rather than sexual abuse.
The book has been described as an important resource for survivors. Judith Alpert, PhD, writes that:
|“||The authors attempt to do a great deal. What is most surprising is that they succeed. This does not mean that reading and completing the exercises always results in all survivors overcoming all effects of child sexual abuse. Rather, survivors who have read the book have reported to me that it was helpful in dealing with the effects of the abuse.||”|
A large number of therapists, between a quarter and a third, adopted the approach advocated in the book. Lacking training in research and awareness of the confirmation bias, these therapists lacked appreciation of the risks of seeing incest behind any symptom, or even a lack of symptoms and did not consider that other factors besides incest may have caused sexual problems in their clients. The book was a bestseller in North America and Europe, and has been described as "the bible of the 'survivors' movement". Discussing the book in relation to their discussion of narratives of incest, professors of English Janice Doane and Devon Hodges believe the book's popularity is due to it offering "an enormously enabling fantasy that by the same token refuses a complex analysis of the very means of recovery, writing, that it so confidently touts" and for promising to completely make sense of the reader's lives through the simple process of writing.
The book has been praised for being the first book for women to break open the taboo about sexual abuse.  The book has also been praised for encouraging disclosure, which is essential for the healing process of sexual abuse survivors. 
Bass and Davis have no formal training in psychiatry, psychology or any form of treatment for mental illness, with critics stating that as a result they are not qualified to write such a book. This lack of training may have resulted in Bass, Davis and others who adopted their approach leaping to conclusions that caused considerable harm, irrespective of their intentions. Bass and Davis also never acknowledged that their basic claims of how memory works were flawed or outright wrong. Paul R. McHugh, professor of psychiatry at Johns Hopkins University and award-winning researcher in the field of memory describes the book as the "bible of incompetent therapists". A report for the Australian branch of the False Memory Syndrome Foundation (FMSF) found the book was linked to nearly 50% of the cases in which a false allegation of child sexual abuse was made based on recovered memories and a 2005 report by the Health Services Commissioner to the Minister for Health of Australia stated that some respondents from families where there were accusations of child sexual abuse called for the book to be banned, believing that it promotes the practice of recovered memory therapy. Frederick Crews has criticized the book for appealing not to women who have always remembered abuse, but rather being aimed at those who struggle to convince themselves they were abused as children in the absence of previously-existing memories, and that the author's claim to promote self-esteem are actually based "on a shattering of their readers' prior sense of identity and trust".
Linda M. Williams, a Sociologist and researcher on trauma and memory, stated that:
|“||To the best of my knowledge there is no empirical evidence whatsoever that demonstrates, nor even a single study that has attempted to demonstrate, that one phrase- that is “If you think you were abused, then you were”- (or even several phrases) in a self help book could trigger and “epidemic” of confabulated memories of sexual abuse."||”|
Elizabeth Loftus, an award-winning researcher on memory, stated that the book was certainly very comforting to individuals living with memories of abuse, but questioned the effect it would have on people who do not have such memories, and suggested The Courage to Heal may be one of many sources of false memories for some individuals. Loftus also stated that "All roads on the search for popular writings inevitably lead to [the book]". The Courage to Heal encourages the use of strategies such as guided imagery to access and attempting to elaborate details and emotions and discouraging individuals from questioning the memories recovered.
According to psychologist Bryan Tully, the philosophy of the authors regarding memories of abuse, or lack thereof, is that:
|“||Forgetting is one of the most effective ways children deal with sexual abuse. The human mind has tremendous powers of repression. Many children are able to forget about the abuse, even as it is happening to them... You may think you don't have memories but often as you begin to talk you do remember, there emerges a constellation of feelings, reactions, and recollections which add up... To say 'I was abused' you don't need the kind of recall that would stand up in a court of law... Often the knowledge that you were abused starts with a tiny feeling, an intuition. It's important to trust that inner voice and work from there. Assume your feelings are valid... So far no-one we've talked to thought she might be abused and then later discovered she hadn't been. The progression always goes the other way, from suspicion to confirmation. If you think you were abused, and your life shows the symptoms, then you were.||”|
Professors of English Doane and Hodges note that the book was widely condemned for its use of checklists to determine if the reader was abused, describing the complaints made against the book as being as formulaic as the stories it engenders (in part due to things like the "notorious") and only criticizing parts of the book. Doane and Hodges also state that the use of "you" throughout the book blinds Davis and Bass to their shaping of the identity of the reader and their story.
Relationship to the False Memory Syndrome Foundation
A 2009 newsletter from the American branch of the FMSF criticizes the 20th anniversary edition, claiming "No book did more to spread false memory syndrome" (though the existence of false memory syndrome, a belief that memories can be created through inappropriate therapy techniques, is itself debated)[improper synthesis?]. The book was described as vicious, and filled with factual errors about the FMSF and the nature of memory, though the anniversary edition is described as better, without the outrageous features of earlier publications and that in the new edition, the FMSF is not mentioned in the book's index. The book is still dedicated to recovering memories, and does not warn the reader of the doubts scientists have about its premises. The book still contains a section on satanic ritual abuse, without noting the FBI's report that concluded there was no evidence for the phenomenon.
The Third Edition of the book, published in 1994, offers a whole chapter titled "Honoring the Truth," in which the authors respond to the book’s critics. The FMSF criticized the chapter about their organization as filled with factual errors and written by a man who had no known credentials and no scientific publications in the relevant fields; the discussion of the FMSF was removed from the 20th anniversary edition.
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