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First Do No Harm: The Sexual Abuse Industry Book Review

First Do No Harm: The Sexual Abuse Industry. Felicity Goodyear-Smith. (New Zealand: Benton-Guy Publishing Ltd., 1993, ISBN 0-86470-047-4), 167 pages.
Reviewed by Bruce Rind, Ph.D., Assistant Professor, Temple University.

For anyone wishing to understand the modern day sex abuse hysteria in terms of its origins, characteristics, and consequences, one could do no better than to read Dr. Goodyear-Smith's book First Do No Harm: The Sexual Abuse Industry. The author relates how she was originally part of this growing industry in New Zealand in the early 1980s. She worked, as a physician, in a rape crisis center. Within a short time, however, the focus of the center shifted to treating women who claimed to have been sexually abused as children. This shift reflected the earlier shifts of focus in the U.S.--New Zealand was about 5 years behind. The author describes the development of rigid, black and white thinking among her fellow workers, which was guided by the ideology that all rape and sex abuse were abuses of male power in a patriarchal society. The center developed protocols to insure that it was politically correct with respect to feminist, racial, and sexual orientation issues.

Dr. Goodyear-Smith saw the writing on the wall: that this new way of "thinking" would result in false accusations and miscarriages of justice. She resigned from the center. This was only the beginning, however. She then married a man, John Smith, who was later arrested, along with his father and others, for having sex with underage teenage girls at a permissive commune during the 1970s--a time when sexual attitudes were generally permissive in our culture. She, herself, was arrested for perjury at one of the trials of the accused. After being acquitted, she set out to attempt to explain the hysteria responsible for her personal plight. The result was this book.

She uses the book to report how those in the child abuse industry, in their efforts to "help," have actually done just the opposite.

They have built up a catalogue of myths and false assumptions that guide their actions. These actions, being falsely grounded, produce iatrogenesis-- that is, therapist or helper induced harm. A key reason for this is that therapists are not focused on helping their clients, but instead are concerned about punishing "perpetrators." Their state of mind, as well as legal mandates based on changes in the law aimed at getting "perpetrators," is that they are deputy law enforcement personnel. Thus, within this framework, their efforts go toward investigation and evidence-gathering, rather than to genuine therapy. The author makes the strong point that "[i]t is not possible to serve Hippocrates, the Healer, at the same time as Hammurabi, the Law-giver" (p. 38). This is the essence of the author's message: First do no harm.

The author takes us into the past to help us understand the present. She argues that the current thinking is socially constructed. That is, our current ideas about the reality of memories of abuse and its effects have been constructed by a society influenced by feminist rhetoric on male abuse of power, as well as by a void created by the depathologizing of other forms of sex during the "sexual revolution." This constructed social reality has been developed by an unlikely coalition of people from the left and the right, each with its own agenda. The anti-pornography, anti-male left emphasizes secret sexual victimization, while the religious right focuses on Satan's campaign of corruption.

The author next shows in detail how the assumptions of the child abuse industry are false. For example, she provides details of disclosure interviews to illustrate how suggestible children are. In one example, a young girl is interviewed 10 times. On the first nine she denies that her father did anything sexual with her. On the tenth, she finally agrees that something did. But the way she came to this agreement was clearly due to coercion from the therapist, rather than because it was true. The therapist continually made promises to the girl, telling her if she told the truth, then she could see her mum or have some cookies. When the girl said things the therapist did not want to hear, then the therapist ignored her or responded with displeasure. When the girl said things in the "right" direction, the therapist showered her with praise. This process is is known by psychologists as selective reinforcement, which steers the subject slowly but surely to the place the questioner wants the subject to go. Whenever the girl did say the "right" things, the therapist insisted on going on, rather than taking her to her mum or getting her cookies-- constituting outright coercion. Eventually, by giving the girl leading response alternatives, both of which pointed to the father's guilt, the therapist was able to get the exhausted child to agree that something did occur. The author points out that this procedure is the standard now for workers in the child abuse industry.

The author then proceeds to show how it works in day care centers. One child has some complaints of not feeling well.

Leading and coercive questioning are then used, generally guided by the assumption that all symptoms suggest sexual abuse. Once the "abuse" is "confirmed," then the social workers move on to all the other children in the center. These other children, unlike the first child, are generally healthy in mind and spirit before the "disclosure" interviews; afterwards, however, they exhibit symptoms. These symptoms are then attributed to the "abuse," rather than to the coercive interviewing, and these symptoms are then used to confirm the "abuse." Thus, the complaint of a single child turns into a scandal. But the real scandal, according to the author, is the harm inflicted on the children by the coercive methods of the interviewers, who are wrapped up in serving Hammurabi rather than Hippocrates.

The author illustrates the mentality of the child abuse industry with a quote from one of its members: "I would rather see ten fathers wrongly accused than one child sent back into what could be an abusive situation." This kind of thinking occurs whenever zealotry overrides reason or humanity. This viewpoint harkens back to the Inquisition, where the first Inquisitor General in Germany made a similar comment: "We would gladly burn a hundred if just one among them were guilty."

The author ends the book by listing a number of pay-offs that motivate women, or children, to claim they are victims. She attacks the victimology movement for its culpability in creating the climate that encourages these false accusations. Finally, the author lists a series of recommendations. One of the most important is that it is time that therapy be held up to the same standards as medical treatment: it should be subject to effectiveness evaluations in terms of not only its benefits, but its costs (e.g., iatrogenesis). The book is highly recommended because it is short and to the point. It covers all the topics necessary for layman and professional alike to understand what is happening in the case of false accusations of sexual abuse.