Violence in Our Families

THE OPEN MIND
Host: Richard D. Heffner
Guest: Dr. Theodore Shapiro
Title: “Violence In Our Families”
VTR: 12/10/88

I’m Richard Heffner, your host on THE OPEN MIND. It doesn’t much matter that figures don’t lie. We all know that liars do figure…indeed, that even the most honest, the most forthcoming, the most thoughtful and concerned among us are of two or perhaps even more minds about the meaning for our nation, for our times of the horrendous figures relating to child and family abuse that literally engulf us these days.

The week we record this program Newsweek’s cover story is “A Tale Of Abuse” about “the horrifying Steinberg trial” in particular, and more frighteningly, about the “psychology of violent relationships” presumably burgeoning in our nation at large. The trial itself is being carried on television in far larger segments than one would earlier have imagined – an indication itself of widespread, perhaps morbid, certainly intrusive popular interest in the family violence that Newsweek documents with such statistics as these: “At least 1.8 million women are battered each year. Some form of violence occurs in 25% of all marriages. 20% of women seeking emergency surgical procedures are victims of domestic violence. More than two million cases of child abuse were reported in 1986 compared with 669,000 in 1976. More than 1,200 children die each year through child abuse and neglect”. Other figures are even more shocking, so that innumerable questions surface. Are we more abusive as a people or are our abuses showing more? Whichever, what do these figures show about what kind of people we are? How must we now evaluate our traditional self-image as a child-centered society? What do all these cameras in our courts, these daily stories in print tell us about changing American attitudes toward privacy, toward the sanctity, however sanctimonious, of family relationship? What have we come to fear most about ourselves, about our violent instincts, our violent actions?

Well, perhaps our guest today on THE OPEN MIND will help us at least begin to deal with these questions. Dr. Theodore Shapiro is the Editor of the Journal of the American Psychoanalytic Association, Professor of Psychiatry at the Cornell University Medical College; he is Head of Child and Adolescent Psychiatry at Payne Whitney Clinic, New York Hospital. And I want to ask Dr. Shapiro if he would conjecture that our abuses are only showing more. That we’ve become more sensitive to America’s violent relationships. Dr. Shapiro?

Shapiro: I agree with what you just said. I think they’re just showing more rather than that there is an absolute increase in the incidence and prevalence of these kinds of behaviors. You might ask me why I would come to that conclusion.

Heffner: Indeed.

Shapiro: (Laughter) It seems to me that we’re only most recently being asked to report when we suspect such behaviors. In the past they went relatively unnoticed, and it wasn’t until the mid-fifties that a man named Henry Kempe, for example, in Colorado described what he called the battered child syndrome, and that was really an x-ray diagnosis of children having multiple fractures at varying places in the body, with no explainable cause in regard to internal problems. That was the beginning of the alerting procedure in the profession to bring to the attention of authorities when they felt and thought that children were being injured and abused. Subsequent to that certainly there was a grand attempt to not only document when these occurrences would happen, but also to take action with regard to some preventative aspects of work that we could do.

Heffner: But what kind of people are we if what is happening now is essentially, in your estimation, pointing a hard cold light at what we have been and what we have done?

Shapiro: When you ask “what kind of people are we now”, I suspect you’re asking “are we different from what we used to be?” Again, it’s very difficult to know that. Every phase of history has certainly had some commentary on our ambivalence towards children. You asked earlier whether or not we are a child-loving society. I’m not so sure we’re only child-loving we’re also child-hating in many ways. From the beginning of time there have been stories which we call “aspects of infanticide”. Our classic stories of Oedipus, Moses and so forth were all documented around the notion that children were to be put to death because somebody was afraid of the rising king, the rising messiah or whatever it was going to be. It was only after the Industrial Revolution, for example, that we instituted such things as child labor laws. Children were exploited, used and abused in regard to making new products, once we were out of the home and we industrialized. So we’re beginning to have to take account for how we take care of children and how the public looks at children rather than the personal issues that dictated family behavior towards children.

Heffner: Which do you think will give first? What it is we do or our need to see ourselves as doing something different? Because certainly the myth has prevailed that we are a child-centered society, a society enormously concerned about the well-being of our children. Is what you describe the human condition?

Shapiro: Well, it might be but that doesn’t mean that the human condition can’t be changed by human beings. I don’t believe in it as a kind of natural fact of man because all those wonderful natural facts of man from his stinginess as well as his generosity, from his altruism as well as his sadism, all can be altered by the way in which we act toward each other and societal rules and family rules. So that if there is a natural ambivalence, and well there might, there also is a natural tendency towards loving and caring for children. Darwin was very clever about it actually. He suggested that there is something about babiness which leads to attachment which was necessary for survival in a species which was very vulnerable to being wiped out if there wasn’t adequate care-taking. We have prolonged care-taking.

Heffner: But you obviously don’t feel that Americans’ attitudes toward or feelings about babiness have necessarily changed.

Shapiro: I do not believe that. If that anything there is an attempt, I think, in the press and in the popular media, films and so forth, to begin to take account of “how can we get back to the joys of child-care when we’re so busy doing other things”? A recent film, if I remember, was about a mother who had a baby thrust upon her, and what kind of vicissitudes she went through until she finally left her job and ran off to Northern climes where she could be a natural mother again, so to speak. So there’s a kind of re-sentimentalization of child-care, and also the whole issue of whether or not there’s more abuse in alternative child-care circumstances, such as day care centers, and certainly we’ve heard about…and we’ve all heard about the accusations of abuse and sexual abuse in those settings. So what it needs is more monitoring, more careful, thoughtful approaches to who we have taking care of our children, and perhaps even adequate funding to do so, so that we can be functional in the community as well as with our families.

Heffner: You say, Dr. Shapiro, “more monitoring”.

Shapiro: Yes.

Heffner: But if we re-decide, set aside the day care center, if we set aside the schools, if we set aside those areas outside the home where abuse takes place, and focus only on the family…

Shapiro: Yes.

Heffner: …how willing are you, and how possible would it be to involve ourselves more and more in the private activities of family relationships in this country?

Shapiro: There’s a real tension there, of course, between what should be public in a family, and what should be private. The Steinberg case that you just mentioned, of course, reveals the fact that an apparently average New York couple rearing a child, supposedly doing good, it was an adopted child…good for a child, ended up abusing the child and killing the child. So it is very difficult in regard to the rights of the public to have surveillance over private families, but I’m not a lawyer, and I’m not going to get into that one.

Heffner: (Laughter) Wait, wait, wait a minute.

Shapiro: (Laughter)

Heffner: I don’t know whether you were saying “I’m not a lawyer comma and I’m not, also not going to get into that” because as a psychiatrist I would ask whether you would get into the appropriateness of our involvement in the privacy of the home.

Shapiro: I personally do not believe that it is appropriate for us to get into the privacy of the home, but when the privacy of the home intrudes upon our vision…If somebody comes to a clinic or to a physician and there is a suspicion that abuse has taken place, then we have the necessity to bring our forces to bear, and see whether we can investigate. That’s an interesting area, where approximately…no matter how many child abuse accusations are made, only 50% of them are verified. So there are many more brought to the attention of authorities than are actually documented. Now, there we have another question. Does the adequacy of the investigative procedure, something that’s to be criticized here, and most people do think that the social services and the social welfare groups that investigate these so-called cases are really inadequate, and inadequately funded by governmental agencies.

Heffner: Of course there’s an interesting switch on that. The more we become involved citizens in other peoples’ business, if I may put it that way, in what goes on in other peoples’ families, the more alerts there go out…

Shapiro: Yes.

Heffner: …the more of a drain and a strain there is on the social welfare services that we have available, and I gather from some of the things that I’ve read, that this is one of the problems, that we are now, as a people, alert to anything happening and we raise so many questions that there is less and less of an opportunity, with the limited resources we have, to investigate competently.

Shapiro: That is undoubtedly the case, and it becomes a vicious circle of how much looking should we do and more importantly, how adequate is the intrusion and the looking so that we can discover what we might wish to discover so that we can enforce some preventative measures. And that becomes another issue, too, is how do you keep this from happening, especially when it may be a first alert? How do you somehow know before the abuse is going to happen that there is a likelihood for it to happen? And there we do know some of the risk factors that are involved, and if we could get adequate help for some of these families prior to the action then that might be useful too.

Heffner: What are some of the factors? The fact that a parent had been an abused child himself or herself?

Shapiro: That seems to be indubitably the case which is that abuse breeds abuse. Most of the abusers have been abused themselves. Alcoholism certainly contributes to the condition, and there is a circumstance that we’re beginning to understand now that there may be a combination of a sociopathic father with a depressed mother in combination which leads sometimes to sexual abuse. Now those become alerting constellations. Of course not every family is looked at that carefully before the abuse actually occurs. Perhaps if the mother’s depression could be treated that would be an intrusion, that would be a useful one. If the alcoholism could be intruded upon that might lead to less irritability and the circumstances under which abuse occurs. There are factors in the child, him or herself, which also seem to be important with respect to whether or not abuse occurs. Many of the children are looked at as special in some way or another. It’s very difficult to know whether or not the large number of mildly retarded children in the group are a result of the abuse, head injuries for example, or were…the case was that prior to the abuse. The other features that seem to represent risk factors in children are early injury or something which makes them stand out in the parental circumstances, the meaning of the child to this parental group. Young mothers, teenage mothers seem to be at much higher risk in regard to their inadequacies as parents and which lead also to abusing situations.

Heffner: Dr. Shapiro, it’s so fascinating to me though that what you seem to be saying, I don’t want to say suggesting, but what you seem to be indicating with the potential that we have for identifying early warning signs…

Shapiro: Yes.

Heffner: …is that there will be even more intrusion on a “before it happens” basis…

Shapiro: Yes.

Heffner: …to avoid the kinds of stories that we have been reading in such great number in recent years.

Shapiro: That’s a critical tension I think in our society is that with respect to how much can we do before to prevent and how intrusive do we have to be in order to do so. Any program that aims at primary prevention has to have some intrusive arm to it, to be sure. On the other hand, society will have to make its own determinations as to whether or not these rising figures are worth the effort, or will wait for the first incident or for the first “after the fact” result. Unfortunately, so many of the children who die from child abuse are under two years of age, so that that means that when it is severe, it is severe and early. The older children somehow survive.

Heffner: Of course you put it so nicely, the tension between the conflicting values that we have, concern for children and their well-being, concern for privacy, more traditional perhaps, more deeply based in our society. If you had to make a bet, which end of that dichotomization is going to give more? Our concern for the well-being of children? Or our traditional notion of “stay out of my personal family life”?

Shapiro: I think the latter is going to win in the society that we’re making in recent years. Politically if one listens to the words of the last election family values seem to be paramount, and family values seem to be paramount over public concern issues except where you get the tension to such a degree that it looks like we’re having epidemic proportion difficulties. The AIDS epidemic is an example of the beginning encroachment on our awareness that you have to do something even if it’s a private matter.

Heffner: How do you account for the enormous public interest in child abuse? The enormous public interest in the Steinberg trial?

Shapiro: Yes. Let’s start with the Steinberg trial, and then go to the enormous public interest in child abuse in general. The Steinberg trial, it seems to me, has stimulated interest for two reasons. One is they are middle-class professional people. That makes them impressively close to the public who’s reading the newspapers, and the public who are interested in this. The closer one can identify with the “who” that they are, the more they want to understand, it seems to me, how could something like that happen in somebody who’s as close to me as that?

Heffner: Because they feel “there but for the grace of God, go I”.

Shapiro: Perhaps. Freud said it very concisely. He said “we murder the murders in our society because we can’t stand to see our own murderous impulses acted upon”. There’s an attempt to not only repress such urges and keep them away from action, but also there’s an attempt to wipe it out from our visualization. But that same tension again creates curiosity. We want to know “how could they do that which I don’t dare to think about?” How could somebody carry out something so atrocious that I, myself, find so difficult to even entertain in my thoughts, so much so that I even have to enter all kinds of ritual avoidances in order to get it out of my head. It’s a little bit like the questions that came up around the matters of the Nazi atrocities. How could such a civilized community engage in such an atrocious act of genocide or whatever it was that was going on? The second part about it has to do…the issue that I think that has to be addressed in the Steinberg case has to do with family violence in general, as well as violence towards children. There’s a repeated question that people become interested in which is “how can someone be in another person’s thrall? How do you keep coming back, why don’t you run away when things are so intolerable?” And the literature on battered women in marriages…interestingly battered women rather than battered men, but I’m sure we’re going to find some battered men as well as battered women. Why do they stay with their spouses? What is the magic of that relationship which makes that circumstance prevail and why do they come back for more? I think that fascinates human beings the world over.

Heffner: What in the world is the answer, Dr. Shapiro?

Shapiro: What is the answer? (Laughter) One of the things that’s been suggested has to do with the notion that I mentioned earlier about Darwin. Strangely enough we can go back to the old master himself. As you go along the water of changing forms of life, one of the things about primates and especially about human beings is that we’re born relatively immature. We have real problems surviving without care-taking. So we who have small broods, small number of children have to take care of them for a much longer time. The price of that attachment may be that we will put up with almost anything in order to maintain that attachment because it’s so linked to our survival. There’s a wonderful set of experiments on primates by Harlow where the infants were separated and when they were grown up they found it difficult to assume the varying positions which permitted procreation, but once they did they abused their children. Those young monkeys, however, stuck to their parents even though they were being abused. The price of attachment seems to involve an awful and terrible repetition of something which seems intolerable.

Heffner: I was in the courtroom the other day, watching cameras in the courts, when the question was asked of the witness, “did she know what masochism is?”, and I guess you’re giving a larger explanation for us.

Shapiro: There’s only one problem with the concept of masochism – when it’s spoken about it sounds as if it explains something, and it’s something which requires explanation. One of the explanations might be the one that I gave, but there are also other descriptions which have been offered. There are some very nice studies which indicate that the tension rising phase of hostile relationships between couples are frequently followed after the abuse by contrite reconciliations…

Heffner: Which has its rewards.

Shapiro: Which has its rewards. In fact it may even be that the tension and the abuse may be for the reward of the contrite reconciliation. When that ratio becomes less successfully directed towards those reconciliations is when the women can break away it seems to be.

Heffner: It’s interesting to me that you don’t say, as I think, as you talk, Dr. Shapiro, “sick, sick, sick”. You seem to be saying that this is something in human relationships that you’re not, you’re not willing, prepared, eager to characterize as illness.

Shapiro: That’s partially true. There is a part of what goes on which I think corresponds to the large mass of how we think about our relationships. Marriages, relationships and so forth are colored not only by loving care, but also by hostility and anger. There’s no question about it. On the other hand, when it gets to this extreme, the question of whether it’s sick or not really should be determined by whether there is concomitant and co-occurring psychiatric illness, would be one of the questions that I would raise, and frequently in these instances it is. So that for example, major depressive disorders are found in the women who permit their daughters to be incestuously abused by the fathers. Alcoholism, sociopathic behavior, repeated shuffles with the law which suggest delinquency and criminal activity prior are prevalent in this population. Some of them are “but for the grace of God”, as you mentioned. But some of them are, indeed, sick.

Heffner: We have two minutes left, something like that…I wondered if you find in our society today forces, elements that are pushing us further along these naturalistic lines, or whether they have reinforced the evolutionary patterns that you’ve described. Has something gone wrong?

Shapiro: The increase in arbitrary violence in the streets, the predictions of “A Clockwork Orange” type of societies certainly would lead one to wonder. It could be related to diminution of clear values, the devotion to former rituals, the desolidification of the society in regard to what are the ritual behaviors that keep us together, may be instrumental and important in loosening the usual kinds of bounds and restraint which people take. I don’t know the answer to that one quite yet, but I think that good sociology and good psychology may lead us to better understanding of those processes.

Heffner: From what you said earlier I gather good chunks of dollars, too, invested in the right places, in education and social welfare.

Shapiro: Well, that’s the key answer to the matter of whether or not we love our children or we’re ambivalent towards our children. More bucks for education than armaments certainly would be part of the answer.

Heffner: Interesting way to end the program. Dr. Shapiro I wish we could have gone on to the descriptions of battered wives, but I guess we have to subsume them under the general rubric of the battered children. Thank you so much for join me today, Dr. Theodore Shapiro.

Shapiro: Thank you.

Heffner: And thanks, too, to you in the audience. I hope you’ll join us again next time. And if you care to share your thoughts about today’s program, about today’s guest, about today’s theme, overwhelming as it is, please write to THE OPEN MIND, P.O. Box 7977, FDR Station, New York, NY 10150. For transcripts send $2.00 in check or money order. Meanwhile, as an old friend used to say, “Good night and good luck”.

Continuing production of this series has generously been made possible by grants from: The Rosalind P. Walter Foundation; The M. Weiner Foundation of New Jersey; The Mediators and Richard and Gloria Manney; The Richard Lounsbery Foundation; Mr. Lawrence A. Wien; and The New York Times Company Foundation.