By Sandra L. Bloom, MD
CommunityWorks
Philadelphia, Pa., USA

Published in the International Handbook of Human Response to Trauma (2000), New York: Kluwer Academic/Plenum Publishers. Edited by Arieh Y. Shalev, Rachel Yehuda and Alexander C. McFarlane.

Crime rates in the United States rose rapidly in the 1960's and attention was also brought to bear on crime against women and children, probably for the first time in history.

The women's movement was instrumental in bringing attention to the incidence of rape and domestic violence that was being perpetrated against women. The first public speak-out on rape was organized by the New York Radical Feminists in 1971 and the first International Tribunal on Crimes Against Women was held in Brussels in 1976 (Herman, 1992).

In 1974, Ann Burgess and Linda Holstrom at Boston City Hospital described the "rape trauma syndrome" noting that the terrifying flashbacks and nightmares seen in these women resembled the traumatic neuroses of war. Susan Brownmiller and other feminist writers and thinkers redefined rape as an act of violence directed at maintaining dominance. In doing so, they placed the act of rape squarely in a political framework of power relationships, laying the groundwork for cross-fertilization with colleagues working with other survivor groups (Herman, 1992).

The feminist politicization of violence led to a deepening understanding of the abuse of power within the family, leading to the "discovery" of domestic battering and sexual abuse. As in the cases of delayed combat stress and rape trauma, domestic violence and sexual abuse awareness began at the grassroots, emerging out of feminist consciousness raising groups.

Lenore Walker published her landmark study on victims of domestic violence (1979), while Gelles and Straus released the results of major studies on family violence (Straus, 1977; Gelles and Straus, 1979). Around the same time, Judith Herman and her colleagues in Boston began to document the effects in adult women of having been sexually abused as children (1981). Rape crisis centers and battered women's shelters began to spring up in various communities around the country, outside of the traditional mental health systems.

Finkelhor has described the increasing professional concern about child abuse over the last several decades as being the "result of a broad social movement and a historic moral transformation" (1996, p.ix). C. Henry Kempe, pediatrician at the University of Colorado first described the "battered child syndrome" in 1962 (Kempe et al, 1962; Kempe, 1978). This conceptualization of child abuse brought the medical profession into this social movement with all the authority, prestige, and legitimacy necessary to bring about legislative change.

At first, clinicians and researchers like Green focused on the physical abuse of children (1978a, b). The 1970's saw the establishment of mandatory child abuse reporting laws and a widened system of child protection that was furthered and supported by the growing feminist movement (Finkelhor, 1996). But then Susan Sgroi (1975), David Finkelhor (1979), and others began to document the widespread incidence of the sexual abuse of children and the harm it was doing to them.

In 1973, the Children's Division of the American Humane Association testified before a Senate Committee, estimating that 100,00 children were sexually abused each year. Burgess and her colleagues noted in 1978 that "concern for the victims of sexual assault has become a national priority only during the past five years. In that time, both public awareness of and knowledge about sexual assault and its victims have grown immeasurably" (Burgess et al., 1978, p.ix).

As early as 1975, Shatan was studying the effects of other kinds of trauma on children. In 1972, he chaired a roundtable discussion at the IV International Psychoanalytic Forum in New York, comparing delayed survivor reactions in two parent groups: Vietnam veterans and concentration camp inmates, having noted significant symptoms of unresolved mourning in young adults who were children of World War II veterans from 1965-1970.

He presented a paper at the 1975 meeting of the American Orthopsychiatric Association (1975) looking at the delayed impact of war-making, persecution and disaster on children. But there was a great deal of professional resistance to recognizing that previously normal and healthy children could be severely damaged by exposure to psychologically traumatizing events. In 1979, Lenore Terr published the first of her series of papers and a book on the children of the Chowchilla, California kidnapping which introduced a developmental focus on the effects of trauma.

Elissa Benedek recalls hearing Terr present her data before a mocking and hostile professional audience who were determined to deny the effects of trauma and disaster on previously healthy children. As she puzzled over this seemingly irrational response on the part of a professional group she knew well, she concluded that 'this meeting was but another form or manifestation of a long tradition of denying psychological and psychiatric sequelae in the child victim of trauma.

The audience's response of disbelief in the face of carefully collected documentation, might have been so intense because it was difficult for professionals to accept that traumatic events, caused by fellow humans, in the lives of children might color and shape their lives for years to come" (Benedek, 1985, p.4).

Crime victimization surveys in the U.S. led to the development of the Law Enforcement Assistance Administration, a federal agency designated to provide victim service programs in the 1970's. While new services were starting, researchers were gathering data about the consequences of victimization to the individual and to the entire society.

In 1975, the National Organization of Victim Assistance (NOVA) was founded and other victim-centered groups emerged, such as Mothers Against Drunk Driving and Parents of Murdered Children (Young, 1988). Morton Bard became involved in the crime victim movement in the 1970's when he consulted with law enforcement agencies in New York City and later the National Institute of Justice (Bard & Sangrey, 1979; Bard & Shellow, 1976). He and Dawn Sangrey published a volume for crime victims in Figley's psychosocial series for Brunner/Mazel in 1979.

Both Robert Rich and Susan Salasin became involved in developing mental health programs and social policies to meet the needs of victims (Rich, 1981; Salasin, 1981).

On February 26, 1972, a dam burst in Buffalo Creek, West Virginia, destroying houses, a community, and many lives. K. Erickson wrote a book about the survivors of the Buffalo Creek disaster (1976) and other researchers, including Bonnie Green, and later, Jacob Lindy, followed up on the long-term effects of this disaster on the survivors (Gleser, Green & Winget, 1981; Lifton & Olson, 1976; Titchner & Kapp, 1976).

On March 28, 1979, a sizeable portion of the Unit 2 reactor at Three Mile Island experienced a meltdown, outside of Harrisburg, Pennsylvania, in the most serious U. S. commercial reactor accident to date. Some gaseous, but inert material was released, and no serious health consequences were expected. The population, however, had to be evacuated and a Task Force was rapidly set up to evaluate the highly publicized effects of this event on the affected populations (Dohrenwend, et al., 1981).

Other disaster studies began to emerge in the literature throughout this time period as well (Boman, 1979; Quarantelli & Dynes, 1977; Parker, 1977), building on a knowledge base that dated back to Lindemann's landmark paper on the Cocoanut Grove fire (Lindemann, 1944; Leopold & Dillon, 1963). Manuals on helping disaster victims began to be developed and published (Tierney & Baisden, 1979).

Beverly Raphael from Australia, began publishing her work around disasters and bereavement and she and John Wilson made early contacts with each other, thereby establishing a firm connection with Australia (Raphael, 1977; Raphael & Maddison, 1976; Wilson, 1997).

This growing body of literature on the psychological effects of disaster indicated that there could be long-term consequences of overwhelming stress in populations generally considered by the public to be free from any culpability in their experienced victimization. The high level of publicity given to disasters helped to increase the general level of consciousness about the consequences of trauma.

In 1974, a bank robber in Stockholm, Sweden took a bank teller hostage. They fell in love and had sex during a long siege in the bank vault (Ochberg, 1996). In the same year, the granddaughter of William Randolph Hearst and heiress to the Hearst fortune, Patty Hearst, age 19, was kidnapped by a terrorist group, while sitting at home with her boyfriend.

Until September of 1975, she was a captive of the group and was physically, sexually, and emotionally tortured. She developed a new persona and a new name, "Tanya" and was caught by the FBI while participating in a bank robbery with the group. In 1976 she was convicted and sentenced to seven years in jail, three of which she served (Hearst, 1981). This odd form of bonding between kidnapper and victim was later recognized in other types of captivity situations and came to be known as the "Stockholm Syndrome" (Strenz, 1982).

Frank Ochberg, a psychiatrist whose career decisions had been in part shaped by the assassinations of Martin Luther King and Robert Kennedy, co-authored a book on violence even as a psychiatric resident (Daniels, Gilula and Ochberg, 1970). He went to work for the National Institute of Mental Health and became the NIMH representative when the U.S. Department of Justice commissioned an inquiry into terrorism in 1975. As a result, he began to focus on victims of terrorism and hostage negotiations.

He served as Associate Director for Crisis Management at NIMH in the late 1970's, consulted to the U.S. Secret Service, and trained Air Force personnel about terrorism and sabotage (Ochberg, 1988a). He published an article on terrorism as early as 1978 in a new journal devoted to the study of terrorism and in 1982 he co-edited one of the first books on terrorism (Ochberg & Soskis, 1982).

In England, an article came out with the seemingly surprising finding that people not seriously harmed in a terrorist bombing were more incapacitated than would have been expected and they termed this an "aftermath neurosis" (Sims, White & Murphy, 1979) Across the nation and around the world, the growing global communication network was tuning us in to tragedy everyday. Trauma was in the air and a budding awareness began to emerge that the various forms of traumatic experience might be similar and even interconnected.

As early as a 1979 paper, Shatan, Haley, and Smith were already comparing the catastrophic stress of natural disasters, man-made disasters, combat trauma, incarceration, Buffalo Creek, Hiroshima, and internment in the death camps. The time was ripe for a convergence, for people to come together and share their knowledge, experience, and sorrow.

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