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An ancestry of circled sisters, naming the shadows that sit at our shoulders, and breathe in our hair. Call them forward to the center, Become the light that will consume them. Celebrate their death, consecrate this time. - from "Naming the Shadows"

The poem's author is a victim of incest and one of six clients seen by Susan Roth during a year-long study of childhood sexual trauma.

DURHAM, N.C. - Victims of sexual childhood trauma, including incest and rape, who remember the abuse only in their later years, often find themselves dealing with post traumatic stress syndrome in isolation, the truth rejected by their family and friends as well as society at large, says Duke psychologist Susan Roth.

Roth, an expert on the psychological aftermath of trauma, is the co-author of Naming the Shadows: A New Approach to Individual and Group Psychotherapy for Adult Survivors of Childhood Incest (1997) and the editor of a newly released pamphlet published by the International Society for Traumatic Stress Studies (ISTSS) : "Childhood Trauma Remembered: A Report on the Current Scientific Knowledge Base and its Applications."

The pamphlet, one of the first of its kind, was designed for lay people as well as lawyers and psychologists. It provides information about childhood trauma remembered as an adult and offers general guidelines about the scientific issues. Among the findings reported: even men and women who were victims of well-documented childhood abuse do not always later recall the traumatic events.

"False memories," a moniker misnomer, refers to the fact that images can be implanted in some highly suggestive people, Roth said. There are legitimate concerns about people being falsely accused and about inadequate and inappropriate psychotherapy, but news media often provide an unbalanced view of the issues, she said.

"One of the positive things that's come out of all the media attention is there's been a lot of research done," Roth said. "We don't know the mechanisms by which people forget things. There are a lot of possible ways traumatic memories may be forgotten. We do know that people do remember them after they're forgotten -- that's a real phenomenon."

Most clinicians would not consider it an acceptable practice to encourage a client to imagine, or make up a story in their head, to see if that aids their recall, Roth said.

"Suggesting to clients that they must have had traumatic experiences or encouraging clients to imagine that they were traumatized without a reported history may promote the development of false memories.

"There is research to show that under some conditions, you can get people to believe things happened to them that didn't. But if you look at the studies closely, you'll see that it's not easy to do. I don't think it happens as much in psychotherapy as people might imagine."

What Roth finds troubling is that many people choose to believe that these memories are "false" rather than accept the horror that childhood sexual trauma happens. She estimates that 20 percent of girls and 5 percent to 10 percent of boys are victims of some form of childhood sexual trauma.

"The whole issue of childhood sexual abuse is very, very loaded. I think it's very disturbing to people that it happens as much as it does. They are more comfortable with the idea that people are making it up than they are with accepting that people are suffering from it."

This form of societal rejection has a strong impact on the victims, she said.

"There is an aura of silencing around childhood sexual abuse within families and that makes it very, very difficult for people to talk about it, much less get help. Most people who come in for treatment are in their '30s or '40s. So, it's like a societal response similar to the response they may have gotten from their mother or teacher: 'Oh, that couldn't really be going on.' "

"But I think the societal response has been somewhat insensitive to victims in the service of protecting people from therapist. The front-burner issue is that people have been sexually abused and they need to get some sort of positive societal response so they can go ahead and do whatever they need to do to deal with it."

Although many people believe that these types of memories are triggered in psychotherapy, more often the triggers are something similar to the trauma or that serves as a reminder.

"It could be a movie about sexual abuse or it could happen after being in a room with wallpaper that's the same as your childhood wallpaper."

Roth, a former president of the ISTSS, said she hopes that the book and pamphlet will make information about forgotten sexual trauma more accessible to lay people and therapists.