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file:// From _Skeptic_ vol. 2, no. 3, 1994, pp. 58-61. The following article is copyright (c) 1994 by the Skeptics Society, 2761 N. Marengo Ave., Altadena, CA 91001, (818) 794-3119. Permission has been granted for noncommercial electronic circulation of this articles in its entirety, including this notice. For information about a special Internet introductory subscription rate, see the file subscription-rates or contact Jim Lippard ( RECOVERED MEMORY THERAPY AND FALSE MEMORY SYNDROME By John Hochman, M.D. Thousands of patients (mostly women) in the United States have undergone or are undergoing attempted treatment by psychotherapists for a non- existent memory disorder. As a result, these same therapists have unwittingly promoted the development of a real memory disorder: False Memory Syndrome. To make sense of this unfortunate situation, I need to offer a few definitions. Some psychotherapists believe that childhood sexual abuse is the specific cause of numerous physical and mental ills later in life. Some term this _Incest Survivor Syndrome (ISS)_. There is no firm evidence that this is the case, since even where there has been documented sexual abuse during childhood, there are numerous other factors that can explain physical or emotional complaints that appear years later in an adult. These therapists believe that the children immediately _repress_ all memory of sexual abuse shortly after it occurs, causing it to vanish from recollection without a trace. The price for having _repressed memories_ is said to be the eventual development of ISS. Therapists attempt to "cure" ISS by engaging patients in _recovered memory therapy (RMT)_, a hodge-podge of techniques varying with each therapist. The purpose of RMT is to enable the patient to _recover_ into consciousness not only wholly accurate recollections of ancient sexual traumas, but also repressed _body memories_ (such as physical pains) that occurred at the time of the traumas. In actuality, RMT produces disturbing fantasies which are misperceived by the patient and misinterpreted by the therapist as memories. Mislabeled by the therapist and patient as _recovered memories_, they are actually _false memories_. The vast majority of false memory cases developing from RMT are in women, which is why this article assumes patients to be female. Initiation of Patients into RMT A woman consults a psychotherapist for relief of various emotional complaints. The therapist informs her that she may have been molested as a child and does not know it, and this could explain her symptoms. Some patients think this idea is absurd and go to another therapist; others accept the therapist's suggestions and stay on. More than a few women have heard about repressed memories from talk shows or tabloids even prior to coming to the therapists office, and may even make the appointment believing they too could be "victims." Though the patient has no memories of abuse, she becomes motivated for "memory recovery" since she is told this will cure her symptoms. The therapist will offer encouragement that "memories" will return. Suggestive dreams or new pains are interpreted by the therapist as proof that repressed memories are lurking. The therapist may refer the patient to a "survivor recovery group." There she will meet women who further encourage her to keep trying to remember. Attendance at these support groups, as well as assigned reading in self-help books, surrounds the patient with validation for the therapist's theories. The vast majority of women with FMS are white, middle class, and above average in education. This corresponds to the profile of a typical woman who enters long term psychotherapy, and who perceives such activity as an important way to solve life's problems. Generating False Memories Unlike courts of law which obtain objective evidence where allegations of evil-doing are made, RMT solely directs the patient to attend toward her inner world for "proof" she was sexually abused. Such RMT techniques may include: --Meditation on fantasy production, such as pictures drawn in "art therapy," dreams, or stream of consciousness journal writing. --Hearing or reading about the "recovered memories" of other women which can serve as inspirations. --Amytal interviews ("truth serum") and/or hypnosis (including "age regression" where the patient is told she is temporarily being transformed into the way she was when she was five years old). --Telling the patient to review family albums; if she looks sad in some of her childhood photos, she is told this is further confirmation that abuse occurred. The Dark Side of "Recovery" Patients start out RMT with the hope that things will be better once they recover their repressed memories. But usually life becomes far more complicated. The FMS patient will often become estranged from the "perpetrator" (most often her father). If the patient has small children, they will be off limits to "perpetrators" as well. Relationships with other family members becomes contingent on their not challenging the patient's beliefs. Therapists may urge parents to come for a "family conference" in order to allow the patient to surprise the "perpetrator" with a rehearsed confrontation. Family members are usually too shocked and disorganized to coherently respond to accusations. The rationale for this scenario is that since "survivors" feel powerless, they need "empowerment." FMS patients may file belated crime reports with local law enforcement agencies and may go on to sue "perpetrators." Such lawsuits demand compensation for bills from psychotherapists and possibly other doctors who treated adult medical problems that therapists somehow link to childhood traumas. Of course, there may be demands for "punitive damages." Spouses of "perpetrators" (usually the patient's mother) may be sued as well for being negligent, thus making householder's insurance into a courtroom piggy bank. Since FMS patients sincerely believe they have been victimized, more than a few juries have given verdicts sympathetic to them. Preoccupied with the continuing chores of "memory recovery," the FMS patient may come to ignore more pressing problems with her marriage, family, schooling, or career. Often the time demands and expense of the therapy itself become a major life disruption. Some patients during the course of RMT develop "multiple personality disorder" (MPD). RMT therapists have claimed that they need to not only recover repressed memories, but also to uncover repressed personality fragments; some women come to believe they are repositories of dozens of hidden personalities ("alters"). "Alters" have their own names and characteristics, and may identify themselves as men or even animals. An increasing number of psychiatrists and psychologists are coming to view MPD as a product of environmental suggestion and reinforcement, since the diagnosis was hardly made prior to ten years ago. One area where there is no controversy: once MPD is diagnosed, therapy bills become astronomical. Some FMS patients become convinced that their abuse was actually "satanic ritual abuse" (SRA), due to participation by relatives in a secret satanic cult. Some therapists believe SRA is the work of a vast underground cult network in these United States. No evidence beyond "recovered memories" has ever been offered as proof that satanic cults exist at this claimed level of frequency. Therapists who lecture on the topic have explained away the lack of evidence that such cults exist by claiming that no defectors speak out due to iron-clad secrecy via brainwashing and terror. The Care and Maintenance of False Memories FMS involves a combination of mistaken perceptions and false beliefs. The fledgling FMS patient is encouraged to "connect" with an environment that will reinforce the FMS state, and is encouraged to "disconnect" from people or information that might lead her to question the results of RMT. The FMS subculture is victim-oriented. Even though they have not undergone anticancer chemotherapy or walked away from airplane crashes, FMS patients are told they too are "survivors." This becomes a kind of new identity, giving FMS patients the feeling of a strong bond with other "survivors" of abuse. Patients will often start attending "survivor" support groups, subscribe to "survivor" newsletters, or even attend "survivor" conventions (sometimes with their therapists). They will read books found in "recovery" sections of bookstores. The best known book, _The Courage to Heal_, is weighty, literate, and thus appears authoritative. Authors Laura Davis and Ellen Bass have no formal training in psychology, psychiatry, or memory. This paperback, modestly priced at $20, has sold over 700,000 copies. Patients are told to shy away from dialogue with skeptical friends or relatives, since this will hinder their "recovery." "Perpetrators" who proclaim their innocence cannot be taken seriously since they are "in denial" and incapable of telling the truth. Aside from these social influences, people by nature often resist seeing themselves as being in error. It can be terribly painful to acknowledge having made a big mistake, particularly when harmful consequences have resulted. RMT exploits the tendency within each of us to blame others for our problems, and to latch onto simple answers for life's complicated problems. RMT therapists suggest that aside from entirely ruining childhoods, childhood sexual abuse can explain anything and everything that goes wrong during adulthood. RMT becomes the ultimate crybaby therapy. How Memory Really Works In Freud's theory of "repression" the mind automatically banishes traumatic events from memory to prevent overwhelming anxiety. Freud further theorized that repressed memories cause "neurosis," which could be cured if the memories were made conscious. While all this is taught in introductory psychology courses and has been taken by novelists and screenwriters to be a truism, Freud's repression theory has never been verified by rigorous scientific proof. Freud, were he alive today, would be traumatized to see how RMT has redefined his pet concept. While Freud talked of the repression of single traumatic episodes, today's therapists maintain that dozens of similar traumatic episodes occurring over years are repressed with 100% efficiency. The well known syndrome of Post Traumatic Stress Disorder shows us that verifiable traumatic events, rather than disappearing from memory, leave trauma victims haunted by intrusive memories in which the victim relives the trauma. For those who were in Nazi concentration camps or underwent torture as POWs in Vietnam, this can become a serious lifelong problem. People forget most of what occurs to them, including some events that were pleasant or significant to them at the time. If an event is lost from memory, there is no scientific way to prove whether it was "repressed" or simply forgotten. And there is no reason that memories of sexual abuse should be handled any differently than childhood memories of physical abuse or of emergency surgery. Events that have slipped away from memory cannot be recalled with the accuracy of a videotape. Individuals forget not only insignificant events in their entirety, but also significant events. Some events (traumatic or not) are recalled, but with significant details altered. A study of children whose school was attacked by a sniper showed that some who were not on the school grounds later insisted they had personal recollections of being in school during the attack. These false memories apparently were inspired by exposure to the stories of those who truly experienced the trauma. Memories can be deliberately distorted in adults by presenting a display of visual information, and later exposing subjects to verbal disinformation about what they saw. This disinformation often becomes incorporated into memory, contaminating the ultimate memories that are recalled. To be sure, some who enter therapy were abused as children, but they have always remembered this abuse. They do not need special help in "memory recovery" to tell the therapist what happened to them. Why Recovered Memory Therapy is Bad Therapy RMT purportedly is undertaken to help patients recover from the effects of sexual abuse from childhood; however, at the onset of RMT there is no evidence that such abuse ever occurred. Thus, instead of a therapist having some evidence for a diagnosis and then adopting a proper treatment plan, RMT therapists use the "treatment" to produce their diagnosis. Some RMT therapists over-attribute common psychological complaints as signs of forgotten childhood sexual abuse. In their zeal to find memories, these therapists overlook any and all alternative explanations for the patient's complaints. RMT therapists ignore basic psychological principles that all individuals are suggestible, and that patients in distress seeking psychotherapy are particularly likely to adopt beliefs and biases of their therapist. Many RMT therapists have studied neither basic sciences related to memory, nor the diagnosis of actual diseases of memory. Their knowledge is often based on a single weekend seminar, as opposed to years of formal training in any graduate program they attended to get their licenses. Hypnosis and sodium amytal administration ("truth serum") are unacceptable procedures for memory recovery. Courts reject hypnosis as a memory aid. Subjects receiving hypnosis or amytal as general memory aids (even in instances where there is no question of sexual abuse) will often generate false memories. Upon returning to their normal state of consciousness, subjects assume all their refreshed "memories" are equally true. RMT therapists generally make no attempt to verify "recovered memories" by interviewing third parties, or obtaining pediatric or school records. Some have explained that they do not verify the serious allegations that arise from RMT because their job is simply to help the patient feel "safe" and "recover." Many patients who have known all their lives that they were mistreated or neglected by their parents, decide as adults to be friends with the offending parents. By contrast, RMT therapists encourage their patients, on the basis of "recovered memories," to break off relationships with the alleged "perpetrators" as well as other relatives who disagree with the patient's views. This is completely at odds with the traditional goals of therapists: to allow competent patients to make their own important decisions, and to improve their patient's relationships with others. Patients undergoing RMT often undergo an increase of symptoms as their treatment progresses, with corresponding disruption in their personal lives. Few therapists will seek consultation in order to clarify the problem, assuming instead that it is due to sexual abuse having been worse than anyone might have imagined. Other Kinds of FMS Some individuals come to believe that they lived "past lives" as a result of having undergone "past life therapy." This phenomenon generally develops in participants who are grounded in the New Age zeitgeist and already open to "discovering" their past lives. They enroll in seminars which can run up to an entire weekend and will involve some measure of group hypnotic induction and guided meditations. This sort of FMS also involves continuing group reinforcement. In contrast to horrific images of sexual abuse, recollections of "past lives" are generally pleasant and interesting. Few participants will recall spending prior lives in lunatic asylums or dungeons. The whole experience is assumed to be therapeutic by helping participants better understand the situation of their present lives. A small number of individuals develop "recovered memories" of being abducted by aliens from outer space. Almost always these individuals had some curiosity about this area and were hardly skeptics before they fell into an alien abduction FMS. In contrast to women who are plagued with concerns that they were sexually abused, these varieties of FMS are of a much more benign nature and do not disrupt personal functioning or family life. While some of these individuals suffer the ignominy of being perceived as "kooks," they may receive compensating group support from those who share their beliefs. A Word About the Future Increasing numbers of women who claimed to have recovered memories of sexual abuse have retracted their claims and now see themselves as having had FMS. This may spontaneously occur when women relocate to another locale and lose contact with their prior therapists and support group. Without the "positive reinforcement" from others to encourage false memory development and maintenance, some women begin to doubt the veracity of what they had believed was true. While some remain suspended in a twilight of doubt, others have fully recanted. These retractors may have a profound influence on getting women with an active FMS to re-evaluate their situation. While FMS patients learn from the FMS culture to dismiss critics as either "perpetrators" or their apologists, the voice of a woman who says she is recovering _from_ FMS is more easily heard. Although most influential among family counselors and social workers, RMT affected the practices of some licensed psychologists and psychiatrists, some of whom were practicing in special "dissociative disorders units" in psychiatric hospitals. These activities have gone on with little challenge, until recently. The number of women with FMS who have become retractors is increasing. Some have sued their former therapists for malpractice (see Laura Pasley's story in this issue of _Skeptic_), and others are weighing the possibilities of doing so. One malpractice insurance carrier for clinical psychologists in California recently tripled its rates without explanation; this has led to speculation that the carrier is anticipating increasing numbers of lawsuits alleging that psychologists caused FMS. The False Memory Syndrome Foundation, formed in 1991, has been contacted by over 7,000 families in the U.S. and Canada who believe their grown children have FMS, and these families let their views be known to state licensing boards and professional organizations. Managed care administrators are starting to question megabills submitted by RMT therapists, some of whom see their patients through lengthy psychiatric hospitalizations. Understandably, all of this has gained the attention of the American Psychiatric Association and American Psychological Association, who are setting up task forces to try to examine the whole phenomenon. Meanwhile, there is a large FMS subculture consisting of women convinced that their "recovered memories" are accurate, therapists keeping busy doing RMT, and of authors on the "recovery" lecture and talk show circuits. In addition, there are some vocal fringes of the feminist movement that cherish RMT since it is "proof" that men are dangerous and rotten, unless proven otherwise. Skeptical challenges to RMT are met by emotional rejoinders that critics are front groups for perpetrators, and make the ridiculous analogy that "some people even say the Holocaust did not happen." RMT will eventually disappear, but not next month. Dr. John Hochman is a practicing psychiatrist in Encino, California, specializing in the evaluation and treatment of victims of cultic entities and/or undue influence; the theoretical study of cult phenomena, psychiatry and the law, and Post-Traumatic Stress Disorders. He is a consultant and expert witness in courtroom cases involving abuse allegations, coercive persuasion and psychotherapy cult involvement. Dr. Hochman is also Assistant Clinical Professor in the Department of Psychiatry at the UCLA School of Medicine and serves on the editorial and advisory boards of the _Cultic Studies Journal_, the American Family Foundation, and the False Memory Syndrome Foundation. In 1990 he won the John C. Clark Award for Distinguished Scholarship in Cultic Studies from the American Family Foundation.


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