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              RECOVERED MEMORY THERAPY AND FALSE MEMORY SYNDROME
                                       
By John Hochman, M.D.

   Contents:
     * Introduction
     * Initiation of Patients into RMT
     * Generating False Memories
     * The Dark Side of "Recovery"
     * The Care and Maintenance of False Memories
     * How Memory Really Works
     * Why Recovered Memory Therapy is Bad Therapy
     * Other Kinds of FMS
     * A Word About the Future
       
   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.
   
  ----------------------------------------------------------------
                                                                                       
   From Skeptic vol. 2, no. 3, 1994, pp. 58-61.
   
   The above article is copyright 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 article
   in its entirety, including this notice. A special Internet 
   introductory subscription rate to Skeptic is available. For more
   information, contact Jim Lippard (lippard@primenet.com).


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