Uncovering Memories of Alleged Sexual Abuse: The Therapists Who Do It

Hollida Wakefield & Ralph Underwager^*

ABSTRACT: Allegations of recovered memories of sexual abuse have been appearing frequently. The abuse is said to have been "repressed" for years until, with the help of a therapist, the memory is recovered. Therapists specializing in this effort maintain that memory deficits, amnesia, and dissociation are characteristic of trauma, that up to half of all incest survivors do not remember their abuse, and that abuse survivors must be helped to retrieve their memories in order to recover. The therapists retrieve memories with intrusive and unvalidated techniques including direct questioning, hypnosis, reading books, attending survivors' groups, age regression, dream analysis, and a variety of unorthodox procedures. They support their assumptions through concepts such as repression, dissociation, traumatic amnesia, body memories, and multiple personality disorder. However, there is no support in the scientific literature for the way these concepts are used, nor any credible evidence that it is common for children to undergo repeated, traumatic sexual abuse but, as adults, have no conscious memories of the abuse until it is uncovered by a therapist "skilled" in such matters.

In the past few years, there has been much publicity about adults claiming suddenly recovered memories of childhood sexual abuse. There are no memories for years because the abuse is supposed to have been completely "repressed" until, generally with a help of a therapist, it is then "recovered." Some of these accounts have been widely publicized in the media (e.g., Arnold, 1991; Heller, 1991; Hull, 1991; Kennedy, 1991; Monaghan, 1990; Sifford, 1991; Toufexis, 1991; Van Derbur Atler, 1991) and sexual abuse "survivors" regularly appear on television talk shows.

Reflecting the influence of the media hype on these stories several states have passed legislation accepting the facticity of claims of recovered memories and extending the statute of limitations so that allegations of abuse 40 or 50 years ago now have legal standing. A federal judge recently ruled that claims of recovered repressed memories are "not at all unreasonable" (Brennan, 1992) and a jury awarded $600,000 for abuse said to have taken place 32 years ago.

Approximately a year ago, several parents whose adult children had accused them of childhood sexual abuse based on recently recovered memories and professionals who had experience with these allegations began contacting one another. In February, 1992 Pamela Freyd, Ph.D. from Philadelphia, along with several other parents and professionals, formed the False Memory Syndrome Foundation (FMS)¹, a tax-exempt research and educational institution. The original group also included some women who had been in therapy, had recovered memories, but then recanted and saw their therapy experience as producing false memories. The goal of this organization, which has a professional advisory board with well-known scientists from throughout the country, is to understand and work towards the prevention of such cases. Its focus is on collecting and disseminating relevant scientific information and on promoting and sponsoring research. It is planning a scientific conference on this question in April, 1993.

Early in 1992, local newspaper columnists in Philadelphia, San Diego, Toronto, and Provo, Utah described the phenomenon and the formation of the FMS Foundation and published an 800 number to call for information. In its first six months of existence, the foundation received calls from approximately 600 families and now, less than a year later, they have received calls from close to 2000 families, representing every state in the union as well several foreign countries. Following the single article in the Provo weekly paper, in three days, over 150 families in this single geographical area called to report their experience. The FMS Foundation currently is receiving over one hundred telephone telephone calls each day and hundreds of letters each week. They also continue to receive calls from people who are recanting their recovered memories and see their therapy experience as negative and harmful. A research study with this population is being planned.

Preliminary Data From The Recovered Memory Survey Project

In cooperation with Pamela Freyd and the False Memory Syndrome Foundation, we are engaged in an ongoing research project in which questionnaires are being sent to people whose adult children have accused them of childhood sexual abuse based on their recently recovered memories. The first 26-page questionnaires were sent last spring. Of the 260 initial questionnaires, 133 were returned. Of those not returned, 18 were later determined to have been inappropriately sent. Therefore, the return rate was 54%.

The subjects were people who responded to newspaper articles or other media presentations about the FMS phenomenon. The newspaper articles contained an 800 number to call for information. Questionnaires were sent to the callers who reported that their adult child had recently recovered a memory of repressed sexual abuse which the caller denied. These respondents therefore are not a random sample. In addition, since the information comes from the accused parents, not the accusing child, the issue of the generalizability of the data must be borne in mind. However, these are the first data available regarding families, parents, and adult children where there are allegations of recovered repressed memories of sexual abuse. In a new research area, this is the way to begin-with as much descriptive data as possible.

Although we had anticipated that most of the families would be dysfunctional and that the adult child reporting a repressed memory of childhood sexual abuse would have a history of significant psychological disturbance, the preliminary results do not support this hypothesis. Instead, the data suggest that these are functional, intact, successful and affluent families. The annual median family income is $60,000 to 69,000. Four- fifths of the parents are still married and four-fifths of these judge their marriages to be happy. The parents are well educated-two-thirds of the fathers and half of the mothers have an undergraduate or graduate degree. The majority of the parents report routinely eating dinner together as a family, going on family vacations, and being actively involved with their children when the child was growing up. It appears these families did what you are supposed to do to have a good family.

The accusing adult children, most (90%) of whom are females, are also highly educated-only one-fifth have just a high school degree. Over one-fourth have a graduate degree and the rest have a B.A. or some college. Although we had believed that the accusing child would have a long history of psychological problems, in only one-third of the cases did the individual have psychological or psychiatric treatment prior to adulthood.

Others besides the fathers were often accused of abuse. In one-third of the families, mothers were accused and in one-third, a variety of other persons were accused, most often along with the parents. The abuse typically was alleged to have started at a very young age-often below age 2. In only one-fifth of the cases was the abuse said to have begun at age 6 and older. The years the memory was "repressed" ranged from 8 to 51 with a median of 25 years.

The parents seldom had any warning that anything was wrong prior to the accusation. Most were told suddenly by a phone call or letter, or by an announcement at a family reunion or holiday when they reacted to the accusation with surprise and shock. All report being devastated.

The parents often had great difficulty getting specific information as to exactly what is was that they were supposed to have done. When they asked for clarification they were told things like, "You know!" "You are an abuser," or "You incested me." The allegations that were specified tended to be of extremely deviant and intrusive behaviors. Only a few were of fondling alone. Repeated physical violence or forced anal or vaginal penetration was alleged in almost half of the cases. Witnesses to the abuse were reported in one-third of the cases and in one-fifth, the allegations were of satanic, ritual abuse.

For over half of the parents, civil lawsuits are a serious concern and for almost one- fifth, lawsuits have already been filed or threatened. Although in some cases, siblings later alleged abuse, in most (86%) they did not. In three-fourths of the cases, the siblings did not believe that the allegations made by the accusing child were true.

The feature common to the sample appears to be the therapy received by the adult children. Although many of the parents know little about the therapist or type of therapy, those who do report similar information. The memories were recovered in therapy in almost all of the cases. The book, The Courage to Heal (Bass & Davis, 1988) was frequently used along with other survivor or self-help books. Hypnotherapy, dream interpretation, and rape counseling were frequently reported along with incest survivor groups, eating disorder groups, and 12-step programs such as Adult Children of Alcoholics. The therapists, approximately three-fourths of whom are females, included social workers (24%), psychologists (33%), psychiatrists (8%), and "counselors" (33%).

The Therapists Who Uncover the Memories

The therapists who uncover "repressed" memories are part of a growing network of professionals who believe that large numbers of women have suffered childhood sexual abuse but that many have repressed their memories of this trauma. Summit (1990) refers to the victims "we don't know about, those who don't disclose" and asserts that the memory of abuse is often buried within a conscious memory of a happy childhood. He claims that half of all women were sexually abused in childhood but many do not remember the abuse and recommends using therapy methods that are "invasive and intrusive" in order to uncover the abuse (Roan, 1990).

Maltz (1990), who claims that half of all incest survivors have some form of memory loss, lists a variety of physical and psychological problems she maintains are caused by sexual abuse. She recommends that therapists help patients without memories validate their experiences so that hidden memories of incest can surface. Paxton (1991) asserts that half of all incest survivors do not remember the abuse, that many will only have vague bits and pieces of memories and/or awareness, and that some will never remember the abuse. Blume (1990) believes that perhaps half of all survivors do not remember the abuse and provides a long and varied list of symptoms that she maintains suggest abuse. Courtois (1992) claims that a therapist can can suspect childhood sexual abuse through "disguised presentation" of symptoms and provides a long list of presenting problems which are likely to indicate sexual abuse, even when the patient provides no history of abuse.

Dolan (1991) recommends assisting a client to recall repressed abuse when the client and therapist suspect abuse, when the client is exhibiting symptoms indicative of abuse, and when these symptoms have not responded to other forms of treatment. The symptoms she describes include a wide range of problems, including dreams of being pursued, sleep disturbances, eating disorders, substance abuse, compulsive sexuality, sexual dysfunction, chronic anxiety attacks, depression, difficulties with relationships, distrust of others, guilt, impaired self-esteem, self-destructive behaviors, and personality disorders. These symptoms are similar to those suggested by others.

The therapists accepting these assumptions maintain that memory deficits, amnesia and dissociation are characteristic of trauma and that abuse survivors must be helped to retrieve their memories so that they can process the trauma (e.g., Bass & Davis, 1988; Blume, 1990; Courtois, 1992; Dolan, 1991; Fredrickson, 1992). Retrieval of these alleged autobiographical memories of abuse is thus necessary for healing and recovery.

The therapists support these assumptions by referring to one or more of several psychological concepts. For example, adult survivors are said to have "repressed" the memory because it was too painful, or to have "dissociated" during the abuse as an automatic protective mechanism. They may have defended themselves against the devastating memories by developing "traumatic amnesia" for the abuse. If the abuse was frequent and prolonged, alter personalities will form to protect the child during the abuse and the adult survivors will therefore have multiple personality disorder. Although the abuse is "repressed" or "dissociated" and not available to conscious memory, the trauma exerts itself through a variety of emotional and behavior problems and will later show itself indirectly through "body memories," "flashbacks, or "nightmares."

A careful review of the scientific literature, however, fails to provide support for the way that these concepts are used (Wakefield & Underwager, in press). There is no support for the assumption that it is common for children to undergo repeated, traumatic sexual abuse but, as adults, have no conscious memories of the abuse until it is uncovered by a therapist "skilled" in such matters.

Repression

Despite the fact that repression is a basic assumption of Freudian personality theory (Erdelyi, 1990; Singer, 1990; Weinert & Perlmutter 1988), there is no empirical quantifiable evidence to support it (Hock, 1982; Holmes, 1974, 1990; Weinert & Perlmutter, 1988). Holmes (1990) states that the only evidence for repression comes from case studies and anecdotal reports and he maintains that there is no controlled laboratory evidence supporting the concept of repression.

Also, traditional analytically-oriented therapists, who may use the concept of repression, are concerned with the patient's perceptions of reality, rather than the historical accuracy of the material uncovered in therapy (Wakefield, 1992). Bower (1990), in discussing the concept of repression and recovery of forgotten memories, notes that techniques in therapy, such as associations, can enable the retrieval of lost memories but it is difficult to ascertain the accuracy and veracity of the memory that is retrieved. Nash (1992) also warns against assuming that childhood memories retrieved in therapy are historically truthful. He gives an example of a young man who, with the help of a previous therapist, uncovered vivid and detailed memories of multiple abductions by space aliens.

Repression, therefore, is not generally accepted in the scientific community except among analytically-oriented therapists, who base their beliefs on anecdotal reports and clinical case studies. Also, there is nothing in the repression literature supporting the belief that it is common for repeated episodes of sexual abuse to be completely repressed for years, only to be remembered only years later.

Dissociation and Psychogenic Amnesia

Another concept used to explain the lack of memory for childhood abuse is dissociation. Dissociation is defined by the DSM-III-R (American Psychiatric Association, 1987) as "a disturbance or alteration in the normally integrative functions of identify, memory, or consciousness" (p. 269). Because the individual's thoughts, feelings, or actions are altered, some information may not be integrated with other information and therefore is not accessible to memory. A dissociated memory is seen as distinctly different from one that is simply forgotten (Spiegel, 1991). Dissociation ranges from minor forms, such as becoming lost in movie or book or "spacing out" while driving, to pathological forms such as depersonalization, amnesia, or multiple personality disorder.

Dissociation is seen as a protective response to traumatic childhood sexual abuse in which the child dissociates the abuse experiences so that they are not available to memory. Since the child is in an altered state of consciousness, there is limited access to these memories during the ordinary state. Retrieval of the memories is therefore accomplished in adulthood through an altered state of consciousness such as hypnosis or age regression.

A major difficulty with the idea that up to one-quarter of the women in the United States have been abused but don't remember it because they dissociated is that one would expect for the behaviors and symptoms of dissociation occurring in childhood to be observed and therefore found in the literature on psychopathology in children. However, recent review articles (Lahey & Kazdin, 1988, 1989, 1990) on childhood disorders do not even mention dissociative disorders and the DSM-III-R lists no dissociative disorders under childhood disorders. There are no data showing large numbers of children producing dissociative symptoms.

Psychogenic amnesia is the dissociation mechanism postulated to explain the lack of memory for childhood abuse. The DSM-III-R (American Psychiatric Association, 1987) states that the essential feature of psychogenic amnesia is a sudden inability to recall important personal information. Although Loewenstein (1991) broadens the definition of psychogenic amnesia to include a group of events, there is no research supporting this conception of psychogenic amnesia. There are no empirical data supporting a concept of psychogenic amnesia for a category of events stretching across several years at different times and under different circumstances in differing environments.

Also, the traditional case studies of psychogenic amnesia in the literature indicate that such persons have undergone severe life stresses, such as violent physical abuse, torture, confinement in concentration camps, or combat. In such cases, the events should be able to be independently verified since without verification that an event has, in fact, occurred, one cannot talk about amnesia for the event. Therefore, when dissociation and/or traumatic amnesia is used to account for the fact that the memory of the abuse is buried within a conscious memory of a happy childhood, there must be verification of the abuse. However, corroboration by parents, siblings, or others seldom occurs in recovered memory cases.

Most people experiencing trauma do not develop amnesia for the trauma. Case studies on the reactions of people to documented severe trauma, such as fires, airplane crashes, automobile accidents, and being held hostage show many symptoms but total amnesia for the event is not mentioned as a common response (Spiegel, 1991). Terr's (1985, 1988, 1990) research with children who have experienced documented trauma indicates that children over the ages of 3 or 4 do not develop amnesia for the trauma. All of the children in this age group had full verbal recall or extensive spot memories, although the memories may have been inaccurate or fragmented. Although they may have denied parts of the aftermath and the effect on them, they did not deny the event. This is consistent with Malmquist (1986) who reports that in a study on children who had seen a parent murdered, not one child age 5 to 10 years "repressed" the memory.

Children under 3 or 4 are unlikely to remember the trauma because of their age, but this is not psychogenic amnesia or repression. Such forgetting is due to the phenomenon of infantile or childhood amnesia. Adults and older children do not usually remember incidents from their lives that happen prior to age 3 to 4 (Eisenberg, 1985; Fivush & Hamond, 1990; Loftus, 1992; Nelson & Ross, 1980). This inability to recall events from an early age is a function of the normal process of growth and development.

Infantile amnesia may even encompass a larger age span. Wetzler and Sweeney (1986), in a review of research investigating childhood of infantile amnesia, report that research shows fewer memories than would be expected through the normal forgetting function under age 5 and they therefore believe that childhood amnesia begins below age 5. The phenomenon of infantile or childhood amnesia also means that claims of recovered memories from a very early age are suspect.

Post-traumatic Stress Disorder

The diagnosis of Post-traumatic Stress Disorder (PTSD) is often found when sexual abuse is alleged. In recovered memory cases, this diagnosis is used to explain the lack of memories for the event.

According to the DSM-III-R (American Psychiatric Association, 1987), the PTSD diagnosis is given when an individual develops characteristic symptoms after experiencing an extremely distressing and traumatic event that is outside the range of usual human experience. This event is usually experienced with intense fear, terror, and helplessness. The symptoms involve reexperiencing the traumatic event, avoidance of stimuli associated with the event or numbing of general responsiveness, and increased arousal. However, although the criteria for PTSD mention numbing and efforts to avoid thoughts or feelings along with psychogenic amnesia for an important aspect of the event, there is no mention of total amnesia for the whole event. Also, in order to diagnose PTSD, there must be a known stressful event. The diagnosis cannot be given on the basis of the symptoms alone without verification of the event.

Multiple Personality Disorder

Multiple personality disorder is often suggested in recovered memory cases, especially when the alleged abuse is violent and sadistic. The DSM-III-R (American Psychiatric Association, 1987) defines multiple personality disorder (MPD) as the existence within the person of two or more distinct personalities or personality states. The disorder is believed to begin early in life and most people with this diagnosis are women.

Many people believe that most individuals diagnosed with MPD were abused as children (Kluft, 1987, 1991; Putnam, Guroff, Silberman, Barban, & Post 1986). A "protector" personality is believed to emerge and take over for the individual, who therefore escapes psychologically from the abuse (Spiegel, 1991). However, support for this theory is based only on clinical case reports and in a recent review of the empirical literature on the long-term effects of child sexual abuse, Beitchman, Zucker, Hood, daCosta, and Akman (1991) concluded that as yet there is insufficient evidence to confirm a relationship between childhood sexual abuse and multiple personality disorder.

In addition, even though it is in the DSM-III-R, MPD itself is controversial. A few therapists are seeing most of the MPD cases, and the majority of them are in the United States. There is little empirical evidence supporting MPD and it is heavily dependent upon cultural influences for both its emergence and its diagnosis. Even if it qualifies as a distinct psychiatric disorder, it is greatly overdiagnosed (Aldridge-Morris, 1989; Fahy, 1988; Thigpen & Cleckley, 1984). Spanos has developed a social psychological conception of MPD (Spanos, 1991; Spanos, Weekes, & Bertrand, 1985) in which he postulates that people learn to enact the role of the multiple personality patient and psychotherapists play an important part in the generation and maintenance of this role enactment. They have conducted an extensive series of experiments to demonstrate this.

Therapy For Uncovering Memories

The questionnaires in the FMS project described above indicates that the recovered memory almost always first surfaces in therapy. What takes place in such therapy? Descriptions of the type of treatment offered are found in the writings and workshop presentations of therapists as well as in the anecdotal reports from women who have undergone such treatment. We found no outcome data in the descriptions of these programs. There is no information given on validity or reliability of the techniques used.

Treatment programs use a variety of techniques to help patients recover memories of sexual abuse. These include direct questioning, hypnosis, reading books, attending survivors' groups, age regression, and dream analysis. In the questionnaire, respondents also reported a variety of unconventional techniques including prayer, meditation, age regression, neurolinguistic programming, reflexology, channeling, psychodrama, casting out demons, yoga, trance writing, and primal scream therapy.

An example of typical treatment is Lundberg-Love's program at the University of Texas at Tyler (1989 & undated). The first goal of treatment is to work on memory retrieval. After the woman can develop memories of the abuse and talk about what happened, she is encouraged to express her rage by throwing darts at pictures of the perpetrator and writing him angry letters. Her feelings of shame are dealt with through art and music, and by taking bubble baths to eliminate dirty feelings.

Courtois (1992) discusses how to bring about the retrieval of memories. The assumption is that events can be perceived and stored by a preverbal child, that visual or imaginal and other sensory cues can stimulate the retrieval of these memories, and that since abuse memories were stored during experiences that produced arousal and helplessness, the client may have to reexperience painful emotion in order to remember. Triggers for recall include developmental events or crises; events that symbolize the original trauma; crises associated with recollection, disclosure, confrontation, reporting, and criminal justice; issues in therapy; and life states or events. Survivors' groups and self-help groups can help stimulate memories.

Techniques used to retrieve the memories include hypnosis, guided imagery, writing an autobiography, drawing, guided movement, body work, psychodrama, making a family genogram, drawing the floor plan of the childhood home, and bringing in family pictures and childhood memorabilia such as toys, report cards, and diaries. The memories may return either overtly or in symbolic form such as flashbacks, body memories, and nightmares and dreams.

Courtois (1992) maintains that a strong alliance between therapist and survivor is necessary for memory work. The therapist should be calm, accepting, reassuring, encouraging, and validating of the disclosures. Although she cautions against the therapist conclusively informing the patient that the abuse happened, Courtois says that it may be necessary for the therapist to speculate about it to the client.

Courtois believes that memory can return physiologically, through body memories and perceptions. The body memory concept assumes that if abuse occurs when the individual is too young to recall, although the mind may not remember the event, the body is able to. Courtois therefore asserts that the survivor may retrieve colors, hear sounds, experience smells, odors and taste sensations, and her body may react in pain reminiscent of the abuse and develop physical stigmata as the memory is retrieved.

Fredrickson (1992) believes that repressed memories of abuse stalk the individual's life but have been held in storage until the person is strong enough to face them. She differentiates between five types of memories: ordinary memories, or "recall" memories, "imagistic" memories (memories that break though the conscious mind with images like a slide show), "feeling" memories (memories that are the feelings that something abusive has happened without the actual memory), "body" memories (the physical manifestation of abuse-"Our physical bodies always remember sexual abuse." p. 93), and "acting-out" memories (unconscious memories in which a repressed incident is spontaneously acted out through some physical action).

Fredrickson (1992) maintains that the "journey" towards retrieving these memories is necessary for recovery, serenity, and even survival. Since few survivors experience spontaneous recall, various memory retrieval techniques are necessary. She recommends dream interpretation, free association writing, massage therapy, body manipulation, hypnosis, feelings work, art therapy, and expanding on imagistic memories.

Dolan (1991) recommends hypnosis, ideomotor signaling with the unconscious, age regression, and automatic writing as aids to memory retrieval. She also describes a variety of techniques for "facilitating integration of recently retrieved memories...(to) strengthen the client's ability to connect consistently to her inner resources...and rituals to facilitate feelings of completion and letting go" (p. 129). These include making and carrying around an Indian "medicine bundle" composed of symbolic articles and written words evocative of the client's healing resources, holding an imaginary funeral for the family of origin, burying pictures of the family, having a divorce ceremony from the family member(s), doing "bodywork," producing art projects such as face masks, collages, and Amish quilts, taking herb-scented bubble baths and buying flowers, writing down feelings and then burning the paper, tape recording expressions of anger, making a tape to the inner child and then burying the tape in the childhood yard, and nurturing the inner child by buying a cuddly teddy bear or rag doll, eating ice cream, and getting a puppy.

Several presenters at a symposium at the 99th Annual Convention of the American Psychological Association (Grand, Alpert, Safer, & Milden, 1991) described how to help a patient uncover memories of sexual abuse. They see the role of the therapist as helping the patient become convinced of the historical reality of the abuse, even when there is no external corroboration and even when the patient herself doubts that the memory is real. The therapist is identified as the one person in the patient's life who "really sees the truth." The therapist, therefore, should never show doubts to the patient, but should stress that the abuse really happened and was terrible. Body memories, dream analysis, and analysis of transference are used both to retrieve the memories and to provide "validation" of the historical reality. The therapist should not be limited by the fact that the historical truth cannot be verified.

An illustration of a network actively engaged in recovering memories is Three in One Concepts, an organization begun and headed by a Gordon Stokes who claims a clinical background in behavioral genetics, psychodrama, and role play training (David, 1992). Stokes claims to have taken specialized kinesiology into new avenues of self-discovery. There are said to be at least 1500 facilitators of this new specialized kinesiology and seminars in this approach are offered all over the world. The technique is to have the individuals extend their arms, then ask them questions and press on their arms. The body, through the unconscious, answers the questions. If the arms stay rigid, that means yes. If the arms fall back, that is a no answer (David, 1992). When the calls came in from Provo, Utah, several of the persons described their experience in therapy that led to the development of putative memories as precisely this procedure.

The book, The Courage to Heal (Bass & Davis, 1988), is used by many therapists. This book contains statements such as: "If you are unable to remember any specific instances...but still have a feeling that something abusive happened to you, it probably did" (p. 21); "If you think you were abused and your life shows the symptoms, then you were" (p. 22); and "If you are don't remember your abuse you are not alone. Many women don't have memories, and some never get memories. This doesn't mean they weren't abused" (p. 81). Demands for details or corroboration are seen as unreasonable: "You are not responsible for proving that you were abused" (p. 137). The book encourages revenge, anger, fantasies of murder or castration, and deathbed confrontations. The veracity of the recovered memories is never questioned-one section uncritically presents an account of ritual abuse by a satanic cult of town leaders and church officials that included sexual abuse, murder, pornography, drugs, electric shock, and forcible impregnation of breeders to produce babies for sacrifice.

In the survey project, a majority of the respondents who had some knowledge of the type of therapy reported that hypnosis was used. However, the use of hypnosis for memory retrieval raises serious questions about the accuracy of the recovered memories. There is agreement and empirical verification regarding several aspects of hypnosis (Cardena & Spiegel, 1991; Orne, Soskis, Dinges, Orne, & Tonry; 1985; Putnam, 1991a; Spanos, Quigley, Gwynn, Glatt, & Perlini, 1991). Under hypnosis, people are more suggestible and are therefore more likely to agree with a persuasive communication. But there are serious problems with the accuracy and validity of memories that are recovered through hypnosis. However, the individual is apt to experience these memories, which can be quite vivid and detailed, as subjectively real. This increases subjective confidence in the reality of the memories. Therefore the individual appears confident and certain about the memories, and can be persuasive and convincing when talking about them. This problem is exacerbated with individuals diagnosed with MPD and PTSD since such persons appear to have high hypnotizability.

Ganaway (1991) notes that memories retrieved in a hypnotic trance are likely to contain a combination of both fact and fantasy in a mixture that cannot be accurately determined without external corroboration. Since hypnosis increases confidence in the veracity of both correct and incorrect recalled material, the therapist should be very cautious about reinforcing the truthfulness of any memories which are elicited through hypnosis unless there is outside corroboration.

Individuals are frequently referred to a survivors' therapy groups or self-help groups such as those for adult children of alcoholics. Such groups are apt to give continual encouragement for uncovering memories of increasingly intrusive and deviant abuse. Herman and Schatzow (1987) report that their survivor therapy group "proved to be a powerful stimulus for recovery of previously repressed traumatic memories" (p. 1). Price (1992) describes the suggestibility and group influence where, after one woman would suddenly recall a new abusive event, others would soon recall similar events. Since the norm is that group members were abused whether or not they remember it, and the task of therapy is to uncover the hidden memories, group members are given attention, encouragement, and reinforcement as they uncover and report their repressed memories. In fact, Campbell (1992) observes that given the process of conformity and compliance that will characterize any group, clients in such a group who deny a history of sexual abuse run the risk of being ostracized as denying deviants.

Survivors groups and books often recommend filing a civil lawsuit as part of the healing process (Bass & Davis, 1988; Crnich & Crnich, 1992; Nohlgren, 1991). As a result, many "survivors" have filed civil lawsuits against their alleged abusers (Colaneri & Johnson, 1992; Kaza, 1991; Wares, 1991). Several states have extended the statutory period of limitations in civil cases so that the statute of limitations does not begin until two or three years after the alleged abuse is remembered and/or after the claimant understands that the abuse caused injury (Colaneri & Johnson, 1992; Geffner, 1991; Hendrix, 1989; Kaza, 1991; Loftus, 1992; Loftus & Kaufman, in press). The FMS Foundation is aware of more than 300 cases in which survivors are at some stage of suing based on the recovery of "repressed memories."

It must be clearly recognized that there is no acceptable evidence for the validity and reliability of any of these alleged therapeutic techniques.

Satanic Ritual Abuse

Memories uncovered in therapy often grow and develop until they include satanic, ritualistic abuse. The recovered memory questionnaire project found that one-fifth of the respondents reported ritual abuse. Preliminary data from a survey by the The American Bar Association indicates that about one-third of local prosecutors have handled cases involving "ritualistic or satanic abuse" (Victor, 1991a, 1991b).

A few therapists seem to be finding almost all of the survivors, who are often diagnosed as multiple personality disorder. Bottoms, Shaver, and Goodman (1991), reporting on preliminary data from a survey of 6000 American Psychological Association psychologists, state that although 30% of the 2709 respondents reported seeing at least one ritualistic or religion-related abuse case-the model number seen was one and the median two. But 16 (2%) clinicians reported having seen more than a hundred apiece and one clinician claimed 2000 cases. Of the respondents who reported seeing such a case, 93% believed that the alleged abuse actually happened.

Shafer and Cozolino (1992) in a study of 20 adult outpatients who reported such abuse, note that these individuals did not seek therapy because of awareness of abuse. Instead they entered treatment for symptoms of severe depression, anxiety, or dissociation. However, once in therapy, the uncovering of memories became the primary focus. The subjects often participated in 12-step programs and incest survivor support groups which became substitute families for the subjects who had cut ties with their biological families. Eventually all 20 retrieved memories of witnessing sacrificial murder of animals, infants, children, and/or adults, cannibalism, and severe and sadistic sexual abuse by multiple perpetrators. Shafer and Cozolino maintain that these retrieved "memories" are of historically real events.

Gould and Cozolino (1992) believe that since psychotherapy is the only way for the victim to escape the cult, the cults interrupt the therapeutic process through programming alter personalities to disrupt treatment. These alters are programmed to stay in regular telephone contact with the cult, to engage in self-injury, to scramble the message received by the patient, and to respond to messages from the cult, such as hand signals, taps on the window, or a word or phrase. The individual must therefore be helped to recall all of the components of the abuse in order to identify and understand all of the alters, who will then no longer be compelled to obey the programming instructions from the cult. A therapeutic alliance should be established with the satanic alters and the therapist should resist impulses to exorcise them.

Young, Sachs, Braun, and Watkins (1991) report on 37 alleged satanic cult survivors found among dissociative disorder patients. These people entered therapy with problems of severe impairment in functioning along with anxiety and depression. Typically they had some memories of abuse but had nearly complete amnesia for the childhood ritual abuse. The ritual abuse memories emerged during the course of treatment. Eventually most of the patients reported memories of satanic ritual abuse, including sexual abuse, physical abuse, torture, death threats, animal mutilation, infant sacrifice, cannibalism, marriage to satan, being buried alive in coffins and graves, and forced impregnation and sacrifice of their own child.

Mulhern (1991) notes that all 37 patients reported by Young, et al. were in treatment for dissociative disorders and that they are highly suggestible patients who move in and out of altered states of consciousness, have significant gaps in autobiographical memory retrieval, suffer from source amnesia, are particularly vulnerable to trance logic, and compulsively seek to discover and conform to even the most subtle expectations of their therapists. Their reports of ritual abuse are basically rarefied memory narratives assembled in therapy over time out of bits of images and affect which emerged when the patients were abreacting, dreaming, experiencing flashbacks, experiencing dissociated states, or responding to explicit questioning during hypnotic interviews.

The allegations in survivors' accounts have not been independently verified. Despite hundreds of investi-gations by the FBI and police, there is no independent evidence of ritual abuse, animal and human sacrifice, murder, and cannibalism of hundreds of children by a conspiracy of apparently normal adults who are functional and organized enough to leave no trace of their activities (Hicks, 1991; Lanning, 1991, 1992; Putnam, 1991b; Richardson, Best, & Bromley, 1991; Victor, 1991a, 1991b, & in press). However, this knowledge does not dissuade the therapists who believe in their existence.

(For further reading on allegations of satanic ritual abuse, see Charlier & Downing, 1988; Hicks, 1991; Lanning, 1991 & 1992; Richardson, Best & Bromley, 1991; Victor, 1991a, 1991b, & in press; Wakefield & Underwager, 1992; and two journals which are devoted to this topic: Issues in Child Abuse Accusations, 1991, 3(4), and the Journal of Psychology and Theology, 1992, 20(3).

Case Examples of Therapy Experiences

Information from two women who underwent therapy experiences such as those that are reported above are included in this issue of the journal (Gavigan, 1992; Gondolf,1992). These accounts give vivid details not only of the techniques and procedures used but of the harmfulness of such a "treatment" experience. Both women entered therapy for problems other than sexual abuse-one woman for depression and the other for an eating disorder. But both were questioned extensively from the beginning about abuse. Both were given a variety of medications, encouraged to confront their parents, read survivors books, and participated in group therapy where the group norm was talking about the abuse. Both were encouraged to remember more and more about the alleged abuse and eventually both developed graphic and detailed stories involving violent, sadistic ritual abuse. Both women clearly became worse as a result of therapy. One instigated a civil lawsuit against her father. (Both also are intelligent and courageous women who are not only able to understand how the therapy process led them to develop the false memories, but are willing to talk about their experiences in the hope that this will provide information helpful in understanding the recovered memory phenomenon.)

In a participant observer study, Nathan (1992) immersed herself in the incest survivors' movement, including attending a marathon retreat for survivors of incest. There were six therapists for three dozen women survivors, who clutched stuffed animals and began the retreat in a room furnished only with mattresses. Rage at the perpetrators was expressed by the women's "inner children" through beating telephone books with rubber hoses while squatting over the mattresses and screaming obscenities.

Eleven of the women had no abuse memories but were told to participate in the activities. The participants were encouraged to give detailed descriptions about their abuse in the group setting because hearing the others' stories might help trigger memories. When one woman, recalling memories of cult abuse by her mother, sobbed and said she didn't know if the memories were really true, the therapist told her she had to face the memories and ordered her to do mattress work, "Now!" She told another woman that, "When your kids inside are ready, more memories will come."

Nathan observes that a competition began over the satanic abuse reported by several of the women in which each produced more and more detailed and bizarre accounts. The only kind of victims with status among the women and therapists were the women who had suffered rape, torture, and black robes. Others who only reported emotional abuse or battering or couldn't remember the abuse had no status in the "swimsuit competition atmosphere" of the retreat.

Loftus (1992) reports on a situation where, after he was accused by his adult daughter, a father hired a private investigator who went to the daughter's therapist complaining of nightmares and trouble sleeping. On the third visit, the therapist told the pseudo-patient that she was certain the woman was experiencing body memories from a trauma, earlier in life, that she could not remember. The pseudo-patient said she didn't remember any trauma.

The therapist said this was the case for many people and told her to read The Courage to Heal. The therapist then read from the long list of symptoms from Blume's book, Secret Survivors. During this, for two-thirds of the symptoms, the therapist looked at the pseudo-patient and nodded her head as though this was confirming the diagnosis. The therapist then recommended the woman attend an incest survivors group. By the fourth session, the diagnosis of probable incest victim was confirmed based on the symptoms of body memories and sleep disorders, even though the pseudo-patient insisted she had no memory of such events

Not to be Fooled and Not to Fool

A common factor in the academic experience both of us had, one at the University of Minnesota and one at University of Maryland, was a general skepticism and a respect for science. The commitment to science can be conceptualized as adhering to the principle Not To Be Fooled and Not To Fool Anybody Else (Meehl, 1986). The passion not to be fooled and not to fool anybody else is not as much in evidence in psychology as it once was but we still maintain that one attribute of a competent psychologist is the ability to evaluate critically the nature or state of the scientific evidence that can be mustered to support an opinion, a view, or a diagnosis.

Especially for clinical psychologists there appears to be a mistaken readiness to rely upon clinical experience, even one's own idiosyncratic experience, as a reliable and valid source of truth. There is no more solidly established fact in the science of psychology than the superiority of actuarial, statistical methods over clinical experience (Dawes, Faust, & Meehl, 1989). It is true that in a clinical setting hard data may be difficult to come by and the clinician is always operating with incomplete data. Nevertheless, it has ethical implications if the clinician uses a diagnostic procedure which has been shown to have negative validity to make life and death decisions about people and their families that may have far reaching destructive consequences. The ethical issues are sharpened if the clinician takes the patient's or the taxpayers' money for a procedure with a high probability of fooling both the clinician and the patient. This is totally different than choosing to act when there is a pragmatic reality. To know that a procedure does not predict anything and produces large numbers of false positives and erroneous diagnoses and to continue to use it is not just foolish, it is unethical.

The therapists who are committed to retrieving recovered repressed memories of childhood sexual abuse argue that it is a therapeutic necessity to believe the patient even if the memories cannot be verified and even if they are not historically accurate. They claim that it has therapeutic benefit and helps the person when the therapist believes their story. But there are no quantified data that can support that claim but only assertions of clinical impressions. This foolish idea rests upon the assumption that error can be beneficial. Error can never contribute to healing nor to a better life.

Anyone familiar with the history of medicine can see that it is not enough to be a compassionate, empathic, warm, even bright person, who wants to help people who are hurting. This is the error that led to medical practices such as performing bleeding (which killed George Washington), using insulin shock therapy, pulling out teeth to treat schizophrenia, performing frontal lobotomies, or putting premature babies in an oxygen-enriched environment (which sometimes blinded them). Most recently, breast mastectomies and heart bypass surgery have been shown often to be ineffective and unnecessary.

The competent psychologist can make the discrimination between explanations that have some support for accuracy and myths or dogmas that do not (Meehl, 1959, 1960). Making an accurate determination of claims of recovered memory involves a probability assessment by the clinician. The inference goes from behavior of the rememberer seen on the outside at the present and guessing about an unobservable inner state, including complex internal dynamics enduring across long periods of time to an unobserved and largely uncorroborated prior event. The less that is known about any of the multitudinous entities, intervening variables, the many layers of interactions, and the antecedent probability of all postulated phenomena, the greater the likelihood of errors.

The psychologist who clings to presumed knowledge with no evidence of validity or reliability but rather a high probability of error is no better than the witch doctor, the astrologer, and the palmist who may fit in on the carnival midway but has no place in a venture calling itself science or claiming to heal.

Claimed Support for Repressed Abuse and Recovered Memories in the Literature

There are a few studies claiming support for the concept of repressed abuse and validation of the historical reality of recovered memories. These are cited frequently by the believers as evidence that the concepts have been empirically validated. But these studies must be read very carefully since there are serious problems in terms of what they purport to demonstrate.

It is difficult to get information about how abuse was verified. Rich (1990) notes that when he has asked for verification of self-reported childhood abuse, the "confirmation" often consisted of sketchy hearsay information from other family members, apparently reported by the woman herself during therapy. The two articles most often referred to are by Briere and Conte (1989) and Herman and Schatzow (1987).

Briere and Conte (1989) describe a sample of 468 adults with self-reported childhood sexual abuse histories and state that 60% of their subjects reported some period before age 18 when they could not recall their first abuse experience. However, they only asked one question to investigate this: "During the period of time before the first forced sexual experienced (sic) happened and your eighteenth birthday was there ever a time when you could not remember the forced sexual experience?"

This is a very confusing and poorly worded question. "Could not remember" is vague and could mean many things besides amnesia or repression. It could be interpreted to mean just not thinking about the abuse for days or months, to mean forgetting about it until reminded somehow, or perhaps, to mean consciously determining not to think about it. Also, some subjects might interpret the question to include a period of time before the abuse occurred, as the question literally asks.

But Briere and Conte (1989) conclude from their study that "repression (partial or otherwise) appears to be a common phenomenon among clinical sexual abuse survivors" (p. 4). However, there is no definition of repression given nor is there any presentation of the presumed relationship between the answer to the question and amnesia, forgetting, and/or repression. There is no distinction made between simple forgetting which psychology has known about since Wundt's first laboratory and repression. They simply assume their single highly confusing question measures the postulated complex process of repression.

They then assert that "some significant proportion" of psychotherapy clients who deny a history of sexual abuse have, nevertheless, been abused. Nowhere in their report, however, is there any information concerning verification of the claimed abuse. It is simply assumed that a client who recovers the memory under the guidance of a therapist is reporting an actual event. At no point do they address the issue of the generalizibility from their sample of patients recruited by therapists and the demand characteristics of being patients in a network of sex-abuse therapists. At best this study may provide a base for hypotheses to be tested by further research but it cannot be advanced as establishing the reality of a process of repression of memories of sexual abuse.

Herman and Schatzow (1987) report on their experience with a therapy group for incest survivors and maintain that three out of four of 53 women in the group were able to "validate their memories by obtaining corroborating evidence from other sources" (p. 1). However, most of their sample was of women who had either full or partial recall of the abuse prior to therapy; only one-fourth (14) had no recall before entering the survivors' group. But in discussing the claimed corroboration, no distinction is made between women who had always remembered the abuse and those who didn't recall it until entering therapy.

In addition, the "corroboration" is not convincing. The details of the corroboration are vague and depended upon the reports of the women in group therapy. Out of the four case examples the authors present to describe the verification process, in only two did the woman have complete amnesia for the abuse prior to therapy. For one of these, there was no corroboration of the abuse. For the other, the corroboration consisted of the women's report in group therapy of discovering her brother's pornography collection and diary after he was killed in Vietnam. But there is no indication that anyone else saw the diary or verified what the woman claimed she found.

Young, et al. (1991), in their report on 37 alleged satanic cult survivors, claim that there was corroboration of the alleged satanic ritual abuse for several. However, all of the alleged corroborative findings are completely nonspecific and cannot be said to provide verification. The "corroboration" consisted of physical findings such as scars on the back, a distorted nipple, a "satanic tattoo" on the scalp and a breast scar on one patient. But there is no information of detailed medical workups or photographs of these alleged physical markings. Other evidence of physical findings included three women with endometriosis diagnosed before age 16, one with pelvic inflammatory disease at age 15, and one whose school performance dropped from age 7 to 10 during the years she supposedly was in the cult until the family moved.

In a longitudinal study, Williams (1992) interviewed 100 women who reported sexual abuse in childhood in 1973, 1974, or 1975. The women had all been brought to the city hospital emergency department and information about the abuse was documented in the hospital records. The sexual abuse ranged from intercourse (36%) to touching and fondling (33%) and the age at at the time of the abuse ranged from infancy to age 12.

The follow-up interviews were when the women were approximately 17 years older. The women were asked several questions designed to elicit their responses about sexual victimization. Williams reports that 38% of the 100 women had amnesia for the abuse or chose not to report the abuse to the interviewers 17 years later. She claims that "qualitative analysis of these reports and non-reports suggests that the vast majority of the 38% were women who did not remember the abuse" (p. 20). The study is then interpreted to support the contention that a large proportion of sexually abused women are amnestic for the abuse as adults.

There are several problems with this study. The subjects are said to have ranged from infancy to 12 years old at the time of the abuse. Therefore, an indeterminate number of the women were abused at such a young age that that they would not be expected to remember any events that occurred during this time. As discussed above, events prior to age 3, 4, or even 5 are unlikely to be remembered because of the phenomenon of childhood or infantile amnesia. This is especially likely to be the case if the abuse consisted of fondling or touching, as occurred in 33% of the cases in Williams's study. A child who was only touched or fondled may not have remembered the abuse because it was not a particularly traumatic or noteworthy experience. Therefore, for many of the subjects a concept of traumatic amnesia or repression will not apply.

The methods section in the only published report of William's study does not give sufficient details about the questions that were asked and what subsequent probes were used if the woman failed to report the abuse. This is not a research report but rather a news story and none of the usual information permitting an adequate evaluation of the study is available. There is not sufficient information to evaluate her assertion that the "vast majority" of the women who failed to report the abuse were amnestic as opposed to simply choosing not to report the abuse to the interviewer.

A study by Femina, Yeager, and Lewis (1990) is relevant here. Femina, et al. conducted a follow-up study of 69 subjects who were interviewed during young adulthood. On follow-up 26 gave histories discrepant with those obtained from records and interviews conducted in adolescence. Eighteen denied or minimized abuse when it was in their records and 8 claimed abuse although there was none in the records. Clarification interviews were conducted with 11 of these subjects-8 who denied abuse although their records indicated abuse, and 3 who reported abuse when abuse was not in the records. The authors concluded from the interviews that all 11 had, in fact, been abused.

But none of the subjects who had originally denied abuse had forgotten or "repressed" their childhood abuse. All acknowledged it in the second interview and gave reasons such as embarrassment, a wish to protect the parents, and a desire to forget for their previous denial or minimization. The differences between these results and those reported by Williams may well be in the type of questions asked in the interviews.

Briere (1990), in responding to criticisms about the validity of self-reports of childhood abuse, justifies accepting clients' reports in a study by Briere and Zaidi (1989) by noting that (1) the abuse rate was comparable to rates found in other studies; (2) aspects of the clients' victimization correlated with symptoms that made intuitive sense and that had been reported by other authors; and (3) the clinical experience of the authors suggested that the disclosures were accompanied by distress, shame, and fear of stigma, as opposed to enjoyment. None of these criteria meets acceptable standards for establishing the veracity of the reports. This is especially true when the reports of abuse come from memories uncovered in therapy.

Briere (1992) believes that some adults are amnesic for some or all of their childhood abuse and claims that the problem of repressed memories in retrospective research is a "significant concern" because the abuse is therefore not reported (p. 197). But at the same time he admits that there is no satisfactory way to ensure the validity of subjects' recollections. He acknowledges that the accuracy of sexual abuse reports cannot be assured in terms of ruling out either false positives or false negatives. Although he briefly mentions fantasies, delusions, or intentional misrepresentations for secondary gain as possible reasons for false positives, he shows no awareness of the danger of clients developing false accounts of abuse through therapy.

The concept of recovered memories rests on a Freudian model in which the brain stores all experiences and therapy is seen as a process of uncovering lost or repressed memories and thus freeing patients from their autonomous and sublimated influence. But this model is inaccurate in terms of the actual nature of memory. Also three studies of questionable quality and problematical scientific status cannot as yet match the failure of 50 years of concerted research effort to find evidence to support repression. Before making any claim that research establishes repression as a dynamic internal objective entity, those who want to do so have a long ways to go to overcome the negative evidence that is already there and is well replicated.

In contrast to the few studies purporting to support the concepts of repressed abuse and the historical reality of memories uncovered in therapy are the robust and repeated findings about the reconstructive nature of memory. The fact that memory is reconstruction rather than recall is generally accepted in the scientific community (Goodman & Hahn 1987). Although people may believe that their memories are a process of dredging up what actually happened, in reality memories are greatly affected by events and experiences that intervene between the event and the present and the individual's current beliefs, feelings, and interpretations (Dawes, 1988; Loftus & Ketcham, 1991; Loftus, Korf, & Schooler, 1989). This process of memory reconstruction is so powerful that people can come to believe firmly in entire events that never happened (Loftus, 1992; Loftus & Ketcham, 1991).

The process of verbally describing memories, which is what happens in therapy, appears to make it even more difficult to distinguish between memories for real and imagined events (Suengas & Johnson, 1988). Bonanno (1990) notes that rather than uncovering historical truth, therapy results "in the production of an articulated narrative understanding or narrative truth" (p. 176). Ganaway (1991) sums up the situation:

The analogy of an intrapsychic videotape machine recording traumatic memories in all their exquisite detail and storing them away in the unconscious until retrieved via "flashback" or abreaction during the interview situation is slick, simplistic and attractive, but not consistent with a hundred years of empirical evidence. Reconstructed memories may incorporate fantasy, distortion, displacement, condensation, symbolism, and other mental mechanisms that make their sum factual reliability highly questionable. When suggestibility, high hypnotizability, and fantasy- proneness are added to the equation, the result is a potential for such a potpourri of facts, fantasy, distortion, and confabulation as to confound even the most astute investigator attempting to separate the wheat from the chaff (p. 5).

The therapeutic techniques described above greatly increase the probability that the material "remembered" is not historically true. The suggestibility of vulnerable clients and their desire to conform to what they believe the therapist expects and wants, the beliefs of the therapists about the reality and frequency of repressed abuse, the common use of unvalidated and questionable therapy techniques, and the conformity effect of a group combine to produce a massive learning experience for the client.

Evaluating Claims of Recovered Memories

Some professionals have proposed ways of evaluating claims of alleged sexual abuse based on recently recovered memories. This is a new area, lacking in empirical research, so the suggestions are based on existing knowledge about such areas as memory, social influence, suggestibility, conformity, the psychotherapy process, hypnosis, and the characteristics and behavior of actual sexual abusers. Daly and Pacifico (1991) note that investigating these allegations of sexual abuse in years gone by requires new investigative techniques that have not yet been perfected. However, a proper evaluation of such allegations requires a broad range of information about the individuals involved, the origin of the disclosure, and the nature of therapy (see Daly & Pacifico, 1991, Rogers, 1992, and Wakefield & Underwager, in press for suggestions of important information to be obtained as part of an investigation).

Gardner (1992a, 1992b)

Although Gardner believes that some accusations of recently recovered memories are true, he observes that others are false. He offers guidelines in terns of characteristics of cases that suggest they are false.

False accusations are often characterized by a strong need to bring the abuse to the attention of the public along with the belief that all of one's psychological problems come from the abuse. Gardner sees the women who make false allegations based on recovered memories as very angry and hostile and sometimes paranoid. He believes that all will have demonstrated some type of psychopathology in earlier parts of their lives.

Gardner is harshly critical of the therapists who participate in the uncovering of false memories of childhood abuse and sees them as incompetent and dangerous. He observes that they show no awareness of well-known facts and concepts in psychology, such as the nature of memory. Therefore, an indication that an allegation is likely false is the involvement of an inadequately trained or incompetent therapist who specializes in uncovering repressed abuse and who finds abuse in the majority of his or her patients.

An important guideline for ascertaining the truth or falsity of an allegation of recently remembered abuse is the length of time the alleged abuse took place-the longer the period of abuse, the less the likelihood of its being repressed. Repression at age 6 or 7 of events that occurred over a two- or three-year-period is more credible than the repression of events that took place from ages 2 to 18. The age at which the abuse is said to have stopped is another factor. Although one may forget events that took place when one was about 5, it is less credible that memory experiences taking place during the teen years have been completely obliterated. Gardner adds that an accusation is more likely to be false if the individual had no observable symptoms of the abuse during the time the abuse supposedly took place.

Memories uncovered with the use of hypnosis run the risk of being false, especially since individuals who are good candidates for hypnotherapy are more suggestible. Another hallmark of a false accusation is the inclusion in the allegations of preposterous and even impossible events. Also, the failure to see the accused father and get his input reflects the therapist's overdetermined bias and therefore strongly suggests a false accusation. An important indicator of a false accusation is when the accuser cuts off contact with those who don't believe the accusation and surrounds herself only with "enablers," such as support groups, therapists, survivor groups, and friends and relatives who support and encourage the accusations.

Rogers (1992)

Rogers discusses clinical assessment methods for evaluating claims of traumatic memories and describes a decision tree regarding factors hypothesized to be associated with valid or invalid complaints. Her focus is on civil litigation and she describes several actual cases to illustrate her observations. She notes that despite the lack of empirical data, there are some common sense clues and observations that can be helpful.

In evaluating a case for litigation, an important consideration is whether the claimant is a bona fide patient or is in treatment for reasons other than pain or dysfunction. Rogers describes a case in which the individual entered therapy at the time her financial resources were depleted and decided on a lawsuit soon afterwards. The woman's psychological testing suggested malingering and the cousin she recovered abuse memories about was the only person in her extended family who had significant money.

Abuse is more likely to be true if the abuse memories have always been present as opposed to only surfacing during therapy. However, Rogers believes that there may be legitimate cases in which memories return in therapy after being shoved aside for years. In those she has seen that appeared to be valid the therapist did not use intrusive techniques such as hypnosis, body work, emotional regression, repeated probing, directed reading about abuse, and the individual was not placed in group treatment until the abuse had already been fully detailed and documented.

False or exaggerated claims are much more likely to portray the alleged perpetrator as a totally bad person who used force and engaged in sadistic activities. True claims show more balance and ambivalence. In false or exaggerated accounts, the individuals may show major differences across time with the same incident.

Descriptions of the abuse incidents in false claims may be much more sparse and lacking in details compared to other memories during the same time period. However, some claimants evidence extremely detailed, highly elaborated accounts-accounts that are far more detailed than other events purported to have occurred during the same or earlier time periods. These individuals seemed to have been more deeply involved in survivors' groups, recovery programs, and to have done extensive reading as well as journaling with its attendant introspective processing.

Wakefield and Underwager (in press)

Wakefield and Underwager discuss several criteria for assessing the probability or improbability of an allegation of recently remembered abuse. They stress that since this is a new area with little directly relevant empirical data, these criteria must be viewed as provisional.

They recommend assessing the allegations in terms of what is known about the behavior of actual child sexual abusers. In the absence of corroborating evidence, when the allegations are of extremely deviant and low-probability behaviors, the recovered memory is unlikely to represent a real event. It is even more unlikely if the person accused is psychologically normal or if the accusations include the mother.

If the recovered memory is for abuse that occurred at a very young age, such as abuse during infancy or under age 3 or 4, the phenomenon of childhood or infantile amnesia makes it unlikely that the memory is of a real event. In addition, this is much younger than the average age of documented sexual abuse victims.

If the abuse has only recently been "remembered," it is much less likely to be true than it has always been remembered but the individual is only now disclosing. It is especially unlikely to be true if the accusations only emerge following reading The Courage to Heal, hypnosis, survivors' group participation, or dream analysis. In such cases, the recovered memories are likely to be the result of therapy. Although psychopathology in some individuals may well make them more susceptible to this influence, since many of the adult children in the questionnaire project had no history of significant problems prior to the recovered memories, the absence of serious problems does not mean that the recovered memory is real.

If there are allegations of a series of abusive incidents across time in different places and situations, the abuse is less likely to be true than if it is for a single incident. Although an individual can develop amnesia for a highly traumatic event, with the exception of MPD, there is nothing in the literature describing selective amnesia for a series of traumatic events which occur at different ages and at different times and environments.

Any claims that the individual must have been abused because of problems in her life must be viewed cautiously. The existence of eating disorders, sexual dysfunction, anxiety, depression, or low self-esteem cannot be used to support the probability of abuse since these can all be caused by a variety of factors. Beitchman, et al. (1992) concluded that as yet there is insufficient evidence to confirm a relationship between childhood sexual abuse and borderline or multiple personality disorder. Pope and Hudson (1992) reviewed studies on bulimia and sexual abuse and report that these studies did not find that bulimic patients show a higher prevalence of childhood sexual abuse than do control groups.

When the disclosures progress across time to ever more intrusive, abusive, and highly improbable behaviors, the growth and embellishment of the story is likely to represent the suggestions and reinforcement in therapy. Allegations of ritual abuse by intergenerational satanic cults are highly unlikely to be true.

Corroborating evidence, such as such as a childhood diary with unambiguous entries or pornographic photographs, obviously makes the allegations more likely to be true. Ambiguous evidence, however, such as a childhood story or drawings now reinterpreted in light of the believed-in abuse, cannot be used as support that the abuse actually occurred.

Conclusions

The claims of recovered repressed memories of childhood sexual abuse represent an striking phenomenon in the mental health community. As Gardner (1992a, 1992b) observes, to believe these "victims" and their therapists, we must consider childhood sexual traumas to be a special experience in which well-accepted psychological principles are inapplicable and an entirely new set of psychological principles must be invented. The claims being presented are at variance with the scientific knowledge about the nature of memory and psychological concepts of dissociation, amnesia, and the reactions of people to documented trauma.

Accepting the claims about recovered memories of repressed abuse means accepting a complex chain of assumptions, speculations, inferred internal states and mental processes with limited scientific support and little if any corroborating data. At best, this is a low-frequency phenomenon.

On the other hand, there are credible data on the reconstructive nature of memory, social influence, conformity, and the power of therapy to produce conformity in the patient. It is much more probable that a claim of recovered memory of sexual abuse comes from a combination of these factors. It is an issue of antecedent probability and the best and most accurate decision always comes from going with the high base rate behavior. It is the only ethical choice a scientist can make.

References