Evaluating Adult Litigants Who Allege Injuries from Sexual Abuse: Clinical Assessment Methods for Traumatic Memories
Martha L. Rogers*
ABSTRACT: The assessment of adults alleging injuries from sexual
abuse as children is difficult and complex. Three areas of concern are
whether the claimant is a bona fide patient or is in treatment for
significant reasons other than pain and dysfunction, whether the memories
of the alleged abuse are more or less continuous, and whether the report
of abuse was spontaneously obtained or was the product of therapy or
extra-therapeutic influences. Methods which may prove useful in
evaluating such clients include the Early Memories Procedure, the TSC-40
Scale, The Impact of Event Scale, and the application of Statement
Validity Analysis to the narrative accounts of the abuse. Factors
hypothesized to be relevant in differentiating between valid and invalid
claims are discussed.
In recent years, the filing of civil damage suits has been seen as
an increasingly frequent remedy for adult victims of childhood sexual
molestation, especially in the current legal climate with changes in
statutes regarding time limitations. This option was summarized in
commentary published in the
Journal of Interpersonal Violence
(Berliner, 1989; Barbarieri, 1989; Dawson, 1989).
Some of these claims may prove valid and the victims are deserving
of financial compensation to provide treatment and meet other needs.
The problem is, of course, separating out nonlegitimate claims. The
facticity of the alleged abuse and the extent of damage attributable
to such abuse must be addressed in comprehensive assessment of these
As noted by Weissman (1991), "The examiner's task of
separating proximate from nonproximate factors ... becomes more complex
with the passage of time" (p. 418). This problem is quite complex
when we are talking about child sexual abuse and assessment for
litigation occurring 10 to 20 or more years later. To evaluate these
claims appropriately, an understanding of the range of presentations of past child sexual abuse may provide a
Some Varieties of Adult Abuse Reports in Therapy
The following types of adult clients claiming sexual abuse as
children are examples from my own experience which were chosen to show
the range of possibilities. They come from psychotherapy clients only
as well as those who were litigants. Some details have been altered to
protect their identities and in some cases the details reflect a
composite from several clients of a similar type.
Some experience in treatment of cases not involving litigation is
necessary to assess effectively those who sue. I see approximately
equal numbers of cases for the plaintiff and defense sides. However,
whether or not litigation has already begun, I first make a careful
assessment to determine if I can reach an opinion as to the alleged
injuries. These are sometimes cases the attorney has asked me to
evaluate before filing any legal action.
The adult who reports childhood sexual abuse in psychotherapy may
present in one of several ways. Some of the case composites reflect
individuals who were treated prior to changes in the law that would
have permitted filing of suits many years after the injuries; whether
all of these individuals would have pursued legal action in the
current climate is unknown. Some are more recent and certainly the
clients had the option to sue but elected not to do so for various
reasons. Many of these appear to reflect legitimate claims against a
Many people enter psychotherapy with a history of having been
abused, which they have always remembered. These individuals typically
do not claim to have forgotten what happened to them or to have
substantial periods of not remembering. What may be more common,
however, is an extensive period of time in which they attempted to set
the traumatic experience(s) aside. Sometimes this was possible because
during certain life phases they were not dealing with current issues
in their lives that necessarily evoked recall of the past trauma.
Young people who have unresolved trauma from childhood molestation
may not realize that serious problems in living are occurring until
they attempt to negotiate particular developmental tasks, such as
getting into their first serious love relationship. These clients may
then experience uncomfortable feelings that were avoided earlier.
enter psychotherapy with a partial awareness that the past molestation
is behind their current difficulties.
Others may be stumbling through life until other issues force them
to address their own past molestation. There may be crises that
develop with the parents of the now adult abuse victims, which they
feel ill-equipped to handle because of the past. Severe enmeshment may
make it hard to break away. They have trouble feeling, thinking, and
behaving separately from a parent. They may be unable to develop
intimate relationships with a spouse, or have continuing conflicts
with a spouse.
When they become parents, they may be very obsessive and
overconcerned about the safety of their children. They fear the same
thing happening to their own children. They may have problems sharing
parenting with the spouse, who is not trusted not to harm the
children. Sexual problems with the spouse may occur from the beginning
or increase at later stages in the marriage. Severe conflict with the
spouse may be inevitable. A number of these marriages fail, and some
of the wives seem to be at high risk for alleging molestation against
the former spouse during divorce actions.
Case Example: Ms. A
Ms. A had been molested from early childhood to age 15, when she
finally disclosed. Her father was criminally charged, and ultimately
he admitted to some of the incidents, was convicted and served time
in prison. At the time the abuse first came to light, Ms. A was
offered psychotherapy and she attended a few sessions. However, she
was not at all enthusiastic or comfortable with the process, and
elected to drop out. Part of her attitude had been shaped by the
family, where internalized attitudes negative to disclosure outside
the family were strongly inculcated by the father, and besides that,
therapists were stupid anyway.
Despite the abuse, she had internalized these attitudes and felt
negative about treatment. Her general demeanor and style for many
years was to hide any sort of inadequacy from others as well as
herself, but a corollary premise was that no one could be trusted to
know who she was. Appearance of adequacy was more important than
After marrying and having children, she and her husband were
having serious problems because of interference from the client's
family of origin. When Ms. A made a decision to maintain more distance from her family, she
became aware of the dynamics that had prevented her from relating to
anyone outside her family of origin, and had kept the abuse issues
covered up for many years. It was then that she realized her need for
treatment for the first time.
Case Example: Mr. B
Mr. B, who had always known he was molested hundreds of times
over a several year period by a religious brother who taught him at
a boarding school, never disclosed to anyone until after his own
child was molested by a relative. There were very serious, lifelong
problems with intimacy and functioning sexually with his wife, as
well as profound problems in relating to his children as a
parent. But he had stumbled along in life until things began to unravel.
then entered psychotherapy to work on these difficulties. His
accounts about his own past abuse were highly detailed, with a
myriad of peripheral details.
There is another group of people who enter psychotherapy for
reasons other than a direct concern about past abuse or trauma. These
individuals may be having problems in living that they themselves may
not correlate with past molestation. When therapeutic methods are not
invasive or intrusive, and there is no expectation that abuse memories
will be produced, their spontaneous recall of abuse is less likely to
have been contaminated by the therapeutic approach.
Case Example: Mr. C
In psychotherapy with a 45-year-old man, Mr. C, a lifelong
pedophile, explorations into his past were more broad. The client
was not directed to search for specific kinds of memories. Early in
the treatment, he was asked if he had any recall of having been
abused in any fashion, and his response was no. No intrusive or
educative techniques were used to explore further the possibility of
abuse or to lead to an expectation that he must have been abused.
Although he was in court-ordered treatment, there did not appear to
be any advantage for him to produce memories of past abuse. His own
case had been fully adjudicated, he had entered a plea, and he was
convicted of child molestation.
However, about a year into therapy, in the context of recalling
what life was like for him as a young child during World War II,
while his father was away from home, he reported two incidents of
sexual abuse which he apparently remembered outside of therapy.
involved a trip he took on a train with his mother at age five, when
he had to go to the bathroom. In the men's bathroom on the train, a
man who was wearing a military uniform reportedly orally copulated
him. Another involved an adolescent maternal aunt, who was his babysitter off and on, and he had the impression
he might have been molested more than one time, but could not pull
back specifics of separate episodes. It appears the recall of these
incidents was relatively spontaneous, and evoked by discussion of
surrounding events in the same time frame as the molestations.
There are others who enter therapy with serious problems who may
have some inkling or suspicion of having been abused, but who lack
certainty of what has transpired. Depending on the skills and patience
of the therapist, they may learn more about what may have actually
Case Example: Ms. D
A college student, Ms. D, was several months into therapy by an
intern when she began experiencing intense panic and suicidal
ideation in conjunction with what appeared to be flashes of memory
fragments of sexual abuse involving her father. Interpersonally, she
was an individual with intense, manipulative, borderline qualities,
and she had entered therapy primarily because of conflicts and
failures in interpersonal relationships; there were components of
acting in and acting out during the therapy. At one point, she
became assaultive toward the therapist and damaged the therapy room.
As her panic escalated, more fragments of memory about possible
abuse seemed to surface.
The nature of some of the memory fragments appeared possibly to
reflect historical events. There was no use of intrusive methods in
evoking these reports, as one of the main therapeutic tasks at that
point was to help her contain and regain control. In one incident,
for example, she experienced herself as on the floor and looking up
at cobwebs under the bed in her bedroom while being molested.
Because there were concerns about her increasing loss of
behavioral controls with intrusive recollections surfacing, she was
hospitalized. During the first week of hospitalization, some staff
at the hospital completely discounted the client's accounts, seeing
her as a personality disorder with borderline and antisocial
features. The intern felt that she had somehow been hoodwinked by
the client and that she was doing poor therapeutic work with her.
Because of the nature of some of the memories, I suggested to the
intern that I didn't think the possibility of actual molestation
could yet be discounted, but I advised that she simply continue on
with treatment, not overfocusing on the sexual abuse issue, but
helping the client regain control.
The client's father came to visit her at the hospital, and in the
course of conversation admitted to her that he had, in fact,
molested her a number of times when she was very young. Upon
becoming aware of her severe suicidal ideation, the father had
become quite guilt-ridden and came forward. The client experienced
great relief, and was able to make significant strides in dealing both with her present
relational difficulties and the impact of the past.
Some individuals enter therapy for reasons other than awareness or
concerns over abuse and are experiencing serious and usually long-term
difficulties that they have been unable to explain to themselves.
part, therapy can provide a way for a person to tell his or her story.
For some, a midlife awareness of failure at particular life tasks,
such as finding a meaningful job or maintaining satisfying friendships
and intimate relationships, leads them to treatment. If the
assumptions, methods, and skills of the therapist are adequate to this
task, the client may indeed discover a means of getting back on track,
In many of these cases, molestation may have been a significant
factor in their difficulties, while in some it may have been a less
overwhelming component of what went wrong.
Case Example: Ms. E
Ms. E had multiple stresses throughout her childhood which
contributed to her current problems. These included having moved
from household to household in the wake of her parents' divorce, her
mother's alcoholism, her father's remarriage to a woman who was not
accepting of a stepmother role, and being placed in foster care with
her grandparents, an aunt and uncle, and others when her parents
were unable to function as parents. These were much more important
in the overall scheme of what happened to her than her childhood
She was molested over the space of a year from ages 12 to 13 by
one of her mother's boyfriends. This was devastating but her own
view is that things couldn't have been much worse before this
happened, but it was only one of the traumas she had to work
through. When she began treatment, she hadn't thought about it for
many years, but when asked whether she had forgotten about it or
just shoved it aside, she concluded she had only shoved it aside
because there had been so many other problems that had to be dealt
If the therapist naively assumes that one must unearth a single
"cause" for pervasive and longstanding unhappiness,
following which the person will then be expected to magically improve,
there is a risk that inappropriate therapeutic techniques and
conclusions will follow. While abuse is a major problem in our
society, there are some therapists whose training has been narrow and
based on assumptions that may be inadequate to conceptualize fully the
difficulties of their clients. Their background in diagnosis and
treatment may be quite limited, but they may have gone to workshops on
multiple personality disorder (MPD), satanic ritual abuse (SRA), or child abuse, and then made diagnostic judgments for which they do
not have adequate foundation, perspective or context. I suspect some of
these therapists are overdiagnosing dissociative disorders, and also are
heavily involved in the excavation of so-called repressed memories.
Looking at the initial data of Wakefield & Underwager (1992),
of families of clients who have made accusations of such abuse, those
who were aware of the background of the therapists reported that they
were comprised of 57% "counselors" or social workers. This
appears consistent with research of Bucky and Dalenberg (1992) in
which a sample of mental health professionals from San Diego County
were polled regarding the frequency with which they have seen
dissociative or SRA symptomatology and the extent of MPD or SRA in
their case loads. Master's level professionals who also attended
training seminars on MPD or SRA appeared markedly more prone to make
these kinds of diagnoses.
Neither of these studies reflected random samples of data;
Wakefield and Underwager's sample comes from parents who claim to have
been falsely accused by their adult children and Bucky and Dalenberg's
reflects the 10% of mental health professionals who took the trouble
to answer a questionnaire about child sexual and satanic ritual abuse.
But both studies suggest that it would be fruitful to investigate
whether the level of professionals, and their background and training
in diagnosis, correlate with the frequency with which these diagnoses
are being made. This is an issue that needs to be more systematically
explored. There is a great risk with some counselors and practitioners
of participating in creating what Loftus (1989) has termed "...
sincere but misguided memory" (p. 155).
Many people who enter therapy may thus become aware of how abuse
affected their own development, this awareness increasing during the
course of therapy. Also, the assumptions or methods of the therapist
may play a significant role in eliciting memories that may have been
substantially modified by the therapeutic process. Some of these
clients need justification provided by the therapist, others need an
explanation of a derailed life, and parents can therefore be blamed
for the person's troubles. In the extreme, the client's need for
justification for all of life's failures, and the therapist's need to
find a cause can result in misdiagnosis of past child abuse. Treatment
then is geared toward the reinforcement of such belief.
Case Example: Ms. F
Ms. F had a long-term history of serious personal, interpersonal,
and occupational difficulties dating from childhood. She had come
from a family in which there had been severe neglect and abuse involving her siblings as well as Ms.
F. She had been receiving alimony for a significant period of time,
and a week before her benefits were to terminate, she presented
herself for psychotherapy at a clinic, citing long-term stressors
including family conflicts, financial difficulties, and several
chronic medical problems. She also stated that she wanted to explore
possible memories of having been abused by a cousin with whom she had
lived for a time as a child. Early on, she was placed in group therapy
with other sexual abuse survivors.
Case Example: Ms. BD
Ms. BD (Rogers, 1992a), a woman in her mid-forties with three
failed marriages, and a couple of advanced degrees, had never been
occupationally or financially stable or secure, went to a therapist
who rapidly diagnosed MPD and SRA. There was no work-up for
dissociative disorder or other problems completed. The therapist
seemed to have had certain preferred symptoms which he viewed as
indicative of MPD and child abuse, but no systematic evaluation was
ever done until the litigation was already underway. Therapeutic
techniques included a form of self-induced trance, joint sessions
with family members, and group therapy with other survivors. BD also
became involved in graduate studies in counseling, attending classes
and seminars in MPD, as well as reading some of the major texts and
journals about MPD.
In a few weeks' time, her younger sister and her daughter were
also diagnosed similarly after they were taken in for therapy.
accused the elderly mother and deceased father of being part of a
satanic ritual abuse ring and having brutally abused them throughout
their childhoods. Her father had died a year or so before, and he
had usually been very generous financially, but her mother
reportedly less so. With his death and then the demise of her last
marriage, she was in crisis. The therapist was a master's level
licensed therapist with a doctorate in ministerial studies whose
primary practice seemed to be MPD and SRA. He alleged that he had
over fifty SRA victims being seen in his several clinics by his
Case Example: Ms. G
Ms. G was seen at the request of a plaintiff attorney in order to
assess her claim of recovered memories of abuse involving both
parents, two brothers, and several other persons including some
females. Ms. G had entered therapy stating that she had read
materials about abuse victims which included a list of symptoms
purported to he suggestive of past sexual abuse in childhood. There
were several such symptoms which she felt she had.
As the therapy progressed, numerous memories of alleged abuse
surfaced, but it did not appear that the therapy had been the major
impetus to her claims; rather, she had several friends who were
"survivors," and she read voraciously various self-help books such as
The Courage to Heal: A
Guide for Women Survivors of Child Sexual Abuse ()()
(Bass & Davis,
1988). She participated in numerous self-help groups, kept a journal,
and continued to "put the pieces together" of memories which
were extremely well elaborated. Her reported memories of sexual abuse
dated back to two years of age, and included numerous peripheral or
non-essential details, as well as sensory details.
Reviewing some of the books she had read early in her therapy
process, or even before she had begun therapy, one would have to
hypothesize a learning of how to develop a memory. Whether she had
been abused or not was quite uncertain, as the alleged memories
differed considerably from what is typically seen in how incest
develops across time.
Operationalizing Factors That May Be Associated with Valid or Invalid
Claims of Past Abuse: A Decision Tree
As stated by Wakefield and Underwager (1992), there is little
available on an empirical basis to aid in the assessment of the
validity of abuse claims by an adult when the alleged trauma occurred
many years previously. Based on past experience, however, there are
some common sense clues and areas worthy of consideration until the
needed research can be conducted. There are three areas of concern:
Whether the claimant is a bona fide patient or is in treatment
for significant reasons other than pain and dysfunction;
Whether the memories of alleged abuse are more or less
Whether the report of abuse was spontaneously obtained or was
the product of treatment or extra-therapeutic influences.
A hypothetical "decision tree" (Appendix
A) based on past
experience and limited research may provide a starting place for
attempting to operationalize and test criteria associated with valid
or invalid complaints. The definitions may need to be refined, and
should not be used in a rigid fashion. The judgments made may have to
include features not addressed by this working model. It is far from
certain that all relevant variables that should be taken into account
have yet been identified. It should be noted that I haven't seen
clients in litigation in all of the potential categories hypothesized
In reviewing the examples given above, clients A, B, C, D, E, and
BD were deemed to have been bona fide therapy clients. Their therapy preceded any consideration of
litigation, and it was only after it became apparent that treatment was
going to be long and complex that litigation was contemplated. It should
be noted, however, that in the case of BD, litigation had apparently
been recommended by the therapist and the decision was made very early
in the treatment to pursue a legal case.
Clients A and B were evaluated at the request of their plaintiff
attorneys who wished an assessment prior to making a decision about
entering litigation. In both of these cases, it was my judgment that
the molestations had occurred and that the individuals had suffered
significant pain and impairment in functioning which was attributable
to the injuries.
Neither of the individuals claimed any significant memory loss.
Both claimed they had not been aware earlier of the extent of their
damage and impairment due to the molestations. Client A's father had
admitted to at least some of the molestations. There was a criminal
conviction in the case. After undertaking therapy, Ms. A asked her
father to assist her with treatment expenses, but she reportedly did
not receive a positive, workable response from him. She subsequently
decided to file a legal action.
Client B contacted some of his former peers in his church and
school and quickly learned that there were several others who had also
been molested. Some of those who admitted having been abused did not
want to enter into any litigation as they did not want their history
to become public information. The defendant in this case admitted to
having molested six different boys. An informal resolution of the case
was attempted prior to filing legal action.
Client G was also evaluated at the request of her plaintiff
attorney, and she appeared to reflect a personality disorder. It was
uncertain as to whether entering therapy was bona fide or not.
alleged symptoms did not match her personality testing. There were
marked influences from reading which occurred before, during, and
aside from therapy, as well as heavy involvement in survivor support
systems. More and more detailed accounts emerged over time.
Clients C, D, arid E were not litigants at any time to my
knowledge. There was no external corroboration for the recovered
memories of Client C. There were several non-essential details and
good contextual aspects to the reports. No advantage accrued to his
legal status for having remembered the abuse. Although Client C
appeared to progress for a time in his court-ordered treatment, he
later terminated treatment and moved away to another state when his
parole period ended. He seemed to have taken up a similar lifestyle as
before which would likely result in a risk for future offenses.
Client D's father acknowledged that she had been abused and took
responsibility for paying for her treatment. She at first considered
but then did not elect to file suit.
Client F was not deemed a bona fide therapy client when evaluated
on behalf of defense. It appeared that she had entered into therapy in
close time proximity to her other financial resources being depleted,
and that she raised the issue of litigation very early in treatment.
She had a past history of manipulating others for meeting her
financial needs. There was also a past history of probable malingering
in a prior legal action. She had claimed that she was too disabled to
work in a prior divorce action. Her psychological testing was grossly
exaggerated and invalid. She claimed that she might have had some
limited awareness of having been abused prior to entering
psychotherapy, but that she needed treatment in order to make certain
that it was true. There were major discrepancies in her accounts of
the abuse over time. The litigated abuse accounts were far more sparse
than other abusive memories reported. She did not seem to
"recover" any further memories about the cousin other than
the ones alleged in the litigation.
The cousin she sued admitted having had sexual contact with her
while they were both minors, alleging that the contacts were
consensual, but denied the forceful sodomies of which he was accused.
The defendant was probably the only person in the extended family who
had significant financial assets. The plaintiff was highly resentful
of his success. She clearly was a disturbed individual for whom it was
difficult to assess just how much damage was attributable to the
sexual contacts with the defendant because of her unreliable response
Client BD was a plaintiff in a lawsuit but I did not not directly
examine her. Her original motives for going into psychotherapy were
probably genuine, but the nature and quality of the assessment and
treatment she received were inadequate and were contaminating
influences. At a very early stage in therapy, her counselor likely
suggested litigation to her and she sought out legal representation.
She also was influenced by the popular media and by educative
participation in seminars and classes about MPD and SRA. She claimed
that she had no memory whatsoever of the alleged abuse prior to
discovery through psychotherapy.
Her defendant mother was evaluated extensively and did not appear
to have any notable characteristics consistent with a parent who had
been abusive (Rogers, 1991). BD and her two co-plaintiffs were
indirectly assessed through a review of their trial testimony which
was videotaped in full (Rogers, 1992a). Their narratives about abuse
were bizarre in the essential details of the accounts, with few or no
non-essential or peripheral details that did not add to the allegations.
SRA is a rapidly developing area regarding which
available research and clinical experience has exploded recently, but
for which there is very limited substantiation at this time (Rogers,
It was unclear to me whether client G was a bona fide therapy client.
The major sources of influence in developing and elaborating her
memories which had reportedly preceded the time she first started
treatment seemed to have been extra-therapeutic. Psychological testing
did not suggest the presence of repressive or dissociative features or
any clear distress, but rather was more consistent with an individual
suffering from a personality disorder. It was my opinion that
litigation was not appropriate in this case.
By the time most lawsuits are filed, the plaintiff has probably
gone over the alleged memories any number of times and ways, depending
on how they surfaced in the first place. In my experience with
plaintiffs with verifiable traumas, there has not been a claim by
either adults or children that the events were forgotten or repressed.
Some bona fide chronic PTSD victims of traumas aside from sexual abuse
have avoided psychotherapy, even though it became apparent in the
course of conducting defense-requested IME exams that their symptoms
and dysfunction were severe. Their symptomatology had to be
practically dragged out of them on examination.
In several civil cases I have seen where the complaint was child
sexual abuse, typically 10 to 20 years earlier, the plaintiffs stated
that the events were always remembered but they didn't realize the
impact or damage they had suffered. I have seen no litigation cases
that I considered legitimate where the abuse was allegedly not
recalled until going into therapy, although I have seen several people
in psychotherapy only where the abuse seemed to surface during the
psychotherapy process without use of any intrusive techniques or
extratherapeutic influences that could have explained the reports.
Some of these would have been legitimate suits.
Thus, it is likely that there will be legitimate cases in which
memories were either recovered or had been just shoved aside for years
and years. Those which appeared to be valid typically did not utilize
hypnosis, "body" work or experiential work leading to
emotional regression, repeated probing, or directed reading about
abuse and were not placed in group treatment until the abuse had
already been fully detailed and documented. These individuals did not
What Are Some Promising Methods For Assessing Adult Litigants Claiming Child Sexual Abuse
In any litigation, evaluations of plaintiffs should be extremely
thorough. When I am examining on behalf of a plaintiff, my goal is to do as thorough a job as I would if retained
by the defense to ascertain whether in fact the case is a valid one
and/or what the problems of the case may be.
Too often, the plaintiff examinations I have reviewed as a
defense-retained psychologist were thin, insubstantial, or even
"bought." Some defense exam findings are also unfair and
give short shrift to people who have been hurt. Methods that provide
the litigant the most complete opportunity to tell the story will also
provide data that may identify those who have exaggerated, fabricated,
and malingered abuse complaints.
A thorough examination should include reviewing all documents on
the individual that might be relevant to their claims, e.g., school,
employment, medical, psychiatric, legal, military records. Any
deposition testimony of the parties, other relatives, treating
personnel, or others may be relevant. Personal documents of any kind
kept by the litigant that might be pertinent, e.g., diaries or
journals, personal correspondence, photographs, audiotapes of phone
calls are important. It is helpful to review these materials prior to
actually examining the individual.
The examination should include a detailed life history, including
accounts of the alleged abuse, and psychological testing. My normal
procedures call for at least one full day to conduct such
examinations. In case of plaintiffs, I may spend more time.
In case of
defense examinations, there are usually efforts to limit the time to
one or two hours and to eliminate psychological testing. I resist
these efforts and will not allow them to control these parameters,
because these cases cannot be adequately assessed in a limited time
If at all possible, obtain collateral interviews with relatives or
others who may provide important information that may tend to confirm
or disconfirm the claims. I will not detail the basics of such an
evaluative process here in the interest of time and space. Weissman
(1984, 1985, 1990, 1991) has provided excellent conceptualizations of
the problems inherent in personal injury assessments.
What has been described thus far would be fundamental to any
examination. I routinely make use of a laptop computer during any
exam, which allows me to make virtually verbatim notes of both my
questions and the litigant's answers. I may audiotape or videotape the
exam in some cases, sometimes at the request of the litigant's
attorney. In assessing sexual abuse cases, it is recommended that the
examination be at least audiotaped.
The following are some techniques that I have been using recently
which have promise both as research and clinical evaluative procedures
in legal cases involving alleged past sexual traumas:
The Early Memories Procedure (EMP) (Arnold R. Bruhn, 1989, 1990,
Bruhn's technique was developed based on studies of earliest
autobiographical memories, and takes the stance that what is
remembered reflects a product of changing perceptions and experiences
across time. It is based on a theory of personality known as
cognitive-perceptual theory, which focuses on the needs, perceptions,
expectations and unresolved issues in early memories. This approach
treats early memories (EMS) as "... fantasies about the past that
reveal present concerns" (Bruhn, 1992a, p. 1).
Bruhn states that from one standpoint, most EMS are not memories at
all and he estimates that, in his experience, 95% of the memories are
experienced as an outside observer and are probably largely fantasy
reconstructions rather than actual recollections. But Bruhn has also
collected some actual cases that were verified as having actually
occurred dating from the first two years of life. He discusses at
length some of the features seen in cases that suggest actual recall
as opposed to later reconstruction (See Appendix B for a description
of his observations and those of Loftus.)
Bruhn's technique can be carried out in one of two ways, one being
through a verbal administration and another by providing the client
with a test booklet to take home and complete. I have routinely
to use both procedures with clients where alleged traumatic events are
an issue, whether reflecting so-called "recovered" memories
or not. The advantage of using both methods is that the verbal
administration catches the respondent by surprise, where he or she
must respond immediately, and it is fairly economical in terms of
examination time. In my experience, approximately one hour will be
used in the verbal administration. The advantage of the follow-up
written format is that more information will be generated at a later
time which can then be compared to the earlier data.
The written format will not uncommonly require six or more hours on
the part of the client. In some legal cases where I have evaluated on
behalf of the defense, the plaintiffs have either not been willing to
later complete the written format, or have been advised by their
attorneys not to do so. Where I have evaluated for the plaintiff, I
have had no difficulty in obtaining compliance, even though it is
time-consuming and although as Bruhn warns, this is often an
uncomfortable procedure for clients.
Instructions to clients are to think back to their earliest
memories of specific events in childhood, choosing events actually remembered, not those they have heard from others.
They are also asked to
make sure it is a "... specific one time event ('I remember one
time ...') and not
a recurring event ('I always used to ...')" (Bruhn, 1989, page 2).
Hence, the instructions attempt to direct the respondent to avoid
so-called script memories or those derived from external sources.
Clients are asked to first report the earliest memory from
childhood. This is then followed by inquiry about what early memory
comes next, which may be chronologically the next early memory
"... or simply another early memory that comes to mind"
(Bruhn, 1989, p.3). A total of six early memories are obtained.
reporting the memory, clients are asked to report the part of the
memory they experience as the clearest part, what the strongest
feeling is associated with the memory and what action or thought this
is connected with, what they would change about the memory if
anything, and the approximate age at the time of the memory.
After completing the six memories, clients provided some Likert
rating scales to assess the affective tone and clearness of each
memory. They are then asked to assess which of the six memories is
most significant and why it is important. They are also asked why it is
that these particular memories are recalled from all childhood
In administering the Early Memory Procedure, the responses should
be tape recorded, or some type of verbatim transcription should be
used. I use a laptop computer in interviews, finding that it is much
less distracting than handwritten notes, allowing me to maintain eye
contact, to keep on talking with the client, and at the same time to
get down virtually a verbatim record both of what was asked and what
was said. This is also very quick, whereas taking handwritten notes
takes much more examination time besides being less complete. Having
verbatim records is essential to some of the analyses that are later
applied to the data.
Subsequent to the above, a second section is comprised of asking
for a series of specific memories associated with various situations
and people, e.g., first school memory, first punishment memory, first
sibling memory, first family memory, a memory of mother, a memory of
father, a memory of someone you admired, happiest memory, a traumatic
memory, a memory of a parental fight or argument, a memory of a parent
or other relative involving alcohol or drugs, an incident that made
you feel ashamed, a memory of being physically or emotionally abused,
a memory of an inappropriate sexual experience, and a fantasy memory.
The respondents are then asked to pick one of these memories and
interpret it the best way that they know how, considering why that
particular incident was selected.
Bruhn treats the data derived from his technique as a projective
personality measure, and, in my experience, it is probably the most rich level of data one can obtain, providing
more detailed idiographic and multi-leveled understanding of clients,
how they reached their current view of themselves and their world.
In addition, one ends up with a discrete set of self-reports, some
of which or some aspects of which may prove verifiable. In some cases,
such as reports involving parents, siblings or other family members,
some of the episodes may have actually been witnessed. In others,
there may be records from other sources that can authenticate at least
aspects of the experience.
Another potential use of these data is to provide a baseline set of
narratives which can be studied and compared to particular events of
interest, such as alleged abusive or traumatic events for which
compensation is being sought. Thus, clients serve as their own
"control" and the nature and quality of these narratives can
be compared across time.
Based on what we know about the nature of children's memory and
their ability to recall and narrate past events, one might hypothesize
that events that are selected by the respondent within a given time
frame have particular meaning and relevance to that individual, and
the nature and quality of details would be relatively consistent.
Memories purported to come from age three would be expected to contain
fewer details than memories coming from age twelve.
The TSC-40 (Elliott, 1990; Elliott & Briere, 1992) is a
research scale which is a more recent version of the earlier TSC-33
Scale (Briere & Runtz, 1989), designed to assess the aftermath of
child sexual abuse in women. There are some score ranges and
comparisons available between individuals who report that they were
molested versus those who report that they were not. The respondent is
asked to report which of a list of 40 items have occurred and to what
extent over the past two months. The instrument instructions could be
modified, and the litigant asked to estimate recall of these
difficulties in the past year, or in the time frame immediately after
the traumas, etc.
To my knowledge it has not been used with males, and studies have
not been completed with males. There are no items in the scale that
would necessarily be different for males that have been molested.
There are some control items that allow an assessment of the degree to
which an individual may tend to overreport.
When using this scale, one should follow up with interviewing to
obtain input as to why the client responded as she did. If the
individual checks that she has frequently experienced flashbacks, for example, one should inquire
into the circumstances of such experiences, where, when, and the
specific nature of the images. Meek (1990) has noted that "laundry
lists" of expected symptomatology for PTSD have become widely
available and accessible to litigants, but genuine symptoms will
typically be attached to individualized, idiosyncratic meaning. In my
experience, when a number of such unusual details are present to which
the individual is able to describe highly situational cues that are
associated with individualistic components of past traumas, they are
less likely to have been made up or to have been acquired from others.
Meek states: "Acute PTSD symptoms, related to the avoidance and
re-experiencing of the trauma, are often unaffected by psychological
sophistication that may be subsequently acquired by the victim from
advocates, counselors, or lawyers" (p.143).
Impact of Event Scale (IES) [Horowitz, Wilner, & Alverez, 1979; Horowitz, Wilner, Kaltreider, & Alverez,
The IES is another research scale that has been studied in PTSD
populations more broadly than just past sexual abuse which may have
resulted in post traumatic symptomatology. But it has also been
studied in various samples of past molestation cases as well. The IES
and the TSC were both utilized in a study of the effects of
brother/sister incest (Laviola, 1992). The IES deals with defensive
coping tactics in cases of PTSD, seeking to assess the extent to which
the victim may report continued intrusive recall versus his or her
ability to avoid such experiences.
As stated for the use of the TSC, the time frames in which the
client is asked to report past symptomatology can be altered, and in
the case of the IES, one would expect to find a diminishment of
intrusive symptomatology and ability to avoid stress would increase
over time, with the former typically more predominant in the time
frames right after the trauma. However, one would want to assess
whether avoidant mechanisms are being overused as this is associated
with poorer adult psychological adjustment (Leitenberg, Greenwald,
& Cado, 1992). As with the TSC, one would want to inquire as to
why respondents answered as they did, as the idiographic aspects of
response will help delineate persons who are answering because they
have somewhere learned that one is supposed to have these symptoms
versus being able to place the symptoms in context of actual life
Obtaining Narrative Accounts of Instant Alleged Abuse and Application
of Statement Validity Analysis (SVA) and Other Clinical Procedures
In cases of sexual abuse in litigation with relatives, it is rare
that we are talking about a single episode; most often, there are many
different instances of abuse alleged. When a case is in litigation,
the chances are that the alleged victim has told and retold the major
incidents so many times that the accounts may have become similar to
some fabricated accounts in being linear, and often devoid of details.
Although linguists have investigated this issue of features of
narrative that might provide insight into the differences between
historical narratives, literary narratives, and narratives which are
invented but attempting to pass as historical, they have concluded
that in all narratives there are rhetorical and interpretive
In Europe, a system of content analysis of narratives to assess the
likely credibility of the witness was developed in the late 1940s and
1950s known as Statement Reality Analysis (SRA). Udo Undeutsch, a
Professor at the University of Cologne was the primary proponent of
this method, by which a transcript of an interview could be analyzed
for presence or absence of certain content and structural features.
The method became widely used and accepted in Europe (Undeutsch,
1982). Its basic premise, known as the Undeutsch Hypothesis, was that
an account based on actual experience will differ in structure,
organization, and content compared to one based upon fabrication or
influence of others in shaping an account.
Similar and related methods were also developed by Arne Trankell in
Stockholm (Trankell, 1972, 1982). Trankell actually published an early
account in English in our own Journal of Abnormal and Social
Psychology (1958), but at that time interest in child sexual abuse had
not emerged in the U.S., and this work was not even noticed.
In the mid-1980s, Undeutsch began to teach his methods to
Americans. There began to be collaboration between some of the German
researchers and those in the U.S. to distill the available research
and experience with SRA into a more systematized methodology which
could then be operationalized and validated (Steller & Köhnken,
1989). The more recent systematized version became known as Statement
Validity Analysis (SVA). An interview must be conducted in which the
role of the interviewer is to obtain useful information without
suggestion, contamination, or persuasion. The interview is then
tape-recorded, transcribed and subjected to Criteria-based Content
Two North American researchers, John Yuille in Canada and David
Raskin in Utah, as well as those in Germany such as Max Steller began
conducting studies including both analog and field studies (c.f.,
Cutshall & Yuille, 1989; Yuille & Cutshall, 1989; Steller,
1988; Wegener, 1988; Raskin & Yuille, 1989; Raskin & Steller,
1989; Esplin, Houed, & Raskin, 1988; Raskin & Esplin, 1991a).
Raskin and his colleagues also began providing workshops to teach
these methods to interested professionals in law enforcement, social
work, and the mental health fields.
Current research efforts are geared toward attempting to validate
the method with children, although traditionally it has also been used
with adult subjects. Part of the power of the method with children is
that they do not typically have such a repertoire of past sexual
experiences from which to draw in telling an event, and thus it is
much more difficult for them to fabricate an account.
With adults, one can more easily relate a real event but change the
players and it may be very difficult to discriminate a true account
from a fabricated one. Nevertheless, Cutshall & Yuille (1989) have
hypothesized from some of their research that in telling an untrue
account, the story teller may have such a job keeping up with the most
relevant details needed to convince the listener that less necessary
or more peripheral details which are normally present in abundance may
tend to drop out. This is not always so, however, in my experience,
which will be described further below.
At this stage in development, SVA is best conceptualized as one
more clinical tool that may provide some assistance in identifying
narrative accounts that seem to be discrepant from the examinee's
overall style and capacities. It is my belief that it may provide one
more avenue from which to look at data that are being studied on
several different levels in the process of an examination. It cannot
be considered a method that will stand alone in assessing these cases
(Raskin & Esplin, 1991a & 1991b; Wells & Loftus, 1991;
McGough, 1991). Rather, it can add to traditional clinical approaches
of developmental analysis or sequence analysis where one carefully
studies any changes in the statement across time. In legal settings,
one may challenge or impeach a witness based on prior statements, and
SVA provides one more avenue for studying such changes.
One way of using SVA and other clinical analysis methods would be
to study some of the data from a verbally administered EMP or from
other questions about past experiences in interview. Those memory
episodes which do not involve abuse, or those which involve abuse
episodes aside from those being litigated can serve as a baseline of the client's narrative capacities, style, and level of
detailing. One advantage would be that some of the episodes narrated
with EMP may be subject to external validation from other witnesses.
When the client has reported memories of events being litigated,
these accounts can also be compared to accounts given by the Plaintiff
at earlier times. Based on SVA methodology, one might expect some
peripheral details to be added or to drop out between one account and
another, but the major elements would be expected to remain more
constant. The older the individual at the time of the alleged incident,
the more details one should expect. Details recovered from a very
young age should be consistent with the perspective of a person who is
very young, without the cognitive labeling of events in the manner of
an older person. There will be detailing consistent with other
surrounding events of the same time frame.
As events are recovered from age 10 or 11 on up, where cognitive
capabilities become close to those in adults, one would expect the
accounts to be more detailed but still consistent with the
capabilities of a young person, and consistent in quality and
detailing with other surrounding events in the same time frame. In any
abuse victim where there may be questions as to the credibility or
validity, it is useful to build a time line of statements from the
earliest known to the most recent and to study the changes across
time. In cases of mistaken or fabricated allegations, typically there
will be some major changes across time (Rogers, 1990).
Another advantage to the use of the EMP is that it is highly likely
the examiner will solicit some abuse incident episodes or additional
aspects of the incidents that the examinee has not related to others
previously. In cases where one particular event has been retold many
times, it may be very difficult to ascertain whether or not one is
dealing with an actual incident, as many of the peripheral details may
drop out. If one can tap aspects of the experience that have not been
previously gone over many times, one has a better chance of assessing
the validity of the complaint
Factors Helpful in Differentiating Between Valid and Invalid Claims
Although many of the cases where I have used these methods are
still in litigation and their actual accounts from the EMP and SVA
methods would be far too identifying to discuss here, there are some
generalities that I can provide about what I have seen thus far:
Plaintiffs who have been viewed as telling the truth about the abuse they experienced and not unduly
exaggerating their claims usually present with considerable
ambivalence about the abusing person, and will be able to relate
spontaneously positive experiences about him or her as well as
Individuals who have made valid complaints usually try hard to
present a balanced picture of their experiences, at times consciously
stating that they know there were positive events in their background.
If the perpetrator is a family member, they may still long for some
kind of reconciliation or acknowledgment from him or her. In
contrast, those who may be exaggerating their abuse claims are more
often seen as providing a very skewed picture where virtually all
incidents reported in the EMP were abusive in some way.
Elements of force and sadistic activities are much more
frequently claimed by those who are exaggerating alleged incest
episodes than by those who appear to be presenting credible accounts
who more often bring up the manipulative, baiting, or coercive
characteristics of the perpetrators. More often the perpetrator is
characterized as a totally bad person by those who are exaggerating
Some individuals whose abuse accounts are viewed as exaggerated
or fabricated provide numerous accounts of other traumatic or abusive
incidents that are very much more detailed than those being litigated.
In other words, episodes which would appear to have been at least as
much, if not more traumatic than those which are disputed, will be
relayed in much greater detail, with many more peripheral or
non-essential elements. The abuse incidents in question may be more
sparse in comparison to the plaintiff's own baseline accounts of early
memories. This is true even when the key abuse incidents occurred at a
much later age than some of the episodes stated to have occurred
For a hypothetical/created example, if a father was being falsely
accused of sexual abuse of his daughter at age 12 to 14, the plaintiff
might well be able to give accounts of other types of abuse occurring
at the hands of the father in a much earlier time frame, such as age 5
where the accounts are much more detailed with both essential and
peripheral details than those purported to reflect abuse by the father
at age 12 to 14.
Compared to their earlier accounts, individuals whose abuse
accounts are viewed as exaggerated or fabricated, may show major
differences across time with the same alleged incident. This was a rather surprising
finding, but in the course of litigation, one may have accounts that
are as much as five years old to compare to more recent ones and to
those asked for in examination. It is important to obtain all accounts
given previously and to carefully study such changes across time.
I would concur with Wakefield and Underwager (1992) that in some
cases involving exaggeration, shaping, or fabrication, the progression
across time is from innocuous behaviors to more and more intrusive or
improbable behaviors. This has often been the case in child cases
where allegations were mistaken.
But whether that is always the specific progression in adults is
uncertain. I believe it depends on the type of litigation, the
of the person who is fabricating, the kind of feedback he or she is
receiving across different interviews and contexts, the length of time
passing between statements, and the external sources of influence on
Some plaintiffs who are fabricating appear to actually forget what
they said before and later to make substantially different statements.
In many personal injury cases, I suspect that the plaintiffs often are
not receiving negative feedback for their claims or being challenged
in any way, as they tend to come in contact with an examiner selected
by the defense only one time, and in these situations one may not
necessarily see the gradual increase in severity and improbability.
Rather, the statements about abuse tend to remain more vague and
undefined as contrasted to other memories in the same time frames
which may be much more detailed.
In cases not involving personal injury litigation, but those
involving fabricated criminal charges, there may be more awareness of
challenge against the adolescent or adult victim who then seemed to
need to "up the ante." I have seen two criminal cases where
an alleged adolescent victim was reinterviewed multiple times by
different people, where the following patterns were observed:
a. The alleged victim makes completely contradictory statements
within days of one another when interviewed by different personnel;
b. As one event becomes closely scrutinized by interviewers, the
victim may begin to add other alleged incidents, often making them
much more forceful and/or further and further back in time with
and fewer details, so that they become very sparse and stereotypic
(Rogers, 1990). This seems to be motivated by the wish to make an
allegation that will stick as far as legal charges for which the
defendant has no hope of defending himself.
As a hypothetical/created example, the victim first alleges
detailed accounts of being molested by the father in a recent time
frame where there were several other people around, or at times for
which the father had a solid alibi. The nature of the allegations may
be more ambiguous or less serious in these initial disclosures. But,
as these incidents are more closely scrutinized in interviews and do
not seem to hold up so well, she may then allege more serious,
forceful episodes in earlier and earlier time frames. Certain details
then are repeated and become more stereotypic.
One adolescent kept bringing up dark "blackout" curtains,
which first appeared in a motel setting, but then was repeated for
incidents that allegedly occurred in her father's home or in the homes
of several friends. Her earlier, more detailed accounts gave way to
extremely stereotypic, repetitive allegations with virtually no
nonessential or peripheral details. She alleged incidents occurring at
a motel, at her father's home, and at homes of several friends whom
they visited overnight over a week vacation period where others slept
in the same room with her and saw nothing.
Another adolescent told of an incident early in the investigation
in which she innocently ran naked through the sprinklers at age five
or six, following which her father dried her off. She adamantly denied
on repeated interviews that anything abusive had occurred at that
time. But over time this incident changed to the point that she was
allegedly raped. She first alleged she had not had intercourse with
the suspect before she was 12, but then the age began to inch downward
and the allegations began to become much more forceful.
c. Additional perpetrators may be added as the case progresses.
some cases, the adding of additional, and progressively less likely
alleged perpetrators has been striking. In a case of one 12-year-old,
she first accused her natural father, then two paternal uncles, her
maternal grandfather, and a maternal step-uncle. Each of the
subsequent allegations seemed to be related to her mother's
"falling out" with one and then another family member.
Some of those who have been allegedly abused have been heavily
involved in various recovery programs, groups, seminars, or have
undertaken extensive reading in the popular recovery literature.
then may produce extremely detailed, highly elaborated accounts of
abuse, with many peripheral and nonessential details. There may be
accounts with such fine detailing even in episodes alleged to have
occurred at age two or three, with numerous sensory/ spatial aspects.
Their accounts of the abuse are far more detailed than other events purported to have occurred in
similar time frames.
It would appear, then, that the amount and degree of elaboration is
an important clue as to the historicity of a claim, but only in light
of the past learning experiences that may have influenced the claim.
comparison of the relative degree of detail in memory reports in the
same time frame may result in a finding that the abuse accounts are
either very sparse in details or much more overelaborated, depending
on the contribution of various sources of influence, the underlying
motivations, and the circumstances under which the interviews took
Those whose accounts of abuse appear exaggerated or fabricated
often present exaggerated symptoms or complaints or even invalid
profiles when evaluated with psychological testing, such as the
MMPI-2, MCMI-II, 16 PF, or Rorschach Inkblot Test. Or, the profiles do
not match the symptomatic pattern seen in the history and interview
and more subtle signs of exaggeration or malingering may be present
Memory does not seem to have been raised as a major issue in
cases that have been finely detailed by the victim and which appear to
be corroborated through both internal and external validating
approaches. Details of the abuse are typically sparse in those cases
where memory loss was claimed, but other life events, some of which
were equally traumatic, are typically described in rich detail.
While I have not had an opportunity to evaluate adult litigants
alleging satanic ritualistic abuse to these detailed methods, from the
standpoint of reviewing accounts given in court in one case,
peripheral or nonessential details which did not add to the allegation
were virtually absent. All of the details had what would be termed
"a touch of expediency" and seemed intended to convince the
listener of the truth of the account. Plaintiffs would periodically
catch themselves in obvious discrepancies.
Since in this case (Rogers, 1991, 1992a) defense had no discovery or
IME exams performed prior to trial, they went into the trial
"blind." The tactic used was to have the plaintiffs
elaborate as fully as possible their allegations, hopefully pushing
them well beyond what they may have rehearsed with their attorney
which worked well in this case. They became testy, defensive,
and rationalizing in regard to their answers even though' the defense
approach was totally non-confrontative, but simply trying to get them to elaborate events in fine detail.
These individuals also came
up with incidents they allegedly remembered from infancy, which are
highly unlikely to be based on actual memory.
Clinical methods that would allow one to collect systematic data
about a range of past memories from individual bona fide
non-litigating therapy clients and litigants in therapy could provide
forensic examiners with better tools to differentiate valid from
invalid claims of injuries. If such a set of methods and techniques
could be agreed upon by clinical/forensic practitioners and academic
memory researchers, a data bank could be established from which
clinical and memory researchers could draw for further study.
The available methodologies are, at this point, more subjective and
unsatisfying from a research standpoint, placing the psychologist
testifying in these types of cases in a difficult position as far as
building an objective basis for opinions that will be fair to
litigants on both sides. If criteria that may prove to help
discriminate valid from invalid cases could be further developed and
tested, some of the subjectivity could be reduced. There are several
methods with sound clinical research already behind them that hold
promise for forensic applications.
Methods used need to allow the litigants every opportunity to tell
their story and, at the same time, provide the means for assessing
their credibility, reliability, and validity to the greatest extent
possible. Determining how different population groups approaching the
assessment tasks with varying motivations will be important in future
research. Another avenue for research and also for dealing with the
present needs in evaluating these cases for litigation is allowing
respondents to serve as their own baseline across time. This will help
provide a greater degree of objectivity in assessing accounts of
abuse. In some cases, the differences in accounts across time are so
striking that jury members exercising common sense will be able to
easily see them if such data are obtained and presented. In other
cases, the examiner may well have to say, "I don't know what
happened." One then may have to rely on one's overall
understanding of the functioning in the litigant in light of the total
circumstances to make judgments. As noted by Loftus (1992), we have no
certain means of knowing who is telling the truth in such cases.
It should be clearly evident that, regardless of which side one has
been requested to perform these evaluations, that the law has raced
ahead of our actual scientific capabilities in cases of so-called
"recovered memories." The needed research has not yet been accomplished and many
practitioners are operating on the basis of clinical lore and popular
but inadequate and faulty conceptualizations of how human memory works.
The methods described herein can only be regarded as a means of
attempting to collect data in some kind of standardized approach to
reduce some of the subjectivity. The fact patterns of the alleged abuse
will then have to be studied in light of known perpetrator patterns and
the situation in which the allegations actually came to light, as
required in evaluating any case of child abuse past or present
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APPENDIX A: Decision Tree Regarding Factors Hypothesized to be Associated with
Valid or Invalid Complaints by Adult Litigants of Childhood
APPENDIX B: Features of Historical Memory According to Loftus and
|* Martha L. Rogers is a forensic psychologist at 17662 Irvine
Boulevard, Suite 12, Tustin, California 92680. This paper was
presented at the Fourth Annual Meeting of the American Psychological Society,
San Diego, California, June 20, 1992.. [Back]
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