A Response to Recovered Memories of Abuse: Assessment,
Therapy, Forensics by Kenneth Pope and Laura Brown*
Ralph Underwager*
(Cite: Issues In Child Abuse Accusations, 8(3/4),
187-191. 1996)
ABSTRACT: Kenneth Pope and Laura Brown in their 1996 book, Recovered
Memories of Abuse: Assessment, Therapy, Forensics (), exhort psychologists
who are critical of the recovered memory phenomenon to be responsible scientists
and to produce empirical data supporting their statements. But the book
contains many examples of biased and sloppy scholarship, and psychologists
who do clinical work with people who report recovered memories are held
to a much lower standard that permits clinical speculation with no supporting
data.
This book is an outstanding and informative example of Pecksniffery.1
It is filled with utterances resembling the unctuous hypocrisy of Dickens'
most hilarious character. In the novel, Martin Chuzzlewit, Dickens
has Pecksniff presenting a posture occupying the high moral ground and suggesting
to others how they ought properly to behave while he himself acts in the
opposite fashion. He describes Pecksniff:
Perhaps there never was a more moral man than Mr. Pecksniff:
especially in his conversation and correspondence. . . . He was a most exemplary
man: fuller of virtuous precept than a copy-book. Some people likened him
to a direction- post, which is always telling the way to a place, and never
goes there . . . (p. 12).
In Recovered Memories of Abuse: Assessment, Therapy, Forensics, the
recurring litany of Pope and Brown, which has previously been repeated in
oral presentations and articles, admonishes and exhorts those with whom
they disagree to be responsible scientists, to produce the empirical data
supporting statements, and to tell what methodology and procedures were
followed that produce empirical information. In the third chapter (an adaptation
of a 1996 article by Pope which appeared in the American Psychologist)
39 times in the 40 pages Pope and Brown ask where is the research, ask questions
implying less than desirable scientific rigor by those they are criticizing,
or imply in one way or another that those who disagree with their beliefs
have not done what they should have done as responsible, competent scientists.
They are especially critical of the False
Memory Syndrome
Foundation and
its Scientific and Professional Advisory Board.
Pope and Brown occupy the high moral ground by claiming repeatedly what
is expressed as a premise of the book:
The fourth major premise is that mental health professionals
must always ask: Is this assertion, instrument, or intervention supported
by (or at least consistent with) empirical findings? And to what degree
are such findings limited in their usefulness or generalizability in this
particular instance? (p. 20).
At various points the claim to be valuing the rubrics and rigor of science
is repeated:
Science, therapy, and forensic practice work best when claims
and hypotheses can be continually questioned. That which tends to disallow
doubt and discredit anyone who disagrees is unlikely to promote clinical
and forensic practices based on scientific principles. Each scientific claim
should prevail or fall on its research validation and logic (pp. 106-107).
Given such protestations it is reasonable to expect that the book's authors
have produced a work matching their claimed aspirations. They have not.
Errors of various types abound throughout the book. A cursory check of a
few of the references given show very sloppy scholarship, misunderstanding
of research reports, or ethically questionable misrepresentations of research
findings. For example, Pope and Brown describe a study by Tsai, Feldman-Summers,
& Edgar, (1979) in this way:
. . . the authors found that while the "no effect"
group was less symptomatic and more functional than the "negative effect"
group, the "no effect" group still scored in the pathological
range on standard psychometric measures when contrasted with a matched sample
with no sexual abuse histories (p. 10).
But Tsai, et al. (1979) state their findings much differently:
The differences in adult adjustment were observed in two ways:
through a standardized instrument long in use as a measure of adult adjustment
(the MMPI) and through self-reports of current psychosexual functioning.
With regard to the MMPI, the results indicated that not all sexually molested
children will necessarily experience adult maladjustment. In fact, the profiles
of the molested women in the non clinical group were "normal"
according to well, accepted standards of interpretation (Dahlstrom, Welsh,
& Dahlstrom, 1972) and did not differ significantly from the the profiles
of the matched control group (p. 414).
The nonclinical group is the no effect group in the study. It was composed
of women who had been sexually abused but reported no negative effects.
Thus Pope and Brown's description of the results of this study is wrong.
In another example, Pope and Brown summarize the conclusions of a review
by Kendall-Tackett, Williams, and Finkelhor (1993):
Kendall-Tackett et al. (1993) in a comprehensive review of the
literature on children who have been sexually abused, note that the group
is more symptomatic as a whole than either nonsexually abused child psychiatric
patients or a comparison group of "normal" children (p. 9).
But the Kendall-Tackett et al. review states its conclusions somewhat differently:
The first and perhaps most important implication is the apparent
lack of evidence for a conspicuous syndrome in children who have been sexually
abused . . . Despite the lack of a single symptom that occurs in the majority
of victims, both sexualized behavior and symptoms of PTSD occurred with
relatively high frequency. These also appeared to be the only two symptoms
more common in sexually abused children than in other clinical groups (p.
173).
Furthermore, in discussing the reports of PTSD symptoms, the article gives
important information that is not mentioned by Pope and Brown:
However, there have been relatively few studies of PTSD, and
half the children included in this calculation were victims of severe ritualistic
abuse from Los Angeles day care cases (Kelly, in press-a), thus inflating
the percentage (p.167).
These were the children in the McMartin case. With the subsequent acquittal
of all the defendants and the complete lack of any corroborating evidence
for the allegations of ritualistic, satanic abuse it becomes rather questionable
as to whether or not there was any actual sexual abuse of these children.
Including this group as truly sexually abused and showing PTSD symptoms
can hardly be said to provide strong empirical support for the statements
made by Pope and Brown.
Pope and Brown describe another review of the effects of sexual abuse:
Beitchman, Zucker, Hood, daCosta, and Ackman (1991) consider
other possible sources of distress, including a more general family dysfunction,
and note that sexual abuse may be a risk factor, if not a direct cause,
of adult emotional distress (p. 9).
However, the article does not concern itself with long-term effects of sexual
abuse, only short-term, and it describes no risk factors for adult emotional
distress. Contrary to Pope and Brown's implication that the article supports
the idea that sexual abuse may be a direct cause of adult emotional distress,
there is no discussion of adult emotional distress in the article. In fact,
Beitchman et al. (1991) state:
A comprehensive analysis of the effects of child sexual abuse
must acknowledge the effects of family functioning on the child. Our review
of the literature indicates a high prevalence of family breakdown and psychopathology
in the histories of sexual abuse victims. Since many of the symptoms reported
in the literature tend to characterize children and adolescents from disturbed
families in general, to attribute outcomes in these samples solely to effects
of sexual abuse it [sic] is difficult (p. 551).
These errors and mischaracterizations of research findings are not random
in their direction. They demonstrate a systematic bias in the direction
of supporting the position of Pope and Brown as advocates of a clinical
acceptance of recovered memory claims. The studies shown to be misinterpreted
deal with the effects of child sexual abuse. In order to claim that memories
of childhood abuse may be repressed, dissociated, forgotten, or whatever,
and then later recovered in adulthood, it is necessary first to maintain
childhood sexual abuse is always highly stressful and traumatic. The systematic
bias appearing so early in the book suggests it may be wise to check carefully
all of the research studies cited by Pope and Brown.
In another example, Pope and Brown cite a study by Foa, Rothbaum, Riggs,
and Murdock (1991) in support of the following assertion:
Empirical data suggest that controlled exposure to affect and
memory in which titrated exposure to trauma-related material is used to
metabolize and integrate previously fragmentary memories into more coherent
cognitive narrative may be specifically helpful in addressing intrusive
symptoms of PTSD (p. 184).
But the Foa et al. study has nothing to do with this assertion at all. Instead,
this study compares the responses of adult rape victims to four conditions
stress
inoculation training, prolonged exposure, supportive counseling, and a wait-list
control. Stress inoculation training was the most effective in reducing
PTSD symptomatology immediately after treatment. Prolonged exposure treatment,
however, showed the best results three and one-half months after treatment
ended. As described by Foa et al., this method (PE) was essentially a behavioral
desensitization procedure. These effects were observed only on PTSD symptoms,
not on any other measures of psychopathology, where there were no significant
group differences. There is nothing in this study dealing with fragmentary
memories integrated into more coherent narratives. It does not support the
convoluted assertion of Pope and Brown about speculative nonobservable internal
events.
There are several other instances of distortions and misrepresentations
that show the same systematic directional twist. On page 102 Pope and Brown
cite Wakefield and Underwager (1994, p. 349) to support their claim that
skeptics use Hoffer's label "true believers" for those who disagree
with the FMSF. But Hoffer's concept of true believers is not found on p.
349 nor anywhere in the Wakefield and Underwager (1994) book.
On page 131 Pope and Brown claim that Wakefield and Underwager (1994) include
a checklist "to determine which individuals may have experienced or
perpetrated sexual abuse." There are no checklists in Wakefield and
Underwager (1994), much less one to make determinations of who is an abuser
and who is abused.
On page 134 Wakefield is alleged by Pope and Brown to have said that the
demographic information on a sample of parents whose children made a claim
of recovered memories of childhood abuse "were used to support the
parents' contentions that their adult children's accusations of child sexual
abuse were false." The citation for this assertion is a 1992 story
by Don Kent in the APS Observer reporting on the first APS symposium
on the topic. But there is nothing in the story suggesting that Wakefield
reported that the demographic data give any information about veracity of
claims. In fact, Wakefield is reported to noted that some of the retrospective
accounts of parents "are likely not to be completely accurate"
(Kent, 1992, p. 7).
Both the above APS Observer story by Kent (1992) and the 1994 Wakefield
and Underwager book, Return of the Furies, indicate that, although
we originally believed that the adult children who recovered memories of
childhood sexual abuse would have a history of significant psychological
disturbance, we soon changed their view on this. In Return of the Furies,
we state:
Our original hypothesis was that people who recovered false
memories were not normal. We believed that they had significant psychological
problems, such as borderline, paranoid, or histrionic personality disorders,
and probably a long history of serious maladjustment. . . . We argued that
normal people don't develop false memories of abuse by their parents, even
with a charismatic and persuasive therapist. We were wrong. . . . Most of
the accusers are educated and successful and only a minority had a history
of psychological treatment prior to adulthood. (Wakefield & Underwager,
1994, p. 87).
But instead of citing this, Pope and Brown instead refer to a 1991 newspaper
story (Sifford, 1991, p. 12) that quotes Wakefield as describing women who
recover memories as being unusually suggestible and having problems, such
as a personality disorder (Pope & Brown, 1996, p. 78). Since Pope and
Brown refer to Wakefield and Underwager (1994) in several other places in
their book, including the same paragraph as the quote from the 1991 newspaper
story, this seems to be a deliberate choice to misrepresent Wakefield's
current position.
Appendix A, Useful Resources, is claimed by Pope and Brown to provide "a
range of views and information about memory, trauma, child abuse, clinical
interventions, and forensic considerations (p. 265). Included here is the
citation for Underwager and Wakefield v. Salter. (1994, April 25).
U. S. Court of Appeals, Seventh Circuit. This case has nothing whatsoever
to do with memories, child abuse, trauma, clinical interventions, or forensic
considerations. It is the ruling of the appellate court upholding the dismissal
of a slander, libel, and defamation suit against the National Center for
the Prosecution of Child Abuse and Anna Salter. The ruling holds that Underwager
and Wakefield are limited purpose public figures and therefore must meet
the heightened legal standard of "actual malice." Although the
ruling holds that what has been done by the prosecutors and Salter is defamatory,
because the standard of actual malice is not met, what they did was not
actionable. The only possible reason for Pope and Brown including this in
their "relatively small sample" (p. 266) of resources is to discredit
us.
In other forums, Pope has recommended the material Salter prepared for the
prosecutors where she asserts that a work is not scientific when there are
errors in the bibliographic citations. But a cursory incidental look shows
there are many errors in the references in the Pope and Brown book. These
include errors regarding authors, incorrect volume and page numbers, and
citations in the body which do not appear in the bibliography. By Pope's
standards, this is at least sloppy scholarship, if not destructive of the
scientific merit of the book.
Earlier I provided examples of misunderstandings and misrepresentations
of research reports. But there is no reason to assume that such biased or
sloppy scholarship is only found in the limited sample of references that
I looked up and read. Most likely, the references that weren't checked would
contain similar errors.
What makes this book Pecksniffian, however, is the contrast between the
demand for rigorous science, research, data, and evidence imposed upon those
whom Pope and Brown see as critical of recovered memory claims and their
presentation of their clinical viewpoint. In chapter five, the clinical
approach, there are at least 40 instances of assertions being made as fact
for which there are no data offered in support. This appears to indicate
a double standard. Those who question claims of recovered memory are required
to meet one standard scientific rigor--but those who accept such claims
are allowed a different standard clinical speculation with no supporting
data. What is rather worrisome is that Pope acknowledges the "editorial
guidance and support" of Ray Fowler, CEO of the American Psychological Association, in the preparation of the article that is the basis for chapter
three (pp. viii-ix). This book is also currently being given full page advertisements
in APA journals.
Here are some of the assertions in chapter five which Pope and Brown make
with no evident requirement or demand for any research evidence and for
which none is given:
However, the question of recall and integration of memories takes place
most effectively within an overall framework of a stage-based treatment,
in which there is an initial emphasis on safety and containment, followed
by integration of memory, affect, and meaning (p. 145).
"[G]ood therapists have high tolerance for ambiguity."
Such an aphorism is never more true nor more timely than when therapist
and client are faced with the profoundly ambiguous material that emerges
during a process of delayed recall in which the thing being explored is
often fragmentary, vague, and dissociated, and may emerge in a form that
might never allow for the development of a clear recollection (pp. 146-147).
The therapist must constantly ask her- or himself which interventions are
most likely to help, heal, and empower the client, and which are most likely
to give the client a sense of renewed competence and autonomy even in the
face of intrusive recollections and overpowering feelings (p. 148).
Reassuring a highly anxious client is a common task for a therapist who
is working with recovery of abuse memories. Clients who, in the dissociative
states of flashbacks or in intrusive words and images, are reliving or recalling
episodes of painful violation by caregivers may also reexperience feelings
related to betrayal trauma (J. Freyd, 1994, 1996)--an awareness of
the terror that they will be abandoned if they tell the truth about abuse
by a caregiver (p. 151).
Providing the client with a cognitive framework for understanding the affective
experience of intense connection engages adult coping skills that may, in
turn, empower the client to feel less frightened and more capable of engaging
in self-soothing mechanisms already in their own repertoire (p. 152).
[I]t was common for Viet Nam veterans with PTSD being treated in the VA
system to be labeled "character disordered" because the prevailing
wisdom was that Viet Nam service was not traumatic; in that context, PTSD
simply did not exist (p. 168).
Because sexual abuse involves the overpowering of a child's reality, body,
and perceptions by a powerful adult, it is important that the therapist
not replicate the experience through attempts to force a new version of
reality on the client (p. 172).
These assertions, together with at least 33 others, are claims about observable
and researchable events or variables. Many describe complex interactions
of intervening variables leading to behaviors. Yet no evidence of any sort
is offered. This is not surprising when a premise of the book is as stated
on page 19:
Another major premise of this book is that science and practice
in this area must not proceed in ignorance of each other but must adequately
inform one another if either is to claim intellectual integrity. Neither
can be considered without the other, and neither should be viewed as more
important than the other.
This premise contradicts the ethical principles of psychology which require
the practice of psychology to be based on the science of psychology. The
science of psychology began long before the clinical practice of psychology
emerged following World War II. It will continue after the end of psychological
practice. If the practice of psychology need not be derivative from nor
based on the science of psychology, how can it ever be distinguished from
magic, necromancy, or sorcery?
With the rapid shifts in the health care system and the reality of limited
funding, this posture of Pope and Brown and APA leadership may well lead
to an equally rapid demise of clinical practice. It is simple. Psychiatry
has pills and hospitals, both of which are cheaper than long-term analytically-oriented
psychotherapy. Social workers are cheaper because they charge lower fees.
Managed care administrators will choose the cheapest option when there is
nothing else distinguishing them. Psychologists will lose out if they have
nothing other than the same thing psychiatry and social work peddle, insight-oriented
talking therapy. In pursuit of the finite amount of health care dollars
the only competitive advantage psychologists have is the science of psychology.
To deny or ignore the dependence of practice on the science of psychology
is to commit economic suicide.
Pope and Brown are in error. The science of psychology is more important
than the practice of psychology.
References
Beitchman, J. H., Zucker, K. J., Hood, J. E., daCosta, G. A., & Akman,
D. (1991). A review of the short-term effects of child sexual abuse.
Child Abuse & Neglect, 15, 537-556.
Dickens, C. (1994). Martin Chuzzlewit []. Hertfordshire, United Kingdom:
Wordsworth Editions Limited. (Originally published 1843/44.)
Foa, E. B., Rothbaum, B. O., Riggs, D. S., & Murdock, T. B. (1991).
Treatment of posttraumatic stress disorder in rape victims: A comparison
between cognitive-behavioral procedures and counseling. Journal of Consulting
and Clinical Psychology, 59, 715-723.
Freyd, J. J. (1994). Betrayal trauma: Traumatic amnesia as an adaptive response
to childhood abuse. Ethics & Behavior, 4, 307-329.
Freyd, J. J. (1996). Betrayal Trauma: The Logic of Forgetting Abuse ()(). Cambridge, MA: Harvard University Press.
Kendall-Tackett, K. A., Williams, L. M., & Finkelhor, D. (1993). Impact
of sexual abuse on children: A review and synthesis of recent empirical
studies. Psychological Bulletin, 113, 164-180.
Pope, K. S. (1996). Memory, abuse, and science: Questioning claims about
the false memory syndrome epidemic. American
Psychologist, 51, 957-974.
Tsai, M., Feldman-Summers, S. & Edgar, M. (1979). Childhood molestation:
Variables related to differential impacts on psychosexual functioning in
adult women. Journal of Abnormal Psychology, 88, 407-417.
Sifford, D. (1991, November 24). Accusations of sex abuse, years later.
The Philadelphia Inquirer, pp. 1F, 5F.
Wakefield, H., & Underwager, R. (1994). Return of the Furies: An Investigation into
Recovered Memory Therapy
(). Chicago: Open Court.
* Ralph Underwager is a psychologist at the
Institute for Psychological Therapies,
5263 130th Street East,
Northfield, MN 55057-4880.
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Footnotes
* Recovered Memories of Abuse: Assessment, Therapy,
Forensics
().
By Kenneth S. Pope and Laura
S. Brown. Washington, DC: American Psychological Association, ©1996,
$24.95. [Back]
1 "Pecksniff. The name of a character in Dickens' novel, 'Martin
Chuzzelwit'
(1884), represented as
an unctuous hypocrite, habitually prating of benevolence, etc. Used allusively"
(Oxford English Dictionary ()).
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