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 (Paperback), 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 [Books by this author]. 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 (Hardcover)(Paperback). 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 (Paperback). Chicago: Open Court.

* Ralph Underwager is a psychologist at the Institute for Psychological Therapies, 5263 130th Street East, Northfield, MN 55057-4880[Back]

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Footnotes

* Recovered Memories of Abuse: Assessment, Therapy, Forensics (Paperback). 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 (Hardcover)). [Back]

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