Repressed-memory therapy is harming patients, devastating families and intensifying a backlash against mental-health practitioners
By Leon Jaroff--Reported by Jeanne McDowell/Los Angeles
Suffering from a prolonged bout of depression and desperate for help, Melody Gavigan, 39, a computer specialist from Long Beach, California, checked herself into a local psychiatric hospital. As Gavigan recalls the experience, her problems were just beginning. During five weeks of treatment there, a family and marriage counselor repeatedly suggested that her depression stemmed from incest during her childhood. While at first Gavigan had no recollection of any abuse, the therapist kept prodding. "I was so distressed and needed help so desperately, I latched on to what he was offering me," she says. "I accepted his answers."
When asked for details, she wrote page after page of what she believed were emerging repressed memories. She told about running into the yard after being raped in the bathroom. She incorporated into another lurid rape scene an actual girlhood incident, in which she had dislocated a shoulder. She went on to recall being molested by her father when she was only a year old--as her diapers were being changed--and sodomized by him at five. Following what she says was the therapist's advice, Gavigan confronted her father with her accusations, severed her relationship with him, moved away and formed an incest survivors' group.
But she remained uneasy. Signing up for a college psychology course, she examined her newfound memories more carefully and concluded that they were false. Now Gavigan has begged her father's forgiveness and filed a lawsuit against the psychiatric hospital for the pain that she and her family suffered.
Gavigan is just one victim of a troubling psychological phenomenon that is harming patients, devastating families, influencing new legislation, taking up courtroom time, stirring fierce controversy among experts and intensifying a backlash against all mental-health practitioners: the "recovery"--usually while in therapy--of repressed memories of childhood sexual abuse, satanic rituals and other bizarre incidents.
"If penis envy made us look dumb, this will make us look totally gullible," says psychiatrist Paul McHugh, chairman of the psychiatry department at Johns Hopkins University. "This is the biggest story in psychiatry in a decade. It is a disaster for orthodox psychotherapists who are doing good work."
No one questions that childhood sexual abuse is widespread and underreported. The subject, rarely mentioned and then only in hushed tones until the 1980s, has become the stuff of talk shows, movies and feature articles. Indeed, many, perhaps millions of Americans have jarring and humiliating memories of abuse, recollections that, painful as they are, have stayed with them through the years.
But can memories of repeated incest and other bizarre incidents be so repressed that the victim is totally unaware of them until they emerge during therapy or as the result of a triggering sight, smell or sound?
Across the U.S. in the past several years, literally thousands of people--mostly women in their 20s, 30s and 40s--have been coming forward with accusations that they were sexually abused as children, usually by members of their own family, at home or, in many cases, at hidden sites where weird rituals were practiced. Says McHugh, "It's reached epidemic proportions."
Unlike the countless adults who have lived for years with painful memories of actual childhood sexual abuse, most individuals with "recovered memory" initially have no specific recollection of incest or molestation. At worst, they have only a vague feeling that something may have happened. Others, simply seeking help to alleviate depression, eating disorders, marital difficulties or other common problems, are informed by unsophisticated therapists or pop-psychology books that their symptoms suggest childhood sexual abuse, all memories of which have been repressed.
In the course of the therapy, many of these troubled souls conjure up exquisitely detailed recollections of sexual abuse by family members. Encouraged by their therapists to reach deeper into the recesses of their memories--often using techniques such as visualization and hypnosis--some go on to describe events that sorely strain credulity, particularly tales of their forced childhood participation in satanic rituals involving animal and infant sacrifices, as well as sexual acts.
In many cases the therapists conclude, and eventually convince the patients through suggestion, that the repressed memories of childhood abuse have caused them to "dissociate." As a result, they appear to develop multiple-personality disorder, the strange and, until recently, rare condition brought to wide public attention by the 1973 book, Sybil, which describes the condition of a woman who develops several strikingly different but interchangeable personas.
Legislatures in nearly half the states have responded to the widespread public acceptance of recovered memories by applying a strange twist to venerable statute-of-limitations laws. In general, the new legislation allows alleged victims of child abuse to sue the accused perpetrators within three to six years after the repressed memories emerge. This means that with little more than the recollection of the accuser, a parent or other relative can be hauled into court decades after the supposed crime.
Taking advantage of the newly enacted legislation, some of the supposed victims have successfully brought civil and even criminal actions against members of their own families. Juries have awarded them damages, and in a few cases the accused parent has been sentenced to jail--based entirely on the recovered memory of his adult offspring.
To many critics of the recovered-memory movement, the accusations and convictions are reminiscent of the 17th century Salem witchcraft trials, in which elderly women and an occasional man were condemned to death, often on the basis of a single unsubstantiated charge that they had demonstrated witchlike behavior.
"Recovered-memory therapy will come to be recognized as the quackery of the 20th century," predicts Richard Ofshe, a social psychologist at the University of California, Berkeley. And in the process, Emory University psychiatry professor George Ganaway fears, it may "trigger a backlash against [legitimate charges of] child abuse. As these stories are discredited, society may end up throwing the baby out with the bath water--and the hard-earned credibility of the child-abuse-survivor movement will go down the drain."
The backlash has already begun. In Texas this summer, a woman patient won a settlement from two therapists and a psychiatric hospital after suing them for therapeutic negligence and fraud. She claimed that four years of recovered false memories had made her a "walking zombie." It was the first of what some reputable therapists fear will be many such rulings that will ultimately give their profession a black eye.
An increasing number of recovered-memory accusers have recanted, and some have reunited with their families and joined them in suing the therapists and clinics they claim led them astray. Many of them are among the more than 7,000 individuals and families who have sought assistance from the False Memory Syndrome Foundation, a Philadelphia-based organization that has taken the lead in publicizing the wrongdoings and in helping the victims of recovered-memory therapy. Pamela Freyd, who co-founded FMSF in 1992, has yet to be reconciled with her accuser daughter.
Growing controversy and concern in the mental-health community has led the American Psychological Association to appoint a false-memory working group to investigate the phenomenon. At a meeting of the American Psychiatric Association last May, the issue of false memories was addressed in three sessions and heatedly debated by experts on both sides. The American Medical Association's house of delegates also indicated its discomfort with such memory-enhancement techniques as guided imagery, hypnosis and body massage, all of which heighten suggestibility and are widely employed by recovered-memory therapists. Use of these practices in eliciting accounts of childhood sexual abuse, the AMA delegates concluded, was "fraught with problems of potential misapplication."
"I wish I could say the debate just involves a few kooks," says Stephen Ceci, a Cornell University developmental psychologist who is a member of the American Psychological Association's work group. "It's much broader than that, happening among the cream of the crop of psychiatrists and clinical psychologists." The battle could not have come at a worse time, says Ceci; some professionals are currently pushing for increased coverage of mental health in the President's proposed national health plan. "It's not a good time for us to be airing our dirty laundry."
Still, the opposing camps are doing just that, arguing bitterly about repressed memories. Critics of recovered-memory therapy insist that there is no scientific evidence for the reality of repression and that many, if not most, of the recovered-memory claims are false. Advocates have no doubts, citing studies on amnesia and clinical experience showing that repression is commonplace. Given that psychology is an inexact science, any resolution of the issue seems distant, at best.
Judie Alpert, a professor of applied psychology at New York University, refutes the critics of recovered-memory therapy. "There is absolutely no question that some people have repressed some memories of early abuse that are just too painful to remember," she says. "In their 20s and 30s some event triggers early memories, and slowly they return. The event has been so overwhelming that the little girl who is being abused can't tolerate to be there in the moment, so she leaves her body, dissociates, as if she is up on a bookshelf looking down on the little girl who is being abused. Over time, she pushes it deep down because she can't integrate the experience."
Christine Courtois, also in the APA work group and a clinical director at the Psychiatric Institute in Washington, charges that criticism of the recovered-memory phenomenon is part of a backlash against society's tardy recognition of widespread sexual abuse. The "wholesale degradation of psychotherapy by some critics," she says, represents "displaced rage" at therapists for bringing the issue to public attention.
That kind of reasoning does not sit well with Margaret Singer, a retired professor from the University of California, Berkeley, and an expert on cults and influence techniques. She has interviewed 50 people who once believed they had recovered repressed memories of incest or ritual abuse but now think they were mistaken. All 50, Singer emphasizes, were in therapy when they "recovered" terrifying memories of abuse. "These people are reporting to me that their therapists were far more sure than they were that their parents had molested them."
Singer insists that trauma does not cause people to repress memories, although bits and pieces of experience can be lost through amnesia. In fact, she says, trauma has just the opposite effect: people can't forget it. As an example, she cites the cases of Vietnam veterans who suffer flashbacks and posttraumatic stress disorder.
Psychologist Ofshe is particularly disdainful of the concept of what he calls "robust" repression: the instantaneous submergence of any memory of sexual abuse. Recovered-memory therapists, he says, "have invented a mechanism that supposedly causes a child's awareness of sexual assault to be driven entirely from consciousness." According to these therapists, Ofshe explains, "there is no limit to the number of traumatic events that can be repressed, and no limit to the length of time over which the series of events can occur." Belief in robust repression, he concludes, "can be found only on the lunatic fringes of science and the mental-health professions."
"Repression definitions are so loose and varied, so abundant, so shifting that it is like trying to shoot a moving target," says Elizabeth Loftus, professor of psychology and law at the University of Washington and an authority on cognitive processes, long-term memory and eyewitness testimony. "If repression is the avoidance in your conscious awareness of unpleasant experiences that come back to you, yes, I believe in repression. But if it is a blocking out of an endless stream of traumas that occur over and over that leave a person with absolutely no awareness that these things happen, that make them behave in destructive ways and re-emerge decades later in some reliable form, I don't see any evidence for it. It flies in the face of everything we know about memory."
If such recovered memories are indeed false, where do they originate? From two sources, critics say: the popular culture and misguided or inept therapy. Sensational tales about recovered memories of incest have been grist for celebrity-magazine cover stories. And repressed-memory incest and satanic-ritual-abuse victims have been featured prominently on Geraldo, Oprah, Sally Jessy Raphael and other daytime TV talk shows.
In bookstores, pop-psychology sections are filled with dozens of self-help survivor titles. By far the most controversial and best selling (more than 700,000 copies) of these books is The Courage to Heal by Ellen Bass and Laura Davis. In their 1988 publication, considered the bible of the recovered-memory movement, they include such dogma as "If you think you were abused and your life shows the symptoms, then you were," and "If you don't remember your abuse, you are not alone. Many women don't have memories...this doesn't mean they weren't abused." Like many of the authors of these self-help books, neither Davis nor Bass has any academic training in psychology, although Davis claims to be an incest survivor. Yet many therapists urge their patients to read Courage and other similar volumes.
Many of these books contain laundry lists of symptoms of repressed-memory victims. They inform their readers that even though they have no memory of the acts, they may have been victims of childhood sexual or ritual abuse if they experience some of the following conditions: depression, anxiety, loss of appetite or eating disorders, sexual problems and difficulty with intimacy. The all-inclusive nature of that list, critics say, suggests that among the entire U.S. population, only the rare individual has managed to escape childhood sexual abuse. That doesn't seem to surprise therapist E. Sue Blume. In her book Secret Survivors, she writes, "It is not unlikely that more than half of all women are survivors of childhood sexual trauma."
Almost any night, in any major American city, adult incest and ritual-abuse survivor meetings are held in church basements and community rooms. Churches and other institutions also offer counseling for dissociative disorders and satanic-ritual-abuse victims.
Private psychiatric hospitals, which advertise in medical journals and airline magazines, are profiting as well. "We can help you remember and heal," promises one ad for ASCA Treatment Centers in Compton, California. "Remembering incest and childhood abuse is the first step to healing."
The thriving recovered-memory industry dismays psychiatrist Ganaway. "In some cases," he says, the hospitals and clinics "are memory mills with an almost assembly-line mentality," he says. "A patient comes in with no memories but leaves with memories of childhood incest or ritual abuse." Yet even some well-trained family and marriage counselors, psychologists and psychiatrists seem too quick to tie their patients' problems to repressed memories of incest and ritual abuse. "That makes psychotherapy very easy at first," explains Johns Hopkins' McHugh. "Therapists and patients can say, `We found the secret.' The fact that the patients and families steadily become more confused, incoherent and chaotic is then believed to be an expression of the original incest." What is really happening, he says, is that "conflicts are being generated by false memories. We have found something to make therapy easy."
Some patients now leave their therapist's office convinced that they suffer from multiple-personality disorder, which is said to stem from repressed memories of early childhood trauma, including physical and sexual abuse. Until the publication of Sybil, MPD was apparently rare; around the world, only a few hundred cases had been documented over the previous three centuries. Since then, however, many thousands of supposed cases of MPD have been identified in the U.S. alone--most of them incorrectly, say critics, by therapists who are looking for an easy solution in their search for evidence of childhood sexual abuse or who too easily accept the likelihood of the disorder. One problem, says Ganaway, is that once these patients have been diagnosed with MPD, they are convinced that they have it, tend to exhibit what they think are the symptoms and often reinterpret their entire life histories accordingly.
Those charges infuriate Dr. Richard Kluft, a Philadelphia psychiatrist, who works extensively with MPD patients. "It's an absolute lie that MPD is a rare psychiatric disorder," he says. He attributes the sharp rise in reported MPD cases to the rise of feminism and the resulting willingness of people "to speak out more openly on issues of exploitation and abuse."
Another doctor who believes that MPD is fairly common is Bennett Braun, medical director of the dissociative-disorders program at Rush-Presbyterian-St. Luke's Medical Center in Chicago. Braun says the number of cases of MPD has risen not for faddish reasons but because therapists have become better at recognizing the symptoms.
In his 12-bed unit at Rush North Shore Medical Center in Skokie, a branch of Rush-Presbyterian-St. Luke's Medical Center, Braun treats MPD cases, some of whom think that they are victims of satanic-ritual abuse. When he first began to hear the satanic stories in 1985, Braun says, he was incredulous. Now, having heard similar tales from many people from different states and countries and having treated more than 200 of them, he declares, "Yes, there is satanic-ritual abuse."
If some of the recovered memories of familial childhood abuse sound fanciful, the recollections of satanic-ritual abuse are downright bizarre. These tales have proliferated since the publication in 1980 of Michelle Remembers, a book about a belatedly aware satanic-ritual victim. They describe a massive secret conspiracy to abuse children sexually in order to brainwash them into worshipping Satan. Victims recall being raped by their parents and then by members of a cult who drink blood and sacrifice fetuses. More often than not the abusers are pillars of their communities--the mayor, police chief or school superintendent--who come out at night and join their parents in terrifying ceremonies.
But could such satanic rituals be that commonplace, let alone exist at all? In 1990, a group of researchers at the State University of New York at Buffalo conducted a nationwide sample of clinical psychologists, asking them if they had encountered claims of ritual abuse. Some 800 of the psychologists, about a third of the sample, had treated at least one case.
Yet, law-enforcement authorities report that not one shred of reliable evidence has turned up to support these claims--no documented marks of torture, no bones of sacrificed adults, infants or fetuses and no reputable eyewitnesses. Lorraine Stanek, a Connecticut rehabilitation counselor for trauma survivors, also stresses the lack of evidence. "If you look at the alleged number of deaths that would be accounted for," she says, "there should be bodies in all our backyards." Still, incest-survivor groups are inundated with these claims. Monarch Resources, a California referral service for survivors, is said to receive more than 5,000 calls annually from people who believe they have been victims of satanic abuse. Alleged ritual abuse is also involved in about 16% of the calls to Philadelphia's False Memory Syndrome Foundation.
Braun demonstrated his belief in satanic rituals during a 1991 trial, when he testified in behalf of two daughters seeking damages from their 76-year-old mother. Recovering childhood memories, they had accused her of abusing them in bloody and murderous ceremonies. Both claimed that they had developed MPD as a result. After Braun told of treating similar cases, the jury found in favor of the two daughters.
Now, however, the tables have turned. Braun and the Chicago medical center are being sued for negligence by a female patient who in two years of in-patient treatment for supposed MPD "recovered" memories of involvement in satanic rituals with her father, mother and relatives. The rituals supposedly included torture, murder and cannibalism of large groups of people--as many as 50 on an average weekend. In addition, before growing doubts led the woman to terminate Braun's treatment in 1992, she had been made to believe she had 300 "alters" or personas, possibly setting a new MPD record. According to her lawyer, she is not currently undergoing any treatment and is doing well.
The ultimate victim of repressed memory may be the psychotherapeutic profession itself. "Therapists are terrified," says MPD specialist Kluft. "Many are feeling very hamstrung because they fear any time they ask a question, it can result in a lawsuit." Instead of seeing a patient "as a person in pain and in need of help," Kluft complains, "the therapist is looking at a potential litigant. Some people have discontinued treating trauma patients."
S. Scott Mayers, a psychotherapist in Venice, California, is hardly terrified. But he is cautious. "What I do to ensure that I don't inflict my agenda or opinion," he says, "is go with the patients' presentation and stay with it, using their own words, their own scenarios. I'm so cautious because we are all very suggestive."
Recovered-memory therapists might do well to heed those guidelines before they cause irreparable damage to their profession. For, as the public begins to recognize that people have been falsely accused by recovered-memory patients, says psychiatrist McHugh, it "opens us up to skepticism and dismay about our capacity to do things. This is a bubble that is going to burst. We will end up having to re-create the trust this country puts in psychotherapy."
Copyright (c) TIME Magazine, 1995 TIME Inc. Magazine Company; (c) 1995 Compact Publishing, Inc.