file://rtd.com/pub/zines/skeptic/02.3.hochman-fms
http://www.rtd.com/~lippard/02.3.hochman-fms.html
From _Skeptic_ vol. 2, no. 3, 1994, pp. 58-61.
The following article is copyright (c) 1994 by the Skeptics Society,
2761 N. Marengo Ave., Altadena, CA 91001, (818) 794-3119.  Permission 
has been granted for noncommercial electronic circulation of this 
articles in its entirety, including this notice.  For information about 
a special Internet introductory subscription rate, see the file
subscription-rates or contact Jim Lippard (lippard@rtd.com).

RECOVERED MEMORY THERAPY AND FALSE MEMORY SYNDROME
By John Hochman, M.D.

Thousands of patients (mostly women) in the United States have undergone 
or are undergoing attempted treatment by psychotherapists for a non-
existent memory disorder. As a result, these same therapists have 
unwittingly promoted the development of a real memory disorder: False 
Memory Syndrome. To make sense of this unfortunate situation, I need to 
offer a few definitions.
   Some psychotherapists believe that childhood sexual abuse is the 
specific cause of numerous physical and mental ills later in life. Some 
term this _Incest Survivor Syndrome (ISS)_. There is no firm evidence 
that this is the case, since even where there has been documented sexual 
abuse during childhood, there are numerous other factors that can 
explain physical or emotional complaints that appear years later in an 
adult.
   These therapists believe that the children immediately _repress_ all 
memory of sexual abuse shortly after it occurs, causing it to vanish 
from recollection without a trace. The price for having _repressed 
memories_ is said to be the eventual development of ISS.
   Therapists attempt to "cure" ISS by engaging patients in _recovered 
memory therapy (RMT)_, a hodge-podge of techniques varying with each 
therapist. The purpose of RMT is to enable the patient to _recover_ into 
consciousness not only wholly accurate recollections of ancient sexual 
traumas, but also repressed _body memories_ (such as physical pains) 
that occurred at the time of the traumas.
   In actuality, RMT produces disturbing fantasies which are 
misperceived by the patient and misinterpreted by the therapist as 
memories. Mislabeled by the therapist and patient as _recovered 
memories_, they are actually _false memories_.
   The vast majority of false memory cases developing from RMT are in 
women, which is why this article assumes patients to be female.

Initiation of 
Patients into RMT

A woman consults a psychotherapist for relief of various emotional 
complaints. The therapist informs her that she may have been molested as 
a child and does not know it, and this could explain her symptoms. Some 
patients think this idea is absurd and go to another therapist; others 
accept the therapist's suggestions and stay on. More than a few women 
have heard about repressed memories from talk shows or tabloids even 
prior to coming to the therapists office, and may even make the 
appointment believing they too could be "victims."
   Though the patient has no memories of abuse, she becomes motivated 
for "memory recovery" since she is told this will cure her symptoms. The 
therapist will offer encouragement that "memories" will return. 
Suggestive dreams or new pains are interpreted by the therapist as proof 
that repressed memories are lurking.
   The therapist may refer the patient to a "survivor recovery group." 
There she will meet women who further encourage her to keep trying to 
remember. Attendance at these support groups, as well as assigned 
reading in self-help books, surrounds the patient with validation for 
the therapist's theories.
   The vast majority of women with FMS are white, middle class, and 
above average in education. This corresponds to the profile of a typical 
woman who enters long term psychotherapy, and who perceives such 
activity as an important way to solve life's problems.

Generating 
False Memories

Unlike courts of law which obtain objective evidence where allegations 
of evil-doing are made, RMT solely directs the patient to attend toward 
her inner world for "proof" she was sexually abused. Such RMT techniques 
may include:

   --Meditation on fantasy production, such as pictures drawn in "art 
therapy," dreams, or stream of consciousness journal writing.

   --Hearing or reading about the "recovered memories" of other women 
which can serve as inspirations.
   --Amytal interviews ("truth serum") and/or hypnosis (including "age 
regression" where the patient is told she is temporarily being 
transformed into the way she was when she was five years old).

   --Telling the patient to review family albums; if she looks sad in 
some of her childhood photos, she is told this is further confirmation 
that abuse occurred.

The Dark Side 
of "Recovery"

Patients start out RMT with the hope that things will be better once 
they recover their repressed memories. But usually life becomes far more 
complicated.
   The FMS patient will often become estranged from the "perpetrator" 
(most often her father). If the patient has small children, they will be 
off limits to "perpetrators" as well. Relationships with other family 
members becomes contingent on their not challenging the patient's 
beliefs.
   Therapists may urge parents to come for a "family conference" in 
order to allow the patient to surprise the "perpetrator" with a 
rehearsed confrontation. Family members are usually too shocked and 
disorganized to coherently respond to accusations. The rationale for 
this scenario is that since "survivors" feel powerless, they need 
"empowerment."
   FMS patients may file belated crime reports with local law 
enforcement agencies and may go on to sue "perpetrators." Such lawsuits 
demand compensation for bills from psychotherapists and possibly other 
doctors who treated adult medical problems that therapists somehow link 
to childhood traumas. Of course, there may be demands for "punitive 
damages." Spouses of "perpetrators" (usually the patient's mother) may 
be sued as well for being negligent, thus making householder's insurance 
into a courtroom piggy bank. Since FMS patients sincerely believe they 
have been victimized, more than a few juries have given verdicts 
sympathetic to them.
   Preoccupied with the continuing chores of "memory recovery," the FMS 
patient may come to ignore more pressing problems with her marriage, 
family, schooling, or career. Often the time demands and expense of the 
therapy itself become a major life disruption.
   Some patients during the course of RMT develop "multiple personality 
disorder" (MPD). RMT therapists have claimed that they need to not only 
recover repressed memories, but also to uncover repressed personality 
fragments; some women come to believe they are repositories of dozens of 
hidden personalities ("alters"). "Alters" have their own names and 
characteristics, and may identify themselves as men or even animals. An 
increasing number of psychiatrists and psychologists are coming to view 
MPD as a product of environmental suggestion and reinforcement, since 
the diagnosis was hardly made prior to ten years ago. One area where 
there is no controversy: once MPD is diagnosed, therapy bills become 
astronomical.
   Some FMS patients become convinced that their abuse was actually 
"satanic ritual abuse" (SRA), due to participation by relatives in a 
secret satanic cult. Some therapists believe SRA is the work of a vast 
underground cult network in these United States. No evidence beyond 
"recovered memories" has ever been offered as proof that satanic cults 
exist at this claimed level of frequency. Therapists who lecture on the 
topic have explained away the lack of evidence that such cults exist by 
claiming that no defectors speak out due to iron-clad secrecy via 
brainwashing and terror. 

The Care 
and Maintenance 
of False Memories

FMS involves a combination of mistaken perceptions and false beliefs. 
The fledgling FMS patient is encouraged to "connect" with an environment 
that will reinforce the FMS state, and is encouraged to "disconnect" 
from people or information that might lead her to question the results 
of RMT.
   The FMS subculture is victim-oriented. Even though they have not 
undergone anticancer chemotherapy or walked away from airplane crashes, 
FMS patients are told they too are "survivors." This becomes a kind of 
new identity, giving FMS patients the feeling of a strong bond with 
other "survivors" of abuse. Patients will often start attending 
"survivor" support groups, subscribe to "survivor" newsletters, or even 
attend "survivor" conventions (sometimes with their therapists).
   They will read books found in "recovery" sections of bookstores. The 
best known book, _The Courage to Heal_, is weighty, literate, and thus 
appears authoritative. Authors Laura Davis and Ellen Bass have no formal 
training in psychology, psychiatry, or memory. This paperback, modestly 
priced at $20, has sold over 700,000 copies.
   Patients are told to shy away from dialogue with skeptical friends or 
relatives, since this will hinder their "recovery." "Perpetrators" who 
proclaim their innocence cannot be taken seriously since they are "in 
denial" and incapable of telling the truth.
   Aside from these social influences, people by nature often resist 
seeing themselves as being in error. It can be terribly painful to 
acknowledge having made a big mistake, particularly when harmful 
consequences have resulted.
   RMT exploits the tendency within each of us to blame others for our 
problems, and to latch onto simple answers for life's complicated 
problems. RMT therapists suggest that aside from entirely ruining 
childhoods, childhood sexual abuse can explain anything and everything 
that goes wrong during adulthood. RMT becomes the ultimate crybaby 
therapy.

How Memory 
Really Works

In Freud's theory of "repression" the mind automatically banishes 
traumatic events from memory to prevent overwhelming anxiety. Freud 
further theorized that repressed memories cause "neurosis," which could 
be cured if the memories were made conscious. While all this is taught 
in introductory psychology courses and has been taken by novelists and 
screenwriters to be a truism, Freud's repression theory has never been 
verified by rigorous scientific proof.
   Freud, were he alive today, would be traumatized to see how RMT has 
redefined his pet concept. While Freud talked of the repression of 
single traumatic episodes, today's therapists maintain that dozens of 
similar traumatic episodes occurring over years are repressed with 100% 
efficiency.
   The well known syndrome of Post Traumatic Stress Disorder shows us 
that verifiable traumatic events, rather than disappearing from memory, 
leave trauma victims haunted by intrusive memories in which the victim 
relives the trauma. For those who were in Nazi concentration camps or 
underwent torture as POWs in Vietnam, this can become a serious lifelong 
problem.
   People forget most of what occurs to them, including some events that 
were pleasant or significant to them at the time. If an event is lost 
from memory, there is no scientific way to prove whether it was 
"repressed" or simply forgotten. And there is no reason that memories of 
sexual abuse should be handled any differently than childhood memories 
of physical abuse or of emergency surgery.
   Events that have slipped away from memory cannot be recalled with the 
accuracy of a videotape. Individuals forget not only insignificant 
events in their entirety, but also significant events. Some events 
(traumatic or not) are recalled, but with significant details altered.
   A study of children whose school was attacked by a sniper showed that 
some who were not on the school grounds later insisted they had personal 
recollections of being in school during the attack. These false memories 
apparently were inspired by exposure to the stories of those who truly 
experienced the trauma.
   Memories can be deliberately distorted in adults by presenting a 
display of visual information, and later exposing subjects to verbal 
disinformation about what they saw. This disinformation often becomes 
incorporated into memory, contaminating the ultimate memories that are 
recalled.
   To be sure, some who enter therapy were abused as children, but they 
have always remembered this abuse. They do not need special help in 
"memory recovery" to tell the therapist what happened to them.

Why Recovered 
Memory Therapy 
is Bad Therapy

RMT purportedly is undertaken to help patients recover from the effects 
of sexual abuse from childhood; however, at the onset of RMT there is no 
evidence that such abuse ever occurred. Thus, instead of a therapist 
having some evidence for a diagnosis and then adopting a proper 
treatment plan, RMT therapists use the "treatment" to produce their 
diagnosis.
   Some RMT therapists over-attribute common psychological complaints as 
signs of forgotten childhood sexual abuse. In their zeal to find 
memories, these therapists overlook any and all alternative explanations 
for the patient's complaints.
   RMT therapists ignore basic psychological principles that all 
individuals are suggestible, and that patients in distress seeking 
psychotherapy are particularly likely to adopt beliefs and biases of 
their therapist.
   Many RMT therapists have studied neither basic sciences related to 
memory, nor the diagnosis of actual diseases of memory. Their knowledge 
is often based on a single weekend seminar, as opposed to years of 
formal training in any graduate program they attended to get their 
licenses.
   Hypnosis and sodium amytal administration ("truth serum") are 
unacceptable procedures for memory recovery. Courts reject hypnosis as a 
memory aid. Subjects receiving hypnosis or amytal as general memory aids 
(even in instances where there is no question of sexual abuse) will 
often generate false memories. Upon returning to their normal state of 
consciousness, subjects assume all their refreshed "memories" are 
equally true.
   RMT therapists generally make no attempt to verify "recovered 
memories" by interviewing third parties, or obtaining pediatric or 
school records. Some have explained that they do not verify the serious 
allegations that arise from RMT because their job is simply to help the 
patient feel "safe" and "recover."
   Many patients who have known all their lives that they were 
mistreated or neglected by their parents, decide as adults to be friends 
with the offending parents. By contrast, RMT therapists encourage their 
patients, on the basis of "recovered memories," to break off 
relationships with the alleged "perpetrators" as well as other relatives 
who disagree with the patient's views. This is completely at odds with 
the traditional goals of therapists: to allow competent patients to make 
their own important decisions, and to improve their patient's 
relationships with others.
   Patients undergoing RMT often undergo an increase of symptoms as 
their treatment progresses, with corresponding disruption in their 
personal lives. Few therapists will seek consultation in order to 
clarify the problem, assuming instead that it is due to sexual abuse 
having been worse than anyone might have imagined.

Other Kinds of FMS

Some individuals come to believe that they lived "past lives" as a 
result of having undergone "past life therapy." This phenomenon 
generally develops in participants who are grounded in the New Age 
zeitgeist and already open to "discovering" their past lives. They 
enroll in seminars which can run up to an entire weekend and will 
involve some measure of group hypnotic induction and guided meditations. 
This sort of FMS also involves continuing group reinforcement. In 
contrast to horrific images of sexual abuse, recollections of "past 
lives" are generally pleasant and interesting. Few participants will 
recall spending prior lives in lunatic asylums or dungeons. The whole 
experience is assumed to be therapeutic by helping participants better 
understand the situation of their present lives.
   A small number of individuals develop "recovered memories" of being 
abducted by aliens from outer space. Almost always these individuals had 
some curiosity about this area and were hardly skeptics before they fell 
into an alien abduction FMS.
   In contrast to women who are plagued with concerns that they were 
sexually abused, these varieties of FMS are of a much more benign nature 
and do not disrupt personal functioning or family life. While some of 
these individuals suffer the ignominy of being perceived as "kooks," 
they may receive compensating group support from those who share their 
beliefs.

A Word About the Future

Increasing numbers of women who claimed to have recovered memories of 
sexual abuse have retracted their claims and now see themselves as 
having had FMS. This may spontaneously occur when women relocate to 
another locale and lose contact with their prior therapists and support 
group. Without the "positive reinforcement" from others to encourage 
false memory development and maintenance, some women begin to doubt the 
veracity of what they had believed was true. While some remain suspended 
in a twilight of doubt, others have fully recanted.
   These retractors may have a profound influence on getting women with 
an active FMS to re-evaluate their situation. While FMS patients learn 
from the FMS culture to dismiss critics as either "perpetrators" or 
their apologists, the voice of a woman who says she is recovering _from_ 
FMS is more easily heard.
   Although most influential among family counselors and social workers, 
RMT affected the practices of some licensed psychologists and 
psychiatrists, some of whom were practicing in special "dissociative 
disorders units" in psychiatric hospitals. These activities have gone on 
with little challenge, until recently.
   The number of women with FMS who have become retractors is 
increasing. Some have sued their former therapists for malpractice (see 
Laura Pasley's story in this issue of _Skeptic_), and others are 
weighing the possibilities of doing so. One malpractice insurance 
carrier for clinical psychologists in California recently tripled its 
rates without explanation; this has led to speculation that the carrier 
is anticipating increasing numbers of lawsuits alleging that 
psychologists caused FMS.
   The False Memory Syndrome Foundation, formed in 1991, has been 
contacted by over 7,000 families in the U.S. and Canada who believe 
their grown children have FMS, and these families let their views be 
known to state licensing boards and professional organizations. Managed 
care administrators are starting to question megabills submitted by RMT 
therapists, some of whom see their patients through lengthy psychiatric 
hospitalizations. Understandably, all of this has gained the attention 
of the American Psychiatric Association and American Psychological 
Association, who are setting up task forces to try to examine the whole 
phenomenon.
   Meanwhile, there is a large FMS subculture consisting of women 
convinced that their "recovered memories" are accurate, therapists 
keeping busy doing RMT, and of authors on the "recovery" lecture and 
talk show circuits. In addition, there are some vocal fringes of the 
feminist movement that cherish RMT since it is "proof" that men are 
dangerous and rotten, unless proven otherwise. Skeptical challenges to 
RMT are met by emotional rejoinders that critics are front groups for 
perpetrators, and make the ridiculous analogy that "some people even say 
the Holocaust did not happen."
   RMT will eventually disappear, but not next month.

Dr. John Hochman is a practicing psychiatrist in Encino, California, 
specializing in the evaluation and treatment of victims of cultic 
entities and/or undue influence; the theoretical study of cult 
phenomena, psychiatry and the law, and Post-Traumatic Stress Disorders.  
He is a consultant and expert witness in courtroom cases involving abuse 
allegations, coercive persuasion and psychotherapy cult involvement.  
Dr. Hochman is also Assistant Clinical Professor in the Department of 
Psychiatry at the UCLA School of Medicine and serves on the editorial 
and advisory boards of the _Cultic Studies Journal_, the American Family 
Foundation, and the False Memory Syndrome Foundation.  In 1990 he won 
the John C. Clark Award for Distinguished Scholarship in Cultic Studies 
from the American Family Foundation.

