The Complex Issues
AbstractThe present article reviews a range of issues including the nature of memory, the role of hypnosis in therapy to recover memories, the personality characteristics of client and therapist, and factors of suggestibility and absorption - but it goes beyond those factors to consider the social and therapeutic context in which memories are recovered. It proposes that "recovered" memories that are false arise from complex interactions that also include family dynamics, social-perceptual pre-conditioning, media induction, secondary gain, therapists' beliefs, and treatment approaches and expectancies with certain precipitating events acting as catalysts.
Estimated at approximately four percent of all reported cases of CSA in the USA, the phenomena have caused confusion for families, therapists, professional groups, statutory bodies, and the community-at-large. With respect to the therapeutic community, an increasing number of accusations are being made about therapists as the cause of family rifts (Kihlstrom, 1996). The exact number of court actions against professionals practising therapy in Australia and New Zealand is unknown, but in the USA in 1997, there were 800 cases (and 5000 planned) where clients and/or their families were suing therapists for implanting "false memories" (Brown, 1997).
In the research community, the debate continues as to whether there is, or is not, a possibility that: (a) memories can be completely or partially forgotten for many years (Loftus, Garry & Feldman, 1994); (b) memories recovered in therapy can be accurate or false (Pope & Brown,1997; Watkins, 1993; Yapko, 1996); (c) all memories change with re-accessing or over time (Sheehan, 1996); and (d) beliefs which therapists hold about memories of childhood abuse may influence the client (Poole, Lindsay, Memon, & Bull, 1995).
The field of memory research has benefited from the furore (see Loftus, 1993; Neisser & Winograd, 1995). However, apart from the work conducted by Spanos and colleagues (1993-1996) and others on UFO abduction reports, past life therapy reports, birth memories, perinatal memories, interuterine lives, multiple personality disorders and satanic ritual abuse, there has been little experimental research aimed at bridging the gap between the real world and the laboratory in this contentious area (see Sheehan, 1997), of the veridicality of memories recovered or re-interpreted long after the abuse has occurred.
Journalists in Australia and the USA have written books and articles on the subject (see Morfit, 1994; Guilliatt, 1996 - who estimated that over 300 people in New South Wales alone sought treatment for memories of SRA, despite the fact that the Australian legal system had not been able to substantiate one case-; & Johnston, 1997), but again with the exception of Spanos (1996), it appears that little research has been done to delineate the influence of individual and social factors on recovered memories. These would include the role played by the media, media personages, self healing books, therapy groups, new age adherents, and the beliefs held by the public and self help groups about the recovery of memories and the accuracy of those memories. Such social factors will be explored in this paper by giving attention sequentially to client factors, socio-perceptual pre-conditioning, therapist factors, and precipitating events.
The construct of Fantasy Proneness had its origins in the work of Hilgard (1979), and it was confirmed by Wilson and Barber (1981) that a small group of the population (about four percent) tended to fantasise for a large part of the time. They found that the typical fantasisers, could see, hear, smell, touch and fully experience their fantasies. Later Lynn and Nash (1994) noted that the experiences seemed so real and pervasive for the fantasy-prone person as to make them prone to distort memories. The same researchers mentioned that the pathway to false memory also involved a propensity to fantasise and conform to expert opinion (Offshe, 1992, cited in Lynn & Nash, 1994), but the link has yet to be validated experimentally. Empirically Bryant (1995) found that fantasy proneness was also associated with higher levels of abuse at an earlier stage of life.
Lynn and Rhue (1986) reported that fantasy prone subjects were higher on measures of hypnotic susceptibility, absorption, imagery vividness, response to waking suggestion and creativity. Then Lynn and Rhue (1987) determined that fantasy proneness coincided with the prevalence of greater frequency and severity of physical punishment, with reported use of fantasy, perhaps in an attempt to block out the pain, loneliness, isolation, and an aversive environment. Silva and Kirsch (1992) went further to demonstrate the function of expectancy in mediating the relationship between hypnotisability and fantasy proneness.
Perceived expectations of the therapist/experimenter can affect the production of reports associated with FMS, and also the consequent belief that the false memory is in fact true. For example, Newman and Baumeister (1996) and Spanos, Menary, Gabora, DuBreuil, and Dewhurst (1991), found that subjects assign more credibility to their pseudomemory when the therapist or experimenter express a belief in the possibility that such phenomena actually do occur. Wilson (1982, cited in Spanos, Menary, et al. 1991) ascertained that the time lapse reported between past lives was consistent with the therapists' beliefs regarding the issue. If the therapist believed that past lives followed directly after each other with no gap, their clients were found also to report it. Conversely, if therapists believed there was a time lapse between such lives, their clients' reports also reflected it. Additionally Spanos, Menary et al. (1991) discovered that subjects incorporated suggestions that they had probably suffered child abuse in a past life, or that in their past life they were of different nationality or sex. By way of explanation, the researchers took the socio-cognitive view that the subjects were responding at the time of interview to situational demands, rather than the view that hypnosis was to blame for implanting the false constructions of abuse.
The eyewitness memory research by Loftus (1993) that post-event misinformation changes an original memory trace, and may even erase or replace it with an inaccurate or false memory, is instructive, and her classical research on "yield" signs and car accidents, thieves and purse-snatching has been used extensively in court cases. However, Pope and Brown (1997) consider that findings from such contrived studies should not be taken as evidence that adults tend to replace memories of an accident, with for instance, memories of an assault. They also query whether the findings in Loftus's laboratory studies can be extrapolated to real world situations. As Yuille and Cutshall (1989) once suggested, people may become more accurate, more cautious and less suggestible when the consequences for incorrect memories become serious and real.
Spanos (1996, p. 113) describes the current litigation fiasco in the West as a "scenario (in which) both the accusing daughters and the accused parents are seen as victims, and the therapist is cast in the role of the evil destroyer of a tranquil family". He goes on to say that when women come to therapy, they are "likely to hold complex and ambivalent views of their parents that include resentments, fears, confusion, and guilt as much as it includes feelings of warmth and trust". He refers to the reality of middle class family life as differing from stereotypic and patriarchal idealisations (see Haaken, 1993, cited in Spanos, 1996), and points out that in normal family life, there is conflict and competition, resentment, misunderstanding, emotional blackmail, abusive and arbitrary use of power, hostility, and the blurring of parent/child role boundaries - a particular picture clearly painted by Maura Johnston (1997) in her book "Spectral Evidence". Spanos (1996) considers that the allegations of incest could act as a medium for the expression of a previously poorly articulated, very powerful, emotional injury - the anger, hurt, disappointment and resentment that women may feel towards their parents before they arrive in the therapist's office. Therefore, as Pope and Brown (1997) suggest, stories of CSA may be metaphors for other painful experiences.
There is also evidence that others, such as older family members, could influence the autobiographical memory of their younger relatives (Loftus & Ketcham, 1994, p. 211; Loftus, 1993, p. 533). But because only 15-20 per cent of the population appear to be highly suggestible personalities (Pezdek & Roe, 1994), it is necessary to consider socio-perceptual factors relating to pre-suggestibility.
Enns, Mc Neilly and Gilbert (1995, p.184) consider that the public media has "helped fuel the emotional ... nature of the debate by often using sensational headlines to attract readers ... and packaging issues within provocative anecdotes rather than providing supporting claims of widespread abuse with appropriate documentation". Radio talkback sessions and TV shows might also have highlighted the possibility of people suddenly remembering that they were abused as children. Just as the movie "Sybil" was singled out as one of the movies to have influenced the production of a multitude of multiple personality disorder (MPD) (or dissociative identity cases (DID)) cases in the western world, so too TV celebrities and well known personages (vis-a-vis The Women's Weekly article in September, 1997) who reveal they too had a history of CSA, might have spurred the emotional involvement of women to consider the possibility of forgotten CSA having occurred in their own lives.
Similarly it is possible that television stories such as X-Files and Millennium, along with the plenitude of psychic and UFO (Unidentified Flying Object) magazines appearing on newsagents' stands throughout the western world, have influenced the public's beliefs about the existence of psychic phenomenon, aliens and supernatural forces. But while many journalists and television and radio producers focussed their attention on the role of hypnosis, inappropriate therapy treatment (Morfit, 1994), feminist groups (Guilliatt, 1996a), and the part that psychics play (Stephen Lamble, Courier Mail, personal communication, 1996), researchers, for their part, have not addressed the influential role that the media has taken in the creation of a climate of receptivity to the existence of repressed memories. Nor has the research community really focused on the heightened arousal levels of viewers when watching television shows and videos dealing with CSA, SRA, and UFO abductions - apart from Coons (1994) who plotted the frequency of reports from DID clinics of SRA and their exposure to stimuli such as television programs or workshops relating to satanic ritual abuse during the period 1984-1993. He found that 58% of his cases occurred in the two years following exposure to a talk show on SRA, and that a further 34% of cases appeared after their exposure to a workshop on SRA.
The appearance of contemporary apprehensions such as satanic cults, date rape and alien visitations in the content of false memories needs explanation. Bartholomew, Basterfield and Howard (1991) thought it only natural that the content of false memories would reflect science fiction and popular beliefs of the time, and
Dittburner and Persinger (1993) considered that "estimates of prevalence for phenomena that receive generalised media coverage may be subjectively inflated". Lynn and Kirsch (1996) agreed with this view because the basic elements of the UFO contact script were identifiable in widely available movies, tabloids, cartoons, and books.
The book market.
Nowhere is the power of the media and popular books more evident than in the area of UFO abductions. Greenberg (1996) reported that the number of people coming forward to report alien contact and abduction increased in proportion to the number of books, movies, and drama styled television programs produced on this topic. In 1979 he noted about 200 reported cases, while approximately 500 events had been reported between 1970 and 1980 (Hopkins, 1981; Rimmer, 1984).The publication of Communion escalated the interest and the reportings, and many thousands of letters arrived in Strieberg's office by 1988, increasing with the publication of King Live. The recent film Contact may have increased that number, along with the new UFO magazines that line the newsagents' shelves.
According to Enns, Mc Neilly and Gilbert (1995, p.199), the growth and proliferation of the "recovery" movement is one of the cultural factors that has contributed to the current climate in which charges of FMS have flourished. Books such as A Nation of Victims, Culture of Complaint and I'm Dysfunctional, You're Dysfunctional elaborate on the emergence of the victim mentality. In some cases, books and magazines articles declare adamantly that if people have a particular cluster of symptoms they have been abused (viz a viz the nine page article on UFO abductions in Woman's Day, 18th August 1997 which included a list of personalised questions such as "What about you ? Do those situations seem familiar? Perhaps you ... suspect that you may have been the subject of an alien abduction").
The public have also been exposed to a plethora of books over the past three decades on the possibility of recovering past lives, returning to life in the womb, progressing to the future or even accessing after-life experiences. The list of suggestive titles includes : Have You Lived Before, Many Life Times, Windows of the Mind, Reliving Past Lives and Past Lives Therapy, The Secret Life of the Unborn Child, Return to the Womb, Born to Live The Radiant Child, True Accounts of Reincarnation, Mind Pro-Hypnosis, Other Lives and Other Selves, Living Your Past Lives, Coming Back: A Psychiatrist Explores Past-Life Journeys and Who Were You Before You Were You.
With regard to research into some such experience of early memory, Van Husen (1988) convinced hypnotically regressed subjects to remember implanted abortion attempts with stories that were vivid, coherent, organised, emotional laden and complex - but false. Spanos, Burgess, and Burgess (1994) asserted that there was no evidence to suggest that people could remember their experiences in the womb, and they found that where the researchers gave misinformation, in either hypnotic or non-hypnotic regression situations, the subjects 'remembered' that they had seen coloured mobiles hung over their cribs.
Remembering past lives is a relatively recent phenomenon. Except under hypnosis, prior to the late 1960's there were few reports of individuals remembering their own past lives (Lucas, 1996). He makes the point that even adults in India, where reincarnation has been taken as a part of the faith system, do not remember their past lives. Therefore the rise of 'past life therapy' in the USA and more recently in Australia and New Zealand, may in fact have led people to believe that people could recover memories they did not know they had, without realising that they were expressing fantasy. Consequently the role of the therapist in inducing such fictitious memories must be given consideration.
As a result of FMS, many researchers have explored the notion that therapists wittingly or unwittingly influence memories elicited in psychotherapy (Benedek & Schetky, 1987; Loftus, 1993; Powell & Boer, 1995; Sinclair, 1995). Loftus (1993) states that the inability to remember within a therapeutic context, is often not attributed to the normal processes of forgetting, but instead it is seen as denial or repression of a traumatic event. The outcome is that clients and therapists embark on a journey of self discovery to recover such lost memories, and in the process, they manufacture memories that did not in fact occur. Thus the central controversy lies in the assertion that these false memories are either actively or unwittingly implanted by therapists through the power of suggestion (e.g., Courtois, 1995; Lynn & Nash, 1994; Milne, 1995; Pope, 1996; Powell & Boer, 1994; Sinclair, 1995; Thomson, 1994).
There has been some exploration of therapist characteristics, such as perceived power and status, biases (Watkins,1993), and prior life experiences including CSA and trauma, their beliefs about the accessing of memories and the accuracy of such recalled memories. Although Loftus (1993) considers that "once activated, manufactured memories are indistinguishable from factual memories", very little research has been carried out to discover how therapists in practice distinguish false from true memories.
Certainly therapists' beliefs about the nature of repression seem to be at the heart of the debate. There the paradigms of narrative truth versus objective evidence, and compassionate empathy versus scepticism, spar for the limelight. This search for truth under the pressure of mounting litigation has led to a major review of the topics of memory and dissociation, trauma and forgetting, suggestibility and recall, fantasy proneness and paranormal beliefs, attribution and certainty. However, it is still not clear why some adults have reported incidents that have never occurred. Loftus (1993) argues that when clients do not have a clear memory of an event, they become especially prone to the powers, suggestive questioning, and misinformation formulated by the therapist. Lynn and Nash (1994) citing Offshe (1992) emphasise that there are substantial rewards, including a "cure" and therapist approval, for the client accepting the therapist's version of the truth within a therapeutic situation. Therapy is a process in which the therapists make their clients feel special and validated, comment that they are lucky to be alive (see Milne, 1995), explain that satanic ritual abuse (for example) is widespread, and invite them to imagine gruesome and lurid scenes, and then the client puts a cause and label to feelings that are as commonplace as depression or anger.
Thus, given the reconstructive elaborative nature of memory, it can be argued that therapists cannot accept narrative truth as historical truth. But the question can be asked as to whether the process makes a difference to therapy. Is it the therapist's role to be compassionate, empathic and supportive of the client's situation, or to interrogate the client as to the veracity of the statements and allegations they are making ? Martinez-Taboas (1996) is firmly of the view that the empirical verification of client's memories of abuse does not fall within the realm of responsibility of psychotherapists and mental health professionals. The courts however seem to view the matter differently.
Beliefs about incidence of CSA.
It can be argued that belief in the veracity of recovered memories interacts with beliefs about the incidence rates. Perhaps the latter belief can be attributed to a number of factors such as the New Age movement, modern trends in therapy relating to body memories, regression style therapies, the greater interest in Eastern religion and philosophies which believe in reincarnation, and quite possibly the failure of governments to regulate the practice of hypnosis and to restrict the practice of such techniques to qualified health professionals within their area of speciality.
However, it has to be said that despite their personal beliefs about the prevalence of repressed memories, in one study the majority of therapists reported that they had no cases of adult clients who entered therapy with no memory of CSA and who subsequently recalled abuse during therapy (Polusny & Follette,1996).
Therapists' clinical and personal experience.
Sometimes the therapist's own abuse background has been held up to scrutiny in an attempt to prove that the therapist has crossed professional boundaries and has not maintained objectivity in dealing with the accusations that clients have made about their abusers. There has been some concern that inexperienced therapists, or therapists who have an abuse history themselves, seem to have more clients recovering memories of abuse for the first time as adults. In the well publicized Ramona case, in which a father was successful in suing is daughter's therapists (Johnston, 1997), the issue of the wounded healer was raised, and it has been said that there were second and third generations of MFCC or social work therapists - called "impaired providers" - who themselves had recovered memories before they became therapists.
Brown (1997) defended those therapists who behaved ethically and professionally in this matter, and regarded the legal suits against them as a new cottage industry in the USA. For that reason post-therapeutic influences, such as exposure to the False Memory Syndrome Foundation information, family influence to retract, pressure to return to the family of origin, custody motivation, negative cognitive reappraisal, reinforcement of retraction belief and malpractice claims, as well as books like Bass and Davis' (1996) The Courage to Heal, should be taken into account as compounding (additive effects) factors in future research.
Before entering a therapy room, clients may have encountered self-help groups, and other professionals who may have suggested that they had relevant 'symptoms'. Some clients approach therapists who are well known for treating a particular problem such as DID, CSA, SRA or UFO abductions. Others might come under the institutionalised influence of other clients in this matter in a group treatment setting. Each and all of these variables need to be taken into account in planning research studies.
Piper (1993) has investigated the use of truth serum in recovered memories, and Lynn and Nash (1994) the secondary gain in maintaining false beliefs. But it seems that it has been left for the journalists and the parents of clients, who have accused their fathers and others of CSA and SRA, to delimit the effects of precipitating events such as post natal depression, adult trauma, institutional psychiatric group therapy, self help groups, parental remarriage and certain feminist ideology. (Guilliatt, 1996a,b) drew attention to the contaminating effect on memory of involvement with groups, with an anti-male attitude that promotes an image of the inevitable male-parental hurt of female children, and that wishes to punish all men, especially the father figure.
The significance of such a cluster of precipitating events is outlined in Figure 1, along with a summary of the major factors listed in this section of the paper.
Figure 1: Causal links in the social construction of "false memories"
It tracks the first serious stage of mis-identification: the client's pre-existing characteristics, their socio-perceptual pre-conditioning, the precipitating event and their exposure to, and absorption of, beliefs about CSA, SRA, and perhaps UFO abduction, as being their own real experience. It covers the therapists' beliefs and clinical experience, their objectivity about the reports of dramatic increases in CSA and SRA in the community, along with the treatment setting. Such experience affects the outcome of the sessions for the client either in a positive, objective way or in an illogical, overinclusive, boundary violating manner. Whether, or not, it is one or many of these factors that somehow influences the client in their formation of false constructions of CSA and/or SRA, and then to believe in them over a continuing period of time, has not yet been determined.
Moreover, there has to be a precipitating event to spark off the interaction of the other influences in this chain of interactions to "false memories". Secondary gain could be present, not just for the client (e.g. 'payback', money, victim role), but also for the therapist (e.g. overidentification with victim, 'payback'). Certainly the decision to confront and sue either the alleged perpetrator or later the therapist and others, may be an individual decision, or one made with one or more advocates.
Whether or not the credentialled therapeutic community should continue to bear the full brunt of this saga is highly questionable. More needs to known about how a normal person could make up stories (and continue to maintain those stories) which are so hurtful and which have such wide ranging negative ramifications for themselves, their families, therapists, and the community. Continued research is needed urgently to delineate the causal factors and their interactions with events in the lives of women who have experienced (or who are vulnerable to experiencing) false constructions of CSA and SRA.
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