Return to FMSF Home Page
**********************************************************************
3401 Market Street suite 130, Philadelphia, PA 19104, (215-387-1865)
This address and the phone numbers have changed as of July 15, 2000
**********************************************************************
The FMSF Newsletter is published 10 times a year by the False
Memory Syndrome Foundation. A hard-copy subscription is in-
cluded in membership fees. Others may subscribe by sending a
check or money order, payable to FMS Foundation, to the ad-
dress above. 1994 subscription rates: USA: 1 year $30, Stu-
dent $10; Canada: $35 (in U.S. dollars); Foreign: $40; Foreign
student $20; Single issue price: $3. ISSN #1069-0484
**********************************************************************
INSIDE:
APA Div.12 Report
Thomas Nagy
Peter Bloom
Alexander Bodkin
John Hochman
Alan Dershowitz
Ralph Slovenko
**********************************************************************
Dear Friends,
"We look forward to the day, to be announced at a later date,
when we all storm the national headquarters of the False
Memory Syndrome Foundation."
Silent No Longer
This quote from Silent No Longer was in the September issue of
"Sojourner: The Forum for Women" in an article about a disruption of a
talk on False Memory Syndrome given by an FMSF Advisory Board member
in the Boston area last June. Following is our reply.
Silent No Longer
Cambridge Women's Center
955 Massachusetts Avenue #262
Cambridge, MA 02139
Dear Members of Silent No Longer:
There is no need to "storm" the headquarters of the False Memory
Syndrome Foundation. You are cordially invited to visit our small
offices to discuss issues that are of concern to you. Just give us a
call and we'll set a mutually convenient time.
We are enclosing some information from the FMS Foundation because
the comments attributed to you in Sojourner: The Women's Forum,
September 1994 indicate a gap between what the Foundation has said
and what you think the Foundation has said. Enclosed you will find
a statement from the American Medical Association that notes, "The
use of recovered memories is fraught with problems of potential
misapplication," "You Must Remember This: How the brain forms 'false
memories'," Newsweek September 26, 1994, pp68-69, and an invitation
to attend the "Memory and Reality: Reconciliation" conference
cosponsored by Johns Hopkins Medical Institutions and the FMS
Foundation. We hope that concerned people can work together to
become part of the solution to the issues of false memories.
The "Sojourner" article noted that Silent No Longer tried to
disrupt a June 21 forum organized by the Brandeis National Women's
Committee. Such action separates those who have similar concerns
about incest. Comments shouted such as "Stop the violence, stop the
lies, incest memories are not lies," fail to recognize that the FMS
Foundation has consistently expressed concern about incest and all
forms of child abuse, the problem of the widespread nature of abuse
and its devastating consequences. The FMS Foundation has said that
there is also a parallel problem of false accusations which if not
checked will undermine efforts to help children. To talk of
"storming" the FMSF headquarters, an organization that from its
inception has been open to visitors, brings into question your
understanding of the term "violence" and your goals.
We hope to see you in Philadelphia or at the conference in
Baltimore on December 9 - 11.
Sincerely,
Executive Director
Comments such as those from Silent No Longer are the exception. More
common are comments that the issues raised by the FMS Foundation will
be helpful in improving the mental health field. Professionals, even
critics, have commented that FMSF has brought much self-reflection to
the field and a much greater awareness about the fallibility of
memory. Indeed, it is remarkable that on most points of memory and
most points of practice, there is agreement.
One issue on which there is agreement is that the public should be
able to expect that therapy is "safe and effective." What is not clear
is how "safe and effective" are to be measured and interpreted. Some
professionals tell us that this is a very complicated issue and that
there is no way to measure the effectiveness of talk-therapies (as
opposed to drug therapies). Others tell us that while it is not simple
to measure a therapy technique because of all the variables, it can
and has been done. A study of effective new psychotherapies and the
training of psychologists in these therapies was conducted by Division
12 of the American Psychological Association and adopted in October
1993. Although there have been previous studies, this study is
important because it examined research after 1980, the year of
publication of the DSM-III which represented a major advance in the
reliable categorization of clinical disorders. (The DSM is the
Diagnostic and Statistical Manual of the American Psychiatric
Association.) The information contained in this study will be
important in formulating a solution to the FMS problem.
The list of empirically validated treatments below is short
considering that there are many recognized mental health therapies. In
ordinary medicine, practicing discredited or unvalidated treatments is
considered quackery. Untested methods must be labeled as
"experimental" and used only with a patient's consent. In the past few
months, families and professionals have been sending us copies of
consent forms, mostly in relation to the use of hypnosis.
But research has shown that therapy (in general) is effective. How
can this be -- if there are so few "treatments" that have been
validated?
There is another way to look at "safe and effective" therapy. As
reported in "House of Cards: Psychology and Psychotherapy Built on
Myth" (1994) by Robyn Dawes, efforts to find a correlation between
therapeutic technique and effectiveness of therapy have failed time
after time. The only thing that has been shown to have any bearing is
the "rapport" between therapist and patient and that bears only on the
patient's evaluation of the therapy. These findings are solid if
disconcerting. They don't seem to fit with our expectations of the
consequences of education and experience with skill or success. Yet
the research has been consistent in this finding. It is "rapport" that
is the determining factor when therapists are the variable that is
examined. It is reasonable to assume that where rapport is developed,
influence is created. Indeed, this has been documented. The belief
systems of the therapist do greatly influence what the patient comes
to believe.
It is instructive in this connection to examine the material
obtained from hysterical and suggestible patients, suffering from
exactly the same symptoms, when they are interviewed or abreacted by
psychiatrists of different schools of thought. Given a psychiatrist
who is interested in birth trauma, or in faulty parental attitudes,
most hysterical and suggestible patients will finally produce many
examples of disturbing parental attitudes, and may even remember in
startling detail some supposed highly traumatic birth experience.
But given another psychiatrist who is interested in quite different
matters, such as whether or not the patient is mother-fixated, or
has been sexually assaulted by the father, the hysterical patient,
because of his state of greatly increased suggestibility, will
produce a quite different set of memories which fit the
psychiatrist's explanation of the symptoms. (p. 56)
"The Mind Possessed" by William Sargant,1974
Therapy can help people. That is not in dispute. At the same time,
any tool or technique that is powerful enough to help is also powerful
enough to harm. Since, with the exceptions listed by the Division 12
report, it doesn't matter what new techniques a therapist uses, why
would some therapists cling to techniques that carry with them the
high potential to do harm? In this newsletter we have reprinted two
sets of guidelines for professionals to follow when "recovering
memories" seems to be an appropriate part of therapy. We are deeply
appreciative to Thomas F. Nagy, Ph.D. and Peter B. Bloom, M.D., who
have moved the field forward through their personal efforts and
concern for good therapy. As we read these sets of guidelines that
seem to go far in providing needed safeguards, we wondered if therapy
that includes memory recovery will reach the point when there are
meetings of law- yers before therapy begins. "Why bother?" we can't
help but ask. "Why bother" with a technique that has never been shown
to do much good when it carries with it such a high risk of doing
damage? How do professionals weigh the potential risk with the
potential benefit? If the therapy has never been shown to be of any
benefit and the risks are so great that lawyers need to be consulted
and legal documents drawn up, why bother doing it? Indeed, there may
be compelling reasons. If so, the reasons need to be explained to the
public. This is a question we ask professionals to consider.
PAMELA
______________________________SIDEBAR_______________________________
/ \
| INTERNATIONAL CONFERENCE |
| Memory and Reality: Reconciliation |
| CoSponsored by |
| The False Memory Syndrome Foundation |
| and |
| The Johns Hopkins Medical Institutions |
| Baltimore, MD December 9, 10, 11 1994 |
| Registration in order of application receipt. |
| |
| Become part of the solution to the False Memory problem. |
\____________________________________________________________________/
**********************************************************************
EXAMPLES OF EMPIRICALLY VALIDATED TREATMENTS
American Psychological Association
from a report of the
Task Force on Promotion and Dissemination of Psychological Procedures,
Dianne L. Chambless, Chair.
Adopted, October 1993, by The Division 12 Board of Directors,
David Barlow, President
"...constituted to consider methods for educating clinical
psychologists, third party payers, and the public about
effective psychotherapies."
WELL ESTABLISHED TREATMENTS
(Citation for Efficacy Evidence)
* Beck's cognitive therapy for depression -- Dobson (1989)
* Behavior modification for developmentally disabled individuals --
Matson & Taras (1989)
* Behavior modification for enuresis and encopresis -- Kupfersmid
(1989); Wright & Walker (1978)
* Behavior therapy for headache and for irritable bowel syndrome --
Blanchard et al. (1987) (1980)
* Behavior therapy for female orgasmic dysfunction and male erectile
dysfunction -- LoPiccolo & Stock (1986) ; Auerbach & Kilmann (1977)
* Behavioral marital therapy -- Azrin, Bersalel et al (1980) ;
Jacobson & Follette (1985)
* Cognitive behavior therapy for chronic pain -- Keefe et al. (1992)
* Cognitive behavior therapy for panic disorder with and without
agoraphobia -- Barlow et al (1989); Clark et al. (in press)
* Cognitive behavior therapy for generalized anxiety disorder --
Butler et al (1991); Borkovec et al. (1987) Chambless & Gillis (1993)
* Exposure treatment for phobias (agoraphobia, social phobia, simple
phobia) and PTSD -- Mattick et al. (1990); Trull et al. (1988); Foa et
al. (1991)
* Exposure and response prevention for obsessive-compulsive disorder
-- Marks & O'Sullivan (1988); Steketee et al. (1982)
* Family education programs for schizophrenia -- Hogarty et
al. (1986); Falloon et al. (1985)
* Group cognitive behavioral therapy for social phobia -- Heimberg et
al. (1990); Mattick & Peters (1988)
* Interpersonal therapy for bulimia -- Fairburn et al. (1993); Wilfley
et al. (1993)
* Klerman and Weissman's interpersonal therapy for depression --
DiMascio et al. (1979); Elkin et al. (1989)
* Parent training programs for children with oppositional behavior --
Wells & Egan (1988); Walter & Gilmore (1973)
* Systematic desensitization for simple phobia -- Kazdin & Wilcoxin
(1976)
* Token economy programs -- Liberman (1972)
PROBABLY EFFICACIOUS TREATMENTS
(Citation for Efficacy Evidence)
* Applied relaxation for panic disorder -- Ost (1988); Ost & Westling
(1991)
* Brief psychodynamic therapies -- Piper et al (1990); Shefler &
Dasberg (1989); Thompson et al. (1987); Winston et al. (1991); Woody
et al. (1990)
* Behavior modification for sex offenders -- Marshall et al. (1991)
* Dialectical behavior therapy for borderline personality disorder --
Linehan et al. (1991)
* Emotionally focused couples therapy -- Johnson & Greenberg (1985)
* Habit reversal and control techniques -- Azrin, Nunn & Frantz (1980;
Azrin, Nunn & Frantz-Renshaw (1980)
* Lewinsohn's psychoeducational treatment for depression -- Lewinsohn
et al. (1989)
(To obtain a copy of the full report, contact Judy Wilson, Division 12
Central Office, P.O. Box 22727, Oklahoma City, OK 73123-1727.)
______________________________SIDEBAR_______________________________
/ \
| UPDATE ON FACILITATED COMMUNICATION |
| At APA's annual meeting the governing board unanimously approved a |
| statement saying that "facilitated communication" was an unproven |
| technique whose effectiveness had not been demonstrated in |
| repeated scientific studies" Brian A. Gladue, senior scientist |
| for APA said the group had found the scientific data to be |
| overwhelmingly against claims that FC could help disabled people |
| communicate independently. |
| Chronicle of Higher Education September 7, 1994 |
\____________________________________________________________________/
**********************************************************************
REPRESSED MEMORIES GUIDELINES & DIRECTION
By Thomas F. Nagy, Ph.D.
Permission to reprint has been granted by "The National Psychologist,"
8100 Channingway Blvd., Ste 303, Columbus, OH 43232.
Dr. Nagy's guidelines were among several articles on repressed memory
that appeared in the July/August 1994 issue of "The National
Psychologist," a bimonthly newspaper for psychology practitioners with
a circulation of 25,000.
There are several ways in which a therapist might contaminate or
otherwise degrade the validity of patients' memories. Formal
interventions, such as hypnosis, guided imagery, dream analysis,
interpretation of somatic sensations, or the elaboration of memory
fragments or "flashbacks," are some of the means commonly used by
therapists in gathering data on early life experiences.
After learning of this "information," therapists are then free to
use it in therapy in any way they please. This generally runs the
gamut between accepting it as historically accurate and rejecting it
as utterly false retrospective reconstruction, depending upon the
therapist's sophistication and experience level in working with
clients with dissociative disorders or post traumatic stress disorder,
delayed onset.
An indirect way in which a therapist may influence the process as
well as the client's beliefs about memory is the holding of a general
attitude which consistently reinforces the notion that early abuse is
pervasive, and can be determined with certainty regardless of the
paucity of evidence. A therapist who constantly is on the lookout for
minimal cues which, to him or her, must denote childhood physical or
sexual abuse, certainly communicates this to clients, both explicitly
and implicitly.
Furthermore, frequently a power differential exists, within certain
therapy dyads, which is of profound importance in influencing the
course of treatment, for better or for worse. In these dyads, it is
the unusual patient indeed who would feel sufficiently secure to
challenge the therapist's views on the veridicality of memory as
regards to early life experiences. The convictions of the psychologist
then become the engine of therapy, driving it to a locale which might
otherwise never be visited by the patient.
For those therapists working with individuals who may have repressed
memories, or those who encounter traumatic material in the course of
treatment, there are some important guidelines to consider before
embarking upon this potentially rocky road. Indeed, since it is
unknown at the outset which patient will uncover memories or have
flashbacks during treatment, it might be wise to seriously consider
for every patient the following guidelines which follow, or to adapt
them as appropriate to the circumstance and diagnosis. It may also be
wise to consult an attorney knowledgeable in these areas for the
purpose of reviewing one's procedures in working with this difficult
treatment population.
1. Always provide thorough informed consent before beginning therapy,
considering the following in your discussion of treatment:
* Provide a general indication of how therapy will proceed.
* Describe how any specialized techniques for memory retrieval, such
as hypnosis or guided imagery, will be integrated into therapy.
* Describe how such specialized techniques can contribute to therapy
as adjuncts, but that they do not constitute the whole of therapy.
* Explain both potential benefits and risks of engaging in such
specialized techniques.
* Consult the APA Ethics Code, with a focus on Standards 4.01
(Structuring the Relationship) and 4.02 (Informed Consent to Therapy).
2. Document your professional activities with all clients by keeping
accurate records of ongoing psychotherapy.
* Use signed consent forms or contracts if appropriate; consult an
attorney about risks and benefits of such a practice.
* Consult APA's "Record Keeping Guidelines" for a current and
comprehensive outline of what to include in your case notes
(cf. American Psychologist, September 1993, pp 984).
3. Be competent in your use of specialized techniques, such as
hypnosis, guided imagery, or dream analysis, to name a few. Enter
these potentially intense areas with caution and thoroughness, through
a formal course of study, and consultation and supervision with
experienced health care professionals. Continue to upgrade your
skills by attending workshops, reading journals, joining a peer
supervisory group, and in other ways.
* Consult the APA Ethics Code with particular emphasis on Standards
1.04 Boundaries of Competence and 1.05 (Basis for Scientific and
Professional Judgments).
4. Make no assumptions about the historical accuracy of hypnotic or
non-hypnotic recall. Also, do not imply that hypnotically experienced
"events" necessarily happened. Remember -- your personal convictions
about the validity of emerging "memories" are highly contagious to
many patients -- and are communicated directly or indirectly in a
variety of ways.
* Refrain from using the words "memories" or "facts" when referring
to material which may emerge in treatment.
It might be wiser to use such concepts as impressions, hypnotic
experiences, sensations, etc., which allow the patient to retain the
dignity of his or her private experiences, without elevating their
status to that of "evidence" or "historic fact."
5. Never attempt an uncovering technique for the first time without
taking a careful history and employing your usual and customary
methods of gathering information, including psychological testing, as
appropriate. In spite of any felt pressure from the patient to explore
the past, therapists should not compromise their standards concerning
this important phase of treatment.
* Use or develop your own standardized history forms if possible.
* The decision to utilize a specialized technique, such as hypnosis,
should be informed by the therapist's wisdom and competence, not by
the patient's wishes.
6. It is wise to have an explanatory interview in which the phenomenon
of hypnosis or other specialized intervention is thoroughly explored.
In this discussion, be sure to include the salient aspects of the
intervention. And, as with every professional contact, document these
discussions thoroughly in your case notes; better still -- audiotape
or videotape this part of the work.
* Use printed handouts, given out early in treatment, which explain
the technique to be used, when possible.
* Address the patient's preconceptions, questions, and fears about
the technique to be used.
* Include information about the potential usefulness of material
which emerges -- that it can be very helpful to the therapy process.
Also some statement about its limitations -- that experiences in
hypnosis are not necessarily historically accurate for everyone.
* Inform patients about the risks of using abreactive techniques or
interventions where material may surface which may be distressing.
* Discuss the intended agenda of the exploratory session about to
take place, at least in a general way.
7. When conducting an exploratory session it is wise to audiotape or
videotape. This may provide a good documentation against claims of
implanting memories in patients. It is also important to document each
session in your case notes.
8. Use a consent form for a specialized technique, carefully drawn up,
which includes the essence of the topics discussed. Consult with an
attorney or senior psychologist familiar with these matters, in
preparing this form.
* Consent forms can be a double-edged sword, promising services or
results which, in reality, could not be guaranteed. Such language
could increase one's vulnerability to an ethics complaint or lawsuit.
Be cautious in wording all consent forms.
9. Always allow time for a thorough debriefing, following the
exploratory session. Continue to audiotape or videotape this for a
permanent record.
* Discuss the patient's thoughts and feelings about the sessions, as
appropriate.
* Explore the patient's beliefs about the historical accuracy of the
session.
* Process the emerging material in any way appropriate, consistent
with your theoretical base and the patient's needs.
* Inquire about any unpleasant or uncomfortable sensations or
experiences, which had not yet been reported by the patient.
* Provide reminders that hypnotic events do not always reflect
literal reality, but are very useful as metaphors or clues to explore
new directions in therapy.
10. In general, remember that APA Code of Ethics is an important
resource in providing standards of conduct. Furthermore, in many parts
of the country it is referenced by the state statutes, which carry the
force of law.
* Be familiar with The Ethical Principles of Psychologists and code
of conduct and focus especially on those standards which have a
bearing on these important issues.
* Take occasional workshops and upgrade your skills continuously in
these clinical and ethical matters.
Thomas F. Nagy served on and chaired the Ethics Code Revision Task
Force for three years, and served on the Revision Comments
SubCommittee for three more years. He is affiliated with the Stanford
University School of Medicine, is in independent practice, and
provides consultation in matters of ethics and professional conduct.
**********************************************************************
CLINICAL GUIDELINES IN USING HYPNOSIS IN
UNCOVERING MEMORIES OF SEXUAL ABUSE:
A Master Class Commentary
Peter B. Bloom, M.D.
Institute of Pennsylvania Hospital
University of Pennsylvania School of Medicine
Reprinted from the July, 1994 International Journal of Clinical and
Experimental Hypnosis. Copyrighted by the Society for Clinical and
Experimental Hypnosis, July, 1994. Vol XLII, No 3, July 1994 173-178.
CASE BACKGROUND
"Joan" wanted to recover these apparently forgotten memories in the
belief she could better control brief dissociative episodes occurring
during her normal and loving sexual relations with her husband. She
had previously spent years in intense psychoanalytic psychotherapy and
yet had a persistent frightening sense of an inner emptiness that was
interfering with her life. She felt such uncovering of past memories
might free her to express appropriate anger and assertiveness in her
professional work. She initially stated that she wanted to keep
whatever was uncovered in the office as part of her therapy, unless
she became convinced that true abuse had occurred. If so, she wanted
him to pay and stated she would never talk to him again.
INTRODUCTION
Every clinician using hypnosis is asked on occasion to facilitate
recall of past memories of trauma including sexual abuse. The response
to these requests by therapist and patient may profoundly shape the
recalled memory itself and how it is subsequently used.
DISCUSSION
I will present 13 clinical guidelines[Guidelines 2,3,4,5,6 and 7 are
from Yapko, M. (1993, September/October).] that I believe are useful
in deciding how to meet these requests, guidelines that first remind
us to do no harm, and second may help us to safely enhance the
personal growth of our patients/clients.
Guideline 1: Primum non nocere.
Clinicians sometimes walk a mine field when they work with repressed
memory patients. The basic tenet of all medical or psychological
therapy is "first, do no harm." Further discussion, notwithstanding,
this guideline is the most important.
Guideline 2: "No therapist should ever, either directly or indirectly,
suggest abuse outside of a specific therapeutic context -- certainly
not to a client who is on the phone making a first appointment!"
(Yapko, 1993, p. 36).
This unfortunate practice of jumping to conclusions before we have
gathered any corroborating evidence could be reduced if we all began
our intakes in an orderly fashion with a full history and mental
status exam.
Guideline 3: "A therapist must not jump quickly to the conclusion that
abuse occurred simply because it is plausible" (Yapko, 1993, p. 36).
It is always hard to discern what is true. However, by either
agreeing or disagreeing with our patients' perceptions, our resulting
certainty removes further opportunity for the patient to grapple with
what may have really happened and what meaning it has in his or her
life.
Guideline 4: "A therapist should never simply assume that a client who
cannot remember much from childhood is repressing traumatic memories
or is in denial" (Yapko, 1993, p. 36).
We have all wondered why some patients do not remember and it is
easy to assume they are repressing something. There is no evidence
that all lack of memory for the past indicates abuse. Some people just
cannot remember.
Guideline 5: Remember "a client is more vulnerable to suggestion and
the untoward influence of leading questions when therapy begins to
delve into painful life situations from the past, particularly from
childhood" (Yapko, 1993, p. 36).
Postulated abuse is a simple explanation for complex complaints.
Maintaining an open mind as emotional intensity increases during
meaningful psychotherapy is much harder. Impulsively accepting that
current problems might be completely understood by past abuses stops
the process of personal growth in its tracks. Projection of blame and
responsibility on to others unfortunately occurs. I know of no
instance where revenge and blame promotes personal wisdom. I do know
of wasted years of therapy in pursuit of revenge -- either personal or
legal.
Guideline 6: "Therapists...should be cautions about suggesting that
clients cut off communication with their families" (Yapko, 1993,
p. 37).
This needless tragedy occurs not only in those patients suffering
from false memories, but in those with documented true memories of
abuse.
Guideline 7: "Therapists should reconsider the 'no pain, no gain'
philosophy of treatment" (Yapko, 1993, p. 37).
Yapko (1993) questions the "common belief that every gory detail of
abuse must be remembered and worked through before the client can
begin to get better" (p.37). The "operation was a success, but the
patient died" is black humor applicable to the as yet unproven notion
that the more knowledge of a trauma the more healing can occur.
Guideline 8: The context of therapy is as important as the content.
For example, demonstrations of personal therapy have no place in
adult educational workshops (Bloom, 1993). In addition, while many
clinicians sometimes argue successfully that anything that can be done
with hypnosis can be done without hypnosis, the context of hypnosis
often affects the resultant psychotherapy because of the special
expectations it creates.
Guideline 9: Tolerate ambiguity.
The most difficult task we clinicians face is the ability to
maintain our objectivity in the face of intense emotional outpourings
during psychotherapy with or without hypnosis. We are trained to
accept our patients' perception of events and believe that such
support can be soothing and healing. However, there is nothing in our
training that gives us confidence in accepting as true the stories our
patients tell us. We always need corroborating evidence.
Sincerity, conviction, and intense emotional arousal when telling a
story are not prima facie evidence of truth, nor are such attitudes
any more true when elicited under sodium amytal or medical hypnosis.
Guideline 10: Respect the current science of memory.
Many scientists including Hilgard, Orne, Bowers, Crawford,
Pettinati, and Perry advise clinicians with the results of their
research on hypnosis and on memory.
If we keep in mind throughout all our work that memory is not
contained in accurate repressed packets of truth, then we can approach
the uncovering of such "truth" with the proper caution.
Guideline 11: Maintain responsibility for making the diagnosis and
choosing the treatment.
As licensed professionals, it is our first task to take a full
history, to perform a mental status examination, and to formulate our
own diagnosis and treatment plan. It is important to avoid solely
responding to a patient who said, "I am disturbed by unrecovered
memories of early sexual abuse and I want hypnosis to help me recover
these memories so I can get on with my life." To accept such a patient
on those terms is to abrogate one's responsibility as a clinician. Any
chance for directing subsequent therapy may be lost from the outset.
Guideline 12: Pursue alternative diagnoses to account for the
symptoms.
While the patient "Joan" described above needs to be met where she
is and in a worldview that is compatible with hers, treatment does not
have to follow her initial suggestions in order to be both safe and
successful.
Guideline 13: Historical and narrative truth: Understand the
difference.
Donald Spence (1982) has suggested how to safely use what patients
say in the service of therapy. He calls such truths "narrative" truth.
Such narrative truths can become organizing principles for self-
understanding that can lead to growth. Whether narrative truth
consists of metaphors or myths, corroborating evidence is unnecessary
as long as the information is not used outside the office to accuse or
harm other people.
Should such hypnosis, however, provide clues to events long
forgotten, and search of medical records from the past supports severe
abuse and trauma, then it is on this objective evidence, and not the
hypnotic refreshed memories, that further action can ensue..
Clinicians might wish to say something like this to their patients:
There is no guarantee that what you experience in hypnosis actually
happened. Sometimes hypnotic recollections have no more to do with
historical events than do dreams. Automatically accepting the events
of a hypnotic reverie as directly representing historical fact would
be as unfortunate as accepting the events of a dream as literal
representations of past ever. Much as with a dream, what you
experience in hypnosis can undoubtedly be exceedingly important, but
that does not mean that it is accurate.
COMMENT: THE ROLE OF INSIGHT: MAINTAINING CHANGE VERSUS CREATING
CHANGE
I want to suggest an idea (Bloom, 1994) that I believe is at the
core of the clinical problem in uncovering repressed memories. One of
the basic tenets in psychotherapy is that a patient's insight is a
prerequisite for change and growth. I do not believe this is true. I
do believe that insight is relatively unimportant in creating and
promoting change but is far more important in maintaining change once
such change has occurred.
I believe the crux of the dilemma in these special patients who get
caught in the morass of repressed memory therapy is the unquestioned
belief that intellectual and emotional insight is a first requisite
for change. There are simply other ways to promote therapeutic change
(Bloom, 1990).
SUMMARY
These clinical guidelines are suggested to enhance the safe practice
of the psychotherapy of increasing numbers of patients seeking help in
uncovering memories of sexual abuse. However, it is ultimately the
clinician's own judgment with each patient/client that determines the
best path to follow. When therapeutic impasse occurs, consideration of
these guidelines will, it is hoped, be beneficial to both therapist
and patient.
REFERENCES
Bloom, P.B. (1990). The creative process in hypnotherapy. In
M.L. Fass & D. Brown (Eds.), Creative mastery in hypnosis and
hypnoanalysis: A Festschrift for Erika Fromm. Hillsdale, NJ: Lawrence
Erlbaum.
Bloom, P.B. (1993). Training issues in hypnosis. In J. W. Rhue,
S.J. Lynn, & I. Kirsch (Eds.), Handbook of clinical hypnosis
(pp. 673-690). Washington, DC: American Psychological Association.
Bloom, P.B. (1994). A discussion of M.D. Yapko, Suggestibility and
repressed memories of abuse: A survey of psychotherapists' beliefs.
American Journal of Clinical Hypnosis, 36, 172-174.
Spence, D.P. (1982). Narrative truth and historical truth: Meaning
and interpretation in psychoanalysis. New York: Norton.
Yapko, M. (1993, September/October). The seductions of memory: The
false memory debate. Family Therapy Networker, 17, 30-37.
______________________________SIDEBAR_______________________________
/ \
| NOTICE |
| Newletter Rate Increase Effective November 1, 1994 |
| USA 1 year $30. Student $10; Canada 1 year $35; (in US dollars); |
| Foreign 1 year $40; Foreign student $20. |
\____________________________________________________________________/
**********************************************************************
IS IT WORTH THE RISK?
J. Alexander Bodkin, M.D.
Department of Psychiatry, Harvard Medical School
Staff Psychiatrist, McLean Hospital, Belmont, MA
A recent piece in the New York Times raises some very important
issues ("When It All Comes Back" by Dr. Hopperwasser, June 8, 1994).
The writer argued that therapist have been intimidated by recent media
and legal attention to the "false memory syndrome," which she
dismissed as supported by little research and no professional
consensus. She is concerned that this may discourage psychotherapists
from helping patients recall early trauma, and thus harm their
treatment.
It must be pointed out that each of countless schools of
insight-oriented psychotherapy propounds its own theory to account for
psychopathology. Freud invoked the Oedipus Complex, Jung the
Archetypes and the Animus and the Anima, John Bradshaw the Inner
Child; the list goes on and on. A recent school, growing in part out
of the work of Jeffrey Masson, asserts that much psychopathology is
attributable to repressed memories of violent abuse, especially of a
sexual character, in child- hood. Adherents of this school pursue the
reconstruction of supposedly "repressed" or "dissociated" memories of
this abuse, which is claimed to be a necessary step toward mental
health. This is often referred to as recovered memory therapy.
It has been shown by empirical research that the effectiveness of
insight-oriented psychotherapies is independent of the theories upon
which they are based. It is the personal attributes of the therapist
rather than the veracity of factual assertions made in the context of
psychotherapy that are important to the success of treatment. That
neither the underlying theory nor the veracity of assertions made in
psychotherapy bear on its effectiveness places an enormous personal
responsibility on the psychotherapist. The therapist would be well-ad-
vised to heed the Hippocratic injunction, "first do no harm," to
patients or to anyone else, in the choice of therapeutic techniques.
Third parties are almost certain to be harmed by the accusations of
improper behavior brought against them which are inherent in
"recovered memory" psychotherapy. Some convictions in courts of law
have been based on such allegations, unsupported or even contradicted
by other evidence, and numerous civil suits have been successfully
pursued with no evidence other than recovered memories.
On June 30th of this year, a prominent New England lawyer, J. Doe,
(named changed) was convicted of sexually molesting the daughter of
his former girl friend thirteen and eleven years ago, when she was six
and eight years old. The plaintiff had had no memory of these alleged
events until her psychotherapist induced their recall after many
months of counseling.
Mr. Doe had an extended relationship with a woman who had a young
daughter. He developed a paternal relationship with the daughter which
persisted for a number of years after he had broken up with her
mother; eventually the two drifted apart. Subsequently the girl
developed a severe mental illness which was diagnosed as bipolar
disorder; treatment with appropriate medications gave good results,
and she entered psychotherapy to help her adjust to the social stigma
of having a major mental illness. The idea that Doe might have
molested her came from her mother, who asked her own psychotherapist
to communicate her suspicion to her daughter's therapist. At first the
patient protested that no such thing had happened and that her mother
had been pushing that idea for some time. However, the therapist
searched tenaciously for hints of early abuse, and after 6 months of
weekly sessions the patient began to provide the requisite
fragmentary, confused "memories" (called "flashbacks") and vivid
nightmares. This was in the context of the onset of a depressive
episode, which eventuated in two hospitalizations for bipolar
depression. During the second hospitalization she had a public
"flashback," and combined with the input of her psychotherapist, this
led to the conviction that sexual abuse must have occurred 11 years
before. The psychotherapist duly reported the alleged incidents to the
authorities, and Doe was arrested and tried. At his trial no evidence
other than recovered memories was presented in support of his having
molested the plaintiff, and the details of this were inconsistent with
substantiated facts. The jury disregarded much contrary evidence as
insignificant in the face of recovered memory, and Doe was convicted
on all counts of sexual abuse. As of this writing he awaits
sentencing, but the judge has intimated that a minimum of 40 years can
be expected.
Meanwhile the plaintiff's mother has consulted several lawyers about
pursuing a civil suit.
It is certainly correct, as the writer of the article noted, that
for many patients, recovered memory therapy is of tremendous value.
But as she admited, it is impossible to ascertain whether memories
recovered in therapy accurately portray past events. The case of Mr.
Doe vividly illustrates that recovered memory therapy has unique and
potentially devastating consequences for third parties that other
(equally efficacious) psychological treatments lack. Thus it must be
questioned whether the risk of harm inherent in recovered memory
therapy is ever warranted.
______________________________SIDEBAR_______________________________
/ \
| ATTN. ALL MEMBERS!! |
| To speed the arrival of newsletters, |
| please ask your postmaster for your |
| ZIP+4 CODE. |
| Send it ASAP along with your |
| name and address clearly marked |
| on a postcard to FMSF, Attn: Nick. |
| We must hear from everyone for this effort to work! |
\____________________________________________________________________/
**********************************************************************
FROM OUR READERS
MAKE A DIFFERENCE
This is a new column that will let you know what people are doing to
challenge the FMS madness. Remember three years ago FMSF didn't
exist. A group of 50 or so people found each other and today we are
over 13,000. Together we have made a difference. How did this happen?
Each month we will report on activities of members.
* In Ohio families held a garage sale to raise money for FMSF.
* In Wisconsin families have been writing letters to the organizers
of the Child Sexual Abuse and Incest conference which is held at the
University of Wisconsin. Recall that last year, this conference closed
all the book vendors rather than allow FMSF material. Because state
and federal money is used for this conference, parents felt that the
presentations on repressed memory should be balanced. Families will
attend this conference.
* In Toronto, families attend all the conferences that are related
to FMS.
* In Washington, family and friends of Paul Ingram have started a
letter writing campaign to have the governor review Paul's
case. (Larry Wright wrote about Paul in Remembering Satan.)
* In many states such as Illinois, Texas and Minnesota, people have
organized their own groups to address issues that they believe are
important.
* In California families have made an effort to see that bookstores
and libraries carry Confabulations, True Stories of False Memories,
and the many new books that have just been published.
* In Texas, Florida, Massachusetts, New York, Ohio, Michigan,
Arizona, Pennsylvania, Virginia and other states, families have
organized seminars in which they have invited lawyers, therapists, law
enforcement, politicians, educators and other to speak to them about
solving the FMS problem. For details, contact the organizers of
meetings listed in the Meeting section of this newsletter.
* In Illinois, retractors have joined a state task force to improve
mental health.
* In Seattle, families have continued their picketing efforts.
You can make a difference. Please send me any ideas you have had
that were or might be successful so that we can tell others. Write to
Katie Spanuello, c/o FMSF.
p.s. The FMSF office requests that people continue to send relevant
clippings because this is the only way the Foundation knows about what
is happening across the country. Please include the publication, the
date and the page number.
______________________________
An Open Letter to FMSF Parents
I received a copy of the September newsletter yesterday. In the
letters section on pages 14-15 there is a letter from a Dad who is
angry at his daughter for accusing him of abusing her. He seems unsure
whether he is justified in feeling anger towards her, instead of
feeling anger at her psychiatrist. I would like to comment on this
letter, and speak about retracting in general, from my point of view.
First of all I do sympathize with this gentleman's anger at his
daughter. I have been wondering why more parents of retractors and so
called survivors are not angry. It has to be horrible to face
accusations of this sort. I am a person who is in the process of
retracting her story. I have not yet reached any absolute conclusion
about the events in my life. It has only been in the last several
months that I have been willing to look hard at False Memory Syndrome
and how it may apply to me.
I did not set out intentionally to hurt anyone, including my
parents. I have had problems with mental illness since my early teens.
I was diagnosed with schizophrenia when I was twenty years old. I
spent about five years in the mental health system being treated like
a chronically mentally ill person. I was prescribed anti-psychotic
medication that eventually led to early signs of tardive dyskinesa.
This was a desperate fearful time in my life, and I began searching
for an alternative answer. I had a case manager who wanted to be a
therapist with me. She began probing, and slowly but surely, I began
coming up with vague memories of sexual abuse. As this progressed more
memories came, and my diagnosis was changed to Multiple Personality
Disorder. This was a relief to me because it meant that I could be
cured if I worked in therapy, whereas schizophrenia was more hopeless.
I continued to work with this therapist for four years. The memories
grew more complicated, gruesome, and detailed. My life also continued
to get worse at this time. I read all the right books, including The
Courage to Heal. I spent most of my time alternating between numb
denial of what I was doing and hysterical panic. At one point I was
hospitalized for three months in a Dissociative Disorders unit to
receive more intensive treatment. It was then that the subject of
ritual abuse came up. I resisted this idea as long as I could, but was
under a great deal of pressure to accept it. I am sad to say that
eventually I caved in and began to come up with ritual abuse memories,
as well as cult alters. This was not a conscious process on my part. I
didn't wake up one day and decide suddenly that I had been abused in a
cult. It was gradual and directly related to subtle and not so subtle
pressure from the staff in this unit and other patients. I was led to
believe that I would not be released if I remained "in denial" about
my abuse. I am not proud of it, but I capitulated, and gave them what
they wanted.
My therapist at home was untrained in dynamic psychotherapy. She
viewed me as a fascinating and interesting client. In fact, I was her
only client. I was flattered by her attention, and this probably led
me to attempt to please her. Pleasing her involved coming up with
still more memories of abuse, and working hard in therapy and never
doubting her abilities. At some point she grew tired of my dependency,
and abruptly terminated therapy. I was devastated at the time, but it
was actually a blessing in disguise.
I have been in therapy for two years with a woman who makes no
effort to decide what my issues are or lead me in any particular
direction. A few months ago I read the book True Stories of False
Memories, and was very moved by the stories in it. I felt a stirring
of recognition. I opened up my mind at that point and came to realize
that not only had I been duped, but that I had actively participated
in it.
Right now my heart goes out to all innocent persons who have been
falsely accused of abuse of any type. I understand why they would be
angry, and I think they have a right to their anger. Therapists and
treatment centers are responsible for part of this epidemic of
"repressed memories," but ultimately each individual must make their
own choices. I take full responsibility for the accusations I have
made. I have had to struggle daily with my sense of guilt and remorse.
It is not an easy process-retracting things you were so sure of at
some point. I fervently wish all this had never happened, but since it
did, I am now seeking to repair the damage. I never accused my parents
directly of abusing me, but they were aware of my MPD diagnosis and my
hospitalization. I can't make it up to them without causing them pain
because if I tell them I made false accusations, then they will want
to know what those accusations were in the first place. It is a
dilemma.
I am truly sorry I allowed myself to be led so easily, and will not
allow it to happen again. I am sorry that sexual abuse exists, and I
am sorry that people are falsely accused of it. The FMS Foundation is
right. False accusations detract from the real needs of sexual abuse
victims. I hope that some of this damage can ultimately be repaired.
Amy P.
_________
RARE BIRD
As that "Rare Bird", an accused mother and a long-time
psychotherapist (Clinical Social Work) in private practice, I've spent
the last three years since being accused, trying to educate myself and
my colleagues about all the aspects of this archetypal phenomenon.
It's complex and the more I know and the deeper I go into the
research, often the less I understand. I do think the answers, based
on deeper understandings, are there for us to discover and/or create
-- and, we've a way to go before we arrive at coherent answers that
satisfactorily fit all the data that replicable, sound research can
provide.
In print, both for some obvious necessities and personal reasons, I
must remain anonymous. Professionally, I find I can talk with my
coleagues by referring to this phenomenon having happened in my own
"extended family." I've worked often behind the scenes trying to get
relevant information to those who most need it. Often, I've felt so
torn, juggling both hats. Knowing both sides intimately, my ongoing
challenge has been to keep integrating what often appears so
polarized.
I had a visceral, negative reaction to the newly and frequently
appearing use of the term RMT (Recovered Memory Therapy) in the July
FMSF Newsletter. I understand the natural desire on FMSF's part to
assign blame to one particular type of therapy by one certain type of
therapist. However, in truth, except perhaps for small, fringe
enclaves of folks, mostly poorly trained and/or credentialed, there is
no such submodality in the field as "Recovered Memory Therapy." With
few exceptions, all therapists work, at least occasionally to recover
memories. Your use of the term "RMT" implies that there is a
definitive "body" of therapy that stands part and can be
differentiated from other kinds of therapy. This is an incorrect
assumption and my fear is that continuing to use it will just further
anger and polarize therapists -- and we need their ears, their
understanding and their help -- speaking now as an appreciative FMSF
Member.
There are many threads that will need to be woven into whole cloth
understandings. And in that process, some dysfunctional, misguided,
self-serving threads need to be pulled. We therapists have all made
mistakes. Scientific validation never has and probably never will
precede clinical practice to anybody's satisfaction. But when we get
the research or begin to get the anecdotal accounts (such as FMSF has)
we need to rethink, adjust and change our methods so we can continue
to "do no harm." These issues affect us all and have implications for
all therapists. surely, Michael Yapko's recent research results
reported in his book, Suggestions of Abuse affirm this. Thus, I also
think coining the term RMT would relieve the rest of the "good"
therapists from responsibility to examine and change their thinking
and methods accordingly. The idea that we can point fingers and accuse
or blame as a way of solving these problems will not solve anything
but will intensify everything. This approach is enticing and scary.
The way out of this mess is by understanding, openness, education and
cooperation. Finding the uniting things among such diverse basic
belief systems, then building from there, with tolerance, dialogue and
good-will. As professionals, we are learning the hard way. As
parents, we have been cruelly caught in the web of this phenomenon. It
is important that we not give credence to a therapy that doesn't exist
and thus legitimize that small fringe I referred to earlier. "It" is a
mainstream problem. I hope FMSF keeps it that way since it is to this
organization's credit that it is just now being recognized as exactly
that.
I was at the April, '93 FMSF Conference. I was pained at the
prevailing "Anti-therapist" attitudes, although there were exceptions.
I was personally attacked on two different occasions by other parents
at lunch when I acknowledged that I, at times, used hypnosis and
guided imagery with my panic disordered clients with much success.
(And yes, I am well trained in both modalities). I understood the raw
anger and need to place blame because I initially felt the same way
about my daughter's therapist. However, it is time to moderate and
move beyond the easy route of "finding the bad guy/gal" to common
ground. Unfortunately, many of our families, including mine, may not
survive intact, this third witch-hunt of the century.
Repressed memory questions go to the heart of our cherished beliefs
as therapists. It never got resolved the first time around (Freud and
colleagues) -- and it just went underground. Now, partly due to the
information highway and global village nature of the historical time
we find ourselves in, we've got another crack at it. I pray we get it
right this time so it need never happen again. We all need to remember
that if "we don't understand (and remember) the past, we are doomed to
repeat it" is true at the personal level all the way up to the
international level. How we do that -- now, that's the rub.
I suggest that you rethink the term RMT as a well-intentioned error.
Instead, perhaps you could find something descriptive that cuts across
all the modalities of therapy and is also inclusive of other
possibilities such as Media induced memories," "Twelve step writing
group" memories, peer suggestion, etc. I'll start off the brain
storming process with my contribution -- S/EMR -- acronym for
Suggested/Enhanced Memory Recovery.
I made grape jelly today. I noticed that the pot, as it was cooking,
contained murky "goo" -- especially just after being stirred. But,
after straining, patience and cooling time, this particular batch has
great clarity. I wish the same for all of us, parents and therapists
alike.
A Professional and A Mom
_____
ANGRY
"Although I was never estranged from my daughter, it was no less
traumatic. I am a teacher and she threatened to go to my school board
unless I went for "help" as I was "sick" Of course I was "in denial"
and only professional help would "save" me. The pressure was
overwhelming. I contacted a psychologist who is a supposed expert in
dealing with sexual abuse and that is when the nightmare became even
worse.
I never had any memory of abusing my daughter but after 20 minutes
with the psychologist, he stated I definitely had abused her. When I
said I had no memories, he stated I was "in denial." I had to join a
sexual offenders group where he claimed I would be helped. He said he
was the only one who could help me and my not having any memories was
Denial. This was the most horrible experience of my life. After every
group session I felt worse. I started thinking and even planning my
suicide. I told him this but he did not seem concerned. His concern
was that I should become closer to the Group and they would help me.
I am a veteran and was in the army shortly after the Korean War. In
the service at this time they were very concerned about the P.O.W's
that had been "brainwashed." As a consequence, we received many hours
of instruction on how this was done. Brainwashing is exactly what went
on in this group. All of the elements were there -- extreme pressure
to be part of the group, confession of our transgressions, even having
one member of the group accuse me of being insincere at one meeting
only to apologize and ask my forgiveness at the next meeting. Constant
encouragement to become friendly with the group as they would "help"
me. Only the group could help me, but they could only help me if I
would "remember the terrible things I did." Then things would be
better. It is difficult to describe to you the tremendous pressure. I
can see it now that I am out of this group but it was difficult to see
at the time.
Knowing if I continued with this, I would not survive as my feelings
about suicide increased. I went to another therapist. It saved my life
as it got me out of the group. Shortly after this I received informa-
tion from FMSF, read articles and for the first time in three years,
my experience made some sense.
My daughter changed psychiatrists. Two months ago she called me and
told me it was all a mistake. The memories had only been vague and
those things never happened. It was a wonderful day. We have never
spoken of this again. I think this will probably be characteristic of
retractors. It was a horrible experience and I think she wants to put
it behind her and that is fine.
I thought I would feel complete relief and put it behind me if my
daughter retracted. But that is not the case. What I feel is rage. How
can the be allowed to happen and those people who are responsible not
be punished. I can understand why people want to put this behind them,
but to this point no one has said to me, "I'm sorry; I don't know how
I could ever believe such terrible things about you." -- no one. This
is something you go through completely alone and it is difficult. I
don't know how many people my daughter told I abused her. I have no
idea how many people are out there thinking I am some kind of a
monster.
Where do I go to get my reputation back? Hopefully the rage will
subside over time and I will be able to get on with my life. This is
probably the most difficult thing anyone will ever have to go through
and each will go through it along. You don't do much talking about
it.
A Dad whose daughter has returned and retracted.
_____________________________________
My main concern now is with the emotional state of my daughter when
she realizes she has been abused by writers of self-help books and
fad-therapy. They make the money and she suffers the pain."
A Mom
____________________
Release from Tyranny
I am free -- free at last from the pain of trying to change the
unchangeable and understand that which is beyond all understanding.
And it is my daughter who has finally set me free.
"I have come to understand the tyranny was self-imposed. I believed
two things that are not true.
First, I believed a mother must love her child no matter what that
child did or how that child behaved. I believed a "good" mother must
always keep the door open and struggle to maintain an ongoing
relationship, no matter how painful that relationship might be. I
believed motherhood meant 'always being there -- always being ready to
forgive and forget" -- no matter what.
And secondly, I believed the mothering of a chronologically adult
child meant the abdication of expressed criticism or unasked for
guidance. An adult child, I believed, should be free to create her own
person, to make her own mistakes, and be free of accountability to her
parents.
It is my lack of insight and misguided interpretation of motherhood
that persuaded me I must endure treatment that included cruelty and
disrespect, that permitted her to criticize, yell, talk about me with
hatred, lie, ignore me, and deliberately hurt me and others. But I
have come to understand my inadequate response to this kind of
behavior, my inability to tell her I found her behavior and her
treatment of me unacceptable, my fantasy that maturity would change
her attitude, is as much responsible for her continued mistreatment of
me, as is her emotional instability, which I am finally able to
acknowledge.
She has slammed the door in my face. She has cut off all
communication. it is as though she has turned on a bright light. she
has forced me to look at her with blinding clarity and see her as
someone I don't want to be with. I can even acknowledge that I don't
love the person she has become -- and not feel guilty about it. I can
love the memory of a dear little girl I cherished, of a loving little
person I cradled in my arms, of the beautiful and loving your woman I
watched blossom into a teenager. And I can admit the fact that the
person she became after that was someone who turned inward and grew
like a sick and crooked tree into a bitter and unhappy woman.
She has slammed the door and I will not try to open it. She cannot
take away the memory of the child I loved, and she can no longer force
me to deal with the woman I do not like.
The tyranny is over and I am free to move forward with my life
without the pain of constant attacks and the wastefulness of
unproductive guilt. I accept the fact that I cannot love the unlovable
and am not required to do so; nor can I change the person I created.
A Mother
______________________________SIDEBAR_______________________________
/ \
| A particularly distinctive and disturbing feature of FMS is the |
| strength and vehemence with which the accusations are made, even |
| in the face of contradictory evidence. This is not unlike the |
|increased subjective conviction that accompanies hypnotically |
| produced pseudomemories." |
| Brian J. Fellows |
| Editorial Comment |
| Contemporary Hypnosis (1994) Vol 11, No.2, pp.ii-iii. |
\____________________________________________________________________/
**********************************************************************
BOOK REVIEW
BEDLAM: Greed, Profiteering and Fraud
in a Mental Health System Gone Crazy.
By Joe Sharkey, St. Martin's Press. $22.95
REVIEW by John Hochman, M.D.
This is not an easy book for a psychiatrist to review. BEDLAM is a
fast-paced journalistic account describing how private psychiatric
hospitals made money, and lots of it, very fast, during the 1980's.
The author describes how a handful of corporate hospital chains
built minor empires of psychiatric facilities, with strategic
concentrations in sunbelt locations. Why the sunbelt? Go where the
insurance is! Here were located not only healthy numbers of employees
of major corporations with rich insurance benefits, but military
families where dependents and retirees had access to the lush
psychiatric benefits of the Defense Department's CHAMPUS program.
Sharkey reels off accounts of how psychiatric hospitals filled their
beds using illegal detentions of minors (more profitable than adult
patients), tapped into state crime victim funds for kids who were
alleged preschool abuse victims, headed north to recruit Canadian
alcoholics who all had coverage with Provincial health plans, and
more.
The author attempts to give us a feeling for the people who made all
this possible. We have the high flying captains of psychiatric
industry (one who teamed up with a patient who was a marketing whiz
from Kentucky Fried Chicken), PR specialists, and nurses who know the
system is rotten but are afraid to protest. There is one chilling
story of a psychiatrist who changed his stripes and began to denounce
the very hospitals that made him wealthy; he was denounced by his
colleagues and pronounced to be mentally ill. (Maybe he was; maybe the
system drove him crazy.) Then there are the faceless "bounty hunters,"
1-800 "hot line" operators and community relations experts who all did
their part to bring patients to the hospital door, insurance cards in
hand, serving to convince them that a brief (maybe) stay is what they
need.
Readers of this newsletter looking for specifics about mind-bending
therapies on special hospital units for "dissociative disorders,"
"eating disorders," and victims of "Satanism" will be disappointed.
The book concentrates on hospitals and doesn't look into abuses that
have taken place in the cottage industry part of the mental health
industry: the offices of individual therapists.
One part of the book that newsletter readers might find enlightening
was an account of how billion dollar Board Room Moguls made it all
happen. Sharkey, who used to work with the Wall Street Journal,
offered summaries of how these high flying psychiatric corporation
stocks, once the darlings of Wall Street, took a big fall when they
had to face the wrath of the Texas Attorney General, the Department of
Justice, and insurance fraud lawsuits from the major health
carriers. But now the party is clearly over, and insurance companies
have changed their strategies from writing big checks to turning
psychiatric benefit control over to penny pinching managed care
companies. Nonetheless, the author claims that the hospitals are down
but not out as they continue to try to find new gimmicks to fill their
empty beds. It was only a few months ago that I received a flyer about
an L.A. area hospital that heralded the opening of a specialized
inpatient program for women who love too much.
The author is less successful when he attempts to ridicule the
entire practice of psychiatry per se. He is particularly off base when
he ridicules the use of medication, finds one of the few psychiatrists
in the US that agrees with him , and quotes him continually. Actually,
if there were no psychiatric medications, hospitals would be filled
with very sick patients who needed to be there for long periods of
time, and there wouldn't have been the temptation to fill up beds with
patients who were relatively healthy.
John Hochman, M.D. is a member of the FMSF Scientific Advisory
board. He is in private practice in Los Angeles.
______________________________SIDEBAR_______________________________
/ \
| More and more troubled people are "remembering" sexual violations, |
| often under the supportive, encouraging, even coercive influence |
| of therapists who are certain that the evocation and abreaction of |
| such memories is the sine qua not of therapeutic success. The |
| topic has become a staple of television talk shows, which |
| disseminate the word worldwide. Such unitary etiological concepts |
| are, of course, nothing new; diabolical influences, "hereditary |
| degeneration," exposure to the "primal scene" -- each has had its |
| day, has enjoyed its vogue, and has either passed into the dustbin |
| of history or assumed its appropriate place in the etiological |
| spectrum. |
| Aaron H. Esman, M.D. |
| Editorial, August, 1994 |
| American Journal of Psychiatry |
\____________________________________________________________________/
**********************************************************************
BOOK REVIEW
Reviewer: J. Alexander Bodkin MD
VICTIMS OF MEMORY: INCEST ACCUSATIONS AND SHATERED LIVES
by Mark Pendergrast.
576 pages, soft cover, $24.95
ISBN -0-942679-16-4
Upper Access Books
P.O. Box 457
Hinesburg VT 05461
1-800-356-9315
These are hopeful times indeed for those who have been harmed by
"Recovered Memory Therapy," as well as for those who have merely been
disgusted by the spectacle of it. Lucid scholars and writers have
begun to expose the intellectual poverty of its "scientific"
foundations, as well as the harsh injustice and the frightening
injuries resulting from this very disturbing social movement.
Dr. Richard Gardner of Columbia University has correctly grouped this
phenomenon with the Salem Witch Trials and the anticommunist frenzy
led by Joseph McCarthy, as a class of periodic hysterias to which our
society is tragically subject.
An important addition to the small but rapidly growing body of
critical literature is the new book by Mark Pendergrast, VICTIMS OF
MEMORY: INCEST ACCUSATIONS AND SHATTERED LIVES. This is both a
comprehensive piece of elegant, readable scholarship and the
realization of an intense personal quest. Mr. Pendergrast, an author
of considerable accomplishment, is himself one of the injured. One of
his grown daughters, despite having no prior belief she had been
maltreated by her father, entered a psychotherapy in which she was
persuaded that he had done something unspeakable to her long ago, and
was counseled that she must exclude him from her life in order to
"heal." She persuaded her sister of their father's misdeeds, whereupon
both of them broke off all contact with him, even changing their
surnames. Their alleged injuries were never specified to him. Wounded
and bewildered, Pendergrast set about informing himself about this
baffling phenomenon so that he could understand what had happened and
perhaps repair the damage.
The result is a superb social and intellectual history of the
Recovered Memory Movement. We are given a vivid exposition of the
bizarre claims of its theoreticians, and we get a close look at the
main written works of the Movement. It is clear that the core thinkers
and writers believe deeply in what they are doing, but they are
completely lacking in critical faculties. Thus, the oft quoted remark
of Ellen Bass and Laura Davis in The Courage to Heal, "If you believe
you were sexually abused, you probably were." The thinking of these
authors has an almost religious fervor. And this is no benign faith:
because of the central tenet that a relative has inflicted damage upon
the believer, it has destroyed families and brought innocent people to
financial and emotional ruin.
The presentation of the Recovered Memory Movement is followed by an
account of what is actually known about human memory. This is a very
comprehensive and scholarly analysis, including reviews of relevant
work by Frederic Bartlett, Uric Neisser, Elizabeth Loftus and others.
We are shown how inconsistent the current scientific understanding is
with the claims of Recovered Memory theorists.
The path by which patients are persuaded of their victimhood is laid
out in a fascinating chapter called "How to Believe the Unbelievable."
For example, hypnosis, which has long been used clinically to modify
beliefs and behaviors by suggestion, is now widely employed to
facilitate recall of abuse by recovered memory therapists. This is in
spite of the fact that hypnotically induced recall is so contaminated
by suggestion that it has been excluded from courts of law as a source
of accurate testimony. In this chapter it is also revealed that
diverse psychiatric symptoms are now being confidently offered by
recovered memory therapist as evidence of past abuse, including
phobias and aversions of all kinds, eating disorders, psychosomatic
symptoms and parasomnias (sleep abnormalities). Perhaps the most
dramatic of these are panic attacks, frightening physiologic phenomena
with a well characterized neurobiologic basis, which are being
interpreted by therapists as "flashbacks" and "body memories," and
presented to patients as strong evidence of repressed memories of
abuse trying to resurface. This is despite the fact that panic
attacks are heritable, respond to medication, can be induced
experimentally in the laboratory by exposure to certain chemicals, and
occur spontaneously in various mood and anxiety disorders.
The author addresses in considerable detail some of the more bizarre
manifestations of the Recovered Memory Movement, exploring the
Multiple Personality Disorder diagnosis, with its highly questionable
empirical basis and curious history, as well as the recent enthusiasm
for discovering fantastic cults of satanic ritual abuse.
The core of the book (chapters 7-10) consists of extended interviews
with therapists, survivors, accused and retractors. Pendergrast does a
good job of letting these people speak for themselves, and he refrains
from intruding his personal views. Again and again it is revealed, in
the words of the True Believers themselves, that the "memories"
produced in therapy are explicitly instilled by the treatment, and are
in no way "recovered." Interestingly, included in the chapter of
interviews with those who have recovered memories of abuse, is an
interview with a woman who had been sexually abused and never
forgotten it. This victim of never-forgotten abuse was fully aware of
the horror to which she was subjected, yet looked upon her experiences
calmly, and had tried to sustain a relationship with the
perpetrator. This is in stark contrast to those who claim to have
recovered memories of forgotten abuse, whose attitudes towards the
alleged perpetrators can best be characterized as vindictive and
vengeful. The interviews with "retractors" make clear the pathological
effects of this treatment on patients, many of these former
"survivors" admitting that preoccupation with recovering memories of
abuse and the plotting of revenge had for years displaced everything
else from their lives.
In chapter 11, ("And a Little Child Shall Lead Them (and Be Led)"),
we learn of the government's role in the proliferating allegations of
surreal child abuse at day-care centers. As a result of the well-in-
tentioned Mondale Act, legions of social service bureaucrats, charged
with uncovering child abuse and enjoying statutory protection from any
penalty for false accusation, have made use of the suggestibility of
your children to put a number of innocent people in prison.
Unfortubately, as the rest of the book makes clear, extreme
suggestibility is not confined to children, and it is this problematic
aspect of human nature that has allowed the Recovered Memory Movement
to flourish.
There is an exploration of the historical roots of the recovered
memory movement (chapters 12-14), which finds its predecessors in
several traditions of medical and religious quackery which specialized
in exploiting and maltreating women for centuries. I think the author
is overly hard on Freud here, but he does make clear the striking
similarity of Freud's early forays into psychotherapy to the current
day practices of recovered memory therapist. It is important, however,
to recall that Freud recanted early on, and is widely seen as an enemy
and traitor by acolytes of the Movement.
Pendergrast thoughtfully addresses the question of why the Recovered
Memory Movement should be occurring right now. He delineates its
relation to the Women's Movement, to the current enthusiasm for
identifying oneself as a victim, and to present day notions of
"Political Correctness." He also delves into the religious character
of the commitment of patients to the belief in their own recovered
abuse, and the cult-like role this plays in many lives.
Among the most alarming ideas in this book is a calculation in the
final chapter of the numerical scope of the problem. Using
conservative, empirically based figures, the author is able to
estimate that approximately 2% of the US population has so far
undergone recovered memory therapy. If only a small fraction of these
treatments eventuated in the destruction of families and the
shattering of lives, the number of injured would already far exceed a
million people.
The book begins and ends with a very personal and quite beautiful
message by the author to his daughters. We are privileged to peer into
the most private corners of his family's history and its tragic
destruction. this setting gives the book a unique emotional power and
meaning which is quite different from that of other works of social
and intellectual history. It reveals this massive and scholarly
textbook to be in part a father's passionate attempt to enable his
daughters to see what has happened to them. But beyond its personal
meaning, I hope that I have made clear that this is an intellectual
tour de force that will enlighten misguided children, falsely accused
parents, and mental health professionals who take the time to study it
with the care it deserves.
Alexander Bodkin, M.D. is a member of the Department of Psychiatry at
Harvard Medical School and on the staff at McLean Hospital.
**********************************************************************
LEGAL CORNER
Incest Authors Dropped from Suit
According to a report in the San Francisco Chronicle, a Sacramento
Superior Court judge dismissed that part of the lawsuit being brought
by Deborah David, her husband and her parents against The Courage to
Heal. The book was published by HarperCollins in 1988 and became a
best-seller with more than 800,000 copies sold. A similar lawsuit is
still pending in San Luis Obispo County.
Katy Butler
San Francisco Chronicle September 7, 1994 page A 13
**********************************************************************
FMSF COMMENT
Emotions concerning The Courage to Heal and the issues of protection
of free speech run high among people who have contacted the FMS
Foundation. We have received information about legal defense funds for
those on both sides in this issue. The FMS Foundation is not involved
in any of these suits. We are including information about both defense
funds. We are also printing two articles by lawyers on the legal
issues involved followed by a short FMSF Comment. While lengthy and
not the focus of the FMS Foundation, we believe that it is important
to understand the legal framework which bounds this discussion .
__________________________________________
FROM THE COURAGE TO HEAL DEFENSE COMMITTEE
Courage to Heal Defense Fund
c/o Dana Scruggs, Attorney at Law
340 Soquel Avenue, #205
Santa Cruz, CA 95062
"Suppose you woke up and found yourself summoned into court -- your
life thrown into turmoil, your livelihood threatened -- all because
you believed what women told you and you dared to write it down?...In
the past two years the press has trumpeted the notion that many
accusations of child sexual assault stem not from actual abuse but
from negligence or deliberate deceit by mental health workers -- and
by authors. Those who make such claims are entitled to express their
beliefs...Those among us who are those survivors, or who work with
them, don't need to be reminded that Ellen Bass and Laura Davis were
there when we needed them. Now they need us."
______________________________________________
FROM THE FALSE MEMORY FAMILY DEFENSE COMMITTEE
False Memory Family Legal Fund
c/o Cathy Carroll, Trustee
1052 Rivera Road
Stockton CA 95207
"Suppose you woke up and found yourself summoned into court, your
life thrown into turmoil, your livelihood threatened -- all because
your child entered therapy and is now accusing you of childhood sexual
abuse, "repressed" for decades only to be retrieved... A three
generational family has filed a lawsuit against several licensed
therapists, a clergyman, a medical HMO, and authors of "Courage to
Heal" alleging malpractice, fraud, misrepresentation, intentional
negligence, infliction of emotional distress, implanting notions of
childhood sexual abuse and satanic ritual abuse to name a few of the
causes cited...A fund has been set up to defer the legal costs of this
suit."
**********************************************************************
"ABUSE EXCUSE" EXTENDED INTO BIZARRE MEMORY SUIT
By Alan Dershowitz
The Buffalo News, July 2, 1994 page 3
Reprinted with permission of UFS, Inc.
There is a new and dangerous wrinkle on the proliferating use of the
"abuse excuse," and this one poses a direct challenge to the First
Amendment. Kimberly Mark is suing the author of a book she read,
claiming that the book falsely induced her to believe that she had
been molested. The book -- "The Courage to Heal Workbook" by Laura
Davis -- is a popular self-help workbook for alleged victims of sexual
abuse. It grows out of the controversial "recovered memory movement,"
which encourages people to remember long forgotten memories of having
been abused.
In one sense, this bizarre lawsuit is poetic justice, since these
kinds of self-help books promote the abuse excuse by turning everyone
-- particularly women -- into alleged "victims" of abuse, real or
imagined. After reading the book, Kimberly Mark says she came to
believe that she had 400 personalities and that she had suffered
satanic ritual abuse at the hands of her father and others. Now she
says that none of this really occurred and that reading the book
produced emotional damage in her by causing her to accuse innocent
people of abusing her. No mention is made of the emotional damage done
to those she falsely accused.
This is a perfect example of what the cycle of excuses inevitably
leads to: everyone blaming someone else for their crimes and problems.
Kimberly Mark first blames her father for abusing her. Then when she
realizes that her allegation is false, she immediately turns the
finger of blame to the author of a book she read. I wonder if she has
ever looked at herself in the mirror and acknowledged her own
responsibility.
"The Courage to Heal Workbook" does encourage people to remember
their repressed memories of abuse, to believe them even when in doubt,
and to confront the alleged abuser. It does not encourage reflective
self-doubt, and it clearly errs on the side of believing vague
memories of even the most bizarre ritual abuse. It is, in my view, a
dangerous and polemical book, which may do more harm than good,
especially to vulnerable readers who are searching for scapegoats on
whom to shift the blame for their personal failures.
It is not surprising, therefore, that these same vulnerable readers
would try to shift the blame away from themselves for falsely accusing
parents of abuse and onto the author of the book. But under our First
Amendment, writers cannot be held legally responsible for how their
readers act in response to their books. If the First Amendment were to
permit such legal responsibility to be imposed on authors, there would
have to be an immediate cessation of all sales of the writings of Karl
Marx, of the Bible and of murder mysteries in which the killer escapes
justice. Our first Amendment imposes responsibility on the readers for
their actions, not on the writers for their ideas.
Indeed, according to Kimberly Mark's lawyer, it was another
publication that made Ms. Mark doubt that she had ever been abused.
After reading "The Courage to Heal Workbook," Kimberly Mark read an
article in Time magazine which raised questions about the "recovered
memory movement." Without the protection of the First Amendment, the
author of "The Courage to Heal Workbook" could sue Time magazine for
defaming her book, her movement, and herself. But under our First
Amendment, no such suits are permitted.
Instead, the marketplace of ideas must remain open to controversy
about such hotly disputed issues as recovered memory. And the
marketplace is working effectively, as evidenced by Kimberly Mark's
rejection of one publication's ideas on he basis of ideas contained in
another publication.
Implicit within the First Amendment's theory of the marketplace of
ideas is the personal responsibility of the consumer of each idea for
how it is used. Thus, the author of "Final Exit" -- a best-seller
"self-help" book about suicide -- is not legally responsible if a
reader commits suicide. Nor was the author of a book about mushrooms
responsible when two of its readers were poisoned by following the
book's advice.
A recent case did hold a therapist liable for malpractice in
encouraging a patient to believe that she had been raped by her
father, and Ms. Mark's lawyer is seeking to use that verdict as
precedent for his lawsuit. But therapists have a one-on-one
relationship with their patients. They are supposed to fit the therapy
to the particular needs of their individual patients. Books are
written for all potential readers, and the authors cannot know who
will read them and how each of their readers may misuse the ideas
contained in their pages. Authors cannot be required to purge their
books of all ideas that are capable of being misused by the most
vulnerable readers.
It wasn't my fault because I read a book" must be rejected as an
excuse. Let the marketplace judge books, and let the buyer beware of
books like "The Courage to Heal Workbook," which encourages readers to
blame others for their problems."
**********************************************************************
COMMENTARY
Blaming a Book
by Professor Ralph Slovenko
Ralph Slovenko is Professor of Law and Psychiatry at Wayne State
University Law School
In Sacramento and San Luis Obispo counties in California, lawsuits
were filed against Laura Davis and Ellen Bass, authors of "The Courage
to Heal" [1] and a companion self-help workbook.[2] It was alleged
that the book falsely induced the plaintiffs to believe that they had
been sexually molested by their father. The lawsuits were the first
to take aim at the "merchandising of the recovered memory movement."
The complaint charged the defendants with negligent
misrepresentation, arguing that the workbook goes beyond free speech
by asking readers "to rely upon the writing" in following the book's
advice and exercises. In arguing that the authors had a duty to their
readers, the plaintiffs relied in part on a product-liability ruling
in which Hearst was held liable for putting its Good Housekeeping Seal
of Approval on a pair of shoes that caused injury.[3]
The book "Courage to Heal" is widely used by so-called "revival of
memory therapists" as a guide in retrieving memories of abuse and
allegedly as an aid in healing. The book says: "Even if you are unable
to remember any specific instances of childhood sexual abuse but you
have a feeling that something happened in your childhood, it probably
did....If you think you were abused and your life shows the symptoms,
then you were." [4] The book encourages retaliation.[5]
A number of patients have sued their therapists alleging wrongful
"revival of memory" of sexual abuse. In a number of these cases the
therapists were held liable. Also, in a much publicized case in
California, a father of a patient, Gary Ramona, successfully sued the
therapist. Not only the patient, but the patient's family, was
affected by the wrongful revival of memory.[6]
Then why not the authors or publishers of books that promote
"revival of memory"? Should they be held legally responsible? Do they
owe an enforceable duty of care to readers?
In a commentary, Professor Alan Dershowitz says "no," because "under
our First Amendment, writers cannot be held legally responsible for
how their readers act in response to their books." Otherwise, he says,
"there would have to be an immediate cessation of all sales on the
writing of Karl Marx, the Bible and murder mysteries in which the
killer escapes justice." And he adds, "Our First Amendment imposes
responsibility on the readers for their actions, not on the writers
for their ideas...[The] market place of ideas must remain open to
controversy." [7]
The attorney who represented authors Davis and Bass said, "These are
ideas, and you can't have liability for ideas."
How broad is the constitutional barrier to lawsuits against authors
or publishers? Is it the law of torts or the Constitution that
provides protection for authors and publishers? Clearly, writers of
theatre, film or restaurant reviews are not held responsible for what
they say. For one, they are expressing an opinion, and for another,
they have no duty under tort law to their readers. Conceivably, the
producer of a play or film or the owner of a restaurant may have a
cause of action for a malicious misstatement of fact.
In Herceg v. Hustler Magazine,[8] a 14-year-old boy died while
engaged in "autoerotic asphyxiation" described in the defendant's
magazine. The Fifth Circuit held that the magazine article did not
incite the adolescent to perform the act that led to his death, and,
therefore, it was entitled to First Amendment protection. In dicta,
the majority also said that imposition of civil liability for damages
violated the First Amendment. There was a vigorous dissent to that
proposition.
How far should the courts go to protect the First Amendment rights
of authors and publishers? The constitutional protection accorded to
freedom of speech and of the press does not countenance assault, defa-
mation, fraud, misrepresentation, and intentional infliction of mental
distress.[9] In these situations, tort goals overcome First Amendment
protection; all publication is not vested with constitutional protect-
ion. It is the failure to establish causation that has protected films
and videos in lawsuits that have claimed they resulted in homicide or
suicide.[10]
In Norwood v. Soldier of Fortune Magazine,[11] the plaintiff was
shot and wounded by two gunmen. He later learned that the gunmen were
paid to kill him by the defendant, who had read "gun for hire"
advertisements in a national magazine for mercenaries. In an action
against the magazine publisher, the plaintiff claimed that the
injuries he suffered were foreseeable by the magazine when it placed
the ad. A federal district court held there was not First Amendment
protection. The issue of causation was left to the jury. In the wake
of liability, the magazine stopped accepting the ads and narrowly
avoided bankruptcy.[12]
It is the practical politics of the law of torts, not the First
Amendment, that is used to protect authors or publishers. In the law
of torts, the question is: Is the author or publisher responsible to
every reader who relies on the writing?
Following a luncheon address at an annual meeting of the Michigan
Bar Association, Ann Landers was asked if she had ever been sued. She
reported that in her years of giving advice, once. The case involved a
housewife who had written to her saying that she was tired of always
being asked what she did for a living. Ann Landers advised in a
column, "Say you're a hooker; that will stop it, they'll be so sur-
prised." The housewife followed the advice, but was overheard by a
policeman and was arrested for soliciting. She suffered indignity, and
now has a criminal record, but nothing came of the suit against Ann
Landers. Advice columnists are not held to a duty to the public at
large.
In a famous 1866 New York case, Ryan v. New York Central R.R. Co.,
[13] a fire broke out in the railroad's woodshed, through the careless
management of an engine. The fire spread from nearby houses to houses
far away from the woodshed. To whom should the railroad pay? The
court shrank from the thought of liability to all these people. The
court said, "To sustain such a claim...would subject [the railroad] to
a liability...which no private fortune would be adequate." The court,
quite atypically -- but revealingly -- made the railroad's capacity to
buy and carry insurance an explicit element in measuring the limit of
liability. The court added, "In a commercial country, each man, to
some extent, runs the hazards of his neighbor's conduct, and each, by
insurance against such hazards, is enabled to obtain a reasonable
security against loss." That is, the various homeowners could protect
themselves by fire or health insurance.[14]
Liability in tort is very much linked to insurance. In one of the
leading cases in the law of torts, Palsgraf v. Long Island R.R.,[15]
Justice Cardozo of the New York Court of Appeals expressed concern
over the extent of liability in the event of wrongdoing. The issue
was: Should a duty of care be owed only to a reasonably foreseeable
victim or to the world at large? The potential of liability in the
latter situation could be withering. Cardozo imposed a "class of
person" limit on liability for a negligent act.
By and large, accountants are not held responsible to one and all
who rely on their financial statements. In Ultramares v. Touche, Niven
& Co.,[16] the classic decision on accountant's liability, Justice
Cardozo denied an action for negligent misrepresentation at the
instance of a party not the defendant's client. Cardozo was again
concerned with limiting liability. He reduced the number of potential
plaintiffs to those in privity. He stated that "if there has been
neither reckless misstatement nor insincere profession of an opinion,
but only honest blunder, [an accountant's] ensuing liability for
negligence is one that is bounded by the contract." [17] Some fifty
years later, the same issue -- "whether an accountant may be held
liable, absent privity of contract, to a party who relies to his
detriment upon a negligently prepared financial report" -- was again
before the New York Court of Appeals and it reached essentially the
same conclusion: no liability absent fraud or a relationship akin to
privity.[18]
In Tarasoff v. University of California,[19] the question was raised
to whom a therapist owes a duty when a patient poses a danger. Is
there a duty to warn only a reasonably identifiable victim or does the
duty extend to anyone injured by the patient? In the latter situation,
the patient poses a greater danger, but out of liability concerns, the
duty has generally been limited, by court decision or statute, to
reasonably identifiable victims. Only that victim has a cause of
action.
In Brady v. Hopper,[20] the individuals injured as a result of John
Hinckley Jr.'s assassination attempt on President Reagan sued the
would-be-assassin's therapist. The federal district court in Colorado
held that the scope of the duty to protect was limited to those
instances where there were "specific threats to specific victims." The
court said that this rule offers a "workable, reasonable and fair
boundary" to the scope of a therapist's liability.
To whom, then, would an author or publisher be exposed to liability
for a writing on a topic which might result in injury? For example,
How to cut trees? How to keep bees? How to prepare food?
In Cardozo v. True,[21] the plaintiff, following a recipe, became
sick by eating a raw ingredient that was poisonous until cooked. The
plaintiff filed a lawsuit against the bookseller from whom the
cookbook was purchased. The claim was based on breach of warranty and
alleged that the book contained inadequate instructions and warnings.
In denying the claim, the court drew a distinction between the
physical book and the ideas contained in it. The court held the
bookseller only to a warranty as to the tangible, physical properties,
i.e., the printing and binding of the book, not its intellectual
content.
In the usual case of a book , it may not be possible to establish
negligence, but might its contents be considered a "product" under
products liability law where fault (negligence) is not an issue? In
Walter v. Bauer,[22] the plaintiff was injured during a science ex-
periment using the textbook "Discovering Science 4," and brought an
action under strict tort liability claiming the text was unreasonably
dangerous in that it contained insufficient warnings. In denying the
claim, the court stated that the textbook was not a "product."
Moreover, not only is it important to determine whether a duty to
compensate exists, but also from where such compensation will come.
Insurance policies usually refer to claims "respecting the product,"
i.e., the physical book with its physical characteristics.
In Sears, Roebuck v. Employers Ins. of Wausau,[23] the complaint
alleged negligence in preparation of a manual explaining the operation
of a power saw. The manual was one of a series of "Know How" books
concerning the operation of various power tools. In a declaratory
action as to whether the insurer was obliged to defend the insured
vendor in a lawsuit brought by a purchaser of the manual, a federal
district court said that the insurance policy in this case made no
distinction between the physical manual and the intellectual content
of the manual, so the insurer was obliged to defend.
In Winter v. G.P. Putnam's Sons,[24] a group of mushroom enthusiasts
became severely ill after picking and eating mushrooms, on reliance of
information in a book. They brought suit against the publisher on
theories of products liability, breach of warranty, negligence,
negligent misrepresentation, and false representation. Holding for
the defendant, the court opined:[25]
In order for negligence to be actionable, there must be a legal duty
to exercise due care. .... The plaintiffs urge this court that the
publisher had a duty to investigate the accuracy of The Encyclopedia
of Mushrooms' contents. We conclude that [it has] no duty to
investigate the accuracy of the contents of the books it publishes.
Continuing, the court explained:[26] A publisher may of course
assume such a burden [to investigate], but there is nothing inherent
in the role of the publisher or the surrounding legal doctrines to
suggest that such a duty should be imposed on publishers. Indeed the
cases uniformly refuse to impose such a duty.[27]
In Barden v. HarperCollins,[28] the plaintiff, described as an
adult victim of child abuse, purchased and read "The Courage to Heal"
for the purpose of helping her recover from the trauma of her alleged
childhood abuse. The plaintiff contacted one of the attorneys listed
in the book, apparently in order to pursue a lawsuit against her
father. Allegedly, the attorney accepted a retainer from her, yet
failed, to perform legal services. Moreover, allegedly, the attorney's
qualifications -- detailed in the book -- were false, and that the
book contained unverified facts. The plaintiff sued the publisher on a
negligent misrepresentation theory. The court held for the defendant.
Under the prevailing view, tort law is used to govern the
responsibility of authors or publishers. Tort law or other law that is
not governed by the Constitution can readily be changed by court
decision or statute. The U.S. Supreme Court has circumscribed the
tort of defamation by the First Amendment.[29]
Cases of negligence are based on a duty of care that the law says is
owed to specific parties. Authors or publishers are not held to a duty
of care to the world at large. Then, once a duty is established, it is
necessary to establish a causal nexus between breach of that duty and
the harm.
As might have been expected, nothing came of the suits against Laura
Davis and Ellen Bass. They were dismissed.[30]
Notes:
1. New York: Harper & Row, 1988
2. New York: Harper & Row, 1990
3. C. Ness, "Recovered Memories Author Sued," San Francisco
Examiner, May 21, 1994, p. F-3; B. Stewart, "The Courage to Sue: New
Chapter in Recovered Memory," American Lawyer, Aug. 23, 1994, p.2.
4. Id., at p. 22.
5. See R. Slovenko, "The 'Revival of Memory' of Child Sexual Abuse:
Is the Tolling of the Statute of Limitations Justified?" J. Psychiatry
& Law 21:7, 1993.
6. M. Hansen, "More False Memory Suits Likely," ABAJ, Aug. 1994,
p.36.
7. A. Dershowitz, "The newest excuse: 'I read a book,'" San
Francisco Examiner (syndicated column), July 23, 1994, p. A-15.
8. 814 F.2d 1017 (5th Cir. 1987), cert. denied, 486 U.S. 959 (1988).
9. See e.g., Hustler Magazine v. Falwell, 485 U.S. 46 (1988).
10. M. Heller, "Teen suicide suit against video store revisits 1st
Amendment issues, " Los Angeles Daily Journal, reprinted in Detroit
Legal News, Sept., 6, 1994. p.1.
11. 651 F. Supp. 1397 (W.D. Ark. 1987).
12. See also Eimann v. Soldier of Fortune Magazine, 880 F.2d 830 (5th
Cir. 1989), cert. denied, 493 U.S. 1024 (1990) (denying liability);
Braun v. Soldier of Fortune Magazine, 968 F.2d 1110 (11th Cir. 1992,
cert. denied, 113 S. Ct. 1028 (1993) (upholding liability).
13. 35 N.Y. 210, 91 Am. Dec. 49 (1866).
14. The role of insurance in the development of tort law is
discussed, for example, in L. Green & A.E. Smith, "No-Fault and Jury
Trial II." Tex L. Rev. 50 (1972); 1297; A.E. Smith, "The Miscegenetic
Union of Liability Insurance and the Tort Process in the Personal
Injury Claims system," Cornell L Rev. 54 (1969): 645; A.A. Ehrenzweig,
"Negligence Without Fault," 54 (1966): 1422; E.J. Weinreb, "Causation
& Wrongdoing," Chi.-Kent L. Rev. 63 (1987): 407.
15. 248 N.Y. 339, 162 N.E. 99 (1928)
16. 174 N.E.441 (N.Y.1931)
17. 174 N.E. at 448.
18. Credit Alliance Corp. v. Arthur Anderson & Co., 483 N.E.2d 110
(N.Y. 1985).
19. 17 Cal.3d 425, 551 P.2d 334, 131 Cal. Rptr. 14 (1976).
20. 570 F. Supp. 1333 (D. Colo. 1983), aff'd, 751 F.2d 329 (10th
Cir. 1984).
21. 342 So.2d 1053 (Fla. App. 1977).
22. 109 Misc.2d 189, 439 N.Y.S.2d 821 (Sup. 1981), aff'd 88 A.D.2d
787, 451 N.Y.S.2d 533 (App. Div. 1982).
23. 585 F. Supp. 739 (N.D. Ill. 1983).
24.938 F.2d 1033 (9th Cir. 1991).
25. Id. at 1037.
26. Id.
27. The Court delineated a number of decisions by courts which also
refused to impose a duty to investigate upon the publisher. See Jones
v. J.B. Lippincott Co., 694 F. Supp. 1216, 1217 (D.Md. 1988)
(publisher not liable to nursing student injured treating self with
remedy described in nursing textbook); Lewin v. McCreight, 655
F. Supp. 282, 283-84 (E.D. Mich. 1987) (publisher not liable to
plaintiffs injured in explosion while missing a mordant according to a
book on metalsmithing); Alm v. Van Nostrand Reinhold Co., 134
Ill. App. 3d 716, 721, 89 Ill. Dec. 520, 524, 480 N.E.2d 1263, 1267
(1985) (publisher not liable to plaintiff injured following
instructions in book on how to make tools); Roman v. New York, 110
Misc. 2d 799, 802, 442 N.Y.S. 2d 945, 948 (Sup. Ct. 1981) (Planned
Parenthood not liable for misstatement in contraceptive pamphlet);
Smith v. Linn, 386 Pa. Super. 392, 396, 563 A.2d 123, 126 (1989)
(publisher of diet book not liable for death caused by complications
arising from the diet).
In First Equity Corp. v. Standard & Poor's Corp., 860 F2d 175 (2d
Cir. 1989), in finding that the case could be disposed of on tort law
grounds, the court ruled that the defendant publisher could not be
held liable for the alleged negligent misstatements of the summary of
the terms of certain convertible securities reported in Corporation
Records, a guide published by the defendant. See also Gutter v. Dow
Jones, Inc., 22 Ohio St. 3d 286, 490 N.E. 2nd 898 (1986) (publisher of
Wall Street Journal not liable to subscriber for nondefamatory negli
gent misrepresentation relied on by reader in choosing securities
investment).
28. 1994 WL 463995 (D. Mass).
29. New York Times v. Sullivan, 376 U.S. 254 (1964).
30. D. J. Saunders (syndicated column), "On the docket: Americans vs.
themselves," Detroit Free Press, Sept.9, 1994, p.11.
**********************************************************************
FMSF Comment
The preceding legal commentary by Professor Slovenko seems to set
forth on an historic basis development of the law granting First
Amendment protection to publishers against civil liability for harm to
individuals arising from the published material. That protection
against liability has prevailed and now prevails except in the cases
of defamation, fraud, misrepresentation, intentional misconduct and
the like. Present actions involving The Courage to Heal and its
companion Workbook challenge First Amendment protection where
negligent misrepresentation in a publication harmfully affects persons
in a foreseeable manner. The thrust of this challenge is the more
persuasive in the case of a workbook or similar publication where the
publisher intends that the public act on the basis of the premises
presented. We have yet to see how the law will develop and whether
recourse will be granted to those aggrieved in this manner.
**********************************************************************
FMSF Meetings
FAMILIES, RETRACTORS & PROFESSIONALS WORKING TOGETHER
STATE MEETINGS
NORTHERN CALIFORNIA
Regional Meeting
Lunch meeting, November 19, 1994
Guest speaker: Richard Ofshe, Ph.D.
author of "Making Monsters"
For info, call San Francisco/Bay Area contacts.
ILLINOIS
Des Plaines, Il - Prairie Lakes Park
October 8, 1994 - 9:00 am to 6:00 pm
Rog or Liz (708) 827-1056
WASHINGTON STATE
November 4, 5, 6, 1994
"Current Topics in the Law and Mental Health"
presented by Missoula Psychiatric Services
The Westin Hotel, Seattle
Call 406-542-7526 for information
UNITED STATES
Call person listed for meeting time & location.
key: (MO) = monthly; (bi-MO) = bi-monthly
ARKANSAS - Area code 501
Little Rock
Al & Lela 363-4368
CALIFORNIA
Northern California
Sacramento/Central Valley - bi-monthly
Charles & Mary Kay (916) 961-8257
San Francisco & Bay Area - bi-monthly
east bay area
Judy (510) 254-2605
san francisco & north bay
Gideon (415) 389-0254
Charles (415) 984-6626 (day); 435-9618 (eve)
south bay area
Jack & Pat (408) 425-1430
Last Saturday, (Bi-MO)
Central Coast
Carole (805) 967-8058
Southern California
burbank (formerly valencia)
Jane & Mark (805) 947-4376
4th Saturday (MO)10:00 am
central orange county
Chris & Alan (714) 733-2925
1st Friday (MO) - 7:00 pm
north county escondido
Joe & Marlene (619)745-5518
orange county (formerly laguna beach)
Jerry & Eileen (714) 494-9704
3rd Sunday (MO) - 6:00 pm
rancho cucamonga group
Floyd (818) 330-2321
1st Monday, (MO) - 7:30 pm
west orange county
Carole (310) 596-8048
2nd Saturday (MO)
COLORADO
Denver
Ruth (303) 757-3622
4th Saturday, (MO)1:00 pm
CONNECTICUT - Area code 203
New Haven area
George 243-2740
FLORIDA
Dade-Broward Area
Madeline (305) 966-4FMS
Delray Beach PRT
Esther (407) 364-8290
2nd & 4th Thursday [MO] 1:00 pm
ILLINOIS
Chicago metro area (South of the Eisenhower)
2nd Sunday [MO] 2:00 pm
Roger (708) 366-1056
INDIANA
Indianapolis area (150 mile radius)
Gene (317) 861-4720 or 861-5832
Nickie (317) 471-0922 (phone & fax)
IOWA
Des Moines
Betty/Gayle (515) 270-6976
KANSAS
Kansas City
Pat (913) 738-4840 or Jan (816)931-1340
2nd Sunday (MO)
KENTUCKY
Lexington
Dixie (606) 356-9309
Louisville
Bob (502) 957-2378
Last Sunday (MO) 2:00 pm
MAINE - Area code 207
Bangor
Irvine & Arlene 942-8473
Camden
Betsy 846-42681
Freeport
Wally 865-4044
3rd Sunday (MO)
MARYLAND
Ellicot City area
Margie (410) 750-8694
MASSACHUSETTS / NEW ENGLAND
Chelmsford
Jean (508) 250-1055
MICHIGAN
Grand Rapids Area - Jenison
Catharine (616) 363-1354
2nd Monday (MO)
MINNESOTA
St. Paul
Terry & Collette (507) 642-3630
MISSOURI
Kansas City
Pat (913) 738-4840 or Jan (816)931-1340
2nd Sunday (MO)
St. Louis area
Mae (314) 837-1976
Karen (314) 432-8789
3rd Sunday [MO] 2:00 pm
Retractors support group also meeting.
Springfield - Area Codes 417 and 501
Dorothy & Pete (417) 882-1821
Nancy & John (417) 883-4873
4th Sunday [MO] 5:30 pm
NEW JERSEY (So.)-See PENNSYLVANIA (Wayne)
NEW YORK - Upstate / Albany area
Elaine (518) 399-5749
OHIO
Cincinnati
Bob (513) 541-5272
Sunday, October 9, 2-4:30 pm
OKLAHOMA - Area code 405
Oklahoma City
Len 364-4063 Dee 942-0531
HJ 755-3816 Rosemary 439-2459
PENNSYLVANIA
Harrisburg area
Paul & Betty (707) 761-3364
Pittsburgh
Rick & Renee (412) 563-5616
Wayne (includes So. Jersey)
Jim & Joanne (610) 783-0396
2nd Saturday [MO] 1:00 pm
TEXAS
Central Texas
Nancy & Jim (512) 478-8395
Houston
Jo or Beverly (713) 464-8970
Wednesday, Nov ember 2, 7:30 pm
Speaker: Eleanor Goldstein
VERMONT & Upstate New York
Elaine (518) 399-5749
WISCONSIN
Katie & Leo (414) 476-0285
CANADA
BRITISH COLUMBIA
Vancouver & Mainland
Ruth (604) 925-1539
Last Saturday (MO) 1:00-4:00 pm
Victoria & Vancouver Island
John (604) 721-3219
3rd Tuesday (MO) 7:30 pm
MANITOBA
Winnipeg
Muriel (204) 261-0212
1st Sunday (MO)
ONTARIO
Ottawa
Eileen (613) 592-4714
Toronto
Pat (416) 445-1995
4th Saturday (MO)
Southwestern
Adrian 519-471-6338
2nd Sunday 2-4 PM, start Nov 13
AUSTRALIA
Ken & June, P O Box 363, Unley, SA 5061
NETHERLANDS
Task Force False Memory Syndrome of
"Ouders voor Kinderen"
Mrs. Anna de Jong (0) 20-693 5692
NEW ZEALAND
Dr. Goodyear-Smith
tel 0-9-415-8095 / fax 0-9-415-8471
UNITED KINGDOM
The British False Memory Society
Roger Scotford (0) 225-868682
* * *
Deadline for November / December Issue:
Friday, October 21
**********************************************************************
RATE INCREASE - Nov 1. '94 The FMSF Newsletter is published 10 times a
year by the False Memory Syndrome Foundation. A subscription is
included in membership fees. Others may subscribe by sending a check
or money order, payable to FMS Foundation, to the address below. 1995
subscription rates: USA: 1 year $30, Student $10; Canada: 1 year $35;
(in U.S. dollars); Foreign: 1 year $40. (Single issue price: $3 plus
postage.)
**********************************************************************
WHAT IF?
What if, parents who are facing lawsuits and want legal information
about FMS cases, had to be told, "I'm sorry, there isn't any such
thing available?"
What if, your son or daughter began to doubt his or her memories and
called FMSF only to get a recording, "This number is no longer in
operation?"
What if, a journalist asks you where to get information about the
FMS phenomenon, and you had to answer, "Sorry, I don't know?"
What if, you want to ask a question that only an expert, familiar
with FMS can answer, and find out that FMSF can no longer provide that
information? Where would you turn?
What if the False Memory Syndrome Foundation did not exist? A
frightening thought, isn't it?
Please support our Foundation. We cannot survive without it!
Reprinted from the August 1994 PFA (MI) Newsletter
__________________________________
Yearly FMSF Membership Information
Professional - Includes Newsletter $125______
Family - Includes Newsletter $100______
Additional Contribution: _____________
__Visa: Card # & expiration date:____________________
__Mastercard:: Card # & expiration date:______________
__Check or Money Order: Payable to FMS Foundation in U.S. dollars
Please include: Name, address, state, country, phone, fax
______________________________SIDEBAR_______________________________
/ \
| Do you have access to e-mail? Send a message to |
| pjf@cis.upenn.edu |
| if you wish to receive electronic versions of this newsletter and |
| notices of radio and television broadcasts about FMS. All the |
| message need say is "add to the FMS list". It would be useful, but |
| not necessary, if you add your full name (all addresses and names |
| will remain strictly confidential). |
\____________________________________________________________________/
The False Memory Syndrome Foundation is a qualified 501(c)3 corpora-
tion with its principal offices in Philadelphia and governed by its
Board of Directors. While it encourages participation by its members
in its activities, it must be understood that the Foundation has no
affiliates and that no other organization or person is authorized to
speak for the Foundation without the prior written approval of the Ex-
ecutive Director. All membership dues and contributions to the Founda-
tion must be forwarded to the Foundation for its disposition.
Pamela Freyd, Ph.D., Executive Director
FMSF Scientific and Professional Advisory Board, October 1, 1994:
TERENCE W. CAMPBELL, Ph.D., Clinical and Forensic Psychology,
Sterling Heights, MI; ROSALIND CARTWRIGHT, Rush Presbyterian St. Lukes
Medical Center, Chicago, IL; JEAN CHAPMAN, Ph.D., University of
Wisconsin, Madison, WI; LOREN CHAPMAN, Ph.D., University of Wisconsin,
Madison, WI; ROBYN M. DAWES, Ph.D., Carnegie Mellon University,
Pittsburgh, PA; DAVID F. DINGES, Ph.D., University of Pennsylvania,
The Institute of Pennsylvania Hospital, Philadelphia, PA; FRED
FRANKEL, M.B.Ch.B., D.P.M., Beth Israel Hospital, Harvard Medical
School, Boston, MA; GEORGE K. GANAWAY, M.D., Emory University of
Medicine, Atlanta, GA; MARTIN GARDNER, Author, Hendersonville, NC;
ROCHEL GELMAN, Ph.D., University of California, Los Angeles, CA; HENRY
GLEITMAN, Ph.D., University of Pennsylvania, Philadelphia, PA; LILA
GLEITMAN, Ph.D., University of Pennsylvania, Philadelphia, PA; RICHARD
GREEN, M.D., J.D., Charing Cross Hospital, London; DAVID A. HALPERIN,
M.D., Mount Sinai School of Medicine, New York, NY; ERNEST HILGARD,
Ph.D., Stanford University, Palo Alto, CA; JOHN HOCHMAN, M.D., UCLA
Medical School, Los Angeles, CA; DAVID S. HOLMES, Ph.D., University
of Kansas, Lawrence, KS; PHILIP S. HOLZMAN, Ph.D., Harvard
University, Cambridge, MA; JOHN KIHLSTROM, Ph.D., Yale University, New
Haven, CT; HAROLD LIEF, M.D., University of Pennsylvania,
Philadelphia, PA; ELIZABETH LOFTUS, Ph.D., University of Washington,
Seattle, WA; PAUL McHUGH, M.D., Johns Hopkins University, Baltimore,
MD; HAROLD MERSKEY, D.M., University of Western Ontario, London,
Canada; ULRIC NEISSER, Ph.D., Emory University, Atlanta, GA; RICHARD
OFSHE, Ph.D., University of California, Berkeley, CA; MARTIN ORNE,
M.D., Ph.D., University of Pennsylvania, The Institute of Pennsylvania
Hospital, Philadelphia, PA; LOREN PANKRATZ, Ph.D., Oregon Health
Sciences University, Portland, OR; CAMPBELL PERRY, Ph.D., Concordia
University, Montreal, Canada; MICHAEL A. PERSINGER, Ph.D., Laurentian
University, Ontario, Canada; AUGUST T. PIPER, Jr., M.D., Seattle, WA;
HARRISON POPE, Jr., M.D., Harvard Medical School, Cambridge, MA; JAMES
RANDI, Author and Magician, Plantation, FL; CAROLYN SAARI, Ph.D.,
Loyola University, Chicago, IL; THEODORE SARBIN, Ph.D., University of
California, Santa Cruz, CA; THOMAS A. SEBEOK, Ph.D., Indiana
Univeristy, Bloomington, IN; LOUISE SHOEMAKER, Ph.D., University of
Pennsylvania, Philadelphia, PA; MARGARET SINGER, Ph.D., University of
California, Berkeley, CA; RALPH SLOVENKO, J.D., Ph.D., Wayne State
University Law School, Detroit, MI; DONALD SPENCE, Ph.D., Robert Wood
Johnson Medical Center, Piscataway, NJ; JEFFREY VICTOR, Ph.D.,
Jamestown Community College, Jamestown, NY; HOLLIDA WAKEFIELD, M.A.,
Institute of Psychological Therapies, Northfield, MN; LOUIS JOLYON
WEST, M.D., UCLA School of Medicine, Los Angeles, CA.