Has the triggering of childhood memories by therapists been a mistake? Concluding this series RICHARD GUILLIATT explains the explosive debate that threatens the very foundation of modern therapy. ... they keep on maintaining that this time nothing has occurred to them. We must not believe what they say, we must always assume, and tell them, too, that they have kept something back ... We must insist on this, we must repeat the pressure and represent ourselves as infallible, till at last we are told something ...
SIGMUND Freud wrote these words almost exactly a century ago, expressing ardent faith in his ability to dredge up repressed memories that even his patients had difficulty finding. The edifice of psychoanalysis was built on this theory of "repression", yet Freud himself soon developed such doubts about the reliability of his patients' memories that he developed his infamous Oedipal theory - that his patients' "memories" of incest were actually subconscious incest fantasies.
One hundred years later, doubts about repressed memories have returned to haunt the psychotherapy profession, but this time the implications are far more explosive. The recovered memory debate is already assuming the proportions of a major crisis for psychotherapy in the US, where a slew of lawsuits now accuses therapists of implanting false memories of incest and causing immense damage to patients and their families. More than 300 people claim to have been induced by their therapists into believing false memories of childhood abuse in the US, and the validity of recovered memory therapy has been attacked in at least 10 bookswritten by psychologists, sociologists and journalists over the past two years.
In Australia, where therapy and litigation are less popular pursuits, the impact of this controversy is not clear. But barely 18 months after the debate first appeared in the media, many therapists acknowledge it raises fundamental questions not only about their work, but about issues of victim compensation, the legal statute of limitations and the regulation of non-registered therapies such as rebirthing, kinesiology and bodywork.
"I would say the implications run deep," says Professor Don Thomson, former head of the Victorian Psychologists Registration Board and now a professor of psychology at Edith Cowan University in Western Australia. "I think to some extent it confronts psychologists and psychiatrists with the whole notion of whether the most effective therapy is taking a person back to their childhood as a means of healing ... That has been brought into sharp relief because of what has been happening with Satanic abuse and sexual abuse claims, because clearly the consequences of what is being alleged are so far reaching." Sandra Pertot, aNewcastle psychologist critical of the indiscriminate acceptance of recovered memories, agrees. "It does strike at the heart of what we are doing. For us now, the ramifications are much, much broader than sexual assault issues: how do we know what to believe and what the appropriate therapy might be?" A lawyer aswell as a psychologist, Professor Thomson believes recovered memories issues could have significant impact on statutes which prevent legal action once a certain period of time has elapsed. He believes a recent High Court appeal case, in which a woman was granted an extension of the statute because her recoveredmemories of sexual abuse dated from decades previously, has already set a precedent in compensation cases. The NSW Victims Compensation Tribunal, which is considering a dozen claims for compensation based on recovered memory, is already wrestling with these issues, says registrar Keith Ferguson.
Like many medical professionals, Professor Thomson is also disturbed by the proliferation of alternative therapists and pop psychology practitioners who have waded in to "diagnose" childhood abuse over the past 10 years without the benefit of formal training in psychology or memory. In one criminal case currently on appeal before the NSW Supreme Court, a man is claiming he was sentenced to six years' jail partly on the basis of a memory "recovered" by his accuser after she had a single session of kinesiology.
Kinesiology is one of the many forms of "body therapy" that have become popular as the public has turned away from traditional psychology and psychiatric treatments in search of more holistic healing. Body therapy, which some psychologists are also beginning to practise, is based on the theory that past traumas can manifest themselves in muscles and other physical symptoms years later.
In recent years, Australia has also been visited by several "inner child" gurus, most notably John Bradshaw from the US, who has spawned a worldwide movement based on the theory that almost all psychological problems can be attributed to abuse and neglect suffered during childhood. Alternative therapy is so popular that more than 55,000 people around Australia attended last year's touring Festival For Mind, Body and Spirit.
Professor Kevin McConkey, head of the psychology department at the University of NSW, points out "there is money involved in this". "There is nothing to prevent you from advertising in Saturday's Herald a workshop called `Find The Scared Child In Your Life', charging $250 a head for a one-day workshop," he says. "You'd get enough people signing up to convince you to do it again." The unregulated nature of alternative counselling is best measured by the fact that several former medical practitioners, who were struck off the register for sexual misconduct, now operate quite legally as psychoanalysts or counsellors.To give one example: in 1991 a psychiatrist was found to have had sexual contact in his consulting rooms with a woman patient who sought treatment for severe depression. The former psychiatrist, whe denied the charges and accused the woman of having a borderline personality disorder which might have caused her toimagine the sexual assault, now advertises himself as a counsellor specialising in marriage and personal relationship problems.
Regulating alternative practitioners would involve large amounts of government money at a time when deregulation has become the catchcry of bureaucracy. A civil libertarian, Professor Thomson says he would prefer to see a campaign of public education rather than a draconian crackdown on everyone labelling themselves counsellor or therapist.
Psychologists and psychiatrists are quick to point out the failing of the alternative therapy industry, but they have been less speedy in recognising the issue in their own back yard. The Australian Psychological Society issued guidelines on recovered memory late last year; the Royal Australian and New Zealand College Of Psychiatrists is still "considering" whether it needs to outline a position. Yet it is clear from court cases overseas that fully qualified professionals have been as prone to believing dubious memories as their New Age inferiors.
"Therapists, like many other people, get caught up in fads," says Professor McConkey. "And one of the problems in getting caught up in fads is that you start to apply it everywhere ... In part, the tendency to look for abuse has that faddish quality to it. I know of many clients who are coming to therapists and saying: `I have this problem and I think it might be because I was abused when I was a child - can you help me find out whether that's true or not?' "One of the things that is very clear is the tendency for people to move away from personal responsibility for their problems," he adds. "If I can blame it on apast life, if I can blame it on alien abduction or something else other than my miserable self, that can be pretty appealing." Many sexual assault and child abuse workers say false or unreliable memories are a relatively minor problem that is being blown out of proportion as part of a political "backlash". But anincreasing number of therapists believe the phenomenon has been far more widespread over the past decade than previously acknowledged.
"I suspect that it is really quite extensive," says Carol Boland, a Sydney psychologist with seven years' experience in sexual assault counselling. Like others, Boland sees the widespread acceptance of Satanic ritual abuse "memories", which frequently involve torture and murder as an indicator of how many sexual assault workers and therapists have been prone to believing dubious memories.
Boland recalls that in her early years of practising she saw a sign in a rape crisis centre which said "Always Believe" - a credo aimed at repudiating society's previous denial of rape and sexual assault. But she is concerned that this credo has led many social workers and sexual assault counsellors to adopt an uncritical attitude to stories which have no supporting evidence beyond the fervent, but perhaps misguided, belief of the client.
"Disbelief disenfranchised so many sexual abuse survivors, and for many therapists now, absolute belief in the truth of what their clients tell them has taken on the status of a ground rule. But in some cases it's vital to differentiate between the sincerity of our clients and the actual reality of what they believe." Sexual assault counsellors often ask the rhetorical question: why would a woman make up a story of incest and risk destroying her family? Dr Jerome Gelb, a Melbourne psychiatrist who has treated nine women who had "memories" of Satanic ritual abuse, believes people suffering depression,eating disorders and other inexplicable conditions may seize on child abuse as a simple, all-encompassing explanation for their problems. Dr Gelb was disturbed to see how his patients became increasingly depressed and suicidal as they were "counselled" by outside support groups and therapists who reinforced theirgenuine belief in their abuse.
"I met one of these therapists," he recalls, "and she told me there was a worldwide conspiracy of Satanists, that people were programmed from birth - the idea being to create an army of of Manchurian Candidates, automatons who on cue in 1999 would kill the appropriate people and then basically take over. This included members of the police force and judiciary, prominent psychiatrists and politicians, some of whom were named." Dr Gelb has since become one of the most outspoken critics of recovered memory in Australia, arguing in the pages of Australiasian Psychiatry that therapists have done untold damage by using highlysuggestive techniques to induce false beliefs in their patients.
Psychiatry and psychology have had previous crises, of course, most notably with the publication of Jeffrey Masson's book Assault on Truth a decade ago. But Masson's book was a scholarly attack on Freud. The recovered memory debate is about families being torn apart by false allegations of incest; it's about issues of memory and repression which are foundations of psychoanalysis. And already it has shone an uncomfortably bright light on the inner workings of the therapist's office.
In a Supreme Court trial in WA last year, two women accused their father of committing 25 years of sadistic sexual abuse which they said they forgot until they went into therapy. A therapist who treated the women, a clinical psychologist with more than 20 years experience, testified that he believed the women's stories of ritualistic abuse and torture, and that the father, mother, brother and uncle of the women might be refuting the charges because they were in denial. Professor Don Thomson, testifying for the defence, criticised the therapist for making such a diagnosis without supporting evidence.
If critics like Dr Gelb and Boland are correct, the cruel ironies of the recovered memory debacle will resonate for years. Not the least of those is that the feminist campaign against sexual assault might have been partially derailed by the theories of Freud, one of history's greatest male chauvinists. Or that "therapy" itself will stand exposed as a source of untold suffering. But perhaps the cruellest irony is that the fight against child abuse - the worthy crusade at the root of the controversy - will have suffered.
Dr Edward Ogden, a Melbourne forensic specialist who has helped investigate many reports of Satanic ritual abuse, already sees evidence of this. "The backlash from this epidemic (of false allegations) might well be to the detriment of people who really are suffering proveable abuse of one kind or another," Dr Ogden says. "Every time someone is found to have been making outrageous and outlandish allegations, someone who is making genuine allegations somehow misses out." Four books on repressed memory syndrome will be reviewed in Spectrum tomorrow.