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The Construction of False Memory Syndrome
The Construction of False Memory Syndrome: The Experience of Retractors
Joseph de RiveraDepartment of Psychology Clark University

More than 300 persons have now retracted charges of childhood sexual abuse (CSA) based on "memories" recovered in psychotherapy. How may we understand their experience? Four of the five retractors from a selected telephone area code were interviewed with a procedure that gave them different possible explanations for what had occurred. The accounts of the retractors and their critique of different explanations are presented. Two of the retractors appear to have been subjected to a sort of "mind control," and two others appear to have become imaginatively involved in a narrative that served a defensive purpose. In all cases, the experiences of the retractors appeared to be determined more by the therapeutic situation than by characteristics of their personalities.

Both professionals and the public have become increasingly aware of the reality of child sexual abuse (CSA), the problems this sort of abuse may create, and the importance of preventing such abuse. Unfortunately, our increased sensitivity to the possibility of abuse has led to charges of abuse where no abuse appears to have occurred. Such charges have had a devastating impact on the falsely accused and their families ( de Rivera, 1994). This problem has been particularly evident in child custody cases and cases in which memories of abuse have been recovered in the course of psychotherapy. In the latter, a phenomenon has occurred that has become known as false memory syndrome (FMS). Although this term is not proposed as a diagnostic disorder, it does refer to a distinctive iatrogenic pattern of beliefs and behaviors that appears to develop in the course of iatrogenic therapy ( Kihlstrom, in press). This pattern may be characterized as follows:

1. A belief that a behavioral problem--an eating disorder, a sexual inhibition or promiscuity, a depressive reaction, or any other behavior that ought not occur--is a reaction to a past event that was so traumatic that its experience was completely repressed or dissociated.
2. The development of pseudomemories that one was sexually abused as a child.
3. A centering of identity and relationships around these pseudomemories (so that the person becomes defined as a "survivor").
4. The development of an extreme dependence on the therapist and a distraction from the problems that initially precipitated therapy.
5. A defensive avoidance of any evidence that might challenge the belief system and a severing of contact with family members and friends who do not support the belief system and are considered to be in denial.
This pattern appears to characterize reports from families who contacted a toll-free number established by the False Memory Syndrome Foundation (FMSF). Between its inception in February 1992 and March 1994, the FMSF (1994) collected 5,851 such reports in the United States. Although the FMSF did not attempt to verify the accuracy of these reports, the reports are on file and available for research purposes. Current records show that more than 300 persons have come to believe that they made false accusations.In one sense the processes involved in the production of pseudomemories seem apparent:

1. Because memory involves imagination, it is susceptible to social influence. Studies have repeatedly shown that memory is a reconstructive rather than
 reproductive process that involves imagination as well as "traces" of past perceptions. Hence, suggestions may influence how events are construed. A suggested image can replace the image that actually occurred, such as when persons remember a yield sign instead of the stop sign they actually saw ( Loftus, Miller, & Burns, 1978) and persons can "remember" entire events that never occurred, such as when adults give details of having been lost in a shopping mall and a relative acts surprised that they do not remember this (fictitious) event ( Hyman , Husband, & Billings, 1995; Loftus, 1993; Loftus & Pickrell, 1995). Distortions are evident even in "flashbulb" memories for emotionally significant events. Thus, Winograd and Neiser ( 1992 ) showed that memories of the Kennedy assassination and Challenger disaster are often replete with errors and that accuracy of memory is unrelated to the confidence with which the memory is reported.
2. The ability to distinguish imagination from perception or memory involves a judgment that depends on the availability of specific cues. Conditions such as relaxation, that may promote the recall of actual events, are the same conditions that may prevent accurate discrimination between what really happened and what was imagined ( Lindsay & Read, 1994).
3. Judgments about "reality" depend on a person's belief system and, hence, are influenced by personal relationships and group norms. When persons are hypnotized and asked to imagine a past life, many report appropriate imagery. (This imagery is influenced by suggestions about whether persons are reborn as members of the same sex, in the same area of the world, etc.) People's judgments about the reality of their experience are a function of their prior beliefs about past lives rather than the intensity of the imagery they experienced ( Spanos, Burgess, & Burgess, 1994).
4. Memories about past attitudes, past behaviors, and past beliefs are systematically distorted to make them congruent with present attitudes, behavior, and beliefs ( Dawes, 1988). Processes of both self-attribution and dissonance reduction ( Aronson, 1995; Davis & Jones, 1960) lead persons to reconstruct the past in terms of present influences.

In another sense, however, the creation of pseudomemories of CSA remains unclear. It is one thing to replace the image of a stop sign with that of a yield sign, to implant an isolated memory of being lost in a shopping center, or retrieve memories of a past life when that person already has a belief in past lives, yet quite another to have a person replace a purportedly happy childhood with a belief that he or she was systematically sexually abused by a previously adored parent.

In fact, several critics have challenged the existence of FMS as an actual phenomenon. Pezdek ( 1994 ) pointed out that studies on the implantation of event memories have involved suggestions by siblings or others who really would have been present when the event occurred. She noted that a therapist would not have been present, and hence, his or her suggestion would not be as convincing. Furthermore, people are more influenced by suggestions that are plausible, and she argued that a suggestion of incestuous sexual contact would not be plausible for a person who had not experienced such contact.

Both Olio ( 1994 ) and Berliner and Williams ( 1994 ) noted that implanting memories for isolated events does not prove that memories for a traumatic childhood can be created in patients with no trauma history. Speaking of traumatic memory, Herman and Harvey ( 1993 ) stated:

Clinical experience shows that these memories are formed in an altered state of consciousness induced by terror. . . . [N]o patient is eager to discover that she was violated by people she loved and trusted. In fact, patients tend to cling to their doubts long past the point where most impartial observers would be convinced. . . . [O]verzealous, incompetent, or even frankly exploitative therapists do not have enough power or influence over their patients to impose an elaborate form of mind control. (p. 5)

It would seem that inducing pseudomemories of CSA in a reasonably healthy person from a reasonably functional family would be extremely difficult. Yet questionnaire results from families who have reported an instance of FMS suggest that many persons and families were relatively functional prior to the therapeutic experience ( Wakefield & Underwager, 1992).

One way to bridge the gap between the processes involved in the production of isolated pseudomemories in experiments and the construction of a narrative of a systematically abusive childhood is to examine the accounts of persons who entered therapy, came to believe that they were sexually abused, and then retracted those "memories." The one case report ( McElroy & Keck, 1995) and eight autobiographical accounts that have been published ( Goldstein & Farmer, 1993) describe instances of intrusive social influence; for example, "He insisted that I was severely sexually abused as a child and that I must remember and talk about it in group therapy or I would never be a productive member of society" ( Goldstein & Farmer, 1993 , p. 227). The case report and seven of the eight accounts state that other therapists were involved and supported the "diagnosis," suggesting a network of therapists who believe that patients should acknowledge repressed sexual abuse. Several of the accounts seem to indicate that patients received more attention from mental health workers when they began to speak of possible abuse and some suggest that therapists were unable to perceive that the patient did not feel the "memories" were real; for example, "He was just not seeing the pressure I was under and how I was caving in with a form of compliance by manufacturing memories" (p. 273). However, in some cases the patient appears to have led a therapist into believing the psuedomemory; for example, "My new therapist . . . was not trained in childhood sexual abuse; he specialized in short-term adjustment problems. We started talking about sexual abuse within two weeks" (p. 226).A questionnaire study of 20 retractors ( Nelson & Simpson, 1994) reports that 12 had been hypnotized, 14 reported pressure to remember from the therapist, and 14 had either read The Courage to Heal ( Bass & Davis, 1992) or other books about early CSA. These findings confirm the idea that a widespread social belief system and strong social influences can influence memory and identity, but raise an important question. Although all 20 retractors reported that they frequently had doubts about whether their memories were true, K. Olio (personal communication, March 3, 1994) pointed out that such doubts stand in contrast to the certainty sometimes involved in the pseudomemories induced by Loftus ( 1993 ) and the confidence in incorrect memories reported by Winograd and Neiser ( 1992 ).After analyzing responses to open-ended questions that asked retractors to describe their experience, Lief and Fetkewicz ( 1995 ) summarized several recurrent themes. These include:

1. The development of an "enormous positive dependence transference" that was increased when the patients were advised to sever contact with their families.
2. The rewarding of the recovery of "memories" by approval, attention, and perquisites (e.g., often almost unlimited telephone contact was allowed). They noted that the therapist's approval appeared to give a "lift" similar to a drug fix.
3. A belief that therapy was salvation and that without therapy the patients would go crazy.

Although the authors did not provide data as to the numbers of retractors who mention each of these themes, 33 of the 40 respondents stated that their therapists made a "direct suggestion" that they were the victims of sexual abuse before any memories of abuse were recovered. The findings seem to support the straightforward social-influence analysis of Ofshe and Watters ( 1994 ) who stated, "the two important variables are patients' emotional investment in the therapy and the therapist's confidence that these supposed pieces of memory (or indicators of memory) are valid" (p. 93).

However, such an analysis does not discriminate between factors that may be crucial in our understanding of individual cases. Social influences may occur in different ways. Did a therapist impose suggestions or merely support a patient's imagination? Was the patient dependent in the sense of needing approval from the therapist or was he or she simply relying on the therapist as an authority who could discriminate truth from fiction? Furthermore, we may grant the power of social influence to affect belief systems and produce pseudomemories and yet still remain puzzled. How could persons possibly ignore the memory of their own childhood, the contrary evidence of other family members, the deep feelings that exist between children and parents? FMS does not only involve the development of a contra-factual belief system such as alien abduction ( Newman & Baumeister, 1996), but it also involves a transformation of personal identity. Persons who appear to be exhibiting FMS may present themselves as "survivors" and exhibit intense and convincing affective reactions. From the perspective of mental health workers, it may appear that repressed material is emerging; from the perspective of parents, it may appear that their child is no longer the person they knew.

On first learning of the existence of FMS, most persons suppose that those succumbing to FMS must be extremely suggestible, or highly disturbed, or have unconscious motivations that they are projecting, and so on. Yet, interviews with families and friends and medical and school records often do not support such explanatory factors. If we are to understand what truly has occurred in a way that will enable us to empathize with persons who have experienced FMS, and if we are to help them understand their experience, we need conceptualizations that address issues of identity and capture the concrete experience of individual retractors.

The American Psychological Association's (APA) Working Group of Investigation of Memories of Childhood Abuse: Final Report ( Alpert et al., 1996) calls for researchers to "develop models that will be scientifically sound while being well-grounded in the realities of clinical practice" (p. 3). It suggests that the isolation between researchers and clinicians may be overcome by the use of critical case studies that "serve to teach valuable lessons about professional behavior that are and are not consistent with standards of good practice or good science" (p. 11). Accordingly, I attempt to articulate two different models or explanatory conceptualizations that might account for how clients who

appear neither highly disturbed nor extremely suggestible could come to make false accusations against parents they appear to have loved prior to therapy. Although the data currently available do not permit testing of these models, researchers can use them to provide a framework for case studies that may help us understand the experience of persons who had FMS and then retracted charges of CSA.

Which conceptualizations might help us understand how a "normal" person could make false accusations against loved parents? At least two plausible explanations come to mind. Perhaps we are dealing with a sort of mind control, the processes that may be involved in cult behavior and the thought reform of some U.S. prisoners during the Korean War ( Lifton, 1961). Although the concept of mind control is controversial, it and the related concept of "undue influence" ( Singer, 1993) have been used to account for changes in identity later disavowed ( Katchen, 1992; West, 1993). By mind control I do not mean to imply malevolent or mercenary intent but the sort of undue influence that might occur if a therapist unwittingly undermined a patient's confidence so that he or she became emotionally dependent and allowed a strong-willed therapist to become the main author of the patient's story. Alternatively, the control may remain with the patient but perhaps our current culture and some therapists are exercising an influence on the narratives persons use to construct their identity ( Gergen & Gergen, 1983). Many therapists espoused the idea that repressed memories may be the cause of problematic behavior, and this idea has been favorably presented in popular culture. To the extent that we use narrative to construct our identity, such an idea, supported by the authority of a therapist, conceivably could be used to create a narrative that could be the basis for constructing a new identity. These models may be more fully explicated as follows.

Mind-Control Mode (Hassan, 1990)

The essential underpinning of mind control is undermining the individual's ability to make his or her own decisions. This often involves the induction of trance states in which the person's attention is focused inward, away from contact with the outside world, but the control itself is achieved by controlling information and the person's behavior, thoughts, and emotions.

Information control involves the monitoring and systematic distortion of information to the person so that no disconfirming evidence is available. Contacts with people who think differently are discouraged so that the person becomes locked into one perspective, thereby incapable of taking the perspectives of others.

Behavior control is achieved by regulating the person's physical reality--where he or she lives, what clothes he or she wears, what food he or she eats, what drugs he or she is given, how much sleep he or she is permitted--and what actions he or she is told to perform.

Thought control regulates how information is processed. The language uses clichés that are divorced from real experience but that help make members feel special and separate them from the general public. It usually involves black-and-white distinctions--all that is good is embodied in the leader of the group and all that is bad is outside the group. The language is deliberately confusing. Whereas initiates believe that they must work hard to learn the truth, they are, in fact, actually learning how to stop thinking by using the language that is given.

Emotion control often uses guilt and fear. Belonging to the group reduces one's sense of guilty responsibility; leaving the group is prevented by the fear of being defenseless, being killed, going insane, becoming addicted, or committing suicide.

The mind-control model implies that persons are not fully responsible for their behavior while they are being influenced. In Hassan's view, all persons (not only those who are extremely susceptible) are potentially susceptible to such control. Although persons are responsible for having entrusted the self to some authority figure, they should not feel inordinate guilt or shame. In the case of retractors, they made the mistake of trusting an authority figure who took advantage of this trust to use methods that literally controlled the mind the way a hypnotist controls the behavior of a person who has agreed to be hypnotized.

Narrative Model (Sarbin, 1995)

Persons are continually engaged in constructing a narrative about who they are. We all try to make sense of our lives by creating a story that will explain why we behave the way we do. When persons are unhappy with the way they act, they may search for explanations from their childhood in an attempt to find an acceptable story. As numerous books and videos--and therapists--attest, many believe that memories may be repressed and recovered. With a little help from isolated images and feelings and a few suggestions from a therapist, persons may use their own imagination to begin to create a story about the way they were abused. Therapists may believe the story and become coauthors; gradually it may become clear that the best way for a person to make sense of his or her problems is to assume that a horrible trauma must have occurred and that pieces of it are breaking through repressive defenses.

This model leads us to ask questions about the plot of the narrative, whether the survivor was portrayed in a heroic light, the character of the villain, and how the therapist acquired the authority to become a coauthor or support its validity. In this model, FMS victims are method actors who become so involved in the drama they are enacting and the identity they are portraying, that they forget they are playing an imagined role. (See, e.g., Rapoport 1960 discussion of the "blindness of involvement.") These patients deceive therapists and others because they believe the part they are playing, forgetting that it is an imaginary role.

In contrast to the mind-control model, the narrative model assumes that the person is responsible for a self-deception that leads him or her to give credibility to an imagined story. Persons suffering from FMS deceive themselves into thinking that the role they are playing is their real story. By a sort of sleight of hand, they do not pay attention to how the story was created or any contrary evidence that would let them know they were only playing a role.

In one sense the two models are not completely exclusive. The mind-control model may be viewed as a narrative (with the therapist as villain and patient as victim). Conversely, when a "narration" involves an overly controlling therapist who makes direct suggestions about what the patient should and should not do, it begins to sound as though mind control is occurring. Nevertheless, the two models offer different lenses with which to view the construction of FMS, and we may gain a better understanding of what retractors experienced in therapy by contrasting their accounts with the two models. Ideally, I would like complete case studies of a random sample of retractors and their therapists. At this time, however, financial, legal, and trust issues preclude such a study. Accordingly, I decided to systematically interview a small representative sample of retractors about the way they themselves understood the experience they had undergone.

Method
Participants

In order to secure a representative sample of retractors, I attempted to contact all persons within a given telephone area code who had reported a retraction to the FMSF. Because the same area code had been' previously used to gather a sample of families who had reported FMS cases ( de Rivera, 1994), evaluating whether the cases seemed typical was possible. I was able to contact four of the five reported cases, and all four agreed to be interviewed. Although the sample is small, it appears representative of much of the diversity of FMS cases. Unfortunately, legal considerations precluded my interviewing the therapists who were involved at the time the memories of abuse emerged. Lacking their accounts and any notes or audio or video recordings, one cannot be certain what actually occurred during the therapy. The patients may have misinterpreted some things their therapists said, or they may have made mistakes in remembering what transpired. However, family members were contacted in order to obtain independent confirmation of general information. In one case, statements were verified with medical records. Importantly, no family members reported memories of any sexual abuse, the retractors themselves reported having had no memories of sexual abuse prior to entering therapy, and in three of the four cases, no other traumatic childhood events were reported. All of the families were intact and functional, although two reported a history of some alcoholism. Three of the four retractors held responsible jobs prior to therapy.

Procedure

The conceptual encounter method was used in all interviews ( de Rivera, 1981). In this method the person interviewed is regarded as a research partner (RP), a coinvestigator of the phenomena in question. Because the RP has had a concrete experience of the phenomena, he or she is regarded as an expert on that specific experience. The interviewer has abstract models that may or may not serve to clarify aspects of the experience. After listening to a detailed account of the experience, the investigator shares these abstract conceptualizations so that they encounter the concrete experience of the RP. A dialogue ensues in which both investigator and the RP try to determine which aspects of the abstract conceptualization fit the concrete experience. Sometimes it is readily apparent that a conceptualization fits or does not fit the RP's experience. Sometimes a conceptualization leads the RP to see a new aspect to the experience, to understand it in a different light. Sometimes the concrete details of an experience force the investigator to change an aspect of the abstract conceptualization or to significantly qualify its applicability. The method has been used to successfully explore, distinguish, and clarify a range of experiences such as anxiety and panic ( Goodman, 1981); psychological distance and closeness ( Kreilkamp, 1984); joy, elation, and gladness ( de Rivera, Possell, Verette, & Weiner, 1989); shame and guilt ( Lindsey- Hartz , de Rivera, & Moscollo, 1995); and forms of loneliness ( Nisenbaum, 1984). A similar method involving dialogues about self-reports has been used in

clinical assessment ( Fischer, 1993 ). For example, an assessment or a diagnosis from a manual may be shared with patients who then comment on the extent to which the descriptions fit their experience with ensuing discussion between patient and therapist.

In the current study, the initial accounts lasted from 1 to 1.5 hr. They were followed by a brief period of questioning about any unclear aspects of the experience. If the RP had not discussed her childhood, family, or susceptibility to suggestion, I inquired about these matters at this point. Typically, the response to these clarifying questions occupied another 15 to 30 min. After a 5-min break, the second part of the interview began.

In this part of the interview, RPs were told that they would be given different conceptualizations and that these models--or parts of models--might or might not fit. I then presented each of the conceptual models presented in the introduction. After each presentation the RPs were asked to comment on which aspects, if any, seemed to fit and which aspects seemed not to be true of their experience. At times I would clarify or modify a conceptualization to see if a better fit could be obtained. On the one hand, I tried to present each of the conceptualizations in a positive light; on the other, I was respectful of the RPs' critiques.

All interviews were tape-recorded, transcribed, and then edited to form a coherent narrative. These accounts were then given to the RPs, who corrected any errors and clarified any ambiguous phrases.

Results

The accounts of the retractors, the conceptual encounters, and my judgment as to the "fit" of the models follow. To ensure confidentiality the names were changed and some identifying information was omitted. Additionally, space requirements necessitated some abstraction. Regardless, these accounts are not composites and no information has been altered.

RPI: Ann

Background. At the time of the interview, Ann was 36, married, and raising two children. A highly intelligent woman from a stable working-class family with three younger sisters, Ann had worked her way through college, graduated near the top of her class, and was quickly promoted to a high-level managerial position at work.

After a structural reorganization in 1988, Ann began to work with a newly hired man who intimidated her. For the first time in her life, this normally self-sufficient woman found herself in a situation in which she felt helpless. She attempted to work around him, but he merely increased his intimidating tactics. One day on her way to work, Ann became unable to breathe and experienced heart palpitations. A medical exam revealed no physical problems; she had apparently suffered a panic attack. Increasingly, Ann found that she was unable to go to work without suffering these panic attacks, and she decided to see a psychologist to find out how to cope with her situation. Feeling like a failure for the first time in her life and needing a respite from a life of rigorous acceptance of responsibility, Ann immediately granted authority to the (PhD level) therapist, and placed herself in the therapist's hands.

Process of induction. Rather than teaching Ann to cope with panic, however, the therapist appears to have elected to search for the cause of the panic: Why had Ann let herself be intimidated by a man? In the third month of therapy (early 1989), the therapist raised the issue of whether Ann had been emotionally abused as a child. The therapist felt that Ann's parents had failed to do justice to their obviously gifted child by not allowing her to skip grades or to attend a better school. Ann began to feel (and say to the therapist) that her parents could have done better by her. Whereas she was previously proud of how self-sufficient she had been as a child (e.g., keeping her room clean and doing her own laundry), she now began to believe that she was pushed to become an adult much too soon.

The therapist then told her that she had the symptoms of someone who had been sexually abused. Ann stated, "I told her, I never wanted her to say that ever again because that was not true, and I said, 'If you say that again, I am going to get up and leave."' (One might conjecture that the strength of this reaction may have actually confirmed the therapist's hypothesis.) In any case, the therapist stopped pursuing this specific issue but continued talking about "past traumas, the wounds that caused me to be so susceptible to this horrendous wound from this man at my employment."

No real progress occurred in the first year of therapy and the panic attacks generalized so that Ann had great difficulty leaving her house. However, she kept her house spotless, sewed clothes, and was usually able to drive herself to therapy.

In January 1991, Ann experienced severe cramping. Believing it was only the flu, she delayed going to her physician. When she finally went, a ruptured ovary was discovered. The therapist pointed out that Ann had not taken care of herself, always putting herself last. She said this neglect was a type of "self-mutilation" and again brought up the possibility that Ann had been sexually abused. This time Ann was not as angry and

negative, and the therapist asked her to read Little Miss Perfect ( Le Boutiller, 1990), a book that discusses having to grow up before one's time.

As Ann read, she realized the book was describing her. She was afraid of being harshly judged, she second guessed what behavior was normal, she suspected she never did anything right, and she overreacted to changes over which she had no control. She took notes on the book and systematically verified that she had all the symptoms. She is not the "natural" child who likes to experiment, is fascinated by the environment, has free use of imagination, imitates others, is not afraid to try new behaviors, and is free to be silly or wrong. Growing up, she was an "adapted" child who needed a time schedule, was very competitive, had to do everything right, was overly serious, and had a strong sense of organization in every aspect of her life. Once proud of her self-sufficiency, Ann now began to agree with her therapist's view that she was quite sick.

The therapist then asked her to read Alice Miller writings, beginning with Drama of the Gifted Child ( 1994 ). The therapist asked her to take notes as she read and hand them in. Ann began to see that her parents had not given her the opportunities she should have had, they had not recognized her achievements, and they had always taken her for granted. The therapist now took on the role of teacher, mother, and confidant, and Ann began to feel that she was the only person who really understood her.

Reading Banished Knowledge ( Miller, 1991), Ann highlighted:

At the slightest resistance on my part to my father's abuse I would have to fear direct punishment and besides having to remain silent, I had to repress my memories and deaden my feelings. He expected me to forgive every injustice and never bear a grudge. I complied as any child in my situation would have done. I had no alternative.

Ann felt that, except for the abuse, the passage described her. She always did what she thought her parents expected of her. She stated, "I really don't think my parents realized how much I wanted them to be proud of me." That is, Ann felt the passage fit her if "insistence that I was good" was substituted for "abuse." However, the therapist continued to believe that Ann must have been sexually abused and was in denial--and she frequently shared this idea with Ann.

Because Ann had not cried in the first years of her therapy, her therapist felt this indicated how very sick Ann was. Finally, Ann did cry. The therapist was happy, and Ann found crying was comforting. Her therapist then sent her to a meeting for adult children of alcoholics (ACOA), even though neither of her parents were alcoholic. Ann "jumped in full force because I got hugs there and was able to cry there openly."

After Ann had read the Alice Miller books, her therapist bought a copy of Courage to Heal ( Bass & Davis, 1992) and gave it to Ann. Ann stated:

That is when I broke. That's when I broke. I went and bought my husband the other book, and my husband stood by me. He believed me. It answered a lot of questions as to my behavior since 1988 to him.

In April 1993 Ann began to withdraw from her parents. She became quite depressed, and her medication was increased. She reports losing more than 60 pounds in 3 months and, because the medication was not adjusted, she may have been overmedicated. In any case, she ran her car into a parked car, severed longstanding friendships, imposed on her husband's good will, and was on a "roller coaster ride." She had always had some problems sleeping and this greatly intensified.

In July 1993 the therapist asked Ann about her will: Who was the executor and who was appointed guardian of her children? On learning that her parents were in that position, the therapist pointed out that if something happened to Ann and her husband, "the perpetrator is going to have custody of your children." Ann went to her lawyer and changed her will. The lawyer pointed out that grandparents could still ask for custody and so, on his encouragement, a document was drawn up and duly notarized, stating that Ann's father was an alcoholic and sex abuser, and that her mother was an enabler. The document was to be used only if the will were contested, but Ann sent her parents a registered letter stating that they had been removed from her will as executors and guardians and that she wanted them to remove her from their will.

Her sisters then wrote to Ann asking how she could possibly be so hurtful to their parents. In October 1994 Ann sent her father a three-page letter accusing him of raping her repeatedly between ages 5 and 15, mutilating her sexual organs, being responsible for her miscarriages and the death of her first son, breaking her nose, and other such tragedies. She accused her mother of knowing about these situations and being an enabler. Interspersed with these accusations, however, were statements asking why her parents did not call her.

She missed her parents a lot, but her therapist explained that this was part of her denial. The reason Ann no longer left her house was that she was terrified of meeting her parents. Ann was conscious of a tremendous rage. She believed her parents had ruined her life, and she was upset that they were not helping her fix it.

At this point in the therapy, Ann's therapist felt her husband was not being sufficiently supportive. In her view, he was intellectually inferior to his wife and not

a good marriage partner. She encouraged Ann to leave him and even helped her formulate a plan. Ann was to stay with a friend in another state for a month, telling her husband that she was doing this to give him a break. After Ann had rested for a month, she was to return home, pack her things, get her son, and move out, leaving her husband and daughter (who adored her father) behind.

Process of retraction. After only 4 days, Ann missed her children and husband so much that she changed her ticket and flew home. She arrived (in November) to find an angry husband who said he had been looking forward to a month of calm. They talked the night through without sleeping, and Ann confessed that she and her therapist had made plans for Ann to leave him. She told her husband that he was probably more to blame for her problems than her parents were. Her husband asked her to put all her medication on the table. He moved the medication to his side of the table and told her that he would give it to her from then on. She angrily told him her therapist had explained to her how her husband wanted to control her life. Her husband devised a plan to withdraw Ann from the medication over the next month, and he ordered her to stop attending the ACOA meetings. She agreed to follow that plan without telling her therapist or her doctor. She rationalized this by telling herself that this would prove her husband wrong.

As Ann was weaned from the medication, she grew closer to her husband and realized that he was trying to help her. She began to see the harm she had been doing to relationships with her children, her parents, and her husband. She was afraid to tell her therapist that she gradually was stopping her medication, but Ann did tell her therapist that she was beginning to doubt whether she really had been abused. Her therapist told Ann that she was "sicker than . . . ever" and increased Ann's therapy to three times a week.

After Thanksgiving, Ann phoned her mother to tell her that she no longer felt she had been abused. As soon as possible she saw her father (who had suffered a stroke), and the two had a loving reconciliation. However, her sisters were still furious with her, her husband was blamed, and the extended family began a difficult period of reconciliation. In mid-December Ann, as yet unfamiliar with FMS, told her therapist that she felt the therapist had been instilling thoughts in her mind, that she loved her husband, and that she wanted to see her father. (Ann was afraid to tell her therapist that she already had seen him.) The therapist said, "that is the face of your perpetrator," and warned her that if Ann saw her father, she would suffer a nervous breakdown and would have to be hospitalized. At this point, Ann angrily terminated therapy.

In the month following her retraction, Ann suffered several bouts of extreme shame and suicidal thoughts. She was ashamed of herself for not being able to stand up to the man who had successfully intimidated her at work, ashamed that she walked away from her job, and devastated that she let her therapist manipulate her into accusing the parents whom she loved. About a month after her retraction, Ann made a halfhearted suicide attempt. From that point on, Ann began to recover her sense of self-worth and appears well on the way to full recovery. She still occasionally becomes overanxious and "light-headed." Her current physician feels that she is a Type A perfectionist with an anxiety disorder.

Conceptual encounter. Ann strongly resonated to the mind-control model and immediately identified with the idea that her decision-making capacity had been reduced. She felt that her therapist achieved control of information by telling her what to read, assigning "homework," and telling her that she should not associate with people who did not believe her. With regard to behavior control, Ann felt that she would not have written the letter to her parents if her therapist had not encouraged her to do so. With regard to thought control, Ann spoke of how her therapist kept influencing her interpretation of what she had read and tried to convince her that her husband was bad for her. Ann also related to the idea of confusing language. She said:

I am a very methodical person, and I can remember countless times sitting back and saying, "that doesn't make sense:" I would write it down, say it again, and I would say, "I still don't know what you are talking about," and she would say, "that is because you are so confused and you can't be responsible for making your own decisions."

Regarding control of emotions, Ann felt that her therapist continually made her feel guilty. Instead of helping Ann learn how to take care of herself, the therapist would say that because Ann had made wrong decisions in the past, she therefore could not be trusted to make future decisions. On three separate occasions when Ann had tried to discontinue therapy, the therapist told her that Ann was afraid of getting to the root of her problems and that if she left, she would have a nervous breakdown and have to be hospitalized. "When," the therapist asked her, "will you stop playing games and let me [the therapist] help you?"

Given the narrative model and asked about the plot of her story--was Ann playing the role of a survivor who needed help or the role of an injured person who

wanted revenge?--Ann replied that she wanted to learn how to manage her panic attacks. Early in therapy, her therapist tried to get Ann to identify with the idea of multiple personalities, but Ann rejected that notion, although she did admit to having mood swings. Ann maintained that her "story" was that she needed help, went to an authority whom she believed could help her, and immediately relinquished responsibility to that person. When asked why she gave her therapist that authority, Ann replied that her parents taught her to respect authority, which had been reinforced throughout her parochial-school education. Indeed, doctors had helped her recover from a car accident and had helped her deliver her children. Ann felt "doctors were gods," and the therapist had been recommended, had many credentials, and had many other psychologists working for her.

Asked if she felt she had deceived herself, Ann objected that she was doing something good for herself. She was reminded that she had written an accusatory letter that she no longer believed was true. Had she not then managed to deceive herself? She objected, saying, "You have to plot a deceit." For Ann, deceit was willful. She had, at times, deceived her therapist and her husband. However, when she had written to her parents she believed she was telling the truth. When asked if she had been so involved in enacting the story that she possibly might not have let herself know what she was doing, Ann's response was insightful. She stated:

I was so desperate to find an answer . . . it took a long time . . . I thought of myself as one of those horses that I see them trying to break, going around in circles, and they try to break it so they can rule it.

Thus, for Ann the idea of self-deception implied a willful deceit; she felt only that she had surrendered her will. In fact, she stated, "I know my will was broken."

For Ann there was a disjunction in her identity. In Sarbin's terms her current narrative is that her will was broken. However, she emphasized that at the time she accused her parents, she did not realize that her will had been broken. Ann does not feel that one part of her was deceiving another part. Rather, at the time of her accusation, she completely believed that the story, which was largely authored by her therapist, was indeed her own story. Toward the end of her therapy, Ann saw herself as having lost control rather than as deceiving herself. She saw herself as a "nobody," as someone literally under the control of the therapist's will. For Ann it would not be correct to say that she had not paid attention to contrary evidence. Rather, her world (e.g., her reading material, phone calls) was contained and controlled by her therapist. She states, "There was no self-deception. It was hell."

The mind-control model seems to be a better description of Ann's experience than the narrative model.

RP 2: Beth

Background. Although Beth's mother had been sick when she was young, Beth, 27 years old, had always been quite creative and liked to play by herself. She had childhood friends, but by age 8 other children began to make fun of her because of a stuttering problem. She remembers being afraid her parents would stop loving her, and Beth began to retreat into herself. In high school, she wanted to be popular in her upper-middleclass community and threw herself into cheerleading and parties, which led to experimenting with drugs, alcohol, sex, and questionable friends. Beth flunked out of the first college she attended, which made her feel as though she were a complete failure, especially compared with her two successful brothers. She recovered by becoming involved, with her mother, in fundamentalist Christianity. To some extent, she was able to use her artistic talents within the church, but she was unable to use them for steady employment. Beth had no close friendships, she felt unattractive, and she did not know how to interact with men. Beth said, "[I was] really unhappy with myself as a person," so much so that she often did not want to get out of bed in the morning.

Process of induction. Searching for answers why she was the way she was, Beth attended a Christian women's conference; in the past, she had gained insight from these meetings. The speaker, who had reportedly endured physical, sexual, and emotional abuse, warned the women that "many of you who don't remember any kind of abuse are going to start remembering it!" Beth stated:

It was like touching a chord in me. . . . I just knew something happened to me. I didn't know what. I didn't get a picture in my head. Emotionally I was okay the rest of the conference. I just knew that something had happened.

Beth began writing all her thoughts in a journal. Always emotional, she now found little things setting her off. She began paying more attention to her dreams and to "sensations" she had experienced since childhood. She recalled how she had often felt awake but paralyzed with "these things" entering her room and feeling hands touching her head. These sensations became increasingly troublesome and she began sleeping with the light on.

In the context of her search for what had happened to her, she thought the sensations must stem from former abuse. She stated, "I just wanted to hit if anybody touched me on an arm or leg or even on my hand. I would just recoil. This anger and this rage in me would want to strike out!" The feelings were almost unworldly, and Beth stated that it was "almost getting to the point where it was going through my head maybe it was satanic abuse."

Beth thought the abuser must have been the sitter she had when she was two. She remembered being afraid when he was coming to stay with her. She had recurrences of a past "flashback": It's as though "I'm being smothered [by] something large . . . and I am really little . . . I am tiny. Something large that was just smothering me." The sensation, Beth said, "always came to the edge of my consciousness but then when I want to figure out what it is, it just vanishes." She reasoned that maybe the sitter had put a blanket over her head. She searched for reasons why she was so tormented. Maybe it had happened at her grandparents' house--but she never had any clear pictures in her head.

Then she had a dream in which a man walked into the room and she was paralyzed again. "It was a man-shaped figure . . . some of them are so wicked and monsterlike . . . this one was just a man and I knew he was six feet tall . . . and he got on top of me." Then, "in a dreamlike state," Beth saw something walk in her room:

And it was a monster but then a light shone on it and it had my father's face. . . . Inside of me this little voice . . . it was just like I reverted . . . to a child [of] three or four years old, . . . [and I said,] "Daddy what are you doing to me? . . . Get away from me."

At this time, Beth's father was away from home and she did not want to tell anyone. She prayed and wanted to get over it by herself. However, she became desperate and began to hit herself. After 2 weeks she told her mother, who "became in shock." After about a week, the two met with friends who had worked through the problems caused by abusive brothers. All were Christians, and they prayed for help together. One of the friends started to touch Beth's toes, playing the "this little piggy went to market" game. Beth's father had played this game with her and it triggered a reaction that "was horrible. I was hysterical." The friends had Beth's mother go over and hold her daughter, and they referred Beth to a Christian counselor, licensed both as a social worker and as a family and marriage counselor.

Beth told her therapist that she was "an incest victim who needed help," but when the therapist asked what specifically her father had done, Beth said she could not remember; she had sensations, felt things, and had dreams, but had no concrete details. The therapist tried unsuccessfully to lead her into age regression and advised her to continue writing in her journal. The rapport with the therapist was not good. Beth felt she was cold and did not really understand her, but she followed her instructions to read and write. Beth's writing "got really bizarre." She felt she could identify with the idea of multiple personalities because at times her writing would change into a sort of angry scribble. However, she did not seem to be getting better, and Beth felt her therapist was not teaching her the coping skills she really wanted to learn. After a few months of sessions, the therapist told Beth nothing more could be accomplished until she confronted her father. Beth did not want to do this. She felt it would hurt her father, who was often depressed. However, Beth rationalized that maybe it would actually help him to talk with her and that once the story was out in the open the family could begin to heal. Therefore, she wrote a letter to her father, who was still away from home, telling him she had remembered how he had sexually abused her, although she stressed that she was not writing out of anger (Beth actually wrote a separate letter to get her anger out) but, rather, to try and lift the burden hanging over the family. Beth's letter was as loving as possible for an accusatory letter to be, and she anticipated that once the story of her abuse was in the open she could go on with her life and her family would be stronger.

To her dismay, Beth's father could not believe what she had written, cried hysterically, and had phoned her brothers, whom she had not told. She felt betrayed by this, that the perpetrator was getting people on his side against her. Devastated, she might have contemplated suicide but for her mother's support. Her therapist seemed concerned and wanted to see Beth's father and get the whole family into therapy. When her father returned home, he seemed broken. Beth felt both sorrow and anger, sometimes feeling he must be innocent, sometimes feeling he was manipulating.

Process of retraction. Beth became increasingly depressed. She was not working, but was able to attend bible school and to apply for jobs. In October 1992 she began seeing a new Christian therapist and social worker. Unlike the first therapist, Beth characterized the new therapist as compassionate and professional. When Beth told her that she believed her father had abused her, the therapist asked her if she were sure. Beth became angry that the therapist would doubt her and said, "Yes!" even though she still had no memory of any specific events. (Note that Beth's abuse story was really constructed to explain sensations and dream images.) The therapist did not dispute her belief but taught Beth how to cope with her current situation; for exam

ple, how to get out of bed in the morning. Beth stated, "It was wonderful, very refreshing. Every single time I left there I felt a little portion of me healing." Whereas the first therapist had been time conscious and lacked rapport, which made Beth feel like a burden, the new therapist greeted her warmly, clearly welcomed her, and sometimes let the session go overtime if ending the discussion proved awkward. Whereas the first therapist impatiently told Beth to remember something so that they would "have something to work with," the second therapist kept a professional distance in spite of her warmth.

Beth was a youth leader at her church. The pastor was aware that she and others in his congregation appeared to be suffering from questionable beliefs. He and his wife had learned about FMS, and he crafted a sermon around it. The sermon began with Peter's betrayal of Christ, dwelling on human frailty and the need for divine help, and stressed that, for a person who accepted Christ as savior, the past was gone and the person was a new creation. To be caught in the past was to miss the forgiveness of salvation. Satan attempted to beguile people and one of his latest tricks was something called false memory syndrome.

Beth thought her father had written to the pastor and became angry. The pastor's wife approached Beth's mother and scheduled a meeting for the next day. During the meeting, the pastor's wife confronted Beth stating, "it did not happen to you. ... God does not make people miserable to show them the truth." She then shared how she herself had to overcome thinking of herself as a victim. According to Beth, the pastor's wife was quite "strong" with her and Beth probably would have left if her mother had not insisted that she stay. The pastor's wife softened a bit, saying how she cared for Beth and how she looked forward to Beth's getting through this problem. Beth stated:

It was something like a big strong wall coming down around me, and the first thing that went through my head was, "it is not so bad being wrong." I've always had a fear of being wrong. I always wanted to be perfect in everything I did, and if I couldn't be perfect, then just don't try at all. It just dawned on me, people are not going to shun me just because I now admit that I was wrong. For some reason, this whole time I thought that if I admit[ted] it, people would mock me and say I was such a fool. It was a very humbling experience.

Beth now knew it had not happened, and she wanted to ask for her father's forgiveness.

She sent her father an Easter card, and then went to see him. She was afraid he would be angry with her, but when she came home he had obviously been crying and gave her a hug. She finished therapy in November feeling emotionally strong. She said, "I can understand why people are talking about this multiple personalit[ies] thing because I felt very divided into little pieces, very shattered."

Conceptual encounter. Beth rejected the mindcontrol model. Responding to the model's central idea that an original identity was replaced by a new identity that was not freely chosen, Beth said that she had not really had an identity in the sense of knowing who she was. She had found herself swayed by whomever she talked with, agreeing with whatever viewpoint was presented. She stated:

I always wanted friends and didn't want anyone mad at me. I didn't know who I was. If anyone asked ... [my opinion], I may have started saying something, but they would give their opinion and I would agree with them. I never knew myself and that's why I think I could get so easily sucked in, [be]cause I had such a void in me and I wanted to have it filled.

Questioned about her hypnotic suggestibility she said she had been very suggestible. She had been hypnotized in a high school demonstration and again on a retreat, which had led the group into an age regression. However, Beth now felt that she was more resistant.

Beth never experienced her therapist as exercising thought, emotion, or information control. She said, "I always felt like I was in control. I was the one who was reading the books." However, she also stated that if she had realized that her therapist had any doubt about her father's abuse, Beth would not have written him the accusatory letter. When the investigator asked if the therapist had had such a thought before she met Beth's father, Beth responded, "I can see how therapists can be deceived if you believe in the patient and the patient shows all the symptoms. I mean I showed her ... all the symptoms I checked out." Beth continued:

During the time that I was being ... I call it being deceived ... there were a few times when I really thought that it may have been satanic abuse, and it was a feeling of horror. In the back of my mind, it was so horrible that I had to push it away. Incredible fear. I remember telling my mom a couple of times, "You know I think it must have happened. ... I think I would [only] allow it to go to a certain point." One time the thought came to my head that it was my mother. I couldn't stand her touching me, and I pushed that out of me. I was scared to believe it, and I refused to believe it ... I could have done that to my father. I could have.

The investigator asked, "Could you say more about [what] you call a 'deception' is like? ... How do you conceptualize that deception?"

Beth responded:

Almost as intelligent. I mean if I didn't know it, it's almost like I was being set up my whole life for this. ... It is so weird. I actually felt different, very, very shattered. I believed such lies about myself, being a victim, feeling that my father was against me, feeling that men in general were against me. Now that I am out of it, it is almost like it was a dark period."

Given the narrative model, Beth responded that she identified with the plot of a book about a wounded heart that was really creative but helped destroy itself. (Note that this story makes an interesting contrast to the previous story of being deceived by some dark force.)

Asked about self-deception, Beth did not feel that she was deceiving herself prior to hearing the sermon about FMS. However, after the sermon, when her mother suggested she might be suffering from FMS, Beth became enraged, began banging her hand against the car door, and collapsed on the floor. She felt at that point that she might have been getting back at her father and the thought she could be so vengeful frightened her.

Beth appears to have constructed a narrative that explained why she had problems. Things that had puzzled her fit into this narrative and others accepted this narrative without questioning it. Her therapist had suggested that she write to her father and she complied. She never really stepped outside the narrative framework to question its validity. However, when her father did not play the role he had been assigned, she was completely surprised. She became extremely emotional, enraged at her father and hating herself so much that she entertained thoughts of suicide.

Questioned about the part of her that wanted to kill herself, Beth responded that it was telling her that she was dirty and bad. Her handwriting would change and she would write, "You bad girl, you bad girl. You can't do anything right." She felt she was hating herself for being herself and for hating her father.

Returning to the narrative model, the investigator asked if her survivor role had a heroic status. Beth replied:

Yes, I thought I felt special. I finally felt like I had a story, something I could share and help others. ... It gave me power, and it was definitely in the "I versus them," or "me versus them" kind of thing, taking sides ... like the good versus the evil.

Asked to contrast the victim story with the Christian story, Beth stated that in the latter:

You can be a new person now. The choice is one you have to make. I've seen that. I saw that it was a choice I had to make to either live in the past or just be a victim, ... pressed down, oppressed, unhappy, and confused, or to see what Jesus did for me on the cross, accept it, [get the] power to help myself, to trust in him, and I knew it worked and I realized I started getting stronger.

Asked to contrast the "getting stronger" with the strength she got from being a victim, Beth responded that the latter felt like the sort of aggressive strength that let one climb to the top, to be king of the mountain and push others off, whereas the strength she felt now was a different sort of strength. She said that now:

There is a serenity in me; all the different voices I used to hear are gone. ... I really think I was on the verge of being mentally ill. ... There is a great strength in forgiving and being humbled and admitting weakness ... [that] you only realize once you do it."

Asked about the role that shame might play in preventing a person from admitting he or she was wrong, Beth responded, "I think there would be a lot more retractors if people weren't so afraid of what other people would think of them. I know that was a big hindrance for me, really big." Beth reported one instance in which her father had given her reading material about false memories and asked if it might apply to her. She felt that it was possible that she was wrong, but that idea had simply created intense anger within her.

In clear contrast to the first case, the narrative model seems a better description of Beth's experience.

RP 3: Cath

Background. Cath, 43 years old, grew up in a Catholic working-class family with an older brother and two younger brothers. As the "adorable" only girl, she was the favored child and became the family "star." When she was 8 years old, her father began drinking heavily and was occasionally violent. The family had a history of alcoholism, and two of her brothers became alcoholics. She was the first in her family to go to college, and the family had great hopes for her. She married well, had three children, and many members of the community looked up to her. Nevertheless, she occasionally experienced depression, and she twice had thought of cutting her wrists. In 1985 one of her children began acting up at home, and Cath began seeking treatment for him. After interviewing two different therapists, a friend referred her to a (PhD level) therapist specializing in family problems related to alcohol

abuse. She began seeing him with the goal of becoming a better parent.

Process of induction. From the beginning, her therapist focused on Cath's being an "adult child." Cath found this conceptualization fit her experience; then, too, she liked her therapist, who seemed very bright, understood her, and had done much work with children. He seemed perfect for her. Because the year was almost over and she had the insurance money, she agreed to see him twice a week. Cath felt she gave him "all her power" quite soon because, in contrast to her husband, who she felt belittled her, "he had so much to offer me and he was kind."

The therapist asked her many questions about her birth family, and Cath began to "dig" for memories. As she related these memories, her therapist would interpret them for her. He had strong reactions and made statements such as, "Growing up in your home was like growing up in a concentration camp." She began to look at her background as "quite horrendous." She felt she had certain strengths--she had done well academically, had started the parent-teacher organization at the school, and saw herself as an "active, together person"--but her therapist said these were actually dysfunctional characteristics. She was an overachiever who busied herself to keep from feeling the pain of her childhood. She read John Bradshaw and realized that in her situation, "human doing" could be substituted for "human being," and her therapist encouraged her to curtail some of her activities.

As she began to concentrate on all the bad things that had happened to her and on her shortcomings, and as she withdrew from some of her projects, Cath began to feel more depressed and began coping by drinking wine at night. Noting a compulsive quality to her drinking, she realized that she might be an alcoholic. Cath had worked hard to get away from that pattern of life, and the thought that she might be falling into it made her feel suicidal. In early 1987 she was hospitalized, and she discovered she did not need alcohol, she had to stay away from it, and she has been sober ever since.

In September 1988 Cath again became suicidal and committed herself to a second hospital where she stayed for 6 weeks. Her therapist repeatedly asked her if she had been sexually abused and, after a battery of tests, Cath asked the hospital psychologist if the results suggested abuse. He replied that although he had looked for that, he could see no indication of abuse.

Her therapist kept encouraging her to call him, and Cath began to do so. Before long, Cath would talk to him for a half an hour every night after his children had gone to bed. Although she knew this was not right, she got the attention and nurturing she desired. She stated, "I wasn't drinking at night anymore. Instead, I was talking to him." Cath was doing well until she had a car accident; her husband became enraged and belittled her. She felt trapped, unable to be angry at him, yet unable to leave because of her children. Five days before Christmas 1988, Cath slashed her wrists and ended up back in the hospital.

Her therapist had begun doing "relaxation techniques" with her, which allowed her to go into "dream" states. After one of these sessions, she remembered that when she was approximately 10, her father had wanted to spank her and asked her to pull down her pants. (Cath believes this was an actual memory.) The next day, Cath, who was on medication and feeling horrible about having to put her favorite cat to sleep, felt "very weird." In retrospect, she feels she went into a trance state that was related to the relaxation techniques. Her therapist told her that a repressed memory was returning.

In January 1989 she became extremely anxious. Her therapist did not like either of the hospitals she had gone to, and he admitted her to a third hospital in its unit for sexually abused women.

Cath was put into an incest survivors therapy group and found herself surrounded by women who were having flashbacks and "body memories." Although Cath felt she really did not belong in the group, she tried hard to remember the ways she had been abused. By keeping a journal and looking at old pictures, she tried to trigger memories. Although she did not remember any specific events, Cath did begin to have what the staff called flashbacks, which she described as states of very high anxiety. When these flashbacks began, Cath was given a great deal of attention. People would come and sit with her, hold her hand, give her a blanket, and so on. During these states, her body was extremely tense and she would feel as though she were not totally present, as if she were "stepping off a cliff into another world." In this dissociated or altered state, she had no images, but felt terrified. The staff told Cath that this was a way to get better and, after a while, going into these states became habitual. At one point, Cath was told that she had had a "spontaneous age regression" and that she had a little girl in her.

After leaving the hospital, her therapy centered around these flashbacks. Finally, memories of real events were incorporated into these trancelike states. An uncle had lived with the family for a few years when Cath was young. He was a drug addict, was messy, and wore an old wool coat; the family took him in because he was down and out. Of all his nieces and nephews, he loved Cath most; she was his prize. He bought Cath her first bike, he gave her 11 presents on her 11 th birthday, and he would take her out for ice cream in his very old car.

The therapist had Cath describe her uncle's bedroom and pushed her to admit that he must have abused her. Then, while in an altered state, Cath began having images of his touching her. As the images developed, she remembered her mother sending her into his room to tell him it was time for dinner. The therapist told her that her mother must have known what was going on and suggested that her uncle must have made her sit on his lap and kiss him. He would give her slobbery kisses and then pull her forward and fondle her breasts. She was not to tell anybody, and this is why her uncle bought Cath all those presents. All of these images were painfully sharp to her.

At this point, the investigator remarked, "It doesn't sound like you ever really had memories of being abused. It sounds like you were kind of playing with the idea of being abused. Am I right or am I missing something?" Cath responded:

Well, I don't know. I guess I would remember being fondled by my uncle ... or did I. ... I believe that I created it ... being in my uncle's room, sitting on his lap, he'd be fondling my breast. ... I can picture that whole thing. ... He [the therapist] helped me create it ... filling me in on any gaps that I couldn't remember.

Asked about the affect during these images, Cath replied, "Fear. I would hold myself very tight. It's like once you have been through this ... I am scared it will happen again. I disassociated so often that it didn't take much for that to happen."

Questioned again about the reality of these images, Cath responded, "On one level, I did always have a sense that this was wrong. ... Part of me believed that it couldn't have happened."

Continuing her search for memories that would have a cathartic effect, Cath remembered when her mother had given her an enema. She remembered being about 5 years old and being in what looked like the bathroom. This memory then became the focus of her therapy. Her therapist would ask to see the little girl and would behave in a very nurturing way, giving her blankets, physical contact, and emotional support. He did not engage in sexual behavior. He referred to her as "his little girl" and told her how precious she was, that she should not be afraid, and that he would take care of her. Asked to describe the "altered state," Cath said it involved a high state of anxiety and physical tension that demanded relief. Her therapist would nurture her through it and then she would feel relief; and, although not at all a sexual orgasm, it had the same sort of buildup of tension and relief. In retrospect, Cath commented, "The sick thing about this was that I was getting a lot of attention ... and so I continued the process. I was very special to this guy. ... He kept telling me I was teaching him so much."

When the investigator asked her to explain these altered states and what the "5-year-old" experienced, it became clear that Cath was reluctant to give a concrete description because it would require her returning to the altered state. That is, the experience was dissociated in the sense that Cath would have to reimagine herself in the role of a 5-year-old being brutalized by her mother. She was afraid of doing this and afraid of regressing to the state of the dependency she had experienced with her therapist.

Her therapist encouraged Cath to sever contact with her mother. Over the next year, Cath was hospitalized four more times. Her marriage had severely disintegrated, but she began to work again and slowly rebuild her self-confidence.

Process of retraction. In 1991 Cath read about the Bean-Bayog case, in which the therapist had referred to her patient as her child. 'This, "set off a warning light," and she brought the information to her therapist. He told her that case exemplified bad therapy, but "ours was very different."

In January 1992 Cath's mother died. At one point, her therapist had remarked that Cath could progress further in her therapy if her mother were dead, and Cath said that he "had me almost wishing my mother would die." Now, however, she missed her mother and noted that her therapist failed to realize what her mother's death meant to her. Her marriage had begun to fall completely apart and, in October 1991 she and her husband began to see a family therapist. When she told the new therapist what was happening in her therapy, the new therapist asked her if she had ever been sexually abused. Cath, "looked at her and said, 'No, no,' and she believed me." Cath gradually weaned herself from the first therapist, but still saw him occasionally. In the summer of 1992, she received a bill for $4,000, and it became clear that her former therapist, who had told her "not to worry" about the sessions, had kept track of everything she had not paid him for. In the past, Cath had frequently cut herself when she left his office. It had been a sign that she was sexually abused. The day she received the bill, Cath cut herself for the first time in months and thought, "wait a minute. I am cutting him. That's what I need to be doing." Cath said:

And I just sobbed. ... And the thing I can't get back is my mother, and I can't get back the six and a half years of my children's lives. Here I set out to be the perfect mother and I got my children into swimming lessons and all this ... and look what I end up doing.

After this, Cath no longer saw her first therapist. However, she wrote to him, stating she felt that as adult children of alcoholics, they had gotten into a relationship of codependency. At that time, she still wanted to please him and receive his acknowledgment that her insight was valuable.

The new therapist treated her quite differently. For example, once when she was talking about her former therapist, Cath began speaking as if she were 5 (her "5-year-old emerged"). Instead of reassuring her, the new therapist had Cath walk around the room to get in another state of mind, and she talked to Cath as an adult rather than as a 5-year-old. After a year with her new therapist, Cath appeared completely intact. She is still working in a job with a great deal of responsibility, has reconciled with her father and brothers, is separated but on friendly terms with her husband, and is raising her three children. However, she is still prone to suffering severe bouts of depression.

Conceptual encounter. Cath believed that many aspects of the mind-control model fit her experience: Dependency and conformity had been encouraged, autonomy discouraged, and her therapist often had her in trance states. Information control was involved because the therapist told her not to talk with her family. Behavior control was not exercised by insisting on obedience, but Cath felt that she needed to ask her therapist's permission to see her family. Cath did not experience thought control outside of therapy, but in therapy when she would angrily deny that episodes of abuse had happened, her therapist would say that her "angry girl" was speaking. Thus, he would deny the reality of her statements by attributing them to an altered personality, and they would then tell the "angry girl" to leave the room. She did not feel that he had used negative emotional control (i.e., guilt or fear) to keep her in therapy, but had used these emotions only to keep her away from her family.

Although he had used nurturance to reward compliance, the therapist had not used punishment to modify her behavior. She was drawn to the mind-control model mainly because she felt differently when she was around him, and because he was constantly misinterpreting the events that happened to fit into his mold.

Given the narrative model, Cath felt that she was telling Sybil's story. She had read the book ( Schreiber, 1989) and watched the movie before entering therapy, and she felt that in many respects she was seeing herself as the story's heroine, which she remembered involved an abusive mother, enemas, and multiple personalities. Her story was supported by numerous hospital workers who told her how courageous she was.

The investigator pointed out that in the narrative model, the person bore some responsibility for telling the story. He asked about the relationship between the victim and the voice that denied the abuse happened. How had she managed to deceive herself'? Cath responded that the part, or side, of her that was deceiving everyone was given all the attention and that the other side took a silent backseat but would cut the part of herself that was engaged in deception. She then stated, "Part of me, I hate it. It feels like a split personality and I am not." The investigator mentioned that Sarbin might see her as playing different roles. The one role might be the heroine in a Sybil-type survival drama with her therapist as stage manager and an appreciative and attentive audience, whereas the other role might be that of the daughter who loved her dying mother. However, from this perspective, it was unclear why this second role kept intruding and insisting that she was guilty of lying.

Cath stated, "I would have to say that there were times when I lost it [the second voice]." The investigator remarked that from Sarbin's perspective these were the times when she had succeeded in deceiving herself. He inquired if she had accomplished this by avoiding looking at certain things. She responded:

I don't know whether it's so much of an avoidance as it is going the other way for pleasure ... because there was so much pleasure; there was pleasure in it, the attention; there was nurturing ... that just sort of takes over.

The investigator said he could understand this occurring when she was with the therapist, but asked if Cath did not have to not look at something when she was at home writing a letter accusing her parents. Cath replied that when she wrote, she was only aware of feelings of anger and desperation. The investigator wondered, from the point of view of role theory, if her anger might have come from her parents not from playing the role in which she had cast them. (Note that Cath did not let her parents have their own voices, just as the therapist did not let Cath have her own voice.) Alternatively, the investigator wondered if Cath's cutting herself could have stemmed from the frustration involved in the difficulty of putting the two narratives together. However, Cath responded that she believed she cut herself because of the fury and guilt at what she and her therapist were doing.

The investigator pointed out if she were playing the role of a loyal daughter who made a false accusation against her mother, the role might well call for anger at the self and hurting the self. However, the relationship between the two narratives still seemed unclear. Within

the "heroic abused daughter" narrative, Cath was able to play different roles in rapid succession. (As she said, "I mean picture me in the fetal position in this guy's office and then coming home to these three kids and cooking dinner.") However, Cath appeared to have no way to switch back and forth between this narrative and the narrative of "loving daughter from an alcoholic family."

The investigator pointed out that an actress can play a role in a drama in which she murders her children and then go and play the role of mother cooking dinner for her children. However, in these two narratives, the actress knows the first role is an imaginary one. Clearly, Cath lost that sense at times. She felt that her belief system was constantly being challenged and taken away from her by the therapist, and she gave it up to please him and secure his attention. Cath felt a "core reality" in the sense that she never doubted in her mind that her father was alcoholic and that her mother had given her an enema. However, Cath did feel that she had been led to embellish this into a false role, a "not me" role, in an imaginary drama that she lived as though it were real.

The mind-control model appears to apply here in that Cath's confidence was undermined, her dependency increased, and her story was largely authored by her therapist. Unlike Beth, she was not intrinsically motivated to find a story that would explain her problems, and she would not have used the Sybil narrative without undue influence from her therapist. However, Cath was certainly aware that at times she was playing a role and at other times a sort of self-deception seems to have been involved.

RP 4: Doris

Background. Doris was an attractive single woman, 25 years old at the time of the interview, was from a Catholic working-class family with one brother. As an 8-year-old, she was a bit of a tomboy--very bubbly and outgoing. She was athletic, sociable, and vivacious. She felt loved and quite powerful until one day at about age 9, she attempted to intervene when her father was enraged at her mother. She described her father as "an alcoholic, but a wonderful human being," who was ordinarily loving but exhibited a lot of repressed anger when he was drunk. Although he had never hit her, on this occasion when she attempted to intervene, he became enraged and began to choke her. She felt that her family's failure to discuss this event may have contributed to her subsequent feelings of worthlessness.

In the year prior to entering therapy, Doris (a high school graduate working as a secretary) experienced several extremely disturbing events. First, a beloved aunt died. Second, she became pregnant and decided to have the child, even though she ended relationship with her partner because of his violence. (He became addicted to cocaine and raped her while she was pregnant.) Third, her daughter died shortly after a difficult birth. Fourth, her father died. Doris said she had not allowed herself to grieve for any of these events nor had she realized how they affected her, although she developed bulimia and lost her desire to live (although not to the point of becoming suicidal).

She entered therapy to deal with her bulimia and feelings of despondence, and appears to have been making some progress. She reported that she had a tendency to take off in imaginative flights, "creating these worlds where she could be with her daughter." She longed to be in heaven with her, but Doris knew that she did not want to die. Although her therapist was relatively inexperienced and still working on her master's degree, she acknowledged Doris's longings, pulled her back to reality, successfully resisted her attempts to become overly dependent, arranged for Doris to learn coping skills for her bulimia, and was beginning to lead Doris to face some of her feelings. Unfortunately, Doris's insurance was canceled, and she had to switch plans. Her therapist offered to try to find a way to continue their work, but Doris was ambivalent about dealing with her feelings and found a new therapist on her new insurance.

Process of induction. The new (master's level) therapist noted that Doris was out of touch with her feelings, but ignored her recent traumas. This was possible because, although Doris mentioned the rape, she did not really want to face what had happened. The therapist repeatedly asked her if her father had sexually abused her. Doris told the therapist that if she knew her father she would not ask such a question. Shortly into the therapy, while talking about intimacy, Doris had a "physical flashback." She described this as being similar to an epileptic seizure saying, "My body just went spasmodic." She had no thoughts or images. Asked if she were experiencing terror, anxiety, or rage, Doris replied, "Everything. Worse than I could tell you. ... I felt like I became a massive swoosh of blood and fire. ... No physical pain is comparable to it. ... I would rather have been on fire."

From that time on, Doris said that she had a hard time maintaining touch with reality. She could not work. The therapist kept telling her that her father had sexually abused her, and Doris stated, "I felt crazy. I felt like a lunatic. I thought I had all these personalities that were really just feelings." Doris now feels that, in one sense, she split into different personalities--an angry one, a

fearful one, and so forth--but that these were really "frozen feelings" that she (eventually) managed to own.

In response to the investigator's inquiry into the trigger for the flashback, Doris replied that they had been talking about difficulties in intimacy and the therapist had said, "Let's take it one step further." Whereas the therapist had been thinking about her relationship with her father, Doris took this to mean her relationship with her former boyfriend.

After Doris's flashback, her therapist knowingly said, "I thought so." At first Doris resisted her interpretation. She felt her therapist was "more messed up" than she was and several times told her therapist that she would not be offended if she referred her to someone else. But the therapist declined, apparently proud to have such a complicated case. When the flashbacks continued, Doris began to believe her therapist. She said, "I had no choice but to believe that the doctors were right."

As the therapy continued, Doris began to feel worthless. She began burning and cutting herself. In retrospect, Doris understands these attacks as blaming herself for her daughter's and her father's deaths. She felt her eating disorder had hurt her daughter and now notes that she began to burn herself and cut herself in every place where her baby had had an IV.

Asked about her mental state at that time, Doris said:

I was crazed. I was euphoric. ... I would enter this crazy place when I would ... [burn myself] and it just gave me the sense of power and control. ... It helped me feel good to do those things to myself. I felt I deserved it and once it was done then I could go on; the psychic pain was so bad that I needed to feel it physically.

She continued, "And I confused that ... because of all the nastiness I felt inside. I thought it was me." Her therapist failed to realize the connections Doris now sees. Instead, the therapist helped her create a narrative in which she had a baby by her father. Members of a cult took the baby from her to be killed. Doris stated:

We created a story as my flashbacks went on. That's what happened. ... My first suicide attempt was because I felt I had no hope and I kept hearing that my father sexually abused me and I didn't want to see it [sic] anymore. I couldn't remember it. I felt crazy.

Doris remarked how neither she nor her therapist questioned how a 13-year-old could give birth to a baby without her teachers noticing. She stated:

She didn't make sense of it; I didn't make sense of it. ... I didn't make sense of anything; I just sort of tried to get to the end, searching so hard to find the answers that I wasn't looking at the content.

During the next year, Doris was hospitalized 14 times. She said, "They diagnosed me as everything in the book." She believes that many patients were in a similar position; that is, rather than being helped to experience feelings from real-life trauma, they were misdiagnosed, drugged, and led to create fanciful traumas.

Asked to say more about her memories and flashbacks, Doris said:

It's not like you forgot ... but you didn't have the feelings. I might have forgot what people said and stuff, but I always knew these things happened. I kept it together [by not feeling the feelings], like if I had actually told myself that was what happened, I wouldn't have been able to keep it down as well as I did.

She reported that she always remembered that her father strangled her, but she had not remembered thinking that she was going to die and the feeling of terror that went with that thought.

She currently understands her bodily flashbacks as a clash between consciousness and subconsciousness with her body trying to explain what she was refusing to speak. She felt that her therapist and the hospital staff did not want to allow her her feelings. They preferred to hear a narrative of satanic abuse. She had to resist this narrative and the sedatives they tried to give her in order to come to grips with her real feelings. She said, "Eventually, as I grieved, everything came together."

The investigator said that it was his understanding that the therapists were trying to help people get to their feelings. He asked Doris to help him understand what she was saying. She replied that the hospital staff would explain what one ought to feel but:

Once you actually feel it you go into straps, you are restrained. The first time a person feels it's going to be explosive ... they call you, "out of control," and they'll restrain you, and restraint means going in the silent room and being strapped into a chair or on a bed and that's totally against one's will.

When the therapist saw that Doris was not getting better and was repeatedly hospitalized, she urged her to stop going after the memories. When Doris responded by asking if she should get another therapist, the therapist reassured her that she had "dealt with my kind before." Doris stated:

You tell me that my father sexually abused me, orally abused me, and made me eat babies, and you don't

want me to find the memories! I don't think so. I needed proof, and I thought the proof was in these memories that she said I would eventually get.

Process of retraction. Doris believed that she had to deal with her feelings so she refused medication and stayed in her room where no one could see her intense grief reactions. She also read some works that presented the idea that current life trauma could lead to dissociated feelings. She feels the work of grieving prepared her to be able to hear what a friend finally told her.

Doris telephoned a close friend who had been present at her daughter's birth to talk about a flashback she had of giving birth to a baby at age 13 and having the child taken from her to be killed. Doris had mourned this imaginary child by wearing black for 5 days, and she mentioned her concern to her friend that perhaps there were really two babies. Her friend gently said:

I just want you to know that I'm not saying that I don't believe you, but just listen to me because I love you very much and I know you love me, so I know you're going to listen to me, ... I remember that you said. ...

and Doris's friend went on to repeat verbatim statements Doris had uttered at the actual birth of her daughter. When Doris mentioned a particular hand gesture, her friend asked Doris if she remembered that when the doctor had tried to give her the baby (delivered by C-section), Doris had put her hand down in the same gesture and said she was not ready to receive the baby.

Doris objected that the scenes were not similar. In the flashback she was crying over the birth of the (imaginary) baby, whereas she had not cried during the "first" (real) birth. However, her friend told her that she had cried tears of joy, and Doris simply did not want to remember how happy she had been. The friend also pointed out that she swore, and because Doris had also sworn in her flashback, this helped connect the two scenes for her. She said, "I remember looking at this bloody mass and I just turned away. I had, even then, an intuitional feeling like there [was] something wrong." She continued:

It was so strong ... I couldn't even bear to be near my daughter. And I think I had a lot of guilt over that and that came out in the flashback as well because my baby was taken from me in the flashback, but really I sent her away, and I couldn't bring myself to admit that in the flashback.

With the help of her friend she was able to piece together other real scenes so that she could make sense of her other flashbacks. Doris left therapy and is ambivalent about going back. She realizes that she has issues to face, but she is not yet ready to take the risks involved. She appears to be taking a great deal of responsibility for what happened. She said, "I've conned so many people already. ... I've done so much damage." She appears to have lost some trust in herself and although she seemed to realize that her therapist bore at least an equal amount of responsibility, she stated that she was afraid that the therapist would "try to make it look like it was all me manipulating her." She feels sorrow rather than shame at what happened because she did not intentionally harm anyone. She still feels some responsibility for the death of her child and for the emotional upset occasioned by her false accusations. However, she is proud that she has been able to discover her own truth and that she has learned how to have feelings without falling apart.

Conceptual encounter. With regard to the mindcontrol model, Doris agreed that her therapist had encouraged her to be dependent rather than autonomous, but Doris did not feel that the therapist had undermined her confidence or really exercised mind control. On the contrary, Doris felt that she had been in control and had sometimes manipulated her therapist. That is, in the battle of wills between Doris and her therapist, Doris appears to have often gained the upper hand by implicitly threatening suicide or intimating that she would hire another therapist. If her therapist came too close to getting past her defenses, she would say, "If you don't believe me, I don't know what else to do because I don't know who is going to believe me." She stated, "She allowed me to guide her ... when she should have been more strong."

Given the narrative model, Doris objected that she believed that narratives or stories were always spoken in the second person (even when a person was saying "I"). She contrasted this to actually speaking in the first person as when a person owns his or her experience by allowing the self to feel. She stated:

We have to say, "yes, I did this, I went through this, I suffered this, I was damaged because of this, I ached because of this," ... and then it's real, and when expressions without words come out, it just is. It's no longer a story to be told, it just is. ... With a story, you can manipulate it.

The investigator asked about the relation between experience and story. Doris replied:

We can all experience traumatic things and say I went through this. There was a time in my life when I had my daughter and she died, and this and that, but if I don't experience it, it's a story--it's not even real

[though it may have actually happened], it didn't even happen because it only exists in my mind.

She felt that her life spiraled downward until she finally owned her experience. She said:

And once I finally did [feel the feelings], I owned it, I made it real, I made it my baby. ... I lost my child [that experience became part of my identity], and when I experience that, I know it and ... it's no longer a story ... it's no longer unreal, or in my mind. It's a part of me, it is, and I can feel that. I can feel that oneness between my mind and my heart. ... With the story in the second person, it remains a story. There's separation there, and we consciously don't know what it feels like. ... Until I actually broke down and felt it ... I never believed it was that bad, and that's the whole difference between a story and what is.

Doris said that when she went into therapy she was trying to "learn how to feel so that I could share what I knew with somebody." The investigator, attempting to be loyal to the narrative model, asked if he might say that she was, "trying to create the true story." She replied, "There is no story involved. I just wanted to be, I just wanted to live, I just wanted to be, I just wanted to be allowed to feel what I was feeling."

The investigator asked her what she wanted to call it when the story and the experience came together. She replied, "Call it the truth, because then you can't, once you know the truth, you can't exaggerate it anymore because you know, or you can't tell a lie about it because you know."

Asked if she felt she had been deceiving herself, she replied:

I was definitely deceiving myself because the experience was too overwhelming to look at [pause] those feelings [pause] I couldn't integrate them as my own ... and so, yes, I did deceive myself in a very destructive way ... and it's a scary thing when feelings are that powerful that you can't accept them. I couldn't accept them, and I went off track and I created a new reality along with other people, not because I wanted to but [because] it was a comfortable way of dealing, I guess. Actually, it wasn't being comfortable--I can't even say that; it was hell; but it was, I don't know, I don't know, it was that whole experience of losing my daughter was just so much--really they were one in the same anyway.

It appears that Doris has modified the traditional trauma model. She believes therapists should work on the acceptance of feelings associated with remembered episodes. Speaking of hospital staff and therapists, she stated, "They don't take them [feelings] seriously enough because the patient doesn't take them seriously enough. ... The patient talks in the second person so, as to speak, and tells a story about the whole thing." Thus, Doris believes a sort of unspoken collusion occurs in which both patient and therapist avoid facing a painful reality.

Although Doris objects to the idea that persons always tell narratives, the narrative model appears to apply to the construction of her satanic abuse story. However, prior to therapy, Doris does not appear to have been searching for a story that would explain her behavior. Rather, she seems to have been searching for a relationship that would allow her to feel and communicate. Furthermore, she makes a distinction between telling a story and experiencing an event by allowing the feelings it occasioned. She believes that when feelings are not processed, there is fertile ground for selfdeception.

Discussion

Clearly, neither the mind-control nor the narrative conceptualization fits the experience of all the retractors, yet each is an excellent description of what was experienced by particular retractors, and both offer important perspectives. To illustrate this, we examine each of the retractors from the perspective of both of the models.

The mind-control model clearly fits Ann's and Cath's experiences. Both feel that their therapist systematically undermined their decision-making capacity and repeatedly insisted that they could not get well until they remembered childhood abuse. That is, they experienced themselves as succumbing to the will of an authority figure who was the real creator of the narrative that they enacted and who controlled information by suggesting books to read and discouraging contacts with family members who had different views.

In many respects their experiences parallel those of participants in Dembo's (1976, original 1930) classic experiment, wherein participants discovered that the authoritative experimenter would only permit them to leave when they discovered the solution to a problem. In fact, no solution existed, and Dembo described how the life-space of the participants became so tense that the boundaries between reality and fantasy were weakened. All of the "normal" participants exhibited irrational behavior within less than 2 hr. In a parallel manner, both Ann and Cath were told they would not get better (i.e., could not leave) until they recaptured abuse memories (i.e., solved an unsolvable problem). Both reported extraordinarily high degrees of tension and a collapse of the boundary between reality and

fantasy. Whereas Ann was held in the field by her fear that she would go crazy if she left, Cath was trapped by her positive feelings for the therapist.

By contrast, the mind-control model only partly fits Doris's experience. On the one hand, the therapist initially suggested the narrative and led her to feel that she had no choice but to believe the narrative. On the other hand, Doris used her own imagination to author the narrative and maintained control in the sense that she manipulated her therapist to avoid facing a painful reality.

The mind-control model clearly does not fit Beth's experience. True, Beth would not have written a letter accusing her father had her therapist not insisted, so, in this sense, Beth's behavior was controlled. However, she did not experience her (already weak) decisionmaking capacity as undermined, nor feel that her will was under the control of the therapist. Rather, she herself was the author of the narrative and the therapist merely a supporting figure. When the therapist withdrew support, Beth lost trust in her direction.

The narrative model clearly fits Beth and Doris, who experience themselves as creating an abuse narrative in order to explain their behavior. Furthermore, clear evidence exists that both Cath and Ann used narratives that were created by others (the Sybil narrative in Cath's case, and an account in the Courage to Heal in Ann's). However, neither Ann nor Cath nor Doris entered therapy with the goal of telling a narrative that would explain their behavior and important aspects of Ann's and Cath's experiences are not accounted for by the narrative model.

Ann was adamant in rejecting the idea of self-deception. She believes that during the period she accused her parents, she became the putative victim. In retrospect, she feels she was a "nobody," that is, completely under the control of her therapist. She argues that she was simply trying to get well. To do so, she followed her therapist's prescription. To be sure, she also wanted her therapist's approval and to please one whom she viewed as a loving authority. She fought against the interpretation that was offered, but, finally, weakened by drugs and insomnia, gave in to a will that was more powerful than her own. When she did give in, she did so completely. She fully believed that her father had abused her, that her mother probably knew about it, and that her sisters were in denial. Yet, she continued to love her family and to want them back at the same time that she rejected them. No "part" of her doubted the story she was enacting at that time.

Cath's story also requires us to acknowledge that a narrative may be almost completely authored by another and dependent on the strength of the other's will. Many of Cath's emotional needs were met by her therapist. Rather than fighting against his interpretation, she went along with it, pretending that the story he told was true. She dissociated in the sense that she would pretend to be a 5-year-old girl, and this role became an important part of the imagined reality of herself as an abuse survivor.

However, in one sense, Cath had doubts that Ann lacked and the narrative model helps us understand her behavior. She was aware that her 5-year-old identity was an act rather than reality and she protested that this was so. (Yet, she was so involved with her therapist that when he would order this protesting self out of the room, she would submit to his interpretation and not pay attention to other possible perspectives.) Hence, she did participate in a sort of self-deception. She fully believed the completely imaginary role that had been created for her and was supported in this illusion by her therapist. She enacted that role much like an actress who forgets she is playing a contrived role. In fact, her relationship with the therapist was based on the construction of a victim role. It was truly a foli a deux or, more appropriately, a foli a beaucoup given the supporting cast of a believing spouse, friends, and so on.

Importantly for the retractors, the victim role assumed is embedded in a real context, unlike the delusions of the insane, which are largely privatized. Like individuals in the "pretend" prison established by Haney, Banks, and Zimbardo ( 1973 ), persons are placed in a social role that becomes real and affects their perception of reality. In fact, to comprehend how relatively normal people can develop FMS, one must realize the extent to which a subculture exists that uncritically believes that traumatic memories can be completely repressed and recovered years later. Therapists, spouses, friends, and many books and movies support a social reality in which the person has supposedly repressed memories of events too horrible to experience. At first, the only evidence that this social reality is delusional is the fact that family members say it does not match their reality.

Given the fact that a family might well be disposed to deny abuse that had actually occurred, what privileges the family's reality over that of the therapist's? The following three deciding factors appear to favor the family. First, the patient has no prior memories of abuse and only believes in the abuse reality as long as he or she remains isolated from the reality held by the rest of the family. Second, because the patient initially had fond memories of their family, the therapist's reality requires us to believe that children could suffer traumatic abuse and dissociate so completely from that abuse that they could act in a loving way toward the abuser without realizing that he or she was an abuser

and without showing signs of dissociation that would be noticed by teachers, doctors, or other third parties. Third, the retractors become less functional as therapy progresses and more functional when they are reunited with their families.

When the retractors themselves were questioned about why they thought their current memories of nonabuse were correct, all four had similar answers: While they were in therapy and recovering "memories" of having been sexually abused, they had been either extremely depressed or extremely anxious (two had attempted suicide, and none was able to work). Now that they were out of therapy and realized that they had not been abused, they felt better, no longer contemplated suicide, and were doing meaningful work.

At some point in the course of therapy all of the retractors exhibited symptoms of dissociation disorder. All four spoke of trancelike states. Hence, one might conclude that FMS only occurs in persons who are characteristically prone to dissociative disorder or, at least, to being highly suggestible or hypnotizable. With the possible exception of Beth, the RPs do not appear to have been particularly prone to interrogatory suggestibility ( Gudjonsson, 1992). The investigator was able to obtain some information on hypnotizability and to administer the Dissociative Experiences Scale (DES; Bernstein & Putnam, 1986) to three of the four retractors. One retractor (Ann) appears to have been highly hypnotizable. In her last year of therapy, she attended a show with a stage hypnotist and fell into a trance state while she was in the audience. She also reported an unusually high ability to become absorbed in tasks. Beth had been hypnotized during high school but, after therapy, had not been able to enter a trance state for research purposes. Cath had attempted hypnosis before therapy in order to stop smoking and had not been able to enter a trance state. DES scores (6.8, 4.6, and 1.2, respectively) were well within the normal range (Median for normal = 4.4; median for posttraumatic stress disorder = 31.2). All reported that during therapy their dissociation experiences were much greater and when they answered the DES with that period in mind, their scores were much higher (21.1, 19.1, and 8.2, respectively). Hence, the dissociation reported by the retractors during therapy appears to have been a function of the stress induced by the therapy rather than a personality characteristic.

It would appear that relatively normal persons from relatively functional families may develop FMS either through the mind control of a therapist pursuing a personal agenda or through a process of narrative construction abetted by a therapist who ignores the defensive position established by the narrative.

Notes

I would like to thank Beth Loftus, Ted Sarbin, and Nick Thompson for their helpful comments on an earlier draft of this article.

Joseph de Rivera, Department of Psychology, Clark University, 950 Main Street, Worcester, MA 01610-1477. E-mail: [email protected] edu

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