Steven Mirin, M.D.., Executive Director
American Psychiatric Association
1400 K Street, N.W.
Washington, DC, 20005
Dear Dr. Mirin:
I am writing to express my deep disappointment at your organization's complete failure to discipline your own profession or even to establish clear guidelines by which professional misconduct can be judged. Your inaction in the face of an epidemic of malpractice silently condones the worst excesses of irresponsible and incompetent therapists, leaves clients and families vulnerable to irreparable harm, and justifiably erodes the credibility of your organization, your profession, and all of its members.
I am referring, of course, to your organization's failure to issue clear, principled, unambiguous, scientifically-based guidelines banning the use of so called "memory recovery therapy," a set of techniques which was rushed into use nationwide in the 80s without any testing for safety and effectiveness and which has been utterly discredited by the impossible "memories" it "recovers" including alien abduction, ritual satanic abuse, and past lives.
Defining the standard of what constitutes professional conduct is your organization's responsibility by the principle of professional self-regulation. Your silence on the topic of so-called "memory recovery therapy" demonstrates a glaring lack of concern for the welfare of clients and the protection of the public and a clear abrogation of your duty.
The contrast of your organization's conduct with that of the Royal College of Psychiatrists in the U.K. is painful. The Royal College formed a Working Group on Reported Recovered Memories of Child Sexual Abuse and adopted the group's "Recommendations for Good Practice" as official practice guidelines. These guidelines state in part that "Psychiatrists are advised to avoid engaging in any 'memory recovery techniques' which are based upon the expectation of past sexual abuse of which the patient has no memory. Such 'memory recovery techniques' may include drug-mediated interviews, hypnosis, regression therapies, guided imagery, 'body memories', literal dream interpretation and journaling." Your organization's failure to issue equivalent guidelines silently condones the continued use of these harmful, discredited techniques in the U.S. by your own membership.
This failure has not gone unnoticed. In their report "Recovered Memories of Childhood Sexual Abuse: Implications for Clinical Practice" in the British Journal of Psychiatry, Sydney Brandon et al note that "the polarisation of views and fierce controversy within the American psychiatric community was in danger of bringing psychotherapy into disrepute." Evaluating the statements issued by the American Psychiatric Association, the American Psychological Association, and the American Medical Association, Brandon further notes that "In their efforts to remain impartial they have failed to resolve the impasse between research and clinical observation."
Much damage has already been done. History will judge your profession harshly for failing to base its practices on the results of scientific research and for failing to insulate your practitioners (and even your continuing education programs!) from therapeutic fads arising from pop psychology bestsellers and the beliefs of untrained, unlicensed "authorities" like Ellen Bass and John Bradshaw.
However, it is not too late for your organization to reform your profession and reduce the risk of future malpractice and injustice. In order to protect clients and their families from the use of demonstrably harmful "therapies," please take the following steps at once:
If you fail to take these minimal steps to ensure patient safety
and professional responsibility, the American public will have to
wonder why you fail to act where the Royal College has taken a clear
stand. Will it be because you are less well informed, less
responsible, or less concerned about patient welfare and justice
than your British and Canadian counterparts?