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Note: As False Memory Syndrome is a problem of American
origin, it is painful to note how much more vigorous and thorough the British
have been in alerting mental health professionals to the risks posed by
so-called "Memory Recovery Therapy" than have been their American
counterparts. I look forward to the day when American mental health organizations
do as much to protect patients and families as the British
ones do. How can we account for this difference? Several possible explanations
come to mind.
You will have to decide which explanations you find most convincing.
History will judge the American organizations for their relative
inaction in the face of injustice.
Concern about recovered memories which have no factual basis should be concentrated on those cases where patients report having had no memory whatsoever of abuse which continued over many years. Royal College of Psychiatrists,
The evidence shows that memories of events which did not in fact occur may develop and be held with total conviction. Such memories commonly develop under the influence of individuals or situations which encourage the development of strong beliefs. They have often been described as arising within therapy, sometimes involving psychiatrists or other mental health workers, as well as psychotherapists. ibid
Previous sexual abuse in the absence of memories of these events cannot be diagnosed through a checklist of symptoms. ibid
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. There is no evidence that the use of consciousness-altering techniques, such as drug-mediated interviews or hypnosis, can reveal or accurately elaborate factual information about any past experiences including childhood sexual abuse. Techniques of regression therapy including 'age regression' and hypnotic regression are of unproven effectiveness. ibid
Forceful or persuasive interviewing techniques are not acceptable in psychiatric practice. Doctors should be aware that patients are susceptible to subtle suggestions and reinforcements whether these communications are intended or not. ibid
The psychiatrist should normally explore his or her doubts with the patient about the accuracy of recovered memories of previously totally forgotten sexual abuse. This may be particularly important if the patient intends to take action outside the therapeutic situation. Memories, however emotionally intense and significant to the individual, do not necessarily reflect actual events. ibid
Adult patients reporting previously forgotten abuse may wish
to confront the alleged abuser. Such action should not be mandated by the
psychiatrist and likewise it is rarely appropriate to discourage or even
to forbid the patient from having contact with the alleged abuser or family
members. The psychiatrist should help the patient to think through the
possible consequences of confrontation with the alleged abuser. In
these circumstances it is appropriate to encourage the search for corroboration.
ibid
Once the accusation is taken outside the consulting room,
especially if any question of confrontation or public accusation arises,
there can rarely be any justification for refusal to allow a member of
the therapeutic team to meet family members.
ibid
It is not known how to distinguish, with complete accuracy,
memories based on true events from those derived from other sources ....
Memories can be significantly influenced by questioning, especially in
young children. Memories also can be significantly influenced by a trusted
person (e.g., therapist, parent involved in a custody dispute) who suggests
abuse as an explanation for symptoms/problems, despite initial lack of
memory of such abuse. It has also been shown that repeated questioning
may lead individuals to report "memories" of events that never occurred.
Statement on Memories of Sexual Abuse,
Board of Trustees of the American Psychiatric
Association
Clinicians who have not had the training necessary to evaluate
and treat patients with a broad range of psychiatric disorders are at risk
of causing harm by providing inadequate care for the patient's psychiatric
problems and by increasing the patient's resistance to obtaining and responding
to appropriate treatment in the future.
Statement on Memories of Sexual Abuse,
Board of Trustees of the American Psychiatric
Association
to treat for repressed memories without any effort at external validation is malpractice pure and simple; malpractice on the basis of standards of care that have developed out of the history of psychiatric service... and malpractice because a misdirection of therapy will injure the patient and the family. Dr. Paul McHugh,
Chair of the Psychiatry Department at Johns
Hopkins University
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