During the witch-hunts of the Early Modern period, a regular pattern emerged. Volumes would be written by theologians and lawyers setting out the diagnostic criteria for identifying and processing witches; these then formed the basis for witchcraft investigations and trials.
Continue readingSo why are the Skeptics Giving Money to Convicted Child Abusers?
Chair-entity Vicki Hyde responds to a letter from a member who resigned from the society over the Skeptics’ donation to the Peter Ellis Defence Fund. We reprint her letter as a clear statement of the Society’s position on a controversial issue.
Continue readingTherapeutic Folie-a-Deux
Folie-a-deux can be defined as a paranoid disorder in which the same delusion is shared by two (or more) persons. The delusion is thought to be transmitted from a dominant but paranoid person to his or her dependent intimate(s), and the latter may recover “normal” reality testing after separation from the former.
To my mind the interesting essential of this situation is that the sharing of a belief bonds and comforts its adherents; this feature may be obvious even where the belief is shared by many and would not ordinarily be regarded as delusional. For example, picture a church congregation reciting its creed in unison.
The Comfort of Shared Belief
What is the nature of the comfort so provided? In our prototypical, pathological case, where the belief is a persecutory delusion, the acceptance of the belief by a “significant other” signifies to “the beleaguered one” that he has found an ally or a protector; contrariwise, skepticism creates the kind of anxiety that would be felt by a small child who hears a robber entering his bedroom, but can’t convince a nearby parent to come to the rescue.
The delusional belief can thus function as a probe with which to test the love, loyalty and ready courage of the other. Where the belief is less persecutory (e.g., belief in God), the sharing of it is at least friendly, like sharing a meal; and the belief may seem to be validated by the numbers subscribing to it.
In either case, if a newcomer to the “church” demands evidence, he either misses the symbolic point, or is being deliberately obtuse and distinctly unfriendly. Those of us who are skeptics at heart will hesitate at the church door, having in the past experienced conflict between that social pressure and its opposite, a desire to be the maverick whose superior science will expose the error of the herd.
Or, if we were doctors, thought we had joined another sort of church, whose members sing in unison, credo in unum deum, Reality; and otherwise have to agree only on the means for finding it (the scientific method).
As doctors, we still take a great deal on trust in our human relationship with patients, and find warmth in that relationship that is cemented, without our consciously considering it, by mutual and traditional assumptions (for example about the nature of the roles each is to play). Generally, we assume the patient is trying to be honest, and certainly don’t demand proof for every detail of the history.
By being credulous in that way, we become the parent who will keep the robber, Death, at bay. Sometimes we come running even when we think the robber is imaginary. And after all, how can one be sure? In a case of suspected child abuse, better to call Social Services after a minimal reality check. “Time may be of the essence.” “Better to be safe than sorry.”
Yet there are many situations in which the credulous posture becomes problematic. The simplest of these is when the patient has been identified as “delusional”, which means that the doctor has decided in her heart that she does not believe, does not stand on common ground with her patient in regard to the delusional idea and does not wish to.
In the interests of the alliance, or out of empathy, she may still search for the grain of truth on which they can agree. Might she even disguise her belief for strategic purposes? Perhaps, after all, her patient is repeating in this doctor-patient relationship a childhood experience of being unable to summon a parent in the moment of terror.
Believing the Fantastic: The Problem
An especially muddled situation depending on credulity in the therapist-patient alliance has been the proliferation in recent years of therapies for victims of fantastic post-traumatic syndromes.
For example hypnotherapies for people who have been contacted, abducted or violated by extraterrestrials, or who have suffered trauma in a previous existence. I assume the reader shares my automatic scepticism regarding these trauma and their treatments. In any case, do we need to concern ourselves with this phenomenon beyond perhaps noting it as an interesting example of folie-a-deux?
But if such is their church, and it comforts them, why not leave them to it? Are not all the communicants consenting adults? The phenomenon is spreading. Abduction stories are becoming epidemic and are gaining more credibility in the media.
Another example, which has been closer to home for psychiatry, is the “growth industry” of treatments and conferences pertaining to multiple personality disorder and Satanic ritual abuse.
I say “closer to home” because, according to the sociologist Jeffrey S. Victor, fifty psychiatrists (and two hundred other professionals) attended the conference on ritual abuse he describes in his article, and two-thirds of the audience at one lecture raised their hands when asked if they had treated Satanic ritual abuse. Most seemed to assume that the survivor stories were literally true and that often such abuse had been the etiology of a multiple personality disorder in the surviving adult.
Admittedly such a conference will concentrate believers, but in my everyday work for a large health plan I too have had occasion to discuss Satanic ritual abuse with credulous therapists and to interview patients who presented typical survivor stories.
The contents of a typical ritual abuse story by now are familiar to many readers: perverse sexual activities occurred at length, repeatedly over the years, between Satanic perpetrators and the child protagonist, embellished with black robes and candles and laboured misuse of Christian symbols; the child was forced to take an active role in the murder of another child; blood was drunk or babies were dismembered and eaten; babies were being bred by the cult for the purpose of ritual sacrifice. Satan himself might appear on the scene.
In day-care cases, the lack of disinterested witnesses is explained by improbable transportation of children to a hidden site (by plane, by tunnels etc.), reminiscent of the “night flight” aspect of witchcraft hysteria. Enthusiasts for the theory hold that such abuse is widespread, for example that fifty thousand ritual sacrifices occur yearly, or that Satanic cults comprise a world-wide multi-generational conspiracy.
According to Kenneth Lanning, in charge of an FBI unit investigating Satanic cult crimes, “We now have hundreds of victims alleging that thousands of offenders are murdering tens of thousands of people, and there is little or no corroborative evidence, from a law-enforcement perspective”.
As therapists, should we care one way or the other about corroborative evidence? Is it not in the nature of an empathic therapeutic alliance to enter into the spirit of the patient’s experience? Is it not in the nature of the therapeutic process to deal evenhandedly with material drawn from fantasy and reality alike? And when it seems that numbers of professionals are unduly impressed by such stories, perhaps it is only their empathy at work; instinctively recognising that there is no better way of forging an alliance with the patient than to endorse the patient’s view of reality.
Yet, I am concerned that in pursuing this course, the therapist can lose track of how much sacrifice of her own intellectual autonomy is being made on behalf of the therapeutic relationship. Taken to an extreme, this kind of empathy ultimately places the therapist in the position of the dependent partner in a folie-a-deux.
There are other possible formulations of the problem I am addressing. Some ritual-abuse patients may be diagnostically closer to having a factitious disorder than to having paranoia, in which case the involved therapists might be regarded as the susceptible targets of a fraud. For example, I interviewed one patient who had obtained disability income on the basis of her post-Satanic multiple-personality disorder, while working with a therapist who had accepted this history without corroboration.
In the case of an adult who identifies cryptic signs of ritual abuse in a child and then applies for treatment or legal action, I see a parallel with the parent enacting a Munchhausen-by-proxy (in which the child is presented for treatment of an odd physical illness which has been fabricated or induced by the parent). In both cases, the parent usually appears especially devoted and concerned for the welfare of her child and compels the admiration of physicians and others involved, until the true situation is uncovered.
What factors beside empathy may have paralysed our capacity to doubt?
Obligatory belief
We all realise the harm that can result from not taking a sexual abuse story seriously, particularly when it comes from a child. We now practice in a state of heightened vigilance to prevent such abuse, interrupt it, or treat its post-traumatic stress disorder. We bend over backwards to correct Freud’s under-estimate of the true incidence of incest.
As a result, many of us have come to feel embarrassed to question any aspect of any story involving sexual abuse, no matter how truly fantastic. Even in the privacy of our own minds, it can seem that belief is obligatory. And when it comes to voicing doubts out loud, we anticipate a consensus to the contrary, or arguments ad hominem that charge our scepticism to our squeamishness, denial or insensitivity.
And here let me make a personal value explicit: that belief ideally rests on evidence that convinces, and that scepticism is a healthy, or at very least, a permissible first response to someone else’s novel hypothesis, especially when that hypothesis involves the supernatural or challenges common sense.
Mass Hysteria
A third formulation to explain therapist credulity is favoured by Jeffrey Victor and other sceptical sociologists. They suggest that the Satanic ritual abuse phenomenon is an example of mass hysteria (a.k.a. moral panic), in which therapists, patients, clergymen, police and others become involved according to individual vulnerability and social context. They support this theory by an analysis of the manner in which the Satanic cult rumours are spread, and by amassing the cases in which no evidence could ever be found to demonstrate a reality behind the rumour.
The content of ritual-abuse stories also lends support to this explanation. For example, some women who seek “deprogramming” claim to have been practicing witches under the domination of Satan. Their scenario of an indulgence followed by repudiation is an exact duplication of that sequence in the behaviour of the children at the core of the seventeenth century witchcraft hysteria in Salem Village in Massachusetts. Beliefs about blood-drinking, baby-sacrifice, perverse intercourse with demons etc were also all represented in such earlier hysterias.
In the three hundred years of European witchcraft hysteria, ending not long after the Salem outbreak, 200,000 innocent men and women were murdered as witches. The hysteria was supported by the establishment, partly because the estates of wealthy “witches” could be confiscated by the court after they had been executed.
It is hard to imagine that three hundred years later, there is any danger of the whole social structure becoming caught up in teh hysteria in the way that it was in those times. It is alarming that part of the contemporary legend is a belief that individual modern cults are part of an ancient conspiracy, whose goal is to “create international chaos in order to allow Satan to take over the world.”
While believers in this theory may never succeed in creating the kind of panic that leads to sanctioned executions, “an unjustified crusade against those perceived as satanists could result in wasted resources, unwarranted damage to reputations, and disruption of civil liberties,” as Kenneth Lanning wrote in 1990. It has happened. Thousands of families in the United States have been needlessly disrupted, even if one can speculate that in some cases distancing the family might have been part of the patient’s agenda.
Causes of Mass Hysteria
The phrase “mass hysteria” describes a social phenomenon not necessarily restricted to people who individually suffer from histrionic or paranoid disorders. Other factors thought to contribute to vulnerability include gender (more often female) and pre-existing social ties. In the case of the Satanic cult hysteria, the “pre-existing social ties” exist within certain sub-groups of the mental-health professional communities. And the law-enforcement contingent at the seminars shares a fundamentalist Christian perspective:
“The most notable circular among cult-crime investigators, File 18 Newsletter, follows a Christian world-view in which police officers who claim to separate their religious views from their professional duties nevertheless maintain that salvation through Jesus Christ is the only sure antidote to Satanic involvement, whether criminal or noncriminal, and point out that no police officer can honourably and properly do his or her duty without reference to Christian standards.”
Many of the participating therapists also share this context.
Modern “local panics” about satanic cults “have almost all occurred in economically declining small towns and rural areas of the country”. Similarly, an analysis of the economic and political factors favouring hysteria can be made on the basis of the location on the Salem map, in 1692, of the homes of the accusers, the accused and their defenders.
It is interesting to speculate about other social causes of such hysteria. One possibility is that many people are interpreting the AIDS epidemic as God’s punishment for sexual wrongdoing, especially as it occurred concurrently with increasing public awareness of the reality of incest. A subgroup of these people may have been conditioned, by religious upbringing or personal history, to deal with anxiety about forbidden impulses through projection and splitting, and the real existence of Satanic cults provided the seed crystal for a conspiracy theory.
Similarly to a conversion symptom, the hysteria also provides the opportunity for disguised expression of sexual and aggressive interests, as the participants can discuss the details of abductions and orgies while claiming to be traumatised or outraged.
Relationship to Real Sexual Abuse
This brings me to the question of just what relationship the Satanic ritual-abuse hysteria bears to real instances of physical and sexual child abuse.
Obviously it can be viewed as a simple imitation of a true abuse situation, which appears cruder or gaudier than the original, as natural imitations generally do. Like the larger and more brightly spotted eggs of the cuckoo, the ritual-abuse story is a winner in the contest for nurturing behaviour.
In some cases, professionals involved in the hysteria have had personal knowledge of real cases of child pornography, incest, physical abuse, neglect, or those rare instances where the sexual molestation of a child was associated with Satanic embellishments (such perhaps was the case of Frank and Iliana Fuster, described by Roland Summit and others). Their subsequent participation in mass hysteria could be viewed as a manifestation of professional shell-shock.
In the New York Times of March 3, 1991, there was a description of a case in which a couple abandoned an infant to death by starvation because of their participation in an extended crack orgy. Three years ago I was involved in a similar case (the mother had been my patient). When her crime was discovered, incredulous friends attributed it to her having been kidnapped by a Satanic cult, which forced her to kill her baby.
This colourful explanation eased vicarious guilt (mine included, at the moments I was tempted to believe it) and extracted a drop of pleasurable drama from what was, in stark reality, an unmitigated horror.
The Satanic ritual-abuse hysteria could well be, in part, the product of that amazing ability of the human mind to transmute pain into pleasure. If so, I can understand why its adherents would be tenacious. Supposing them to have had childhoods studded by such painful episodes, one can hardly begrudge them the soothing balm and spangly entertainment of hysteria; of fictionising and dramatising their trauma at the moment of its emergence into publicity. At one remove, I am doing something similar as I now write.
Let me look a little more closely, though, at the nature of the relief provided to the ritual-abuse patient. It could go like this: if Satan and all his minions ravished her or her child, she was really not to blame. Never mind if mental health professionals had been trying to tell her that for years; when it comes to ground-in guilt, nothing gets it out like a home-made remedy.
How can it hurt to let the patient go on feeling that we validate this version of her story? In some cases that might seem the best course, or is the only alliance the patient will allow. But leaving aside the potential division of a family, within the patient herself, the split is left unhealed. Somewhere deep in her heart, she could still be wondering whether Satan, penis and all, is not a piece of herself, torn like Adam from her own chest.
And to get at that question, she will have to tell the real story — more homely, sad, or embarrassing. It might be a real incest story, but more likely it will be the story of a puritanical childhood, which — as in Marion Starkey’s Salem — allowed exitement only via tales of sin and punishment.
Secondary Gain
And what of the patients who, though now in no great distress, instinctively exploit a mass hysteria? What treatment will divert them from a life of disability under a factitious personality disorder or post-Satanic stress syndrome?
Thigpen and Cleckley, the authors of The Three Faces of Eve, believe that full-blown multiple-personality is extremely rare. Most patients seeking the diagnosis are histrionic personalities with a capacity for some dissociation, and a desire to promote that capacity “to … gain attention, or maintain an acceptable self-image, or accrue financial gain, or even escape responsibility for actions.” Multiple personality is almost unknown in England, where sensational biographical accounts of such patients are less available.
Fahy et al suggest treating multiple personality and lesser degrees of dissociation as symptoms of personality disorder. “It is our contention that sanctioning the dissociative behaviour, by concentrating on symptoms or encouraging symptomatic behaviour, may lead to reinforcement and entrenchment of the relevant symptom.” (The same argument applies to preoccupation with the ritual-abuse story.)
In a personal communication, Bessel VanDerKolk reframed the “attention-getting” motive I have here attributed to the multiple-personality or ritual-abuse patient. He takes a therapist’s sense that a patient is exhibiting or “getting off on trauma”, to be a marker for the presence of narcissistic issues in that patient, such as would derive from a childhood that was lacking the minimum essential mirroring from the parents. The resulting hunger to feel important to someone is appropriately gratified by an outraged therapist, even if the trauma is mislabelled by both therapist and patient.
There is a lively dialogue on the subject of therapist scepticism regarding multiple personality in The Journal of Nervous and Mental Disease. I wonder if professionals polarise over endorsing this diagnosis because of personal values regarding responsibility vs. dependency.
Physicians tend to be responsible, counterdependent stoics; as such we face a continual choice between envying the apparent ability of the dissociative patient to escape accountability, or merging with this patient in order to enjoy vicariously the gratifications he seems to achieve in that way. It is possible to shift between the two positions, but most will have a tendency toward one or the other.
Iatrogenic Contributions to Mass Hysteria
We must finally confront the fourth, and least palatable form in which therapist particiption has contributed to mass hysteria: case-finding therapists have been playing a role analogous to the witch-finders of earlier hysterias.
Of course then, the witches were not so much found as created, often by quite deliberate fraud with an obvious profit motive; I had presumed the therapist motivation to be more complicated, including for example the understandable pleasure of sharing the limelight falling on such a case.
An article on Satanic ritual abuse in the April, 1992 issue of The Psychiatric Times describes a case of a therapist who allegedly pressured her patient into telling the ritual abuse story. The patient explained, “It was never just enough to tell her that my grandmother had abused and tortured me. It always needed to be worse.”
This was a harbinger of the flood of false-memory retractions now appearing in the United States. Such zealous therapists would be the dominant partners of the folies-a-deux, the parents in a Munchausen-by-proxy, and the driving force behind hysteria. The past year’s work of the False Memory Syndrome Foundation would suggest that numbers of recanting accusers feel they had been pressured by their therapists in just this way.
The profit motive must now be taken more seriously. It is not necessarily unethical to pursue a specialty which meets the need of fashion, even if one does so with the covert through, “there’s money to be made from this”. Consider for example a hypnotist who decides that because of new anti-smoking laws, a smoking-cessation practice is likely to succeed. It is perfectly possible that he is sincere and zealous about this practice which also happens to be profitable. Yet, if somehow it turned out that hypnotism were more harmful than cigarettes, we would begin to wonder just how long the practitioner might have secretly stilled the doubts now shared by all.
Education or Tolerance?
It will not be possible to eradicate this type of mass hysteria, which has such a strong appeal and is so nearly adaptive for so many. Indeed, a fifth and final reframe for the phenomenon was suggested to me by the anthropologist Sherrill Mulhern (director of the Laboratoire des Rumeurs, des Mythes du Futur et des Sectes at the University of Paris). She believes that the satanic-abuse survivors and their convert therapists comprise an American possession cult.
Labeling mass hysteria in this way, reminds us of the adaptive and comforting aspects of religion, and blames no one (not parent, nor patient, nor therapist) for a phenomenon that springs from some widespread cultural source.
Yet (along with Ms. Mulhern) I remain concerned about the dangerous and counter-therapeutic aspects of cultic religions, in which vulnerable individuals may feel too much pressure to conform and to renounce family ties that might still have been a net positive resource.
And I feel bewildered to walk into my scientific church and find a significant portion of the congregation busily sacrificing a scapegoat on the altar.
Part of our role as doctors is to educate. We can make an effort to enlighten those of our colleagues who are treating factitious and conversion disorders without recognising them as such, and to come to the aid of those who sense the symptomatic nature of the story-telling but are confused as to what “empathy” requires in that situation.
Empathy need not disable the therapist’s observing ego, nor its faculty of critical thought. That is what generates the full list of diagnostic hypotheses and assesses the quality of the evidence available for choosing between them, so our empathy will be attuned to the real source of pain in a particular patient.
Institutionally, we can make more conscious choices about limiting clinical resources such as hospitalisations, especially where the relevant symptom is fully ego-syntonic or factitious. And finally, I think we need to examine the role played by ritual-abuse conferences, courses or therapies in feeding hysteria or proselytising for a new religion.
Multiple Personality Disorder
What can events 100 years ago tell us about a modern disorder?
Students often ask me whether multiple personality disorder (MPD) really exists. I usually reply that the symptoms attributed to it are as genuine as hysterical paralysis and seizures, and teach us lessons already learned by psychiatrists more than a hundred years ago.
Consider the dramatic events that occurred at the Salpêtriére Hospital in Paris in the 1880s. For a time, the chief physician, Jean-Martin Charcot, thought he had discovered a new disease he called “hystero-epilepsy”, a disorder of mind and brain combining features of hysteria and epilepsy. The patients displayed a variety of symptoms, including convulsions, contortions, fainting and transient impairment of consciousness.
A skeptical student, Joseph Babinski, decided that Charcot had invented rather than discovered hystero-epilepsy. The patients had come to the hospital with vague complaints of distress and demoralisation. Charcot had persuaded them that they were victims of hystero-epilepsy and should join the others under his care. Charcot’s interest in their problems, the encouragement of attendants, and the example of others on the same ward prompted patients to accept Charcot’s view of them and eventually to display the expected symptoms. These symptoms resembled epilepsy, Babinski believed, because of a municipal decision to house epileptic and hysterical patients together (both having “episodic” conditions). The hysterical patients, already vulnerable to suggestion and persuasion, were continually subjected to life in the ward and to Charcot’s neuropsychiatric examinations. They began to imitate the epileptic attacks they repeatedly witnessed.
Babinski Vindicated
Babinski eventually won the argument. In fact, he persuaded Charcot that doctors can induce a variety of physical and mental disorders, especially in young, inexperienced, emotionally troubled women. There was no “hystero-epilepsy”. These patients were afflicted not by a disease but by an idea. With this understanding, Charcot and Babinski devised a two-stage treatment consisting of isolation and counter-suggestion.
First, “hystero-epileptic” patients were transferred to the general wards of the hospital and kept apart from one another. Thus they were separated from everyone else who was behaving in the same way and also from staff members who had been induced by sympathy or investigatory zeal to show great interest in the symptoms. The success of this first step was remarkable. Babinski and Charcot were reminded of the rare but impressive epidemic of fainting, convulsions, and wild screaming in convents and boarding schools that ended when the group of afflicted persons was broken up and scattered.
The second step, counter-suggestion, was designed to give the patients a view of themselves that would persuade them to abandon their symptoms. Dramatic counter-suggestions, such as electrical stimulation of “paralyzed” muscles, proved to be unreliable. The most effective technique was simply ignoring the hysterical behaviour and concentrating on the present circumstances of these patients.
They were suffering from many forms of stress, including sexual feelings and traumas, economic fears, religious conflicts, and a conviction (perhaps correct) that they were being exploited or neglected by their families. In some cases their distress had been provoked by a mental or physical illness. The hysterical symptoms obscured the underlying emotional conflicts and traumas. How trivial a sexual fear seemed to a patient in whom convulsive attacks produced paralysis and temporary blindness every day!
Staff members expressed their withdrawal of interest in hysterical behaviour subtly, in such words as, “You’re in recovery now and we will give you some physiotherapy, but let us concentrate on the home situation that may have brought this on”.
These face-saving counter-suggestions reduced a patient’s need to go on producing hystero-epileptic symptoms in order to certify that her problems were real. The symptoms then gradually withered from lack of nourishing attention. Patients began to take a more coherent and disciplined approach to their problems and found a resolution more appropriate than hysterical displays.
The rules discovered by Babinski and Charcot, now embedded in psychiatric textbooks and confirmed by decades of research in social psychology, are being overlooked in the midst of a nationwide epidemic of alleged MPD that is wreaking havoc on both patients and therapists. MPD is an iatrogenic behavioural syndrome, promoted by suggestion, social consequences, and group loyalties. It rests on ideas about the self that obscure reality, and it responds to standard treatments.
To begin with the first point, MPD, like hystero-epilepsy, is created by therapists. This formerly rare and disputed diagnosis became popular after the appearance of several best-selling books and movies. It is often based on the crudest form of suggestion. Here, for example, is some advice on how to elicit alternative personalities (alters, as they have come to be called), from an introduction to MPD by Stephen E. Buie, MD, who is director of the Dissociative Disorders Treatment Program at a North Carolina hospital:
It may happen that an alter personality will reveal itself to you during this [assessment] process, but more likely it will not. So you may have to elicit an alter… You can begin by indirect [sic] questioning such as, “Have you ever felt like another part of you does things that you can’t control?” If she gives positive or ambiguous responses, ask for specific examples. You are trying to develop a picture of what the alter personality is like… At this point you may ask the host personality, `”Does this set of feelings have a name?”… Often the host personality will not know. You can then focus upon a particular event or set of behaviours. “Can I talk to the part of you that is taking those long drives in the country?”
Once patients have permitted a psychiatrist to “talk to the part…that is taking these long drives”, they are committed to the idea that they have MPD and must act in ways consistent with this self-image. The patient may be placed on a hospital service (often called the dissociative service) with others who have given the same compliant responses. The emergence of the first alter breaches the barrier of reality, and fantasy is allowed free rein. The patient and staff now begin a search for further alters surrounding the so-called host personality. The original two or three personalities proliferate into 90 or 100. A lore evolves. At least one alter must be of the opposite sex (Patricia may have Penny but also must have Patrick). Sometimes it is even suggested that one alter is an animal. A dog, cat, or cow must be found and made to speak! Individual alters are followed in special notes for the hospital record. Every time an alter emerges, the hospital staff shows great interest.
The search for fresh symptoms sustains the original commitment while cultivating and embellishing the suggestion. It becomes harder and harder for a patient to say to the psychiatrist or to anyone else, “Oh, let’s stop this. It’s just me taking those long drives in the country.”
The cause of MPD is supposed to be childhood sexual trauma so horrible that it has to be split off (dissociated) from the host consciousness and lodged in the alters. Patient and therapist begin a search for alters who remember the trauma and can identify the abusers. Thus commitment to the diagnosis of MPD is enhanced by the sense that a crime is being exposed and justice is being done. The patient now has such a powerful vested interest in sustaining the MPD enterprise that it almost becomes an end in itself.
Certainly these patients, like Charcot’s, have many emotional conflicts and have often suffered traumatic experiences. But everyone is distracted from the patient’s main problems by a preoccupation with dramatic symptoms, and perhaps by a commitment to a single kind of psychological trauma. Furthermore, given that treatment may become interminable when therapists concentrate on fascinating symptoms, it is no wonder that MPD is regarded as a chronic disorder that often requires long stretches of time on dissociative units.
Charcot removed his patients from the special wards when he realised what he had been inventing. We can do the same. Close the dissociation services and disperse the patients to general psychiatric units. Ignore the alters. Stop talking to them, taking notes on them, and discussing them in staff conferences. Pay attention to real present problems and conflicts rather than fantasy. If these simple, familiar rules are followed, multiple personalities will soon wither away and psychotherapy can begin.
Bread, circuses, and garbage
Did you catch TV3’s Inside New Zealand documentary programme a few weeks ago on “Satanic Ritual Abuse”? If so, you won’t have forgotten it, try as you might to “repress” the memory. It was one of the most sublimely awful hours of television ever to be broadcast in Godzone — silly, irresponsible and sleazy. A middle-aged woman led a camera crew around the North Island to the sites where as a child she claims to have been been sexually abused in the late 1940s and 1950s by her mum and dad, the parish priest, town dignitaries, and no doubt the local dog catcher and all the dogs.
Therapists testfied that her stories ought to be taken seriously, despite the fact that she only “remembered” them a couple of years ago. The police have not been so gullible, but that didn’t stop TV3 from presenting the whole sorry fantasy, defaming the dead (and the lady’s mum, who is in a resthome with Alzheimer’s) with stories of sadistic sexual rituals, where babies were killed, blood drunk, and a good time had by all.
Two years ago I would have sworn that television in this country had scraped bottom, but when considering commercial television, there is more garbage in heaven and the broadcast day than is dreamt of in your philosophy.
TVNZ squanders two hours of prime time on a pseudodocumentary, apparently on Egyptology, in which Charlton Heston seems to start reasonably enough but which ends with Sphinx-building aliens and the “Face on Mars,” and has regular offerings on the paranormal, proving what every New Ager has always wanted to believe about quack medicine, clairvoyancy, and ESP. The “news” goes infotainment wherever possible and any possible decent programming is cleverly scheduled at a time sufficiently inconvenient — say, 7.30 am — that precious few will see it. But TVNZ can always say, “Oh, we do have fine educational programmes — you elitist snobs can tape them”.
The latest assault on the taste and intelligence of New Zealanders comes at 7.00 pm on weeknights. TV3 is trying to draw viewers away from TVNZ’s Shortland Street and Wheel of Fortune by screening Hard Copy. This deplorable offering is bad enough at any time of day, but it is particularly egregious in this spot, because it carries segments that are rated “AO”. Thus the spirit of competition drives TV3 to flout the “watershed” code which requires that Adults Only material must not be shown before 8.30 pm. By their standards it may seem a small infraction, but it is just another symptom of the degradation of public discourse and entertainment.
New Zealand remains the only English-speaking country in the world without an intelligent, noncommercial alternative to junk television. What a tragedy — especially for young people, whose eyes and minds might be opened to worlds of science, history, and cultural understanding were families given a choice away from the cheap game shows, shallow soaps, and violent entertainment that dominates our evening television.
The current Broadcasting Minister, Maurice Wiiliamson, doesn’t want the change (he’s for competition), and neither does the Labour Broadcasting Spokesperson, Steve Maharey, who doesn’t like anything that smacks of “elitism”. Both these chaps tell us New Zealand cannot afford a noncommercial television channel, which misses the point entirely. All that’s needed is a nightly prime-time band of two or three hours for high-quality programmes presented without commercial interruption in the body of the programme. Such an arrangment is eminently affordable for New Zealand.
Williamson and Maharey, however, are happy for their private reasons that we’re to be fed this junk. And every night that passes squanders yet another opportunity to open people’s minds to something better, to make a constructive contribution to knowledge and understanding in New Zealand.
The Easy Conclusion
In the years since the Skeptics’ beginnings in 1985 we’ve seen paranormal and pseudoscientific fads come and go. The Shroud of Turin was big back then, till carbon dating did it in (except in the minds of the hard-core Shroud Crowd, who now claim that rising from the dead involves an emission of neutrons which increases the atomic weight of the carbon in your winding cloth). Uri Geller is more feeble than ever, UFO sightings are in decline, and Bigfoot has made himself even scarcer than usual. But quackery in the name of “alternative” medicine still flourishes, and cold readers (such as the lamentable James Byrne) periodically meander on stage.
However, there haven’t been any significant new trends in the pseudoscience until the recent arrival of False Memory Syndrome (see reprint, “The New Victims of Sex Abuse”, p. 12). In a sense, this fad was a disaster waiting to happen. In the 1950s, hypnotic regression was used to help people discover their past lives. Harmless, perhaps, and a even comfort for someone to learn of having once been a rich courtesan in Atlantis or, better still, a Chinese Empress (but oh those aching feet!). In the 1980s, this same structure of therapeutic hypnosis was being used to help people remember how they were spirited to the planet Zork in a flying saucer in order to be subjected to medical procedures.
The sorry new development sets out from UFO abduction, but is much more sinister because it attaches itself to a demonstrably real social problem: sexual abuse. By incorporating the concept of hypnotic recovery of repressed memories into the current hysteria over sex abuse, the lives of thousands of families are being destroyed.
Consider a phone call I recently received. An articulate widow in her seventies, who with her husband raised five children, had seen my newspaper article on False Memory Syndrome and wanted to tell me her story. One of the children, a woman in her middle thirties, is a troubled soul who had been visiting a counsellor for the last year. The daughter’s therapy has “disclosed” that her mother and late father sexually abused her in her childhood. The abuse began before she was three (a remarkable memory to have, since the hard-wiring for long-term memory doesn’t even exist till after then). Her father had regularly raped her till she was seventeen. She had “forgotten” all this until just now.
Her brother says it’s rubbish, and the mother is shattered, but the daughter fully believes it, having been manipulated by her therapist to confabulate pseudomemories. The daughter has now denied her mother access to the grandchildren. This distraught old woman, who knew nothing about FMS or that others have had the same thing happen to them, had been contemplating suicide. (Fortunately, I’ve been able to get her some competent help.)
Hers is not a unique case, and if something isn’t done to bring the problem of FMS to public attention we will see many more cases in New Zealand. We’re working on it.
This issue of the Skeptic is coming to you a few weeks late because the last two months have been among the busiest in our history. The spectacularly successful visit of James Randi, along with a very well covered annual conference have helped us to boost Skeptics membership to about 350. Thanks to everyone who helped in organising those events.
One a per capita basis, we are probably the strongest national Skeptics organisation in the world. It would be temptingly easy to conclude from this that New Zealanders are simply more sensible and intelligent than people elsewhere. So why argue? For once, we’ll take the easy, tempting conclusion!
Satanic Panic in Christchurch
There is a worldwide epidemic of satanic child abuse allegations. Are they true? Has satanic child abuse happened here in New Zealand?
The most extensive child sex abuse case to be heard in a New Zealand court was the Christchurch Civic Creche affair. Nor was this an ordinary sexual abuse case, for throughout the lengthy period of investigation and the initial depositions hearings, bizarre claims of ritual sexual abuse were made. There were several similarities between this case and a sexual abuse case which had first surfaced in the US ten years earlier in 1983 — the highly publicised McMartin preschool case in Los Angeles — which also dealt with claims of ritual sexual abuse. In both cases, claims were made of the existence of child pornography networks and satanic conspiracy.
Although New Zealand has frequently been judged a highly secularised society, claims of Satanism were widely accepted during the initial investigation into the Christchurch creche case, and were repeated during the depositions hearings. Indeed, the whole affair led to a moral panic concerning child sexual abuse which later spread throughout the country.
It is important to stress that a moral panic is not an entirely spontaneous public reaction to a perceived problem such as child sexual abuse. It is also a consciously planned course of action which involves one or a number of different interest groups. Panics concerned with sexual abuse cases in general often involve groups such as fundamentalist Christians, mental health professionals, social workers, law enforcement officers, and the media.
The events which led to this particular “satanic panic” in Christchurch can be traced to Christian fundamentalist groups and the direct import from the United States of the satanic ritual abuse scenario.
The Satanism scare in the United States gained momentum during the 1980s, in the aftermath of the religious cult scare of the 1970s. Christian fundamentalist interests — especially groups which subscribed to the belief that the “end time” had arrived and that satanic forces would be particularly strong during this period — were behind the moral panic which spread across the United States.
Additionally, some mental health professionals and law enforcement officers were prepared to disseminate the idea that Satanism was rife. Of these two groups, the former were often associated with adults who alleged that they were “survivors” of ritual sexual abuse.
Indeed, the origin of the modern Satanism scare can be traced to the earliest “survivor” account — the book Michelle Remembers, which was published in 1980 by Michelle Smith, co-authored by her therapist, later husband, Lawrence Pazder.
As the panic spread during the 1980s, the satanic scenario was broadened to incorporate such elements as large-scale child abduction, ritualistic abuse of children, human and animal sacrifice, and cannibalism.
Law enforcement officers, social workers, and mental health professionals provided the key secular network for spreading ideas of Satanism through their involvement in seminars and workshops aimed at combatting the satanic menace.
It was in this manner that the anti-satanic movement spread to Britain later in the 1980s, and eventually to New Zealand. American fundamentalist Christians, presenting themselves as “experts” in the field of ritual child abuse, were invited to speak at social worker and police seminars. One such “expert” visited Christchurch in August 1991 and was reported as saying that “satanic ritual abuse posed as great a threat to children as sexual abuse” (Christchurch Press, 27 August 1991).
Although the Satanism scare appears to cover a unique, if somewhat bizarre, series of events, it is in fact a development of earlier trends in the child protection movement.
Beginning in the 1960s with the “discovery” of the battered baby syndrome, by the late 1970s child protection became increasingly focused on sexual abuse. This was expanded during the 1980s when false claims were made (in the United States) that as many as 50,000 — or even 90,000 — children were abducted by strangers each year.
It was in the early 1980s that the first adult “survivor” accounts of satanic abuse began to emerge. Following such accounts, the child protection movement made claims that satanic cults were responsible for the majority of the child abductions. The most prominent claims came from an extensive network of social workers, police, and psychotherapists — groups which were already involved in the task of aiding child victims of adult exploitation. They assumed responsibility for this “new” form of child victimisation — satanic abuse — and thus were able to expand their organisational base.
It should also be noted that claims of satanic abuse incorporated psychological categories to explain victims’ behaviour. The psychological material is too complex to permit more than a brief summary here, but two important aspects should be mentioned.
First is post-traumatic stress disorder (PTSD) — a term used in the diagnosis of patients whose maladaptive behaviour could be explained by supposedly traumatic past experiences. PTSD, it has been suggested, is often coupled with multiple personality disorder (MPD) and “occult survivors” were typically attributed with this condition. Indeed, the “expert” mentioned earlier was reported as saying that MPD was the usual damage caused to children by satanic ritual abuse. He also argued that “about half the children suffering [MPD] had been victims of satanic ritual abuse” (Press, 27 August 1991).
A major factor in the diagnosis of “survivors” with PTSD and/or MPD was that patients’ denial was proof; any denial of involvement with satanic ritual was dismissed as a typical symptom of the underlying disorder.
The media’s role in spreading the Satanism scenario cannot be overlooked, since in the United States, Britain, and New Zealand, popular newspapers and television talk shows were very much involved. The New Zealand media, in September 1991 (shortly after reports of the visiting American sexual abuse therapist), reported a workshop presentation which was given at the Family Violence Prevention Conference in Christchurch. The main theme of this particular workshop was ritual abuse and was a prominent feature of the conference.
As co-ordinators of this workshop, the Ritual Action Group (RAG) were concerned with presenting ritual abuse as a serious threat to children in this country. Their presentation drew on both anti-cult and anti-Satanist literature, detailing a definition of ritual abuse, the situations in which it was likely to occur, and the signs parents should be looking for to determine whether their child had been abused.
There was a period of intensified media interest in claims of Satanism following the September conference and the RAG workshop. This included reports that police were stepping up investigations into ritualistic cults, following bizarre claims coming from Australia which told of satanic cults there. These cults were said to have links with child pornography rings, but they were also reported as killing and eating babies.
It was also reported at this time that a “prominent New Zealand policeman” had spent time in the United States studying techniques for investigating links between child pornography and Satanism: the same policeman had earlier been linked with the RAG group. It was during this period of intense media coverage that allegations of ritual abuse in the Christchurch Civic Creche began to surface.
Following similar patterns in the United States and Britain, the links between child pornography, organised sex rings, and ritual abuse have been a prominent feature of the Satanism scare in this country.
Although the first reports of Satanism appeared in 1991, it was not until a year later that a moral panic which focused on the sexual abuse of children broke. From early in 1992, a former male worker from the Christchurch Civic Creche had been under investigation for indecent assault and sexual violation of children. Subsequent events further amplified the panic — the abrupt closure of the civic creche; the police investigation into a “major paedophile ring” operating in New Zealand and reputed to have links with an international network of child pornography dealers; the leader of the Centerpoint commune facing charges of child sexual abuse; and sporadic claims of abuse emerging from other childcare centers around the country.
All these events occurred within the space of two months during the latter half of 1992. Although the Department of Social Welfare began to express concern about their rapidly increasing caseloads of child abuse, it was not until the news broke that four female co-workers were also alleged to have committed indecent assault and sexual violation of children at the creche that the panic gained full momentum. The creche case now took on elements of “organised” abuse rather than being one involving a lone “predatory” male abuser.
It was at this stage that the media concentrated on the bizarre nature of the case, with its alleged elements of ritual abuse. In particular, one alleged incident known as the “circle incident” provided a vivid image which enabled the media to locate this case within an established stereotype of ritual abuse. However, it was not only the media who made links between this case and the ritual abuse scenario. During the depositions hearings the mother of an alleged victim had called for an overseas “expert” on ritual abuse to be brought into the inquiry.
As the events leading to the Christchurch case have shown, religious concepts still feature in the public perception of problem conditions such as child sexual abuse and the amplification of deviance thus generated. This is despite the increasingly secularised nature of New Zealand society.
Christian fundamentalists in particular have been relatively successful in having their ideas on issues such as child pornography and alleged satanic abuse incorporated into the rhetoric of secular agencies such as social work, counselling, and law enforcement. It is no coincidence that this moral panic has focused on children given that, in periods of rapid social change and uncertainty such as New Zealand has experienced in recent years, children represent the hope for the future. This is likely to prove a recurrent theme of perceived social problems.