Recovered memory therapy

Recovered memory therapy (RMT) is a term coined by affiliates of the False Memory Syndrome Foundation (FMSF) in the early 1990s,cite book|title=Misinformation Concerning Child Sexual Abuse and Adult Survivors |last= Whitfield |first=CL |coauthors= Silberg JL; Fink PJ |pages= |publisher=Haworth Press |year=2001 |isbn=0789019019; page 56.] cite news | first = Stephanie | last = Salter | title = Feminist Treason and Intellectual Fascism | work = San Francisco Examiner |date=1993-04-07 | accessdate = 2007-12-15 |format = reprint] cite book | last = Underwager | first = Ralph | authorlink = Ralph Underwager | coauthors = Hollida Wakefield | title = Return of the Furies: An Investigation into Recovered Memory Therapy | year = 1994 | Month = October | publisher = Open Court Pub Co | ISBN = 978-0812692716 | pages = 360 ] to refer what they described as a range of psychotherapy methods based on recalling memories of abuse that had previously been forgotten by the patient.cite journal | last = Lief | first = Harold I | year = 1999 | month = November | title = Patients Versus Therapists: Legal Actions Over Recovered Memory Therapy | journal = Psychiatric Times | volume = XVI | issue = 11 | url = http://www.psychiatrictimes.com/p991136.html] It does not refer to a specific, recognized treatment method, but rather several controversial and/or unproven interviewing techniques, such as hypnosis and the use of sedative-hypnotic drugs. The term is not listed in DSM-IV or used by any mainstream formal psychotherapy modality.

Terminology

The term "recovered memory therapy" was coined between 1992 and 1993 by the False Memory Syndrome Foundation. The FMSF, an organization that advocates on behalf of individuals who claim they have been falsely accused of perpetrating child sexual abuse,cite journal|title=Crisis or Creation: A Systematic Examination of 'False Memory Syndrome' |last=Dallam |first=Stephanie J. |journal=Journal of Child Sexual Abuse |publisher=Haworth Press |volume=Vol 9; No. 3/4, pp. 9-36 |year=2001] hypothesized that RMT can result in patients recalling instances of sexual abuse from their childhood that may not have actually occurred.While not a therapeutic technique in and of itself, RMT generally is applied to such methods as hypnosis, age regression, drug-assisted interviewing (using substances such as sodium amytal), and guided visualization.cite book |author=Greene, Edith; Wrightsman, Lawrence S.; Nietzel, Michael T.; Fortune, William H. |title=Psychology and the legal system |publisher=Wadsworth/Thomson Learning |location=Belmont, CA |year=2002 |pages= |isbn=0-534-36544-2 |oclc= |doi= |accessdate=] It should be noted that while practiced by some individual therapists, these techniques were never recognized by the psychiatric or psychological community, and are generally not practiced in mainstream treatment modalities.cite book |author=Wood, Ellen Meiksins; Wood, Samuel H. |title=The World of Psychology |publisher=Allyn & Bacon |location=Boston, Mass |year=1999 |pages= |isbn=0-205-29329-8 |oclc= |doi= |accessdate=]

The term RMT has been called a reactionary construct used by activists affiliated with the False Memory Syndrome Foundation as a way to contest the efficacy of the trauma model of psychopathology.cite book | last = Whitfield M.D. | first = Charles L.| contributors= Christine Courtois |title = Memory and Abuse - Remembering and Healing the Effects of Trauma | publisher = Health Communications, Inc | year = 1995 | location = Deerfield Beach, FL |pages = 313 |ISBN=1558743200 | url = http://books.google.com/books?id=z1LW3u1e04YC&dq=whitfield+memory+and+abuse&pg=PP1&ots=Q_GZ1Yy1iE&sig=ivzKYWTrLhVa3HODty7kwIuJp0Y&hl=en&prev=http://www.google.com/search?hl=en&ie=ISO-8859-1&q=Whitfield+Memory+and+Abuse&sa=X&oi=print&ct=title&cad=one-book-with-thumbnail] An inquiry into the practice by the Australian government found little support for or use of RMT from health professionals; rather the term was created by associations for political use. [cite web | url = http://www.health.vic.gov.au/hsc/downloads/final_rmt_inquiry.pdf | format = pdf | year = 2005 | title = Inquiry into the practice of recovered memory therapy | author = Australian Health Services Commissioner | publisher = Office of the Health Services Commissioner | accessdate = 2008-01-31] In October, 2007, Scientific American published an article critical of RMT, [cite web | first = K | last = Lambert | coauthors = Lilienfeld SO | url = http://www.sciam.com/article.cfm?chanID=sa006&articleID=4338D296-E7F2-99DF-3D7F5370B4FB5D10 | publisher = Scientific American | title = Brain Stains | date = 2007-10-01 | accessdate = 2008-01-25] which was criticized as erroneous for presenting the idea that there was a coherent method or training for something called 'recovered memory therapy.' [citation |author = Executive Council, International Society for the Study of Trauma and Dissociation |date = 2007-11-30 | title = Letter to Scientific American, Inc. Editor and Chief | accessdate = 2008-01-08 | url = http://www.isst-d.org/education/sciamerican-ltr.pdf | format = pdf ]

Research

A range of studies have concluded that at least 10% of physical and sexual abuse victims forget the abuse.cite journal | last = Widom | first = Cathy Spatz | coauthors = Morris, Suzanne | year = 1997 | month = March | title = Accuracy of Adult Recollections of Childhood Victimization: Part 2. Childhood Sexual Abuse. | journal = Psychological Assessment | volume = 9 | issue = 1 | pages = 34–46 | publisher = American Psychological Association | location = Washington, DC, US | issn = 1040-3590 | id = EJ545434 | url = http://www.eric.ed.gov/ERICWebPortal/Home.portal?_nfpb=true&ERICExtSearch_SearchValue_0=EJ545434&searchtype=keyword&ERICExtSearch_SearchType_0=no&_pageLabel=RecordDetails&objectId=0900019b801126a6&accno=EJ545434&_nfls=false | accessdate = 2007-12-18 | doi = 10.1037/1040-3590.9.1.34] cite journal | last = Sheflin | first = Alan W | coauthors = Brown, Daniel |year=1996 | title = Repressed Memory or Dissociative Amnesia: What the Science Says. | journal = Journal of Psychiatry & Law | volume = 24 | issue = Summer | pages = 143–88 | issn = 0093-1853 | accessdate = 2007-12-18] cite journal | last = Widom | first = Cathy Spatz | coauthors = Shepard, Robin L. | year = 1996 | month = December | title = Accuracy of adult recollections of childhood victimization : Part 1. Childhood physical abuse | journal = Psychological Assessment | volume = 8 | issue = 4 | pages = 412–21 | publisher = American Psychological Association | location = Washington, DC, US | issn = 1040-3590 | id = EJ542113 | url = http://www.eric.ed.gov/ERICWebPortal/custom/portlets/recordDetails/detailmini.jsp?_nfpb=true&_&ERICExtSearch_SearchValue_0=EJ542113&ERICExtSearch_SearchType_0=no&accno=EJ542113
accessdate = 2007-12-18 | doi = 10.1037/1040-3590.8.4.412] The rate of delayed recall of many forms of traumatic experiences (including natural disasters, kidnapping, torture and more) averages among studies at approximately 15%, with the highest rates resulting from child sexual abuse, military combat, and witnessing a family member murdered.cite journal |url=http://www.psychiatrictimes.com/display/article/10168/1158311 |title=Posttraumatic Stress Disorder and Memory |last=van der Kolk, M.D. |first=Bessel |journal=Psychiatric Times. |volume=Vol. 14 No. 3 |date=March 1, 1997] The rate of recall of previously forgotten traumatic events was shown by Elliot and Briere (1996) to be unaffected by whether or not the victim had a history of being in psychotherapy.. Williams found that among women with confirmed histories of sexual abuse, approximately 38% did not recall the abuse 17 years later, especially when it was perpetrated by a someone familiar to them. Hopper cites several studies which indicate that some abuse victims will have intervals of complete amnesia for their abuse.cite web | url=http://www.jimhopper.com/memory | title = Recovered Memories of Sexual Abuse Scientific Research & Scholarly Resources | last = Hopper | first = Jim | accessdate = 2007-12-15] Peer reviewed and clinical studies have documented the existence of recovered memory, one list cites 43 legal cases where an individual whose claim to have recovered a repressed memory has been accepted by a court.cite web | url = http://www.brown.edu/Departments/Taubman_Center/Recovmem | title = Recovered Memory Project | accessdate = 2007-12-15 | publisher = Taubman Center for Public Policy & American Institutions at Brown University ]

A 1996 interview survey of 711 women reported that forgetting and later remembering childhood sexual abuse is not uncommon; more than a quarter of the respondents who reported abuse also reported forgetting the abuse for some period of time and then recalling it on their own. Of those who reported abuse, less than 2% reported that the recall of the abuse was assisted by a therapist or other professional. cite journal |title=Self-reports of forgetting and remembering childhood sexual abuse in a nationally representative sample of US women |url=http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6V7N-45KNBKP-3&_user=10&_rdoc=1&_fmt=&_orig=search&_sort=d&view=c&_version=1&_urlVersion=0&_userid=10&md5=fc327a6c0117b41c426efb93f235defe |authors=Sharon C. Wilsnack, Stephen A. Wonderlich, Arlinda F. Kristjanson, Nancy D. Vogeltanz-Holm, Richard W. Wilsnack |journal=Child Abuse & Neglect |volume=Volume 26, Issue 2, February 2002, Pages 139-147]

A review article on potentially harmful therapies listed RMT as a treatment that will probably produce harm in some who receive it. [cite journal|last=Lilienfeld|first=SO|year=2007|title=Psychological Treatments That Cause Harm|journal=Perspectives on Psychological Science|volume=2|issue=1|pages=53–70|url=http://www.blackwell-synergy.com/doi/abs/10.1111/j.1745-6916.2007.00029.x|accessdate=2008-05-16 | doi = 10.1111/j.1745-6916.2007.00029.x ]
Richard Ofshe, a member of the FMSF, describes the practice of "recovering" memories as fraudulent and dangerous. [cite book|title=Making Monsters: False Memories, Psychotherapy, and Sexual Hysteria|last= Ofshe|first= Richard |coauthors=Ethan Watters|publisher=Charles Scribner's |year=1994 |isbn=0684196980]

Studies by Elizabeth Loftus and others have concluded that it is possible to produce false memories of childhood incidents.cite journal | last = Loftus | first = E | coauthors = Davis D | year = 2006 | title = Recovered Memories | journal = Annual Review of Clinical Psychology | volume = 2 | pages = 469–98 | url = https://webfiles.uci.edu/eloftus/LoftusDavisAnnualReview06.pdf?uniq=-qcmbr3 | accessdate = 2008-05-16 | doi = 10.1146/annurev.clinpsy.2.022305.095315] The experiments involved manipulating subjects into believing that they had some fictitious experience in childhood, such as being lost in a shopping mall at age 6. This involved using a suggestive technique called "familial informant false narrative procedure," in which the experimenter claims the validity of the false event is supported by a family member of the subject. The study has been used to support the theory that false memories of traumatic sexual abuse can be implanted in a patient by therapists. However, the techniques used in these studies do not resemble any approved or mainstream treatment modality, and there are criticisms that the implanted events used are not emotionally comparable to sexual abuse. [cite book |author=Rogers, Richard |title=Clinical Assessment of Malingering and Deception, Third Edition |publisher=The Guilford Press |location=New York |year=2008 |pages= |isbn=1-59385-699-7 |oclc= |doi= |accessdate=] cite journal |author=Williams LM |title=Recall of childhood trauma: a prospective study of women's memories of child sexual abuse |journal=J Consult Clin Psychol |volume=62 |issue=6 |pages=1167–76 |year=1994 |month=December |pmid=7860814 |doi= |url=http://content.apa.org/journals/ccp/62/6/1167] Further, it was only successful 30% of the time across multiple studies. This is considered by some critics to be overreaching the evidence. cite journal |url=http://kspope.com/memory/repweb2a.php |last=Pope |first=KS |title=Pseudoscience, Cross-examination, and Scientific Evidence in the Recovered Memory Controversy |volume=vol. 4, issue #4 |pages=pp1160-1181 |journal=Psychology, Public Policy, and Law |publisher=American Psychological Association ]

Some patients later retract memories they had previously believed to be recovered. Whilst false or contrived memories are possible reasons for such retractions, other explanations suggested for the retraction of allegations of abuse made by children and adults include guilt, a feeling of obligation to protect their family and a reaction to familial stress rather than a genuine belief that their memories are false.cite journal |last= Summit |first= R. |year= 1983 |month= |title= The child sexual abuse accommodation syndrome. |journal= Child Abuse & Neglect |volume=7 |issue= |pages=177–193|doi= 10.1016/0145-2134(83)90070-4 ] The number of retractions is reported to be small compared to the actual number of child sexual abuse allegations made based on recovered memories.

A study at the Dissociative Disorders and Trauma Program of the McLean Hospital concluded that that recovered memories are mostly unconnected to psychotherapeutic treatment and that memories are often corroborated by independent evidence, often appearing while home or with family and friends, with suggestion being generally denied as a factor in recovering memories.cite journal |last=Chu |first=J |coauthors= Frey L, Ganzel B, Matthews J |year=1999 |month=May |title=Memories of childhood abuse: dissociation, amnesia, and corroboration. |journal=American Journal of Psychiatry |volume=156 |issue=5 |pages=749–55 |pmid = 10327909|accessdate= 2008-01-16] Very few participants were in therapy during their first memory recovery and a majority of participants in this study found strong corroboration of their recovered memories.

Professional guidelines

There are several individuals and groups that have published guidelines, criticisms or cautions about recovered memory therapy and techniques to stimulate recall:
* In the "Brandon Report", a set of training, practice, research and professional development recommendations, the United Kingdom's Royal College of Psychiatrists advised psychiatrists to avoid use of RMT or any "memory recovery techniques", citing a lack of evidence to support the accuracy of memories recovered in this way.cite journal | author = Brandon, S. | coauthors = Boakes, J.; Glaser, D.; Green, R.; MacKeith, J.; Whewell, P. | year = 1997 | title = Reported recovered memories of child sexual abuse: Recommendations for good practice and implications for training, continuing professional development and research | journal = Psychiatric Bulletin | volume = 21 | pages = 663–665]
* In 2004, the government of the Health Council of the Netherlands issued a report in response to inquiries from professionals regarding RMT and memories of traumatic child sexual abuse.cite book | title = Disputed memories | publisher = Health Council of the Netherlands | location = The Hague | date = 2004-01-27 | edition = 2004/02 | isbn = 905545123 | url = http://www.gr.nl/samenvatting.php?ID=888 | accessdate = 2008-05-16 | language=English] The Health Council stated that while traumatic childhood experiences were major risk factors for psychological problems in adulthood, most traumatic memories are well remembered but can be forgotten or become inaccessible though the influence of specific circumstances precludes a simple description of the relationship between memory and trauma. The report also notes that memories can be confabulated, re-interpreted and even apparently vivid or dramatic memories can be false, a risk that is increased when therapists use suggestive techniques, attempt to link symptoms to past trauma, with certain patients and through the use of methods to stimulate memories.
* The Australian Hypnotherapists Association (AHA) issued a similar statement, for contexts where false memories of child sexual abuse may arise. The AHA acknowledges that child sexual abuse is serious, damaging and at least some memories are genuine, while cautioning that some questioning techniques and interventions may lead to illusory memories leading to false beliefs about abuse. [cite web | url = http://www.ahahypnotherapy.org.au/downloads/AHA%20Code%20of%20Ethics.pdf | title = Australian Hypnotherapists Association Code of Ethics: Guidelines for AHA Members working with clients in contexts in which issues related to false memories of childhood sexual abuse may arise | publisher = Australian Hypnotherapists Association | accessdate = 2008-05-16 | format = pdf ]
* The Canadian Psychological Association has issued guidelines for psychologists addressing recovered memories. [cite book | url = http://www.cpa.ca/cpasite/userfiles/Documents/publications/Recovered%20memory.pdf | format = pdf | year = 1996 | isbn = 1-896538-38-X | last = Ogloff | first = JRP | publisher = Canadian Psychological Association | title = GUIDELINES FOR PSYCHOLOGISTS ADDRESSING RECOVERED MEMORIES |accessdate = 2008-05-16 ] Psychologists are urged to be aware of their limitations in knowledge and training regarding memory, trauma and development and "that there is no constellation of symptoms which is diagnostic of child sexual abuse". The guidelines also urge caution and awareness of the benefits and limitations of "relaxation, hypnosis, guided imagery, free associations, inner child exercises, age regression, body memory interpretation, body massage, dream interpretation, and the use of projective techniques" and special caution regarding any legal involvement of memories, abuse and therapy.

Legal issues

Discussing RMT in parliament in 1995, an Australian state Minister for Health, Dr Andrew Refshauge – a former medical practitioner – stated that the general issue of admissibility of evidence based on recovered memories was one for the Attorney General. [ [http://www.parliament.nsw.gov.au/prod/parlment/hansart.nsf/V3Key/LA19951122023 Legislative Assembly, 22 November 1995, Full Day Hansard Transcript, Hansard] ] In 2004 Australian Counseling Association issued a draft position statement regarding recovered memories in which they informed their membership of possible legal difficulties if they affirm accusations as true based solely upon discussion of a patient's recovered memories without adequate corroborating evidence. [http://www.theaca.net.au/journals/ca_archive/ACA%20Mag%20Vol4%20No3%20Spring%2004.pdf ACA Newsletter Spring 2004 Draft position statement on RMT page 109] ]

A degree of controversy does remain within legal circles, with some holding the view that therapists and courts should consider repressed memories the same as they consider regular memories. Three relevant studies state that repressed memories are "no more and no less accurate than continuous memories." [ [http://www.psychiatrictimes.com/p991137.html Ground Lost: The False Memory/Recovered Memory Therapy Debate, by Alan Scheflin, Psychiatric Times 11/99, Vol. XVI Issue 11] ]

Recovered memory therapy was an issue in the criminal trials of some Catholic priests accused of fondling or sexually assaulting juvenile-turned-adult parishioners. [cite journal | author=Martin Gardner | authorlink=Martin Gardner | title=The Memory Wars, Part 1 | journal=Skeptical Inquirer Magazine | month=January | year=2006 | volume=30(1) | url=http://www.csicop.org/si/2006-01/ ] [cite journal | author=Martin Gardner | authorlink=Martin Gardner | title=The Memory Wars, Parts 2 and 3 | journal=Skeptical Inquirer Magazine | month=March | year=2006 | volume=30(2) | url=http://www.csicop.org/si/2006-02/ ]

Several court cases awarded multi-million dollar verdicts against Minnesota psychiatrist Diane Bay Humenansky, who used hypnosis and other suggestive techniques associated with RMT, resulting in accusations by several patients against family members, that were later found to be false. [Gustafson, Paul. "Jury awards patient $2.6 million: Verdict finds therapist Humenansky liable in repressed memory trial". Minneapolis St. Paul Tribune, August 1, 1995.] [cite news |url=http://query.nytimes.com/gst/fullpage.html?res=9B04E7D91F30F935A35752C1A961958260&sec=health&spon= |title=Memory Therapy Leads to a Lawsuit and Big Settlement |author=Pam Belluck |publisher=The New York Times |date=November 6, 1997 |accessmonthday=December 26 |accessyear=2007] [ Guthrey, M. and Kaplan, T., 2nd Patient Wins Against Psychiatrist: Accusation of planting memories brings multi-million dollar verdict. St. Paul Pioneer Press, Jan. 25, 1996, 4B.]

In the UK, a woman who said she had falsely accused her father of rape successfully sued the hospital and psychologist who had treated her with what she described as a form of RMT and was awarded a large court settlement. [ [http://www.dailymail.co.uk/pages/live/articles/news/news.html?in_article_id=488623&in_page_id=1770 £20,000 payout for woman who falsely accused her father of rape after 'recovered memory' therapy Daily Mail UK 2007] ]

ee also

*Amnesia
*Emotion and memory
*Memory inhibition
*Psychological trauma

References

Further reading

*cite book |last= Freyd |first= Jennifer J. |title= Betrayal Trauma - The Logic of Forgetting Childhood Abuse |year= 1996 |publisher= Harvard University Press |location= Cambridge, MA |isbn= 0-674-06805-x
*Ofshe, Richard and Watters, Ethan. "Making Monsters: False Memories, Psychotherapy, And Sexual Hysteria". University of California Press; Reprint edition, 1996.
*Loftus, Elizabeth and Ketcham, Katherine. "The Myth of Repressed Memory: False Memories and Allegations of Sexual Abuse". St. Martin's Griffin, 1st St. Martin's Griffin ed edition, 1996.
*Lilienfeld, Scott. "Psychological treatments that cause harm." Perspectives on Psychological Science, Volume 2(1), pp. 53-70, 2007.
*cite book |last= Knopp |first= Fay Honey |title= A Primer on the Complexities of Traumatic Memory of Childhood Sexual Abuse - A Psychobiological Approach |year= 1996 |publisher= Safer Society Press |location= Brandon, VT |isbn= 1-884444-20-2
*
* Pendergrast, Mark, "Victims of Memory." (1993) ISBN 0942679180

External links

* [http://www.apa.org/pubinfo/mem.html Answers to questions about recovered memory] by the American Psychological Association
* [http://www.skepdic.com/repress.html Recovered/repressed memories] entry on Skeptic’s Dictionary
* [http://www.religioustolerance.org/rmt.htm Summary/history of recovered memory debate]
* [http://www.fmsfonline.org/ False Memory Syndrome Foundation]
* [http://www.bfms.org.uk UK False Memory Syndrome Website]
* [http://www.brown.edu/Departments/Taubman_Center/Recovmem/ The Recovered Memory Project]
* [http://dynamic.uoregon.edu/~jjf/whatabout.html What about Recovered Memories?]