Ms. Morfit acknowledges that at this point she has a clear position on many of these issues. "Some would call this a 'bias,'" she says, "but I have done ten years of homework on these issues and if it is a bias it is a considered one." She says that although the views she expresses here are personal opinion, she is not an accused nor an accuser, not a therapist nor a plaintiff in a malpractice case, and she hopes the questions she raises may further some of the debate about these issues.
The opinions below are those of the author, and do not necessarily reflect the position or opinion of the False Memory Syndrome Foundation.
Let me define my terms. I mean three very specific things when I talk about "contemporary clinical psychotherapy."
First, by "contemporary" I mean therapy since Freud. Given the rise of such therapies as cognitive behavioral therapy, I may have to revise my definition in the near future, but for purposes of this discussion and the history of the phenomena we address here, we are talking about ideas that arise from Freudian roots.
The questions asked in therapy are not new questions. They are very ancient questions about the meaning of life, our relations with others, our roles as citizens of the world, etc. What is new since Freud is that these questions are not raised within a philosophical, religious, moral or intellectual framework but within a theoretical framework that relies upon dreams, memories, slips of the tongue and such hypothetical constructs as "the unconscious" and "repression." This is all highly speculative and subjective. Therapy has remained upon this subjective and speculative ground ever since. And, to the extent we adopt therapeutic principles for daily life, we are moving into progressively more subjective ground as a culture. I recently heard a news commentator describe America as "in a subjective meltdown."
Second, I use the term "clinical" to distinguish clinical from research psychology. There is little dialog between the two and where there is it is fraught with antagonism. Many therapists stubbornly hold out for the supremacy of anecdotal material and personal clinical experience -- introducing yet more elements of speculation and subjectivity.
Third, psychotherapy has subsumed a number of human activities that have been carried on for all of human history. These activities might be called "advising," "mediating," or "counseling." These roles are not exclusive to therapy and I do not call them "therapy." What makes "therapy" "therapy" is the reference to a conceptual framework that includes these ideas of "repression" or "the unconscious," defines behaviors as "normal" or "abnormal," "functional" or "dysfunctional," interprets dreams, memories and the aforementioned speculative and subjective material.
While there are a lot of factors contributing to the present hysteria, there is a common thread. That common thread is an idea system about how the human psyche functions. This is an idea system that has been largely constructed, marketed and taught by psychotherapists whom we have regarded as "experts." However, upon examination, I find there is little foundation in rationalism -- much less empiricism -- for what we have regarded as psychotherapeutic "expertise" though it has left us dealing with each other through veils of interpretation.
The reliance upon an "expertise" that has no solid foundation is a precondition for injustice. When it works, justice is always very particular. It proceeds on a case-by-case basis with a careful weighing of the facts and an equally careful examination of the underlying logic of key arguments. When "facts" are wrong and thinking sloppy, justice is easily suborned. Junk science = bad evidence.
I do not have worlds enough or time to lay out all my reasoning on this, but I would like to examine two concepts that are central to recent phenomena and set them against each other. These two ideas are "repression" and suggestion.
I find a great deal of disagreement among professionals about "repression." Professionals disagree not only about whether "repression" exists, but, if it does, how to define it. If we cannot define our terms that is going to make meaningful discussion or research difficult.
First, recently there seems to be a growing consensus on the definition of "repression" as "motivated forgetting." However, probe behind this definition and you still find considerable disagreement on how "repression" works.
Second, author David Holmes (among others) has documented six decades of research conducted to establish something like "repression." Suffice to say that so far the concept of "repression" has proved to have more holes than a sieve.
Third, let us say for the sake of argument that we could establish or had established a basis for "repression." Even then, we would have to establish its role in the development of mental illness and its treatment. But there is no agreement on this either. Some therapists think that "repression" is the cause of mental illness, that the goal of therapy is to "lift repression," and that this is a necessary condition for successful therapy,. The trouble with this is that other therapists do not believe this and without this belief have been able to achieve results that are as good or better for their clients. And then there are therapists in the middle. For instance, I have talked to therapists who firmly believe there is such a thing as "repression," but they think this is more an artifact of the therapy than its proper focus or the source of "cure." Bottom line: Even if we could prove the existence of "repression," we would still have to prove that a focus on "repression" is a necessary or sufficient condition for therapy.
I think we are a long way from that. And I think that until or unless we can establish some credible evidence for "repression" we ought to abide by a logical and philosophical principle known as "Ockham's Razor." Ockham's Razor is the principle that, "Whenever you are confronted with more than one explanation for a phenomenon, the simplest one that accounts for all the facts is best." This axiom insures that superfluous material does not pass into an explanation unnoticed.
Now, let's take a look at suggestion. Suggestion is far, far more common and we are all more subject to its influence than we like to acknowledge. Recent research has used very simple -- even mundane -- techniques to induce false ideas in its subjects. In fact, it has proved much easier to demonstrate suggestion than "repression." Suggestion is always social and the potential for suggestion increases whenever one person is confused and another is more certain, where one is in a perceived position of authority and another respects that authority. It always increases in groups. In the therapeutic milieu, as well as in the courtroom and society at large, the acceptance of common beliefs in such concepts as "repression" and "the unconscious" creates a bridge across which suggestion crosses -- in both directions.
But beware! Accept the ideas that your behavior is not in your conscious control (the antithesis of the assumption from which cognitive behavioral therapy proceeds, by the way), that you cannot access your own memories without appeal to such speculative materials as dreams, fantasies, and slips of the tongue, that you cannot get relief from these symptoms until or unless you access these memories, and that, furthermore, you cannot do so without the help of someone who is professionally trained but who was, a short time ago, a total stranger to you, your history, and your family, and you have just swallowed one of the biggest intellectual Mickey Finns in human history. Some people look and see "motivated forgetting." I look and see "motivated remembering." I don't think we are going to see an end to some of these issues until the Mickey Finn is vomited up or we recover from its effects in some other way.
Psychiatrist and author Robert Jay Lifton wrote a book called Thought Reform and the Psychology of Totalism. This book reports on work he did when he went to Korea to study people who were refugees from the Chinese Cultural Revolution and who had been subjected to what he calls "thought reform" and we commonly call "brainwashing." In the book, Lifton acknowledges that the techniques of thought reform and those of much psychotherapy are virtually the same. However, he made this distinction: He said that therapy is voluntary while thought reform is coercive. To me, this is a distinction without a difference, except in degree. "Brainwashing" may indeed deprive a person of his or her freedom of action in the social and political spheres and may involve torture. But there is a deprivation in therapy as well. The patient is generally deprived of the right to ask questions about the nature of the treatment, its rationale, etc. Such questions are commonly regarded as "resistance." To the extent the patient is deprived of knowledge, the patient is deprived of freedom.
I do not think we can hope effectively to challenge injustices in the courtroom, overzealous censorship, or any of the other undesirable consequences of this "false" memory phenomenon if we resist a rigorous look a the therapeutic theory from which some of the core ideas arise. These are issues that transcend right and left, liberal and conservative, male and female, abused and accused. It's Does-The-Emperor-Have-Any-Clothes time for therapy.