For over a decade now, the controversial practice of "recovered repressed memory" therapy, based on faulty assumptions regarding memory, repression and suggestibility, has continued largely unchecked. Repressed memory therapy is based on the theory that patients' presenting problems, e.g., depression, marriage problems, eating disorders, etc., can be explained by the fact that they have repressed memories of traumatic sexual abuse. Through treatment, patients with no prior knowledge come to believe that they have suffered horrible abuse, often at the hands of their parents, decades earlier. In general, patients who come to believe they have recovered repressed memories of sexual abuse fall into three categories: 1) those who believe they were sexually abused either once or continually for years; 2) those who believe they have suffered satanic ritual abuse at the hands of a cult; and 3) those who believe they harbor multiple personalities, each with its own memory and set of experiences. As social psychologist Richard Ofshe points out, these categories are not mutually exclusive, i.e., it is not uncommon for a patient to begin to manifest symptoms of the first category and end up representing all three categories.
After repressed memory therapy "movement" emerged in the mid-1980s, many alarmed and concerned researchers and clinicians began studying the issue closely and found that the suggestive techniques recommended in the self-help literature and employed by many therapists led patients to evaluate mental images incorrectly as accurate memories of actual events. Ofshe summarizes, "the mistakes made in this therapy are not due to the lack of reliable information but are largely the result of reliable information being ignored. Although much research has been conducted regarding human memory, the coercive nature of the therapy setting, and the effect of techniques like hypnosis, this knowledge has been ignored by repressed memory therapists." As noted, the diagnosis of Multiple Personality Disorder (MPD) is frequently associated with the recovered memory movement because of the belief that the "repressed" traumatic abuse causes the child to split or dissociate into "alter" personalities. MPD is a highly controversial diagnosis that has grown into an epidemic in the United States and Canada since the early 1970's. The Diagnostic and Statistical Manual, Fourth Edition (DSM-IV) notes that the controversy arises between those in the mental health community who believe in the diagnosis as opposed to those who believe the syndrome has been overdiagnosed in individuals who are highly suggestible. (See also "It's in the DSM-IV" in the October 1998 edition of the False Memory Syndrome Foundation newsletter for a review of this issue.)
In the early 1990s, surveys conducted in the United States and Canada showed a majority of psychiatrists had not made the diagnosis or even seen a case of MPD. These results suggest that the high figure for the disorder is best explained by the fact that a small number of psychiatrists are making a large number of diagnoses. Due to the efforts of a group of multiple personality disorder proponents, Frank W. Putnam, M.D., Bennett G. Braun, M.D., Philip Coons, M.D., Colin Ross, M.D., Eugene Bliss, M.D. and Richard P. Kluft, M.D., the diagnosis of MPD came to be listed in the DSM-III in 1980. Prior to 1980, there were approximately 200 cases reported worldwide. In 1990, however, over 20,000 persons had been diagnosed with MPD. Today, there are estimates of as many as two million more. Since 1980, many prominent members of the psychiatric community have challenged the existence of the diagnosis and its inclusion in the DSM. 
Critics characterize MPD as a therapist-induced social construction. For example, where a patient comes to a therapist with standard psychiatric complaints such as anxiety or depression, a MPD therapist may suggest that these symptoms represent the actions of "alters" co-existing in the patient's mental life. Dr. Paul McHugh, Director of the Department of Psychiatry and Behavioral Sciences at Johns Hopkins, treated MPD patients referred to Johns Hopkins and found that in each case, the MPD diagnosis had been therapy-induced, played out in a stereotyped, script-like way. Each woman initially sought assistance for some straightforward set of psychiatric symptoms, e.g., depression, demoralization. Thereafter, her therapist would stretch the psychiatric symptoms into a diagnosis of MPD by suggesting that the patient may harbor "alter" personalities and eventually, an accusation of prior sexual abuse was leveled against a family member, usually the father. Dr. McHugh found that proper rehabilitation could occur only by directing attention away from the manufactured behaviors.
One of the most notable cultural factors credited with bringing the issue of child abuse and MPD together in the minds of the public and mental health community is the popular 1973 book and film, Sybil. MPD proponent, Frank W. Putnam, M.D., wrote, "Schreiber's account [of Sybil] is both detailed and accurate enough to serve as mandatory reading for students of MPD." After Sybil, many therapists began to cull both "alter" personalities and corresponding ěrepressedî memories of childhood abuse from their patients, often with the use of hypnosis. Significantly, however, there exists strong evidence that Sybil herself was mis-diagnosed MPD. Herbert Spiegel, M.D., a recognized specialist in hypnosis, who worked with Sybil and her psychiatrist, Dr. Cornelia Wilbur, maintains that Sybil was a highly hypnotizable 'hysteric' and not a multiple personality. Dr. Spiegel reports that when he told Dr. Wilbur that it would not be accurate to label Sybil a multiple personality, Dr. Wilbur retorted, "But if we don't call it multiple personality, we don't have a book! The publishers want it to be that, otherwise it won't sell." Recently, psychologist, Robert Rieber, reported at the annual American Psychological Association meeting, that newly discovered 25-year old tapes show that Dr. Wilbur clearly led Sybil into the MPD diagnosis through the use of hypnosis, sodium amytal and other therapeutic techniques. According to Dr. Rieber, her psychiatrist wanted to "make Sybil a multiple personality no matter what. Once the book became a financial success, there was no turning back."
"There is considerable controversy in the psychiatric and psychotherapeutic communities about the diagnosis of DID. Experts cannot agree whether the occurrence of dissociation and the emergence of alters are sometimes encouraged or even produced by psychotherapy, and whether the disorder is overdiagnosed by a small number of psychotherapists. See DSM-IV, at 486-487. Coming to a reasoned conclusion on this issue is particularly difficult because the mental health community has not yet reached a consensus on the nature of the disorder." (Minnesota Supreme Court, Slavik v Wall, 1988, WL 540967.) (MPD is now called Dissociative Identity Disorder, or DID.)
Another disturbing by-product of the MPD diagnosis is the prevalence of alleged repressed memories of satanic ritual abuse. The association of satanic ritual abuse in MPD diagnoses has been attributed to the belief by numerous MPD adherents in the existence of an intergenerational satanic cult conspiracy that has murdered thousands without leaving a trace of evidence. FBI Special Agent Kenneth Lanning's extensive investigation found that no evidence for satanic cults exists and concludes that it is "up to the mental health professionals, not law enforcement, to explain why victims are alleging things that don't seem to have happened." Mr. Lanning further found that "charges of organized satanic or occult sexual abuse routinely stem from four scenarios: the adult survivor scenario, the day care scenario, the extended family/isolated neighborhood case, and those involving custody and visitation disputes."
A group of well-known and vocal psychotherapists also believe in the existence of a vast satanic cult conspiracy. For example, Bennett G. Braun, M.D., founder and past-president of the International Society for the Study of Dissociation (ISSD), has published extensively on the subject and publicly stated that his multiple personality patients came by their symptoms as a result of brutalization by an international satanic-cult ring. Similarly, psychiatrist, Colin Ross, two-time past-president of ISSD and author of an influential book on MPD as well as numerous articles, believes that his multiple personality patients were trained as children by evil top-secret agents of the CIA. Dr. Ross has publicly stated that criticism of MPD therapy is the result of a CIA conspiracy to cover up what he was discovering through his patientís "alters".
Unfortunately, the contamination and contagion caused by this group of psychotherapists who were vocal about an epidemic of sexual abuse, multiple personality disorder and an intergenerational satanic cult resulted in a widespread social panic throughout the country beginning with the 1983 McMartin preschool case in Los Angeles. In addition to McMartin, numerous cases have been overturned based on the suggestive interviewing techniques employed by 'overzealous' child abuse investigators. Currently, organizations, conferences, publications, web-sites, etc. on ritual abuse, secret societies and mind-control conspiracy theories are widespread.
Dr. McHugh wrote in 1992, "These practices will eventually be discredited, and this epidemic will end in the same way that the witch trials ended in Salem. But time is passing, many families are being hurt, and confidence in the competence and impartiality of psychiatry is eroding." Dr. McHugh concludes that psychiatric thought gone awry, fueled by social factors, is a recurring event in the history of psychiatry. He cautions that history should teach that psychiatry is capable of "glorious medical triumphs and hideous medical mistakes."
Unfortunately, the epidemic has not waned. During the past decade, the idea of MPD and its cause has been bolstered by the proliferation of organizations, publications, videotapes, conferences, training seminars, popular media, etc., and the numbers of reported cases have risen in tandem with the recovered memory therapy movement. As a result, patients and their families continue to suffer incalculable harm. It is only recently, through criminal indictments and litigation brought by former patients against their therapists, that the extent of harm caused by a MPD diagnosis is being fully comprehended.
2 Ofshe, R. and E. Watters, supra.
3 MPD recently renamed Dissociative Identity Disorder or DID in the Diagnostic and Statistical Manual - IV published by the American Psychiatric Association. (DSM-IV).This brief will refer to the disorder as it is most commonly known, MPD.
4 Piper, A. (1997), Hoax & Reality: The Bizarre World of Multiple Personality Disorder, Jason Aronson: Northvale, NJ; McHugh, P.R. (1992), "Psychiatric misadventures," The American Scholar, 61:4:497-510.
5 DSM-IV, supra at 486-487.
6 Merskey, H. (1995), "Multiple Personality Disorder and False Memory Syndrome," British Journal of Psychiatry, 166:281-283; Spanos, N.P. (1996), Multiple identities and false memories: A sociocognitive perspective, American Psychological Association: Washington, D.C.
8 Borch-Jacobsen, M. (1997), "Sybil: The making of a disease: An interview with Dr. Herbert Spiegel," The New York Review, April 27, 1997, p. 60; Pendergrast, M. (1995), Victims of Memory: Incest Accusations and Shattered Lives, Upper Access: Hinesburg, VT; Piper, A. (1997), supra at 161-162.
9 Merskey, H. (1995), supra at 281; Spanos, N.P. (1996), supra at 234.
11 Reuters, "Tapes raise doubts about ëSybilí personalities," The New York Times, August 19, 1998, p. A-21.
12 Merskey, H. (1995) supra.
13 McHugh, P.R. (1992), supra; McHugh, P.R. (1994), "Resolved: Multiple personality disorder is an individually and socially created artifact," Journal of the American Academy of Child Adolescent Psychiatry, 34:7:957-963; McHugh, P.R. (1995), "Witches, multiple personalities and other psychiatric artifacts," Nature Medicine, 1:2:110-114; Merskey, H. (1995), supra; Spanos, N.P. (1996), supra; Piper, A. (1997), supra; Ofshe, R. and E. Watters (1994), supra.
14 McHugh, P.R. (1992), supra.
15 McHugh, P.R. (1995), supra at 113.
19 Merskey, H. (1995), supra; Spanos, N.P. (1996), supra at 267; Ofshe, R. and E. Watters (1994), supra at 221; Borch-Jacobsen, M. (1997), supra at 60.
20 Borch-Jacobsen (1997), supra at 60.
21 Ofshe, R. and E. Watters (1994), supra at 221.
22 Schrof, J.M. (1997), "Questioning Sybil: Being a 'multiple' is chic. But does the illness exist?" U.S. News & World Report, January 27, 1997, p. 66; Borch-Jacobsen, M. (1997), supra at 63.
25 Reuters (1998), supra.
27 Lanning, K.V. (1992), "Investigator's guide to allegations of 'ritual' child abuse," Behavioral Science Unit, National Center for the Analysis of Violent Crime, FBI Academy, Quantico, Virginia 22135.
28 Lanning, K.V. (1992), supra; Ofshe, R. and E. Watters (1994), supra at 180.
29 Hausman, K. (1991), "Cultsí link to child sexual abuse said to be less common than mental health professionals suspect," Psychiatric News, XXVI:23.
30 For example, the roster of a 1989 conference entitled, "Ritual child abuse: A professional overview," reads: Bennett Braun, M.D. (Rush Presbyterian St. Luke's Medical Center); Jean Goodwin, M.D. (Medical College of Wisconsin), Catherine Gould, Ph.D. (clinical psychologist), Corydon Hammond, Ph.D. (University of Utah), Richard Kluft, M.D. (Institute of Pennsylvania Hospital), Roberta Sachs, Ph.D. (Rush-Presbyterian St. Luke's Medical Center), Roland Summit, M.D. (UCLA Medical Center) and Walter Young, M.D. (Columbia Psychiatric Center). The advertisement for the conference notes that the professionals featured are clinicians who are directly involved in the treatment of ritually abused children and adult survivors.
31 Ofshe, R. and E. Watters (1994), supra at 224 (citing Braun, B. taped presentation given at Midwestern Conference on Child Sexual Abuse and Incest, University of Wisconsin, Madison, October 12, 1992 and Ross, C. on Canadian television program, "The Fifth Estate," November 8, 1993); Pendergrast, M. (1995), supra at 193 (citing Braun quote in Mulhern, "Satanism and Psychotherapy," The Satanism Scare, p. 166, Braun in "Ritual Child Abuse" Cavalcade video, 1989; Piper, A. (1997), supra at 131-132 (citing Braun, B. (1989), "Psychotherapy of the survivor of incest with a dissociative disorder," Psychiatric Clinics of North America, 12:307-324).
32 Ofshe, R. and E. Watters (1994), supra at 222.
34 Nathan, D. and M. Snedeker (1995), supra; Goldberg, C. (1998), "Getting to the truth in child abuse cases: New methods," The New York Times, September 8, 1998, p. F1.
35 Nathan, D. and M. Snedeker (1995), supra.
36 Piper, A. (1997), supra at 131.
37 McHugh, P.R. (1992), supra at 509-510.
39 Ofshe, R. and E. Watters (1994), supra at 205; Piper, A. (1997), supra.