Cultic Studies Review, Vol. 2, No. 2, 2003, Page 92
A unique proposal of Sirkin and Wynne (1990) suggests that cult involvement be classified
within the diagnostic category relational problems (as a type of extrafamilial relational
problem), which, along with ―foliè a deux,‖ would constitute two specific identities of such a
category. Sirkin and Wynne‘s proposal also specifies severity, a very necessary element.
Thus, the diagnosis may be further specified as mild (two symptoms), moderate (three
symptoms), or severe (four or more symptoms). The following are this proposal‘s diagnostic
criteria:
1. The patient‘s involvement with a group or organization is characterized by impaired
autonomous mental functioning (outside the group context) as evidenced by any two
of the following: a) extreme anxiety when separated from the group or group
members b) difficulty processing and evaluating information that contradicts the
doctrine c) impaired reality testing, especially around issues pertaining directly to
the cult or cult leader d) commission of antisocial acts supposed justified by cult
doctrine or directions from a leader e) decisions made outside the group context
repeatedly reversed upon pressure from the group or group members.
2. The patient‘s involvement with the group has been facilitated by partial and
incomplete disclosure of the group‘s doctrines, beliefs, and goals. Full disclosure
following intense involvement may not be sufficient to counteract group influence.
3. The patient‘s involvement has not been preceded by psychotic disorder within the
past six months.
Obviously, along with these two diagnostic proposals, other psychopathological
complications that can arise among the followers are not excluded, such as (1) schizoid
affective reactions in people without a previous history, (2) post-traumatic stress disorders,
(3) anxiety induced by relaxation, and (4) miscellaneous reactions (phobias, memory
deficits, etc.) (Singer and Ofshe, 1990).
Group Dependency States
Since its start in 1986, the therapeutic team of Attention and Research on Socioaddictions
(formerly, Assessment and Information on Cults, AIS) works toward an improved diagnostic
delineation of the problem at hand. The model that in this case includes the description of
the psychopathological state of the follower is that of dependence.
Beyond the phonetic similarity of ―addict‖ and ―follower‖ in Spanish,2 there is interesting
clinical evidence, as pointed out by a Canadian psychoanalyst (Roy, 1998): (1) the
phenomenon of crossed dependence, which leads to different addictions being
interchangeable (2) the fact that drug addicts more frequently commit to highly
manipulative groups and do not seem stimulated by groups with a low manipulative profile
(3) the observation that, when an addict commits to a group, he can temporarily or
permanently quit his addiction (4) the fact that some rehabilitation groups for addicts
present manipulative characteristics (5) the similarity between the discomfort that the
person who abandons a group experiences with the withdrawal symptoms of an addict (5)
the evidence that the states of depersonalization an ex-follower can experience are close to
the states ex-addicts experience (6) the fact that the sensations of depersonalization,
along with the anxiety peaks that are experienced during group practices, also hold a
parallelism with the sensations that the addict obtains from his drug (7) the existing bond
between affective dependence and cult dependence, as referred by ex-followers and (8)
the sensation that both the follower and the addict have of being ―beyond it all,‖ to the
point of believing that drugs and/or dogma does not affect them.
2 In Spanish, we use the terms ―adepto‖ and ―adicto.‖

Cultic Studies Review, Vol. 2, No. 2, 2003, Page 93
But the clinical model of dependence goes far beyond dependencies to exogenous
substances, in that along with such exogenous dependencies we would also find (1)
dependence on endogenous substances (secreted by the organism), as, for example,
dependence on physical exercise and (2) psychosocial dependency, wherein we could
include certain affective or financial dependencies (such as compulsion to work) we include
in this group new forms of addiction, such as to the Internet and sexual dependencies (in
which compulsive sexual behavior predominates, such as pornography, sexual tourism,
etc.).
In the AIS therapeutic team, the field of work has increased to comprise these diverse
forms of ―socio-addictions,‖ in which we would include the dependency to cults. In relation
to the latter, we have arrived at a compact systematization extracted from clinical work,
and that has recently been defined as follows under the designation of group dependence
disorder, which will be diagnosed when at least seven of the following criteria are met:
1. Excessive time dedicated to group (at least one of the following criteria): a) the time
dedicated to the group tends to increase progressively b) time dedicated to the
family, work, or social relationships decreases excessively.
2. The subject reacts with great irritability and/or anxiety when unable to attend
meetings or group activities.
3. Subject manifests intense affiliation feelings toward the group and its members.
4. Changes in attitude toward people in his previous environment (at least two of the
following): a) cold and distanced attitude, b) lies, c) hostile attitudes.
5. Unmeasured self-criticism of his pre-cult past.
6. Conceding the group an excessive importance, which is in disagreement with reality.
7. Tolerates and justifies personal exploitation in different areas for example, work,
economic, or sexual.
8. Increase of daily activities as a consequence of the growing dedication to the group.
9. Experiences of great euphoria or enthusiasm.
10. Tendency to a monothematic discourse.
11. Behavioral changes that stand out that are in accordance with group norms or habits
(at least two of the following criteria): a) in dressing or personal care, b) in
language, c) in hobbies, d) in sexual behavior.
Relational Aspects in Cult Involvement
The problem of cults is not only scarcely addressed by psychiatrists, but also by those who
work within psychoanalytical theory. Although there is some interesting research in this
respect, neither the ―cult-group‖ nor its complexity are the object of substantial
psychoanalytical research. At the same time, the psychoanalytical model is not comparable
to thought reform models, whether dissociative or based on dependency, in that
psychoanalysis is in itself a metapsychology.
In its more than 100 years of evolution, psychoanalysis has gained comprehension and has
left far behind mechanistic models that are more commonly known.
At an individual level, analytical practice has shown how, inside every one of us, many
diverse nuclei exist that can combine with each other. Hence, we find neurotic structures
with psychotic nuclei, such as psychotic patients with a neurotic area of personality that is
sufficiently ample so as not be engulfed by the patients‘ pathologies. Other research has
shown that the existence of fanatical nuclei, as presented in Lifton´s psychohistoric work