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to Heal (Bass and Davis, 1988) and Secret Survivors: Uncovering Incest and Its Aftereffects
in Women (Blume, 1990), which patients were encouraged to read. These therapists
typically used suggestion to ―recover‖ lost memories of abuse. As mentioned previously,
hypnotic techniques such as guided imagery, and drugs such as sodium amytal, were
sometimes used to elicit supposedly repressed memories. There was no recognition that
hypnosis and soporific drugs render a patient more open to suggestion. Some studies have
shown that hypnosis does not necessarily help subjects to remember accurately, but that its
use increases the subject‘s belief that what they have ―remembered‖ is accurate (Yapko, p.
56). These therapists often placed their patients into groups for survivors of sexual abuse.
Similar to the dynamics of cult groups, peer pressure and the resulting tendency towards
uniformity of thought can interfere with critical thinking. Therapists would interpret dream
material and physical symptoms, along with recovered memories, as scientific evidence of
traumatic memories of sexual abuse and they would interpret recovered memories as
scientific evidence of abuse (Yapko, 1994). Their stance was, ―All recovered memories are
reality.‖
The patients of trauma therapists, particularly those who were more anxious and
suggestible, often accepted the suggestion of abuse, because it became the simple
causative answer for all their problems and pain. In this way, these patients were similar to
those who were recruited successfully into cults. Simple answers for life‘s difficulties can be
very reassuring. Furthermore, Brenneis, writing in a recent JAPA article, has indicated that
the anxious patient seeks comfort and direction from, and affiliation with, a perceived
expert. Suggestion operates in areas of doubt and uncertainty. The force of {the
therapist‘s} convictions creates for the patient what amounts to a stacked deck: solace and
direction require affiliation, and affiliation in turn requires some measure of agreement or
acceptance of the beliefs of the analyst. (Brenneis, p. 1034)
Brenneis also points out that both the therapist and the patient gain what they are seeking:
The therapist gains confirmation of her/his beliefs and the patient gains ―cognitive clarity
and affiliation with an accepting authority figure‖ (Brenneis, 1035).
Ganaway states that the new belief system becomes the substitute for the symptoms that
had brought the patient to the therapist. While the patient may gain a new identity and
satisfy a desire for affiliation by being a member of the abuse survivor movement, the
therapist has diverted the patient from an understanding of the true, more complex
meaning of the symptoms and their underlying defenses (Ganaway, 1994).
Many of these patients would become increasingly angry over time. This increased anger
may have been generated because these patient were not feeling better emotionally since
real issues were not being addressed and, for some, there was a loss of the support system
of the family. Also, contagion might exist as the patient‘s anger is set off exacerbated by
the anger of the believing therapist and/or group members. Therapists often would join
with the patients against the ―abusers. They would abandon their neutral stance and
encourage patients to take action against the abusers (including lawsuits). This joining with
the patients‘ actions against the abusers, usually the parents, was fed by the
countertransferential reaction to keep the anger away from the therapists (Hedges, L.,
1994). Cutting off the relationship with family members also served to increase the patient‘s
dependency on the therapist.
Hearing about these incidents was disturbing. Psychoanalysts believe that recovered
memories may be reconstructions rather than exact reproductions of past events and
experiences. These memories are continuously influenced by conscious and unconscious
fantasies, beliefs, moods wishes, etc. (Ganaway, 1994). The patients need not be believed
(traumatists were insisting), but needed to be taken seriously (Hedges 1994). Memories
could be seen as metaphors for boundary violation from the past and present (Spence,

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1982). Furthermore, the literature on experiments in cognitive psychology showed memory
to be highly plastic and highly susceptible to influence and suggestion (Loftus, 1993].
Additionally, Ceci‘s research with children indicated how easily young children can be
influenced to remember differently from week to week (Ceci, S.J., Ross, D.F., and Toglia,
M.P., 1987). Therefore, how could recovered memories from early life be accepted as
accurate without question?
Conclusions
There is no doubt that childhood sexual abuse exists. In many cases, those who have gone
to trauma therapists have experienced childhood sexual abuse. However, it is problematic
to discern the veracity of recovered memories of sexual abuse, particularly those memories
that did not arise spontaneously within the confines of a therapeutic relationship, but which
were induced through suggestion, hypnosis, soporific drugs or peer pressure. As reported in
this paper, memories can easily be re-shaped by both external and internal forces. The
appropriate role for the therapist is to explain this fact to the patient and to take a wait-
and-see approach. As Esman states, the ―empathic‖ acceptance of all material can lead to
iatrogenic suggestion. Esman recommends that, ―Neither unquestioning credulity nor
categorical disbelief, but a properly scientific attitude of enlightened skepticism would seem
to be in order‖ (Esman, 1994. Letter, JAPA, 43: 1, 195-296). Uncertainty is uncomfortable.
However, both patients and therapists need to be able to tolerate complexity and
uncertainty in life and resist the need for closure. It is unrealistic and harmful for patients to
see their therapists as all-knowing human beings.
Of course, all of this needs to be explored in the context of the therapeutic relationship,
particularly focusing on possible transference and counter transference reactions. Questions
to explore might include the following: Why is this memory surfacing at this point in the
therapy? Has this memory been influenced by a recent event occurring inside or outside a
therapeutic session? How is the patient feeling towards the therapist and how is the
therapist feeling towards the patient? What is the meaning of this memory to the patient?
How does the patient expect the therapist to receive this material and how does she/he
react when the therapist takes a wait-and-see approach? Certainly therapists are induced to
feel that patients who suspect they were abused need us to believe them. It is important for
therapists to be sensitive to all material presented in therapy sessions, especially when
traumatic events are shared. However, in the face of recovered memories that formerly
have been repressed, is the therapist responding empathically by automatically believing? Is
it more important to believe our patients in all matters or to be the voice of reality? It has
been pointed out by Galatzer-Levy that the parents‘ failures to respond empathically when
bad things happen frequently have a more profound impact on the child than the event
itself. Therefore, the therapist‘s desire to avoid repeating this response may lead him/her to
prematurely appreciate the patient‘s experience of the event. As Galatzer-Levy notes,
―Paradoxically, this very process may subtly repeat the parental failure to understand. It
invites assumptions of understanding that the analyst may lack‖ (Galatzer-Levy, 3. 998).
The more ―empathic‖ response is to be a concerned, careful, and caring listener who
informs the patient of the difficulty in knowing the historical truth when memories are
recovered. However, as Galatzer-Levy has noted, the emphasis should be on the meaning of
the recalled memory as it relates to the past, as it relates to the transference, as it relates
to other experiences with important figures and events from the past, and as it relates to
the patient‘s fantasy life. A case may illustrate some of these points.
A woman, 62 years of age, came to see the author two years after her husband‘s death,
because she continued to feel depressed. In early sessions she quietly extolled her happy
life with her husband. He was described as very ―proper‖ and this propriety had attracted
her to him. She had believed that she would feel ―safe‖ with this successful businessman.
After several sessions, she admitted with extreme shame and trepidation that she