Cultic Studies Journal, Vol. 2 No. 1 1985, Page 21
Cult-Induced Psychopathology,
Part 1: Clinical Picture
Stephen M. Ash, Psy. D.
Abstract
A conceptual framework is proposed to synthesize the literature on the
psychological impairment caused by participation in extremist cults. This
framework includes three stages of cult departure (incorporating previously
presented stages of cult recovery), upon which are hung the various details of
the clinical picture of these cult victims. The essence of the observed
psychopathology is a combination of dissociation and dediffentiation of ego
boundaries (or mind extension or expansion). The resulting dissociative
disorder is distinguished from William James‘ description of mystical
experience, as well as from other psychiatric disorders that incorporate these
two ego defense mechanisms as core features of their ego structures (i.e.,
multiple personality, borderline and narcissistic personality disorders).
Utilizing a metaphor of water, the clinical picture of the cult-induced disorder
is described according to the changes which occur during the stages of cult
departure and recovery.
Just six years ago Lita Schwartz and Florence Kaslow (1979) referred to ―a dearth of
literature ...in the professional journals‖ regarding therapeutic treatment for the problems
used by participation in extremist cults (p. 22). They attributed this state of affairs to a lack
of knowledge about the problem, a concern echoed by several others (Carr, 81 Clark,
1978 Conway &Siegelman, 1978 Maleson, 81 and Singer, 1979). Small wonder then,
that Jean Merritt remonstrated that ―mental health professionals and the clergy are
generally the worst people to talk to about cults (―Experts Say‖, 1981, p. 3).
Despite all the literature that has come out since, the philosophical battles that have
dominated the discussions leave much room for doubt regarding just how advanced our
knowledge really is. Almost certainly, egalitarians will question the very foundation of this
paper, that is, that participation in an extremist cult causes psychological impairment,
which, depending on the cult‘s degree of destructiveness, results in a need for varying levels
of ex-cultist counseling (see the exchange, Ash, 1984a Robbins, 1984 Ash, 1984b)
Egalitarians usually dismiss the presence of psychological problems in current members of
extremist cults by referring to such studies as Galanter &Buckley, 1978 Galanter, Rabkin,
Rabkin, &Deutsch, 1979 Ross,1983 and Ungerleider &Wellisch, 1979b, which report a
relative absence of mental illness and emotional distress in cult members as measured by
psychological inventories and clinical interviews. However, while they are quick to point out
the very same methodological weaknesses, only in the reverse direction, in the studies
reporting a relative absence of impairment. They pay little attention to ―the possibility of
motivated distortion and/or deception by subjects and the lack of representative samples‖
(Langone, 1984, p. 66) (Note i).
Furthermore, Galanter‘s finding an absence of significant emotional distress as measured by
his General Well-Being Schedule and Neurotic Distress Scale is not the same as finding an
absence of psychopathology, nor can it be implied to indicate such. His results do lend
credence to his ―relief effect‖ theory, i.e., that affiliation with such cultic groups brings relief
from emotional/neurotic distress (Galanter, 1978, 1980, 1983a, 1983b). However, this is

Cultic Studies Journal, Vol. 2 No. 1 1985, Page 22
not necessarily the same as ―psychological well-being‖. Galanter says that the relief effect
comes from the perception of availability of social support and cognitive guidance in
mastering stress (p. 1201). Even if this were true, it still does not rule out the presence of
psychopathological defense mechanisms, which aid in bringing about this perception of well-
being, through denial and dissociation. Moreover, Galanter cannot deny that self-report
questionnaires, such as the General Well-Being Schedule and Neurotic Distress Scale, are
dreadfully easy to fake, thereby making both conscious and unconscious forms of denial
possible sources of error here.
In using the more powerful Minnesota Multiphasic Personality Inventory (MMPI) Ross (1983)
and Ungerleider and Wellisch (1979b) both found support for the notion that cultists tend to
―fake good‖ via elevations on certain validity scales (Ungerleider and Wellisch found L high,
Ross found K high). Therefore, the lack of elevation on the MMPI clinical scales for the
cultists in these two studies cannot be taken as proof of the absence of psychopathology,
for as Ungerleider and Wellisch themselves noted, ―it is likely that many of the in-group‘s
(scales) would have been elevated had they not consciously skewed their responses‖ (p.
281).
Finally, dissociative disorders, of which the author believes the cultic personality to be a
type, quite often do show ―normality‖ on objective tests such as the MMPI, while also
exhibiting psychopathology on projective tests such as the Rorschach, TAT, or drawings,
e.g., borderline personality disorder (Gunderson &Singer, 1975 Stone, 1980, pp. 264-270
Tibe, 1979, pp. 14-15 18-20, 29-33 Weinger, 1966, pp. 404-405). Therefore, it should
come as no surprise that the only two studies which did use projectives did find
psychopathology in cult devotees (Deutsch &Miller, 1983 Spero, 1982). Furthermore,
Spero specifically found much evidence of ―frank borderline-type (dissociative) phenomena‖
(p. 335) operating in the ego defenses of 37% of his cult devotees.
In conclusion, the egalitarians‘ use of the actuarial studies of cult devotees to ―prove‖ an
absence of psychopathology is highly questionable: the studies reflected the cultists‘
tendency to avoid acknowledgement of psychological problems the self-report
questionnaires employed in the studies were easily ―fakeable‖ (General Well-Being Schedule
&Neurotic Distress Scale) or had questionable validity due to the faking response set
(MMPI) and the studies under consideration ignored two other studies which used
projective testing and did show evidence of psychopathology.
Regarding the presence of problems in ex-cultists, egalitarians declare that the vast
majority left voluntarily, Implying that these individuals suffer no, or at least fewer,
problems. Additionally, they call cult critics to task for the lack of statistical data supporting
the prevalence of ex-cultist problems (e.g., Saliba, 1985, p. 44). Nonetheless, much clinical
evidence, such as that which will be presented in this paper, ―suggests that the prevalence
of harm is substantial, although not necessarily normative or the same from group to
group‖ (Langone, 1984, p. 66). In fact, the only available study which examined the
prevalence of harm (Galanter, 1983b) found 36% of ex-Moonies (71% of whom had clearly
departed voluntarily) experienced ―serious emotional problems after leaving,‖ problems that
continued for an average of 3.8 years (p. 984). Furthermore, the General Well-Being
Schedule used in this study (the Neurotic Distress Scale was not employed) is not able to
detect emotional problems not labeled ―serious‖ by this self-report method. Therefore,
actual prevalence of psychological problems as measured by more powerful psychological
assessment techniques could conceivably result in an even higher prevalence rate.
Lately, egalitarians have begun to concede that there are (or can be) problems which
surface when individuals leave the newer cult groups, but they also insist that these
problems are ―cult-related,‖ not cult caused (Robbins, 1984 Saliba, 1985), and they usually
relegate them to problems of adjustment akin to the culture shock missionaries experience