Cultic Studies Journal, Vol. 2 No. 1 1985, Page 47
including ideas of influence and reference, or even some auditory, olfactory, or visual
hallucinations. Furthermore, depersonalization and derealization are seen in almost all ex-
cultists. Therefore, some comments regarding differential diagnosis of schizophrenia and
the cult dissociative disorder are in order.
Since no writer has yet provided any demarcation between schizophrenia and the cult
dissociative disorder, perhaps Beahr‘s (1982) differentiation between schizophrenia and the
multiple personality would shed some light. In contrast to the schizophrenic, the multiple
will demonstrate times of coherence and no loosening of associations. Even when multiples
―hear voices they are coherent,‖ and they frequently ―report severe to extreme adverse
reactions to all neuroleptics tried‖ (p. 91). Likewise, the cult dissociatives never
demonstrate loosening of associations or incoherence and their transitory delusions and/or
hallucinations are logically consistent with their (ex-) cult life experiences. In contrast to the
symbiotic phychosis (p. 166), the cult dissociative‘s reality testing may be impaired, but
never is it totally absent.
Unfortunately, the medication picture is not as clear, as will be seen in ―Part 11‖ to follow.
In essence, while some authors have suggested that psychotropic medication, including
anti-psychotics, have proven helpful, Clark (in AFF) advised much discretionary caution
because ―ex-members respond to medications more rapidly (and sometimes more
adversely) than one would normally expect‖ (p. 79). Therefore, in this regard the cult
dissociative once again resembles the borderline more than the multiple.
In summary then, until future research can clarify the issue, Beahrs‘ differentiation between
the multiple personality and the schizophrenic may be adapted for a ―quick and dirty‖
differentiation between the cult
dissociative and the schizophrenic. In contrast to schizophrenia, both the multiple and the
(ex-) cultist demonstrate no loosening or incoherence and both respond differently to anti-
psychotic medication: the multiple more adversely and the cult dissociative possibly more
rapidly.
Narcissistic personality disorder. The clinical picture of the narcissistic personality disorder
(DSM-111 #301.81) and the cult dissociative disorder as described throughout the bulk of
this paper look almost nothing alike. However, when their similar underlying core ego
structures are compared (see Figure 4), one begins to see the opposing clinical pictures as
mirror opposites! Both are stable dissociative disorders that utilize projective identification.
The key difference is what they want reinforced by others. While the narcissist wants others
to mirror and confirm just how great he is (Masterson, 1981, pp. 21-24, 31, 60-63), the
cultist seeks someone to idolize, someone to be the ideal, powerful father they never had
(see ―Personal Vulnerability‖ family factors and ―Borderline personality disorder‖ sections
above).
The implications are obvious. While many cult leaders undoubtedly are psychopathic
characters who joined to seek power (Clark, 1979b, p. 96), many other leaders are probably
functional narcissistic personalities who either joined or started their group in order to gain
adoration. Furthermore, it would not be unreasonable to see some with both narcissistic and
psychopathic traits (Masterson, 1981, p. 48). although psychopaths are more antisocial and
show less regard for others (Masterson, 1981, PP. 40-48), whereas the pure narcissistic cult
leader would care very much what his followers thought of him (e.g., an inability to tolerate
those having less than ideal thoughts of him).
On the other hand, because some narcissistic personalities serve as defenses against
underlying core borderline personality structures (Masterson, 1981, pp. 28-32), it would not
be surprising to see individuals who were initially converted via the dissociative path
develop into functional narcissistic personalities after attaining leadership status. Perhaps

Cultic Studies Journal, Vol. 2 No. 1 1985, Page 48
this can help to explain the Goldbergs‘ (1982) puzzling finding that those who ―have
attained leadership status, and have, in effect, become the controllers‖ usually ―take longer
to disavow the (group) experience‖ after leaving, even though their departure was almost
always on their own (p. 167). (Is this due to the complicated layers of dissociated ego parts
they must work through?) For example, the narcissistic personality/ego state could be
defending against a dissociative state, which may be defending against even deeper pre-cult
personality conflicts, which paradoxically could even revolve around a borderline personality
disorder itself.
The author also believes that Erhard Seminars Training (est) utilizes a dissociative-inducing
process to produce functionally narcissistic personalities in that ―getting it‖ means
realizing your inner divinity and accountability to yourself only (Ash, 1984c). If research
bears this out, then it would not be too great a leap to imagine the more typical passive
dependent cult personality flipping over in Its dissociative/dedifferentiative ego structure
into a narcissistic personality once he attains a leadership position.
Post-traumatic Stress Disorder
Although the atypical dissociative disorder is the diagnosis of choice for the cultist syndrome
during the reevaluation phase of cult departure, a DSM-111 diagnosis is less clear for those
who have broken the dissociation through deprogramming or other means. Zerin (1982) has
suggested a similarity to post-traumatic stress disorder, which would be of the acute
subtype (308.30) as the post-deprogramming stage of cult recovery rarely extends past six
months.
Indeed, there are many similarities, most of which center around dissociative phenomena,
particularly floating, e.g., ―the sudden acting or. feeling as if the traumatic event were
reoccurring because of an association with an environmental or ideational stimulus‖ (DSM-
111, APA, p. 137). Others of particular similarity are the recurring dreams of the event
(nightmares), guilt about surviving, and memory impairment or trouble concentrating.
Indeed, it appears as if almost all of the post-traumatic stress disorder symptoms may fit
within the clinical picture of the post-mind-control syndrome.
However, an across-the-board comparison should await research on this issue, for
differences do linger in the shadows. For example, not included in the post-traumatic stress
disorder symptoms list, but present in the clinical picture of ex-cultists, are problems such
as indecisiveness, perceptual difficulties, depression, fear, anger, and interpersonal
problems centering around ambivalence. Survivors of concentration camps or battles in
Viet Nam rarely wish to return to the ―safety‖ and simplicity of their traumatic environment.
They knew they were in a stressful situation both during the experience and afterward,
whereas ex-cultists often express a desire to return to their experience, while cultists deny
that it is traumatic or stressful at all.
Consequently, the utilization of DSM-111 #308.30 for ex-cultists in stage one of cult
recovery may be supported, but not without question.
Summary
The clinical picture which has been portrayed here is that of individuals who have been
psychologically impaired by their participation in an extremist cult as defined by Ash,
1984b). Although the entire scope of all (ex-) cultist problems has been reviewed, it must
be remembered that not all individuals will experience all these problems. Nevertheless,
with the exception of the psychopathic or narcissistic personality types (and possibly the
very healthy), the ―poison‖ of the extremist cult conversion process will to some degree
affect all who participate. Furthermore, the more extremist the individual‘s group is in its
cultism (i.e., being a totalitarian closed system utilizing deceptive mind manipulating