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that issues relating to ritual crime in the mental health field possess their own unique series of
problems.
Because therapists are necessarily concerned with treatment issues, their initial response to
clients who report ritual abuses is to seek a determination as to what effect this has had on
the client. Ascertaining the validity of the reports may be important in treatment planning, but
it is not the objective of the therapist to attain or compile evidence in support of a criminal
investigation or prosecution. Indeed, attempts in that regard may tend to impede effective
treatment.
Where patients allege being subjected to abuse, claims of ritual crime take on a new focus,
directed at the victim solely. This impacts directly in two ways. While the nature of inquiry
differs, the ultimate objectives are also distinct. The mission of law enforcement is at odds
with that of the therapist since, for the therapist, challenging a client‟s story may be
inappropriate. It is imperative, however, for law enforcement to establish factual accuracy
with regard to alleged criminal offenses. Additionally, the goal for addressing complaints
directed to therapists varies from that sought by the criminal justice system. Law
enforcement agencies exist to prevent, investigate, and prosecute crime. In the majority of
cases the therapist is likely never to seek nor encounter the client‟s victimizer. Typically, only
if the patient is the actual perpetrator of the crime will the therapist address this side of the
equation.
This dichotomy is of particular significance for those attempting to establish the true extent of
ritual crime because claims involving the most serious and widespread offenses derive
predominantly from the realm of mental health. Often these claims are never reported to law
enforcement at all, or only after a therapist has elicited the information.
But if the nature of therapists‟ work makes more difficult the verification of claims involving
ritual crime, the concerns reflected by such claims remain just as real. Unfortunately,
controversy regarding treatment of clients reporting ritual abuse is as intense among
therapists as is the subject among the broader general population. Actually, mental health
professionals who espouse any opinion about the ritual crime phenomenon tend to fall into
one of the three earlier referenced categories.
However, while these professionals point to many of the same factors as others in debate
over the true extent of ritual crime, the discussion assumes a higher level of complexity. The
causes and effects of victims‟ mental conditions, and their impact on claims of ritual crime,
add fuel to the fire. The inquiry shifts readily from questions about the victim‟s veracity to
issues concerning their beliefs.
Just as the therapist‟s role contrasts with that of the law enforcer, so too is the patient‟s role
incomparable to that of the average citizen reporting a crime. The patient is there for the
specific purpose of seeking treatment and therefore properly views as unique communications
within the doctor-patient relationship. These communications are neither directed to, nor
intended for, an officer‟s ears. Further, the conditions for which the patient seeks help often
affect his or her ability to perceive and process information, which in turn relates to the
reliability of information relayed by such a patient.
The credibility that a therapist attributes to a patient‟s claims of abuse will depend
substantially on the pathology for which the patient is diagnosed. Manifestation of psychosis
may evidence distortions of reality apparent on their face, either because they involve
inaccuracies with which the therapist is personally familiar or because the reports follow an
inherently illogical path. Many claims of ritual abuse appear to be so bizarre that psychosis is
assumed. If objective testing does not indicate the presence of such psychosis, however, the
therapist might well attribute greater potential credibility to a patient‟s claims of abuse.

Cultic Studies Journal, Vol. 8, No. 2, 1991, Page 85
Other bases for questioning credibility of patients‟ accounts might include malingering patients
or a factitious disorder. In these cases the patient will deliberately fabricate stories to serve
an ulterior motive. Lack of sincerity on a patient‟s part makes uncovering discrepancies in the
stories less difficult than is the case with other psychological conditions that involve more
deeply imbedded memories or beliefs.
Increasingly victims of abuse are being diagnosed with dissociative disorders. Multiple
Personality Disorder (MPD) in particular has come to be viewed as a common manifestation of
severe abuse. Substantial debate remains, however, as to the prevalence of MPD. In cases of
abuse, MPD would typically manifest itself as an adaptive ego defense mechanism. Alter egos
are created to assume various roles in the individual‟s life. Borderline Personality Disorder,
which traditionally has been heavily associated with victims of severe habitual abuse, has
taken a back seat as a diagnosis in the offices of many therapists who are gaining increased
knowledge and understanding of MPD.
The Diagnostic and Statistical Manual of Mental Disorders, Third Edition (DSMIII-R), revised in
1987, now recognizes MPD as the essential feature of certain dissociative disorders and as
one response to severe abuse. Among mental health professionals, however, there are many
who feel that some patients reporting abuse are being misdiagnosed as sufferers of MPD. That
some therapists have a high concentration of clients diagnosed as MPD in their caseloads is
beyond dispute. There are those who point to this fact as support for their hypothesis. On the
other hand, therapists known as experts in dealing with MPD patients tend to receive referrals
for these clients, so that they may be expected to have a disproportionate number of such
patients.
Continued publicity stressing the link between ritual abuse and MPD has popularized the
notion that MPD is the result of ritual abuse. In fact, this has not been firmly established. A
broadly accepted model, Kluft‟s Four-Factor Theory, suggests that the disorder results from
the interrelation of various factors. Unfortunately the converse to the position has also been
implied: that all MPD sufferers are in fact victims of ritual abuse. Yet this is only one of many
traumas that may precipitate the disorder. Since the introduction of his theory, Kluft has
published findings of MPD case studies covering a period of a decade and a half of that
indicate that approximately one third of these patients reported ritual abuse (Kluft, 1988). He
goes on to say that this third included many of the more complex cases. These findings
suggest, however, that the majority of those suffering from MPD did not become so
encumbered as the result of ritual abuse.
Whether patients are properly diagnosed or not, a problem that may arise from the
perception of these individuals as victims of abuse is the tendency to conclude that each such
patient necessarily represents one more in a growing throng of ritual crime victims. This
potential is enhanced as these diagnoses increase. But because not all MPD patients are
victims of ritual abuse, and because there is good reason to question the veracity of the
accounts of MPD patients, such a conclusion would be premature (pending other corroborating
evidence).
An essential component of MPD is the susceptibility to autohypnotic trance experiences. This
susceptibility to trance aids therapists in the hypnosis that is often used in abreaction (a
method used by therapists to elicit repressed emotions). A number of ramifications ensue
from this proclivity toward trance states. Persons under hypnosis are more highly suggestible.
Studies affirm that they are also more inclined to accept the accuracy of information that is
obtained while in the hypnotic state. Because elements of fantasy are likely to exist to one
degree or another in the evolution of the disorder, persons suffering from MPD may, with
complete conviction, report events that either did not occur or were distorted by their
perceptions.