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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
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Also significant is the fact that most MPD patients who report ritual abuse state that they were
the object of such abuse at a young age. The limited cognitive functions of young children
permit manipulation by adults who may convince the child that a certain series of events
occurred when in fact they were contrived (that is, the event in question appeared to be real
when it was mere theatrics). Even innocent acts of adults may be distorted in the minds of
children. Because adults who recount these childhood experiences view them through
children‟s eyes their stories retain such distortions. This factor may help to explain certain
accounts of ritual crime that, if accepted at face value, would be physically impossible.
While the evidence in support of organized ritual crime is found almost exclusively within the
mental health community (in the form of testimony from patients and therapists), there are
many practitioners who reject the existence of such a broad-based criminal conspiracy but
who do assert experience suggestive of more limited ritual crime. Much of the information in
support of their opinions comes not from victims but from perpetrators of what is described as
ritual crime. These crimes are most often property crimes of a relatively minor nature,
consistent with the information obtained through surveying schools and law enforcement and
social services agencies.
Patients who report participation in illegal endeavors, and who also demonstrate interest in
the occult, may cause therapists to jump to the conclusion that the delinquent acts involve
ritual crime when in actuality the belief system plays no part in the criminal acts. There is
some evidence, however, that troubled youth experience a disproportionate interest in so-
called aberrant belief systems.
Clinical studies indicate that youth who turn to occult beliefs reflective of socially ostracized
value systems tend to exhibit antisocial behavior generally, and may be self-destructive. Self-
esteem is likely to be abnormally low, suggesting the youth‟s attempt to gain greater power,
acceptance, and confidence through his participation in the occult and groups who engage in
associated practices. Also demonstrated was a high incidence of substance abuse among
these individuals. Clinical evidence does not support the conclusion that either drug abuse or
a general interest in the occult leads to ritual crime. The research does suggest the possibility
that drug abuse and participation in aberrant belief systems can be symptomatic of
psychological problems.
There is no question that psychotic and sociopathic persons who engage in various atrocities
involving loss of human life may be associated with belief systems that rationalize or explain
their behavior. Such persons may fit the model of a “self-stylist” who integrates the concepts
of other religions into a personal (and self-serving) belief system. In this case it is not a
particular belief system that influences their behavior. Rather, the behavior is a result of the
interaction between their illness and their personal belief system, and may itself affect that
illness and belief system.
Clearly there remains substantial debate within the field as to the extent to which ritual
crimes occur. Some of this debate is attributable to the same definitional problems that
generally plague this area of study. The ritual abuse often cited by therapists, for example,
encompasses interfamilial generational abuse. The reason for its characterization as ritual
abuse is sometimes due to the bizarre or habitual nature of it, despite the absence of a belief
system and associated rituals. Characterization of such abuse as ritual is not incorrect per se.
It may, however, convey false images to other professionals and to the public. And it could
certainly ignite challenges to proffered statistics of ritual abuse.
As greater understanding of physical and sexual abuse of children is gained, it is becoming
ever more evident that the proclivity for such abuse is passed from parents to children, from
one generation to the next. Thus, that generational abuse within families occurs seems
unquestionable. This fact does not establish, nor necessarily make more likely, the existence
of organized ritual abuse. The increasing publicity accorded ritual abuse claims, however,