Cultic Studies Journal, Vol. 13, No. 1, 1996, page 42
The notion that ICA is commonly hidden by total amnesia for the abuse (Gelinas, 1983) has
frightening implications for those concerned with the iatrogenic creation of false memories
of ICA. The problem is that literally anyone can be suspected of being an ICA victim. This
enormously increases the number of patients who may be caught up in the highly
suggestive exploration for hidden ICA discussed at the beginning of this article. For
example, Ganaway (1995) reports a communication from Chris Sizemore, the actual patient
described in Thigpen and Cleckley‟s (1957) The Three Faces of Eve: “Sizemore reports being
openly confronted at speaking engagements with accusations that despite her claims of
having been successfully treated for multiple personality disorder, she must still be in denial
about her sexual abuse (Sizemore, personal communication, 1994)” (p. 131, fn. 4).
How will the presence or absence of ICA as an etiologic factor be diagnosed among patients
who may be amnesic for its presence? In the popular literature (e.g., Fredrickson, 1992),
lists of allegedly telltale symptoms are long and contain common enough problems to create
a “Barnum effect”--a description that fits one and all (Ofshe &Watters, 1994). Less
inclusive, professional guides to the diagnosis of hidden ICA often suggest superficially
plausible relationships between specific symptoms and ICA (e.g., bulimia).
However, the early research supporting this view is methodologically flawed and the
relationships between ICA and various forms of adult psychopathology may reflect
nonspecific effects (cf. Pope &Hudson, 1992). For example, two careful, methodologically-
sophisticated studies of the relationship between bulimia and ICA failed to find any
relationship between the two (Kinzl, Traweger, Guenther, &Biebl, 1994 Rorty, Yager, &
Rossoto, 1994), though many clinicians mistakenly continue to see conditions such as
bulimia as strong indicators of “hidden” ICA. As an example, the psychologist Ms. Borawick
consulted before seeing Valerian St. Regis espoused such views (Affidavit of Anthony E.
Reading, Ph.D., labeled as Exhibit F [a part of the record not under seal] and included as
part of the Plaintiff‟s Submission Re: Ruling on Defendant‟s Motion in Limine submitted to
the U.S. District Court, District of Connecticut).
Some therapists feel that experiences such as dreams or memories of Aodd feelings” can be
used as a guide to the diagnosis of hidden ICA. More vivid experiences, such as flashbacks
or revivification of memories during hypnosis, with or without an abreaction, are usually
seen as confirmation of ICA both by the patient and therapist. However, like hypnotically
influenced memories, flashbacks quite often have little or no relationship to objective,
historical reality (Frankel, 1994). As is the case for most events that occur in
psychotherapy, appropriate interpretation has to do with the patient‟s inner world, not the
external one (Spence, 1994). Similarly, many clinicians feel that poor memory for
childhood, especially early childhood, is diagnostic of a history of sexual abuse. However,
people can generally remember only scattered moments before age 5 or 6 and have almost
no retrievable memories before age 2 or 3. If they were under 4 years old at the time, for
example, most people remember very little, if anything, about the birth of a younger sibling
(Usher &Neisser, 1993). Little memory of early childhood is normal, not a sign of pathology
(Lindsay &Read, 1994).
Without reliable pathognomic signs, the identification of patients who endured, but do not
remember, childhood sexual abuse involves a complex series of decisions. It is too easy to
make mistakes. ICA is a hidden etiologic problem which can only be inferred, not observed.
From the “Research Diagnostic Criteria” that preceded DSM-III (Spitzer, Endicott, &Robins,
1977) through the ongoing process of revising DSM-IV (American Psychiatric Association,
1994), attempts to create reliable diagnostic categories have eschewed such supposed
etiologic factors in favor of overt, verifiable symptoms because experts will routinely
disagree about hidden causes.
A Statistical Approach to the Incidence and Prevalence of False Positives
The notion that ICA is commonly hidden by total amnesia for the abuse (Gelinas, 1983) has
frightening implications for those concerned with the iatrogenic creation of false memories
of ICA. The problem is that literally anyone can be suspected of being an ICA victim. This
enormously increases the number of patients who may be caught up in the highly
suggestive exploration for hidden ICA discussed at the beginning of this article. For
example, Ganaway (1995) reports a communication from Chris Sizemore, the actual patient
described in Thigpen and Cleckley‟s (1957) The Three Faces of Eve: “Sizemore reports being
openly confronted at speaking engagements with accusations that despite her claims of
having been successfully treated for multiple personality disorder, she must still be in denial
about her sexual abuse (Sizemore, personal communication, 1994)” (p. 131, fn. 4).
How will the presence or absence of ICA as an etiologic factor be diagnosed among patients
who may be amnesic for its presence? In the popular literature (e.g., Fredrickson, 1992),
lists of allegedly telltale symptoms are long and contain common enough problems to create
a “Barnum effect”--a description that fits one and all (Ofshe &Watters, 1994). Less
inclusive, professional guides to the diagnosis of hidden ICA often suggest superficially
plausible relationships between specific symptoms and ICA (e.g., bulimia).
However, the early research supporting this view is methodologically flawed and the
relationships between ICA and various forms of adult psychopathology may reflect
nonspecific effects (cf. Pope &Hudson, 1992). For example, two careful, methodologically-
sophisticated studies of the relationship between bulimia and ICA failed to find any
relationship between the two (Kinzl, Traweger, Guenther, &Biebl, 1994 Rorty, Yager, &
Rossoto, 1994), though many clinicians mistakenly continue to see conditions such as
bulimia as strong indicators of “hidden” ICA. As an example, the psychologist Ms. Borawick
consulted before seeing Valerian St. Regis espoused such views (Affidavit of Anthony E.
Reading, Ph.D., labeled as Exhibit F [a part of the record not under seal] and included as
part of the Plaintiff‟s Submission Re: Ruling on Defendant‟s Motion in Limine submitted to
the U.S. District Court, District of Connecticut).
Some therapists feel that experiences such as dreams or memories of Aodd feelings” can be
used as a guide to the diagnosis of hidden ICA. More vivid experiences, such as flashbacks
or revivification of memories during hypnosis, with or without an abreaction, are usually
seen as confirmation of ICA both by the patient and therapist. However, like hypnotically
influenced memories, flashbacks quite often have little or no relationship to objective,
historical reality (Frankel, 1994). As is the case for most events that occur in
psychotherapy, appropriate interpretation has to do with the patient‟s inner world, not the
external one (Spence, 1994). Similarly, many clinicians feel that poor memory for
childhood, especially early childhood, is diagnostic of a history of sexual abuse. However,
people can generally remember only scattered moments before age 5 or 6 and have almost
no retrievable memories before age 2 or 3. If they were under 4 years old at the time, for
example, most people remember very little, if anything, about the birth of a younger sibling
(Usher &Neisser, 1993). Little memory of early childhood is normal, not a sign of pathology
(Lindsay &Read, 1994).
Without reliable pathognomic signs, the identification of patients who endured, but do not
remember, childhood sexual abuse involves a complex series of decisions. It is too easy to
make mistakes. ICA is a hidden etiologic problem which can only be inferred, not observed.
From the “Research Diagnostic Criteria” that preceded DSM-III (Spitzer, Endicott, &Robins,
1977) through the ongoing process of revising DSM-IV (American Psychiatric Association,
1994), attempts to create reliable diagnostic categories have eschewed such supposed
etiologic factors in favor of overt, verifiable symptoms because experts will routinely
disagree about hidden causes.
A Statistical Approach to the Incidence and Prevalence of False Positives
