International Journal of Coercion, Abuse, and Manipulation Volume 9, Issue 2 2026 60
well as degrees of physical, emotional, financial, and
sexual exploitation and abuse that may exist in the
group or context (Dubrow-Marshall, 2010 Scheflin,
2015 Woody, 2009). Consideration of actual and
potential harm to members remains paramount (West
&Langone, 1986 Woody, 2009). Broadly, HCGs
seek new members and financial resources (Hassan,
2016), and they may also promote exercise, politics,
philosophy, self-help, religion, multi-level marketing,
and other goals—including ST or terrorism (Hassan
&Shah, 2019 Singer, 2003). To achieve these goals,
HCGs use deceptive and manipulative social and
psychological tactics, which “heighten suggestibility
and subservience” (Farber, 2014, p. 2) and shape the
behaviors, thoughts, and feelings of members to serve
the wishes and desires of the leader(s) (Hassan &Shah,
2019). Singer (1990) stated that HCG “relationships
refer to relationships in which a person intentionally
induces others to become totally or nearly totally
dependent on the leader for most major life decisions”
(p. 1). HCG leaders often deceive their followers into
believing that leaders possess special knowledge,
talents, or gifts that benefit followers only if the
followers remain loyal (Singer et al., 1990).
Hassan and Shah (2019) estimated that the number of
HCG members worldwide was in the millions. South
Korea alone has a projected two million members
of HCGs (Vice World News, 2021). Eichel (2018)
suggested there are up to 10,000 HCG groups in the
United States, and Bancroft (2022) reported up to
2,000 HCGs in the United Kingdom. Observers have
identified HCGs in Norway, Chile, Japan, Uganda,
Russia, Canada, Switzerland, and France, among
others (Boyle-Laisure, 2018). Although Clark (1993)
estimated worldwide that HCGs have 6–10 million
followers, Hassan and Shah (2019) more recently
argued that it is not possible to estimate current
numbers.
HCGs and Lifton’s Criteria
HCGs use coercion and manipulation to remain in
power. They typically reflect Lifton’s (1961/2014) eight
criteria for thought reform.
1. Milieu Control: HCGs typically dominate
the environment, communication, and
individual thought.
2. Loading the Language: HCGs strictly
manage vocabulary.
3. Purity of Thought and Actions: HCGs
required followers to denounce previous beliefs
and moral standards, using shame and guilt to
devalue them.
4. Mystical Manipulation: HCGs typically
reframe members’ past experiences in a
negative light and describe group actions as
supernatural and as the most important values
in life.
5. Confessions: HCGs lower personal and
emotional boundaries through oversharing
and public confession.
6. Sacred Science: HCGs prioritize the group’s
beliefs over science and other sources of
information.
7. Doctrine over Person: HCGs typically
emphasize the group’s needs and values over
members’ needs and values.
8. Dispensing of Existence: HCGs generally
portray those outside the group as flawed or
evil, who may gain legitimacy only by joining
the group. For example, many HGCs exclude or
deny the existence of the LGBT+ community.
HCG Identity Progression
Scholars have devoted extensive attention to identity
progression in HGCs. Prior to joining an HCG as an
adult, an individual usually has an intact pre-group
identity. Upon entering an HCG, a destabilization of
the sense of self can occur (Doychak &Raghavan,
2020 Singer, 2003), and a new HCG-identity (also
called a pseudo-identity [West &Martin, 1994 Hassan
&Shah, 2019]) forms gradually through peer pressure,
interactions with the new social structure, and the
intense psychological milieu. Silverstone et al. (2021)
describe the process as causing the victim to “break
with both their subordinate and personal levels of
identity” (p. 27) in other words, this process changes
the entire person.
61
Connie A. Mitchell |Abuses Produce Similar Psychological Effects in Survivors
Many perspectives exist regarding HCG identity
development (see Farber, 2014 Jenkinson, 2008
Langone, 1992 Lifton, 2000 Stein, 2016 West &
Martin, 1994), but scholars broadly agree that an HCG
identity emerges during the process of joining and
belonging to an HCG. In this review, we emphasize
Hassan’s (2010, 2013) description of HCG identity
development.
Hassan (2000, 2013) argued that the HCG identity
attaches itself to pre-group identity parts that have
been discarded, forgotten, or outgrown and that it
unfolds in a series of stages. First, HCGs unfreeze the
pre-HCG identity through disorientation, sensory
deprivation or overload, physiological manipulation,
activities encouraging dissociation (meditation,
chanting, rapping), questioning the person’s identity,
and redefining the person’s past. Second, the creation
of a new identity occurs in small stages, often starting
with indoctrination meetings, membership, books,
and podcasts. Following this introduction, HCGs
typically modify behavior through punishments and
rewards, environmental controls, and techniques that
force thought interruptions. Third, HCGs use powerful
confessions and moving testimonials to refreeze the
new identity and social system while emphasizing
separation from family and friends (Hassan, 2013).
Hassan and Shah (2019) argue that HCG membership
does not erase the authentic or pre-HGC identity but
grafts the dominating new HCG identity to the pre-
HCG identity. Recovering victims who have left the
group typically describe the HCG identity as superficial.
For adults, researchers describe the HCG identity
experience as a form of psychological age regression
through thought-stopping or thought-suppressing
techniques (West &Martin, 1994). This HCG identity
becomes more comprehensive and associated with
increased controllability and suggestibility (Dubrow-
Marshall, 2010 West &Martin, 1994).
This HCG identity evolves from the pre-HCG
identity, typically with the member viewing the HCG
as a deeply desired social group (Dubrow-Marshall
&Dubrow-Marshall, 2015). The person’s clothing,
likes, dislikes, humor, values, friends, and political
views begin to take on the characteristics of the group
(Dubrow-Marshall &Dubrow-Marshall, 2015 Stein,
2016). Further, accepting group norms reinforces
the new, totalistic, and dominant HCG identity
(Dubrow-Marshall &Dubrow-Marshall, 2015), which
becomes more important than one’s pre-HCG identity
(Schore, 2012), particularly as the individual typically
experiences a new existential purpose (Dubrow-
Marshall, 2010). This scenario often culminates in
an us-versus-them view of the world with a coerced
group-dependent dynamic (Dubrow-Marshall, 2010),
which can include members taking actions that violate
their moral principles, thereby inducing moral injury
and further committing them to the HCG (Herman,
1992 VanderWeele et al., 2025). These changes interact
with coercive and manipulative tactics and can lead to
mental health issues. As noted above, controlling the
language within the group and controlling the social
environment work to bind the newly developed HCG
identity to the group (Dubrow-Marshall, 2010 Lifton,
1961/2014).
A related view of identity progression describes the
HCG identity as a totalistic identity (Dubrow-Marshall
&Dubrow-Marshall, 2016): “The domination of
a person’s self-identity by a single identity with a
group or person to the exclusion of other aspects of
identity with potential effects on mental health” (p.
393). This domination can result in pathology, with
symptoms that may include depression, anxiety,
phobias, personality changes, and varying levels of
dissociation (Dubrow-Marshall &Dubrow-Marshall,
2016 Hassan &Shah, 2019). More specifically, the
DSM-5-TR (American Psychiatric Association, 2022)
lists identity disturbance as a qualified diagnosis
under the classification of Unspecified Dissociative
Disorders. The second descriptor describes this
qualified diagnosis as “Identity disturbance due to
prolonged and intense coercive persuasion ...(thought
reform, indoctrination, ...recruitment by [HCGs] ...)”
(p. 347). The above common mental health outcomes
can increase difficulties for survivors.
First-, Second-, and Multi-Generation HCG Survivors
Survivors of HCGs have been termed first-generation,
second-generation, or multi-generation (Matthews,
2017). First-generation members are those who were
adults when they joined the group and developed an
HCG identity. A second -generation individual was
born or brought into the group during or before early
adolescence. Multi-generation members have more
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