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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

International Journal of Coercion, Abuse, and Manipulation Volume 9, Issue 2 2026 62
than two generations inside the group.
Second- and multi-generation survivors typically have
not had opportunities to develop their own identities
or values independently of the group. Those who
enter HCGs as children often remain in a childlike
state with limited, if any, opportunities to think and
decide for themselves (Goldberg, 2006). This arrested
psychological development often prevents them from
maturing emotionally, and victims typically remain
anxiously group-dependent (Hassan, 2013 Jenkinson,
2008 Lifton, 1961/2014). Second- and multi-
generation members’ identities are typically more
deeply entrenched than first-generation identities,
and second- and third-generation members often
face substantial identity struggles when they leave the
group (Stein, 2016). Generally, they report feeling
tremendous shame, and they often seek therapy to
discover who they are outside the group (see Jessup,
2008, 2010).
These issues remain particularly relevant for second-,
third-, and multi-generation members who passed
through adolescence in the HCG. At approximately
age 13, adolescents typically undergo a brain transition
called apoptosis (Schore, 2012), during which the
social influence of peers becomes substantially more
important (Wilder &Woolridge, 2022). In the highly
controlled environment of an HCG, social pressures
from peers who are also members can lead to self-
sealing of the HCG identity (Lalich &Tobias, 2006
West &Martin, 1994).
HCG Trauma Bonds
Trauma bonds occur as “a psychological response
to abuse... when the abused person forms an
unhealthy bond with the person who abuses them”
through alternating terror and comfort (Medical
News Today, 2023, para. 1). Trauma bonds occur in
HCG populations (Stein, 2016) and are similar to
concepts such as psychological entrapment, coerced
dependency, distorted self-view, psychological
captivity, and trauma-coerced attachment (Doychak
&Raghavan, 2020 Raghaven &Doychak, 2015). “The
impact of trauma is psychological, neurobiological,
and psychobiological” (Carnes, 2018, p. 26), affecting
the victim’s body, mind, spirit, and relationships.
Regarding the mind and body, four key neurochemicals
are involved in trauma bonds: endogenous opioids,
dopamine, oxytocin, and corticotropin-releasing
factor (Freeman, 2017). Trauma bonding causes strong
emotional and physical attachments as individuals
facing abuse seek comfort, safety, and love (Stein,
2016). Unresolved trauma challenges one’s resilience.
It undermines the connection to the self and causes a
loss of connection to one’s identity, body, and memory
(Carnes, 2018). In particular, deleterious bonds with
HCGs may incorporate a triple bond: one with the
leader, one with peers, and one with the group itself
(Stein, 2016). Raghavan and Doychak (2015) suggest
that trauma-coerced bonding enacts an internal shift
in reality due to a deteriorating sense of self in the
HCG, as discussed above. Trauma bonding can leave
the victim believing that they are at fault for crimes
committed even while facing coercion in the HCG
some victims have testified in favor of HCG leaders or
refused to testify against them (Hassan et al., 2022).
Sex Trafficking
According to United States federal law, ST occurs
when someone uses “force, threats of force, fraud,
coercion... or any combination of such means... to
cause the person to engage in a commercial sex act”
(CSA) (Congressional Research Service, 2026, para.
2). A CSA is defined as any sex act “on account of
which anything of value is given to or received by any
person” such as money, drugs, shelter, food, or clothing
(Cornell Law School, 2026, para. 7) further, CSA can
also include prostitution and pornography (National
Human Trafficking Resource Center, 2026).
Trafficking enterprises have two main purposes: 1)
recruiting new members and 2) making money. In
these ways, trafficking can serve as a form of organized
crime (Interpol, 2023). ST disproportionately affects
women, children, immigrants, people of color, people
who identify as LGBT+, and lower socio-economic
populations (Polaris, 2026). Vulnerable populations
of girls and women make up a substantial majority of
those trafficked sexually in the United States (Polaris,
2026) however, that is not to minimize the similar
exploitation and horrors faced by men and boys. Farley
(2003) described the experience of an individual in
ST as repeated and daily “bought and sold rape” (p.
173). Common forms of ST include pornography,
illicit massage businesses, escort services, brothels