Mar 12 2007

Another Nail in the Coffin of Repressed Memory

By now it is old news that so-called “repressed memory syndrome” is a dangerous myth, but it keeps cropping up in the news from time to time, and the notion still has its adherents. Recently, Harvard researchers published an interesting study suggesting that repressed memory syndrome is a cultural phenomenon, not a scientific one. The lessons of this sad episode in therapy are timeless and it will likely endure as a classic cautionary tale of psychological pseudoscience.

The Courage to Heal

In 1988 Ellen Bass and Laura Davis published The Courage To Heal: A Guide for Women Survivors of Child Sexual Abuse (now in its third edition). In it they claim that over 45%, maybe more, of all women have been sexually abused as children, but most have repressed the memory, resulting in a host of psychological problems from eating disorders to depression. The book sparked an industry of repressed memory therapists whose goal in therapy was to recover the repressed memories of abuse as a path to solving the psychological manifestations.

Belief in repressed memory spread quickly and countless women, seeking a bit of counseling to help them deal with their problems or mental health issues, found themselves confronted with a repressed memory therapy who insisted they are sexually abused by their father but just didn’t remember it. Psychologist Elizabeth Loftus wrote an excellent article exposing the harmful techniques employed by many such therapists.

With a few years, however, the tide already started to turn. A backlash against repressed memory took form, and the ideas expressed in The Courage to Heal were thoroughly debunked as junk science. To help reverse the tide and deal with the many victims of this movement, the False Memory Syndrome association was formed. Their primary point is that “repressed memories” are actually false memories created by the malpractice of repressed memory therapists. Now repressed memory syndrome survives (as such nonsense always does) but it has been largely marginalized.

The Lessons of Repressed Memory

There are many important lessons to be learned from the repressed memory fiasco:

1) Good healthcare (mental or otherwise) is science and evidence based.

The core problem with the repressed memory idea is that it was never properly tested scientifically. Bass and Davis bypassed the process of peer-review and scientific testing and went straight to the public with their book. Repressed memory was taken from an idea and then put directly into practice. This model of healthcare is characterized as “philosophy based” and is a pre-scientific model. It has a very bad track record of success.

The science came after the fact, but by then many people had been victimized by repressed memory pseudoscience. Also, there was now already an infrastructure of seminars and books, and a large number of trained therapists dedicated to repressed memory therapy. Unfortunately, this practice of putting the therapy cart before the science horse is endemic in the mental health field. There are many competent and scientific practitioners out there, but there is also a host of unscientific ideas that are incorporated into practice before being tested scientifically.

2) If your only tool is a hammer, every problem looks like a nail.

The methods of repressed memory therapists violate many of the basic rules of counseling professionalism. The first of which is do to no harm – this stems from an appropriate humility and respect for the proper role of a therapist. Rather, repressed memory therapists, certain that they knew the truth, ran roughshod over their client’s mental health and spread a ripple-effect of misery through their families.

The primary malfunction is that the techniques used involve starting with the assumption that any female client who comes through your door was abused and has repressed memories. The goal of the therapy therefore becomes uncovering the repressed memories (validating the assumptions) rather than figuring out what is actually going on with the client.

3) Modern day witch hunt.

The repressed memory syndrome affair has been compared, accurately, to a modern day witch hunt. The key feature that makes this comparison appropriate is that of equating accusation with guilt. Parents who were accused of abusing their children we assumed to be guilty based solely on the accusation. Loftus reports in her article the therapist saying, “I have a therapist friend who says that the only proof she needs to know that something happened is if you think it might have.”

In the witch hunts of Europe courts accepted what was known as “spectral evidence,” which could be a dream or vision had by the accuser. Repressed memory is just another form of spectral evidence. In most cases, like with the real witch hunts, there is no external corroborating evidence.

4) Memory is malleable and subjective.

An appreciation for the true nature of human memory is crucial to a properly skeptical and scientific outlook on many issues. Undue faith in the accuracy and reality of memories leads many down the yellow brick road to fantasy land. It is now clearly established that memories are highly malleable – they can be modified by suggestion, different memories can fuse – merging their details, and memories can be created out of whole cloth.

Repressed memory therapy used techniques that were perfect for manufacturing false memories. Clients are encouraged to imagine themselves being abused, to try to fill in the “missing details.” If you imagine something often and hard enough, the memory of your imaginings become indistinguishable from memories of actual events.

In this respect repressed memory therapy is very similar to the abduction therapists who use similar techniques, and hypnosis, to create false memories in their clients of having been abducted by aliens.

5) Extraordinary claims require extraordinary evidence

Repressed memory believers demonstrated a distinct lack of skepticism for the core claims of this type of therapy. They either did not appreciate how extraordinary the claims were, or were simply overwhelmed by the emotional appeal of accepting the claims uncritically.

For example, the notion that almost half of all women were sexually abused as children should have been a huge red flag that something is just not adding up. That such an enormous hidden epidemic could occur beneath our noses should have caused proponents to step back and ask themselves, “Hmmm….could this really be true?”

Every other link in the repressed memory chain should have been questioned also. Can memories of a long-term traumatic episode be completely repressed from memory? Can such an episode occur without any evidence – problems at school, doctor visits, etc. Can repressed memories cause eating disorders?

Also, some of the “recovered” memories took on bizarre dimensions – exposing vast cults of devil worshipers among middle-class suburban families. The cults, often involving multiple family members, were allegedly engaged in cannibalism, infanticide, incest, and bestiality. Rather than taking the bizarreness of the recovered memories as evidence that perhaps the memories were not accurate, the therapists (starting with the unshakable a-priori assumption that the repressed memories were real) accepted the claims – no matter how extraordinary.

6) Seek and ye shall find.

The episode also reveals a process that is not uncommon in the world of pseudoscience – if you look for something hard enough you are likely to find it. Part of this psychological process is called subjective validation – if you start with a conclusion it is easy to backfill the evidence. This evidence (often cherry picked and distorted) can seem very compelling.

Repressed memory therapists went looking for repressed memories – and they found them. But the process of searching was almost guaranteed to find repressed memories – in fact they manufactured the memories they were allegedly looking for. What evidence they found they simply interpreted as evidence for repressed memories. And what evidence was lacking was simply explained away. You can use this process to construct any belief system you wish.

Good science is a process of questioning your assumptions – not validating them. It also uses carefully constructed methods and statistic to help distinguish real phenomenon from illusions. Repressed memory proponents never subjected their ideas to the kinds of tests that could potentially falsify them.

The new study I referred to earlier takes a look at literature and finds that the concept of repressed memories is absent in literature older than 200 years. Older literature contains many references to other mental illnesses, such as depression and schizophrenia, but not a single reference to anything that can be considered repressed memories. This notion was invented in the 19th century and was not observed as a phenomenon prior to that. The authors conclude that this suggests repressed memory is a cultural phenomenon. This type of evidence, of course, is far from conclusive, but it is suggestive.

It is amazing and unfortunate that belief in repressed memory survives to this day (although thankfully marginalized). We need to frequently remind ourselves of the lessons of repressed memory. Otherwise, like the repressed memory believers themselves, we are doomed to repeat the mistakes of the past.

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