Eating Disorders Residential Treatment Facility and Psychologist Sued by Former Patient

A Missouri eating disorders treatment center, Castlewood and one of its co-directors, psychologist Mark Schwartz, are being sued for malpractice in the Missouri Circuit Court by former patient Lisa Nasseff, who is reported to have been a patient, off and on for a total of 15 months, at the facility from 2007 through 2009 and also received outpatient therapy through 2010.  Please note that at this point, everything I am about to describe has the status of an allegation, as the case has not yet been heard and tried. Go here to read the full complaint by Lisa Nasseff against Castlewood and Dr. Schwartz.

The charges are very serious and include the allegations that false memories were implanted of sexual abuse, multiple rapes, Satanic ritual abuse, membership in a Satanic cult where serious crimes were committed, as well as convincing the patient that she had 20 multiple personalities. Lisa Nasseff is being represented by attorney Kenneth Vuylsteke. Nasseff alleges that Dr. Schwartz, as her therapist, hypnotized her and implanted false memories. Dr. Schwartz has spoken to the press and is completely denying the charges. Schwartz, who reported as of the date of that article that he had not retained legal counsel responded, “We don’t use hypnosis” although an introductory video on the website by clinical co-director Lori Galperin, when listing the various specialties of the staff, does mention hypnosis and it is also mentioned in a written description of staff specialties (see #5).

One of the main therapies used in the center is Internal Family Systems (IFS) and the website states that all staff are trained this approach. These cannot be said to be some rogue therapists misusing IFS because the creator of IFS, Richard Schwartz (not sure if he and Mark Schwartz are related), is listed as staff at Castlewood and reportedly trained all the staff in IFS.  Internal Family Systems is basically family systems, applied not to actual families, but to internal “parts” within a person. This approach has also been used by Dissociative Identity Disorder (DID) therapists although it does not necessarily have to be only for DID.  The IFS model is described on the Castlewood website. Several strong claims are made about IFS in the treatment of eating disorders, claiming that it helps the client to get to the root of the problem and find “parts” that may be sabotaging treatment success and hence, provides long-lasting results. However, I have been unable to find references to peer reviewed published outcome research that would support such claims.

On a side note, Steve Hassan has reported in a Psychology Today advertisement that he is trained in and utilizes IFS in his treatment of former cult members and this concerns me greatly, since I have not seen any evidence that it is effective and does no harm. This fits with his own theory that there is a “cult self” that has been created by cult indoctrination. Ironically, the description of IFS, the way parts are identified and located according to how they are felt in the body, bears some similarities to Scientology’s secret upper level called OT III, which also somaticizes “parts” that they call “body thetans”. Needless to say, IFS does not have the accompanying sci fi narrative as to how this came about, but I’ve often wondered if it is Scientology’s “parts work” that has damaged some on this level to the point they have had to be hospitalized or worse. Like IFS, Scientology promises, ironically, “return of full self determinism” by completing that level. Here we have a promise of return to an authentic self, free of influence, when the reality is all too often just the opposite. This may be the ultimate form of betrayal.

What I have learned since,  from my study of a large volume of social psychology literature is that no human being is completely free from influence. What we can do is learn about influence techniques and do the best we can to identify them when they occur, learn and practice critical thinking skills and apply them wherever possible, but to think that one is immune and fully self-determined is what makes us most vulnerable. The “authentic self” is an imperfect self and varies from individual to individual. Not all “authentic selves” are likable, charismatic, and good, as the IFS description implies. Although we are all born with the potential to be virtuous, we are not born with virtues, nor do I believe we are we born “evil”. Virtues have to be earned through our actions. My own point of view is that who we are, ultimately is the sum total of all we have done in our lives, some of it chosen and some of it not and subject to change, depending on what we are doing now and will do in the future. Note that I am saying all, not isolated acts or periods in our lives, taken out of context as we have all done things in our lives that we are less than proud of that do not have to be our identity, although smear propagandists would like to portray it that way. When a person admits to mistakes and strives to learn from them, that speaks volumes for who they are. When a person arrogantly refuses to admit mistakes and shows no remorse for causing harm (e.g. Conrad Murray in his most recent documentary) that also speaks volumes and those are the individuals who are indeed a danger to society.

In any case, although it is promoted as being just the opposite, IFS seems to be a convenient way not to take responsibility for ones own actions if someone does something he or she is not proud of (e.g. getting involved in a cult or behaving in a reprehensible manner or simply losing ones temper). According to IFS, it’s the “part” that did it and the real “self” is completely benign, honest, authentic and good. This also bears similarities to Scientology’s conception of the native state of a spiritual being, aka, the thetan. It is highly questionable if IFS is helpful and not harmful for anyone, let alone former cult members. It seems to complicate things unnecessarily. The client originates a feeling connected with a presenting problem and this gets labeled by the therapist as a “part” rather than simply a feeling. I can see how this would be a compelling belief, but the question remains, whether it is helpful or harmful. I raise these concerns, not to make claims, but I raise them as possibilities that need to be investigated. Although it is claimed that the goal is to integrate the parts, labeling and reinforcing them in this manner may result in further fragmentation and since at this point this is clinical lore that hasn’t been subjected to randomized controlled trials, we simply do not know and it should be labeled experimental outlining possible risks to clients, if therapists are determined to use it. There may be people who genuinely befit from such an approach, even if it turns out that others were harmed. No therapy or therapist is 100% harmful all the time for everyone. I point this out because often this becomes a primary form of defense, showing testimonials of people who feel they were helped. Although this may be the case (not necessarily because testimonials are not evidence, even for the individuals who give them since it is possible for a person to believe he or she is better when that actually is not the case and testimonials can easily be faked), it does not in any disprove that others were harmed, as the differences in outcomes are not mutually exclusive and can coexist. The State of California v Conrad Murray in the death of Michael Jackson clearly illustrates this, as I have no doubt that when he practiced standard medicine, he truly did save lives and help the patients who testified for him who appeared to be very honest and credible individuals, yet with Michael Jackson, he was found guilty of egregious violations and he richly deserved every word uttered by Judge Michael Pastor and his ensuing sentence, regardless of who he helped in the past. Whether that is the case with Castlewood, remains to be seen, but thankfully no one has died there, as far as I know but there are allegations of serious damage, at great expense. Since Castlewood uses a wide variety of different modalities (some of them with an evidence-base, such as DBT) and treatment varies by individual, some individuals may well have benefited from their treatment there. Whether some individuals have been harmed, remains to be seen. The evidence presented in this case, if it continues, or if others come forward, will reveal whether this is the case.

Nasseff’s allegations that she was alienated from family members is particularly concerning since family therapy (with an actual family, not an internal “parts” family) is an empirically supported approach to eating disorders. In other words, family support is very important and can be very helpful in recovery. The therapies shown to work for eating disorders are those such as Cognitive-Behavioral therapy that deal with the present and interpersonal therapy is helpful with relationships and systems of support. There is no good evidence that going back into the past and hunting for trauma is helpful, nor is there evidence of a causal relationship between trauma and eating disorders (correlation is not necessarily causation).

Although Mark Schwartz is vigorously denying the allegations in the complaint, according to legal counsel Vuylsteke, there are “several” other former patients who are alleging similar experiences and thus corroborating Nasseff’s allegations and may come forward at some point.

It is also interesting to note that Mark Schwartz has presented at ISST-D conferences, as recently as 2010 and is listed as a therapist in their membership referral database on the ISST-D website. Recently, some other high profile members of ISST-D, such as Dr. Richard Kluft, have maintained that the memories of satanic cults are screen memories for other forms of abuse. However, Nasseff alleges in her complaint that she was threatened by Dr. Schwartz that if she were to come forward and sue him, the crimes she revealed in therapy to have perpetrated as part of the alleged Satanic cult, would have to come out. If this allegation is shown to be true, the it would mean that at least by some therapists, these memories are believed to literally be true. Time will tell as the evidence unfolds, whether or not this is the case. Will ISST-D support and defend Dr. Schwartz, as they have earlier defendants such as Judith Peterson? Again, time will tell.

Although there were a number of very high profile recovered memory lawsuits in the 1990s, this recent lawsuit, if Nasseff’s allegations are proven in a court of law, would show that, as I have long suspected, such therapy has not ceased but has merely gone underground and not publicly discussed and indeed, Dr. Schwartz has denied that he has ever discussed Satanic cults with the plaintiff. It will be interesting to see how this case proceeds and plays out and this is a case I will continue to follow with great interest.