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The Jodi Arias Defense Expert: More Myths About Psychology and Mental Health Assessment

Thursday, Richard Samuels, the defense psychologist expert witness in the Jodi Arias case answered questions from the jury and was then once again questioned by the defense and then the prosecution began a re-cross examination of him. A common theme throughout his testimony is how many years of experience he has had and the assertion that this makes him more credible and accurate at what he does when he assesses and diagnoses people. As I have written previously, the scientific evidence shows that this is not necessarily the case.

Samuels and the defense counsel trying to play the experience card, I suspect is a way subtle way for them to take a swipe at the prosecution’s rebuttal expert. Although I haven’t seen her full CV, she is obviously much younger and a more recent PhD (2009). Does this mean that her opinion is inferior to Samuels? Research evidence says not necessarily. She might actually have an advantage over Samuels, being more recently in school and being more up on the latest research. Some of the statements made by Samuels displayed an astonishing ignorance of developments over the last decade or so. For example, he testified that sodium pentathol and hypnosis were good ways to recover repressed memories when these methods have been discredited as unreliable and even dangerous because they may produce false memories and do great harm. Even though he made it clear he didn’t think Jodi Arias had repressed memories, he still presented these myths to the jury about what he thought was a good idea for people who did have them. He thought Jodi Arias had dissociative amnesia, due to the hippocampus shutting down completely during the part of the murder she says she cannot remember. That too, is a highly questionable notion, as the literature shows that this is very rare and when amnesia does occur during a murder, it is usually temporary. More typically trauma is very well remembered and people with PTSD have the opposite problem — they wish they could forget the trauma but cannot stop thinking about it.

Samuels would do well to review the literature on psychological assessment and whether psychologists learn well from experience and improve. There is quite a large body of literature showing that this is not the case and also how unreliable clinical judgment is. He was correct to call it “speculation” and Juan Martinez was very correct to pin him down on what he said. Some of this literature is reviewed in Howard Garb & Patricia Boyle’s chapter in Scott Lilienfeld’s edited volume, Science and Pseudoscience in Clinical Psychology on “Understanding Why Some Clinicians Use Pseudoscientific Methods” (2nd Edition to be published soon). Garb & Boyle discuss experienced vs. less experienced clinicians. They write:

For the task of interpreting personality assessment test results, alleged experts have not been more accurate than other clinicians, and experienced clinicians have not been more accurate than less experienced clinicians.

They cite a large body of literature accumulated over 30 year period that supports this. One of the examples they provide is about one of the tests used by the Jodi Arias defense, the MMPI. Two groups of psychologists were presented with MMPI protocols. One group consisted of PhD psychologists who had routinely used the MMPI in practice for 5 years, the other group were psychologists who had used the MMPI for over 5 years and demonstrated a broad knowledge of the research literature. Both groups were asked to interpret the MMPI. The findings showed that the psychologists with more experience were no more accurate in their interpretations than the group with less experience. The two were completely unrelated.

We can only hope that the prosecutions’ expert Janeen Demarte is aware of this literature so she can soundly refute any attempts by the defense to make less of her by claiming that because she has less years of experience than Samuels, she is not as credible — this is absolutely false.

Once again, we are seeing myth after myth presented on national television for all to see, although for the purposes of this case, from the juror’s questions that were asked last Thursday, it doesn’t look like the defense has been very successful in persuading the jury of his credibility.

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Jodi Arias Case: Juan Martinez Cross-Examination of Psychologist Expert Begins

During the last hour of court yesterday, prosecutor Juan Martinez’s cross-examination of psychologist defense expert Richard Samuels began and it has already been devastating. Martinez demonstrated that Arias lied on the assessment for PTSD, listing the main event responsible as the one she now admits she lied about, that two intruders broke into Travis’ home and murdered him. Amazingly, Samuels gave her this test and accepted her answer, even though he knew her story was not credible and strongly suspected she was lying. He admitted he made a mistake in not readministering the test.

Prosecutor Martinez also exposed the fact that Samuels exceeded his role, which was to evaluate Arias, by sending her a self-help book and cards when he learned she was depressed and suicidal.

The cross-examination is available on YouTube and there will be more to come today. Martinez has just barely gotten started. Stay Tuned.

I do hope his grossly inaccurate claims about dissociative amnesia and PTSD get challenged and the actual controversy over this exposed, but for the purposes of the case, that might not even be necessary, given that it was shown the test results were invalid to begin with, since she lied.

The Jodi Arias Case: Controversial Theories and Junk Science in the Courtroom

A few years ago, I blogged about a case in Texas, The State of Texas v. Billy Joe Harris, where the defendant, charged with rape, was trying to plead insanity by claiming he had Dissociative Identity Disorder.  The defense’s expert witness attempted to argue that because DID was in the DSM, it was therefore scientific and valid. The prosecution’s expert witness challenged this and demonstrated that just because something was in the DSM, that did not mean it was necessarily scientifically valid. The DSM represents consensus of those on the DSM committee and is all too often more political than it is scientific. Ultimately, the junk science in this case was defeated, thanks to R. Chris Barden, PhD, JD’s expert testimony for the prosecution and the defendant was found guilty of rape.

We now have another case, the State of Arizona v. Jodi Arias, this one airing on national television for all to see, where highly questionable and controversial theories about traumatic amnesia are being misrepresented as unquestioned science by defense expert witness Richard Samuels. This case begs for the kind of expert rebuttal witnesses for the prosecution that the State of Texas was fortunate to have. Let’s hope such witnesses are lined up to refute the expert witness testimony that has been given by the defense’s expert. Prosecutor Juan Martinez is doing an excellent job in presenting a compelling case against Arias, but he  really needs a strong expert witness to refute the many layers problems with Samuels’ testimony. It is questionable if Arias even suffers from PTSD, but even if she does, the notion that her memory would be permanently wiped out for the incident in question, even five years later, is scientifically, highly improbable. To have an effective rebuttal to the tangled web being woven by Samuels, all these layers of problems with Samuels’ testimony need to be challenged.

Samuels proudly held up and read from a copy of the DSM during his testimony, as if it were the Holy Bible, praising it as being written by “learned” professionals as if its authority was above question. Far from it. In recent years, during the development of DSM V there has been massive protest against many of its proposed diagnoses, as well as already existing ones that are not sufficiently supported by scientific evidence. More than 7000 psychologists, psychiatrist and clinical social workers signed an open letter to protest several of the proposed changes. In other words, in the opinion of many scientific mental health professionals, the DSM is loaded with junk science, not only the changes, but with some of the existing diagnoses as well. The fact that something appears in the DSM does not mean that it will meet the Daubert standard for scientific evidence, as was demonstrated in the State of Texas v. Billy Joe Harris. The defense expert in that case, Colin Ross, tried to argue that because DID was in the DSM, it was scientific. Thanks to the prosecution’s expert witness, R. Chris Barden who debunked that notion, the defense failed. This is a notion that also needs to be debunked in the Jodi Arias case, this time for what is being claimed regarding PTSD and Acute Stress Disorder.

Jodi Arias has been charged with first degree murder in the death of Travis Alexander. If convicted, she could get the death penalty or life in prison without possibility of parole. She has already admitted that she was the one who shot Travis Alexander in the head, stabbed him 29 times and slit his throat from ear-to-ear.  She claims that she did it in self defense (even though the facts of the case thus far presented do not appear to support this and she gives a story that sounds highly implausible and the prosecution who, in my opinion, has demonstrated was physically impossible for a number of reasons beyond the scope of this article). Arias testified that a mental “fog” rolled in and she cannot remember anything beyond the initial stages of the incident. In other words, she forgot that she stabbed him 29 times and slit his throat.

The defense expert is claiming she suffers from PTSD and amnesia. In reading the DSM criteria for PTSD and Acute Stress Disorder, he points out that one of the symptoms listed ( for Acute Stress Disorder) is inability to remember parts of the trauma — in her case, stabbing him 29 times and slitting his throat. What Samuels either seems to be unaware of or is not disclosing is that this notion of traumatic amnesia has been repeatedly challenged in the literature on PTSD and trauma and there are peer reviewed publications that have proposed eliminating the association of the criteria for Acute Stress Disorder (which includes forgetting important parts of the trauma and other dissociative symptoms) with PTSD. The fact that it wasn’t, doesn’t prove that the decision was scientific. This is nothing more than a political victory that does nothing to change the fact that there is very little scientific support for the notion of traumatic amnesia. The point here is that controversial notions have no business being presented in a court of law, especially when they are being presented as if they are uncontroversial, undisputed facts when they are far from it.

Go here to read all that psychiatrist Robert Spitzer, the main founder of the DSM who is now highly critical of many aspects of it and his esteemed coauthors see as being wrong with the current DSM-IV-TR criteria for PTSD, the edition being so revered by Jodi Arias’ defense expert. Harvard Psychology Professor Richard J. McNally writes that “Controversy has haunted the diagnosis of posttraumatic  stress disorder since its first appearance in the Diagnostic and Statistical Manual of Mental Disorders.”

In a peer reviewed article entitled “Saving PTSD from itself in DSM-V, critiquing the DSM IV-TR PTSD diagnosis, published in the Journal of Anxiety Disorders, Spitzer and his coauthors, in their analysis of what is wrong with the DSM definition of PTSD, list many proposed changes.  Here are some of the ones most relevant to the Jodi Arias case.

On malingering (faking a PTSD diagnosis), Spitzer and his colleagues write:

Malingering – the intentional production of false or grossly exaggerated physical or psychological symptoms motivated by external incentives – is a potential explanation for any psychiatric presentation, but is of particular concern with PTSD since the diagnosis often results in findings of disability or entitlement to financial compensation. Although malingering is included in the differential diagnosis section of the DSM-IV text for PTSD, we think that it would be useful to specifically remind clinicians that malingering needs to be considered and ruled out. This goal can be accomplished by explicitly including this consideration within the diagnostic criteria.

Contrary to what Samuels would have us believe, PTSD is not at all difficult to fake. There are all kinds of popular books available to the public on PTSD that describe it very thoroughly, which Jodi Arias could have had access to and she is certainly bright enough to understand them and incorporate them into her narrative. Spitzer points out that financial compensation would be motive to malinger. Having the possibility of the death penalty hanging over ones head, as is the case with Jodi Arias, would be even more of a motive.

Regarding Acute Stress Disorder, which was brought up repeatedly by Samuels, these authors proposed deleting this altogether from the DSM because the evidence of its association with PTSD is really very weak and points out that the research evidence shows that only a minority of PTSD cases started out as ASD, which is contrary to what Samuels would have us believe.  Although about three-quarters of people diagnosed with ASD do go onto develop PTSD, most of those with the PTSD diagnosis never had ASD. Therefore the assumption that someone with PTSD first had ASD is highly unwarranted. See the difference.

This is of critical importance to the Jodi Arias case, since it is the symptoms of ASD (which can only be diagnosed for a month following the trauma), not PTSD that include dissociative amnesia or inability to remember the trauma or parts of it.  Since it hasn’t been demonstrated as far as I can tell from the evidence I have heard, that Jodi Arias was examined and diagnosed with ASD within one month of the trauma (at that time she was still by her own later admission, lying about two intruders killing Travis and was not yet claiming to have amnesia), we cannot assume she ever had ASD. The fact she now has a diagnosis of PTSD, does not necessarily mean she ever had ASD. The bulk of the scientific evidence shows that people with PTSD remember their trauma all too well — in fact they are tormented by their traumas to the point where they wish they could forget about the trauma, but they cannot stop thinking about it. The person who suffers from PTSD is often so absorbed by the traumatic event, that he or she becomes forgetful of everyday things, but not of the trauma itself, which is vividly remembered.

That being said, the entire concept of dissociative amnesia is highly questionable and as Richard J. McNally and others have demonstrated in numerous publications, much of the evidence claimed to support it, does not, when examined closely, support it.

Will the prosecution rebuttal witnesses have the knowledge necessary to refute the highly controversial notions presented incorrectly as undisputed science that the jury has been subjected to by the defense? The trial is still in progress. The first defense expert is currently testifying (to be continued tomorrow), which will be followed by his cross-examination, another defense expert witness and the prosecution’s rebuttal case. Stay tuned. The trial can be watched either online or on HLN.

Have You Had a Bad Experience with a “Cult Expert”?

There are a number of individuals, some mental health professionals, some not, who offer services to families who have loved ones in groups that are considered to be destructive cults who identify themselves by a variety of titles, the most common ones being exit counseling, thought reform consultant, deprogrammer (a term usually reserved for forcible abduction, which is illegal) or strategic interaction. For convenience, I will refer to this group as exit counselors, although that is not the title all use. There are some exit counselors who are honest, do not charge excessive fees for their services or make unrealistic claims. However, that is not the case for some. Because often, such families feel they are in desperate circumstances, some exit counselors take advantage of this and the result has been that some families have spent as much or more than they would have spent on a child’s college education (as Steve Hassan argues to justify the high cost in his recent book), yet have not achieved the results they hoped for. Families that spent tens of thousands of dollars, yet never got to the point of even doing an intervention are not typically counted when “success rates” are calculated. Some self proclaimed “cult experts” (a meaningless term since there are no real criteria for determining who is an expert unless someone has been an expert in court) have been known to charge up to $500 an hour or $5000 a day for their services to desperate families, but that does not stop cult watch organizations from welcoming them as conference speakers and allowing them to promote their books and services. This is a topic that deserves more discussion, as unsupported claims are being made in this area and families are sometimes being exploited, both financially and emotionally.

Have you had a bad experience with a “cult expert”? Have you hired someone who has charged excessive fees with all kinds of extra charges (e.g. hundreds of dollars per hour just to respond to emails or phone calls) that were not advertised on his or her website and ended up spending far more than you expected with no results?  If there was a failure, did you get blamed for it? If anyone reading this has had a negative experience with someone who they hired to get their loved one out of a cult, please let us know, either by responding to this blog or to me privately at pignotti@att.net . If you do not wish to go public, I will keep what you tell me in confidence or you can post here under a pseudonym.

 

Setting the Record Straight: Why I Broke with Roger Callahan and TFT

The topic of my 2004 split with Roger Callahan has come up on the ACEP Research discussion list and all kinds of unfounded speculation is occurring as to the reasons. To set the record straight, here is the posting I did in 2004 to the TFT Algorithm list serv, explaining my reasons. Note that the study mentioned was later published in the peer reviewed journal, The Scientific Review of Mental Health Practice in 2005. In spite of the fact that TFT proponents with a vested interest in Callahan’s TFT denounced the study as “flawed” this study underwent a rigorous peer review by people without such a vested interest and was accepted for publication. The purpose of the study was to discover whether Roger Callahan’s proprietary Voice Technology sequences made a difference in results. My study clearly showed they did not, hence the expenditure of $100,000 to train in VT and therapy clients paying Callahan up to $600 for VT treatment was not warranted, as they could have gotten the same results with random sequences not requiring any special proprietary treatment.

I’m sure that many people will be shocked at the announcement I just made about
the change that will be taking place on this list. I am therefore posting what
I have just posted to the TFT Dx, which will explain the circumstances.

In August, 2001, I did a posting to the TFT Dx list serv announcing research I
was conducting on some cutting edge algorithms derived from an experimental
procedure. Recently, I did another posting [to that list serv] making one final
call for reports. I have decided that at this time, my data are conclusive and
I am ready to report the results of my research, which includes a controlled,
single blind study I conducted on these same algorithms, the summer of 2001.
Please be forewarned that the results I am about to announce are going to be
very surprising to most of you, and I believe that they completely overturn the
basic premises behind CT-TFT and causal diagnosis.

As you all know, the critical distinction between TFT and forms of most energy
psychology offshoots of TFT, is causal diagnosis, which provides a precise code
of specific treatment points. The TFT algorithms were developed through causal
diagnosis and when algorithms don’t work, individualized treatment sequences are
obtained through TFT Dx or Voice Technology. Dx and VT practitioners have
reported being able to help people through causal diagnosis, where algorithms
failed, thus it would seem reasonable to conclude that especially for such
complex cases, precise sequence was critical to the success of the treatment.

However, there are those who have challenged this notion. As most of you know,
Gary Craig, the first person to train in the Voice Technology adamantly
disagrees with Roger Callahan. He has repeatedly claimed that he can disregard
the VT and still get the same results he got with the VT. More recently on his
list serv postings, he is claiming that his success rate with EFT is close to
100% and the way he got it this high was not with causal diagnosis or dealing
with toxins, but by having the client get more specific about issues being
treated.

In 1998, Gary Craig conducted a seminar that several Dx trained people
attended. The transcript of this seminar can be downloaded from his website.
During this seminar, he had a discussion with several Dx trained people who have
very different reports about their experience getting VT support, some even
claiming that most of their clients who received VT support were not helped by
VT. Roger Callahan, however has his side to the story, that these people have
apexed or forgotten that he did, in fact, help these clients. The upshot of all
this was that some people believed Gary Craig and these Dx trainees and other
people believed Roger Callahan. Basically, what we had, as much as we hate
using this word, is conflicting anecdotes — their word against his. Although
Roger does have tapes of the session, the trainees’ interpretation and
perception of what went on is very different from Roger’s.

How is this to be resolved? In the summer of 2001, I decided that the only way
this could be definitively resolved would be to take the bull by the horns and
do a single-blind controlled study on VT vs. random sequences. I undertook to
conduct such a study. Over a period of several months, I collected data from
eight different algorithm trainings held in the US, the UK, and Australia. I
informed the instructors that I was collecting data, but I didn’t tell the
instructor or the participants that I was using a random algorithm on half the
group. Every other person got VT, and every other person got the random
sequence, and no one could hear the difference over the phone because I kept
everything else about the protocol, including all the reversal corrections, CB2,
etc. the same.

I obtained the random sequences by putting cut up pieces of paper with the
initials of the treatment points into a container and drawing 5-7 points (the
number of points also randomly determined). I ended up with 24 random
sequences.

Because I was expecting to have a high failure rate with the random sequences,
especially at trainings where people were sometimes presenting problems that
didn’t respond to algorithms, I had predetermined that whenever a random
treatment sequence failed to get a drop in the SUD for 3 holons in a row, I
would switch to VT, thus not depriving the person of a cure and each person,
regardless of the group they were assigned to, would get the highest quality
help available.

The results I got from this experiment stunned me. It turned out that I had
identical results for each group – a 97% success rate, success being defined as
it was in the 4 other VT studies cited by Roger Callahan on p. 51-2 of *Stop the
Nightmares of Trauma* (Callahan, Leonoff, Daniel & Pignotti), as a SUD of 1
(using a scale of 1-10) – complete elimination of all subjective units of
distress.

Note that this study was identical to the one done by Stephen Daniel (n=214)
and an additional study done by myself (n=72), where just VT was used with
algorithm trainees. These studies were adduced by Roger in support of the power
of TFT VT. Please keep this in mind, that any criticisms that people might have
on the limitations of my study (and there are indeed valid criticisms) must also
be directed at the two VT studies done by Stephen Daniel and myself. The only
difference was that this time I added a control group.

There was literally no difference between the two groups and it took the same
average number of holons to get the SUD to a 1 (3 holons). The control group
had 1 failure, someone with fybromyalgia who started at an 8 and only got down
to a 7. After 3 failed holons, I switched to VT and the VT also failed to help
this person. In the VT group, I also had one case where the SUD failed to get
to a 1, but this one was partially successful – the SUD dropped to a 3. In
short, there was no statistically significant difference between the two groups
at all.

What was even more incredible was that there were individuals at that training
who had utterly failed with algorithms who were helped with these random
sequences. For example, a woman had a SUD of 10 on a trauma that she had been
trying to treat all day with the trauma algorithm. With the random sequences,
her SUD came down to a 1 and she was greatly relieved and thanked me profusely.

Once I had collected and analyzed this data, I reported my results to Roger
Callahan and he was, of course, stunned. We both were. Neither of us knew what
to make of these completely unpredicted results. What he suggested I do was to
post to the Dx list, announcing that I was doing research on some cutting edge
algorithms. This was the post I made, which I reposted here recently. The
reports I got back were overwhelmingly positive with individuals being helped
where Dx had failed.

The treatment sequences I have been been sending out to people who requested
them, where such powerful results were reported, are these randomly selected
treatment sequences. They were not derived from VT or any form of causal
diagnosis. They were not even derived from intuitive diagnosis because I
literally drew slips of paper out of a hat. In every test I have done so far,
they have performed just as well as VT.

The failures reported with these algorithms were people who had also failed
with VT, either previously or subsequently, with one exception. That exception
was myself. One day in late Sept, 2001, I was experiencing a high degree of
anxiety so I decided to try some of the random sequences. They failed to reduce
my SUD. I then called Roger and reported this to him. He quickly got my SUD
down with the VT. However, there are three additional factors to consider: 1)
Roger identified toxins I had, in addition to the VT treatment, which I hadn’t
done with the random sequences. 2) I obviously wasn’t blinded to the fact I was
doing random sequences on myself; and 3) it has been my experience and that of
several other people, that there have been times when we try to treat ourselves
and the treatment fails, whereas if we call another VT person and have them
treat us, the treatment succeeds. Therefore, these are three alternative
explanations for my treatment success.

Nevertheless, as Roger recently pointed out to me when I brought this up on the
VT list, having my very high anxiety which was bordering on a panic attack, so
immediately eliminated was a powerful personal experience for me and one which
did, at least temporarily, have an impact on my conviction that the results of
my previous controlled study were conclusive. Roger did not believe that the
results of my study were conclusive enough to overturn 20+ years of his own
personal experience to the contrary and at the time, I was convinced also and so
refrained reporting what, at the time, I considered to be inconclusive results.
There was too much at stake here because if I were to prematurely report these
results, this could completely destroy the credibility of the Voice Technology,
in some people’s eyes. If I was in error, I could potentially be putting an end
to the most powerful treatment in the history of psychology and I wanted to be
certain before doing this.

Around that same time, I made a move to the west coast from NYC and this
further took my mind off the study I had conducted. I thought very little about
the study until very recently. However, during that time I had been
increasingly having a number of doubts and misgivings about a number of aspects
of TFT, Voice Technology and even HRV. I will be outlining these in a separate
posting, which will more clearly help people to understand the process I went
through which culminated in my changing my mind about the meaning of my results
and what must appear to all of you to be my radical change in my opinion of TFT
and VT. I began to once again think about the study I had conducted, the
summer of 2001 and to reconsider.

What I ended up doing was discussing my study and my results to two PhD friends
of mine, who were not TFT trained who have a high expertise in research and
asked their opinions of my data. These were people who I trusted to hold what I
told them in confidence until such time I chose to release the data, and they
have kept their promise.

The opinion of both of these people is that the data from my controlled study,
which had 66 people, were conclusive, in terms of falsifying the claim that the
VT provides precise treatment sequences which are critical to the success or
failure of treatment. A sample that size with the p values being what they were
yielded highly conclusive results. I then remembered that from everything I had
learned in my research training, this was correct. I also was running my data
with smaller numbers and noticed that as my sample grew, the numbers got more
and more alike. If a sample any bigger was needed to get statistical
significance, that could hardly be considered clinically significant. A robust
treatment as VT was claimed to be, should have gotten large clinically
significant differences, even with a small number of people.

Note, that even though there was a success rate of 97% in both groups, this
does not prove that either is efficacious. There were a number of serious
limitations to my study which precludes drawing this conclusion. What my study
does conclusively show is that there is no difference between the VT and random
sequences derived from drawing treatment points out of a hat.

Had there been any truth to the claims of the VT being a precision treatment on
a par with hard science, there should have been a difference between my VT group
and my control group. Some people would be expected to be helped by the random
sequences, but there should have been a sizeable number who were not helped and
needed VT. This isn’t what the facts have shown, ladies and gentlemen. My data
show that there is no difference between the VT and random sequences that
anyone, regardless of training level, could randomly determine.

To summarize, I have decided that in spite my previous tremendously high
enthusiasm for and investment in the Voice Technology, I am forced by the facts
of reality I am faced with, to conclude that no longer need to use it. I
cannot, in the face of these results, in all good conscience, continue to use
VT. Thus, I have decided that I no longer will be accepting any new VT clients.
I am announcing my results publicly and will leave it up to each person to
decide how best to interpret them.

When I first became acquainted with TFT, I was highly skeptical. However, I
have always been open to evidence and the truth has always been more important
to me than being “right” or “wrong”. At that time, I had been debating Roger
and other TFT proponents on a list serv, but when Roger offered me evidence, in
the form of an algorithm, I tried it and when I saw the results, I announced
that I had been wrong in my negative judgment against TFT. You all know the
rest of the story. I became one of the most passionate advocates of TFT and of
Voice Technology. However, now, the facts of reality have presented me with
another correction and I have to, once again, say that I have been wrong.

During my life, I have repeatedly found myself coming to conclusions that have
surprised me. I could never have predicted my involvement in TFT and I never
could have predicted the conclusions I have now been forced to come to about the
VT.

Roger has repeatedly pointed out that this is the way of the scientist is to be
completely open, as much as possible to the facts of reality and to strive for
objectivity. This is how I have always lived my life and this openness, to me,
is the ultimate spirituality. My path in life has always been to follow the
facts of reality, as best as I can determine them by rational thought, wherever
that takes me. While it saddens me to have to have a parting of the way with
Roger on this issue, I must continue to live by the principle of truth and
loyalty to my values, above all else. Roger said in a posting to the VT list
that I am passionate about truth and he is correct in his assessment of me.

I also want to state, for the record, that in my opinion the secrecy behind the
VT proprietary procedure is the antithesis of scientific openness and is the
biggest mistake Roger Callahan has ever made. I am now of the opinion that the
VT is not at all objective — far from it.

I intend to write up this research and attempt to have it published in whatever
forum I can publish it. All I can do is present you with my data and what my
interpretation of it is. The rest is up to you and I will respect whatever
conclusions people come to.

Monica Pignotti, MSW

 

Cults, Dissociation and Models of Helping and Recovery

In order to set the record straight about some misconceptions about the presentation I made at a 2009 conference of the International Cultic Studies Association (ICSA) in Denver, I am posting the Power Point to this presentation. Strangely, enough, the gossip about this presentation was that it was an attack on Steve Hassan when in fact, as the Power Point shows, this presentation was not about him and contained no personal attacks upon anyone. I was therefore quite surprised that Steve took it this way and then told others who were not there that this was the case, as well as letting me know that evening that he perceived that way. To this day, his perception of it baffles me as there was nothing unique to him in this presentation.

In fact, the presentation outlines different models of recovery and pointed out the predominance of the medical model among certain “cult experts”. While this does apply to some extent to Steve Hassan, more of it applies to other therapists  who do cult recovery work (e.g. Rosanne Henry, LPC), who were probably not at all happy with what I had to say since I directly challenged her suggestion of having clients identify cult leaders as having certain diagnoses. There is also psychoanalyst Daniel Shaw’s (and a number of other people’s) preoccupation with so-called malignant narcissism and the “traumatizing narcissist” (not even valid diagnoses) of cult leaders.  Although I presented credible, well recognized and accepted models, not one of these people  issued one word of rebuttal to anything discussed in this session. In fact, when some of us tried to raise these issues on a supposedly professional discussion list, these therapists were ultra sensitive and took my challenges very personally saying it made them feel “unsafe” to be questioned and challenged in this manner, rather than engage in a discussion that would have been healthy, not only for them as professionals but also for the clients they profess to serve. Is this kind of model of putting psychiatric labels on cult leaders and cult survivors really helpful to recovery? At this point we simply do not know and there is good reason to suspect that it may do more harm than good to label both the cult leader and victim with psychiatric disorders who then feel they need intensive and extensive therapy and years of support groups to recover when there is no good evidence that any of this is effective and does no harm.

To access the PDF, click on the link below:

ICSA Denver 2009 Pignotti_PDF version

This way, people can view the presentation and decide for themselves whether Steve Hassan, who was reportedly in tears during this presentation, has any cause to complain.

I can understand how some people could be upset about this, as I challenged the dominant model of so-called cult recovery in this presentation and proposed some possible different models but there were no attacks on anyone in this presentation.

Cathleen Mann also presented in this same session. The session was entitled Cults, PTSD and Dissociation: Is the Medical Model Helpful to Ex-Cultists? I guess some people were not happy that we posed this question. This is not surprising, given that some masters level mental health professionals who claim to be cult experts have been known to charge some pretty hefty fees for their services that are far above what most masters level therapists would charge.

Dr. Cathleen Mann Reviews Steven Hassan’s Latest (self-published) Book

Dr. Cathleen Mann, a court-recognized expert in the area of cults, has written a review of Steven Hassan’s latest self-published book, Freedom of Mind.  She has done an excellent job of succinctly summarizing the major problems with Hassan’s unsupported theories and claims that he has been making for years, while being uncritically accepted by a certain segment of ex-cult members (Anton Hein’s unsubstantiated assertions are a prime example). Self-proclaimed anti-cult “experts” would do well to take note of the last paragraph of Dr. Mann’s review:

It is interesting to note that on page 25 under the condition “thought control,” is listed the “[r]ejection of rational analysis, critical  thinking and constructive criticism”. This is an excellent point and one that should be followed by every cult critic, cult interventionist, professional counselor, or expert. This would include accepting criticism without becoming defensive and the ability to see and correct problems. Debate should be based upon rational analysis. A person working in the cult recovery or education field should endeavor to emulate these characteristics. It is incumbent upon him or her to model this behavior, as it is the rejection of such values that quite often forms the basis for criticizing the leaders and dynamics of cults.

Pseudoscience and unsupported claims within the “anti-cult” community that tend to pathologize anyone who has been in a “cult” group as well as the problems with bracket creep in models of so-called “cults”, is an area that has received far too little attention, in my opinion and this is a good start.

Go here to read the review.

Here is some further response from Dr. Mann in response to some recent comments on this review:

In terms of research with cult members, current or past, there are many ethical issues. I will attempt to explain the strengths and weakness of the Snapping study in a subsequent post. There have been other attempts to study the effects of cult activity on individuals, but due to the limitations of IRB boards and selection problems, these results have been mixed.
Therefore, it is important to realize that no one can claim superior methods over another because there is nothing to back this up. It’s fine to say that the methods used by any in the cult recovery field are theories based on some general research in psychology, but the SIA approached generated by Steve Hassan has no research support. Thus, it is not possible to say that his approach achieves greater success rates or even helps ex cult members. There is a rich and vast trove of research from social psychology and other disciplines that informs the treatment of cult members. When I testify in court and go through the qualification process, I am able to cite and apply the latest research, on all sides of the issue.
In March of 1996, in the case of Kendall v. Kendall, the United States District Court for the Commonwealth of Massachusetts declined to quality Hassan as an expert witness. Hassan’s disclosure in this one and only attempt shows that he was charging $200 per hour for preparation and $1,500 per day for his “expert testimony” on new religions, yet he had never testified in court before and his only qualification was a a degree in counseling from Cambridge College, a school that accepts life experience as a substitute for coursework. In March of 1996, in the case of Kendall v. Kendall, the United States District Court for the Commonwealth of Massachusetts also rejected Hassan as an expert witness. Hassan’s disclosure in this case shows that he was charging $200 per hour for preparation and $1,500 per day for his “expert testimony” on new religions, yet he had never testified in court before. Nor could show that he deserved such an exorbitant fee.
The criticism of Hassan’s methodology, his marketing strategy, his unusually high fees, and the fact that he claims relationships and associations with other experts is very much overdue. I have had a personal relationship with Hassan until 2009. We discussed things freely, yet there were many issues that he failed to resolve. Hassan denies this, but he knows exactly why our relationship was terminated by me as a last resort. I have observed Hassan in interactions with fellow professionals, current and former cult members, friends, and family. I have worked on legal cases where he has previously done an intervention. Hassan relies on the fact that most people believe his marketing approach and do not know him personally.
My review of Hassan’s latest book was not undertaken lightly. I believe that his books and claims contain misleading information, do not reflect current understanding of how to work with current or former cult members, do not show an attempt to update his skills or knowledge, and he does not attempt at any level to truly work collegially with anyone. He also refuses to discuss any challenges to his work or claims, but sends others to advocate for him, usually individuals that have no personal experience with him outside of a business relationship.

 

Castlewood Treatment Center: A Second Lawsuit is Filed.

This just in today. A second lawsuit has just been filed by a 26 year old woman, also from Minnesota, against Castlewood Treatment Center and Mark Schwartz. Click here for details.

The lawsuit against the eating disorders treatment center is very similar to the first one, filed by ex-Castlewood patient Lisa Nasseff.  After Lisa Nasseff spoke out publicly about the center in an interview that is now available online, Castlewood and Schwartz are seeking a gag order that would forbid any parties from speaking publicly during this case. Decision by the court on whether to grant the gag order is pending. The second lawsuit, filed by Leslie Thompson, alleges being led at Castlewood to believing she has multiple personalities, as well as repressed memories of satanic ritual abuse. We now know that Lisa Nasseff is not alone in her allegations. The report states that there are others who willing to be witnesses who corroborate these women but for most, the statute of limitations had expired and so they were unable to sue.

New Review on DID and Dissociative Disorders

A new review of DID and Dissociative Disorders has just been published in the APS journal, Current Directions in Psychological Science.

Lynn, S.J., Lilienfeld, S.O., Merckelbach, H., Giesbrecht, T., & van der Kloet, D.  (2012).  Dissociation and Dissociative Disorders:  Challenging Conventional Wisdom.  Current Directions in Psychological Science, 21,48-53.

Abstract

Conventional wisdom holds that dissociation is a coping mechanism triggered by exposure to intense stressors. Drawing on recent research from multiple laboratories, we challenge this prevailing posttraumatic model of dissociation and dissociative disorders. Proponents of this model hold that dissociation and dissociative disorders are associated with (a) intense objective stressors (e.g., childhood trauma), (b) serious cognitive deficits that impede processing of emotionally laden information, and (c) an avoidant information-processing style characterized by a tendency to forget painful memories. We review findings that contradict these widely accepted assumptions and argue that a sociocognitive model better accounts for the extant data. We further propose a perspective on dissociation based on a recently established link between a labile sleep-wake cycle and memory errors, cognitive failures, problems in attentional control, and difficulties in distinguishing fantasy from reality. We conclude that this perspective may help to reconcile the posttraumatic and sociocognitive models of dissociation and dissociative disorders.

The authors compare and contrast two models associated with DID: the Posttraumatic Model and the Sociocognitive Model. Proponents of the Posttraumatic Model have claimed that DID is associated with very high rates of childhood trauma, especially sexual abuse. However, as the authors of this review point out, the studies that show these “high rates”  lack objective corroboration of the abuse and instead rely mainly on uncorroborated self reports. Assessing a person for DID and then asking them if they remember having been abused in childhood is what is known as a retrospective study, a study that relies on participants’ memories of past experiences. In contrast, prospective studies, which follow people after the fact of having undergone documented childhood trauma have failed to substantiate the notion that childhood trauma leads to DID.  Other problems with this model are researchers’ failure to control for overlapping conditions such as eating, anxiety and personality disorders, which are not necessarily unique to people with dissociative disorders. It also may be that people with dissociative disorders who also have childhood abuse issues are more likely to seek treatment, thus the studies reporting high rates that took their subjects from a clinical population are the result of selection and referral bias. Additionally, in studies that have controlled for perception of family pathology, the correlation between abuse and psychopathology has greatly lessened or disappeared entirely. The authors point out that this could mean that the “association is due to global familial maladjustment rather than the abuse itself.”

In contrast, the authors describe the Sociocognitive Model of DID:

This model holds that DID results from inadvertent therapist cueing (e.g., suggestive questioning regarding the existence of possible alters, hypnosis for memory recovery, sodium amytal), media influences (e.g., television and film portrayals of DID), and sociocultural expectations regarding the presumed clinical features of DID. In aggregate, the sociocognitive model posits that these influences can lead predisposed individuals to become convinced that indwelling entities—alters—account for their dramatic mood swings, identity changes, impulsive actions, and other puzzling behaviors (see below). Over time, especially when abetted by suggestive therapeutic procedures, efforts to recover memories, and a propensity to fantasize, they may come to attribute distinctive memories and personality traits to one or more imaginary alters. (Lynn et al., p. 49).

The authors then review a number of research findings that are consistent with the Sociocognitive Model. For example, the number of DID diagnoses and the number of alters diagnosed greatly increased after the book and TV movie, Sybil was released and popularized during the 1970s. Therapy techniques involved in DID therapy can often be suggestive, asking leading questions and naming alters, that reinforce and reifies the alters. Also, the vast majority of DID diagnoses are found among a small minority of therapists who identify themselves as having expertise in treating DID.  Of course, DID therapists, in turn, argue that the diagnosis was missed by previous therapists who were not adequately trained but when the disorder is on such shaky grounds in the first place, this appears to be a circular argument. If DID were a naturally arising condition, it ought to be immediately obvious to therapists who have no such bias.

This review also includes some very recent findings on the association (in both clinical and nonclinical samples) of sleep, memory problems and dissociation. They note:

This link, they contend, is evident across a range of sleep-related phenomena, including waking dreams, nightmares, and hypnagogic (occurring while falling asleep) and hypnopompic (occurring while awakening) hallucinations.

Lynn and his colleagues cited studies that showed that when healthy volunteers are deprived of sleep under experimental conditions, they exhibit dissociative symptoms. This is especially interesting in light of what people who study destructive cults have noted regarding dissociative symptoms displayed by people who are members of such groups, commonly attributed to brainwashing and mind control. Given that sleep deprivation is common in many such groups, the dissociative symptoms might be better explained by sleep deprivation and this would be well worth further study.

Most interesting is that the authors cite a growing body of literature showing that when people with dissociative disorders are treated for sleep problems by learning good sleep hygiene, their dissociative problems markedly improved. In one such study of 266 participants, 24% met the clinical cut-off for dissociative disorders prior to treatment, whereas after treatment (sleep hygiene) at follow up, the percentage dropped to 12%. The authors point out that these studies were missed in meta-analyses conducted by DID proponents such as Bethany Brand and her colleagues who instead, included only eight studies that revolved around treating trauma. The findings of the sleep hygiene intervention fly in the face of those who believe that it is necessary to treat trauma to help people with DID and other dissociative disorders.

Lynn and his colleagues do not entirely rule out trauma playing a role in dissociative disorders, but they do urge people to consider other factors that have come to light through research findings. They conclude their review by noting:

The data we have summarized have received only scant attention in the clinical literature. Nevertheless, they have the potential to reshape the conceptualization and operationalization of dissociative disorders in the upcoming edition of the Diagnostic and Statistical Manual of Mental Disorders (DSMV, publication scheduled in 2013). In particular, they suggest that sleep disturbances, as well as sociocultural and psychotherapeutic influences, merit greater attention in the conceptualization and perhaps classification of dissociative disorders (Lynn et al., in press). From this perspective, the hypothesis that dissociative disorders can be triggered by (a) a labile sleep cycle that impairs cognitive functioning, combined with (b) highly suggestive psychotherapeutic techniques, warrants empirical investigation. More broadly, the data reviewed point to fruitful directions for our thinking and research regarding dissociation and dissociative disorders in years to come. (p. 51)

 

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