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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)

 

Steven Hassan: Critical Material Deleted from his Wikipedia Biography Page

While I understand that some readers might see this as harsh, when someone is making the kinds of claims and charging the kind of fees this person does, it is important that mental health consumers have an alternate source of information and discussion about his work and claims, since his Wikipedia page appears to be sanitized with criticism kept to a very bare minimum. Again, I remind readers that the statements on this blog are an expression of my opinions regarding the individuals under discussion. For further details see the Wikipedia talk page for Steve Hassan and the talk page for biographies of living persons where this was discussed and ultimately, the material censored.

When I added some validly referenced criticism of Steve Hassan from his Wikipedia entry, one of the Wikipedia editors (who denies he has any association with Hassan) has repeatedly attempted to delete it.  Here is what Steve Hassan’s followers apparently do not want you to read:

Criticism from Other Cult Experts

Cult experts David Clark, Carol Giambalvo, Noel Giambalvo, Kevin Garvy and Michael Langone, PhD have criticized Steve Hassan’s approach to exit counseling in a chapter entitled “Exit Counseling: A Practical Overview” from an edited volume “[26]. These authors stated that Hassan’s four core beliefs are “vague and rather standard fare for counseling approaches within the field of humanistic psychology. As with many humanistic counseling approaches, Hassan runs the risk of imposing clarity, however subtly, on the framework’s foundational ambiguity and thereby manipulating the client.” (p. 175). The authors gave Hassan an opportunity to respond. Hassan’s response was that the critique “exaggerates the manipulativeness of his approach” and offered clarification that he tries to “minimize the danger by taking a step-by-step approach to help the cultist ‘grow'”. Clark et al.’s reply is “Despite these clarifications of Hassan’s approach, we still have several concerns.” Their concerns were first, that Hassan did not clearly communicate this sensitivity in his writings, second, that other professionals who rely on Hassan’s writings might not be sensitive enough to the potential of his approach to become manipulative, third, that Hassan’s approach “even when practiced in its most pure form, strategic intervention therapy is still overtly intrusive” (p. 176). Their fourth objection is that “subordinating exit counseling to a family counseling structure is usually not necessary for a successful exit counseling.” Their central criticism is that Hassan’s approach is said to “effect” change without the cult-involved person’s prior approval and is hence, manipulative, whereas in contrast, Clark et al’s informational approach “invites” change. To date, no research exists that demonstrates the superiority of either method of exit counseling.

^Recovery from Cults, Michael Langone (ed), 1993, New York: W.W. Norton and Company, ISBN 0-393-70164-6, p. 173-177

In a future article, I plan on posting an in-depth discussion of the material in this chapter. Contrary to the assertions and rationalizations of the individual who deleted this material, it is not a trivial matter. This is a controversy that has been central to people who do this type of work. I have attended a number of meetings of the exit counselors association at conferences where this has been discussed, where opinion was overwhelming against his work. Note that I am not trying to make an argument from majority here, only to point out that the Wikipedian’s arguments that people who criticize Hassan are in the minority is incorrect, as anyone who has been this scene for more than a few years can verify. A number of people who were his strong supporters in the past, have now defected from his camp, so to speak. I am far from being the only one who has come to realize the serious problems with his work. The problem is that much of this material is from conference proceedings that are not available on the internet and unfortunately some people seem to believe that everything on the internet is true and anything not on the internet is not true. What a sad state of affairs. I am hoping to remedy this soon by publishing some articles that will bring this and other controversies within the anticult community to light.

In the meantime, I  have to ask, why the attempt at information control of validly cited, published criticism of Mr. Steven Alan Hassan?

The final outcome is that after a discussion with the moderator, that because I am known to have had disagreements with  Steve Hassan, I am not allowed to contribute to the Wikipedia article on him since it constitutes a “conflict of interest”. Unfortunately the moderator gave credence to anonymous, completely undocumented and false allegations that came up on Google searches on my name that alleged with no basis whatsoever that I was trying to get Hassan’s license revoked. This is not true. The same anonymous posters lied that I had sexual relations with Hassan, also completely false and not just in the Clintonesque sense. Nevertheless, the upshot is that because of this false material that came up on Google, I am no longer allowed to post material to Steve Hassan’s Wikipedia Bio. It is too bad that the moderator apparently believes everything he reads on the internet.

That being said, Steve Hassan and his supporters can rest assured that this will not stop me from posting elsewhere about his work, including the criticism from other cult experts. That, they will not be able to censor. I find it interesting that Wikipedia stops critics from posting in biographies of living persons but not ardent supporters. Although this particular Wikipedia editor denies connections with Hassan, I know from my past direct experience with Hassan that he has enlisted his supporters to update his Wikipedia article and deal with negative information. To me, that looks like a recipe for a puff piece rather than an objective encyclopedia. This caution might be due to fear of lawsuits, although if Steve Hassan ever did decide to sue anyone, he can rest assured he would be thoroughly deposed during the discovery phase and as a plaintiff he would not be able to evade such a deposition. This means he would be required to produce full documentation on his fee structure, which aside from the fees for his first session, he no longer posts on his website and he would also be questioned in detail about the largely unsubstantiated claims he makes about the superiority of his method of counseling.

It is interesting that the Wikipedia editors denigrated the critique of Hassan’s work, saying it was just a “my theory is better than yours” type of critique when the authors never claimed that and unlike Steve Hassan, were honest enough to state that there was no research one way or the other. On the contrary, it is Steve Hassan who has repeatedly claimed, with no empirical basis whatsoever, that his approach is superior to all others. For example, on his website, promoting his book, it states:

Releasing the bonds reveals a much more refined method to help family and friends, called the Strategic Interaction Approach. This non-coercive, completely legal approach is far better than deprogramming, and even exit counseling.

There is no valid research evidence to support this baseless, bald assertion in this promotional piece for Steve Hassan’s second book (published by Freedom of Mind Press — essentially self-published).

The crowning irony is that Steve Hassan’s work is supposed to represent freedom of mind and freedom to engage in criticism, but apparently this only applies to the groups he considers “cults” rather than his own work. It appears that Steve Hassan has become what he is fighting and criticism of his work is not acceptable. Thankfully, however, free speech still exists on the internet.

Facilitated Communication Rears Its Pseudoscientific Head Once Again: When will they ever learn?

Last Friday’s 20/20 featured a 2007 case involving an autistic teen in Michigan, Aislinn Wendrow, who was subjected to a thoroughly discredited intervention, Facilitated Communication which resulted in bogus charges of sexual abuse against her father and even though he was eventually cleared of all charges,  irreparable damage to this vulnerable child and her family has been done.

This is a heartbreaking reminder of why what those of us do who are exposing pseudoscience and potentially harmful therapies, is so vital.  It is cases such as this that make me all the more determined to continue what I am doing, regardless of push back and resistance from certain mental health professionals who are doing everything they can to silence the voices of those who dare to blow the whistle.

For those unfamiliar with Facilitated Communication (FC), what it is and its background, an earlier Frontline documentary is available online, which gives the background on FC and shows how it was completely discredited by double-blind controlled studies which provided irrefutable evidence that it was the facilitator, not the autistic person, who was doing the typing. Not only did FC result in bogus charges of sexual abuse being filed, but more commonly, it gave parents false hopes that their child was actually communicating with them when in fact, they were not.

Whether intentional or not, I cannot imagine a crueler hoax, to lead a parent to believe that their child is communicating with them when really it is the doings of some stranger who was guiding their hands. It appears that most FC proponents are not intentionally perpetrating a hoax and they really believe in what they are doing, but nevertheless, it is highly irresponsible to be using a method that has been so thoroughly discredited.

It was bad enough when FC was being used in the 1990s when it was untested rather than discredited but now that double blind controlled studies have been done, anyone who uses it now, in my opinion is committing a gross deviation from any proper standard of care I can think of.  What happened with FC in the 1990s is an illustration of why it is so important to thoroughly test interventions before they are released to the public because without such testing we have no idea whether the intervention will help, do nothing or harm. When FC first came out, positive anecdotes and success stories abounded and it was said to be a miracle that gave autistic children, for the very first time, a voice. Sadly, it was nothing of the sort.

While it is no surprise that true believers in pseudoscientific practices will explain away any studies that falsify their claims (that is a hallmark indicator of a pseudoscience) and conduct poorly designed studies of their own, what is shocking to me is that in the year 2007, more than 15 years after the practice was so thoroughly discredited, police and prosecutors accepted it so uncritically. Additionally, the school paid to have an FC facilitator accompany the child to classes and apparently the school never questioned its validity. The father spent 80 days in jail and the parents had both of their children removed from the home and placed in foster care, based solely on the results of a Facilitated Communication session where accusations of abuse were typed out. Additionally, her brother was subjected to a grueling interrogation by police where they did everything they could to try to pressure him into saying the charges were true. It took some doing to get those charges dropped and the children returned to their loving home with their parents.

Thankfully, the “facilitator” Cynthia Scarsella, according to the 20/20 report, currently makes her living as a clerk at a clothing store in a mall. She refused to talk to reporters. Let’s hope Ms. Scarsella is never allowed to go near another child again in the role of any kind of a therapist or “facilitator”. However she was ever given any credibility in a court of law, remains a mystery.

This case serves as a heartbreaking reminder of the kind of damage that can be done through the use of untested or in this case, thoroughly discredited interventions. This practice ought to have ended in the 1990s when similar false accusations were made and the practice was falsified via double blind studies. When will they ever learn?

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