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By August Piper Jr., M.D.

The masses think it is easy to flee from reality, when actually, it is the most difficult thing in the world.
Ortega y Gasset, 1948

A woman -- who lives in Philadelphia, oddly enough -- wrote last month to say that she had heard the False Memory Syndrome Foundation had gone out of existence. I called her to say that although probably any number of people most ardently wished this were indeed the case, the rumor contained neither jot nor tittle of the truth. A phone call to the FMSF office assured her that I had spoken correctly.

The main reason for the letter, however, was to ask a question about her 26-year-old daughter, Linda, who has become convinced that she is a victim of sexual abuse (she is not sure by whom) and satanic ritual abuse. "And in the past few years," the mother’s letter continues, "with the help of two therapists, she has discovered she has some seventy different personalities."

The mother said that she had half believed Linda’s story as it evolved. Though she had never seen evidence that her husband had improperly touched her daughter, it was hard to argue with the therapist. For one reason, she claimed to be an expert. For another, she refused to meet with Linda’s mother or to even talk to her on the phone.

Over the years, Linda’s memories became more and more incredible. Finally, she came to remember being sexually molested in a ceremony in her parents’ house -- while her mother watched, doing nothing to assist Linda. The mother’s letter says, "This accusation, though painful, nonetheless brought me an odd kind of relief. Whereas I didn’t know whether or not my daughter’s earlier claims were based in reality, I knew beyond any doubt that this one was absolutely false. So this preposterous accusation helped me see that my daughter had fallen victim to a cruel delusion; it helped me finally realize that her memories were unreliable."

She has told her daughter of this realization -- to no avail: "Linda continues to cling firmly to all her beliefs, including that her brother is part of a huge cult."

This story, in all its dismal sordidness, must smell depressingly familiar to many of us: Childhood maltreatment that is remembered for the first time during psychotherapy. The ubiquitous "cult" -- for which no one can ever seem to produce evidence. The expert therapist, so confident of his or her ability to unearth the truth buried in the past. Multiplication of "personalities," as far as the eye can see. Ever-more fantastic memories of evermore fantastic mistreatment. The dreary features of this story are staples of the lawsuits, now blossoming all over the country, against both major and minor practitioners of recovered-memory psychotherapy.

In her letter, the mother asks the impassioned question voiced by so many FMSF members:"What can I do to help my daughter?"

Some research, based on sound cognitive-behavioral principles, might help answer this question. In treating patients who have delusions -- that is, beliefs that are held firmly, despite a lack of evidence to support them, and in the face of evidence against them -- psychiatrists have found that attempting to argue against the delusional belief usually accomplishes little. Rather, the research indicates a better course: simply ask the patient to generate his or her own alternative hypothesis for the phenomenon under discussion. After such explanations come forth, therapist and patient rationally discuss and weigh the merits and demerits of the various alternative explanations.

Beauty and elegance lie in this admittedly rather passive approach: in essence, patients are asked to argue against their own beliefs. It avoids the struggle that occurs when one side attempts to press its beliefs on the other. The therapist might offer an hypothesis, but only as something that the patient might -- or might not -- want to examine; the therapist is not passionately invested in one position or another.

So Linda’s mother might say something like this: "Yes, dear, I understand you believe you were raped on an altar in our living room by the pastor and assistant pastor of our neighborhood Lutheran church while I watched. But is there any other hypothesis we might want to consider here?" She then refuses to discuss the matter further until daughter does the work of generating another theory that, one hopes, would conform more closely to the reality that most of us hold close.

Yes -- the problems of this approach are many. It’s slow. The accusing family member may never develop an alternative theory. It requires conveying the message that a delusional belief deserves the same credence as a reality-based belief. It requires cool, rational discussion of a hot, emotional issue. But I don’t know any other research-validated method that tackles the vexing problem of therapy- induced false memories. Let me hear from all you wise readers who have other suggestions for Linda’s mother!

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