Suggestibility and repressed memories of abuse: a survey of psychotherapists' beliefs

Judges and lawyers' beliefs in repression and dissociative amnesia may imperil justice: further guidance required

This article examines continuing misunderstanding about memory function especially for trauma, across three UK samples (N = 717). Delayed allegations of child sexual and physical abuse are prevalent in Western legal systems and often rely upon uncorroborated memory testimony to prove guilt. U.K. legal professionals and jurors typically assess the reliability of such memory recall via common sense, yet decades of scientific research show common sense beliefs often conflict with science. Recent international surveys show controversial notions of repression and accurate memory recovery remain strongly endorsed. In historical cases, these notions may lead to wrongful convictions. The current study surveyed the U.K. public, lawyers, and mental health professionals' beliefs about repression, dissociative amnesia and false memories. Study findings give unique data on judges' and barristers' beliefs. Overall, the study findings reinforce international scientists' concerns of a science - knowledge-gap. Repression was strongly endorsed by lay, legal and clinical participants (> 78%) as was dissociative amnesia (> 87%). Moreover, suboptimal professional legal education and juror guidance may increase misunderstanding. Correcting beliefs about memory function, and extending the contribution of memory science in the courtroom remains an important quest for cognitive scientists.

Hypnosis in psychotherapy, psychosomatics and medicine. A brief overview

Aspects of hypnosis and its application in psychotherapy, psychosomatics and medicine are examined and contextualized in the 250-year history of hypnosis. Imagination as an essential element of hypnotic treatments appeared as early as 1784 as an argument rejecting the theory of animal magnetism of Franz Anton Mesmer. In somnambulism of German romanticism, another proto-form of hypnosis after 1800, concepts of the mind-body problem were dealt with, which still characterize the understanding of unconscious mental processes today. Hypnosis was at the beginning of psychoanalysis, but was not pursued further by Sigmund Freud from 1900 onwards. Nevertheless, there were some hypnoanalytical approaches in the 20th century, as well as attempts to integrate hypnosis into behavior therapy. Techniques of imagination and relaxation combine both; in particular findings from cognitive psychology explain processes of both hypnosis and cognitive behavioral therapy. The influence of social psychology brought a new perspective to the debate about the nature of hypnosis, which continues to this day: is hypnosis to be understood as a special state of consciousness or is it a completely normal, mundane interaction? The experiments that were carried out to support one side or the other were also dependent on the hypnotizability of the subjects involved, as the more difficult hypnotic phenomena such as paralysis, hallucinations or identity delusions can only be demonstrated by highly hypnotizable subjects. The fact that these are not mere compliance reactions has now been proven by many studies using imaging techniques. But even those who are moderately hypnotizable benefit from hypnosis rituals. Variables postulated by socio-cognitive hypnosis researchers, such as motivation and expectation, are relevant, as is a good "hypnotic rapport." Practical application of hypnotherapy today is characterized by the innovative techniques and strategies developed by Milton H. Erickson. Research into the effectiveness of hypnosis in the field of psychotherapy and psychosomatics still leaves much to be done. The situation is different in the field of medical hypnosis, where there are considerably more studies with a satisfactory design and verifiable effects. However, the impact in practical application in everyday medical practice is still low. Newer developments such as virtual reality and artificial intelligence are being looked at with critical interest.

Tilting at Windmills: Why Attacks on Repression Are Misguided

In the November 2019 issue of Perspectives, Otgaar et al. argued that the "memory wars" persist and that "the controversial issue of repressed memories is alive and well and may even be on the rise" (p. 1072). Their thesis overlooked the well-established consensus that recovered memories of trauma may be genuine, false, or a mixture of the two and instead focused on a disputed mechanism: unconscious repression. A formal cocitation analysis identified the major publications mentioning repressed memories, but none endorsed a theory of unconscious repression. Studies of beliefs about repressed memories by the general public and other groups do not support Otgaar et al.'s thesis either because these studies did not adequately assess the key ideas defining the theory of repression. Clinical evidence is consistent with recovered memories occurring in many different forms of therapy, including ones that do not use suggestive techniques or rely on the concept of repression. Thus, Otgaar et al. have proposed the existence of a problem for which little objective evidence can be found. Continuing theoretical uncertainties about the mechanisms responsible for forgetting are less important than the general recognition since the 1990s that suggestive therapy and attempts to exhume memories are hazardous and generally inappropriate.

Psychological Myths as Therapeutic Instructions in Eye Movement Desensitization and Reprocessing

The Dutch protocol for Eye Movement Desensitization and Reprocessing (EMDR) uses two psychological myths as part of the therapeutic instruction: memory works as a video camera and individuals can have a photographic memory. This study explored how participants experience and evaluate such instructions and if these instructions affect their beliefs on memory. Participants received a video, photo, or a control instruction. Participants indicated on a visual analog scale how vivid and emotional they expected to recall the traumatic memory, how credible the therapeutic instruction was, and how reliable they would consider a therapist providing such an instruction. Next, participants completed a memory belief survey. Participants who received the video instruction were most likely to expect to vividly recall a memory. The credibility of the instructions and the reliability of the therapist providing the instruction were at chance level, which might pose problems for the therapeutic alliance and therapy outcome.

Teaching psychology students to change (or correct) controversial beliefs about memory works

Therapists, judges, law enforcement, and students often believe in the existence of automatic and unconscious repression. Such a belief can be perilous as it might lead therapists to suggestively search for repressed memories leading to false memories. Recovering therapy-induced false memories of criminal acts can have serious consequences. Here, we tested whether erroneous beliefs in repressed memories can be corrected. Surveying two cohorts of Forensic and Legal Psychology Master's students, we examined whether education about the science of (eyewitness) memory can correct erroneous beliefs in repressed memories. Students assessed memory statements before taking a course on eyewitness memory, six weeks after the course exam, and 18 or 6 months later, respectively (Ns = 33-74 per cohort and measurement). As expected, students in both cohorts on average initially strongly agreed with the statement that memories of traumatic events can be unconsciously blocked, but strongly disagreed with the statement after the course. Belief-corrections also persisted after the longer delay. These findings show that educating people about the science of (eyewitness) memory can be effective in correcting false and controversial memory beliefs in general and the existence of repressed memories in specific.

The Return of the Repressed: The Persistent and Problematic Claims of Long-Forgotten Trauma

Can purely psychological trauma lead to a complete blockage of autobiographical memories? This long-standing question about the existence of repressed memories has been at the heart of one of the most heated debates in modern psychology. These so-called memory wars originated in the 1990s, and many scholars have assumed that they are over. We demonstrate that this assumption is incorrect and that the controversial issue of repressed memories is alive and well and may even be on the rise. We review converging research and data from legal cases indicating that the topic of repressed memories remains active in clinical, legal, and academic settings. We show that the belief in repressed memories occurs on a nontrivial scale (58%) and appears to have increased among clinical psychologists since the 1990s. We also demonstrate that the scientifically controversial concept of dissociative amnesia, which we argue is a substitute term for memory repression, has gained in popularity. Finally, we review work on the adverse side effects of certain psychotherapeutic techniques, some of which may be linked to the recovery of repressed memories. The memory wars have not vanished. They have continued to endure and contribute to potentially damaging consequences in clinical, legal, and academic contexts.

Reports of recovered memories of childhood abuse in therapy in France

Recovered memories of abuse in therapy are especially controversial if the clients were not aware they were abused before therapy. In the past, such memory recovery has led to legal action, as well as a debate about whether such memories might be repressed, forgotten, or false memories. More than two decades after the height of the controversy, it is unclear to what degree such memories are still recovered today, and to what extent it occurs in France. In our French survey of 1312 participants (M_age = 33; 53% female), 551 reported having done therapy at some point. Of that 551, 33 (6%) indicated they had recovered memories of abuse in therapy that they did not know about before therapy. Sexual abuse was the most commonly reported type that was recovered in therapy (79%). As in past research, discussing the possibility of repressed memories with therapists was associated with reports of recovered memories of abuse. Surprisingly, memory recovery occurred just as much in behavioural and cognitive therapies as it did in therapies focused on trauma. We found recovered memories in a proportion of clients who began therapy recently. Recovered memories in therapy appears to be an ongoing concern in France.

Memory experts' beliefs about repressed memory

ABSTRACTWhat we believe about how memory works affects the decisions we make in many aspects of life. In Patihis, Ho et al. [Patihis, L., Ho, L. Y., Tingen, I. W., Lilienfeld, S. O., & Loftus, E. F. (2014). Are the "memory wars" over? A scientist-practitioner gap in beliefs about repressed memory. Psychological Science, 25, 519-530.], we documented several group's beliefs on repressed memories and other aspects of how memory works. Here, we present previously unreported data on the beliefs of perhaps the most credible minority in our dataset: memory experts. We provide the statistics and written responses of the beliefs for 17 memory experts. Although memory experts held similarly sceptical beliefs about repressed memory as other research-focused groups, they were significantly more sceptical about repressed memory compared to practitioners, students and the public. Although a minority of memory experts wrote that they maintained an open mind about repressed memories - citing research such as retrieval inhibition - all of the memory experts emphasised the dangers of memory distortion.

Latent variables underlying the memory beliefs of Chartered Clinical Psychologists, Hypnotherapists and undergraduate students

In courts in the United Kingdom, understanding of memory phenomena is often assumed to be a matter of common sense. To test this assumption 337 UK respondents, consisting of 125 Chartered Clinical Psychologists, 88 individuals who advertised their services as Hypnotherapists (HTs) in a classified directory, the Yellow Pages^TM, and 124 first year undergraduate psychology students, completed a questionnaire that assessed their knowledge of 10 memory phenomena about which there is a broad scientific consensus. HTs' responses were the most inconsistent with the scientific consensus, scoring lowest on six of these ten items. Principal Components Analysis indicated two latent variables - reflecting beliefs about memory quality and malleability - underlying respondents' responses. In addition, respondents were asked to rate their own knowledge of the academic memory literature in general. There was no significant relationship between participants' self reported knowledge and their actual knowledge (as measured by their responses to the 10-item questionnaire). There was evidence of beliefs among the HTs that could give rise to some concern (e.g., that early memories from the first year of life are accurately stored and are retrievable).

Are the "memory wars" over? A scientist-practitioner gap in beliefs about repressed memory

The "memory wars" of the 1990s refers to the controversy between some clinicians and memory scientists about the reliability of repressed memories. To investigate whether such disagreement persists, we compared various groups' beliefs about memory and compared their current beliefs with beliefs expressed in past studies. In Study 1, we found high rates of belief in repressed memory among undergraduates. We also found that greater critical-thinking ability was associated with more skepticism about repressed memories. In Study 2, we found less belief in repressed memory among mainstream clinicians today compared with the 1990s. Groups that contained research-oriented psychologists and memory experts expressed more skepticism about the validity of repressed memories relative to other groups. Thus, a substantial gap between the memory beliefs of clinical-psychology researchers and those of practitioners persists today. These results hold implications for the potential resolution of the science-practice gap and for the dissemination of memory research in the training of mental-health professionals.

Confirmatory factor analysis of the Valencia Scale on Attitudes and Beliefs toward Hypnosis, Therapist version

Health professionals' beliefs and attitudes toward hypnosis may make them reluctant to use it or even to foster misapplications and iatrogenic uses of hypnosis. The Valencia Scale on Attitudes and Beliefs toward Hypnosis-Therapist version (VSABH-T) is a specific instrument to evaluate therapists' attitudes and beliefs. The aims of this study are to evaluate the 8-factor structure of the VSABH-T proposed from a confirmatory perspective. The sample comprised 1,661 licensed psychologists who are members of the Spanish Psychological Association for the initial test and 787 for the retest. Results confirmed the 8-factor structure obtained in a previous exploratory study, namely: Fear, Memory, Help, Control, Collaboration, Interest, Magic, and Marginal. The scale also showed adequate psychometric properties, including good internal consistency and test-retest reliability.

Examining hypnosis legislation: a survey of the practice in Israel

Hypnosis as a therapeutic technique bears potential risks when carried out inexpertly. Because of this, Israel was the first to legislate hypnosis. This study examines the current state of clinical hypnosis practice in Israel. A questionnaire was sent to 470 licensed hypnotists and 1250 unlicensed professionals; 478 (25.7%) of the 1720 potential respondents returned the questionnaires. Of these, 249 (51.8%) were licensed hypnotists, and 232 (48.2%) were unlicensed. Of the unlicensed professionals, 45% reported practicing hypnosis; 50% of them practice hypnosis with adolescents and 41.2% with children. Many of them practice hypnosis in public clinics (71.6%). Of the licensed professionals, 94.4% reported practicing hypnosis in the course of their clinical work. The authors conclude that great number of unlicensed hypnotists carry on clinical practice of hypnosis and suggest steps to increase the efficiency of the law as part of a regulatory system.

People believe it is plausible to have forgotten memories of childhood sexual abuse

Pezdek, Blandon-Gitlin, and Gabbay (2006) found that perceptions of the plausibility of events increase the likelihood that imagination may induce false memories of those events. Using a survey conducted by Gallup, we asked a large sample of the general population how plausible it would be for a person with longstanding emotional problems and a need for psychotherapy to be a victim of childhood sexual abuse, even though the person could not remember the abuse. Only 18% indicated that it was implausible or very implausible, whereas 67% indicated that such an occurrence was either plausible or very plausible. Combined with Pezdek et al.s' findings, and counter to their conclusions, our findings imply that there is a substantial danger of inducing false memories of childhood sexual abuse through imagination in psychotherapy.

What should we mean by empirical validation in hypnotherapy: evidence-based practice in clinical hypnosis

This paper briefly surveys the trend of and controversy surrounding empirical validation in psychotherapy. Empirical validation of hypnotherapy has paralleled the practice of validation in psychotherapy and the professionalization of clinical psychology, in general. This evolution in determining what counts as evidence for bona fide clinical practice has gone from theory-driven clinical approaches in the 1960s and 1970s through critical attempts at categorization of empirically supported therapies in the 1990s on to the concept of evidence-based practice in 2006. Implications of this progression in professional psychology are discussed in the light of hypnosis's current quest for validation and empirical accreditation.

Development and Validation of the Implicit Memory Theory Scale

Abstract. The present research developed and tested a new individual-difference measure of beliefs about autobiographical memory. We assumed that someone's implicit memory theory results in high or low skepticism about memory credibility. Based on the metamemory literature we hypothesized that this skepticism might be a predictor of memory accuracy in various memory tasks. The first phase of the research developed the Implicit Memory Theory Scale (IMTS). The exploratory factor analysis revealed three factors that were converted into three subscales of the 37-item measure. Cronbach α coefficients and test-retest correlations showed acceptable to high reliability for the global scale and three subscales. Validation studies indicated that the scale was sensitive to individual differences in professional knowledge of autobiographical memory and manipulation that involved providing respondents with this kind of knowledge. As predicted, IMTS scores were associated with accuracy in a misinformation experiment. The potential utility of the IMTS for memory research and an applied setting is discussed.

Recovering memories of the offense in "amnesic" sexual offenders

This paper describes a technique designed to assist sexual offenders to recover memories of their offense. We have consistently observed that some sexual offenders present as having no recall of their offense although they are able to remember other events of the day of the offense. This failure to recall offense details prevents the offenders from making an appropriate disclosure which, in turn, blocks attempts to identify their offense pathways and develop relapse prevention plans. The memory recovery technique we describe is based on experimental literature on memory and we outline its use with 22 clients, 20 of whom showed satisfactory recovery of their memories.

What's in a Name for Memory Errors? Implications and Ethical Issues Arising From the Use of the Term "False Memory" for Errors in Memory for Details

The term "false memories" has been used to refer to suggestibility experiments in which whole events are apparently confabulated and in media accounts of contested memories of childhood abuse. Since 1992 psychologists have increasingly used the term "false memory" when discussing memory errors for details, such as specific words within lists. Use of the term to refer to errors in details is a shift in language away from other terms used historically (e.g., "memory intrusions"). We empirically examine this shift in language and discuss implications of the new use of the term "false memories." Use of the term presents serious ethical challenges to the data-interpretation process by encouraging over-generalization and misapplication of research findings on word memory to social issues.

Fact or fantasy? A review of recovered memories of childhood sexual abuse

More than a century ago Freud provoked a bitter controversy concerning alleged recollections of childhood sexual abuse: Were they fact or fiction? This debate is still ongoing, with some professionals stubbornly holding on to deeply entrenched and polarised positions. On the one side there are those who continue to deny the veracity of all 'recovered memories', and thus also of the implicated psychological defenses of repression and dissociation. At the other extreme are those therapists who simplistically assume that particular symptoms invariably imply sexual abuse. Over the decades there is a growing corpus of anecdotal, clinical and, more recently, research evidence supporting the contention that childhood sexual abuse, like all other trauma, can be forgotten for days, and even for many years, before being recalled. However, the reconstruction of these memories is a complex and, at times, a rather fallible process.

Psychologists' beliefs about the prevalence of childhood sexual abuse: the influence of sexual abuse history, gender, and theoretical orientation

OBJECTIVE

This study examined the influence of sexual abuse history, gender, theoretical orientation, and age on beliefs about the prevalence of childhood sexual abuse among clinical and counseling psychologists.

METHOD

A mail survey design was used in this study. Participants were randomly selected from the American Psychological Association membership database. There were 615 psychologists who completed self-report measures on beliefs about the prevalence of childhood sexual abuse and demographic characteristics.

RESULTS

Overall, clinicians' scores on the prevalence of childhood sexual abuse were moderate. There were significant gender differences on beliefs, suggesting that women were more likely believe that childhood sexual abuse is a common occurrence compared to men. Multiple regression analysis indicated that clinician characteristics (history of sexual abuse, gender, and theoretical orientation) were significantly related to beliefs about the prevalence of childhood sexual abuse. However, these characteristics only accounted for a small amount of the overall variance predicting beliefs.

CONCLUSIONS

These results suggest that clinicians do not hold extreme beliefs regarding the prevalence of childhood sexual abuse. Moreover, certain clinician characteristics are associated with their beliefs, which in turn, may impact their clinical judgment and treatment decisions. Furthermore, much of the variance was unaccounted for in the model indicating that psychologists' beliefs are complex and are not unduly influenced by their personal characteristics. Implications for clinical practice and future research are discussed.

Beliefs and opinions about hypnosis held by the general public: a systematic evaluation

A study was conducted to systematically evaluate the general public's beliefs and opinions about hypnosis as well as to ascertain the sources of their beliefs. The evaluation was based on four samples representing different ages, socio-economic backgrounds, interests, and geographical locations. A 27 item, two-page questionnaire was developed to evaluate the opinions on a wide variety of topics related to hypnosis and clinical applications of hypnosis. The results indicate that although the different sample groups obtain their information about hypnosis from different sources, their beliefs about hypnosis are remarkably consistent. While the results indicate an interesting mix of ideas about hypnosis, some results indicate that most people have a positive view of the therapeutic benefits, with a vast majority of respondents believing that it reduces the time that is usually required to uncover causes of a person's problems and that hypnotized persons can undergo dental and medical procedures without pain. Other findings indicate that an extremely large proportion of the general public views hypnosis as a powerful tool to recover accurate memories under a variety of conditions including accurate memories as far back as birth or even past lives. These findings may extend and dovetail with the findings that some professionals overestimate the influence of hypnosis on retrieving accurate memories.

On memories of childhood abuse: a phenomenological study

OBJECTIVE

To explore the phenomenon of memories and reported recovered memories of childhood abuse, and to examine ways in which clients and therapists assess the veridicality of such memories.

METHOD

Qualitative methodology utilizing phenomenological inquiry. Within the context of a wider study exploring perceptions of helpful and unhelpful factors in the therapeutic process, a sub-sample of 36 in-depth interviews with clients, therapists, and therapists who considered themselves to have been abused as children included a focus on abuse-memory experiences. Data were analyzed according to Grounded Theory principles.

RESULTS

Participants described six types of abuse-memory experiences. The most frequently reported type was where abuse was known about but kept "out of mind." The six types can be collapsed into three main categories: (1) continual knowledge of abuse (69.5%); (2) unexpected abuse-memories recovered from a prior state of partial knowledge of abuse (16.5%); and (3) abuse-memories recovered from a prior state of no knowledge of abuse (30%). Independent corroboration of recovered memories was rare; and criteria which were reportedly used to assess the veridicality of such memories were problematic when viewed in the light of cognitive psychology research on memory processes.

CONCLUSION

It seems that most people who were abused as children have always had continual knowledge of this, although it is often only much later than many connect problems in adult life with the consequences of such abuse. People also experience the recovery of memories of abuse about which they were previously unaware. There is a danger that the specific controversy surrounding "false memories" may become over-generalized contributing to increased public scepticism about the prevalence and negative impact of child abuse, and the potential effectiveness of appropriate therapeutic services.

Memory recovery and repression: what is the evidence?

Both the theory that traumatic childhood memories can be repressed, and the reliability of the techniques used to retrieve these memories are challenged in this paper. Questions are raised about the robustness of the theory and the literature that purports to provide scientific evidence for it. Evidence to this end is provided by the authors which surveyed New Zealand families in which one member had accused another (or others) of sexual abuse on the basis of recovered memories. It is shown that a number of these allegations involve very low probability events. Since memory repression theory is not currently scientifically substantiated it is argued that care needs to be taken in the mental health, legal and insurance compensation arenas. Memories recalled during therapy may be treated as metaphorical but, in the absence of corroborative evidence, should not be considered factually true. Clinicians who wish to use memory recovery techniques should inform patients of their experimental and controversial nature, point out adverse effects, and obtain consent before proceeding.

False attribution of suggestibility to explain recovered memory of childhood sexual abuse following extended amnesia

Suggestibility is central to arguments proffered by critics of recovered memory of childhood sexual abuse who believe that memories involving amnesia are false creations of treatment. The present study represents the first direct investigation of suggestibility among patients who report recovered memory. Suggestibility was measured in 44 patients who recovered memories and in a 31 patient comparison group without a history of sexual trauma using the Gudjonsson Suggestibility Scale. Results indicated that patients who recover memories were remarkably less suggestible than the clinical field has been led to believe by advocates of false memory. As a group, they scored low on suggestibility. Recovered Memory patients yielded to suggested prompts an average of 6.7 times per case. This compares to an average of 10.6 in the Psychiatric comparison group. Paradoxically, patients without a history of sex abuse were more at risk for altering memory to suggestive prompts. These findings appreciably challenge advocated theories of suggested memory.

Incest memories recalled in hypnosis--a case study: a brief communication

Accuracy of repressed memories recovered in hypnosis cannot be reliably determined with any greater certainty than non-hypnotically recalled events. Therefore, the practice of therapists' accepting hypnotically enhanced memories as veridical, absent corroborating evidence, is not advocated. A 52-year-old woman with a 27-year history of panic attacks and sleep disorder inadvertently recovered incest memories in hypnosis. Photographs and remembered events by other family members were thought by the patient to provide general support although they did not constitute actual proof of abuse. Implications are discussed.

Factors to consider in assessing adult litigants' complaints of childhood sexual abuse

Based on limited research, clinical and forensic experience and observations, factors hypothesized to be potentially useful in forensic evaluation of claims of decades-delayed discovery of childhood sexual abuse are delineated. Factors considered include: (1) alleged victim factors, (2) memory factors, (3) therapist/examiner factors, (4) external influences on the abuse account, (5) evidential patterns. Differences among a limited sample of cases seen by the author are described. Present knowledge does not provide a basis for reliable determination of whether a specific recollection is true or false, based only upon the claimant's account. At this time, there is no empirically validated method for discriminating valid from invalid cases. Experts testifying for either side must exercise caution and restraint as it may be premature and even unethical in many cases to propound opinions about the validity or invalidity of the memories.