Psychiatric Testimony in ""

Donald T. Lunde, MD; and Henry A. Sigal, MD

Changes in political or religious beliefs among POWs and hostages have often been attributed to "" or "coercive persuasion." The cases reported have usually involved people held involuntarily. Since the publication of DSM-Ill, the authors have noted frequent usage of the term "atypical dissociative disorder" in civil lawsuits by plaintiffs seeking damages from groups or they joined voluntarily. The effects of "psychological captivity" are claimed to be comparable to the effects of involuntary participation in instances of kidnapping or being taken prisoner. The authors suggest that voluntary and involuntary activities are funda- mentally dissimilar and that the use of DSM-Ill is problematic in these cases.

Behavioral scientists have long struggled there were lengthy indoctrination ses- to understand relatively sudden real or sions composed of tireless repetition of apparent changes in religious or political questions and discussion. Central to beliefs. Perhaps the first example of this each of these elements, and indeed to phenomenon to gain the attention of the the entire indoctrination process, is the psychiatric community was that of the fact that these men were prisoners, held initially unexplained collaboration by against their will and entirely dependent American POWs in Korea with their on their captors for life itself. Coopera- Communist captors. As American serv- tion with elements of the indoctrination icemen began to return from Korea in process was achieved by means of ex- 1953, the nature of their experiences treme coercion. Prisoners were isolated became known. The POWs were sub- and tortured, food and medical supplies jected to a systematic, manipulative, and were withheld pending cooperation, and very heavy-handed indoctrination proc- the POWs were housed in a grossly in- ess. adequate environment.' Through this The indoctrination process was com- combination of indoctrination tech- posed of several elements: the men were nique (social isolation, repetition of separated by race, nationality, and rank, questions and demands, manipulation and later by willingness to cooperate. of rewards and punishments) and coer- Spies and informants were used and cion, some American servicemen were induced to collaborate with their cap- Dr. Lunde is clinical associate professor of psychiatry and behavioral sciences, Stanford Medical School, and tors. Dr. Sigal is chief resident in psychiatry, Stanford Uni- When this process of indoctrination/ versity Medical Center. Address reprint requests to Dr. Lunde, 900 Welch Rd., #400, Palo Alto, CA 94304. coercion was first described it was ini-

Bull Am Acad Psychiatry Law, Vol. 15, No. 2, 1987 205 Lunde and Sigal tially referred to in both the popular combined by Schein5 to yield a model press2 and the professional literature3 as of conversion. Briefly, a subject's com- "brainwashing." Brainwashing is ac- mitment to his belief system is first loos- tually a term coined by an American ened by physical threats and abuse, so- journalist in 195 1 to describe the "reed- cial isolation, deprivation, and so forth. ucation process" for the Chinese masses Next, the subject adopts the beliefs of after the Communist rev~lution.~Due (identifies with) his or her captors out of partly to its subsequent overexposure in needs to rationalize the coerced behavior the media, the term brainwashing came and to establish communication with to be thought of as the "total replace- others. Certainly, coercive persuasion ment" of one set of political/religious cannot occur without coercion. That is, beliefs with an~ther.~However, it be- the forced, involuntary nature of captiv- came clear from interviews with the Ko- ity is a necessary condition to account rean POWs that their belief changes were for belief change within this model. often not total but partial, and indeed, Without the use of substantial force sometimes completely feigned simply in (often torture) there is no reason to sus- order to obtain physical or emotional pect that belief change would have oc- relief.' The term brainwashing was then curred in the preceding examples. rejected by many psychiatrists in favor of the term "coercive persuasion" to de- Belief Changes in Voluntarily scribe intense and prolonged coercive Joined Cults tactics and persuasion forcibly applied In recent years, much concern has with whatever result^.^ been generated among mental health The concept of coercive persuasion professionals, parents, and lawmakers has subsequently been used to explain by the relatively sudden and often radi- apparent belief changes in other situa- cal belief changes apparently experi- tions. In 1968, puzzling pro-Communist enced by new members of unorthodox propaganda statements were made by religious groups or "cults." Perhaps the captured American sailors taken from best example here is that of the Unifi- the USS Pueblo; later interviews with cation Church, led by Reverend Sun Captain Bucher revealed these state- Myung Moon. In an effort to understand ments to have been made under severe apparent belief changes in "Moonies," duress. Coercive persuasion was also theorists turned initially to the concepts suggested as an explanation for Patty of "brainwashing" and "coercive persua- Hearst's complicity in a bank r~bbery.~ sion." However, most religious cults do More recently, this concept has been not even approximate the homd physi- used to explain various hostage situa- cal conditions experienced by POWs in tions. Korea or certain hostages. In the Moonie Several theoretical explanations have retreat centers, for example, inductees been offered to account for the (partial) are adequately fed, they may sleep ade- belief conversion process in coercive quately, they may communicate with persuasion. These theories have been outsiders (such communication is often

206 Bull Am Acad Psychiatry Law, Vol. 15, No. 2, la7 Psychiatric Testimony in "Cult" Litigation discouraged but not prevented), and 1975, at which point she was again held they are not physically threatened or captive, this time by government au- abused. Perhaps most importantly, in- thorities. Other subjects who were held ductees are aware that they are free to captive included a group of survivors of leave.7 ' Peoples Temple. Although The voluntary joining of a cult can they were not physically abducted into thus be a qualitatively different experi- the group, most (but not all) were even- ence from the involuntary captivity de- tually held captive at , Guy- scribed by coercive persuasion. How, ana, and were not allowed to commu- then can one account for the changes nicate with the outside world until their normally associated with cult member- release after the mass murder/suicide on ship? Some psychologists and psychia- November 1 8, 1978. The subjects inter- trists have recently suggested that cult viewed who were neither taken nor held membership involves a kind of "psycho- by force or threat of physical force were logical captivity" akin in effect if not in members or former members of Rever- fact to coercive persuasion. The ele- end Moon's Unification Church. All of ments of this process are said to include these subjects were examined in connec- deception during the recruiting process; tion with either criminal or civil litiga- manipulation of information; peer pres- tion, with the exception of Commander sure; and "excessive affection," espe- Bucher, who was interviewed at length cially toward new members.' However, after the U.S. Navy dropped its charges comparison of interviews with persons against him. All of the subjects appeared having undergone these experiences sug- to have undergone radical changes in gests that psychological captivity is sim- their political or religious beliefs as a ilar to coercive persuasion neither in fact result of their experiences, with the ex- nor in effect. ception of Commander Bucher. Al- though Bucher's experience of coercive Comparison of Interviews with persuasion was the most horrendous of Voluntary and Involuntary Group all (in terms of duration, intensity, and Members severity of physical torture) he maintains Among those subjects interviewed that his "confessions" of being a spy for who were taken and held by force was the "U.S. Imperialist Aggressor Forces" Commander Lloyd M. Bucher, U.S. were made solely to protect members of Navy (Commanding Officer of the USS his crew who were being threatened with Pueblo). Commander Bucher was inter- execution. He reports that at no time viewed on July 28 and July 29, 1976. did he believe his own confessions and Another subject was Patricia Hearst, that he expected he might be court-mar- who was taken captive in February 1974 tialed for making them. He states that by the Symbionese Liberation Army and he decided to worry about that problem held prisoner at first. She was subse- later. quently free to leave but did not until Patricia Hearst, like Bucher, was her arrest by FBI agents in September taken prisoner and subjected to physical

Bull Am Acad Psychiatry Law, Vol. 15, No. 2, 1987 207 Lunde and Sigal abuse combined with political indoctri- media and others about the powerful nation. She also had reason (at least methods of the "Moonies," 90 percent initially) to fear for her own life. Her of new recruits drop out and simply recorded political statements, like Buch- leave within three weeks of their arrivaL9 er's confessions, were made under con- The relationship between psychological ditions of clear coercion and duress. captivity and coercive persuasion thus The conditions at Jonestown were appears tenuous. somewhat different. People were not confined in prison cells or locked closets Expert Testimony in "Cult" but, on the other hand, the geographical Litigation isolation of Jonestown made escape dif- Upon leaving a religious cult (either ficult (although not impossible). Fur- on one's own or after having been kid- thermore, although there were weapons napped and deprogrammed), some for- on the premises and a small "security mer cult members have instigated civil force" authorized to use them, as a rule, litigation against the cult. In this litiga- members were not being held captive at tion, plaintiffs allege (among other gunpoint. Beatings and threats of vio- things) that their group membership in- lence were used at certain times during duced an emotional disorder. Since the the almost 20-year history of Peoples publication of DSM-111, some psychol- Temple (especially in the mid- 1970s) ogists and psychiatrists have testified but not consistently. Communications that the emotional disorder induced by with nonmembers by telephone or mail voluntarily joined groups is an "atypical were not physically controlled until the dissociative disorder." "Psychological group moved to in 1977. captivity," "mind control," coercive per- Conditions at Unification Church fa- suasion, brainwashing, and other such cilities are significantly different from all terms are often mentioned as important of the aforementioned, based on inter- in the etiology of the alleged disorder." views with current members as well as There are several difficulties with this bitter defectors who are currently suing sort of testimony. As discussed above, the church. (These data have also been these terms each have different mean- confirmed by personal inspection of the ings and are not simply interchangeable. facilities on May 27 and 28, 1983.) Some of these terms imply physical vi- Members and potential converts are nei- olence or captivity; others do not. (In ther taken by force nor held at gunpoint. fact, the term brainwashing has been Although some of the facilities are in used in so many different contexts that rural areas, they are not surrounded by it now appears to lack any semblance of barbed wire, nor are they patrolled by scientific precision.) Indiscriminate use armed guards. Letters, phone calls, and of these terms in cult litigation blurs the occasional face-to-face visits with non- theoretically important distinction be- members take place, and transportation tween voluntary and involuntary cult to the nearest town or city is available. membership. In fact, despite dire warnings from the Additionally, the term atypical disso-

208 Bull Am Acad Psychiatry Law, Vol. 15, No. 2, 1987 Psychiatric Testimony in "Cult" Litigation

ciative disorder is itself poorly defined gests, that for the vast majority of cult in DSM-111. Adequate, reliable diagnos- members their membership represents tic criteria are lacking. As a result, dif- an unusual but fundamentally nonpath- ferent professionals attribute different ologic developmental step. It may be phenomena to atypical dissociative dis- that some members are damaged by order. Virtually any undesirable symp- their membership, but this does not tom or quality may be said to result from mean that such membership itself cre- the disorder. One prominent expert, ates a psychiatric disorder. We suggest, when asked to describe the symptoms of first, that the distinction between in- atypical dissociative disorder found in a voluntarily joined groups (where per- former "Moonie," gave the following an- sons are subjected to coercive persua- swer: sion) and voluntarily joined groups (in which there may have been, at most, She described that she felt totally emotion- ally drained, was like a zombie. She felt "manipulation of social variables") be absolutely empty inside. kept clear, as there appear to be good reasons to suspect that these two types The lawyer then asked if there were any of groups are indeed different. Second, additional symptoms of atypical disso- although atypical dissociative disorder ciative disorder present. The reply was: may be a convenient label to use in cult From her descriptions to me in the interview, litigation because its vague definition al- she described this draining, numbed feeling and that a big behavioral change was ob- lows it to be applied in this context, we viously noticeable to some of the Unification believe that precisely because the term Church management personnel because they is vague and poorly defined it should be tried to make contact with her. They tried to used only with extreme caution by psy- get her to smile . . ." chiatrists testifying in such litigation. When asked if this "mental disorder" persisted throughout the plaintiffs five- References year membership in the church the ex- Segal HA: Initial psychiatric findings of re- pert testified, "yes." cently repatriated prisoners of war. Am J Such "symptoms" may in fact reflect Psychiatry 1 1 1 :358-363, 1954 New York Times, March l I, April 4, 5, 13- preexisting personality variables, effects 17. 1953 (in some instances) of kidnapping and Winokur G: Brainwashing-A social phe- , or simply a normal re- nomenon of our time. Hum Organ 1 1: 16- 23, 1955 action to a new, intense experience. Ap- Hunter E: Brainwashing in Red China; the parently realizing this, the trial court in Calculated Destruction of Men's Minds. New York, Vanguard, 195 1 a recent case described such testimony Schein E: Coercive Persuasion: A Socio-Psy- as "veiled value judgements concerning chological Analysis of the "Brainwashing" of the entire outlook of the Unification American Civilian Prisoners by the Chinese Communists. New York, Norton, 196 1 Church."12 Lunde DT, Wilson TE: Brainwashing as a Apparent belief changes in voluntarily defense to criminal liability: revisited. Criminal Law Bull 13:34 1-382, joined groups, then, are not yet fully 1977 understood. It may be, as Levine13 sug- Levine S: Radical Departures. New York.

Bull Am Acad Psychiatry Law, Vol. 15, No. 2, 1987 Lunde and Sigal

Harcourt, Brace, Jovanovich, 1984 10. See experts' testimony in: Barbara Dole v. 8. See experts' testimony in: David Molko and HSAIU WC (Unification Church), Calif. Tracy Leaf v. HSAIUWC (Un1$cation 554520-8 (California Superior Ct., Alameda, Church), Calif. 769529 (California Superior 1981) Ct., , 1983). See also West LJ, I I. Testimony of Dr. in Dole v. Singer MT: Cults, quacks and nonprofes- HSAIU WC (ref. no. 10) Deposition taken sional therapies. in Comprehensive Textbook February 23, 1984, pp. 104-6 of Psychiatry, 3rd ed, vol 3. Edited by Freed- 12. David Molko and Tracy Leal v. HSAIUWC, man AM, Kaplan HI, Sadoff BJ. Baltimore. A025338, Cal. Ap. 3d, 1986, p. 23 Williams & Wilkins, 1980 13. Levine S: Op cit. See also: Mateson FG: 9. Galanter M: Psychological induction into the Dilemmas in the evaluation and manage- large-group: findings from a modern religious ment of religious cultists. Am J Psychiatry sect. Am J Psychiatry 137: 1574-9, 1980 138:925-9, 198 1

Bull Am Acad Psychiatry Law, Vol. 15, No. 2, 1987