INQUIRY INTO THE PRACTICE OF RECOVERED MEMORY THERAPY September 2005 Report by the Health Services Commissioner to the Minister for Health, the Hon. Bronwyn Pike MP under Section 9(1)(m) of the Health Services (Conciliation and Review) Act 1987 TABLE OF CONTENTS 1 DEFINITIONS...............................................................................................................................4 2 EXECUTIVE SUMMARY ............................................................................................................7 3 RECOMMENDATIONS .............................................................................................................17 4 BACKGROUND TO THE INQUIRY.....................................................................................18 4.1 Introduction ...........................................................................................................................18 4.2 Terms of Reference.............................................................................................................19 4.3 The Inquiry Team ................................................................................................................20 4.4 Methodology...........................................................................................................................20 4.4.1 Literature review ..........................................................................................................20 4.4.2 Legislative review ........................................................................................................20 4.4.3 Questionnaire ................................................................................................................21 4.4.4 Written and verbal submissions .............................................................................21 4.4.5 Forums .............................................................................................................................21 5 FINDINGS.....................................................................................................................................22 5.1 Literature Review.................................................................................................................22 5.1.1 Introduction....................................................................................................................22 5.1.2 Conceptualising memory...........................................................................................22 5.1.3 Determinants of accuracy.........................................................................................23 5.1.4 Experimental evidence for false memories ........................................................23 5.1.5 Reports of false memories........................................................................................24 5.1.5.1 Legal cases .............................................................................................................24 5.1.5.1.1 Canadian authority: R v Norman ...........................................................25 5.1.5.1.2 New Zealand authority: R v R.................................................................25 5.1.5.1.3 Australian authority: R v Bartlett...........................................................26 5.1.5.2 An investigation into Recovered Memory Therapy by the Health Services Commissioner......................................................................................................27 5.1.5.3 Media reports.........................................................................................................28 5.1.5.4 Limitations ..............................................................................................................32 5.1.6 Experimental evidence for recovered memories..............................................32 5.1.7 Experiential evidence for recovered memories ................................................33 5.1.8 Theoretical explanations for blocked and recovered memories.................35 5.1.8.1 Infantile amnesia: Storage difficulties or retrieval failures? ...............35 5.1.8.2 Dissociation ............................................................................................................35 5.1.8.3 Repression ..............................................................................................................36 5.1.8.4 Suppression............................................................................................................36 5.1.9 Clinical techniques associated with recovered memories of sexual abuse ........................................................................................................................................................37 5.1.10 Government responses and guidelines from professional bodies...........38 5.1.10.1 International professional bodies ................................................................39 5.1.10.1.1 American Psychological Association ...................................................39 5.1.10.1.2 American Psychiatric Association.........................................................40 5.1.10.1.3 Canadian Psychological Association....................................................41 5.1.10.1.4 British Psychological Society .................................................................42 5.1.10.2 National professional bodies..........................................................................42 5.1.10.2.1 Australian Psychological Society..........................................................42 5.1.10.3 International government reports...............................................................43 5.1.10.3.1 Netherlands Health Council ...................................................................43 2 5.1.10.4 National government reports........................................................................44 5.1.10.4.1 Crime and Misconduct Commission ....................................................44 5.1.10.5 Summary of the literature review...............................................................45 5.2 Legislative review: Difficulties in Dealing with Third Party Complainants .....46 5.3 Questionnaire: The Extent to which Recovered Memory Therapy is Practised. ........................................................................................................................................48 5.4 Submissions: The Perspectives of those who have been affected by the Practice of Recovered Memory Therapy. ............................................................................49 5.4.1 Survivors of Childhood Abuse .................................................................................49 5.4.1.1 Concern regarding the focus of the Inquiry...............................................51 5.4.1.2 Memory triggers ...................................................................................................52 5.4.1.3 Types of memory .................................................................................................52 5.4.1.4 Experiences of therapy ......................................................................................52 5.4.1.5 Professional practice ...........................................................................................52 5.4.1.6 Improvement in wellbeing................................................................................53 5.4.1.7 Respondents’ recommendations ....................................................................53 5.4.2 Organisations for Survivors of Child Abuse .......................................................55 5.4.3 Critics of Recovered Memory Therapy .................................................................56 5.4.3.1 No scientific evidence for repression............................................................56 5.4.3.2 Guilty before proven innocent.........................................................................57 5.4.3.3 The Courage to Heal ...........................................................................................57 5.4.3.4 Effects of accusations.........................................................................................58 5.4.3.5 Problems associated with Recovered Memory Therapy ........................58 5.4.3.5.1 Third party complaints ...............................................................................58 5.4.3.5.2 Prevention of communication..................................................................58 5.4.3.5.3 Deterioration in patient’s wellbeing ......................................................59 5.4.3.6 Respondents’ recommendations ....................................................................59 5.4.4 False Memory Support Associations .....................................................................60 5.4.5 Mental Health Professionals and Professional Bodies.....................................60 5.4.5.1 Traumatic memory and cognitive processes .............................................61 5.4.5.2 Preverbal trauma .................................................................................................61 5.4.5.3 The terms: Recovered, repressed and false memories.........................62 5.4.5.4 The definition in the Terms of Reference....................................................63 5.4.5.5 Concern over impact of Inquiry......................................................................63 5.4.5.6 Presentation of patient.......................................................................................64