Advances in Psychiatric Treatment (1998), vol. 4, pp. 253-262 Prevention and management of false memory syndrome Harold Merskey As with most issues in medicine, the prevention and The accused person is most often the father or management of a problem is best understood when another relative. In 30% of cases in a survey the origins are known. The term 'false memory undertaken by the FMSF (1993), mothers were syndrome' (FMS) came into use in March 1992 with accused of participating in the activity, as well as the foundation of the False Memory Syndrome fathers (see Box 1). These memories do not appear Foundation (FMSF), a non-profit-making organis as a rule until the person is exposed to some type of ation established in the USA by a group of families suggestion. Some of the striking features of the modal in which one or more of the parents was accused. pattern of FMS include frequent discovery of The parents in these families were reacting to a 'memories' from before the age of three years (a phenomenon which developed in a characteristic biological impossibility); diagnoses of multiple form in the preceding decade and had become personality disorder alleged to be related to sexual common enough by 1991 for a number of them to abuse, but only discovered after the start of treat realise that they were not alone, and to join in setting ment; and bizarre claims of having been involved in up the Foundation with a professional and scientific multi-generational satanic ritual abuse, with the advisory board. breeding of foetuses or babies for sacrifice and cannibalism. The development of recovered mem ories extended to one report of being anxious in the course of passage through the fallopian tubes, Presentation claims of regression to past lives and belief in abductions by aliens from outer space. Typically, sufferers from FMS are female, usually participating in some type of psychotherapy, who report sexual abuse in childhood which it is claimed Development through has been forgotten and only recovered in adult life. suggestion Commonly, it is claimed that the alleged abuse has been repressed for periods ranging from 8 to 40 years. The individuals who attracted the most attention originally appeared to be from middle-class families Box 1. Accusers and accused and were well-educated. They entered treatment for a variety of reasons: symptoms of depression or False memories most often occur in women anxiety, poorly explained pains and other bodily Typically, repression is alleged for 8-40 years complaints, eating disorders, alcohol misuse, Fathers and male connections (stepfathers difficulties in marriage or after a divorce, bereave or brothers) are most often accused ment and so on. In the hands of therapists who In the False Memory Syndrome Foundation believed in searching for repressed memories of cases 30% of the mothers were accused childhood abuse, the individual was encouraged to recall such events. If memories did not come quickly, Harold Merskey (London Health Sciences Centre, University Campus, 339 Windermere Avenue, London, Ontario N6A 5A5, Canada), Professor Emeritus of Psychiatry at the University of Western Ontario, graduated MA, BMBCh in 1953 and DM 1965. He is particularly interested in body-mind relationships, and has published extensively on pain, hysteria and other topics including psychiatric ethics. This One APT(1998),vol.4,p.254 Merskey/Wltttvcll more pressure was exerted. Once a memory devel oped the person was told to stay away from members Box 3. Suggestive influences of the family, until they acknowledged their wicked ness and guilt, and law suits might be commenced Dream interpretation to pay for the damage done and for further therapy. Hypnosis Families were torn apart (and still are) by uncorrob Guided imagery orated evidence, based upon solicited recall by indiv Survivors' groups iduals who had had no knowledge, for 10 years or Groups for adult children of parents with more, of the events said to have taken place (see Box2). alcohol dependency The leading feature which distinguished this therapy from dynamic exploratory psychotherapy as it has usually been practised before was an insistence on the part of most of the therapists, if not methods and in these settings, the special feature is all, that the symptoms - whatever their nature - the emphasis not merely on finding material by could only have been due to childhood sexual abuse, psychotherapy, but on the therapist actively helping whether remembered or not. If not remembered, the patient to determine what shows the occurrence it had to be recovered. Sometimes this strong of abuse. Lesser degrees of suggestion include being suggestion came from reading the book TheCourage treated in regular psychotherapy sessions or regular 'therapy' sessions where the therapist expects to Heal (Bass & Davis, 1988), either before the person was participating in therapy or on the recom certain results and conveys the expectation consis mendation of the therapist. This book, which is tently to the service user; even these have been very consistently dedicated to recovering supposed powerful in producing false memories. memories of abuse and dealing with them, includes notorious statements such as: "If you don't remember your abuse you are not Spread of accusations alone. Many women don't have memories, and some never get memories. This doesn't mean they weren't abused" (p. 81) False memory syndrome is not a diagnostic category and as such, but is accurately described as a syndrome "If you don't have any memory of it, it can be hard in terms of a number of features occurring together. to believe the abuse really happened" (p. 82). As knowledge about it has spread, it has become recognised that laying claim to having discovered This book is by two creative writers with no repressed memories in therapy may hinder accept professional training in the fields of psychology or ance of allegations of sexual abuse. Hence, histories psychotherapy, and soon after its initial publication and accusations that began as claims of recovered in 1988 had sold over 750 000 copies. memory have tended to be revised, and statements Suggestive methods of treatment frequently have been made that the items in question were employed (Box3) include hypnosis, guided imagery, always remembered. dream interpretation and narcoanalysis. Group Another field in which false accusations have treatment with others claiming to be survivors is proliferated as a form of mass hysteria (epidemic common in people with FMS and includes member non-organic symptoms or ideas of illness) is found ship in survivor groups, attendance at women's in nursery day care (see Box 4) where care-givers centres and participation in groups for adult chil have been subjected to the most grave and bizarre dren of people with alcohol dependency. With these accusations and a number have been convicted. In North America many, but not all, of these cases have been overturned by now or are under appeal. If Box 2. The search for memory individuals were not convicted, their families nevertheless suffered great disruption as in the First cases appeared in psychotherapy Cleveland and Orkney cases in Britain. Pendergrast Subjects were well-educated, with well- (1997) describes a number of the most flagrant cases adjusted families in North America and the UK. Suggestions were frequent and often forceful Common sources of false accusations also include The search for memories was promoted custody disputes where children are led or per recklessly suaded into giving testimony of abuse by the parent Reconciliation was rejected and confrontation with whom they do not reside. There is reason to demanded think that the frequency of false rape allegations is also high. For example, Kanin (1994), in a small False memory syndrome APT (1998), vol. 4, p. 255 American metropolitan community, studied 109 allegations of forcible rape of which 41% were Box 4. Widespread accusations have been determined by the police to be false on the basis of made in the context of both independent evidence and confession. These false allegations appeared to serve three major func Day nurseries/pre-schools/crèches tions for the complainants: providing an 'alibi', seek Non-custodial/separated parents ing revenge and obtaining sympathy and attention. Adult accusations of rape For obvious reasons there are no good epidemio- logical data on the frequency of false accusations of various types, but the occurrence of court cases based on fantastic allegations - now ending more the perpetrator. Typically, the confrontation is set up so that the parents or other accused relatives are and more often in acquittal or in damages against the therapist's accuser - is common in nearly every told they can see their child, the child will have something to say to them, but comment in response community of more than 30 000 people across North will not be acceptable. They may be deliberately America. Pendergrast calculates on the basis of the deceived about the tenor of the meeting and then numbers of therapists who claim to recover memories confronted very harshly. If such a meeting takes actively that on a conservative estimate as many as place, the accuser may read a prepared statement 1% of the population of the USA have been given describing the abuse and the need for apology, such false beliefs and adopted them, which therefore confession and emotional reparation. Perhaps more may have disrupted at least one in 25 families. often, the split is gradual and a confrontation in It seems plausible that something similar is person does not occur, but demands are made for happening in Britain from the number of cases confession, for example, "Until you admit how coming to notice in the press, and also from the much you abused me I can have nothing more to do attitudes reported by the British Psychological with you".