Introduction

A relatively recent debate within the various fields of therapy concerns the suggestion that a history of childhood sexual abuse (CSA) is being suggested to those who in fact have no such history. Researchers such as Pope (1996) suggest that clients who accept such a history as their own are suffering from an theoretical disorder known as 'false memory syndrome' (FMS). While there is no doubt that sexual abuse occurs, and is unfortunately common (Daro, 1988, cited by Loftus, 1993), it is distressing to consider that incidences of FMS may possibly be undermining the credibility of serious reports of CSA. The main focus of the debate seems to be the concept of repression and the memory recovery techniques (such as hypnosis or dream interpretation) used to retrieve buried memories of CSA which may or may not be fabricated (see Loftus, 1993). Incestuous contact abuse is no doubt the focus of these techniques (Blume, 1990, and Courtois, 1991, cited in Lindsay & Reid, 1994), but the concern arises from observations such as Blume's (1990, cited in Loftus, 1993) that people without such traumatic recollections before seeking therapy often leave with them.

It is my contention that memory recovery techniques provide a platform for well-meaning therapists to inadvertently lead clients to believe that they were abused as children. In addition, as suggested by Ganaway (1989, cited in Loftus, 1993) these false memories could replace existing cognitive explanations for intolerable, but more prosaic, childhood trauma.

Repression

The belief in repression of traumatic events within childhood is readily accepted (Bruhn, 1990, cited in Loftus, 1993) and is the foundation for psychoanalysis (Bower, 1990, cited in Loftus, 1993). Legitimate debate concerning the concept of repression is fueled by findings that amnesia for CSA is not listed as a sequelae for its occurrence in two recent reviews (Beitchman et al., 1992, and Cole & Putnam, 1992, both cited in Lindsay & Reid, 1994), and that repression does not receive general acceptance by members of the psychiatric community (Gardner, 1993, cited by Pope, 1996). This may be due to the fact that clinical evidence at this time does not support the conclusion that individuals can repress memories of CSA (Pope & Hudson, 1995). Conversely, as Berliner and Williams (1994) point out, the fact that the exact mechanism by which repression operates has not been demonstrated nor identified in laboratory studies is not evidence that it does not exist at all. It would seem that repression is only widely accepted in the rare cases which involve actual brain damage (Gardner, 1993, cited by Pope, 1996). Otherwise, the belief is that horrible or traumatic experiences are remembered (FMSF, 1992b, cited by Pope, 1996).

One of the most frequently cited studies in reference to repression is that of Holmes (1990, cited in Pope & Hudson, 1995; Berliner & Williams, 1994; and Loftus, 1993), who asserted that in 60 years of research, no clear, clinical evidence of repression exists. Pope and Hudson (1995) argue that this finding logically suggests that the study of real-life trauma must therefore acknowledge the existence of the null hypothesis that repression does not exist. However, as Berliner and Williams (1994) point out, this finding does not reflect current interest in psychological responses to trauma.

It is interesting to note that 57 per cent of clients (as reported by their therapists) remembered apparent sexual abuse after denying it initially (see Lindsay & Reid 1994). If we accept the hypothesis that repression is in fact not a valid explanation for this phenomenon, then what is the cause? Femina, et al. (1990, cited by Lindsay & Reid, 1994) performed a longitudinal study in which subjects provided an answer to this question. It was indicated that they had earlier denied abuse for social, self-protective and self-esteem reasons, rather than actually failing to remember it. I would suggest that this is evidence in support of the claim that memories of traumatic experiences are always remembered, rather than repressed.

An area in which the argument that traumatic experiences becomes a little more complicated involves memories of incidences that occurred in early childhood. reported amnesia for CSA has been found to be much more likely with early molestation onset (Briere & Conte, in press, cited by Loftus, 1993). This is not necessarily an example of repression due to abuse, as it is well established that human recollections of early childhood are extremely poor (Loftus, 1993). Few people can recall events before the age of two or three years, and only remnants from before the age of five or six (Howe & Courage, 1993, Kihlstrom & Harackiewicz, 1982, Rubin, et al., 1986, Usher and Neisser, 1993, and, Waldvogel, 1948/1982, all cited by Lindsay and Reid, 1994). This phenomenon is known as 'infantile amnesia' (Fivush & Hamond, 1990, cited by Lindsay and Reid, 1994; Usher & Neisser, 1993, cited by Pope & Hudson, 1995). Due to the fact that infantile amnesia has also been demonstrated in rats (Spear, 1979, cited by Lindsay & Reid, 1994), it is generally accepted that it is related to developmental changes in the structure of the brain rather than repression of life experiences.

In order to prove that repression actually exists outside infantile amnesia, evidence for traumatic events and the amnesia developed by the victim as a result of these events needs to be established (Pope & Hudson, 1995). This is a goal which cannot be completely fulfilled by attempts at memory recovery, despite the apparent evidence that seems to be provided by the powerful emotional agony experienced by the client (Wylie, 1993, cited by Poole, Lindsay, Memon & Bull, 1995). As Lindsay and Reid (1994) point out, no reliable 'post-sexual abuse syndrome' has been identified, and although it has been established that psychotherapists do not intentionally focus on getting clients to remember CSA (Poole, Lindsay, Memon & Bull, 1995), they may be unintentionally attributing current problems manifested in therapy to the concept of repressed memory of CSA when in fact this is not the case (Berliner & Williams, 1994).

False memory

The aim of treatment for suspected CSA is to become survivors rather than victims by overcoming the denial that helped them tolerate abuse during childhood (Sgroi, 1989, cited by Loftus, 1993). However, the fear is that psychotherapy may be harming clients by leading them to believe that they were sexually abused when in fact they were not (see Lindsay & Reid, 1994). And in fact, studies such as Lindsay (1994, cited by Lindsay & Reid, 1994), Schuler, Gerhard and Loftus (1986, cited by Lindsay & Reid, 1994) and Weingard, Toland and Loftus (1994, cited by Lindsay & Reid, 1994) have suggested that in some instances, subjects may make eyewitness reports of very vivid and detailed recollections that in fact rely on misleading suggestions.

This translates into the possibility that therapies in which suggestive memory recovery techniques and ancillary practices are being employed, are in fact fostering the development of illusory memories or false beliefs (Lindsay & Poole, 1995, cited by Pope, 1995). Even defenders of memory work acknowledge that highly suggestive memory recovery techniques will lead some people to create such memories or beliefs (Pezdek, 1994, and Berliner & Williams, 1994, both cited by Poole, Lindsay, Memon, & Bull, 1995). Indeed, as Poole and his associates (1995) have noted, it seems that the therapeutic community is in a state of transition from enthusiasm for memory recovery techniques to concerns about the suggestive nature of these methods of reparation.

The acknowledgment of these facts has lead to the definition of 'false memory syndrome' as a condition in which a person's identity is centered around the memory of a traumatic experience which may not be accurate (Kihlstrom, 1996, cited by Pope, 1996), a definition adopted by the False Memory Syndrome Foundation (FMSF, 1995, cited by Pope, 1996). Research by those affiliated with the FMSF points towards a condition which meets all the requirements in the DSM-IV for a syndrome (Wakefield & Underwager, 1994, cited by Pope, 1996) and has reportedly reached "epidemic proportions" (Goldstein & Farmer, 1993, p.9, cited by Pope, 1996). One of the most interesting surveys by Wakefield and Underwager (1992, cited by Pope, 1996) is of 133 parents contacting the FMS Foundation who revealed that in most cases memory recovery techniques were used in psychotherapy before the accusation.

Since the indication seems to be that false memories arise during therapy, we need to first examine how these memories may be constructed to understand how the therapist may or may not influence them. Ganaway (1989, cited by Loftus, 1993) suggests that false memories could originate from either external or internal sources. The internal motivation for the creation of these memories could be the need to create a fantasy for use as a defense mechanism in which distinctions of good and evil are far more clear cut. This illusory memory could then serve as a more acceptable means of dealing with more prosaic, although less tolerable, memories from childhood in which these distinctions do not exist, leading to confusion of feelings and experiences. Once in place, these illusory memories are unfortunately indistinguishable from real ones, particularly if hypnosis was involved in memory recovery as it improves the confidence in what is recalled rather than the accuracy (Bowers, 1992, cited in Loftus, 1993). External sources would serve as evidence to support these illusory memories, a phenomenon known as 'confirmatory bias' (Baron, Beattie, & Hershey, 1988, cited by Loftus, 1993), which also might help explain the therapists continued suggestion of ideas after the initial implantation of a false belief of CSA (see Loftus, 1993). The client and the therapist are cooperating in creating a social reality as they engage in a 'self-fulfilling prophecy' (Snyder, 1984, cited by Loftus, 1993) in which a history of CSA is a part of the client's 'memories'.

Even though there is no evidence to suggest that a complete false memory of CSA can be implanted into someone that has never experienced such trauma nor produced the symptoms of posttraumatic stress disorder (Olio, 1994), the suggestion by Ganaway (1989, cited by Loftus, 1993) that more prosaic memories may serve as the basis for the construction of false memories seems entirely plausible.

The attribution of current events to memory, the fact that people use relatively poor memory source-monitoring criteria, and the fact that the illusory memory has the characteristics of a real one, are the criteria for a false memory discussed by Lindsay and Reid (1994).

Conclusion

There is often little clarity concerning whether repression is a valid explanation for memories of childhood sexual abuse being uncovered within therapy, particularly when the client originally entered therapy without any history of abuse. Evidence suggests that the explanation is much more likely to be that illusory memories of CSA have arisen due to suggestion or implantation by a therapist. It is much more probable that memories of abuse, rather than being repressed, are remembered by the victim, and the stress that results from acknowledgment of these past abuses is the reason that therapy is sought out in the first place. Although it has been established that therapists do not intentionally seek out memories of CSA, they may nevertheless lead a client towards this conclusion unintentionally. Both therapist and client will then only seek information that will support and maintain their beliefs, this being the essence of the 'confirmatory bias', and part of the reason that illusory memories can prosper in contemporary psychotherapy. The sharp distinction between good and evil supplied by the false memory of CSA will serve as a more legitimate mental screen by which more prosaic memories of childhood can be filtered and understood. The evidence presented leads to the conclusion that through an unintentional cooperation between therapist and client, illusory memories of childhood sexual abuse are being fostered by memory recovery techniques such as hypnosis, and thereby undermining the credibility of actual legitimate claims.

References

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Olio, K. A. (1994). Truth in memory. American Psychologist, 49, 442.
Poole, D. A., Lindsay, D. S., Memon, A., & Bull, R. (1995). Psychotherapy and the recovery of memories of childhood sexual abuse: U.S. and British practitioners' opinions, practices, and experiences. Journal of Consulting and Clinical Psychology, 63, 426- 437.
Pope, H. G. & Hudson, J. I. (1995). Can memories of childhood sexual abuse be repressed? Psychological Medicine, 25, 121-126.
Pope, K. S. (1996). Memory, abuse, and science: Questioning claims about the false memory syndrome epidemic. American Psychologist, 51, 957-974.