HYPNOTHERAPY THERAPHY IN TURMOILTHE MEMORY CONTROVERSY

A HERALD SERIES

RICHARD GUILLIATT

A two-week course is all it takes to set up shop as a hypnotherapist - there are no regulations.Now experts are worried about the dangers of placing vulnerable minds in the care of inexperienced hypnotists. RICHARD GUILLIATT reports, in part two of a three-part series.

MS C is a 21-year-old woman who has come to a hypnotherapist to solve a mystery about her past. Her sister has accused their father of being a sexual abuser, but Ms C cannot remember the events her sister describes from their childhood. Could hypnosis unlock such a memory? "I am asking you now ..." says the therapist early in their first hypnotherapy session, "... whether you are a witness in the past to any impropriety that your father may or may not have committed towards your sister?" "No," replies the hypnotised woman. But as the session continues and the therapist repeatedly refers to the allegations madeagainst her father, Ms C undergoes a remarkable change of perspective, shifting from having no recollection to "recovering" a memory of something happening on a bed at her home many years before.

In her second and third hypnotherapy sessions, these memories begin to take shape, and as details emerge from a decade previously the therapist's tone has become more encouraging.

"It's worth it to expose whatever information is there, that you've been through ..." he urges. "Something that you previously, possibly, blocked off from your mind. Tried to ignore but for (your sister's) sake, for your sake and, strangely enough, for your mother's sake, you don't want to ignore it any more." By the end of the third session, Ms C is recounting detailed sexual encounters between her father and sister, and her therapist's tone has become congratulatory.

"Your subconscious mind is a memory bank and you can entrust a third party to help you resolve all that you've seen ..." he assures her. "So through Jesus Christ you can pray for this, that these issues be resolved for yourself, as a previous victim and now a survivor (and) for your sister, the victim but hopefully a survivor, through the grace of Jesus Christ ... I'm going to count from zero to five. On the count of five you will be wide awake, feeling really good ..." Professor Kevin McConkey, head of the school of psychology at the University of NSW, first heard the tape-recorded transcripts of this therapysession in his capacity as head of the Australian Psychological Society. The tapes came from a prosecutor who was mounting a criminal case against Ms C's father and wanted Professor McConkey's opinion about the reliability of her corroborative evidence. Ms C was convinced that the memories she had recoveredunder hypnosis were reliable, and her hypnotherapist assured police he had not used any leading questions or suggestive techniques during the counselling. Professor McConkey disagreed on both points.

To this day, Professor McConkey does not know how the case was resolved. But he cites it as an example of how a well-meaning hypnotherapist can help a patient recover vivid and explicit "memories" from childhood, which are extremely dubious in their reliability.

Hypnotherapy has never been regulated in NSW and today it is practised by hundreds of counsellors with wildly varying qualifications and belief systems, from fully qualified psychiatrists to medically unqualified "lay" hypnotists such as the one who treated Ms C. But the controversy about false memory which is now sweeping through the therapy professions has reactivated a debate about the damage that might be resulting from this laissez-faire policy.

Seven years ago, when the NSW Government introduced laws requiring minimum qualifications for psychologists, controls were proposed on hypnotherapists. But those proposals were withdrawn at the last minute, and NSW remains the only State which has not legislated to regulate hypnosis. That means anyone can set themselves up as a hypnotherapist, with no requirement for registration or professional monitoring of their work. A two-week course is enough to earn you an impressive diploma to hang on the wall of your rented suite. The only equipment required is a chair for your patients.

Sydney's hypnotherapists are a diverse bunch. Beverly A Bultitide, a Caringbah therapist, is a psychic who specialises in hands-on healing. Akash Olver, a qualified psychologist, uses hypnosis to explore his patients' "past lives". Denis Timothy Burke, who was disciplined by the South Australian Medical Board in 1979 for making inappropriate sexual remarks to his patients, has acknowledged using hypnotherapy in his past-life counselling. Mr Burke practises in Parramatta, apparently without complaint. These are all long-standing practitioners in NSW, but there is also a high turnover of others judging fromthe listings in the Sydney Yellow Pages. Of about 150 hypnotherapists who advertised three years ago, 70 are no longer listed.

"For some people who call themselves hypnotherapists, NSW is quack heaven," says Carol Boland, a psychologist who specialises in professional supervision of therapists. Ms Boland is particularly concerned about poorly trained therapists, who operate independently of the major organisations.

"The standards that exist all over the place are questionable as far as I am concerned," says Leon Cowen, a practitioner for more than 15 years and head of the Academy of Applied Hypnosis in the city.

"I'm surprised the Government has not done something before this," says Dr Alan Fahey, a medical practitioner, hypnotherapist and co-founder of the College Of Medical Hypnotherapy in Westmead. "I think most hypnotherapists have expected that at some stage the Government will regulate hypnotherapy in NSW. I think it's seen to be inevitable." Ironically, the reputation of hypnosis has markedly improved since the 1960s, when its image was largely based on sinister horror movies or stage shows in which hapless audience members were induced to cluck like chickens. Hypnosis is now used by many psychotherapists,psychologists and even some surgeons, most remarkably in the case of Dorothy Sayers, an Australian woman who had a gall-bladder operation under hypnosis without any general anaesthetic.

Hypnotherapists mounted a spirited campaign against the regulation of their business in 1988, arguing that hypnosis itself has never been shown to be harmful. While that is technically true, the "recovered memory" debate has highlighted just how dangerous poorly trained therapists can be when therapy aims to recover memories buried deeply in the past - particularly if those memories involve criminal acts such as incest.

People under hypnosis can be extremely vulnerable to suggestion, a phenomenon the hypnosis expert Dr Herbert Spiegel demonstrated on American television in 1968, when he convinced a man under hypnosis that radio and television stations across the US were under threat of communist takeover. When the man came out of hypnosis, he began describing the communist plot in elaborate detail, before Dr Spiegel hypnotised him again and erased it from his thoughts. This "honest liar" phenomenon has enormous implications for people who go to a hypnotherapist seeking to explore possible childhood traumas.

"People under hypnosis become far more confident that what they are remembering is true," says Lindsay Yeates, of the Rose Bay Hypnotherapy Centre. "There's no clear evidence that they actually remember anything more under hypnosis than out of it, but they may be 10 times more confident about what they remember." How many therapists use hypnosis in their "recovered memory" work is impossible to estimate, but anecdotal evidence suggests a significant number. A survey of 869 US therapists by the psychologist Michael Yapko found that more than half used it. Hypnosis has played a central role in the "discovery" ofMultiple Personality Disorder (MPD), a condition usually exhibited by women who claim to have recovered memories of childhood Satanic abuse. Dr Richard Kluft, one of America's leading proponents of MPD, held a seminar in Melbourne last year in which he taught hypnotic techniques for therapists dealing withrecovered memories of abuse.

The reliability of memories recovered during hypnosis is a source of great dispute and misunderstanding. Mr Yapko, for instance, found that almost half the US therapists he surveyed believed hypnosis memories were more reliable than ordinary memories, even though this has never been proved. Almost one in five falsely believed that people cannot lie under hypnosis, and more than half believed that hypnosis could be used to recall events "as far back as birth".

Many psychologists and psychiatrists argue that hypnosis should only be used by professionals with years of medical training. "There is no such thing as hypnotherapy," argues Professor McConkey. "Hypnosis is a useful therapeutic adjunct for some people and some disorders, some of the time. It is not an independent therapy. It should not be used for all people and all disorders and it definitely should not be used all the time." Some medically qualified hypnotherapists have, however, been disciplined in NSW. Dr David Collison, a Chatswood hypnotherapist who wrote the book Understanding Hypnosis and was apast president of the International Society Of Hypnosis and Psychosymatic Medicine, was struck off the medical register in 1991 for supplying drugs in exchange for a sexual relationship. Dr Collison did not dispute the charges and was found to have committed "gross errors of judgment", although there is nosuggestion that any further complaints have been made about him. And last December, Dr James Jackson, another Chatswood practitioner and author of the book Stress Control Through Self Hypnosis, was found guilty of professional misconduct after a woman claimed they had a sexual relationship during hertreatment for depression.

Hypnotherapists argue that psychologists and psychiatrists simply want control of a lucrative market. Lindsay Yeates believes medical practitioners are more prone to inducing false memories because they often dabble in hypnotherapy without having full training. He recalls being horrified by an authoritative 600-page guide put out by the American Society of Clinical Hypnotherapists which laid out highly suggestive techniques for helping Satanic ritual abuse victims "recover" their memories of abuse.

"According to my information, there is not one false memory court case in the US, Canada, or Australia against a lay hypnotherapist," Yeates says.

That might be true, but anyone wanting to complain about a lay hypnotherapist in NSW would have run up against a major problem in the past few decades - there was no independent body to complain to. Until last year, the Healthcare Complaints Commission had no jurisdiction over the conduct of "alternative" practitioners such as lay hypnotherapists.

Instead of a central body such as the Psychologists Registration Board, hypnotherapy operates under a dizzying array of competing bodies - the Australian Society Of Hypnosis, the Australian Society Of Clinical Hypnotherapists, the Australian Society Of Hypnotic Examiners, the Australian Hypnotherapists Association and the Society of Therapists.

These bodies are the most estblished in the field, but they often give accreditation to hypnotherapy schools with which they are closely linked. Hence the NSW School of Hypnotic Sciences is approved by the Australian Society Of Clinical Hypnotherapists (ASCH), which shares the same address as the school. The Brice-Wright School of Professional Hypnotherapy is accredited to the Centre For Analytical Hypnotherapy Research and Training (Australasia), which is run by Gregory Brice and Frank Wright. Leon Cowen's school, the Academy Of Applied Hypnosis, is accredited to the National Council For Experiential Therapies, anew organisation which Mr Cowen is helping to establish.

Elizabeth Carmen, honorary secretary of the ASCH, acknowledges that she is also the registrar of the NSW School For Hypnotic Sciences, that the two organisations share the same address and that many graduates of the school join the society, but she says the two organisations are "totally separate". Greg Brice agrees that there is an "incestuous" relationship between his school and its accrediting body, but says that is simply because CARTA is still in its infancy. And Leon Cowen argues that although he is a key member of the Council For Experiential Therapies, which accredits his school, he was not actually afounding member of the council.

Little wonder that attempts to amalgamate these associations or impose uniform minimum qualifications have frequently fallen apart, most recently last year when Mike Usher, of the Australian Hypnotherapists Association - the longest-established and most stringent professional body - tried to organise a self-regulating umbrella group for the industry. Many hypnotherapists admit that an agreement between all these competing interests is highly unlikely. So the ideal of a self-regulated hypnotherapy industry looks quite a way off. That's the problem with self-regulation: unlike hypnotism, it is very difficult toinduce.

CAPTION: Illus: Reform advocate ... Mike Usher, of the Australian Hypnotherapists Association - the longest-established and most stringent professional body - with a patient seeking stress-relief and relaxation. Photograph by SAHLAN HAYES

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FREUDIAN SLIP
THERAPY IN TURMOILTHE MEMORY CONTROVERSY

Richard Guilliatt

Has the triggering of childhood memories by therapists been a mistake? Concluding this series RICHARD GUILLIATT explains the explosive debate that threatens the very foundation of modern therapy. ... they keep on maintaining that this time nothing has occurred to them. We must not believe what they say, we must always assume, and tell them, too, that they have kept something back ... We must insist on this, we must repeat the pressure and represent ourselves as infallible, till at last we are told something ...

SIGMUND Freud wrote these words almost exactly a century ago, expressing ardent faith in his ability to dredge up repressed memories that even his patients had difficulty finding. The edifice of psychoanalysis was built on this theory of "repression", yet Freud himself soon developed such doubts about the reliability of his patients' memories that he developed his infamous Oedipal theory - that his patients' "memories" of incest were actually subconscious incest fantasies.

One hundred years later, doubts about repressed memories have returned to haunt the psychotherapy profession, but this time the implications are far more explosive. The recovered memory debate is already assuming the proportions of a major crisis for psychotherapy in the US, where a slew of lawsuits now accuses therapists of implanting false memories of incest and causing immense damage to patients and their families. More than 300 people claim to have been induced by their therapists into believing false memories of childhood abuse in the US, and the validity of recovered memory therapy has been attacked in at least 10 bookswritten by psychologists, sociologists and journalists over the past two years.

In Australia, where therapy and litigation are less popular pursuits, the impact of this controversy is not clear. But barely 18 months after the debate first appeared in the media, many therapists acknowledge it raises fundamental questions not only about their work, but about issues of victim compensation, the legal statute of limitations and the regulation of non-registered therapies such as rebirthing, kinesiology and bodywork.

"I would say the implications run deep," says Professor Don Thomson, former head of the Victorian Psychologists Registration Board and now a professor of psychology at Edith Cowan University in Western Australia. "I think to some extent it confronts psychologists and psychiatrists with the whole notion of whether the most effective therapy is taking a person back to their childhood as a means of healing ... That has been brought into sharp relief because of what has been happening with Satanic abuse and sexual abuse claims, because clearly the consequences of what is being alleged are so far reaching." Sandra Pertot, aNewcastle psychologist critical of the indiscriminate acceptance of recovered memories, agrees. "It does strike at the heart of what we are doing. For us now, the ramifications are much, much broader than sexual assault issues: how do we know what to believe and what the appropriate therapy might be?" A lawyer aswell as a psychologist, Professor Thomson believes recovered memories issues could have significant impact on statutes which prevent legal action once a certain period of time has elapsed. He believes a recent High Court appeal case, in which a woman was granted an extension of the statute because her recoveredmemories of sexual abuse dated from decades previously, has already set a precedent in compensation cases. The NSW Victims Compensation Tribunal, which is considering a dozen claims for compensation based on recovered memory, is already wrestling with these issues, says registrar Keith Ferguson.

Like many medical professionals, Professor Thomson is also disturbed by the proliferation of alternative therapists and pop psychology practitioners who have waded in to "diagnose" childhood abuse over the past 10 years without the benefit of formal training in psychology or memory. In one criminal case currently on appeal before the NSW Supreme Court, a man is claiming he was sentenced to six years' jail partly on the basis of a memory "recovered" by his accuser after she had a single session of kinesiology.

Kinesiology is one of the many forms of "body therapy" that have become popular as the public has turned away from traditional psychology and psychiatric treatments in search of more holistic healing. Body therapy, which some psychologists are also beginning to practise, is based on the theory that past traumas can manifest themselves in muscles and other physical symptoms years later.

In recent years, Australia has also been visited by several "inner child" gurus, most notably John Bradshaw from the US, who has spawned a worldwide movement based on the theory that almost all psychological problems can be attributed to abuse and neglect suffered during childhood. Alternative therapy is so popular that more than 55,000 people around Australia attended last year's touring Festival For Mind, Body and Spirit.

Professor Kevin McConkey, head of the psychology department at the University of NSW, points out "there is money involved in this". "There is nothing to prevent you from advertising in Saturday's Herald a workshop called `Find The Scared Child In Your Life', charging $250 a head for a one-day workshop," he says. "You'd get enough people signing up to convince you to do it again." The unregulated nature of alternative counselling is best measured by the fact that several former medical practitioners, who were struck off the register for sexual misconduct, now operate quite legally as psychoanalysts or counsellors.To give one example: in 1991 a psychiatrist was found to have had sexual contact in his consulting rooms with a woman patient who sought treatment for severe depression. The former psychiatrist, whe denied the charges and accused the woman of having a borderline personality disorder which might have caused her toimagine the sexual assault, now advertises himself as a counsellor specialising in marriage and personal relationship problems.

Regulating alternative practitioners would involve large amounts of government money at a time when deregulation has become the catchcry of bureaucracy. A civil libertarian, Professor Thomson says he would prefer to see a campaign of public education rather than a draconian crackdown on everyone labelling themselves counsellor or therapist.

Psychologists and psychiatrists are quick to point out the failing of the alternative therapy industry, but they have been less speedy in recognising the issue in their own back yard. The Australian Psychological Society issued guidelines on recovered memory late last year; the Royal Australian and New Zealand College Of Psychiatrists is still "considering" whether it needs to outline a position. Yet it is clear from court cases overseas that fully qualified professionals have been as prone to believing dubious memories as their New Age inferiors.

"Therapists, like many other people, get caught up in fads," says Professor McConkey. "And one of the problems in getting caught up in fads is that you start to apply it everywhere ... In part, the tendency to look for abuse has that faddish quality to it. I know of many clients who are coming to therapists and saying: `I have this problem and I think it might be because I was abused when I was a child - can you help me find out whether that's true or not?' "One of the things that is very clear is the tendency for people to move away from personal responsibility for their problems," he adds. "If I can blame it on apast life, if I can blame it on alien abduction or something else other than my miserable self, that can be pretty appealing." Many sexual assault and child abuse workers say false or unreliable memories are a relatively minor problem that is being blown out of proportion as part of a political "backlash". But anincreasing number of therapists believe the phenomenon has been far more widespread over the past decade than previously acknowledged.

"I suspect that it is really quite extensive," says Carol Boland, a Sydney psychologist with seven years' experience in sexual assault counselling. Like others, Boland sees the widespread acceptance of Satanic ritual abuse "memories", which frequently involve torture and murder as an indicator of how many sexual assault workers and therapists have been prone to believing dubious memories.

Boland recalls that in her early years of practising she saw a sign in a rape crisis centre which said "Always Believe" - a credo aimed at repudiating society's previous denial of rape and sexual assault. But she is concerned that this credo has led many social workers and sexual assault counsellors to adopt an uncritical attitude to stories which have no supporting evidence beyond the fervent, but perhaps misguided, belief of the client.

"Disbelief disenfranchised so many sexual abuse survivors, and for many therapists now, absolute belief in the truth of what their clients tell them has taken on the status of a ground rule. But in some cases it's vital to differentiate between the sincerity of our clients and the actual reality of what they believe." Sexual assault counsellors often ask the rhetorical question: why would a woman make up a story of incest and risk destroying her family? Dr Jerome Gelb, a Melbourne psychiatrist who has treated nine women who had "memories" of Satanic ritual abuse, believes people suffering depression,eating disorders and other inexplicable conditions may seize on child abuse as a simple, all-encompassing explanation for their problems. Dr Gelb was disturbed to see how his patients became increasingly depressed and suicidal as they were "counselled" by outside support groups and therapists who reinforced theirgenuine belief in their abuse.

"I met one of these therapists," he recalls, "and she told me there was a worldwide conspiracy of Satanists, that people were programmed from birth - the idea being to create an army of of Manchurian Candidates, automatons who on cue in 1999 would kill the appropriate people and then basically take over. This included members of the police force and judiciary, prominent psychiatrists and politicians, some of whom were named." Dr Gelb has since become one of the most outspoken critics of recovered memory in Australia, arguing in the pages of Australiasian Psychiatry that therapists have done untold damage by using highlysuggestive techniques to induce false beliefs in their patients.

Psychiatry and psychology have had previous crises, of course, most notably with the publication of Jeffrey Masson's book Assault on Truth a decade ago. But Masson's book was a scholarly attack on Freud. The recovered memory debate is about families being torn apart by false allegations of incest; it's about issues of memory and repression which are foundations of psychoanalysis. And already it has shone an uncomfortably bright light on the inner workings of the therapist's office.

In a Supreme Court trial in WA last year, two women accused their father of committing 25 years of sadistic sexual abuse which they said they forgot until they went into therapy. A therapist who treated the women, a clinical psychologist with more than 20 years experience, testified that he believed the women's stories of ritualistic abuse and torture, and that the father, mother, brother and uncle of the women might be refuting the charges because they were in denial. Professor Don Thomson, testifying for the defence, criticised the therapist for making such a diagnosis without supporting evidence.

If critics like Dr Gelb and Boland are correct, the cruel ironies of the recovered memory debacle will resonate for years. Not the least of those is that the feminist campaign against sexual assault might have been partially derailed by the theories of Freud, one of history's greatest male chauvinists. Or that "therapy" itself will stand exposed as a source of untold suffering. But perhaps the cruellest irony is that the fight against child abuse - the worthy crusade at the root of the controversy - will have suffered.

Dr Edward Ogden, a Melbourne forensic specialist who has helped investigate many reports of Satanic ritual abuse, already sees evidence of this. "The backlash from this epidemic (of false allegations) might well be to the detriment of people who really are suffering proveable abuse of one kind or another," Dr Ogden says. "Every time someone is found to have been making outrageous and outlandish allegations, someone who is making genuine allegations somehow misses out." Four books on repressed memory syndrome will be reviewed in Spectrum tomorrow.

CAPTION: Drawing: by Suzanne White