Oral History Interviews of Therapists, Survivors, the Accused, and Retractors. Also available in print in

Charlotte Halpern, Psychiatrist

Psychiatrist Charlotte Halpern did not claim to be a real expert on incest survivors or multiple personalities; she deferred on those issues to authors such as Frank Putnam. She was, in fact, hesitant to allow the interview until I explained that I wasn't looking for experts, but representative therapists in the field. In her office was an interesting assortment of books, including The Harvard Guide to Psychiatry, Christianity and World Religion, The Handbook of Feminist Therapy, and The Courage to Heal. Halpern, 35, had been in private practice for several years and taught part-time at a Connecticut university. She saw about 60 patients per year.
I don't want my patients to say I violated their confidentiality, so I'll speak only in generalities. In my experience, people, typically women, are in their 20s, 30s, or 40s when something begins to trigger them to remember repressed memories of abuse. The triggers can be a variety of things. Often, they are already in therapy for some other reason and feel safe enough for other stuff to come out. Some women are triggered by TV shows. Another common trigger is when you have children the same age as you when you were abused. That often comes up. We call them “anniversary reactions.”

Others are triggered in support groups for ACOAs [Adult Children of Alcoholics] or SIA [Survivors of Incest Anonymous]. If someone else in the group is having a flashback with a heavy memory, they can get pretty shook. It's important to feel safe in a support group. One of the experts on MPD thinks groups should always be professionally led. I've had patients who had positive experiences with peer-led groups, but if someone is severely overwhelmed, the process can get out of control.

It's very scary to people when memories first come back. They don't know where they're coming from. Sometimes they have read about it and don't want to know. They think, “Oh crap, this stuff is really here,” or “This is going on and I'm losing my mind.” You can have the same feeling during regular psychotherapy, that the bottom is dropping out from under who you are. It's really frightening to think, “My unconscious knows more than I do, and I don't know what's going on.” It's a fear of being out of control.

Do I worry that I myself might have repressed memories, since I'm at the right age for them to come back? It's funny you should ask that. I was thinking about it this morning. I've had inappropriate touch and been sexually harassed on the job, but I'm not a survivor of severe sexual abuse as far as I know. I think it would have come up for me by now. I've worked on inpatient units where people were really going through heavy-duty stuff, and it would have triggered me, I think.

I realize that some repressed memories might be iatrogenic—caused by the doctor. That's why I don't usually do hypnosis, because it makes people too suggestible. And some patients are very suggestible. I let the patients discover the truth for themselves. Yes, I do suggest the possibility that they might have been sexually abused and repressed the memory. I suppose you might call that inadvertent cuing, but what else can I do? If I don't even mention the possibility, I would be remiss. I doubt that a patient would come in with no abusive background and just create a fantasy. But with someone who was severely physically or sexually abused, it's much harder to sort out whether something could look like a memory that didn't really happen.

My job is to take whatever the patient brings to me. We don't know what the literal truth is. I try to understand issues, but I'm not a court of law. I try to help them solve problems. Often they can't hold a job, can't trust men, are terribly disorganized. In other words, if someone comes in and says, “I hate my father,” I don't question whether he was an asshole. We explore it. I never find out if the guy was really a jerk or not. We will know what's true for them. My own ethical sense would be that it's true.

No, I would never bring in parents for sessions. They're not going to confess to what they did. If the trauma is severe, parents don't usually know how badly they hurt their children. The chances of getting a family together are poor. This is supposed to be a safe place for the patient, but it might not be if the family were here. In fact, before they confront their family at all, they need to process it thoroughly ahead of time. How safe are you going to feel if the perpetrator denies it? How are you going to react? What happens if the family goes and tells everyone? You have to prepare for all contingencies. I recommend they take a friend with them.

The chances are that the perpetrators were dissociated when they were abusing you. They might have multiple personalities, too. So if dissociation was involved, how can you confront them and expect to have it go anywhere? They wouldn't remember what they did.

Inner child work can be useful, but I have reservations about concentrating on it. Sometimes it can lead a therapist to becoming inappropriately enmeshed with clients. I never hug or touch my patients for that reason. Inner child work can sometimes result in a patient regressing and staying in a childish state. I emphasize that to get along in the world, they must at least appear to be adults, instead of clutching a teddy bear walking down Main Street.

Therapists have to be careful about not working out their own stuff on their clients, too. You shouldn't see people who are too close to your problems. Don't splash your own stuff into someone else's thing. That's why therapists need supervision. I pay a colleague to kick butt, to sit down on a regular basis and talk over cases. If I have a case that's particularly difficult for me, I seek advice from someone else. You know, you think, “Wait a minute, this is getting fishy. Is this counter transference?”

These cases stir up a lot of feelings. I am on my own spiritual and psychological journey. Many people come to therapy looking for meaning. “Why does shit happen to me? How can I make a life out of what God has done to me?” Like in the Book of Job. Everyone has a faith, but not everyone articulates it. What do we stake our lives on, how do we find meaning? I personally think people need to be guided by God, but I don't use therapy as a place to convert people. There are real issues I have to think about regarding my being a Christian. What if I wore a crucifix and a patient had been abused by a priest?

I don't promote the idea of multiple personalities. Patients bring it up; they've heard of it. I tell them they may possibly have MPD, maybe not—that we'll know the truth as we go along. I'm not guiding them. In my experience, the alter personalities don't have real names. A typical case of MPD can look like so many other psychological diseases, but it usually involves a trauma syndrome, depression, panic attacks, and dissociation. I try to err on the side of them telling me, not me telling them. When they do, I'd rather err on the side of believing them.

When patients first come in, they appear to be just one personality, usually the core alter. I may suspect they have a dissociative disorder or MPD if they tell me they often forget someone's name on the street when they meet them, or if they can't remember chunks of time. There's a whole constellation of symptoms. Once the patient feels safe and starts revealing different alters, they usually just “free-flow.” In some cases, I might ask to speak to a particular alter. If things are getting out of hand, I might ask to speak to everyone at once, sort of a “Now-hear-this” announcement to the assembled personalities. Some alters can hear one another; some can't. Some are just fragments of personalities. It's funny—you think you're going to be doing individual therapy, and sometimes it turns out you're doing group therapy with one person!

Some of the cases involve ritual abuse. Yes, satanic cult abuse exists and it exists here. Some sick shit goes on. In cases of family incest as well as cults, I've heard every conceivable method of shaming, hurting, and torturing people, as barbaric as Nazi concentration camps. Electric shocks to genitals, burning, hanging children upside down and raping them. Our society is good at not looking at things it doesn't want to see. That's why there's no proof. Also, cults don't want to be found.

Is there a real Devil? I have to keep an open mind. They could be worshiping something that doesn't exist. I also leave my mind open to the possibility of demonic possession. Scott Peck, author of People of the Lie, believes in it. I've personally never done an exorcism. Clinically, I just approach it from the client's belief system. If an alter says it's a demon, I say, “Okay, you're a demon, tell me about that.”

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Jason Ransom, Body Worker

In his early forties, tanned, trim Jason Ransom looked extraordinarily fit, and he was. “I'm really active, play every sport I can, and love being outside,” which was one of the reasons he lived in New Mexico. Originally trained as a masseur, he preferred the designation “body worker,” since his therapeutic touch had moved beyond simple muscle manipulation. Since the late 1980s, when a client first recalled sexual abuse during a session, more and more memories had emerged under the tutelage of his expert hands. “I have a reputation now for working with survivors, who make up half of my patient load.”
I believe it's clearly possible that people can stimulate false memories. On the other hand, I'm worried that long-forgotten trauma might get written off as false memory. Both can occur, in other words. It's quite possible to suppress the memory of that type of trauma, which will only return when the person returns to the same state, whether emotional or physical. We call these state-dependent memories. When you're in a highly psychologically disturbed state, information gets encoded into the brain and body at a certain level or frequency. Think of it like a radio band. The only way to tune in the station is to get that frequency, and then, voilà, the information comes back.

The memories are encoded on an unconscious level in the brain, and at a cellular level in the body. There's a communication system between the two that we're just beginning to understand. Sometimes the memory is stored in a tense part of the body, part of the musculature locked into an armoring protective pattern. Sometimes it's stored in an area of chronic injury, such as the low back, neck, or knee. But it can be any physical location. The body stores it, on hold, sort of like an Individual Retirement Account, ready to come out when the person is old enough.

I'm not really focused on helping people get specific memories. That's not the point to me. I want people to enjoy their bodies again, to relish in their advantages and thrills. After they get their memories out, they don't have to store them in their bodies any more. They can play sports again, garden, go bowling or fishing or whatever they've had to put away, because they thought they couldn't risk it.

I had one male client with a deep core muscle problem in his lower back, which he had strained playing football in college. In a sense, we were going back in time through massage. He started saying that he felt anxious, scared, nervous when I touched him there. He had this horrible feeling that he had been abused, and his mind kicked in to determine who it could have been. I asked if he saw an image. He just felt this presence and saw blackness. I said, “Look into that,” and he saw his father's face. During times like that, I still maintain contact, but I am not actively massaging. If I just stopped or withdrew, it would give the message that this was not okay to talk about.

A lot of therapists looking for repressed memories encourage their clients to fill in memory gaps, to put together a movie or script. I disagree with that, because mountains can be made out of molehills. These are serious accusations. But where there's smoke, there's fire. Something is going on with that client, who is psychologically distressed and has physical symptoms. But to sever relations with family, that's a terrible cost, and I don't advocate it. It really irritates me that a lot of therapists are on a kind of witch hunt. If you're screwed up, had a bad childhood, can't maintain a job or relationship, then you were automatically sexually abused. I hate that kind of interpretation, that sex abuse is the cause of every symptom. It keeps people from taking responsibility for their lives.

At the same time, we know that abuse does occur, much more frequently than anyone knew. So how do you balance it out? There's no clear way to do it. Yes, it is quite possible to be raped once a week for years and not recall it. I go back to that state-bound idea. Information is locked away in a certain compartment, and it doesn't come out until it's triggered.

Repressed memories are part of a larger pattern I see in most of my clients, who feel uncomfortable, disconnected and dissociated from their bodies. They live from the neck up, where everything is cognitive and analytical. So only part of what I do is to help retrieve memories. The bigger part is body image stuff, to help the client come to an acceptance of the body, to make wise choices about how to take care of the body in the future.

I have one current client who has retrieved memories of being sexually and ritually abused. She was working with a female therapist and already had an idea that some things had happened when she came to me. She started to retrieve memories at a rapid rate. For instance, I would pull her arm back to work on the triceps, and she would resist every time at that part of the massage. It turns out that during ritual abuse, she had witnessed another victim's arm being lifted in a similar fashion and severed at the shoulder, which explained her fear. When she was four, she remembered witnessing a girl her age being molested, killed, and dismembered. A lot of times, she wakes up at three in the morning and realizes, “Oh, my God, I know what that's about now!”

Similarly, in working with her hands, I put lotion on them. She felt that was creepy and had an image of blood being poured on her. Once she got the memory, then it felt fine to massage her fingers and hands.

That's what we mean about being free of muscle memory. Now she gets her hand and body back. The last two weeks have been great for her. Her world is so bright right now, it makes it all worthwhile. She went through a scary time when she was getting worse instead of better, when she was less able to function, but she's through that now. We held her head above water until she could tread water, and now she can hold her head up and swim strongly.

I don't say, “Yes, this happened.” I know that she believes it happened, and that's enough. Her well-being is my concern, making sure that she gets over the effects of whatever it was. Whether it was witnessing this ritualistic dismemberment or something else, she's reclaiming her body and power. That's my commitment. I don't verify that it happened, nor do I deny it. I just don't know.

No, I've never felt that I was being used by someone who wanted to get a memory, and that it was false.

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Hamish Pitceathly, British primary cause analyst

Until his early retirement in 1993, Hamish Pitceathly [his real name] was a professor of history at the Roehampton Institute of Higher Education. Since the early 1980s, however, he also practiced as a psychotherapist. Though lacking formal education in psychology, he had read widely in Freud, Jung, Adler, and others. In particular, he was a follower of the late New Zealand therapist James Bennett, who invented the “primary activation” method. Pitceathly had altered the name somewhat to “primary cause analysis” (PCA), but his approach was fundamentally the same. He believed that there are 39 basic “scenes” of sexual abuse, all repressed until recalled under hypnosis in therapy. He presumably uncovered scenes of his own when he undertook a personal analysis with Bennett in 1986. Stung by what he called “a hatchet job” in the Sunday Times (“Fanatical Therapists Train Secretly in UK,”May 22, 1994) and a subsequent television documentary, Pitceathly agreed to an extensive interview to set the record straight.

He belonged to the British Association of Counseling and the National Council of Psychotherapists. The BAC demanded to see his training manual, but Pitceathly refused, and the organization backed down. He had trained some 50 British therapists, but only 30 were then PCA analysts. Pitceathly saw approximately 90 clients a year.
Basically, I spend the first session or two just talking with clients, getting to know them. I want to know about their attitude toward themselves. Do they like themselves? Have confidence in themselves? Most people who come in say, “I lack confidence,” or “I don’t feel I’m reaching my full potential, and something is holding me back.” That opens a Pandora’s box that runs across a wide spectrum. You begin to find that if they’re feeling inadequate in one area, they feel inadequate in a whole range of areas -- relationships with siblings, parents, wives, mistresses, husband, their children. A whole range of self-doubts come up, feelings they can’t handle of one sort or another.

We all create a framework within which we function until something disturbs it. We sort of manage within it, then something like a divorce happens, and it starts pushing around the frame a bit, putting a bit more guilt on. Some people say, this framework won’t do, I must do something about it. This can’t go on. But once you start working with them, and they look change in the face, it can be rather frightening. Sometimes it’s a bit of a tussle.

After getting acquainted, we spend a session doing a long induction of a traditional kind, which is a gradual body relaxation, followed by a series of exercises. We try to keep the conscious mind occupied, perhaps by writing letters on a mental blackboard. Then we have exercises in communication, so they get used to talking to you while in a suitably relaxed state. I spend a lot of time emphasizing that they are in control of this whole procedure, it’s their analysis, not mine. I’m trying to avoid any unnecessary transference. The memories are their memories, the feelings are their feelings. Then we spend some time building up their sense of confidence in the procedure and what they’re going to do and their motivation. We use simple suggestion that they’re going to allow themselves to feel physically better, mentally more alert, feel calmer, and develop a better attitude in life.

We ask them to practice self-hypnosis in between whiles. It’s quite simple. While they are still in a relaxed state, we give them a few directions, it’s a very simple procedure. When they come round, we ask if they remember how to do it, then practice it immediately. Often when they come back for the next session, I just tell them to close their eyes and relax, and that’s it. The induction takes only a few minutes, sometimes not even that. They just close their eyes and they can switch themselves into whatever mode we want. I don’t like all the hullabaloo that goes on around the word “hypnosis.” You’re hypnotized a good deal of the time anyway, such as driving on the M1 in a trance and saying, “How the hell did I get here?”

During hypnosis, I look for a general part, maybe the part responsible for their feeling inadequate, or for feelings of rejection. For every event that has a negative significance, which we can’t resolve at the time, which we therefore have to repress, we create a defense mechanism for which a part of us is responsible. I try to get that “part” to respond. And when it is ready to do so, I ask it a yes/no question. The part responds with an ideomotor signal, one finger for “yes,” another for “no.” We establish how old the whole person was when that part came into being. Did it come into being when the whole person was a child? Was the whole person younger than 10? Most parts, I find, are already established by the time we’re five. Some are sort of put in storage as it were and triggered off by something at one stage or another. Sometimes they even precipitate events in order to operate.

I don’t use ideomotor signaling for finding out about the scene itself. I simply ask where they are, identify the time and place. I ask, “Was he playing with you?” or “Was he reading the newspaper?” Was the whole person upset by this event? Did he feel afraid? Was it fun? As one begins to touch on the area where feelings might become involved, you ask the part to allow the whole person to experience those feelings, to make contact with himself by whatever way is convenient to him, either by visualization, by feeling himself back there, and so on. I’ll say, “Tell me if you’re seeing anything or feeling anything.” Sometimes they remember it with very little emotion -- with a bald and emotionless statement.

Some people will go back and will behave as if they are really right back there. I emphasize, “You are going back as an adult sitting in this chair.” This “child within” is a marvelous metaphor, but that’s all it is. You’re asking for a lot of emotional mess with that concept. I prefer to work with an adult, even if he chooses to re-enact childhood. I treat them as adults all the time.

We stay in it, go through it, get them, once they’ve been through the entire scene, to try to find the point at which they repressed it. Bennett emphasized that the process of repression -- to change it from simple amnesia to full repression -- requires collapse (sleep, in other words) and dream. One of the major functions of dreams is to repress something, to change one reality into another symbolic representation. We have people remember the dream, because it completes the process. The dream won’t be any use any more to them, so they will stop having it.

I don’t want to go into detail about all of the scenes, but I will give you a few examples, such as a little boy whose father forces him into oral sex. Oral rape of a male could relate to the development of all kinds of characteristic behaviors, such as a feeling of being put down. After all, that’s what’s happening to him, being controlled and put in his place. He’s also often made to feel responsible for what happens because such acts are often preceded by something which is quite pleasurable. Then the child gets hurt and withdraws from the pleasurable contact.

This causes the father to go to the next stage. He loses his temper or detaches, dissociates. The word “dissociation” caught on in the late 1980s. Bennett called it detachment. So the individual detaches from conscious responsibility, then performs something automatically. Often, the child has learned to detach by this time, too. Sometimes the child recognizes when the parent has detached and therefore it detaches as a sort of safety guard. It then doesn’t feel it so badly, and then represses it. And the adult represses it too.

There’s a sort of intergenerational thing about this. Let’s say something happened to you when you were three, you were orally raped. You bury that, along with all memories of the circumstances. But it’s built into it. You have reactions to authority figures, plus a desire to get even. You may become a driver on the road who wants to beat up everyone else on the road, pass everyone, a general road raider as they call it. Then you get to adulthood and marry and have your own child. Then lo and behold, when your child is three, you see your child playing exactly the same game that you were playing when you were three, on the sitting room floor, and that tricks your mind back into the same situation that you experienced. Now the person you see playing on the floor is not your child, you now see yourself at that age.

Then you see the child not as a child at all, but as your father who did it to you. So you are then driven to do it back to him. The person you think you’re doing it to is not your child, but your father. It’s automatic behavior. You think you’re doing it to your father, but in fact you’re doing it to the next generation, and you’re making sure it’s passed on to the next generation after that. When you’ve done it, you will then walk out of the room, and you will go and lie down and go to sleep and have a dream, and you will repress it. And the dream you will have will be either the same as the dream you had when you were three or a very similar one. That’s the basic theory. And I’m afraid we’ve dug up many many many “passing-on” scenes of that kind.

Now the principle of “passing on” is well known with conscious sex abusers. It’s commonplace to say, “Oh, they suffered sex abuse themselves as children.” We’re just taking it a stage further. The subconscious scene has to be acted out with a kind of appalling logic. This gets uncovered under hypnosis. Some people may recall passing-on scenes from later in life. Some have to do with puberty, adolescence, or even post-marital activities. A parent sometimes establishes hold over a grown child by performing a sexual scene even after marriage.

My brother, who lives in New Zealand and also practices PCA, told me of a woman who used to take her child to school and would then have no memory until she found herself in a car park looking out at the sea around 11 a.m. Analysis showed that in fact she was going home to her father, having a sexual relationship with him on an automatic basis, then leaving him until she found herself in the car park. Once she recalled it, she stopped doing it. He was equally unconscious, so there was no point in confronting him. That’s why our therapy avoids all confrontation between children and parents. It’s non-productive. They are liable to confront someone who has no memory whatsoever either, and they’re not going to get it unless they too are prepared to go through the proper kind of therapy.

Most people have some sort of scene such as this in their past. Yes, this is clearly very important information. I have been worried about the right time to come forward with it. I am preparing not just one book but perhaps several, full of case histories, including verbatim transcripts. I’ve been at it for over a decade now, and as a result of the Sunday Times article, and all the other crap that came out, I went into sort of automatic mode and couldn’t take any more. It destroyed my practice for a while. But that doesn’t matter. It’s taken off again now.

One of the earliest scenes usually occurs between birth and six months old. The mother holds up the child by one leg and presses the child’s head against her genitals. This can have a large number of effects. The most important is distrust, because after all, at that stage, the infant feels the mother is the entire source of sustenance. Suddenly the whole world gets turned upside down quite literally and metaphorically, and the damned thing is nearly asphyxiated -- and in some cases is asphyxiated. Then you get a built-in distrust which begins to affect virtually everything it does thereafter in life. Others might develop a fear of heights, or claustrophobia. Also, some type of autistic reactions can probably be taken back to this kind of thing.

This often leads to a second scene when the child is a little older. The mother can’t hold it up by one leg any more, but she can sit on the damned thing on the ground. The mother is involving her own sexual organs, sitting on his face. By that age, the child is much bigger and can always breath.

She rubbishes the child. She beats it up basically. There’s no sexual gratification for her. She is too angry. The best way of making yourself angry and frustrated at the same time is to use the sexual drive and frustrate it, which is what seems to happen.

Funnily enough, the most important part of that scene is not so much the physical discomfort, which is bad enough, but the verbalization that goes on with it, which usually contains statements like, “You’re no bloody good, I can do it better myself. You’re useless, just like your father. You’ll never be any good to anyone.” You can see that if this sort of material goes into the subconscious of that child, it lays a foundation for all sorts of debasing thereafter, such as an inability to form good relationships. She makes herself more and more and more angry and gets to the point where she hits or kicks the child.

These things tend to end once the child’s resistance ends. If a child puts up a fight, she will fight harder, and she will win, of course. What appears to happen in the very early scene, the child learns detachment by blacking out in the earliest scenes. Having learned how to black out, by the time the second one occurs, subconsciously it remembers that when it blacked out, it all ended. So in this case, it just detaches and goes within. It can’t black out because it can still breathe, but psychologically it can make a dissociation or detachment, and at that point, it all ends.

I see this sort of thing over and over again in my practice. We stand accused, of course, by those who don’t want to know anything about it, of implanting ideas in people’s minds, but I’m afraid we don’t. I would fight that one right the way down the line. Actually, we waste an awful lot of patients’ time making sure we are not leading them. There’s no reason why you shouldn’t have a damned good idea what’s there simply on the basis of your own experience of the type of material the patients give you.

I mean, if I go to a doctor, and I say, “Look, doctor, I’ve got a bloody awful headache,” I would expect him to give me some kind of diagnosis. After appropriate tests, I would expect him to say, “You may have a tumor,” or “You may just have a hangover.” Similarly, someone comes along to me and says, “I have this whole range of feelings.” A symptom is a symptom but once you start putting symptoms together with many others, you can begin to suspect. So in fact, I would regard myself as incompetent and irresponsible if I did not look out for things and satisfy myself that they weren’t there.

If I start looking to see if a particular event is there, I will camouflage my activities until I’m almost black all over, as it were. But Bennett would go about it in a much more direct way. I have used his ways in the past, and with those with whom you establish a resonance, the scene will come out, even though the approach itself describes nothing. On the other hand, those for whom there is no resonance bring up nothing. In principle, yes, you could ask directly if the mother held the child up by the leg, and if there were no resonance, they would simply say “No.” I would only do this with someone I had worked with for some time.

Say we’ve already taken out a fair number of scenes, in which case, that client has trust in me, and I have trust in that client. I will get them relaxed and say something like, “I want to look and see if something happened to you below the age of 10. Perhaps you were ill and at home. Let’s just imagine that you’re in bed, and your mother’s come to look after you and give you a bowl of soup and wipe your face.” That may not be the right scene at all, but I’m afraid if that’s what I’m looking for, usually it is. But someone may say, “No, no, it’s not there at all, I’m on the settee, I’ve been allowed to get up and watch television.” And they’ll take it on from there. Or they may say, “No, I’m afraid there’s nothing there at all.” And by that time, we have enough knowledge of each other, I’ll say, “OK, fine, leave it.” But at least I’ve checked it out.

The topic of false memory comes up. People want to talk about it, so we talk about it a bit. I don’t accept the automatic assumption that any material brought up in hypnosis is false. I keep an open mind. I must admit, on some occasions I wonder whether what I’m hearing is necessarily actually totally true. I adopt a pragmatic attitude. I mean, if, if, IF, IF, with a big if, it turns out to be fantasy, well then it’s just as well the fantasy’s brought out, isn’t it? Because it’s clearly being used for some purpose or another. But on the whole, I’ve never myself in the end found any reason to doubt the stories people tell me.

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