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Section 2
Track #2 - 5 Ways False Memories are Generated

Ethics CEU Question 2 | Ethics CEU Answer Booklet | Table of Contents | Boundaries CEU Courses
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On the last track, we discussed how false memories may be generated and several ethical dilemmas to keep in mind when you suspect a client may be under the influence of a false memory.

On this track, we will examine ethical dilemmas that occur when determining whether or not a client has fabricated a memory.

5 Ethical Dilemmas

Share on Facebook Dilemma #1 - Fallacies of the Client
One dilemma inherent in false memory generation is the client's unwavering belief in the memory itself. Consciously, they are not lying, but relating memories. The memories themselves, however, may be false and lead to the client to draw false conclusions.

One such client, Marie age 33, was the first to suggest she might have been molested as a child. Marie went through three therapists, who all were convinced of her childhood abuse. Marie recalled wanting to bite down and clench her teeth. Soon her entire body was reacting: first, a few of her limbs would go numb, and soon she felt a heavy weight on her chest. One of her therapists diagnosed her as going through post traumatic stress disorder.

Interestingly enough, before feeling these symptoms of depression and bodily reactions, Marie had experienced a miscarriage. However, once the idea that sexual abuse was introduced, the possibility that the miscarriage was responsible for her post-traumatic stress took a secondary emphasis and repressed childhood sexual abuse was immediately focused upon.

Think of a client you are currently treating and the directional role you take in your sessions. Could you be violating an ethical boundary by being too directive?

Share on Facebook Dilemma #2 - Misconceptions about Functions of the Brain
In addition to the dilemma created by a client's unwavering belief in the memory itself, a second dilemma arises when we consider the belief that the brain remembers every single experience to ever happen to a person. Contrary to this belief, according to Bartlett the brain does not function in such a manner.

Bartlett, a memory researcher, states that the widely held view of this kind must be discarded. He states that remembering is "an imaginative reconstruction, or construction, built out of the relation of our attitude toward a whole active mass of organized past reactions or experience." When considered this way, the idea that all memories are infallibly recorded is disproved.

Share on Facebook Dilemma #3 - Recovered Memories Highly Colored by Emotions
A third dilemma to take into account is the fact that your client's versions of his or her personal past are highly colored by their emotions and family myths, as you are well aware. After recalling a significant memory of her childhood, Sue admitted that her memory was faulty. She stated, "My sister Liddie says it's her memory. One that she told me later. But it seemed so clear to me, like a picture, I could have sworn this was exactly what happened." Sue's memory was unknowingly influenced by her sister's story. As you can see, any client could be manipulated by outside stimuli.

Share on Facebook Dilemma #4 - Memories Can be Changed by Current Beliefs
Fourth, in addition to unwavering beliefs; the belief that the brain remembers every experience; and manipulation by outside stimuli, as you may already know, many clients who can rewrite their past to make the events match their current attitudes and opinions. Memories live with interests and change with them. Have you ever considered that clients might be internal novelists?

In order to give life purpose, it is possible to reshape the past to fit to currently held beliefs. So could it be possible that your clients, who have the idea of sexual abuse in their head, could shape their memories to fit identified maladaptive behaviors? In this way, they can explain their symptoms with relatively little invasive therapy. A quick solution means sparing oneself the hardship of more therapy.

So the ethical tightrope to walk here is how can you manifest client self-determination in a session given the information above regarding client's possible faulty, unwavering beliefs; the belief that the brain remembers every experience; manipulations your client's may have experienced by outside stimuli; as well as your client's conscious or unconscious efforts to rewrite their past based on their current attitudes and opinions. It's sort of like trying to build a house on quicksand with no stable supports and very shifting conditions.

Have you ever had the compulsion if even just for an instant to terminate a client whom you feel has been blatantly and intentionally misrepresenting facts during the session?

Share on Facebook Dilemma #5 - Consulting with Colleagues
These fleeting thoughts, or perhaps not so fleeting may occur to you, especially in the case of a sexually abused client where the stakes are extremely high, for example, jail terms and custody rights. Have you ever felt that you have been duped, manipulated, or have been used as a pawn between dueling parents over custody with perhaps false accusations of sexual misconduct with the child? Perhaps it hasn't happened to you yet, but if it is discovered that your client has fabricating their stories, especially when months of therapy have already gone by, let's talk about the specifics of client abandonment.

As you are most probably aware, by terminating the client you may be violating the client-therapist bond by not doing all in your power to repair the relationship. Professional codes of ethics states, "The therapist should take reasonable steps to avoid abandoning clients who are still in need of services. The therapist should withdraw services with caustion only under unusual circumstances, giving careful consideration to all factors in the situation and taking care to minimize possible adverse effects." It goes without saying, if you should abandon the client prematurely, this could result in a relapse in symptoms. This could also lead to allegations of abandonment.

Share on Facebook Seven Ethics Criteria to Keep in Mind before Terminating Services

However, if you are considering terminating services with a client, for whatever reason here are seven criteria to keep in mind:
Criteria #1 - Consult with colleagues and supervisors about a decision to terminate services. In some cases, termination can be prevented by addressing relevant issues.
Criteria #2 - Give as much advance warning as possible to clients who will be terminated.
Criteria #3 - Provide clients with the names, addresses, and telephone numbers of at least tree appropriate referrals when it is necessary to terminate services.
Criteria #4 - When clients announce their decision to terminate prematurely, explain to them the risks involved and offer suggestions for alternative services.
Criteria #5 - Follow up with a client who had been terminated. If he or she does not go to the referral, write a letter to the client about the risks involved should she or he not follow through with the referral.
Criteria #6 - Provide clients with clear instructions to follow and telephone numbers to use in case of emergency. Include a copy of these instructions in their case records. Ask clients to sign this copy, indicating that they received the instructions and the instructions were explained to them.
Criteria #7 - Carefully document in the case record all decisions and actions related to termination of services.

On this track, we discussed dilemmas in determining whether or not a client has fabricated a memory, as well as seven ethical points to consider when terminating a client.

On the next track, we will examine the various sides of the argument regarding repressive memories.

Ethics CEU QUESTION 2
What are four factors contributing to you client's creation of a false memory? To select and enter your answer go to Ethics CEU Answer Booklet.

 
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