On the last track, we discussed the ethical risks of
countertransference and an efficient way to avoid it through supervision related
to #1. unconscious assumptions, #2. inappropriate prescribing methods, and #3.
APA code of ethics.
On this track... we will discuss four ethically
questionable possible results of hypnosis. 1. clients create memories; 2. distort
existing memories; 3. incorporate cues from leading therapist questions; and 4.
incorporate therapist beliefs. We will also examine the path the client might take
to resolve their supposed sexual abuse.
According to Professor
Alan Scheflin in a talk given at the International Society for the
Study of Dissociation (ISSD) and International Society for Traumatic Stress Studies
(ISTSS) conferences in Montreal, there was a $10.6 million lawsuit settled out-of-court in Chicago for a therapist who treated Dissociative Identity Disorder, also more
recently, the U.S. government has brought criminal charges against Judith Peterson,
a Texas psychologist who treats dissociative clients. The charges allege that
Dr. Peterson, trauma therapist, intentionally created and diagnosed DID and intentionally implanted false memories in her patients in order to keep the patients in the
hospital longer, thereby providing fraudulent therapy for traumas that did not
Let us examine the technique of hypnotism
to recover repressed memories and its ethical implications. This concept was briefly
touched upon in the home study course. Ethical Dilemmas in the Use of Client's
Repressed Memories. Since there is much controversy about the possibility of hypnosis
actually generating or creating, rather than merely recovering memories of sexual
abuse the Institute felt this area may need additional specific attention.
As you probably know, hypnotism is one of the most popular
and well-known methods in recovering repressed memories. How do you define hypnosis?
Clark Hull and A. M. Weitzenhoffer defined hypnosis as "a state of enhanced suggestibility." It should be noted at this point that the Comprehensive
Textbook of Psychiatry states: "An overwhelming body of research indicates
that hypnosis does not increase accurate memory, but does increase the person's
willingness to repost or change previously uncertain memories with strong conviction."
Furthermore, the hypnotized client, according to the Textbook,
1. "has a pronounced
tendency to confabulate or create in those areas where there is little or no recollection.
2. the client distorts memories to enable these memories to become more congruent
with currently held beliefs
3. The client also incorporates
cues from leading questions by the therapist as factual memories.
there is a high likelihood that the beliefs of the therapist will somehow be communicated
to the patient in hypnosis, and incorporated into what the patient believes to
be memories, often with strong conviction."
according to the Comprehensive Textbook of Psychiatry clients create memories;
distort existing memories; incorporate cues from leading therapist questions;
and incorporate therapist beliefs. Wow, what an ethical landmine this is. Do you
#2 Hypnotism and the Distortions of Memory
on the above information from the Comprehensive Textbook of Psychiatry, "there
appears to be a high likelihood that the beliefs of the therapist will somehow
be communicated to the patient in hypnosis." What do you think? You may be
thinking "I don't use hypnotism in my sessions", but what about deep relaxation or
guided visualizations? Could you be implanting false memories or confabulations
in your client's mind and raising the ethical issue of client self-determination?
According to psychologist Robert Baker, "confabulation or false memories shows up without fail in nearly every context in which hypnosis
is employed." Granted this is a pretty all-encompassing statement. Where
do you stand on Baker's idea that, "confabulation or false memories shows
up without fail in nearly every context in which hypnosis is employed?"
other researchers observe that, "It is difficult to disregard totally the
wealth of anecdotal reports praising the virtues of hypnotic memory enhancement".
It may be possible to utilize hypnosis in enhancing real memories, but the risk
of also enhancing fantasies is always present and is an ethical question.
A Client Requests Hypnotism
So should a therapist completely deny a client's
request to be hypnotized because of its ethical risks? To consider this, one might
take into account the client's right to self-determination, as mentioned earlier,
and consider carefully this dilemma. Standard 1.02 in the NASW Code of Ethics
maintains that "Social Workers respect and promote the rights of clients
to self-determination and assist clients in their efforts to identify and clarify
their goals. Social workers may limit clients' rights to self-determination when,
in the social workers' professional judgment, clients' actions or potential actions
pose a serious, foreseeable, and imminent risk to themselves or others."
In short, self-determination is an essential feeling of control and one that the
therapist does not violate unless there are other ethical risks involved such
as a risk of self-harm.
Here in lies the rub
hypnosis, the therapist takes an active role in trying to find the memory he or
she believes exists somewhere in the client's subconscious. By purposefully attempting
to pull out memories that might not even be there, the therapist severely compromises
established ethics of over-influential treatment.
Cycle of Confabulation
the cycle begin? How does a therapist through hypnosis implant false memories?
How is it that the client came to the hypnotist in the first place? The following
is an excerpt from an interview with a therapist regarding the therapist's opinion
of a typical progression of events for sexual abuse discovery. As I am reading
this to you, see if you agree with me, that the missing step is exploring other
alternatives besides sexual abuse:
--Q. There seems to be a lot
of stories of women having been sexually abused as children. They have repressed
the memories and now it's coming out.
--A. I work so much with that.
does it start?
--A. The progression is that often there is some kind of an addictive
behavior. The client has forgotten all the sexual abuse and all they know is that
they can't stop eating and throwing up or they are addicted to alcohol. Let's
take the bulimics. Bulimia, somehow, is clearly linked to sexual abuse.
girl finds that she's eating and throwing up, so the first step is to go to OA,
Overeaters Anonymous. So she goes to OA and she gets abstinent which is the word
they use for eating what you are supposed to eat.
And then she starts hearing
about therapy and how some of the people are in therapy and they are doing inner
child work. Then she comes to a therapist like me and at this point the sexual
abuse is all blocked out but little by little we get to the abuse. But they don't
come in knowing about the abuse.
Do you agree with this
therapist that, "Bulimia, somehow, is clearly linked to sexual abuse."
I don't. But that's just the opinion of one person.
track... we discussed four ethically questionable possible results of hypnosis.
1. clients create memories; 2. distort existing memories; 3. incorporate cues
from leading therapist questions; and 4. incorporate therapist beliefs. We also
examined the path the client might take to resolve their supposed sexual abuse.
the next track, we will discuss facilitated communication and its possible ethical
misuse related to the trauma of sexual abuse.
According to the Comprehensive Textbook of Psychiatry what are four
possible results of hypnosis which may raise ethical questions regarding confabulation
of sexual abuse? To select and enter your answer go to .