Ethical Boundary Considerations and Repressed Memories of Sexual Abuse

As with the study of memory, some recovered memory experts have argued that empirical research on hypnosis has little or no meaning for the practice of recovered memory therapy because memory of trauma is fundamentally different from other memories. On its surface, this argument makes a certain amount of intuitive sense. Memories of being awakened at night by a loud noise, after all, are not the equivalent of memories of being raped. It should be noted, however, that the research showing the suggestibility of hypnosis and its ineffectiveness in uncovering accurate memories has for years been applied to the question of whether hypnosis should be used in a criminal investigation-where victims and witnesses have often experienced trauma. Researchers have noted that when the subject of the memory is highly charged or the subject more motivated to remember-to identify a suspect of a crime, for instance- hypnosis may increase the inaccuracy of the memories retrieved. According to Bowers and Professor Ernest Hilgard, of Stanford University, research shows that hypnotically refreshed testimony should be corroborated independently: "In effect, this means that under hypnosis a person's associative networks are activated in a manner that is minimally or remotely tied to external reality constraints, and maximally responsive to a person's idiosyncratic mnemonic themes, imaginings, and fantasies. In other words, it is precisely under hypnotic conditions that we are apt to learn more about a person's idiosyncratic and imaginal contributions to memory reports, and less about the specific external events he or she is trying to recall." The overwhelming bulk of both the laboratory and field reports suggests that memories of witnessing or being victim to violent crimes are at least as susceptible to manipulation and confabulation during hypnosis as other, less disturbing, memories.

In addition, some researchers have indeed created in test subjects highly traumatic "memories." However, instead of building false beliefs about the subjects' childhoods (which would be grossly unethical), researchers convinced subjects that the "memories" they were to experience under hypnosis would be from previous incarnations. Using past-life ruse, experimenters managed to avoid the possible damage to the client of suggesting traumatic memory-belief for the person's actual childhood. Because past-life regressions tend to deal with traumas and death in a supposed former life, the technique dramatically illustrates that hypnosis can create believed-in "memories" of trauma.

In the most applicable study, Professor Nicholas Spanos and his colleagues at Carlton University, Canada, tested subjects selected for their hypnotizability to see whether they would conform to the suggestion of abuse in a past life.'5 Two groups of subjects were used. Before past-life regression, one group was told that people who lived in past times had much more abusive childhoods, and that the purpose of their past-life experience was to find out more about abuse suffered by children in previous generations. The other group of subjects was prompted with information that said nothing about child abuse. A series of questions was asked of the subjects during their hypnotically induced past-life fantasies, including: "Have you ever been abused by one or both of your parents?" followed by "Have you ever been abused by any other adult?" Those who said yes to either question were asked to elaborate. The responses were then rated for severity by two researchers uninformed of the purpose of the study.

The results were interesting for two reasons. First, there was no significant difference between the two groups in the number who reported abuse in their past-life fantasy. Eleven out of 14 in the abuse-prompted group said they were abused, as did 11 out of 15 of the group that was given no suggestion about the abuse. The researchers found, however, a significant difference in the severity of the abuse "remembered." The researchers concluded that the group that was given the suggestion that they were looking for abusive experiences "recalled higher levels of abuse when enacting their past-life identity than did the corresponding subjects in the [other group]." They concluded that "These findings are consistent with anecdotal reports indicating that clients in psychotherapy sometimes confabulate complex and extensive pseudomemories that are consistent with the expectations help by their therapists." The fact that there was no significant difference between the groups in their initial report of abuse is perhaps not so surprising when one considers that the questions themselves might have functioned as implicit suggestions. After all, a full three quarters of both groups confirmed that they were somehow abused in their past-life childhoods.

In three other studies reported in the same paper, researchers found that they could greatly influence the subjects' confidence in the truth of their regression memories by attesting to their own faith in the concept prior to hypnosis. When the hypnotist prepped the subject by suggesting that his or her trip to another lifetime would most likely be true, the subject would have a significantly greater likelihood of reflecting that belief after hypnosis. "Subjects with equally intense subjective experiences of a past life tended to interpret these experiences as actual incarnations or as fantasies, depending on the . . . context provided by the hypnotist."

Regardless of even this evidence, Herman's objection that memories retrieved in the laboratory are distinct from those retrieved in a clinical setting should, perhaps, not be dismissed so quickly. No one in the laboratory has ever attempted what we believe is happening in therapy settings. Like all good scientific tests, what the experiments surrounding hypnosis are clearly intended to do is establish unambiguous causation. This requires that the experiment be boiled down to very small, controllable variables. Done well, however, these experiments allow the researcher to say with assurance that one variable was responsible for changing another. To apply the results of these experiments to the real world requires careful extrapolation. While these experiments do not prove that complex memories of childhood can be implanted in patients, they do seem to prove that singular beliefs about memory can be influenced. While laboratory experiments have only intended to prove that a single subtle suggestion can be implanted and internalized, the potential for such influence in therapy is manifold. Directly or through questions therapists offer not one suggestion but thousands-each of which can build on the response to the preceding suggestion.

Indeed, there is evidence that what happens in therapy is a good deal more manipulative than even this would suggest. While laboratory experimenters seldom hypnotize their subjects more than once or twice, recovered memory patients are often hypnotized weekly for periods of months or years. While experimenters are careful not to influence the responses of the subject (excepting where such influence is part of the experiment), recovered memory therapists often show no such concern, blatantly suggesting histories of abuse, as in the case of Sue described at the beginning of this chapter.

The literature on the dangers of the use of hypnosis is not an obscure body of research that a reasonably competent therapist might have simply missed. Warnings about the suggestibility of a hypnotized patient, and the likelihood that he or she will classify what is imagined during hypnosis as memory, have come from any number of sources including the courts, the Journal of the American Medical Association, and prudent hypnotherapists.
- Ofshe, Richard & Ethan Watters, Making Monsters: False Memories, Psychotherapy, and Sexual Hysteria, Charles Scribner's Sons: New York, 1994.
The article above contains foundational information. Articles below contain optional updates.

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Personal Reflection Exercise #5
The preceding section contained information about the creation of pseudo memories. Write three case study examples regarding how you might use the content of this section in your practice.

Ethics CEU QUESTION 11
Researchers have noted that when the subject of the memory is highly charged or the subject more motivated to remember-to identify a suspect of a crime, for instance- what may increase the inaccuracy of the memories retrieved? Record the letter of the correct answer the <Ethics CEU Answer Booklet.