Ethical Boundary Considerations and Repressed Memories of Sexual Abuse

In the last section, we discussed the influence of the feminist movement view of rape and sexual abuse and related these issues to and assessment of your personal value system.

In this section, we will examine the effect of false memory generation on innocent so-called perpetrators and the obvious resulting ethical dilemmas.

One of the most tangible victims of false memory generation when it involves sexual abuse are those fathers, mothers, relatives, teachers, etc. who are the accused. Many times, these are family members of the victims and close friends. Generally, there is a gradual process involved when clients come to the conclusion, whether accurate or inaccurate, that their parents are guilty of incest and abuse.

♦ 5 Steps in False Accusations with Repressed Memories
According to Bartlett, unfortunately, many of these conclusions come from therapists that believe in repressed memories and hypnosis. These steps start with:
-- (1) the therapist suggesting sexual abuse;
-- (2) through hypnotism, relaxation or guided visualizations, "repressed memories" are found;
-- (3) the client then goes through a repertoire of suspects before reaching the final conclusion that usually a parent is the abuser;
-- (4) the client confronts the parent who denies any such action; and finally,
-- (5) the client disowns his or her parent or perhaps both parents.

Obviously, the most ethical implication relies on the pivotal point of the therapist's methods. Unfortunately, the use of such vulnerable state-inducing exercises, such as hypnotism, has been proven to increase the risk of false memory generation.

5 Steps in Incest Accusation

♦ Step 1: Suggestion by the Therapist
Let's examine each of these five steps in the process of incest accusation in detail. (1) The therapist suggests sexual abuse. Sometimes, within the first session, the therapist suggests that the client might be a candidate for childhood sexual abuse. Could this quick diagnosis be an indication of a preconceived notion within the therapist? If so, this predetermined concept might have excessively influenced the therapist's analysis and therein lies an ethical dilemma.

By immediately expecting a sexual abuse client, the therapist can find many symptoms that relate and support his or her theory. However, these symptoms can commonly be the result of another source. Without proper evidence, the sudden conclusion of sexual abuse might be a false one. As a result, the client, taking the therapist as an infallible authority figure, immediately considers that he or she is most likely the survivor of sexual abuse. Once the idea of sexual abuse becomes prevalent in the therapist's and the client's minds, any inclination that supports other ideas only increases your client's confusion.

♦ Step 2: Recovery
Second, after sexual abuse is suggested, through the use of hypnosis, relaxation or guided visualizations, the therapist may start to "recover" the memories. As you have read in the previous sections, without the proper training, the therapist can easily influence the client who is already in a vulnerable state. According to Bartlett, even those therapists sufficiently trained in the area of hypnosis cannot retrieve memories thoroughly and with total accuracy . As was discussed previously, Bartlett feels hypnosis is not a proper method in enhancing past memories, only in inventing them.

Of course this point is open for debate. This is especially true when the client has been inundating themselves with thoughts of sexual abuse and ways to discover if there truly was any such abuse in their childhood. If such is the case and hypnosis is used to recover memories, the therapist has a more likely chance of fabricating memories than of retrieving true memories of sexual abuse or rape. This leads to the unfortunate result found in the next stage, creating a list of suspects.

♦ Step 3: Suspicion
After the therapist suggesting sexual abuse and perhaps enhancing these memories with hypnosis or guided visualizations, a list of suspects is created, usually predominately by the client. However, sometimes the therapist may be involved. This also violates the section of the American Association of Marriage and Family Therapists Code of Ethics which states, "Marriage and family therapists, because of their ability to influence and alter the lives of others, exercise special care when making public their professional recommendations and opinions through testimony or other public statements."

Without sufficient consultation over the client's family status, any advice given could result in erroneous conclusions. This list can range from close friends of the family to baby-sitters, teachers, coaches, and finally family members themselves. It is usually not until a few of these candidates have been ruled out that the client begins to consider his or her parent as a suspect of abuse.

♦ Steps 4 & 5: Confrontation and Denial
Once this point has been reached, the fourth step after therapist's suggestions, hypnosis-type techniques, and suspect listing, is the confrontation by the client of the suspects, usually the parents. The client's allegations are almost always denied by the parents. Because the client has already become unchangeably certain of the abuse, the client cannot be dissuaded by the family members, especially if, as mentioned in a previous section, the client has a tendency towards codependency and people-pleasing the authority figure of the therapist.

These well-implanted ideas have become the client's new reality. When a person goes through such a tumultuous change in their world around them, any persons who try to challenge this new ideal are viewed with mistrust. The client then separates themselves from any person who would contradict their new reality.

Client's Damage to Themselves
The ramifications of this are obvious. Not only has the client possibly accused their parents of false allegations, but also has cut off a valuable life line in the pursuit of full recovery. Without the support of loved ones and friends that have known the client for most of their life, the possibility for recovery becomes even more distant. As a result, the client becomes extremely dependent on, you guessed it - the therapist alone, and this makes the idea of termination even more difficult.

One way of looking at this scenario is Support groups that recognize the efficacy of repressed memories fuel the client's need for dependency and weakens their ability to live life fully without the prop of therapy. As you know, termination is a necessary step in the full recovery of a client. Without this stage, the client cannot live a healthy, happy, and most importantly, independent lifestyle.

In this section, we discussed the effect of false memory generation on the innocent so-called, "perpetrators."

The False Memory Syndrome: Experimental Studies
and Comparison to Confabulations

- Mendez, M., & Fras, I. (2011). The false memory syndrome: Experimental studies and comparison to confabulations. Medical Hypotheses, 76(4), 492-496. doi:10.1016/j.mehy.2010.11.033.
Reviewed 2023

Peer-Reviewed Journal Article References:
Brainerd, C. J., & Bookbinder, S. H. (2019). The semantics of emotion in false memory. Emotion, 19(1), 146–159.

Conlin, W. E., & Boness, C. L. (2019). Ethical considerations for addressing distorted beliefs in psychotherapy. Psychotherapy, 56(4), 449–458

Gottlieb, M. C. (1990). Accusation of sexual misconduct: Assisting in the complaint process. Professional Psychology: Research and Practice, 21(6), 455–461.

Karon, B. P., & Widener, A. J. (2001). Repressed memories: Avoiding the obvious. Psychoanalytic Psychology, 18(1), 161–164.

“Youth-perpetrated child sexual abuse: The effects of age at court on legal outcomes”: Correction to Vargen et al. (2018) (2018). Psychology, Public Policy, and Law, 24(3), 306.

Ethics CEU QUESTION 7
What is the five step process that leads the client to accuse the innocent? To select and enter your answer go to Ethics CEU Test

I hope you have found the information to be both practical and beneficial. We appreciate that you've chosen the Healthcare Training Institute as a means for receiving your continuing education credit. I wish you the best of luck in your practice. Thank you. Please consider us for future home study needs at mentalhealthce.com