Fictitious Memories? : Tighter regulation is needed in psychotherapy community

The real message sent by a jury in Napa goes well beyond the $500,000 in damages it ordered two psychotherapists to pay Gary Ramona. The verdict was a ringing call for leaders of the mental health community to police their professions better, and for state legislatures nationally to enact new laws to bring more verifiability and more forensic science to the use of psychological evidence in court.

The case marked the first time that a non-patient was allowed to sue a therapist for monetary damages suffered incidentally as a result of treatment of another person. Ramona, once a $400,000-a-year winery executive, charged that the two therapists had elicited from his adult daughter false memories of his raping her as a child. After she sued him, he lost his job, his home and his marriage. The defendants were a psychiatrist and a marriage and family counselor.

The case is perhaps the most dramatic among a rising number of painful family confrontations stirred by recovered-memory techniques. Most often, the patient is a woman who enters treatment for bulimia or other psychological disorder. The therapist--employing various aggressive memory-enhancement techniques such as hypnosis, the drug sodium amytal, dream analysis and even body massages--often recovers “repressed” memories of childhood abuses, sexual and otherwise, some in great and lurid detail.

Undoubtedly, memories of childhood incest can be repressed, and thousands of people have been helped by such therapy to regain psychological balance. And undoubtedly sexual abuse of children is real and widespread. But evidence grows that many of these memories are, in effect, implanted by therapists’ suggestions. They are wreaking considerable damage on families, as the jury in Napa seemed to have agreed.

The False Memory Syndrome Foundation in Philadelphia claims that 12,000 families have been disrupted by this problem. That number is difficult to verify, but clearly the psychotherapeutic community must confront the issue. In some parts of the country, public crime victims’ funds are going to these “victims,” leaving little for true victims.

California alone has 75,000 licensed psychotherapists, including psychiatrists, psychologists, psychiatric nurses, family counselors, social workers and others, not to mention all manner of unlicensed free-lancers. Few of them engage in recovered-memory methods. But they operate largely in privacy, without the supervision and peer review common in other professions. It is time for the California Psychological Assn., national groups, state licensing boards and other authorities to take a stronger hand in monitoring these practitioners.

The most obvious reform is to require therapists to use the same informed consent asked by doctors when they perform routine surgery, spelling out the risks and alternative therapies. The mental health professions are notoriously underregulated; state licensing boards are largely empty shells that discipline only the most egregious offenders and do little to enforce minimum standards.

Beyond that, though, the time has come for more concerted legal efforts to distinguish real from false memories. A model for national adoption comes from the Minnesota State Board of Psychology. It requires that any oral testimony or written reports by therapists include descriptions of the limitations of the techniques used and any reservations about their reliability and validity. In addition, states must re-examine the recent trend toward extending the statute of limitations on bringing charges of childhood sexual abuse from the date of alleged crime to the date of recall.

Critics of the Ramona suit say it is part of a backlash against recent legal gains made by women in punishing men who rape and abuse women as a means of domination. We agree that sexual abuse is a serious matter that deserves stern punishment by the courts. But both the courts and therapists must be careful not to find it where it does not exist, nor to ruin families on the basis of unproven and unreliable evidence.