From the archive: ‘Psychotherapy and memories of childhood sexual abuse: A cognitive perspective’ by D. S. Lindsay & J. D. Read (1994). Applied Cognitive Psychology, 8, 281–338 with commentary

Cognitive psychological research on the fallibility of human memory is reviewed, focusing on evidence of memory distortions and illusions, with the aim of sharing research on memory with clinical psychologists and practitioners who use memory recovery techniques to help clients recover suspected memories of childhood sexual abuse. The memory literature suggests that incautious use of memory recovery techniques may lead some adult clients who were not abused to come to believe that they were. Considerations relevant to assessing whether or not clients have repressed memories of childhood sexual abuse are discussed, as are suggestions for minimizing the risk of leading clients to create illusory memories or beliefs of childhood sexual abuse.

We sought studies which have attempted to test whether memories of childhood sexual abuse can be repressed. Despite our broad search criteria, which excluded only unsystematic anecdotal reports, we found only four applicable studies. We then examined these studies to assess whether the investigators: (1) presented confirmatory evidence that abuse had actually occurred; and (2) demonstrated that their subjects had actually developed amnesia for the abuse. None of the four studies provided both clear confirmation of trauma and adequate documentation of amnesia in their subjects. Thus, present clinical evidence is insufficient to permit the conclusion that individuals can repress memories of childhood sexual abuse. This finding is surprising, since many writers have implied that hundreds of thousands, or even millions of persons harbour such repressed memories. In view of the widespread recent public and scientific interest in the areas of trauma and memory, it is important to investigate further whether memories of sexual abuse can be repressed.

In this commentary on the paper, Psychotherapy and Memories of Childhood Sexual Abuse: A Cognitive Perspective, by Lindsay and Read, three points are addressed. First, although the bulk of Lindsay and Read's paper is devoted to elaborating an explanation for the phenomenon that ‘memory recovery therapies’ may ‘inadvertently lead some adult clients to create illusory memories of childhood sexual abuse’, this phenomenon itself has never been demonstrated. There is a logical flaw in inferring the existence of a phenomenon from the fact that there might be an explanation for it. Second, Signal Detection Theory (SDT) is proposed as a useful heuristic for conceptualizing the debate regarding true memory versus illusory memory for sexual abuse. SDT is applied to elucidate the phenomenon of memory for sexual abuse, and then several directions for future research on this topic using the SDT framework are proposed. Finally, the cognitive research literature on the prevalence of suggestively planted memories is discussed. It is proposed that ‘memory recovery therapy’ is not widespread in the field of psychotherapy and that the evidence for therapist‐implanted illusory memories for incestuous sexual abuse is very weak.

The elusive search for the truth: A review of Pezdek, K. and Banks, W.P. (1996). The memory/false memory debate. San Diego: Academic Press. (394 pages). Over the last decade, there has been a virtual explosion in the number of adults coming forward claiming to have been sexually abused as children. The prototypical claimant is an educated women in her late 20s who initially sought therapy for help in dealing with any of a variety of symptoms, including depression, low self-esteem, substance abuse, eating disorders, and sleeping disorders. Importantly, it is often the case that prior to beginning therapy there were no memories of childhood sexual abuse. The debate addressed by this book is whether memories of sexual abuse which are recalled during the course of therapy are real - i.e., memories - or the result of suggestions made by the therapist - i.e., memories. The debate is primarily between clinicians and cognitive psychologists, and has at its root their different views of how memory operates. The model of memory held by many therapists is that memory is like a video-recorder, keeping a permanent record of all experiences. Failure to remember an event results either from a lack of the appropriate retrieval cues, or from the active repression of an event due to its traumatic nature. The general belief is that the symptoms which the patient is manifesting result from these unconscious, repressed memories. The goal of therapy, then, is to help the subject remember the childhood sexual abuse. By this model, there is no mechanism whereby a memory can be false; it may not be available, but once it becomes available, it is a veridical representation of a real event. There is no reason to expect memory distortion or fabrication. In contrast, the model of memory adhered to by most cognitive psychologists is very different. Memory is not a passive recording of information, but an active, re-constructive process. Most importantly, memory is seen as being susceptible to suggestion. Since the groundbreaking work of Elizabeth Loftus, cognitive psychologists have demonstrated how suggestions can not only change memory, but actually produce new memories. In light of the susceptibility of memory to suggestions -- particularly if they are made repeatedly, and if the person making the suggestions is an authority figure -- cognitive psychologists have raised the possibility that some of the memories of childhood sexual abuse during therapy may not be accurate. The edited book by Pezdek and Banks is addressed to this issue. Despite the title, it is not really a debate in the strict sense of the word, in which a given position is taken by one person, attacked by someone on the other side, and followed by a rebuttal. Rather, the book presents a series of articles, some of which are sympathetic to the recovered memory approach and others to the false memory approach. In the preface, the authors write: We tried to hew a middle course, looking for value in all sides. Many of the articles in the book originally appeared in a special issue of Consciousness & Cognition, Volume 3, 1994, the journal which is edited by William Banks, one of the editors of this volume. A major strength of the book is that all the included articles argue their respective positions based on actual experimental data rather than on philosophical biases. The book is divided into four sections, each devoted to a different aspect of the controversy. The comprehensive overview provided by Pezdek and Banks at the beginning of each section provides both a useful guide for the reader and a convenient summary. I will consider each of the sections separately. I. Childhood Trauma and Memory As noted by Pezdek and Banks in the introduction to this section, it is very difficult to do controlled studies of sexual abuse, which by its very nature is secretive, private, often repetitive, and often occurs at the hand of a caregiver with whom the child must remain attached. …

Evidence indicates that perceived event plausibility influences the likelihood of false memory implantation. Accordingly, it is central to map out the beliefs that people hold regarding the plausibility of different events. In three studies, we examined beliefs concerning the plausibility of being unable to remember childhood sexual abuse by use of two vignettes. This was investigated in Danish (Study 1; N = 94) and American laypeople (Study 2; N = 303) and Danish professionals across six different groups of potential relevance to the legal system (Study 3; N = 335). Most participants in Studies 1 and 2 answered either “Plausible” or “Very plausible” to both vignettes, replicating previous findings. In Study 3, the majority of professionals endorsed the belief that it is plausible to have inaccessible memories of childhood sexual abuse, but it varied across professional groups how strong the belief was, with highest scores among police and social workers. Our findings suggest that both laypeople and professionals typically hold the belief that an inability to remember the traumatic event is a likely and common reaction to childhood sexual abuse. The findings are important for informing the recurrent debate concerning repressed memories of childhood sexual abuse.

Sleep paralysis and recovered memories of sexual abuse: Comment on McNally and Clancy (2005)

The recovered-memory/false-memory debate focuses on theoretical issues pertaining to the plausibility of total repression, denial and subsequent full recovery of traumatic memories of childhood sexual abuse. Proponents and opponents of recovered memory therapy are divided in regard to the question whether recovered memories are true or false. Supporters of the ‘recovered memory hypothesis’, which states that memories of sexual abuse can be repressed and then recovered, consider the memories authentic, whereas supporters of the ‘false memory hypothesis’ who do not believe that total repression and subsequent full recovery are possible, consider the memories false. In the present paper a proposal is put forward to conceptualize the debate in terms of deception and self-deception. Within this framework, claimants of recovered memories of childhood sexual abuse might be considered truthful by supporters of the ‘recovered memory hypothesis’, and self-deceivers by supporters of the ‘false memory hypothesis’. Self-deception is viewed as a split between a given cognitive subsystem and the rest of the system. The split must not necessarily be dynamically driven.

This paper reports preliminary data on a sample of therapists with memory of childhood sexual abuse. Therapists who reported experiencing childhood sexual abuse (CSA, n = 131) were compared with therapists who suspected sexual abuse but had no memories (n = 24) on variables related to abuse characteristics, outcomes, and perceived difficulties working with clients with a CSA history. Therapists who suspected abuse, in contrast to those who made definite reports, were more likely to report that the perpetrator was a family member, that their CSA did not involve physical contact, that there was alcoholism in their families of origin, and that the CSA had negative effects on their relationships with their own children, ability to trust others, sexual satisfaction, and work life. Therapists who suspected abuse also reported more difficulty treating CSA clients because of interpersonal pulls during sessions, arousal without memories of abuse, and some countertransferential behaviors. These findings indicate that issues related to personal trauma should be addressed during training and practice.

Fantasy proneness, but not self-reported trauma is related to DRM performance of women reporting recovered memories of childhood sexual abuse

The controversy regarding recovered memories of childhood sexual abuse (CSA) has been characterized by two perspectives. According to one perspective, some people repress their memories of abuse because these experiences have been so emotionally traumatic, and they become capable of recalling the CSA only when it is psychologically safe to do so many years later. According to the other perspective, many reports of recovered memories of sexual abuse are false memories, often inadvertently fostered by therapists. In this article, we provide evidence for a third interpretation that applies to a subset of people reporting recollections of CSA; it does not require the concepts of repression, trauma, or false memory. These people did not experience their CSA as traumatic; they either failed to think about their abuse for years or forgot their previous recollections, and they recalled their CSA spontaneously after encountering reminders outside of psychotherapy. Their recovered memories are corroborated at the same rate as those of people who never forgot their abuse. Hence, recalling CSA after many years is not the same thing as having recalled a previously repressed memory of trauma.

Licensed U.S. doctoral-level psychotherapists randomly sampled from the National Register of Health Service Providers in Psychology (Surveys 1 and 2, n = 145; Council for the National Register of Health Service Providers in Psychology, 1992) and British psychologists sampled from the Register of Chartered Clinical Psychologists (Survey 2, n = 57; British Psychological Society, 1993) were surveyed regarding clients' memories of childhood sexual abuse (CSA). The 3 samples were highly similar on the vast majority of measures. Respondents listed a wide variety of behavioral symptoms as potential indicators of CSA, and 71% indicated that they had used various techniques (e.g., hypnosis, interpretation of dreams) to help clients recover suspected memories of CSA. Across samples, 25% of the respondents reported a constellation of beliefs and practices suggestive of a focus on memory recovery, and these psychologists reported relatively high rates of memory recovery in their clients.

Recovered Memories of Child Sexual Abuse: Psychological, Social, and Legal Perspectives on a Contemporary Mental Health Controversy

There are two types of recovered memories: those that gradually return in recovered memory therapy and those that are spontaneously recovered outside the context of therapy. In the current study, we employed a thought suppression paradigm, with autobiographical experiences as target thoughts, to test whether individuals reporting spontaneously recovered memories of childhood sexual abuse (CSA) are more adept at suppressing positive and anxious autobiographical thoughts, relative to individuals reporting CSA memories recovered in therapy, relative to individuals with continuous abuse memories, and relative to controls reporting no history of abuse. Results showed that people reporting spontaneously recovered memories are superior in suppressing anxious autobiographical thoughts, both in the short term and long term (7 days). Our findings may partly explain why people with spontaneous CSA memories have the subjective impression that they have "repressed" their CSA memories for many years.

The authenticity of recovered memories is a much debated issue. Surprisingly, no study has systematically looked at symptom overreporting in people claiming recovered memories of childhood sexual abuse (CSA). In a first sample we administered the Structured Inventory of Malingered Symptomatology (SIMS) to individuals who said they had recovered CSA memories (n=66), individuals who said their CSA had always been accessible (continuous CSA memory group; n=119), and controls who said they had no CSA experiences (n=83). In a second sample individuals reporting recovered (n=45) or continuous (n=45) CSA memories completed the Morel Emotional Numbing Test (MENT). Our aim was to compare these groups with regard to their tendency to overreport symptoms. The results indicate that people with recovered memories do not score higher on the SIMS and the MENT than other CSA survivors suggesting that symptom overreporting is not typical for people reporting recovered memories.

The current study examined mock jurors' perceptions of recovered memories of child sexual abuse. Participants were presented with one of four written vignettes of an adult female who recovers memories of child sexual abuse during therapy. Two variables in the vignettes were manipulated: the method of memory recovery (hypnosis informed vs. control uninformed) and presentation of psychological symptoms commonly related to history of sexual maltreatment (symptoms informed vs. symptoms uninformed). Participant mock jurors were asked to respond to questions regarding credibility, defendant guilt, and award of monetary damages. The continuous dependent variable analyses found significant results with regard to plaintiff credibility and defendant guilt with the hypnosis uninformed condition. Additionally, the hypnosis uninformed condition of the dichotomous dependent variable analyses significantly predicted the likelihood of participants deciding the defendant guilty, as well as the plaintiff as credible. Based on these findings, mock jurors' perceived hypnosis to be detrimental to memory recovery.