Posts Tagged ‘iatrogenesis’

Scientists Are Beginning to Understand What Causes Multiple Personality Disorder

“Researchers believe that indicates that DID sufferers do not merely have overactive imaginations, and that the origins of their ailment stem more likely from trauma.”

“These results do not support the idea of a sociogenic origin for DID.”

Scientists Are Beginning to Understand What Causes Multiple Personality Disorder

Despite the fact that dissociative identity disorder has been listed in psychiatry bible Diagnostic and Statistical Manual of Mental Disorders (currently DSM-IV) for years, the origins of the condition are not well-understood.  By Makini Brice  July 02, 2012

Dissociative identity disorder (DID) – or multiple personality disorder, as it is commonly known – affects one percent of the population, roughly the same amount as schizophrenia. Often sufferers from the condition have been misdiagnosed with schizophrenia and bipolar disorder before receiving their DID diagnosis. DID is usually characterized as a person who has with two or more personalities with completely different viewpoints on their environments and themselves.

Some believe that those afflicted use DID as a means of coping with extreme trauma, while others think that those affected simply have overactive imaginations. Of those who believe in the overactive imagination theory, scientists do not believe that DID is a genuine mental disorder.

Researchers at King’s College London sought to find a clearer picture of the answer to that question. They studied 29 people, 11 had dissociative identity disorder, 10 were people who were highly prone to fantasy and 8 people were not very prone to fantasy, as a control. Of those without DID, they were made to simulate the symptoms of dissociative identity disorder. The researchers measured subjects’ brain activity, cardiovascular system, and their reactions.

They found that there were strong differences, both in regional blood flow and in reactions, between the DID sufferers and the control subjects. Researchers believe that indicates that DID sufferers do not merely have overactive imaginations, and that the origins of their ailment stem more likely from trauma….http://www.medicaldaily.com/news/20120702/10574/dissociative-identity-disorder-multiple-personality-brain-mental-trauma.htm

Fact or Factitious? A Psychobiological Study of Authentic and Simulated Dissociative Identity States
A. A. T. Simone Reinders, Antoon T. M. Willemsen, Herry P. J. Vos, Johan A. den Boer, Ellert R. S. Nijenhuis PLoS ONE 7(6): e39279. doi:10.1371/journal.pone.0039279

Abstract

Background

Dissociative identity disorder (DID) is a disputed psychiatric disorder. Research findings and clinical observations suggest that DID involves an authentic mental disorder related to factors such as traumatization and disrupted attachment. A competing view indicates that DID is due to fantasy proneness, suggestibility, suggestion, and role-playing. Here we examine whether dissociative identity state-dependent psychobiological features in DID can be induced in high or low fantasy prone individuals by instructed and motivated role-playing, and suggestion.

Methodology/Principal Findings

DID patients, high fantasy prone and low fantasy prone controls were studied in two different types of identity states (neutral and trauma-related) in an autobiographical memory script-driven (neutral or trauma-related) imagery paradigm. The controls were instructed to enact the two DID identity states. Twenty-nine subjects participated in the study: 11 patients with DID, 10 high fantasy prone DID simulating controls, and 8 low fantasy prone DID simulating controls. Autonomic and subjective reactions were obtained. Differences in psychophysiological and neural activation patterns were found between the DID patients and both high and low fantasy prone controls. That is, the identity states in DID were not convincingly enacted by DID simulating controls. Thus, important differences regarding regional cerebral bloodflow and psychophysiological responses for different types of identity states in patients with DID were upheld after controlling for DID simulation.

Conclusions/Significance

The findings are at odds with the idea that differences among different types of dissociative identity states in DID can be explained by high fantasy proneness, motivated role-enactment, and suggestion. They indicate that DID does not have a sociocultural (e.g., iatrogenic) origin.

“For the first time, it is shown using brain imaging that neither high nor low fantasy prone healthy women, who enacted two different types of dissociative identity states, were able to substantially simulate these identity states in psychobiological terms. These results do not support the idea of a sociogenic origin for DID.” http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0039279

Paul McHugh

Information on Paul McHugh Bishops Select Lay Board On Sexual Abuse Review By Laurie Goodstein 6/25/02  “Dr. McHugh, who was a founder and board member of the False Memory Syndrome Foundation.”  http://query.nytimes.com/gst/fullpage.html?res=9C0DEFD91038F936A15754C0A9649C8B63

Brown, D; Frischholz E, Scheflin A. (1999). “Iatrogenic dissociative identity disorder – an evaluation of the scientific evidence”. The Journal of Psychiatry and Law XXVII No. 3-4 (Fall-Winter 1999):549–637. p. 604 – 605 “The problem with McHugh’s publications on MPD/DID, like those of Mersky, is that they are mere speculation. From deposition testimony in several cases, McHugh has made it clear that other than an occasional consultation, he has very little actual clinical experience with the ongoing treatment of MPD/DID patients and is generally unfamiliar with both the clinical features of MPD/DID and with what usually occurs in their treatment. This McHugh’s opinion is informed neither by actual in-depth clinical experience with contemporary MPD/DID patients nor by any scientific research on MPD. Furthermore, with regard to McHugh’s main hypothesis that hysterical behavior is implicated in DID iatrogenesis, Gleaves has shown that such phenomena are no more prevalent in DID than in any other psychiatric condition.” (Gleaves, D. July 1996 The sociocognitive model of dissociative identity disorder: a reexamination of the evidence, Psychological Bulletin 120, 1  p.42-59 http://www.ncbi.nlm.nih.gov/pubmed/8711016?ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVAbstractPlus) “ No reason exists to doubt the connection between DID and childhood trauma.http://ritualabuse.us/research/did/basic-information-on-didmpd/

Morrison threatens to sue witness – Expert witness Paul McHugh, a psychiatrist, could face disciplinary action for revealing information in Wichita abortion records. By Dion Leflert 6/13/07 Wichita Eagle – Kansas Attorney General Paul Morrison on Tuesday threatened to sue a psychiatric expert hired by his predecessor if he doesn’t stop making public statements about medical records from an investigation of Wichita abortion provider George Tiller. In a letter, Morrison told psychiatrist Paul McHugh that if he persists, the attorney general’s office will “pursue all available remedies.” That could include legal action to get a refund of $5,000 the state has paid McHugh and possible disciplinary action against him in his home state of Maryland. http://www.accessmylibrary.com/coms2/summary_0286-31256521_ITM

Dubious choice for resolving church scandal by Mara J. Math 9/21/02 “McHugh’s actions…pose the deepest threat to the council’s credibility. McHugh is the only therapist on the lay council. This makes his participation especially significant, because other members may rely on his presumed expertise. Because he frequently testifies on behalf of accused molesters, doubts may be raised about the council’s desire to truly solve the problem. McHugh…is the man whose report to the court in one case stated that a defendant’s harassing phone calls were not obscene – including the call that detailed a fantasy of a 4-year-old sex slave locked in a dog cage and fed human waste. At least eight men have been convicted of sexually abusing Maryland children while under treatment at the “sex disorders” clinic McHugh runs at Johns Hopkins University School of Medicine – abuse the doctors did not report, citing client confidentiality. When Maryland law was changed to require that doctors report child molestation, the clinic fought it and advised patients on how to get around the law. The memo to patients suggested that molesters report their pedophilic activities to their lawyers, who could in turn tell staff; attorney-client privilege would then protect the molesters from being reported. This memo was fully approved by the boss – Dr. Paul McHugh…” http://www.sfgate.com/cgi-bin/article.cgi?file=/chronicle/archive/2002/09/20/ED175849.DTL

Paul McHugh on transsexualism - From an article by Elizabeth Gilbert: McHugh has always reserved special scorn for the practice of sex-change surgery on adult transsexuals. Classifying transsexualism as merely one symptom in a larger complex of personality disorders, McHugh had long believed that psychiatrists should treat such patients with the talking cure, not radical, irreversible surgeries. In a 1992 article in the American Scholar, McHugh lambasted transsexual surgery as ‘the most radical therapy ever encouraged by twentieth century psychiatrists’ and likened its popularity to the once widespread practice of frontal lobotomy.  http://www.tsroadmap.com/info/paul-mchugh.html

Dissociative identity disorder – multiple personality disorder

Gleaves, D. (July 1996). “The sociocognitive model of dissociative identity disorder: a reexamination of the evidence”. Psychological Bulletin 120 (1): 42–59. doi:10.1037/0033-2909.120.1.42. PMID 8711016. Gleaves states that the research on DID does not support the ideas that DID is a construct of either psychotherapy or the media (the sociocognitive model), but that there is a connection between DID and childhood trauma. “According to the sociocognitive model of dissociative identity disorder…DID is not a valid psychiatric disorder of posttraumatic origin; rather, it is a creation of psychotherapy and the media…In this article, the author reexamines the evidence for the model and concludes that it is based on numerous false assumptions about the psychopathology, assessment, and treatment of DID. Most recent research on the dissociative disorders does not support (and in fact disconfirms) the sociocognitive model, and many inferences drawn from previous research appear unwarranted. No reason exists to doubt the connection between DID and childhood trauma. Treatment recommendations that follow from the sociocognitive model may be harmful because they involve ignoring the posttraumatic symptomatology of persons with DID.

Brown, D; Frischholz E, Scheflin A. (1999). “Iatrogenic dissociative identity disorder – an evaluation of the scientific evidence”. The Journal of Psychiatry and Law XXVII No. 3-4 (Fall-Winter 1999): 549–637. p. 604 – 605 “The problem with McHugh’s publications on MPD/DID, like those of Mersky, is that they are mere speculation. From deposition testimony in several cases, McHugh has made it clear that other than an occasional consultation, he has very little actual clinical experience with the ongoing treatment of MPD/DID patients and is generally unfamiliar with both the clinical features of MPD/DID and with what usually occurs in their treatment. This McHugh’s opinion is informed neither by actual in-depth clinical experience with contemporary MPD/DID patients nor by any scientific research on MPD. Furthermore, with regard to McHugh’s main hypothesis that hysterical behavior is implicated in DID iatrogenesis, Gleaves has shown that such phenomena are no more prevalent in DID than in any other psychiatric condition.”

“Conclusions…At present the scientific evidence is insufficient and inadequate to support plaintiffs’ complaints that suggestive influences allegedly operative in psychotherapy can create a major psychiatric disorder like MPD per se…there is virtually no support for the unique contribution of hypnosis to the alleged iatrogenic creation of MPD in appropriately controlled research. “The Spanos socio-cognitive model reduces MPD to socially constructed role enactments. In this model, the often severe psychopathology associated with clinical MPD is minimized. Very recent studies suggest a possible neurobiological basis to MPD in at least certain MPD patients….It is clear that Spanos et al.’s 1985 conclusion that MPD is a role enactment based on their observation of role-playing subjects is based on circular logic: You ask a subject to pretend that he has alters and he complies; then you conclude that having alters is the product of role playing….Spanos’s conclusion of the iatrogenic nature of MPD also suffers from an additional logical error. Even if it were true that MPD could be created iatrogenically, that does not prove that every case for noniatrogenic MPD cases….Situationally bound enactment of predefined secondary-personality roles presumes sufficient executive control to do it. Genuine MPD is defined in DSM as the loss of executive control…Genuine DID was defined in DSM-IV as the loss of a unified identity…Presumably none of Spanos’s laboratory subjects suffered from a fundamental loss of a unified identity as a result of the experimental instructions….”’Genuine MPD is characterized by enduring alter-personality states that are defined by a relatively stable set of personality characteristics over time….The secondary-personality states reported by Spanos’s subjects in the laboratory were very temporary role enactments….Spanos has seriously overgeneralized from the data of his 1985, 1986 and 1991 laboratory experiments that multiple personalities can be created in the laboratory.”’ The more conservative interpretation merited by these data is that certain individuals with certain personality characteristics in a particular social context report temporary role enactments of different identities that are limited to the context of the experiment….Overall the Spanos data offer no evidence that either stable alter personalities or the range of clinical features typically associated with MPD can be created in the laboratory, and the data certainly offer no support whatsoever that MPD per se can be created through suggestive influences. At best, these data support the view that certain individuals in a high-demand context, and/or under extreme interview conditions wherein misinformation is systematically supplied, report temporary secondary-personality states….Overall, these data offer little evidence that the disorder MPD per se can be created through suggestive influences.”

Ross, C.; Norton, G. & Fraser, G. (1989). “Evidence against the iatrogenesis of multiple personality disorder”. Dissociation 2 https://scholarsbank.uoregon.edu/dspace/bitstream/1794/1424/1/Diss_2_2_2_OCR.pdf

“The authors present data which argue against the iatrogenesis of multiple personality disorder (MPD). Twenty-two cases reported by one Canadian psychiatrist, 23 cases reported by a.second Canadian psychiatrist, 48 cases seen by 44 American psychiatrists specializing in MPD, and 44 cases seen by 40 Canadian general psychiatrists without a special interest in MPD are compared. The Canadian general psychiatrists had seen an average of 2.2 cases of MPD, while the Americans had seen an average of 160. There were no differences between these groups on the diagnostic criteria, for MPD or the number of personalities identified. Specialists in. MPD are not influencing their patients to create an increased number of personalities or to endorse more diagnostic criteria. Exposure to hypnosis does not appear to influence the phenomenology of MPD.

Kluft, R.P. (1989). “Iatrogenic creation of new alter personalities”. Dissociation 2 (2): 83–91. https://scholarsbank.uoregon.edu/dspace/bitstream/1794/1428/1/Diss_2_2_6_OCR.pdf
“It would appear that the weight of available evidence, although far from conclusive, suggests quite strongly that the iatrogenesis of MPD de norm has yet to be demonstrated. Most of what would appear to be examples of the iatrogenic creation of new alters reflects the uncovering process of psychotherapy as it reaches already extant alters that were not immediately accessible for a variety of reasons, or the ongoing use by the patient of his or her characteristic ways of coping within the context of therapy.”
Braun, B.G. (1989). “Dissociation: Vol. 2, No. 2, p. 066-069: Iatrophilia and Iatrophobia in the diagnosis and treatment of MPD https://scholarsbank.uoregon.edu/dspace/bitstream/1794/1425/1/Diss_2_2_3_OCR.pdf
“Iatrogenic induction of an alter personality by hypnotic or other means is highly unlikely, given the DSM-III-R criteria for defining an alter.”

Kluft, RP (2003). “Current Issues in Dissociative Identity Disorder”. Bridging Eastern and Western Psychiatry 1 (1): 71–87. http://www.psyter.org/allegati/180/Kluft.pdf
“DID is emerging as a not uncommon consequence of overwhelming childhood events. It has been identified as occurring in many nations and is often very responsive to treatment.”

Pearson, M.L. (1997). “Childhood trauma, adult trauma, and dissociation”. Dissociation 10 (1): 58–62. https://scholarsbank.uoregon.edu/dspace/bitstream/1794/1837/1/Diss_10_1_9_OCR.pdf
“This paper studies the relationship among childhood trauma, recent trauma, and dissociation. Literature has suggested that early trauma may lead to dissociation. It was hypothesized that dissociation, including symptoms associated with Dissociative Identity Disorder (DID), would be more prevalent in those survivors of childhood abuse who were later traumatized in adulthood . Seventy-five female subjects completed a survey protocol. Subjects who experienced both early and recent trauma were more dissociative and endorsed more symptoms consistent with DID.”

International Society for the Study of Trauma and Dissociation http://www.isst-d.org/

Goettmann, B. A.; Greaves, B. G., Coons M. P. (1994). Multiple personality and dissociation, 1791-1992: a complete bibliography. Lutherville, MD: The Sidran Press, 85. ISBN 0-9629164-5-5. http://boundless.uoregon.edu/cgi-bin/showfile.exe?CISOROOT=/diss&CISOPTR=38&filename=39.pdf

blog on book “Switching Time” by Richard Baer http://switchingtime.wordpress.com/

Recovered Memory Data

Recovered Memory Data

Definition:
http://dynamic.uoregon.edu/~jjf/whatabout.html
What about Recovered Memories? Jennifer J. Freyd, University of Oregon
“Sivers, Schooler, and Freyd (2002, p 169) define recovered memory as “The recollection of a memory that is perceived to have been unavailable for some period of time.”

Recovered Memory Corroboration:

http://dynamic.uoregon.edu/~jjf/suggestedrefs.html
Research discussing corroboration and accuracy of recovered memories:  An Annotated Bibliography by Lynn Crook

http://www.brown.edu/Departments/Taubman_Center/Recovmem/index.html
“…debate has focused on recovered memories of childhood sexual abuse. But the phenomenon extends to other traumas, including physical abuse or witnessing a murder. Almost everyone would agree that such traumas are normally remembered. That is, most people who experience such a trauma are likely to remember it, perhaps vividly and to the point of being intrusive. But do some people forget completely? A variety of scientific sources say “yes.” The purpose of this website, then, is to bring together the extensive and growing evidence of cases ignored or overlooked by self-described skeptics of various sorts. Peer-reviewed prospective studies and clinical studies continue to document this phenomenon. Moreover, cognitive psychologists have combined experimental data with these other sources to develop better ways of understanding this phenomenon.”

http://www.brown.edu/Departments/Taubman_Center/Recovmem/archive.html
101 Corroborated Cases of Recovered Memory

http://www.jimhopper.com/memory/
Recovered Memories of Sexual Abuse Scientific Research & Scholarly Resources by Jim Hopper
“Amnesia for childhood sexual abuse is a condition. The existence of this condition is beyond dispute. Repression is merely one  explanation – often a confusing and misleading one –  for what causes the condition of amnesia. At least 10% of people sexually abused in childhood will have periods of complete amnesia for their  abuse, followed by experiences of delayed recall.”

http://www.leadershipcouncil.org/1/tm/tm.html
Research has shown that traumatized individuals respond by using a variety of psychological mechanisms. One of the most common means of dealing with the pain is to try and push it out of awareness. Some label the phenomenon of the process whereby the mind avoids conscious acknowledgment of traumatic experiences as dissociative amnesia .  Others use terms such as repression , dissociative state , traumatic amnesia, psychogenic shock, or motivated forgetting .  Semantics aside, there is near-universal scientific acceptance of the fact that the mind is capable of avoiding conscious recall of traumatic experiences.

The False Memory Debate – Research discussing corroboration for, and accuracy of recovered memories – An Annotated Bibliography – http://groups.yahoo.com/group/psnews/message/743
from – Brown, D., Scheflin, A., and Whitfield, C. (1999). Recovered memories: the current weight of the evidence in science and in the courts. The Journal of Psychiatry & Law 27/Spring 1999.

“The recovery of memories in clinical practice: Experiences and beliefs of British Psychological Society practitioners” Andrews, Bernice; Morton, John; Bekerian, Debra A.; Brewin, Chris R.; Davis, Graham M.; Mollon, Phil The Psychologist 1995 May, Vol. 8, pp. 209-214 “ “…recovery from total amnesia of past traumatic material involving both CSA and non-CSA experiences is (not) uncommon”” … our large-scale survey confirms and extends previous research…. Memory recovery appears to be a robust and frequent phenomenon.”

“Recall of childhood trauma: A prospective study of women’s memories of child sexual abuse.” Williams, Linda Meyer U New Hampshire, Family Research Lab, Durham, US Journal of Consulting & Clinical Psychology 1994 Dec Vol 62(6) 1167-1176  In a study of 129 women “with previously documented histories of sexual victimization” A large proportion of the women (38%) did not recall the abuse that had been reported 17 years earlier.” Women younger in age when abused and women “molested by someone they knew were more likely to have no recall of the abuse…Long periods with no memory of abuse should not be regarded as evidence that the abuse did not occur.”

“Recovered memories of abuse among therapy patients: A national survey.” Pope, Kenneth S.; Tabachnick, Barbara G.  Independent practice, Norwalk, CT, US Ethics & Behavior 1995 Vol 5(3) 237-248, “According to the therapists, about 50% of the  patients who claimed to have recovered the memories had found external validation, a percentage that coincides with that obtained in the Feldman-Summers & Pope, 1994 study”

Corroboration of Child Abuse Memories
http://mentalhealth.about.com/cs/abuse/a/cooroborate.htm
“Studies vary in frequency. Between 31 and 64 percent of abuse survivors in six major studies reported that they forgot “some of the abuse.” Numbers reporting severe amnesia ranged from under 12% to 59%….Studies report 50-75% of abuse survivors corroborating the facts of their abuse through an outside source. Corroboration of ritual abuse was lower. One study of ritual abuse found 3% corroboration in delayed memory patients and 20% corroboration in patients with continuous memories of ritual abuse. Another study put the numbers between 14% and 37%.” Reference: Bowman, Elizabeth. Delayed Memories of Child Abuse: Part I: An Overview of Research Findings on Forgetting, Remembering, and Corroborating Trauma. Dissociation, IX (4) pp. 221-231

Synopsis of data from “Memory, Trauma Treatment, and the Law” by Brown, Scheflin and Hammond, W.W. Norton and Co. New York and London, C 1998 (http://www.wwnorton.com) Page 370-381

The base rates for memory commission errors are quite low, at least in professional trauma treatment. The base rates in adult misinformation studies run between zero and 5 percent for adults and between 3 – 5 percent for children.

“Occasional unwitting misleading suggestions (Yapko, 1994a), even the suggestion of a diagnosis of abuse, cannot adequately explain illusory memories of child sexual abuse.” (p. 379)

It is almost totally impossible for anyone to make a memory error for the central plot of a memory simply by hearing disinformation. A variety of other factors would have to be in place. Even under hypnosis without several social influence factors, it is extremely rare (4-6% of 7-10%, less than one percent of people) may be influenced by disinformation.

Memory on Trial – Research suggests that children’s memory may be more reliable than adults’ in court cases …3/6/08 The U.S. legal system has long assumed that all testimony is not equally credible, that some witnesses are more reliable than others. In tough cases with child witnesses, it assumes adult witnesses to be more reliable. But what if the legal system had it wrong? Researchers Valerie Reyna, human development professor, and Chuck Brainerd, human development and law school professor — both from Cornell University — argue that like the two-headed Roman god Janus, memory is of two minds — that is, memories are captured and recorded separately and differently in two distinct parts of the mind. They say children depend more heavily on a part of the mind that records, “what actually happened,” while adults depend more on another part of the mind that records, “the meaning of what happened.” As a result, they say, adults are more susceptible to false memories, which can be extremely problematic in court cases. Reyna’s and Brainerd’s research, funded by the National Science Foundation, Arlington, Va., sparked more than 30 follow-up memory studies, many of them also funded by NSF. The researchers review the follow-on studies in an upcoming issue of Psychological Bulletin….Reyna and Brainerd’s findings are summarized in a new book, The Science of False Memory, published by Oxford University Press. http://www.nsf.gov/news/news_summ.jsp?cntn_id=111230&org=NSF&from=news?
“Forgetting and Recovering the Unforgettable.” Psychological Science – Volume 19, Number 5  – May 2008 Steven M. Smith & Sarah C. Moynan “Some experiences, particularly those that are emotional and distinctive, may seem unforgettable. Can memories of emotional and distinctive events be blocked from consciousness, and if so, can those memories subsequently be recovered? Although there is considerable laboratory research demonstrating false memories, relatively few studies have examined blocked and recovered memories, as we did in the study reported in this article. As noted in reviews by Gleaves, Smith, Butler, and Spiegel (2004) and by Roediger and Bergman (1998), the false-memory debate must be informed by experimental laboratory research examining not only false memories, but also blocked and recovered memories….In the present study, we investigated whether interference can cause dramatic forgetting that is subsequently reversed when retrieval cues are provided. Using a combination of classic laboratory methods for manipulating interference and cuing, we repeatedly found high levels of blocked and recovered memories, even for materials that had sexually explicit and violent content.  correspondence to Steven M. Smith, Department of Psychology, Texas A&M University, College Station, TX 77843, e-mail: stevesmith@tamu.edu  http://www.psychologicalscience.org/journals/ps/19_5.cfm

Duggal, S., & Sroufe, L. A. (1998). Recovered memory of childhood sexual trauma: A documented case from a longitudinal study. Journal of Traumatic Stress, 11(2), 301-321.
This account contains a prospective report of memory loss in a case in which there is both documented evidence of trauma and evidence of recovery of memory.

“Child Maltreatment, Vol. 2, No. 2, 91-112 (1997) DOI: 10.1177/1077559597002002001
Videotaped Discovery of a Reportedly Unrecallable Memory of Child Sexual Abuse: Comparison with a Childhood Interview Videotaped 11 Years Before  David L. Corwin, Erna Olafson….This article presents the history, verbatim transcripts, and behavioral observations of a child’s disclosure of sexual abuse to Dr. David Corwin in 1984 and the spontaneous return of that reportedly unrecallable memory during an interview between the same individual, now a young adult, and Dr. Corwin 11 years later. Both interviews were videotape recorded.“ http://cmx.sagepub.com/cgi/content/abstract/2/2/91

Consider This, Skeptics of Recovered Memory   Author: Ross E. Cheit
DOI: 10.1207/s15327019eb0802_4  Ethics & Behavior, Volume 8, Issue 2 June 1998 , pages 141 – 160  Formats available: PDF (English)  Abstract : Some self-proclaimed skeptics of recovered memory claim that traumatic childhood events simply cannot be forgotten at the time only to be remembered later in life. This claim has been made repeatedly by the Advisory Board members of a prominent advocacy group for parents accused of sexual abuse, the so-called False Memory Syndrome Foundation. The research project described in this article identifies and documents the growing number of cases that have been ignored or distorted by such skeptics. To date, this project has documented 35 cases in which recovered memories of traumatic childhood events were corroborated by clear and convincing evidence. This article concludes with some observations about the politics of the false memory movement, particularly the tendency to conceal or omit evidence of corroboration. Several instances of this vanishing facts syndrome are documented and analyzed. http://www.leaonline.com/doi/abs/10.1207/s15327019eb0802_4?journalCode=eb

Pezdek, Hodge, D. (1999) July-August Planting false childhood memories: The role of event plausibility Child Development 70(4) p.887-895 http://links.jstor.org/sici?sici=0009-3920%28199907%2F08%2970%3A4%3C887%3APFCMIC%3E2.0.CO%3B2-G&size=LARGE&origin=JSTOR-enlargePage
partial synopsis : study found that although 3 (15%) of 20 participants recalled a plausible false memory of getting lost in a shopping mall, none of the participants accepted an implausible false memory that they had received a painful enema as a child from their parent.
Abuse, Memory, Science, Therapy, Ethics, Malpractice – Kenneth S. Pope, Ph.D. about this Site – This site provides free access to peer-reviewed research articles, abstracts, APA list utilities, guides, announcements, & other resources.
http://web.archive.org/web/20010803163457/http://www.idealist.com/memories

theories on recovered memory:

http://dynamic.uoregon.edu/~jjf/defineBT.html
The phrase “betrayal trauma” can be used to refer to a kind of trauma (independent of the reaction to the trauma). E.G. This definition is on the web: “Most mental health professionals have expanded the definition of trauma to include betrayal trauma. Betrayal trauma occurs when the people or institutions we depend on for survival violate us in some way. An example of betrayal trauma is childhood physical, emotional, or sexual abuse.” from http://www.loyola.edu/campuslife/healthservices/counselingcenter/trauma.html
The phrase “Betrayal Trauma theory” is generally used to refer to the prediction/theory about the cause of unawareness and amnesia as in: “Betrayal Trauma Theory: A theory that predicts that the degree to which a negative event represents a betrayal by a trusted needed other will influence the way in which that events is processed and remembered.” This definition is from: Sivers, H., Schooler, J. , Freyd, J. J. (2002) Recovered memories. In V.S. Ramachandran (Ed.) Encyclopedia of the Human Brain, Volume 4.(pp 169-184). San Diego, California and London: Academic Press.

It has been proposed in the Betrayal Trauma Theory that “that psychogenic amnesia is an adaptive response to childhood abuse” and that “victims may need to remain unaware of the trauma not to reduce suffering but rather to promote survival.”  Freyd, J. (1994) Betrayal Trauma: Traumatic Amnesia as an Adaptive Response to Childhood Abuse. Ethics & Behavior 4 (4) p. 307-330 http://www.questia.com/read/95814385
The amnesia allows the child maintain attachment to a person that a child needs to depend on for survival and development.

legal information:

Ground Lost: The False Memory/Recovered Memory Therapy Debate, by Alan Scheflin, Psychiatric Times 11/99,  Vol. XVI  Issue 11,
“The appearance in the DSM-IV indicates that the concept of repressed memory is generally accepted in the relevant scientific community. This satisfies courts following the Frye v United States, 293 F.1013 (1923) or Daubert v Merrell Dow Pharmaceutical, 113 S. Ct. 2786 (1993) rules regarding the admissibility of scientific testimony into evidence in court.”
And “Although the science is limited on this issue, the only three relevant studies conclude that repressed memories are no more and no less accurate than continuous memories (Dalenberg, 1996; Widom and Morris, 1997; Williams, 1995). Thus, courts and therapists should consider repressed memories no differently than they consider ordinary memories.” At
http://www.psychiatrictimes.com/p991137.html

http://www.jimhopper.com/memory-decision “The Validity of Recovered Memory: Decision of a US District Court” Judge Edward F. Harrington,  Presentation by Jim Hopper, Ph.D. The legal documentation citation is: 923 Federal Supplement 286 (D. Mass. 1996), United States District Court – District of Massachusetts
Ann Shahzade, plaintiff Civil Action No.: V. 92-12139-EFH George Gregory, Defendant.

Some quotes from the decision:
“The factors to be considered when deciding if proffered testimony is valid ‘scientific knowledge,’ and therefore reliable, are…” (p.3)
“This Court finds that the reliability of the phenomenon of repressed memory has been established” and will allow the plaintiff to introduce evidence related to their recovered memories (p.3).
“Dr. van der Kolk testified that repressed memories is not a scientific controversy, but… a political and forensic one” (p.5).
“Diagnostic and Statistical Manual of Mental Disorders (DSM-IV, 1994)…also recognizes the concept of repressed memories” (p.7).
“in considering the admissibility of repressed memory evidence,” the court must rule on the “validity of the theory itself… for the law to reject a diagnostic category generally accepted by those who practice the art and science of psychiatry would be folly.” (p.9).

physiological evidence for memory suppression:

The Neurological Basis for the Theory of Recovered Memory
http://members.aol.com/smartnews/Neurological_Memory.htm

synopsis of part of van der Kolk, B. A. & Fisler, R. (1995) Dissociation and the fragmentary nature of traumatic memories: Overview and exploratory study.  http://web.archive.org/web/20021211024350/http://www.trauma-pages.com/vanderk2.htm
van der Kolk and Fisler’s research shows that traumatic memories are retrieved, at least at first, in the form of mental imprints that are dissociated. These imprints are of the affective and sensory elements of the traumatic experience. Clients have reported the slow emergence of a personal narrative that can be considered explicit (conscious) memory. The level of emotional significance of a memory correlates directly with the memory’s veracity. Studies of subjective reports of memory show that memories of highly significant events are unusually accurate and stable over time. There are a variety of memory systems which usually operate outside of conscious awareness. These systems operate with some independence from the other memory systems. While people appear to easily assimilate expected and known experiences, aspects of traumatic experiences appear to get stuck in the mind, unaltered by time passing or experiences that may follow. The imprints of traumatic experiences appear to be qualitatively different from those of nontraumatic events. Explicit memories of personal facts or events are affected by lesions of the front lobe and hippocampus. These parts of the brain are also involved in PTSD neurobiology. Traumatic memories may be coded differently than ordinary event memories, possibly because of alterations in attentional focusing or the fact that extreme emotional arousal interferes with the memory functions of the hippocampus.

Traumas can interfere with several memory functions. van der Kolk divided these functional disturbances into four sets, traumatic amnesia, global memory impairment, dissociative processes and traumatic memories’ sensorimotor organization. Traumatic amnesia involves the loss of remembering traumatic experiences. The younger the subject and the longer the traumatic event is, the greater the chance of significant amnesia. Global memory impairment makes it difficult for these subjects to construct an accurate account of their present and past history. Dissociation refers to memories being stored as fragments and not as unitary wholes. Not being able to integrate traumatic memories seems to be the main element which leads to PTSD. In the sensorimotor organization of traumatic memories, sensations are fragmented into different sensory components.

Synopsis of part of van der Kolk, B. A. (1994). The body keeps the score: Memory and the evolving psychobiology of post traumatic stress. http://web.archive.org/web/20041204204758/http://www.trauma-pages.com/vanderk4.htm

Trauma victims do not respond to stress the way normals do. Pressure situations may cause a feeling of retraumatization. High states of arousal may promote the retrieval of trauma memories and associated phenomena such as sensory information or behaviors connected to prior trauma. Therefore, traumatic memories may be considered state dependent. Under stress, people secrete endogenous stress hormones that affect memory consolidation strength. Through studies on animal models, it is assumed that the large secretion of neurohormones during a traumatic event in part causes long-term potentiation (LTP) and the over-consolidation of traumatic memories. This LTP may cause an organism to remember a trauma whenever aroused. Neuroepinepehrine may be the major hormone causing LTP. Endorphins and oxytocin may actually cause inhibition of the consolidation of memories. Reliving the traumatic event may cause stress hormones to strength the memory trace causing a positive feedback loop.

The limbic system is believed to be critically involved in memory storage and retrieval as well as giving emotional significance to sensory inputs. Research in brain imaging studies suggests that trauma patients may have limbic system abnormalities. One part of the limbic system, the amygdala, may assign free-floating feelings to input which are then elaborated upon by the neocortex and imbued with personal meaning. It may also integrate internal representations of the external world in memory image form associating emotional experiences with these memories. The septo-hippocampal system is thought to record memory in temporal and spatial dimensions, and plays an important role in storing and categorizing incoming stimuli in memory. Hippocampal damage is connected to over responsiveness to external stimuli. When stress interferes with the hippocampus’ mediation of memory, it is possible that some of the memory is kept by a system that records emotional experience, but there is no symbolic placement of it in time or space. In animals, high stimulation of the amygdala interferes with hippocampal processing. Strong affect may disallow proper evaluating and categorizing of an experience.

Professor uncovers the nature of memories – Associate Professor Michael Anderson recently published a new study of what the brain does when a person forgets By Caron Alarab 1/14/03 “A University researcher is receiving international attention this week for a recent experiment exploring why people forget. With a team of Stanford researchers, Associate Professor of psychology Michael Anderson found people can use certain brain regions to block memories just as they do to control physical actions. “It’s no longer possible to say that human beings can’t actively forget,” said Anderson, one of the nation’s leading memory researchers. “Our research demystifies the idea of memory suppression.” The findings, which were published in the Jan. 9 issue of Science magazine, support Sigmund Freud’s controversial century-old theory about the existence of voluntary memory suppression. For the experiment, Anderson recruited Stanford researcher John Gabrieli and the two co-wrote the Science article “Neural Systems Underlying the Suppression of Unwanted Memories.” http://www.dailyemerald.com/

Research Reveals Brain Has Biological Mechanism To Block Unwanted Memories 1/9/04 “For the first time, researchers at Stanford University and the University of Oregon have shown that a biological mechanism exists in the human brain to block unwanted memories. The findings, to be published Jan. 9 in the journal Science, reinforce Sigmund Freud’s controversial century-old thesis about the existence of voluntary memory suppression. “The big news is that we’ve shown how the human brain blocks an unwanted memory, that there is such a mechanism and it has a biological basis,” said Stanford psychology Professor John Gabrieli, a co-author of the paper titled “Neural Systems Underlying the Suppression of Unwanted Memories.” “It gets you past the possibility that there’s nothing in the brain that would suppress a memory – that it was all a misunderstood fiction.” The experiment showed that people are capable of repeatedly blocking thoughts of experiences they don’t want to remember until they can no longer retrieve the memory, even if they want to, Gabrieli explained.”
http://www.sciencedaily.com/releases/2004/01/040109072004.htm

The nature of traumatic memories: A 4-T FMRI functional connectivity analysis.
Lanius RA, Williamson PC, Densmore M, Boksman K, Neufeld RW, Gati JS, Menon
RS. Am J Psychiatry 2004 Jan; 161(1):36-44. RESULTS: Significant between-group differences in functional connectivity were found. Comparison of connectivity maps at coordinates x=2, y=20, z=36 (right anterior cingulate gyrus) for the two groups showed that the subjects without PTSD had greater correlation than the PTSD subjects in the left superior frontal gyrus (Brodmann’s area 9), left anterior cingulate gyrus (Brodmann’s area 32), left striatum (caudate), left parietal lobe (Brodmann’s areas 40 and 43), and left insula (Brodmann’s area 13). In contrast, the PTSD subjects showed greater correlation than the subjects without PTSD in the right posterior cingulate gyrus (Brodmann’s area 29), right caudate, right parietal lobe (Brodmann’s areas 7 and 40), and right occipital lobe (Brodmann’s area 19). CONCLUSIONS: The differences in brain connectivity between PTSD and comparison subjects may account for the nonverbal nature of traumatic memory recall in PTSD subjects, compared to a more verbal pattern of traumatic
memory recall in comparison subjects.

replies to skeptics:

Imagination inflation: A statistical artifact of regression toward the mean. Pezdek K, Eddy RM Mem Cognit 2001 Jul; 29(5):707-18; discussion 719-29 “In the imagination inflation procedure of Garry, Manning, Loftus, and Sherman (1996), subjects rated a list of events in terms of how likely each was to have occurred in their childhood. Two weeks later, some of the events were imagined; control events were not. The subjects then rated the likelihood of occurrence for each event a second time. Garry et al. (1996) reported that the act of imagining the target events led to increased ratings of likelihood. This finding has been interpreted as indicating that false events can be suggestively planted in memory by simply having people imagine them. The present study tests and confirms the hypothesis that the results that have been attributed to imagination inflation are simply a statistical artifact of regression toward the mean.” Author contact: Department of Psychology, Claremont Graduate University, California 91711-3955, USA. kathy.pezdek@cgu.edu

Originally published in Moving Forward, Volume 3, No. 3, pp 1, 12-21, 1995. The Highly Misleading Truth and Responsibility in Mental Health Practices Act:  The “False Memory” Movement’s Remedy for a Nonexistent Problem by Judith M. Simon “Over the past few years, the “false memory” movement has manifested primarily as a media presence that discounts sexual abuse survivors as first-hand witnesses to their own experiences. Its message of disbelief has compromised the healing process of many and placed more children at risk by helping perpetrators escape accountability.” http://members.aol.com/conch8/antiTRMP1.html

Dr. Jim Freisen’s new book The Truth About False Memory Syndrome,  “The number of studies which have subjected false memory syndrome to scientific inquiry is zero. There is nothing scientific about it. There is nothing which defines it. There is no list of symptoms which  describes it, nor is there anything which helps us distinguish it from other syndromes. No studies. No such thing. That’s that. “ (Pg. 16) Shepherd’s House,  7136 Haskell St., #210, Van Nuys, CA 91406.

False Memory Syndrome Facts (not an FMSF sponsored site) at http://www.fmsf.com

False Memory Syndrome : A False Construct by Juliette Cutler Page “The concept of “recovered memory”, that is, memory of a traumatic event that had been forgotten for some period of time, has been variously explained by such mechanisms as repression, amnesia, and dissociation. However, there are over 100 years of reports and descriptions of recovered memory in the literature, including instances from times of war, torture, bereavement, natural disasters, and concentration camp imprisonment. (HOROWITZ) Many corroborated cases have been documented in instances of recovered memory of sexual abuse…”

“For example, women with known histories of abuse have been studied to determine if they had ever had periods in which the abuse had been forgotten. The abstract of Linda M. Williams’ 1995 study, Recovered memories of abuse in women with documented child sexual victimization histories.  (Journal of Traumatic Stress, 8,649 — 673, 1995) states:

The study provides evidence that some adults who claimed to have recovered memories of sexual abuse recall actual events that occurred in childhood. 129 women with documented histories of sexual victimization in childhood were interviewed and asked about abuse history. 17 years following the initial report of the abuse, 80 of the women recalled the victimization. One in 10 women (16 percent of those who recalled the abuse) reported that at some time in the past they had forgotten about the abuse. Those with a prior period of forgetting — the women with”recovered memories” — were younger at the time of abuse and were less likely to have received support from their mothers than the women who reported that they had always remembered their victimization. The women who had recovered memories and those who had always remembered had the same number of discrepancies when their account of the abuse were compared to the reports from the early 1970s.

None of the women in this study who had forgotten the abuse were in therapy at the time they began to remember again, and women’s memories, when they returned, were consistent with the actual abuse.

Charles L. Whitfield, M.D. performed a review of 36 studies on over 6,000 children and adults who were abused as children. His results showed that between 16 and 78% of subjects in these studies experienced partial to total amnesia for their abuse for some substantial amount of time. Most of the subjects had been sexually abused as children. Eight of these studies involved only subjects with fully corroborated abuse histories, four had to a corroboration rate of 60 to 80 percent, and four had corroboration among half of the subjects. All groups were similar in occurrence of traumatic amnesia.

Elizabeth Loftus herself has published studies showing evidence of recovered memory.  The 4 January 1996 issue of Accuracy About Abuse notes:

Elizabeth Loftus, high profile FMSF advocate, published a paper with colleagues on Remembering and Repressing in 1994. In a study of 105 women outpatients in a substance abuse clinic 54 % reported a history of childhood sexual abuse. 81% remembered all or part of the abuse. 19% reported they forgot the abuse for a period of time and later the memory returned. Women who remembered the abuse their whole lives reported a clearer memory, with a more detailed picture. Women who remembered the abuse their whole lives did not differ from others in terms of the violence of the abuse or whether the violence was incestuous. [Psychology of Women Quarterly, 18 (1994) 67-84.]

Loftus has also discussed “motivated forgetting”, and has presented the documented study of a college professor who became unable to remember a series of traumas, but after some time was able to recover those memories. Loftus remarked “after such an enormously stressful experience, many individuals wish to forget… And often their wish is granted.” (Loftus, 1980/1988, p. 73)
http://web.archive.org/web/20030608221633/http://www.feminista.com/v1n9/false-memory.html

How People Forget: The Truth About Delayed Memory Studies of Delayed Memory    http://web.archive.org/web/20000609035705/http://ncasa.org/memory.html
That dissociation and amnesia are relatively common in child sexual abuse survivors is well-documented. There have been several recent studies that verify the repression of trauma and the fact of delayed memories: In a survey of 450 adults in treatment for child sexual abuse, 59% had periods in which they could not remember the abuse. (Briere and Conte, in press).

In a study of 53 women in therapy, Judith Herman and Emily Schatzow found that 74% were able to obtain corroborating evidence for the abuse, through witnesses, offenders’ diaries, pornographic pictures, offender confessions, and other sources.  Nine percent found evidence that was “strongly suggestive, but not conclusive;” 11% did not try to confirm their memories; and only 6% found no supportive evidence.  The conclusion of the researchers was that, “delayed recall of sexual abuse is as verifiable as any other form of disclosure.”

Interviews were conducted with 100 women who as children reported sexual abuse in 1973,1974 or 1975.  The records of these girls were obtained from a city hospital emergency department which had interviewed the girls and the families and collected forensic evidence.  In 1990 and 1991 the women, aged 18-31, were interviewed for two hours for what they were told was a study that examined the lives and health of women who obtained care at the hospital.  In the course of the interview, the women were asked about their childhood experiences with sex. They were asked whether they or their families had ever reported childhood sexual abuse, or if anyone in their family ‘got in trouble’ for his or her sexual activities.  Thirty-eight percent of the women either did not remember the abuse or chose not to report it to the interviewer.  The interviewer states,”…qualitative analysis of these reports and non-reports suggests that the vast majority of the 38% were women who did not remember the abuse.  They responded openly to other personal matters, and over one-half of the women who were amnestic reported other childhood victimizations.”

In the recent case of Father James Porter – a Catholic priest who admitted molesting more than100 boys and girls – many of his victims, now adults, remembered the abuse only after hearing about the case through the media  Even the first victim to come forward stated that there had been a period of amnesia for the abuse.  In these cases, both the fact of the abuse and the reality of the delayed memories were confirmed.

Iatrogenic memory change. Examining the empirical evidence. Leavitt F Am J Forensic Psychol (19)2: 21-32, 2001. “Certainty of sexual abuse predated treatment in 33% of the cases. Therapeutic causation was unlikely in another 26% because personal certainty of abuse emerged on average 4.1 years after termination of treatment. The pattern was similar for groups treated with and without hypnosis. Remarkably few patients recovered first memories in therapy with the help of hypnosis. This study places the percentage at 4%. Thus, in the direct study of patients who recovered memory of childhood sexual abuse, hypnosis was not an important factor in the emergence of sexual abuse memories. …The results do not support widespread implanting of novel memories of sexual abuse by therapists.”

Suspected repressed childhood sexual abuse: Gender effects on diagnosis and treatment. Sullins CD Psychology of Women Quarterly 1998 Sep Vol 22(3) 403-418 “These results do not support reports that many therapists neglect clients’ current symptoms and instead focus on memories, use controversial techniques, make suggestive statements regarding abuse, or immediately assume that their clients have repressed memories.”

J. Herman, author of “Trauma and Recovery” replies to Ethan Watters “Doors of Memory” (Jan./Feb. ’93) in Mother Jones
http://www.motherjones.com/commentary/letters/1993/03/backtalk.html
“by now exhaustively documented. Sexual abuse of children is common (best estimates: at least one girl in three, one boy in ten). It is not over reported but vastly under-reported (best estimates: under 10 percent of all cases come to the attention of child-protective agencies or police). False complaints do occur, but they are rare (best estimates: under 5 percent of all complaints). Most victims do not disclose their abuse until long after the fact, if ever. Though many suffer long-lasting psychological harm, the great majority never see a therapist.”

Is There a False Memory Epidemic? by Stephanie J. Dallam, RN, MSN, FNP ….Conclusions
There is no reliable evidence to substantiate claims that the false memory syndrome is a “growing problem”, a “crisis”, or that it constitutes an”epidemic”. Despite the False Memory Syndrome Foundation’s pledge to disseminate only accurate information on memory, their contact and membership statistics, as reported in their newsletters and in the media, reveal a disturbing lack of clarity and consistency.  These same statistics, in turn, have provided credibility to claims that a false memory “epidemic” is sweeping the country.
Although 25 studies have confirmed the reality of amnesia in sexually traumatized populations, no reliable research has provided evidence to substantiate the existence of the false memory syndrome as it is defined by the False Memory Syndrome Foundation.
http://web.archive.org/web/19991128134659/http://idealist.com/tat/97-07-03-epidemic.shtml

U-Turn on Memory Lane  Columbia Journalism Review – July/August 1997 by Mike Stanton “The FMSF builds much of its case against recovered memory by attacking a generally discredited Freudian concept of repression that proponents of recovered memory don’t buy, either. In so doing, the foundation ignores the fifty-year-old literature on traumatic, or psychogenic, amnesia, which is an accepted diagnosis by the American Psychiatric Association. In his 1996 book “Searching for Memory,” the Harvard psychologist and brain researcher Daniel L. Schachter — who believes that both true and false memories exist — says there is no conclusive scientific evidence that false memories can be created. The FMSF acknowledges that it’s impossible to distinguish true memories from false ones, but then dismisses incontrovertible cases like Ross Cheit’s as aberrations. The foundation and its backers “remind me of a high school debate team,” says the Stanford psychiatrist David Spiegel, an authority on traumatic amnesia. “They go to the library, surgically extract the information convenient to them and throw out thrt.” A Harvard Law Review article in January 1996 argued that while scientific evidence proves the existence of delayed memories, biased reporting has helped create a social climate in which people, including some judges, have come to believe just the opposite.” http://web.archive.org/web/20000511001659/www.cjr.org/year/97/4/memory.asp

“The hypothesis that false memories can easily be implanted in psychotherapy (Lindsay & Read, 1994; Loftus 1993; Loftus & Ketcham, 1994; Ofshe and Watters, 1993, 1994; Yapko, 1994a) seriously overstates the available data. Since no studies have been conducted on suggested effects in psychotherapy per se, the idea of iatrogenic suggestion of false memories remains an untested hypothesis. (Memory, Trauma Treatment, And the Law Brown, Scheflin and Hammond (D. Corydon), 1998, W. W. Norton 0-393-70254-5)

books and articles on memory:

Memory and Abuse – Remembering and Healing the Effects of Trauma  C. Whitfield M.D. Health Communications, Inc 3201 SW 15th St, Deerfield Beach, FL.33442-8190.

Traumatic Amnesia: The Evolution of Our Understanding From A Clinical and Legal Perspective, Dr. Charles Whitfield (Sexual Addiction and Compulsivity, 4(2), 3-34, 1997), E-mail: acaadc@aol.com (Eileen King), 202-289-2174.

Trauma and Memory: Clinical & legal understanding of traumatic  amnesia (Chapter 12) in Burgess, Ann W. (ed): Advanced Practice Psychiatric Nursing. Appleton & Lange, Stamford, Ct., 1998, pp 171-186. C. Whitfield, M.D.

Memory, Trauma Treatment, And the Law   Brown,  Scheflin and Hammond (D. Corydon), 1998, W. W. Norton (0-393-70254-5),  1-800-233-4830 or http://www.wwnorton.com.

Child Abuse & Neglect, 1999, 23, No. 12, pp. 1221-1224. Manufactured Memory, Altered Belief and Self Report Mirage: The Alleged False Memory of Jean Piaget Revisited by Frank Leavitt, Ph. D. http://groups.yahoo.com/group/psnews/message/328

Sexual Addiction & Compulsivity, 4, 2, 1997, Brunner/Mazel.Inc. c 1997, Traumatic Amnesia: The Evolution of Our Understanding From a Clinical and Legal Perspective by C. Whitfield, M.D.

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