Sarah Nelson’s Can of Worms

The thought provoking and observational 'Private Eye' last week (issue 1150) published an informative article highlighting the continued pursuit of ritual abuse cases by professionals. 'Satanic Panic' referred to a number of large scale cases, most of which arose in the late 1980's and early 1990's, but also referred to the Lewis satanic case of 2003/4.

In the wake of the disturbing but excellent BBC1 documentary on the Rochdale alleged satanic case of 1990, it is important that the public are made aware that despite having been discredited on a number of occasions, belief in the existence ritual abuse in apparently normal British homes is still rife amongst professionals.

In Scotland this has extended to support groups specifically targeting those who are alleged to have been victims of ritual abuse, TRASH (Tayside Ritual Abuse Support and Help) and RANS (Ritual Abuse Network Support) are both run by Laurie Matthew and have received funding from various organisations including the Lottery Fund.

The 'Eye' article also draws attention to Sarah Nelson, and the recently published booklet 'A Can of Worms - Working with Survivors of Childhood Sexual Abuse' (Scottish Executive, December 2005) which she co-authored with Sue Hampson. This booklet is aimed at 'healthcare, social work professionals and other frontline workers.'

In this booklet, Sarah Nelson and her colleague have dismissed deep concerns voiced by professionals with regard to the validity of recollections of childhood abuse unearthed by recovered memory therapy (RMT). These concerns were voiced most strongly by the Royal College of Psychiatrists' Working Group on Reported Recovered Memories of Child Sexual Abuse.

It was concluded that "when 'memories' are recovered after long periods of amnesia, particularly when questionable techniques were used to recover them, there is a high probability that the memories are false."

It was also acknowledged that memories are subject to error and distortion, and that suggestibility and confabulation increase with time. The fact that people often cannot remember large parts of their past is not considered abnormal.

In their conclusions, the Working Group, headed by Professor Sydney Brandon (deceased - 2002) were extremely critical of a number of memory enhancement techniques practiced by professionals. These included; the use of 'check-lists', drug - induced abreaction, hypnosis (memories apparently uncovered by the use of hypnosis are no longer admissible as legal testimony), age regression, dream interpretation (used by social workers in the Rochdale case amongst others) and art therapy. Even survivors groups raised concerns, with their possibility of suggestion and contagion.

“Doctors should be aware that patients are susceptible to subtle suggestions and reinforcements whether these communications are intended or unintended.” Royal College of Psychiatrists, 1997.

“Memories can be significantly influenced by questioning, especially in young children. Memories also can be significantly influenced by a trusted person (e.g., therapist, parent involved in a custody dispute) who suggests abuse as an explanation for symptoms/problems, despite initial lack of memory of such abuse. It has also been shown that repeated questioning may lead individuals to report "memories " of events that never occurred.” The American Psychiatric Association Board Statement on Memories of Sexual Abuse.

“In formulating their symbolic interpretations, analytic therapists do not rely on any body of scientific research to verify them; such research simply does not exist. More than anything else, symbolic interpretations reflect the personal idiosyncrasies of the therapists who indulge in them. Then different analytic therapists could make ten different interpretations of the same dream, thought or fantasy.” Terence Campbell Ph. D. ‘Beware The Talking Cure‘, p 70.

“Contrary to what is generally believed by the public, recollections obtained during hypnosis not only fail to be more accurate but actually appear to be generally less reliable than non-hypnotic recall.” Scientific Status of Refreshing Recollection by the Use of Hypnosis, American Medical associations Council on Scientific Affairs 1985.

“No evidence exists for the repression and recovery of verified severely traumatic events, and their role in symptom formation has yet to be proved. There is also a striking absence ion the literature of well - corroborated cases of such repressed memories recovered through psychotherapy. Given the prevalence of childhood sexual abuse, even if only a small proportion are repressed and only some of them are subsequently recovered, there should be a significant number of corroborated cases. In fact there is none.” (Pope and Hudson 1995, Pendergrast 1996) Sydney Brandon et.al. ‘Recovered memories of childhood sexual abuse: Implications for clinical practice’.

Professor Sydney Brandon illustrated clearly the potential for inappropriate therapy to cause severe damage to individuals:

“Loftus (1997) reviewed 30 cases selected at random from 670 claims submitted to the Washington Victims Compensation Program, twenty-six had ‘recovered’ a memory of abuse through therapy. All thirty were still in therapy after three years, 18 for more than 5 years. After treatment twenty were suicidal compare with three before treatment began, eleven were hospitalised (cf. two before treatment), eight engaged in self-mutilation (cf. one before) and marriage break-up had occurred in almost all. It appears that in these cases, recovery and abreaction (the reliving of abuse in detail) had serious adverse effects.” Sydney Brandon M.D. et al, ‘Recovered memories of childhood sexual abuse: implications for clinical practice’, British Journal of Psychiatry, April 1998.

Contrary to the recommendations for good practice made by Professor Sydney Brandon and others, Sarah Nelson appears to advocate therapy used to obtain ‘recovered memories’ as credible proof of childhood sexual abuse, referring to amnesia as evidence of CSA.

A number of statements in ‘A Can of Worms’ are open to dispute and raise serious concerns about the apparent lack of an independent review of this material by experts in mental health.

“Amnesia is another very common response to serious trauma, which has complex physiological and psychological causes (incidentally, it is considered uncontroversial in respect of other traumas such as war horrors or major disasters). Amnesia, for large chunks of childhood, should invite curiosity about a possible history of sexual/physical/emotional trauma.” ‘A Can of Worms’, 2005, p.10.

In this statement Nelson and Hampson ignore accepted studies on the subject of recovered memory in association with both child abuse and war trauma, the lack of evidence to support her claims are illustrated in the following texts:

“Most people who were sexually abused as children remember all or part of what happened to them.” Interim Report of the American Psychological Association Working Group on Investigations of Memories of Childhood Abuse.

“Evidence concerning memory for real-life traumas in children and adults indicates that these events--such as the Chowchilla kidnappings, the sniper killing at an elementary school, or the collapse of skywalks at a Kansas City hotel--are generally well remembered....complete amnesia for these terrifying episodes is virtually nonexistent” Schacter 1996, 256.

“Seventy-eight Holocaust survivors were interviewed four decades after the end of World War II. None had repressed their memories of experiences in the prison camps. All but one remembered forgotten details with simple prompting.” W.A. Wagenaar & J. Groeneweg, "The Memory of Concentration Camp Survivors," Applied Cognitive Psychology, 4 (1990), Page 77.

Nelson and Hampson go on to discuss another controversial subject which appears now to be pursued by a select few therapists, ‘Dissociative Identity Disorder’. This is associated with apparently ‘hidden’ childhood sexual abuse.

“Sometimes the associations are very strong. For instance, high percentages of people with histories of CSA trauma have consistently been found in those diagnosed with “borderline personality disorder” and “dissociative identity disorder” (previously called multiple personality disorder).” ‘A Can of Worms’, 2005, p.6.

Again this illustrates an ignorant dismissal of professional findings on the subject of DID (Dissociative Identity Disorder), as well as a startling lack of clarity about their own statement. No further explanation is given as to what this ‘high percentage’ actually is, nor is it made clear exactly what is accepted as evidence of a history of CSA. According to their own definition, ‘histories of CSA’ may refer solely to recovered memories themselves. The following studies are amongst those that have been critical of the reliability of DID as evidence of childhood trauma.

“Psychiatrists should be careful to ensure that they do not directly encourage patients to develop 'alters' in whom they may invest aspects of their personality, fantasies or current problems. Any spontaneous presentation of dissociative identity disorder should be sympathetically considered but there seems little doubt that some cases of multiple personality are iatrogenically determined should not be made the subject of undue attention nor should the patient be encouraged to develop further 'multiples'.“ Royal College of Psychiatrists, 1997.

“There are not tests or set of procedures that invariably distinguish Dissociative Amnesia from Malingering.” Diagnostic and statistical Manual of mental disorders IV p. 480.

“Slater and Roth 1969 stated unequivocally: 'It seems that these multiple personalities are always artificial productions, the product of the medical attention that they arouse.' Many specialists still doubt the existence of multiple personality disorder a distinctive psychiatric condition and consider it to be iatrogenic in origin.” (Piper 1994; Merskey, 1995) It does appear that diagnoses cluster in a few specialist clinics and this suggests that bias may be operating in referral or practice. Video tapes and clinical demonstrations of the condition suggest that it arises in suggestible individuals as a consequence of the expectations of the therapist. As in hypnotic states, it is not easy to differentiate between involuntary and simulated states. There is evidence that attention (particularly from therapists) perpetuates the dissociation and leads to the creation of ever more 'alter personalities' (Merskey, 1995)." Sydney Brandon, M.D. et al, "Recovered memories of childhood sexual abuse: Implications for clinical practice," British Journal of Psychiatry, April 1998, P 302.

‘A Can of Worms’ further recommends that adults who are facing certain life challenges or personal suffering should be automatically assessed for a history of CSA. Making such an assumption is completely unsafe and again does not appear to have any scientific basis. On the contrary, professionals warn against any expectations when providing therapy.

"Psychiatrists should maintain an empathic non-judgemental neutral stance towards reported memories of sexual abuse. As in the treatment of all patients care must be taken to avoid prejudging the cause of the patients difficulties, or the veracity of the patient's reports. A strong prior belief by the psychiatrist that sexual abuse, or other factors, are or are not the cause of the patient's problems is likely to interfere with appropriate assessment and treatment." The American Psychiatric Association Board Statement on memories of sexual abuse.

"Psychiatrists are advised to avoid engaging in any 'memory recovery techniques' which are based upon the expectation of past sexual abuse of which the patient has no memory. Such 'memory recovery techniques' may include drug-mediated interviews, hypnosis, regression therapies, guided imagery, 'body memories', literal dream interpretation and journaling. There is no evidence that the use of consciousness-altering techniques, such as drug-mediated interviews or hypnosis, can reveal or accurately elaborate factual information about any past experiences including childhood sexual abuse. Techniques of regression therapy including 'age regression' and hypnotic regression are of unproven effectiveness." Royal College of Psychiatrists, U.K., 1997

It is unclear upon what research Nelson and Hampson have based the information contained in this booklet. It is disturbing that the Scottish Executive have seen fit to publish information aimed at staff and volunteers on such an important subject that ranges from inaccurate to vague and appears not to have been reviewed by any mental health experts prior to publication.

Further information on false memory syndrome can be obtained from BFMS (British False Memory Society).

Since the publication in the 'Eye' of the article 'Satanic Panic', Sarah Nelson has written to Private Eye with a response that, like her professional work, appears to be based on personal assumption and unproven theories.

In Private Eye, issue number 1151, Nelson attempts to reverse the roles played in large scale ritual abuse cases by claiming that the 'Satanic Panic' was created by abusers and that the professionals are the only true victims, having seen their careers destroyed.

"The Satanic Abuse Witch-Hunt is the only witch-hunt in history where those supposedly leading it were its victims and found their careers destroyed." she writes.

Contrary to this incredible statement, child abuse professionals, even when evidence proves that they are guilty of serious professional misconduct, continue to work and are often promoted.

Judith Jones (Dawson), a member of the Shieldfield nursery nurses case review team, which condemned Dawn Reed and Christopher Lillie, (who later won their libel case against the team) and involved in the Nottingham case, lives and works in London as an expert witness.

Jacqui Saradjian, also a member of the Shieldfield review team, continues to work as an independent clinical psychologist.

Marietta Higgs, notorious paediatrician at the centre of the Cleveland case, works for an NHS trust, as well as running her own private clinic, at the Medway Maritime Hospital, Gillingham, Kent.

Sue Richardson, also involved in the Cleveland case, presently works as a psychotherapist in Middlesborough, and is also a committee member for the UK Society for the Study of Dissociation.

These are just a few of the professionals involved in past child abuse scandals who are still working today.

Last year, Dr Camille de San Lazaro appeared before the GMC (General Medical Council). It was the medical findings of Dr de San Lazaro that formed the basis of the case against Dawn Reed and Christopher Lillie.

Heavily criticised at the time by Mr Justice Eady, Dr de San Lazaro escaped any punishment by the GMC despite admitting herself that she had "exaggerated and overstated" findings of sexual abuse.

Writer Richard Webster, who, together with journalist Bob Woffinden, assisted Reed and Lillie in bringing their successful libel case after tracking their whereabouts 5 years ago. Webster describes how, despite having sufficient evidence to bring a ruling of serious professional misconduct against Dr de San Lazaro, the GMC have done nothing to restrict her work.

"Yesterday, (written on Sat. 14 May 2005) The General Medical Council ..... ruled that some of her work was 'inappropriate', 'irresponsible' and 'unprofessional', came to the conclusion that all this was perfectly acceptable and that the paediatrician should be free to carry on destroying the lives of innocent people by making more false diagnoses. Not only was she not struck off, she was not even found guilty of serious professional misconduct. No restrictions whatsoever were placed on her work."

He goes on to say, "One of the most bizarre features of the case, which was not registered in the Press Association report of the proceedings, was that the GMC actually concluded that the evidence before them reached the threshold which would permit them to make a finding of serious professional misconduct. But they then decided that Camille Lazaro's pleas of mitigation - that she was overworked and overstressed at the time - meant that she should be given a reprieve."

This is further proof that professionals directly responsible for some of the worst child abuse scandals that the UK has seen, are completely unaccountable for the irreparable damage they have caused, and continue to cause.

Sarah Nelson’s letter further supports the fact that professionals in the field of child protection mislead and misrepresent as a matter of course, even when they can be proved wrong.