James W. Pennebaker and Amina Memon
Southern Methodist University* and University of Southampton
* Correspondence should be a addressed to either James W. Pennebaker, Department of Psychology, University of Texas at Austin or Amina Memon, Psychology Department, University of Southampton, Southampton SO17 1BJ, England. Preparation of this manuscript was supported, in part, by NSF grant SBR9411674 and NIH grant R01MH52391 to the first author. We are indebted to Laura King and Mark Young for their helpful comments on an earlier draft.
The recovered memory debate exposes several traditional and recent contradictions within psychology. Building on Bowers and Farvolden, the truth of recovered memories has profoundly different meanings for therapeutic versus legal settings. Whereas memory can be distorted during the process of retrieval, certain techniques -- such as nondirective writing -- may be helpful in reducing suggestive influences in recall. Ironically, methods which have been found to produce the most accurate recollections of the past appear only subtly different from those that yield the greatest distortions. The recovered memory debate must ultimately be viewed within a cultural context, both in terms of the phenomenon and its treatment. Parallels to other explanatory and therapeutic fads related to states of nonspecific distress are discussed.
Keywords: recovered memory, therapeutic fads, retrieval, suggestion
The evolution of the recovered/false memory debate within the last few years is a psychological, social, and cultural phenomenon. Rarely in the last century has an essentially psychological debate attracted such polarized rhetoric from academicians and the general population. At the heart of this conflict lies the question of whether it is possible for individuals to have traumatic experiences in childhood or adolescence and then not remember them until decades later.
Within this charged debate, virtually all of us are in agreement that:
1. Traumatic sexual experiences in childhood and adolescence can be associated with longterm physical and mental health problems.
2. Individuals can occasionally fail to recall important psychological events for minutes, days, and even years.
3. Through hypnosis or other forms of persuasion or suggestion, people can construct images in their minds wherein true memories may be distorted or false images created which are believed to be true.
In their compelling and timely article, Kenneth Bowers and Peter Farvolden (this issue) trace the debate about repressed and recovered memories from Freud's vacillation on the topic to current work on memory. In general, we concur with most of their arguments. Rather than quibble about details, we will be briefly address four issues of mutual concern and interest.
Truth and the Magic Bullet
In these days of deconstructionism and interest in narrative, references to Truth border on the unfashionable. Indeed, Bowers and Farvolden question whether knowing if a traumatic experience really occurred is important for the therapeutic process. Further, if a real or imagined trauma is discovered, would therapy progress more effectively? Two issues arise from this perspective. The first, which we call the "magic bullet" argument, claims that if only we can isolate the single cause of an incident, we will understand it. Presumably, sexual abuse serves as the linchpin of mental health and if it occurs, everything else falls apart. As Bowers and Farvolden suggest, the magic bullet argument rarely explains everything. In known cases, sexual abuse is typically accompanied by extremely poor or distorted relationships among family members, secrecy, denial of reality, alcohol and other substance abuse, and longterm patterns of major family conflict. Sexual abuse, like alcohol abuse or family violence, can be considered both a symptom and a cause of disturbances that can affect the entire family on multiple levels. The existence of sexual abuse is typically only one of several themes that must be addressed by the client and therapist. Focusing only on the abuse itself would not resolve many of the surrounding issues of family conflict and disturbance. In short, the magic bullet argument which assumes a single grand cause of the client's suffering is not sufficient.
More important than finding a magic bullet is establishing whether the recovered memories are true. Here, we think that Bowers and Farvolden have artfully dodged the issue. Knowing whether sexual abuse occurred within a family IS important for the client, the therapist, the family, and, in many cases, others. Legally, if a serious crime has been committed then it is imperative that the perpetrator be caught and prevented from harming others. Given this tenuous balance between psychological care and justice, the therapist must exercise caution in the techniques used during the recovery process in order that truth can be reached without contaminating it. These intertwined legal and psychological issues have not been addressed satisfactorily by researchers or clinicians.
Perhaps the central problem is that the criteria for establishing the occurrence of abuse (i.e., Truth) are different for clinicians, researchers, and lawyers. From a clinical perspective, knowing whether abuse has truly occurred may help therapy progress. Understanding the history and contributing causes of clients' current problems are standard psychotherapeutic methods that are effectively used in many forms of therapy. Clients and therapists traditionally seek to discover the degree to which earlier experiences tally with current feelings, beliefs, or behavior patterns. This relatively weak version of the Tally Argument is typically aimed at alleviating current problems rather than establishing hard truths about the past. Clinical "truth" is ultimately defined by the improvement in functioning and the reduction of distress in the client.
Whereas the Tally Argument may be a reasonable tool for clinical gains, it is an extremely weak -- and, indeed, circular -- strategy for establishing the veracity of historical events. Consider the historian who seeks to learn if John F. Kennedy's assassination was the result of a conspiracy or if novelist Jane Austen was secretly married. Historical evidence demands corroborating hard evidence from relatively objective sources such as diaries, bank account records, other people's observations at the time. Although Tally Arguments are occasionally made (e.g., "Kennedy must have been murdered by a devious government because it tallies with our knowledge of today's government"), they are forever suspect without corroborating evidence.
Psychological researchers have established their own rules for establishing historical truth. Memory researchers -- some of whom have been active in the recovered memory debate -- typically have access to the past and can therefore define accuracy of recall in a probabalistic way, such as the percentage of details correctly recalled. Armed with certain knowledge of the past, these researchers are able to explore memory distortions -- such as those resulting from leading questions, reliance on tally-esque forms of thinking, etc. Their training and research methods, however, are not always useful in helping individuals sort out historical truth when the truth is not already known.
Much of the conflict arising from the recovered memory debate ultimately pits clinical Truth against legal Truth. Legal truth, like historical truth, demands reliable and objective corroborating evidence. In the court's eyes, the mental or physical health of the client is secondary to establishing the details of occurrence of the abuse (Sales, Schuman, and O'Connor, 1994). For the therapist and lawyer, the figure and ground are reversed: the therapist is more likely to consider the alledged abuse as the background to the figure of current distress. The lawyer assumes a background of current distress and is focused on the facts of the past abuse.
The case of George Franklin, alluded to by Bowers and Farvolden, provides a telling example of conflicting therapeutic and legal agendas. Franklin was accused of the 1969 murder of Susan Nason based, to a large degree, on the memories recovered 20 years after the event by Franklin's daughter, Eileen. Although it is not clear when Eileen's memories began to return, she claims that the initial recollection occurred when she recognized an expression on her own daughter's face as being identical to that of her friend Susan before she was killed. Eileen was seeing a therapist and acknowledged that she had undergone hypnosis. More importantly, her reports of what she remembered clearly changed during the course of the investigation and the trial (MacClean, 1993). This is not surprising given that she was questioned repeatedly by a number of different people with conflicting motives.
The prosecution's case that George Franklin murdered Nason tallied with the history of abuse in the Franklin family and the involvement of Franklin in behaviors consistent with pedophilia. A jury convicted Franklin of first degree murder in November, 1990. His conviction was overturned in 1995 due, in part, to the fact that the defense was not permitted to introduce newspaper accounts of the crime scene which would have shown that Eileen's memories may have come from this source. The latter contained details similar to those given by Eileen after she recovered the memories.
The tally criterion can be useful within a strictly clinical setting where one is attempting to understand the patient's distress and world view. To the degree that the therapy client seeks to understand and move beyond the past, data matching the tally criterion is probably sufficient. Indeed, Eileen's recovered memories may have tallied with other memories in her life as well as many of her emotions and perceptions in adulthood. However, if recovered memories are to be the basis for confronting presumed past abusers, for instituting legal actions, or for otherwise radically changing the course of the client's or other people's lives, the therapist has a moral obligation to seek additional data that could confirm or disconfirm the recovered memories. If the therapist is unable or unwilling to serve as a detective of historical truth, she or he should inform the client of the relevant issues. Similarly, if memories such as Eileen's murder recollections surface, therapy may need to progress with great caution following or concurrently with a legal investigation.
Confronting the Past, Insight, and Healing
Although uncovering truth may be important in putting together one's past, it fails to address the broader clinical question of the relative value of insight versus more problem-oriented therapies. Whereas behavioral treatments have been found to be somewhat superior to other methods in treating highly specific phobias, insight, cognitive, and behavioral therapies apparently provide equivalent relief from more complex problems compared to control or placebo therapies (e.g., Smith, Glass, & Miller, 1980). To our knowledge, no large scale studies have compared the relative effectiveness of therapies focusing on recovered traumas among adults. (Such a project may never be completed, of course, since the presenting problems of people ultimately diagnosed with recovered memories will, by definition, not be the childhood traumas.) Nevertheless, the Smith et al. meta-analyses together with a number of recent traditions, including our own work on written disclosure, indicate that confronting earlier traumas can be physically and mentally beneficial.
A danger of traumatic experiences is that they disrupt virtually every feature of individuals' lives. Most research, of course, has only focused on traumatic experiences which patients remember and are aware. In these studies, there is little doubt that an upheaval -- even many years in the past -- is correlated with physical and mental health complications (cf., Pennebaker & Susman, 1988). Massive emotional upheavals that may have occurred decades earlier such as incest (Silver, Boon, & Stones, 1983), the witnessing of the murder of one's parents (Malmquist, 1986), wartime experiences including living in concentration camps during the Holocaust (Krystal, 1981), etc., can result in high rates of mental rumination, anxiety reactions, and poorer physical health for years following the incidences. Many individuals who have survived these traumas suffer from recurrent and often vivid images and memories of the events. Unlike cases of recovered memories, those who have access to the traumatic memories are unable to suppress their unwanted thoughts (see Wegner, 1992).
Interestingly, a great deal of research indicates that confronting upsetting experiences in the past can improve both physical and mental health. Further, a therapist may not always be needed. In our own work, we have had a variety of samples (professionals laid off from their jobs, medical students, maximum security prisoners, college students) write about emotionally upsetting experiences for 15-30 minutes a day for 3-5 days. Those randomly assigned to control conditions write for the same amount of time on superficial, non-emotional topics. Across several studies, those who confront upsetting experiences subsequently visit physicians less for illness, evidence improved serum immune function, find jobs more quickly after being laid off, make better grades at school, and evidence greater happiness and less longterm distress (see Pennebaker, 1993; Greenberg, Stone, & Wortman, in press; Esterling et al., 1994 for reviews). Putting upsetting experiences into words, then, has salutary effects.
Particularly striking about the writing research is that in well over three thousand essays written by almost a thousand participants in our own and others' studies no person has ever spontaneously reported the recovery of a completely new experience. This is not to say that participants don't have new memories -- they do. Indeed, a recent writing experiment by Schoutrop and her colleagues (1995) found that 68 percent of individuals writing about early traumatic experience noted that they "discovered hidden feelings and memories associated with the traumatic event of which they were unaware before." These memories were described by the authors more as features of the emotional events which helped the participants to gain "insight into their ways of coping with the traumatic experience."
An intriguing paradox about individual, unstructured writing is the degree to which it is not suggestion-free. Obviously social and cultural forces beyond the therapists' expectations help guide the distressed writers' self-analyses. Whereas the 17th century distressed individual might have sought to understand his behavior by writing about Evil Forces; the 21st century person is more likely to invoke codependency, alcohol, or bad genes as a way of explaining the same behavior. Although not suggestion-free, we have rarely found self-guided writing to be heavily deductive wherein the writers begin with a theory (i.e., "Truth") to define their problems and then seek instances to support the theory. Rather, most distressed individuals are grounded theorists (cf., Glaser, 1967). That is, they are aware of their emotions and particular thoughts, behaviors, and memories. They entertain hypotheses and tally them against experience to find understanding and insight.
We are in complete agreement with Bowers and Farvolden about the powers of suggestion. Therapists -- including Freud -- who are certain that they know Truth in their clients' past can certainly affect the information gathering strategy within therapy. For this reason, we concur with the suggestion that therapists make their biases clear and attempt to entertain multiple hypotheses about the clients' underlying problems. Indeed, we would encourage therapists to have their clients write out their assessments of their own problems and lives before formal therapy begins. Such a strategy would be beneficial for both the client and therapist. For the client, it would help to identify the presenting problems and set up the basis for tallying past experiences. For the therapist, it would serve as a relatively unsullied guide to the patient's perceptions of her or his own problems.
Memories: Lost and Found
At the heart of their paper, Bowers and Farvolden indicate that it is possible for people to recover memories created earlier in their lives. Memories, in their view, could be forgotten, suppressed, denied, ignored, or possibly even repressed. Whatever the psychological cause of the forgetting of the memories, the pertinent issue is why they come back and the context in which this recovery occurs. While the dangers of using various memory recover techniques have been made explicit in several recent reviews (e.g., Lindsay & Read, 1995; Schooler, 1994), there has been relatively little discussion of what techniques should be used by therapists.
One of the best-known techniques to aid recall is to recreate the context in which an event was experienced (e.g., Memon & Bruce, 1985). Any aspect of the original environment may serve as a cue, including emotional elements (such as feelings, bodily sensations), perceptual elements (colors, sounds, and smells), and physical features (characteristics of the location where the event took place). These techniques have been incorporated into various interviewing procedures used by investigators, a good example being "the cognitive interview." The cognitive interview encourages witnesses to take themselves back to the original event -- as if reliving it -- and to report every detail possible during the course of multiple retrieval attempts (e.g., Fisher & Geiselman, 1992). Such a strategy has been found to generate a high degree of information but, at the same time, more errors than traditional fact-oriented interviews (Memon, Wark, Koehnken, & Bull, in press).
Ironically, the techniques that are effective in aiding recall are the very ones that can distort memory. Methods, such as the cognitive interview, elicit more details about events as well as more mistakes about details. As Bowers and Farvolden note, real-world memories linked to details of events that are recalled multiple times may emerge with high (and undeserved) confidence. Further, the greater the power differential between the witness and the authority figure, the more likely the witness will give a false confession (Gudjonsson, 1992).
Within controlled laboratory studies, the basic techniques of the cognitive interview when paired with insidious forms of suggestion can result in the most striking examples of false memories. Using their "lost-in-the-mall" technique, Loftus and Pickrell (in press) ask young participants to describe the (false) time they were lost in the mall. The participants are interviewed repeatedly and asked to provide as much detail and contextual information as possible. (Note the resemblance to the procedures described above). During follow-up interviews, 25 percent of the respondents now recall the false stories as true. Interestingly, participants in these and related studies (e.g., Hyman, Husband, & Billings, 1995) are quite good at recalling true past events when few or accurate suggestions are implanted.1
The extent to which one has some prior knowledge of or a script for the implanted event may determine the likelihood that the event will be suggestively implanted into memory. Pezdek (1995) has found that familiar events (such as being lost) are more likely to be planted than unfamiliar events (receiving a rectal enema). This highlights the role that prior knowledge may play in determining whether a false memory can be successfully implanted and incorporated into memory. To what extent is someone likely to rely on script-based inferences when describing a sexual abuse scenario? To what extent are therapists likely to use their prior knowledge in framing questions? These questions have not as yet been tackled by researchers.
Ultimately, researchers are placing highly competent and well-meaning clinicians in a difficult position. The memory implantation techniques of Loftus, Hyman, and other researchers are variations on valid, well-established memory recovery methods. That is, real recall strategies should develop emotional, perceptual, and physical cues to help recall incomplete or forgotten past events. To the degree to which the therapist (and client) can avoid explicit and implicit suggestions in guiding the recall procedure, the accuracy of the memories should be optimized.
The Recovered Memory Debate Within a Cultural Context
The growth of the recovered memory movement reflects, in part, an earnest attempt by many therapists to explain distress in clients who can't understand or readily see the causes of their distress. Today's therapists, much like Freud, are working from difficult-to-validate hypotheses about their clients' early experiences. Sometimes the sexual abuse hypotheses may be true; other times not. Given that documented childhood sexual abuse has been shown to have objective longterm harmful effects, on the surface it would seem reasonable that suppressed, repressed, or forgotten abuse could carry equally adverse consequences.
Interestingly, repressed abuse memories share several features with other popular, but undocumented agents thought to produce distress. Examples of attempts to explain distress by patients, therapists, physicians, and culture in general include: electromagnetic force fields, Agent Orange, hypoglycemia, mitral valve prolapse, iron poor blood, food additives, silicone breast implants. Historically, Satanic possession (as in the Salem Witch Trials or even the dancing manias of the middle ages), UFO abductions, or effects of evil spirits have an even richer tradition. Interestingly, these diverse explanations share several features -- they offer a magic bullet explanation (i.e., single cause), are congruent with the prevailing cultural beliefs and values, are typically associated with longterm exposure without awareness, are logically plausible, and unconfirmable (see also cases of mass psychogenic illness, Colligan, Pennebaker & Murphy, 1982). Further, their use as an explanatory tool is limited in time -- perhaps as short as 5-10 years. In each of these cases, growing scientific evidence typically fails to find convincing aggregate data to support the causal claims of the presumed toxic event or substance. Certainly many, but not all, cases of recovered memory at the hands of True Believer therapists would conform to this profile of a questionable causal explanation.
Just as there are theoretical fads that help explain distress, therapeutic fads rise and fall to support and cure the new disorders. Many are as suspect as the explanations themselves. Widespread, almost unquestioned adoption of movements such as EST (now called The Forum), codependency, color therapy, aroma therapy, pyramid power, etc. are a testament to the True Believer mentality of the founding leaders of these approaches and their apostles. As beautifully illustrated by Bowers and Farvolden, even Freud became subject to the True Believer mentality. After discovering what he thought was a true cause, he founded the true treatment. Knowing Truth, then, begs for suggestion effects in therapy.
The potential dangers of suggestion in today's therapeutic climate can be seen in two recent surveys of the beliefs and practices of clinicians with respect to childhood sexual abuse (Poole, Lindsay, Memon and Bull, 1995). The first survey (300 U.S. registered psychotherapists, 43% response rate) was conducted in 1992. The second survey conducted at the end of 1993 comprised an additional 300 U.S. doctoral clinicians and 300 British Chartered Clinical Psychologists (response rates 35% and 38%). In general, the responses to questions about childhood sexual abuse from U.S. and British samples were similar. Averaging across the two surveys, 60% of the respondents felt it was important to remember abuse for therapy to be effective. Ninety-four percent accepted that it was possible to develop illusory memories. Interestingly, respondents were confident that when it came to their own clients, they were more likely to rate clients' memories as accurate. When asked about the use of so called memory recovery techniques such as hypnosis, guided imagery and dream interpretation, 71 percent of the entire sample indicated the use of such techniques. While reported use was somewhat lower in the British sample, 63% reported use of at least one memory recovery technique.
How should we be sensitizing therapists and licensing bodies to the problems of suggestion? We concur with Bowers and Farvolden that therapists must be made aware of the various factors that can adversely affect memories. Similarly, we hope that potential therapists confront questions regarding the degree to which possible early childhood traumas may or may not be influencing their clients' current problems. It is often much easier for clients (and therapists) to blame complex problems on repressed abuse than on a web of current situational pressures. Indeed, Karen Horney (1937) noted that it was tempting for female patients to cling to the notion that they suffered from unconscious penis envy rather than to admit to the contemporary causes of their problems. Finally, we urge the use of relatively unguided techniques -- such as writing -- in the early stages of therapy which should encourage clients to begin to define and understand their own problems.
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1. In interpreting the literature on recovered memories, some caution should be exercised in generalizing from the results of group effects (false memories can be readily implanted) to individual cases. Within the field of eyewitness memory, individual differences in behavior have largely been ignored despite the availability of various indices designed to measure suggestibility and memory ability (see Schooler & Loftus, 1993 for a review). Recent research has begun to look at the cognitive and personality characteristics of individuals that may predict vulnerability to suggestion (Hyman and Billings, in press). This could prove to be a fruitful line of investigation as it may identify characteristics of individuals who are likely to be most vulnerable to suggestion.