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Pseudo-Identity
and the Treatment of Personality Change
in Victims of Captivity and Cults

Part 2 of 3

Towards the end of his teen years, Danny became interested in religion and eventually joined a sect (by our definition a totalist cult) that was an offshoot of the Reorganized Church of Jesus Christ of Latter Day Saints (LDS). His parents grew concerned about the personality change they saw in their son. Danny's father made several trips to the town where the cult was located and talked to pastors, police officers, and the FBI. They assured him that his son was merely going through a "phase" and that he would soon grow weary of the group and return home. However, far more ominous events transpired. The cult leader, Jeffrey Lundgren, declared that God had told him that members of a certain family within the group must be judged. "Judgment" meant that blood must be shed. Danny participated in Lundgren's murder of the victimized family. He assisted the Lundgrens in killing the two parents and all three daughters, aged 7, 13, and 15. The family members were lured one by one into a barn, bound and gagged, and then taken to a large hole that had been dug in the barn floor, where Lundgren shot them with a .45 automatic pistol and buried the bodies. Lundgren, his family, and his followers then moved westward. Eventually they were apprehended in California, returned to Ohio, and tried for murder.

In subsequent interviews, Danny appeared calm and unperturbed. There was no evidence of a personality disorder, except for the appearance of high dependency elevations and high normal elevations on the narcissistic and antisocial scales of the Millon Clinical Multiaxial Inventory (MCMI). All other tests and repeated clinical interviews showed no evidence of emotional distress or thought disorder.

At first Danny denied that he had had anything to do with the murder of the family. But when he was asked about the judgment of God, he admitted that he had served as God's instrument in executing His judgment. While confessing, Danny showed no apparent remorse. In fact, there was a wooden, matter-of-fact quality in his admission and in his entire demeanor.

At the sentencing hearing, Danny's father appealed without success for professional help for his son to break the spell that Lundgren had seemingly cast over him. As one reporter observed, "the younger Kraft (Danny) only smirked and appeared indifferent as Lake County Common Pleas Judge James W. Jackson listened to experienceses in the second day of the ex-cult member's sentencing hearing" (McGillivray, 1990, p. 2). His defense lawyer, Elmer Giuliani, argued, "He (Lundgren) has divided this young man from what he was at one time to what you see today. He divided this man's mind from a free thinker to a mirror image [of Lundgren]" (McGillivray, 1990, p. 2).

Other than Lundgren's wife and son, Danny is the only person who was convicted who is apparently still under the control of Lundgren. The zealous beliefs of the other cultists eventually faded, and they now perceive Jeffrey Lundgren as anything but a prophet of God. It remains to be seen whether Danny's fairly classical case of pseudo-identity will yield to treatment (if any can be provided in prison) or to the passage of time.

Sometimes the pseudo-identity becomes destabilized. Such destabilization can occur when internal defense mechanisms break down; when changes in the group occur that cannot be explained or tolerated by the member; when information is received from outside sources that is dissonant with currently held beliefs, or otherwise anxiety provoking; when gradual fatigue and strain occur after a period of arduous work on behalf of the cult, perhaps with concomitant threats of punishment for poor performance; or when the cult member is traumatized by such events as humiliation by a superior. Destabilization may also be seen when a cult member experiences a sense of failure or impending doom for not being able to meet the group's demands or otherwise satisfactorily to conform. The three clinical pictures described below may be seen in recent converts who experience destabilization to the point that they drop out before a more fixed pseudo-identity is formed. They may also be seen after a pseudo-identity is formed but is subsequently destabilized, even after departure from the cult. 1. The "Floater." Nothing distresses parents and loved ones more than experiencesing a recovering, former cult member begin to "float." Floating is a dissociative phenomenon that is best described as a sudden switch back to the pseudo-identity, a regression which is most commonly triggered by certain sights, sounds, touches, smells, or tastes in everyday life that were ubiquitous and salient stimuli in the cultic milieu. Characteristically, floating occurs in cult members who have left the group of their own accord, have received incomplete counseling, or are still in the beginning phases of counseling. A former member who floats after phoning a cult member may, as a result, even return to the cult.

Jennifer, a college graduate, had served as a teacher overseas for 7 years with a well-respected religious organization. She then returned to the United States and joined a different church. Gradually, she and others of the congregation became entranced by their charismatic pastor. Over time, Jennifer began to believe ideas and to practice behaviors that previously would have been unthinkable to her. Despite her previous fundamentalist Christian beliefs regarding ethics and morality, Jennifer repeatedly engaged in illicit sexual activity with her cultic pastor, who told her that it would make her "more spiritual." No amount of persuasion by friends and family could convince her that the group or its teachings and practices were unhealthy. She eventually agreed to seek counseling, but only to convince her parents and friends that the cult was in fact healthy and that their fears were unfounded.

Initially Jennifer presented a rather robotic picture to the therapist. Her affect was flat and her speech was mechanical, as were her bodily movements. She exhibited clinical signs of dependency, anxiety, and depression. After many daily sessions, one day the therapist said something that shifted Jennifer away from her pseudo-identity. In the following session her affect and bodily movements were no longer stilted, and she began to express some of the doubt and pain that were appropriate to the reality of her experiences in the cult. In short, the "old Jennifer" began to re-emerge. The change was dramatic. Needless to say, Jennifer's parents were much encouraged.

A few days later in a group therapy session another patient said something critical about Jennifer's cult leader. The therapist watched Jennifer's eyes loose their focus. She stared off into space. Suddenly the pseudo-identity was back. Criticism of the leader apparently served as a trigger for her automatically to recite the programming that she had received in the group: that is, to defend the leader against all criticism. Subsequently Jennifer required 5 to 6 hours of continuous discussion during which the therapist reviewed with her the cult leader's abusive and unethical behavior. With this cognitive exercise, Jennifer's frozen affect began to thaw again. She has since remained free from the cult, is now married with one child, and works as a school teacher.

2. The "Contemplator." Dissociated trance-like symptoms are often seen in members of cults or sects in which contemplative exercises are practiced, such as chanting or meditation. "Speaking in tongues" may also produce this effect.

Sabrina was a member of a martial arts cult for a number of years. Her parents became concerned about progressive behavioral and personality changes, together with her gradual estrangement from the family. Eventually Sabrina sought counseling when she began to experience significantly distressing symptoms. She was found to be suffering from a major depressive episode, with predisposing passive dependent and schizoid personality characteristics. Her therapist noted that sometimes Sabrina would begin to stare, her eyes would become unfocused, and she would become unaware of her surroundings. The therapist would literally have to call out her name several times in order for Sabrina to reorient herself as to time, place, person, and event. With Sabrina, there were no apparent cues or triggers for these trance-like states. When she entered these states she would find herself automatically engaging in some of the activities that had been a part of her martial arts training. Over the course of several weeks of therapy, Sabrina's episodes of contemplative dissociation diminished in frequency. In time, they disappeared entirely.

Sabrina was fortunate. In some cases, contemplative dissociation is very resistant to modification. Former cult members who have practiced chanting and meditation for hours a day over a period of many years may require special rehabilitation or extensive therapeutic measures (see "General Treatment Issues," below).

3. The "Survivor." Certain dissociative symptoms are frequently evident in persons who have survived severely traumatic events. Herman (1992) notes that victims of incest, rape, terrorism, concentration camps, and cults share common responses to trauma, which may include feeling disconnected or detached from their selves or their surroundings (depersonalization, derealization), psychophysiological hyperarousal, intrusive memories of the trauma, and/or emotional and behavioral constriction.

Our clinical experiences with former cultists confirm that they may develop symptoms similar to those seen in victims of imprisonment, torture, terrorism, incest, physical abuse, or rape. In about 25% of our cases, cults are found to have perpetrated sexual and physical coercion and other abuse, including the inculcation of fear, terror, or dread. Further, cults are seen to exploit group dynamics for social control, and to employ specific techniques to induce altered states of consciousness. It is interesting to note that one study of former cultists (Martin, Langone, Dole, & Wiltrout, 1992) revealed no significant differences in the MCMI between those who had been subjected to sexual and/or physical abuse, and those who did not report an abuse history. While usually the case, apparently neither brutal treatment nor confinement is necessary to produce the survivor type of clinical picture, as is illustrated in the following case.

Charles was a graduate of a large state university. His parents enjoyed a solid marriage. His father was an anesthesiologist. Charles had joined a Bible study group while at the university and after graduation he, along with many of the group's members, moved to be closer to the leader of the group. These Bible study members found themselves part of a small, cultic rural compound that advocated white supremacy, militancy, and a belief in demons as the source of virtually every personal problem. The leader advocated a series of extreme measures to rid the cultists of their demons. These measures included long and arduous fasts, beatings, physical threats of death, prolonged verbal abuse, isolation, public confession, and almost constant shaming and humiliation. Charles was subjected to all of these methods to exorcise his demons. His parents, fearing that he might be dying from the fasts, contacted local police and had their son seen by a counselor. Charles was later referred for more extensive counseling in a residential setting.

At first appearance Charles was gaunt, his eyes were sunken, and he stared into space incessantly. He was listless and passive, resembling a Holocaust survivor. Although Charles was no longer in the cult, he had apparently come to believe that he was indeed hopeless, wicked and demonized. Clinically, Charles suffered from a depressive illness with obsessive compulsive features. He also met the criteria for the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV; American Psychiatric Association, 1994) diagnosis of Acute Stress Disorder and Brief Reactive Dissociative Disorder. His dissociative symptoms included trance-like states, derealization, depersonalization, and psychic numbing: "I feel nothing; I feel dead." In addition, Charles experienced fear, intrusive recollections or flashbacks, hopelessness, and despair. Charles received daily intensive psychotherapy for more than 5 weeks. He was also prescribed fluoxetine, an antidepressive medication. By the time Charles left the treatment center he had gained weight and was no longer depersonalized, numb, or feeling a sense of despair. He continued in outpatient therapy for nearly year. Currently, he is performing very well as a graduate student and was recently married.

GENERAL TREATMENT ISSUES

Misunderstandings about cult victims and their treatment abound (Martin, 1983; Singer & Addis, 1992). Perhaps the most disturbing myth is that only troubled individuals or those from dysfunctional homes join cults, while well-adjusted youth are immune. Although several well-designed studies and numerous clinical reports have refuted this idea, it stubbornly persists (Wright & Piper, 1986; Maron, l988). Another common misconception about cults is that their dangers are either greatly exaggerated or are nothing more than fictitious concoctions by over-controlling, neurotic, or ignorant parents; by misinformed religious (or anti-religious) bigots; or by unscrupulous therapists bent on terrifying families, traumatizing followers of "new religions" through brutal deprogramming sessions, and collecting enormous fees (Bromley & Shupe, 1981; Bromley & Richardson, 1983; Barker, 1984; Robbins, 1988). Objective therapists will reject such viewpoints (often promulgated by nonclinicians if not armchair philosophers) and will prefer to trust the evidence of their own information as obtained from experienced colleagues, patients, family members and other reliable informants. Such therapists will quickly perceive that the cultic situation impinges upon the particularities of each member's personality and behavioral history to produce a resulting constellation of symptoms, or even to precipitate a serious psychiatric illness.

Some specific methods used in treating cult victims have been described in a number of recent books and articles (Martin, 1989; Martin, Langone, Dole & Wiltrout, 1992; Martin, 1993a; Martin, 1993b). These publications note that proper treatment can be difficult, that it is more education-oriented than many other therapies, and that it progresses through several fairly predictable phases. Following is a brief summary of some of the salient features of these treatment methods.

The goal of treating a former cultist is to relieve the patient's cult-induced psychopathology and thus to restore his pre-cult personality. This can be a daunting task. The difficult and necessary challenge of all therapy with former cult members is to carefully restructure the patient's unhealthy responses to the stressful demands made by the cult on the patient's previous sense of identity, including values, mood, thought and behavior. The therapist must also clearly define the patient's dissociative symptoms, so that treatment can be oriented toward the particular type of psychopathology that is present. For example, dissociation caused by meditative practices may require a different approach than dissociation secondary to physical trauma. Moreover, more than one dissociative symptom may be manifest in the same patient, either simultaneously or sequentially. Different types of dissociation must be identified clearly and treated appropriately for the best therapeutic results.

Classic pseudo-identity cases require treatment very much like that employed by most therapists who treat patients coming out of cults. Generally treatment of cult victims contains several elements. Some or all of the following may be required:

  1. . Medical care for illness, often related to malnutrition, avitaminosis, neglect of chronic disorders such as diabetes or peptic ulcer, and neglect of preventive health measures such as inoculations, proper diet, regular exercise, and the like.

  2. Psychiatric treatment for mental illness, including medication to manage symptoms of depression, anxiety, panic disorder, etc., and perhaps the use of special methods such as hypnosis or narco-synthesis for resistant dissociative symptoms.

  3. Individual psychotherapy.

  4. Group psychotherapy.

  5. Exit counseling.

  6. Family therapy.

  7. Educational guidance and counseling.

  8. Vocational rehabilitation and training.

  9. Special referrals for pastoral counseling if indicated (e.g., when the recovering patient seeks affiliation with a legitimate religious group, or wishes to return to his original family church).

  10. Legal consultation, if needed, to help the patient put his affairs back in proper order if -- as often happens -- they have been much neglected, disrupted, or exploited during the period of cult membership. Legal action, including both punishment of offenders and recovery of damages by the victim, can be very therapeutic in many cases.

TREATMENT STRATEGIES

Patients showing clinical pictures of the subtypes described above may require special treatment strategies. Suggestions about these include the following. 1. Treating the "Contemplator." Dissociative and other symptoms resulting from contemplative cult practices may continue to be problematic in treatment long after other symptoms have improved. Contemplative symptoms can include inability to concentrate, relaxation-induced anxiety, and dissociative phenomena such as automatic lapsing into meditation, chanting, or trance-like states. Ryan (1993) found that one of the most effective methods to remedy "spacing out" is physical exercise. Exercise may also help to alleviate other contemplative symptoms, such as lack of awareness of bodily sensations, muscle tension, fatigue, and the association of these with emotional dysfunction or distress. Other helpful techniques include identifying aspects of the environment that create stimulus overload, slowly building up reading stamina by setting a timer and thereby gradually prolonging reading time, and learning to counter magical thinking through a specific series of reality checks.

Dissociation has been viewed as a phenomenon that is associated with subcortical areas of the brain (West, 1967; Putnam, 1989). To a certain, though lesser, degree the cognitive processing problems ex-cultists experience resemble difficulties encountered by some head trauma or stroke patients. Therefore, as with patients who have known neural lesions, selected cult victims may benefit from the employment of structured linguistic remediation. Some patients report that such methods, which focus on memory, concentration, and linguistic encoding and decoding, are very helpful in reducing various types of dissociation. Specific exercises include (1) reading several paragraphs aloud to the patient and asking him to restate the ideas expressed in the passage, (2) asking questions pertinent to the sequence of the content read to the patient, (3) asking the patient to analyze the story or to repeat it, and (4) inviting the patient to respond to sentences that require an expression of opinion relevant to the content. The clinician should note the latency of responses, the need for clarification of the task or topic, the patient's memory for details, problems in his ability to focus and concentrate on the task, and deficits in expressive verbal skills.

Since altered states may result from a narrowed focus of attention and a limiting or restricting of external stimuli (as occurs in many cultic environments), awareness training in the visual, auditory, and aesthetic modes can be helpful. For example, by encouraging clients to name all the different sounds they hear in 30 seconds, and then all the colors and shapes they see in a room, the therapist reinforces awareness of sensory stimuli that a dissociative state may have diminished or even (in the case of a trance) abolished.

Various mnemonic devices for remembering the details needed to engage in everyday activities can be taught to a former member so that he can better recall, for example, the five or six items he recently purchased at the grocery store. Daily readings of newspapers, magazines, or short stories can be useful as well, particularly when the patient interrupts the activity at regular intervals to check his recall ability and his awareness of the present environmental situation.

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