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Pseudo-Identity
and the Treatment of Personality Change
in Victims of Captivity and Cults
Part 3 of 3
2. Treating the "Floater." Typically, a former member
floats, or returns to a pseudo-identity state, as a result of a trigger
that can be visual (e.g., seeing a book written by the cult leader),
verbal, physical, gustatory, or even olfactory. To defuse the trigger, it
must be identified and the cultic language or jargon associated with it
examined. Words that are given unique or idiosyncratic meaning by the
cult should be correctly redefined by showing the client the dictionary
definition of the word. Sometimes merely concentrating on crossword
puzzles and other word games may help a patient to diminish or prevent
floating (Tobias, 1993).
The immediate or crisis treatment for floating involves orienting the
patient sharply to present reality with respect to time, place, person,
event, and self. It may be necessary to remind him repeatedly that he is
no longer in the cult, to encourage him to engage in conversation, and to
review facts that promote the experience of being himself in the here and
now. Crisis treatment should also include a review of why he left the
cult and the problems associated with it (e.g., exploitative or criminal
behavior). Patients should be encouraged to make notes and list the
reasons why they left the cult, along with the personal and social
problems that ensued from their cult experience. If they cannot reach
their clinicians when episodes of floating occur, they can review their
notebooks until the floating stops or they receive help.
Generally, floating is diminished by a thorough and comprehensive exit
counseling process. The more the former member learns about the
cult, and the more he is helped to understand the negative impact
the cult has had on him, the less likely he will be to experience
episodes
of floating. If these episodes persist, more rigorous methods -- similar
to
those employed in treatment of major dissociative disorders -- may be
required.
3. Treating the "Survivor." People forced by manipulative
cult leaders to engage in and/or experiences heinous acts often manifest
symptoms of PTSD. Nightmares, intrusive thoughts or images, fearfulness,
and various psychosomatic malfunctions are common reactions. However, the
formation of a pseudo-identity is not necessarily associated with
specific traumata, and the symptoms that cult members experience after
they leave the cult may not be exactly those which meet the diagnostic
criteria for PTSD. Nevertheless, the cult experience itself, and the
process of disengaging from the cult, inevitably involve some degree of
trauma to the person. The picture of a concentration camp survivor may
result. To promote a full recovery from the sequelae of cult membership,
the therapist should help the former member to learn about the dynamics
of cultic groups and to understand how individuals in such situations can
be induced to behave in ways highly deviant from their previous patterns,
or to fail to behave in ways that were previously characteristic. Therapy
should focus on "detriggering" and "reframing" the traumatic incidents
that continue to affect the former cult member via educative strategies,
cognitive-behavioral techniques, memory work, and dynamically oriented
psychotherapy, as indicated.
> SPECIFIC TREATMENT ISSUES
During the course of therapy, the following issues must be addressed in
treating the traumatized former cult member.
1. Formulate how the cultic trauma interacted with the unique aspects of
the patient, pre-abuse factors must be evaluated including the patient's
age, gender, personality, coping style, family of origin, and pre-cult
personal history.
2. The specific nature of the cultic trauma must also be examined;
including the following:
a. Did predisposing personality or situational factors render the cult
member vulnerable to recruitment? It is important to note that most
people who are recruited into cults were not seeking to become cult
members, did not suffer from any significant psychosocial handicaps, and
did not come from atypical family situations. Although it is important to
explore the individual vulnerabilities of the patient to the recruitment
process, it can also be helpful for former cult members to recognize that
cult recruiters regularly play on a myriad of personal characteristics
that are normal or even desirable in the general population,
characteristics such as loyalty, honesty, idealism, and a trusting
nature.
b. How was the cult member's pseudo-identity shaped by use of
deception, guilt, coercion, conditioning techniques involving deliberate
positive and negative reinforcement, group indoctrination, environmental
manipulation, hypnotic methods, and other maneuvers to increase
suggestibility or produce trance-like states?
c. How was the patient: affected psychologically by the "thought
reform" elements in the cultic environment? Specific issues and symptoms
that can be addressed include denial, fragmentation of the self,
depression, anxiety, phobias, dissociation, dissociation triggers, and
how these various mental mechanisms and symptoms are related to the
cultic milieu.
d. How were specific traumatic incidents stored? Storage could be
cognitive via the doctrinal framework, sensory via visual and auditory
stimuli, or interpersonal in terms of automatized behaviors, action
tendencies, or group-determined roles. Further, what is the means by
which this patient's trauma-related stimuli trigger memories of painful,
confusing, and guilt-producing cult experiences?
e. How can painful memories of the cult experience, and the eventual
disillusionment, be defused? As with victims of other types of
trauma, three basic assumptions have been violated or undermined with
respect to ex-cult members' view of themselves and the world: "the
belief in personal invulnerability, the perception of the world as
meaningful, and the perception of oneself as positive" (Janoff-Bulman,
1985,
p. 15). The clinician must facilitate the former member's task of
recapturing or reframing positive attitudes about life, the self, the
family, society, and the like.
The consequences of pre-cult abuse (if any) and the subsequent cultic
abuse are treated initially by educating the former cult member with
respect to the psychological manipulation techniques that were used to
deceive or mislead him. In this way, he learns that he was not solely
responsible for his misfortune. (Blaming the victim is ubiquitous; even
victims do it.) Some former members may say, "I'm fine," and show extreme
defensiveness about the group's flagrant abuses. Such denial must be
confronted by educating them about the after effects of cultic abuse in a
manner analogous to the early intervention work with victims of rape,
physical abuse, and other types of interpersonal trauma.
Former members can gain a sense of perspective about their cultic
involvement by learning about the manipulative teaching of their
particular cult, the practices of their cult leader, and the group's
ethical tenets and exploitative use of personal relationships. This can
be accomplished by presenting didactic material on the techniques of
thought reform used; showing the ex-member testimonials of other former
cult members who have made a successful post-cult recovery; encouraging
the ex-member to talk to or visit with other former members; providing
general readings and other educational materials about cults; and
examining how a cult, if it
claims to be religious, actually deviates from the main traditions of the
religion from which it presumably derived (e.g., Protestant
Christianity), or how a psychotherapy cult departs from the accepted
standards of care and ethics practiced by reputable mental health
professionals.
The educational aspects of treatment are primarily part of the first of
the three stages of recovery, which overlap with each other. The three
stages of recovery can generally be assessed by the type of questions the
ex-cultist asks. For example, when a therapist hears the following
questions and statements, he will know that the former cult member is in
the first phase of recovery: "Is the group really a cult?" "Maybe I could
have tried harder.I'm so confused.Were my needs really being met in
the group?I'm fine. The group had some problems, but it wasn't that
bad.I know something is wrong; I just can't put my finger on it." The
initial treatment goal for the patient who asks such questions is to
finish the exiting process. This entails a thorough examination of the
cultic milieu, the resultant trauma, and the various pre-abuse factors
that may be relevant. In short, the clinician must educate
the patient, as described above. Valuable insights may be gained at this
stage by using instruments such as the MCMI and asking patients specific
questions about the cult and why they left. High scores on the
Dependency, Avoidant, Schizoid, Anxiety, and Dysthymia scales are
typically associated with untreated former cultists. Defensive and
guarded answers about the group may indicate that the patient is still
processing or denying a well-documented history of abuse within the cult.
Once issues in the first stage of post-cult recovery are resolved,
patients will begin to make comments along the following lines: "I miss
my friends in the group.I feel like a fool.I want to get my things
back from the cult.I don't know what to believe anymore about God,
groups, religion, or friends.There are issues I never dealt with
before joining.I want to learn all I can about cults.Will they try
to come after me?I have lost all this time." Patients who express such
thoughts are in the second stage of recovery. While the first stage
corresponds to a focus on the past, comments made during the second stage
of recovery reflect an ability to focus on the present, and to view the
cult involvement as a past experience. At this point, the dissociative
symptoms of floating are usually no longer evident. Likewise, the stunned
and frozen affect of the post-traumatic first phase is often much
diminished, although in some ex-members, contemplative dissociative
states may linger and persist throughout the second and even the third
stages of recovery.
Treatment issues at the second stage correspond more to those of
traditional therapy. Permission to grieve is of utmost importance. Anger
and rage at this stage can be intense. Agonized verbalizations such as "I
feel as though I have been murdered" are not uncommon. In addition to
grief work, patients are now able to examine how they were recruited.
Because cults
manipulate each person's strengths and weakness, it is important for the
patient to realize fully how he was lured into involvement with the cult.
At this stage, it is important for the ex-cultist to regain his ability
to validate the pre-cult self and to learn in more detail how this self
was suppressed and displaced by the pseudo-identity. Work on emotional
expression and self-awareness of feeling states is essential because
psychic numbing can still persist at this stage of treatment. Special
exercises are necessary for patients who cannot yet normally experience
emotions, or who are too guilt ridden to express rage or anger.
Stage three is more future oriented and optimistic than stage two. At
this phase of treatment, patients ask questions pertinent to what they
will do in the future regarding jobs, going back to school, finding
careers, where they will live, whom they will date, and how they will
rejoin their families. Treatment at this time is best oriented to career
and guidance counseling. Family therapy, time and skills management
training, and job and interview skills training may well be pursued at
this juncture. Certain cult victims may require legal advice if criminal
or civil charges against the cult are contemplated or pending.
Each stage of recovery can be marked not only by progressive insight but
also by appropriate emotions. It is important for the clinician
repeatedly to return to the source of emotional distress. For example,
the early depression that a former member might feel for having "failed
God," which accounts for why he is no longer in the group, is very
different from the depression of a member who finally comes to the full
realization that his trust fund was stolen by the cult leader or that his
spouse became the cult leader's concubine. It is important for the
clinician to analyze the nature of the conflicts and issues facing the
patient, in addition to evaluating the patient's psychopathology, as
treatment proceeds.
Natural strengths and assets can be discerned in the recovering cultist,
and the clinician will be gratified to notice the accelerating momentum
of improvement as he fosters the former cult member's progress from the
early to the more advanced stages of recovery. In every way the clinician
should strive to facilitate the recovery process and to help provide the
appropriate resources, support, and tools needed by the patient along the
path of recovery. Ultimately, if all goes well, the clinician who has
facilitated the patient's recovery will be deeply gratified as the
symptoms of the pseudo-identity syndrome progressively vanish, and the
pre-cult self is restored, repaired, and returned to a more normal life.
NOTE
1. The detached masculine pronoun is used throughout in the traditional
convention to designate both sexes.
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