Satanic Ritual Abuse: Principles of Treatment

Sarah Robertson is an associate editor of the Canadian Book Review
Annual.

Within the psychiatric community there rages a highly polarized debate
about the objective reality of Satanic ritual abuse (SRA). In a book
that revisits many of the themes addressed in The Osiris Complex (1994),
a collection of case studies in multiple personality disorder (MPD), Dr.
Colin Ross seeks to establish a middle ground between the extremes of
scepticism and belief. On the basis of historical precedents for SRA
(the subject of this book’s first section), he suggests, “for the
sake of discussion, that 10 percent of the content of [SRA] memories
could be historically accurate and based on distorted recall of
childhood participation in small Christian cults; small, isolated groups
of Satanists; deviant elements of the Ku Klux Klan; pornography; or
other forms of abuse that a child could misinterpret as Satanic.” Ross
argues that the therapist’s position should be one of “ideological
neutrality.”

According to Ross, most SRA patients have MPD. The course of therapy he
advocates for MPD cases with ritual-abuse memories is problem-oriented
and cognitively based. The deprogramming model, whereby the therapist
adopts the self-inflating role of “cult-buster” and “rescuer,”
is rejected in favor of “treatment alliances” established between
the therapist and the alter personalities. Other specific treatment
issues addressed include memory work (caution is advised due to the
potentially retraumatizing consequences of memory recovery); boundary
violations on the part of therapists who themselves have “unresolved
trauma histories”; the management of double binds in patients and
traumatic countertransferences in therapists; and the relationship
between SRA and borderline personality disorder. In Ross’s view,
treatment for both SRA and MPD is seriously undermined by the fact that
“psychiatry, as a profession, is undertrained to deal with the
long-term consequences of serious childhood trauma.” The book’s
final section includes a discussion of how therapists can counter
“frivolous” false-memory lawsuits.

In her afterword, Elizabeth Loftus, an apparent sceptic in the
repressed-memory debate, questions Ross’s ideological neutrality and
raises the possibility that SRA memories are in toto a construct of
therapy—a fitting end to a book that is as much about the
psychodynamics of the opposing sides in the dissociative-disorders field
as it is about the psychodynamics of SRA patients.