The Magazine

Memory on Trial

Psychotherapy as expert witness.

Jun 1, 2009, Vol. 14, No. 35 • By CAITRIN NICOL
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Patients' forays into this realm in search of rotten treasure were scheduled frequently, sometimes daily, for months or years on end, fostering--instead of the psychic resources to get on with life that good therapy provides--an extreme reliance on the therapist, that indispensable creature, for continuing the spooky insights. Along the way, everything the patients thought they knew, the coherence of their very identities and knowledge of their own past, exploded.

The resulting supernova had public consequences far beyond what its incendiaries had probably thought through. Families such as the Souzas were caught up in a tragically bizarre miscarriage of justice in which the truth was of no use to them because no one wanted to be seen as defending the damned. It is revealing of our cultural psychology to consider what crimes are so unthinkable that the mere suspicion of them renders the suspect forever outcast: Better to be a good clean killer than what these poor souls were charged with. And yet, with all of its unthinkability, this crime was readily believed to be ubiquitous, the sort of thing that "happens in the best of families"--a paradox sustained by an unholy fascination.

After some defensive scuffling in the criminal courts, McHugh and his allies at the False Memory Syndrome Foundation went on the offensive, testifying in civil suits against the therapists and clinics responsible for all the trouble. They enjoyed some success on these fronts, and the "epidemic" went into remission. But the proponents of MPD never acknowledged their error, instead retreating into metaphors and fiddling around with terminology so that they could go on peddling the same basic theory.

"History does not repeat itself," Mark Twain is rumored to have said, "but it does rhyme."

To stave off such a stanza, McHugh devotes the latter half of his book to a guided tour of related topics in psychotherapy, the structural features of the discipline that gave rise to this "hysterical response to hysteria." The Diagnostic and Statistical Manual, psychiatry's central reference book, played its part in lending scientific credence to an unscientific condition in the way it classifies disorders by symptoms without regard to cause. As the new edition, DSM-V, is being prepared for release in 2012, its authors would be well advised to heed Dr. McHugh's suggestions for reform.

More fundamentally, McHugh traces the philosophical roots of the recovered memory craze to ideas of hidden conflict and "foundational viciousness" in family life central to the dominant school of thought at Harvard during his training there. And as goes Harvard, so goes the nation.

Boston, town and gown, had taken to Freudian psychology and psychotherapy like a religious awakening. Especially for young men and women, Freudian ideas seemed to explain so much about human nature and to suggest even more about the reforming of society that an enthusiasm of almost Salvationist hope carried them along.

In the mold of other great Northeastern awakenings--mesmerism, abolitionism, Transcendentalism, Christian Science--its bold vision of a bright new world sold itself with a seductive beneficence. The small, dreary work of mending social cracks, conserving, protecting, and improving what is there, was pitted against razing civilization to the ground and building up a dream to take its place. But the dream, brought into the light of day, became a nightmare, and when everyone awoke, it was not to step into a great new shining world, but to move among the battered structures of the old one.

That more of them are still standing than might have been is thanks, in part, to Paul McHugh, M.D.

Caitrin Nicol is managing editor of the New Atlantis.