Book Review Topic: Ritual Abuse

Survivors and Victims Empowered

Treating Abuse Today

Journal of Survivorship, Treatment and Trends

  • Managing Editor: Phil Sheldon
  • Editor, Lynn Crook, MEd
  • Published by Survivors and Victims Empowered

    Book reviews from Volume 7, Number 2, March/April 1997

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    Cult and Ritual Abuse

    Its History, Anthropology, and Recent Discovery in Contemporary America.

    James Randall Noblitt, Ph.D., and Pamela Perskin. Westport, CT: Praeger Publishers, 1995.

    Satanic Ritual Abuse

    Principles of Treatment.

    Colin Ross, M.D. Toronto: University of Toronto Press, 1995.

    Reviewed by: Ann S. Earle, C.C.S.W., B.C.D.

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    Given the current trend in our society to discount ritual abuse
    allegations, it is perhaps no coincidence that there has been a dearth
    of information on this topic for professionals who treat ritual trauma.
    However, two books, both released in the fall of 1995, help fill this
    gap in the literature: Cult and Ritual Abuse by Dr. James Noblitt and
    Pamela Perskin and Satanic Ritual Abuse by Dr. Colin Ross. These books
    are among the very few that have been written by professionals who
    actually treat ritual abuse survivors and related disorders. While
    both books address the political issues in this area of treatment, they
    differ in their responses to these issues.

    Noblitt and Perskin appear to have three primary goals in writing their
    book. First, to present ample evidence to suggest that ritual abuse has
    been practiced cross-culturally throughout the course of history.
    Second, to suggest that altered states of consciousness, historically
    referred to as “possession” in many religious traditions, are actually a
    dissociative phenomenon which includes Multiple Personality Disorder
    (now referred to as Dissociative Identity Disorder [DID] in DSM IV).
    Finally, the authors contend that Cult and Ritual Trauma Disorder should
    be considered a new diagnosis.

    Noblitt and Perskin offer an extensive examination of the historical and
    anthropological background of various religions, cults, and fraternal
    organizations, to substantiate that traumatic rituals have been used for
    centuries to produce altered states of consciousness. Whereas in some
    cases these altered states have been viewed as “sacred,” in many others
    the purpose was to establish control over other people. The authors’
    assertions are carefully documented and their footnotes provide much
    additional information. Their survey includes African-derived cults
    such as Vodoun, Santeria, and Palo Mayobe; “New World Cultures”
    including the Incas, Mayans, and Aztecs; Shamanic traditions; and
    Gnosticism. They note that Christianity has a long history of belief in
    demonic possession and of the use of exorcism or deliverance to expel
    these evil spirits or demons. Noblitt and Perskin point out that alter
    personalities may present as malevolent or demonic; but from a secular,
    scientific viewpoint they do not agree that these are actually “demons.”
    They also present a list of fourteen similarities between DID and
    possession phenomena.

    Noblitt describes himself as a “skeptic,” by nature and training,
    and his acceptance of MPD came slowly. He describes the treatment of
    his first diagnosed case of MPD, who turned out to be a ritual abuse
    survivor. This became a disconcerting trend in his practice as he saw
    increasing numbers of MPD patients who turned out to have a ritual abuse

    A chapter on cult programming describes the programming process as, in
    many respects, an uncomplicated procedure based on classical operant
    conditioning. However, this uncomplicated programming can wreak havoc
    in the patient’s personal life and in therapy since the patient can be
    triggered, or accessed, by various stimuli outside of their awareness.
    These destructive programs may lead to self-harm or even suicide, or may
    draw the patient back into the cult. Words, phrases, sounds, hand
    signals, visual cues, and touch are some of the triggers that may induce
    a trance state. The authors note that patients from different cults in
    different parts of the country demonstrate the same or similar
    programming at the most basic level.

    The last section of the book is devoted to the contemporary problems and
    politics associated with the field of ritual abuse. These issues
    include the effect of cutbacks in public funding for mental health as
    well as the impact of managed care on the treatment of DID patients who
    often require intensive long-term care. This section describes the
    authors’ own experiences with the media and touches on the media’s
    apparent bias against dissociated memories and ritual abuse which the
    authors allege has created a general disbelief and even some ridicule in
    our society. The authors are particularly concerned as to how this bias
    might impact patients who were told, as part of their abusive
    programming, that no one would believe them if they told, and, who now
    feel further victimized by cultural disbelief.

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    Noblitt and Perskin recommend a new diagnosis: Cult and Ritual Trauma
    Disorder and present their proposed diagnosis in the usual DSM format.
    They contend that there is no other established diagnosis that
    completely accounts for this disorder. For example, although many
    survivors have a dissociative disorder, there are others who do not.
    Similarly, not all survivors meet the criteria for Post-Traumatic Stress
    Disorder. The authors assert that this new diagnosis would assist in
    providing a more accurate evaluation and treatment plan, advance the
    establishment of empirically validated criteria for research purposes,
    and lend greater clarity to forensic evaluations involving ritual abuse.

    Noblitt and Perskin conclude with an analysis of the critics and
    skeptics of ritual abuse, whom they refer to as “nihilists” and
    “revisionists.” They present ten arguments supporting the existence of
    ritual abuse, which are further elaborated and documented throughout
    the book. They ask: “Why do critics of this subject have to stretch
    reason and distort facts to make their point, given the serious
    consequences that may result if this kind of activity is occurring in

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    Ross states that his purpose in writing Satanic Ritual Abuse was “to
    establish that good clinical work requires a balanced perspective, free
    of the limitations imposed by adherence to either end of the ideological
    continuum.” He identifies these two extremes as the “skeptics” and the
    “believers” in ritual trauma. Ross belabors this point throughout the
    book to such an extent that his historical review and treatment
    suggestions appear almost secondary. The book concludes with an
    Afterword by False Memory Syndrome Foundation (FMSF) Scientific Advisory
    Board member, Elizabeth Loftus, Ph.D.

    Initially, Ross describes the historical and social background of
    various destructive cults, sects, and secret societies throughout
    history which may be connected with Satanism and ritual abuse. This
    review covers some of the same material as the Noblitt/Perskin book and
    is not intended to be exhaustive. However, the review sufficiently
    establishes the probable existence of ritual abuse as a historical,
    cross-cultural phenomenon. Ross places special emphasis on the Nazi
    Holocaust and the Catholic Inquisition, devoting an entire chapter to
    the latter.

    A key concept that Ross refers to throughout the book is the “Psychology
    of Satan.” He discusses the historical context and cultural
    psychodynamics which gave rise to a belief in Satan and points out that
    the split or “dissociation” of God and Satan has led to a repression of
    the principle of evil which is then projected out onto another person,
    group, or entity–a process that occurs in both the individual psyche
    and in the culture. Ross also sees the polarization between “believers”
    in ritual abuse and “extreme skeptics” as a contemporary example of this

    There is some confusion as Ross moves back and forth addressing both
    ends of the continuum of belief regarding ritual abuse. Throughout much
    of the book he appears to describe ritual abuse as a reality and then
    appears to be attempting to convince skeptics of this reality. For
    example, he describes five levels of Satanism, ranging from “isolated
    criminal deviants” up through “orthodox multigenerational Satanic cults”
    and points out there have been successful prosecutions in every category
    except the last one. However, moving to the other end of the continuum
    he offers “alternative hypotheses” to the ritual abuse claims. Although
    Ross’ intention is to be “neutral,” he often appears to come across as
    equivocal and, at times, even contradictory.

    Ross further states that among the approximately eighty SRA cases he has
    worked with that “in none of these cases has the reality of the
    memories been objectively verified” and in some cases the memories are
    clearly false. He suggests “for the sake of discussion” that perhaps
    only ten percent of SRA memories may be true. Although Ross
    acknowledges that this is not a scientific estimate, he repeats it later
    in the book.

    The strongest part of Ross’ book is his section on treatment. He
    emphasizes that treatment should be based on general principles of DID
    therapy, with little variation for ritual abuse survivors. He provides
    a list of ten rules of therapy which address limits, boundaries, and
    ethics. He provides illustrations of what may happen if these rules are
    violated. This illustrations are helpful, and reminiscent of Ross’
    early book, Multiple Personality Disorder. In this current book, he
    seems to favor a more problem-oriented treatment utilizing cognitive and
    internal family systems therapy. He specifically addresses some of the
    common problems in therapy and how to deal with them such as double
    binds, suicide attempts, and other self-destructive behaviors. He seems
    equivocal on the subject of cult programming. He believes the
    “deprogramming” model which some therapists employ disempowers the
    client; however, he acknowledges that “the psychotherapy of
    traumatically implanted programming is arduous and difficult, no matter
    how it is framed.”

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    Ross provides valuable information on treatment techniques. In
    reference to the management of counter-transference he emphasizes the
    importance of the therapist’s taking care of him or herself. He
    recommends a neutral stance toward the veracity of the patients’
    memories. His clinical picture of a ritual abuse survivor includes
    diagnostic indicators, and provides many useful suggestions for dealing
    with hyper-complex personality systems, and alters who claim to be
    “satanic” or demons.” Ross also discusses how to identify and correct
    cognitive errors, how to deal with post-traumatic hyper-arousal, and his
    use of “fractionated abreactions” in which memories are recovered in
    stages at a controlled rate. He points out the importance of balancing
    memory work with a focus on current problems.

    After returning once again to the question: “Is Satanic Abuse Real?”,
    and pointing out that Satanism can be a cover for more mundane problems,
    Ross concludes by addressing the extremes of denial and acceptance. He
    provides a history of the False Memory Syndrome Foundation and states
    that there is “technically no such syndrome as ‘False Memory Syndrome’

    After evaluating this syndrome, Ross concludes at the other end of
    continuum with an Afterward by Dr. Elizabeth Loftus. Not surprisingly,
    Loftus focuses on Ross’ arbitrary ten percent estimate and takes it a
    step further–she suggests that perhaps only ten percent of the elements
    in the memories of these ten percent are factual. For example, the
    patient may have accurately remembered a scene from her childhood but
    the directly abusive aspects of the memory may not be true.

    Loftus also dismisses Ross’ information related to the veracity of
    ritual abuse with a single sentence which proposes that just because bad
    things have occurred historically and there are bad people who continue
    to do bad things, this does not prove that ritual abuse is a reality.
    She similarly dismisses Ross’ treatment recommendations in a few
    sentences, suggesting that the best way to treat MPD is to simply
    “ignore the alters” and they will disappear.

    In her Afterword, Loftus does not appear to indicate that she is open to
    either compromise or serious dialogue–which is Ross’ plea throughout
    his book. So it is surprising that Ross would allow his book to close
    with this rather summary dismissal of the basic tenets and principles
    which he has so carefully elaborated.

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    Ann S. Earle, C.C.S.W., B.C.D., is a psychotherapist in private practice
    in Chapel Hill, North Carolina, who is currently editing a book on
    theoretical and practical considerations of trauma. She specializes in
    the treatment of abuse, trauma, and Dissociative Disorders. She can be
    contacted by writing her at 185 McGregor Woods, Chapel Hill, NC 27514.

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    Created by Tom Hanna on November 15, 1997.

    For more information, please send mail to Tom Hanna, Electronic Editor.