Recovered memories, hypnosis, and dissociation

Dr. Grant writes, “Recovered memory, hypnosis, and multiple personality disorder lack a clear standard of care and are potential legal minefields for any clinician” (“Malpractice Verdicts”).

This misinformation has done the trauma profession—and your readers—an injustice. The American Medical Association and American Psychiatric Association both sanction the use of hypnosis, the oldest Western version of psychotherapy. Furthermore:

• All memories are recovered memories.
  
• “Multiple personality disorder” is now called “dissociative identity disorder.”
  

At least six scientific organizations over the past decade have published treatment guidelines for dissociative identity disorder, recovered memories, and use of hypnosis.^1-7 When the guidelines are followed, these areas are not dangerous.

Dr. Grant’s article could prompt clinicians to avoid effective and safe treatments. We have treated dissociative identity disorder and recovered memories for 23 years and 30 years, respectively, without touching a legal land mine.

Elizabeth S. Bowman, MD
Editor emerita, Journal of Trauma and Dissociation
Adjunct professor, Department of neurology
Indiana University, Indianapolis

David Spiegel, MD
Jack, Lulu and Sam Willson
Professor in the School of Medicine
Associate chair of psychiatry & behavioral sciences
Stanford University School of Medicine
Stanford, CA

References

1. Roth S, Friedman MJ (eds). Childhood trauma remembered. A report on the current scientific knowledge base and its applications. International Society for Traumatic Stress Studies; 1997. Available at: www.istss.org/publications/ChildhoodTraumaRemembered.pdf. Accessed Feb. 7, 2005.
   
2. American Medical Association. Memories of childhood abuse. Report of the Council on Scientific Affairs. (CSA Report 5-A-94). Available at: www.amaassn.org/apps/pf_new/pf_online?f_n=resultLink&doc=policyfiles/HnE/H-515.973.HTM. Accessed Feb. 7, 2005.
   
3. American Psychiatric Association Fact Sheet: Therapies focused on memories of childhood physical and sexual abuse. Available at: www.psych.org/public_info/memorieschildphysexualabuse.pdf. Accessed Jan. 28, 2005.
   
4. Recovered memories. The report of the working party of the British Psychological Society. In: Pezdek K, Banks W (eds). The recovered memory/false memory debate. New York: Academic Press; 1996.
   
5. International Society for the Study of Dissociation Standards of Practice Committee. Guidelines for treating dissociative identity disorder (multiple personality disorder) in adults (1997). J Trauma Dissoc 2000;1:115-34.
   
6. International Society for the Study of Dissociation Task Force on Children and Adolescents. Guidelines for the evaluation and treatment of dissociative symptoms in children and adolescents. J Trauma Dissoc 2004;5:119-50.
   
7. American Society of Clinical Hypnosis, Hypnosis and Memory Committee. Clinical hypnosis and memory: guidelines for clinicians and for forensic hypnosis. Chicago: American Society for Clinical Hypnosis Press; 1995.
   

Dr. Grant responds

I appreciate the above comments and respect the authors’ clinical and research perspectives.

To clarify, I don’t want to suggest that clinicians avoid effective treatments for any psychiatric difficulty, such as dissociative identity disorder or childhood sexual abuse. These treatments by experienced clinicians can be beneficial.

My intention, however, was to convey the need for caution when using hypnosis for recovered memories of childhood sexual abuse, as this may represent complex legal issues.

Jon E. Grant, JD, MD, MPH
Assistant professor of psychiatry and human behavior
Brown Medical School, Providence, RI