>
> > Diagnostic Features
> >
> >
> >
> > The essential feature of Cult and Ritual Trauma Disorder is
clinically
> > significant distress or functional impairment with either: (1)
disturbing
> > or intrusive recollections of abuse, or (2) the presence of
involuntary
> > dissociated mental states, either or both of which are the result
of
> ritual
> > (circumscribed or ceremonial) abuse. Dissociated mental states may
take
> the
> > form of unwanted or intrusive dissociated alter identities, trance
states,
> > automatisms, catalepsy, stupor, or coma or coma-like states. These
> > dissociated mental states may appear in a spontaneous manner or
they may
> be
> > triggered by particular stimuli or cues or by the individual's
experience
> of
> > distress.
> >
> > Ritual abuse consists of traumatizing procedures that
are
> > conducted in a circumscribed or ceremonial manner. Such abuse may
include
> > the actual or simulated killing or mutilation of an animal, the
actual
or
> > simulated killing or mutilation of a person, forced ingestion of
real or
>
>
> > simulated human body fluids, excrement or flesh,
>
> The eucharist?
>
> forced sexual activity, as
> > well as acts involving severe physical pain
>
> self-flagellation?
>
> or humiliation. Frequently,
> > these abusive experiences employ real or staged features of deviant
occult
> > or religious practices, but this is not always the case. Some
reports
of
> > this phenomenon indicate that the abuse may occur outdoors, in a
> residence,
> > day care, laboratory or hospital setting as well as other
locations.
> Ritual
> > abuse may occur in a group setting, but occasionally it is
perpetrated
by
> an
> > individual.
> >
> >
> >
> > Associated Features and Disorders
> >
> >
> >
> > Associated descriptive features and mental disorders. Evidence of
> > psychological trauma is usually present and many individuals with
Cult
and
> > Ritual Trauma Disorder also exhibit some symptoms of Post-traumatic
Stress
> > Disorder, if not actually meeting the criteria for this diagnosis
as
well.
> > Intrusive and often fragmentary memories of abuse, alternating
terror
and
> > emotional numbing, nightmares, amnesia, anxiety, panic, flashbacks,
phobic
> > avoidance, and signs of increased arousal are often present. These
> > individuals typically report chronic depression, often with
cyclical
> > characteristics.
> >
> > Dissociation of identity is a feature of Cult and
Ritual
> Trauma
> > Disorder, and Dissociative Identity Disorder or Dissociative
Disorder
Not
> > Otherwise Specified, are frequently concurrently diagnosed.
> >
> > . Features of Borderline Personality Disorder are also
often
> > exhibited and occasionally individuals with Cult and Ritual Trauma
> Disorder
> > will also experience brief psychotic episodes, sometimes with
auditory
or
> > visual hallucinations. More commonly these individuals experience
or
act
> > out strong self-destructive urges including attempted or actual
suicide
> and
> > self-mutilation. Frequently there is a strong desire to injure the
self
> in
> > a manner that produces blood (e.g., "I have to see blood").
Sometimes
the
> > individual will report a desire to taste, touch, or smell their own
blood.
> > Chronic and unmodulated anger and sometimes rage alternate with
other
mood
> > states to create the impression that the individual is
unpredictable in
> mood
> > and unable to manage anger. Strong feelings of dependency
alternate
with
> > social aloofness. Narcissism and self-hatred are frequently
experienced
> > separately and together.
> >
> > In children (in addition to the above) motoric
hyperactivity,
> > impulsivity and problems in attention and concentration are seen at
a
rate
> > which exceeds the baseline for children without psychiatric
disorders.
> >
> >
> >
> > Associated laboratory findings. Individuals with Cult and Ritual
Trauma
> > Disorder typically show evidence of psychological trauma and
dissociation
> on
> > psychological testing.
> >
> > Associated physical examination findings and general medical
conditions.
> > There may be scars from self-inflicted injuries or physical abuse.
> Somatic
> > symptoms with or without objective medical findings typically
include
> > headaches, gastrointestinal, and genito-urinary complaints, but
other
> > reports of physical pain may be present. In some cases, physical
pain
> will
> > not reflect a current injury but will be a psychological component
of
> > implicit memories (e.g., "body memories") associated with previous
abuse.
> > These individuals also frequently show evidence of mild
neuropsychological
> > impairment that in some cases may result from a history of head
trauma.
> > Others have argued that psychological trauma in childhood may cause
mild
> > neuropsychological deficits in some individuals (e.g., van der
Kolk,
1987)
> > but further research is needed to clarify this question.
> >
> >
> >
> > Prevalence
> >
> >
> >
> > The prevalence of Cult and Ritual Trauma Disorder is unknown due to
a
lack
> > of reliable information. The alleged secrecy associated with
ritual
abuse
> > may make the accurate tabulation of such statistics difficult or
> impossible.
> >
> >
> >
> > Course
> >
> >
> >
> > The clinical course of these individuals is typically chronic with
> periodic
> > exacerbations and sometimes partial remission of symptoms. Some of
these
> > individuals report that they continue to participate in ritual
abuse
> either
> > as a victim, a perpetrator or both, typically while in a
dissociated
> state.
> >
> >
> >
> > Familial Pattern
> >
> >
> >
> > A history of sexual or ritual abuse is frequently reported among
family
> > members. In particular, transgenerational victimization is a
commonly
> > indicated pattern, consistent with the familial trends associated
with
> > non-ritual sexual abuse of children. However, the extent to which
ritual
> > abuse is a transgenerational phenomenon is presently unknown.
Features
of
> > dissociation are also frequently seen in family members.
> >
> >
> >
> > Differential Diagnosis
> >
> >
> >
> > Cult and Ritual Trauma Disorder must be distinguished from
Delusional
> > Disorder and other psychotic disorders where delusional beliefs are
better
> > able to account for the reports of abuse particularly when it can
be
> > demonstrated that the allegations of abuse are false. However,
there
are
> > also cases where these diagnoses can exist concurrently with Cult
and
> Ritual
> > Trauma Disorder, particularly when corroborating evidence of such
abuse
> > exists in an individual who is also exhibiting delusional or other
> psychotic
> > symptoms. Cult and Ritual Trauma Disorder must be distinguished
from
> > Malingering in situations where there may be forensic or financial
gain
> and
> > from Factitious Disorder where there may be a maladaptive pattern
of
> > help-seeking behavior. The possibility of suggestibility should
also be
> > evaluated and ruled out as a possible alternative explanation for
the
> > individual's reports of ritual abuse.
> >
> >
> >
> >
> >
> >
> >
> > ? Diagnostic criteria for 309.82 Cult and Ritual Trauma
Disorder
> >
> >
> >
> > A. The presence of clinically significant distress or
> > functional impairment with either
(1) or
> (2):
> >
> >
> >
> > (1) disturbing or intrusive recollections
of
> abuse.
> >
> > (2) involuntary dissociated mental states
> > consisting of at least one of the following:
> >
> > (a) dissociated alter
identities
> >
> > (b) involuntary trance states
> >
> > (c) automatisms
> >
> > (c) catalepsy
> >
> > (d) stupor, coma or coma-like
states
> >
> >
> >
> > B. The disturbance described in A is the result of
ritual
> > (circumscribed or ceremonial) abuse.
> >
> >
> >
> > C. The disturbance described in A cannot be better
accounted
> > for by Delusional
> >
> > Disorder or another psychotic disorder in which
> delusions
> > are present, Malingering
> >
> > or Factitious Disorder or as a consequence of
the
> patient
> > 's suggestibility.
> >
> >
> >
> >
> >
> > Many patients who report childhood ritual abuse
experiences
> also
> > allege lifelong revictimization. They frequently report being
crime
> > victims, particularly victims of rape and assault. It is sometimes
> unclear
> > whether their belief that they have been revictimized is a
consequence
of
> > intrusive recall, flashbacks, abreaction, or other phenomena, since
they
> may
> > not make a timely report to police or to submit to proper physical
> > examination in support of their claim.
> >
> > A patient claimed that she had been sexually assaulted
by
> > someone gaining access to her second floor bedroom via a window.
The
> > patient's house-mates denied the possibility that the patient could
have
> > been assaulted in such a manner and within the time-frame as she
reported
> it
> > since the house-mates were at home during the times the patient
reported
> the
> > attacks, and the bedroom was inaccessible from the outside. The
patient
> > held firm in her beliefs that she was being continually
revictimized
until
> > she came to recognize that she was actually experiencing vivid
recall of
> > what she believed to be past experiences.
> >
> > One of the most disturbing observations regarding the
language
> > of ritual abuse that has been developed thus far is that the
language
> > applied to such experiences has come almost exclusively from the
survivor
> > and backlash communities. The survivor community has provided such
> > terminology[2] as "ritual abuse," "programming," "triggering," and
> > "accessing." The backlash community has contributed such terms as
> > "recovered memory therapy," "false memory syndrome," and "parental
> > alienation syndrome," although these terms do not apply exclusively
to
the
> > area of ritual abuse. The treatment community has been dangerously
> reactive
> > and passive with respect to both their patient's claims and the
assault
on
> > their professions by backlash organizations. It has become
commonplace
> for
> > the media to report on unethical practices by "recovered memory
> therapists"
> > who routinely destroy families by implanting false memories of
horrific
> > experiences. The media, television, radio and print journalism,
serves
as
> > both arbiter and catalyst for the ongoing debate regarding the
veracity
of
> > ritual abuse allegations and claims of recalled accounts of
childhood
> abuse.
> > Unfortunately, the media appears to uncritically accept and
promulgate
the
> > version promoted by the most effective lobby, regardless of
evidence in
> its
> > support. Terms such as "recovered memory therapy," "false memory
> syndrome,"
> > and "parental alienation syndrome," permeate the scanty literature
on
> modern
> > day accounts of ritual abuse.
> >
> > Kenneth Lanning, an agent of the Federal Bureau of
> > Investigation, authored the monograph, Investigator's Guide to
Allegations
> > of "Ritual" Child Abuse, in which he wrote, "There is little or no
> evidence
> > for . . . organized satanic conspiracies," (1992, p.40.)
Individuals
and
> > organizations taking the position that ritual abuse allegations are
false
> > have subsequently adapted this claim. It is interesting to note
that
from
> > the time of its creation in 1908, the FBI was invested with the
> > investigation and prosecution of the elusive Mafia, to which a
large
> portion
> > of crimes ranging from extortion, to gambling, to bootlegging, to
murder
> > were attributed. Because of an extensive and effective lobby by a
> coalition
> > of Italian-American advocacy groups and other individuals and
> organizations,
> > the FBI was unable to substantiate the existence of the Mafia until
1989,
> > when a Mafia initiation ceremony was audio-taped by undercover
agents.
> > Previously, in order to facilitate prosecutions despite its
inability to
> > specifically identify a criminal entity called the Mafia, the FBI
> broadened
> > its focus by targeting "organized crime" as its primary agenda.
This
> raises
> > the question of why, when there are thousands of individuals
alleging
> ritual
> > abuse, some of which has resulted in arrests, confessions, criminal
> > convictions[3] and civil litigation, the FBI, or specifically Agent
> Lanning,
> > clings to the position that there is no evidence of widespread
satanic
> > ritual abuse. In truth, there may be no evidence of an "organized
satanic
> > conspiracy," but there is all manner of evidence in support of
crimes
> > against people and property that have occultic or ritualistic
elements[4].
> > If the FBI could alter its language in order to justify its
investigations
> > into the Mafia, it seems a small thing to reconsider the
terminology it
> > applies to investigations of crimes that contain ritualistic
elements.
> >
> > Considering the history of crimes against children and
the
> > traditional denial with which society has responded to such
allegations,
> it
> > is not surprising that reports of ritual abuse against children and
others
> > are frequently discounted. There appears to be a greater societal
> interest
> > in protecting the illusion that our children are safe, that
families are
> > inherently good and decent, and that danger comes infrequently and
only
> then
> > at the hands of demented strangers. In reality, most individuals
> reporting
> > histories of ritual abuse allege that the abuse occurred within the
> family.
> > And while there are periodic reminders that families do not always
protect
> > their own children and may, in fact, represent the greatest threat
to
> their
> > child's safety and life, it is evidently too painful for the public
to
> > accept the probability that some children are regularly and
deliberately
> > abused within their family unit. Nevertheless, this is a harsh
reality
we
> > must all be willing to face if we are ever to be able to fully
protect
> > children or to comprehend and address the sequelae of such abuses.
> >
> > Several years ago, I was contacted by a woman in
another
state
> > requesting advice regarding her four foster children, siblings who
had
> been
> > removed from their family of origin by the state due to chronic
abuse
and
> > neglect. These children, ranging in age from 18 months to five
years,
> > demonstrated extremely maladaptive behaviors. They had poor
vocabulary
> and
> > limited capacity to communicate. They had no apparent experience
with
> > modern plumbing. They could not identify or manipulate eating
utensils.
> > They were fearful of water, certain foods, and the night. The
children
> were
> > violent with each other and other people. They had uncontrollable
rages
> > without apparent cause. They were all sexually self-abusive. Upon
> physical
> > examination, all four children were diagnosed with genital herpes.
The
> boys
> > suffered from impacted bowels and scarring of their rectums. All
four
> > children had scars all over their bodies, most of which appeared to
have
> > been the result of deliberate injury. The three older children
talked
> about
> > being tortured by people in black robes.
> >
> > None of this information had been revealed by the
Department
> of
> > Social Services caseworkers responsible for transferring the
children's
> care
> > from the state to the foster family. The foster parents were
frightened,
> > anxious, concerned and confused. They wanted to help these
extremely
> needy
> > children, but were at a loss as to how to accomplish this. They
contacted
> > me in my capacity as executive director of the International
Council on
> > Cultism and Ritual Trauma to obtain information about ritual abuse
and
to
> > gain some insight into its effects. This telephone conversation
evolved
> > into several more between the foster family and myself and
eventually, I
> was
> > able to assist the family in obtaining consultation from my
co-author,
> > psychologist James Randall Noblitt, who has had extensive
experience in
> the
> > area of evaluating and treating individuals with ritually abusive
> > backgrounds. Dr. Noblitt and I visited the family, interviewed
everyone
> > involved including the foster family, DHS caseworkers and
administrators,
> > and ancillary helping professionals. Dr. Noblitt evaluated the
children
> and
> > reviewed the records of their previous therapists. I researched
the
> > children's histories, the manner in which they came to the
attention of
> DHS
> > caseworkers and the mechanisms by which their care was being funded
by
the
> > state. What our investigations revealed was evidence of a
conspiracy
> > designed to shield various county and state agencies from liability
for
> > negligence and fraud.
> >
> > A review of the family history revealed that the children's mother
had
> been
> > the subject of investigations by the DHS as a victim of child abuse
and
> > neglect perpetrated against her by her parents. This child was
evaluated
> by
> > a DHS staff psychologist who diagnosed her as marginally retarded
and
> > disoriented to person, place and time. His notes from his meeting
with
> her
> > reflect her report of hearing voices in her head that directed her
> behavior.
> > She was under DHS supervision when she became pregnant with her
first
> child
> > at age 15. Between the ages of 15 and 20, this young woman had
four
> > children from four different fathers, at least one of whom is
likely to
> have
> > been a close family member. Despite this young girl's age and
legal
> > status at the time of her first pregnancy, no intervention was made
on
her
> > behalf to educate her in either birth control or child care, or to
assist
> > her in improving her living situation. This young woman continued
to
> reside
> > in the home of her parents along with her children, exposing this
new
> > generation to the same neglectful and abusive environment in which
she
was
> > raised. DHS caseworkers did continue to observe the family and did
> > intervene on the children's behalf as they observed neglectful
conditions,
> > including lice infestation in all the children, malnourishment,
unhygienic
> > conditions, etc. The children were removed from the mother's
custody on
> two
> > occasions during which they were placed in foster care while an
effort
was
> > made to educate the mother in order to repatriate the children.
These
> > attempts failed and the mother's parental rights were finally
terminated,
> at
> > which time the children were placed with their third foster family,
who
> had
> > an interest in adoption.
> >
> > The children's bizarre behaviors led to psychiatric
hospitalizations and
> > placement with therapists in the community to pursue outpatient
> > psychotherapy. During the course of their therapy, the children
revealed
> > more and more details of abuse, including sexual abuse in their
second
> > foster home and in their family of origin. However, the three
therapists
> > engaged in these children's care never made a report to law
enforcement
as
> > mandated child abuse reporters. Furthermore, the therapists
appeared
> > unqualified to address the children's behaviors and emotional
distress
and
> > the children subsequently deteriorated under their care. When the
foster
> > parents repeatedly complained about the failure of these mental
health
> > professionals to address the children's reports, the therapists
were
asked
> > to resign from the case by a supervising psychologist contracted by
DHS
to
> > supervise distribution of services. The therapists subsequently
wrote a
> > letter of termination in which they blamed the children's symptoms
and
> > deterioration on the foster mother's overprotective position.
> >
> > The children required additional supervision by paraprofessionals
called
> > High Risk Interventionists (HRI). The HMO charged with the
administration
> > and dispersal of Medicaid funds funded the children's psychotherapy
and
> > high-risk interventionists. Our investigations revealed that this
HMO
> also
> > operated the HRI program and in effect, subcontracted the
children's
care
> to
> > their own agency resulting in hundreds of thousands of dollars paid
to
> > itself. In the meantime, few of the dollars allocated to the
foster
> family
> > and the children were actually delivered. Furthermore, the case
> supervisor
> > employed by the HMO was the same psychologist who years before had
worked
> > for DHS and had been the professional who evaluated the children's
> > biological mother.
> >
> > What we learned is that the professionals involved in
the
care
> > of the children were motivated more by self-interest than in
concern for
> the
> > well being of the children. In the meantime, the foster parents
engaged
> in
> > a concerted effort at recognizing and understanding their charges'
> > psychological, emotional, physical and educational concerns and
succeeded
> in
> > creating a highly effective integrated program to address these
concerns.
> > Now, several years have passed and the children have been adopted
by
their
> > foster family. But the effort to provide for these children's
therapy
and
> > safety needs continues to be a struggle between the adoptive
parents and
> the
> > county and state agencies controlling their funding. And for this,
we
> would
> > have to ask, "Why?"
> >
> > Why is there so much resistance to assisting these and
other
> > child victims? Why is there such a contentious environment when
victims,
> > children and adults abused as children, make an outcry? What
motivates
> > individuals to organize into lobbying groups with the intended
purpose
of
> > impeaching the testimony of abuse victims and vilifying their
advocates?
> > What are the politics behind such machinations? There are several
> possible
> > answers to explain this disturbing trend. One possibility is that
there
> is
> > truly a conspiracy of individuals and groups who perpetrate against
> children
> > and other vulnerable people using ritual abuse as a mechanism of
control
> and
> > containment. Some of these individuals are likely to have
infiltrated
> > various areas of society including child protection, the court
system,
law
> > enforcement, government, military, the media, etc., resulting in a
vast
> > cover-up. A second possibility could be that the reality that
children
> are
> > being systematically tortured and betrayed by their families and
trusted
> > others is so frightening and painful to the majority of people that
they
> are
> > in denial of this possibility. And in order to accommodate the
accounts
> > that allege that such things can and do happen, society has "killed
the
> > messenger" by blaming the epidemic of reports of child abuse on the
mental
> > health professionals and child advocates who attempt to intervene.
> >
> > The resulting attack on mental health professionals has
been
> > devastating to both the profession and to individuals desperately
in
need
> of
> > psychological services. Therapists under constant threat of
litigation
> have
> > been forced to amend their treatment style and even the manner in
which
> they
> > document patient claims. For example, in the interest of
protecting
> > patients from potential harm by recording claims that could be
> > self-incriminating if records were subpoenaed, therapists routinely
made
> > vague or sketchy notes, interpretable only by themselves. Now, to
protect
> > their own professional status, therapists are taking a more
> self-protective
> > stance. Fewer hospitals are providing inpatient programs that
address
the
> > special needs of this patient population, increasing the danger to
> patients
> > and society. In response to growing allegations against mental
health
> > professionals, licensing boards are altering and adjusting rules of
> > practice. As a consequence of civil suits brought against
therapists
for
> > "implanting false memories" of abuse, malpractice insurance
carriers are
> > increasingly limiting coverage for the treatment of certain types
of
> > psychological disorders. Consequently, fewer mental health
professionals
> > are willing to see patients alleging ritually abusive experiences
or
> > demonstrating symptoms of dissociative disorders.
> >
> > What is clear is that something is happening that results in
sometimes
> > disabling psychological illness that impacts on the individual, the
> family,
> > and society. How we respond to the resultant crisis is a measure
of our
> > collective character. Will we ignore the outcries of people in
pain in
> > order to embrace the comfort of denial? Or will we confront our
worst
> > nightmare, acknowledging the worst threat to children may be our
own
> > reluctance to admit that the dark secrets of our ancestors survive
today?
> >
> >
> >
> >
> >
> >
> >
> >
> >
> > Bibliography / References
> > Gardner, R.A. (1991). Sex abuse hysteria: Salem witch trials
revisited.
> >
> > Cresskill, NJ: Creative Therapeutics.
> >
> > Goldstein, E. (1992). Confabulations: Creating false memories,
> destroying
> >
> > families. Boca Raton, FL: SIRS Books.
> >
> > Kahaner, L. (1988). Cults that kill: Probing the underworld of
occult
> > crime. New
> >
> > York: Warner Books.
> >
> > Lanning, K.V. (1992). Investigator's guide to allegations of
"ritual"
> child
> > abuse.
> >
> > Quantico, VA: National Center for the Analysis of
Violent
> > Crime.
> >
> > Newton, M. (1993). Raising hell: An encyclopedia of devil worship
and
> > Satanic crime. New York: Avon Books.
> >
> > Noblitt, J.R. (1998). Accessing dissociated mental states.
> [Self-published
> >
> > monograph available through the Center for Counseling
and
> >
> > Psychological Services, P.C., PO Box 820729, Dallas, TX
> 75382].
> >
> > Noblitt, J.R., & Perskin, P.S. (1995). Cult and ritual abuse: Its
> history,
> >
> > anthropology and recent discovery in contemporary
America.
> > Westport,
> >
> > CT: Praeger Publishers.
> >
> > Noblitt, J.R., & Perskin, P.S. (2000). Cult and ritual abuse: Its
> history,
> >
> > anthropology and recent discovery in contemporary America, revised
> edition.
> > Westport, CT: Praeger Publishers.
> >
> > Ofshe, R., & Watters, E. (1994). Making monsters: False memories,
> >
> > psychotherapy and sexual hysteria. New York: Charles
> Scribner's
> > Sons.
> >
> > for the Study of Multiple Personality and Dissociation,
> Chicago.
> >
> > Raschke, C.A. (1990). Painted black. New York: HarperCollins.
> >
> > Terry, M. (1987). The ultimate evil. Garden City, NY: Doubleday.
> >
> > Wassil-Grimm, C. (1995). Diagnosis for disaster. Woodstock, New
York:
> The
> >
> > Overlook Press.
> >
> > Waterman, J., Kelly, R.J., Olivieri, M.K., McCord, J. (1993).
Beyond
the
> >
> > playground walls: Sexual abuse in preschools. New
York:
> > Guilford
> >
> > Yapko, M.D. (1994). Suggestions of abuse: True and false memories
of
> >
> > childhood sexual trauma. New York: Simon & Schuster.
> >
> >
> >
> >
> >
>
>
--------------------------------------------------------------------------
> --
> > ----
> >
> > [1] From Noblitt and Perskin (1995, 2000)
> >
> > [2] I have no objection to the terminology introduced by the
survivor
> > community. My concern is that the professional community has not
> generated
> > adequate language to meet the requirements of science and law.
> >
> > [3] Newton, M.
> >
> > [4] Terry (1987), Raschke (1990), Newton (1993), Kahaner (1988).
> >
> > Diagnostic Features
> >
> >
> >
> > The essential feature of Cult and Ritual Trauma Disorder is
clinically
> > significant distress or functional impairment with either: (1)
disturbing
> > or intrusive recollections of abuse, or (2) the presence of
involuntary
> > dissociated mental states, either or both of which are the result
of
> ritual
> > (circumscribed or ceremonial) abuse. Dissociated mental states may
take
> the
> > form of unwanted or intrusive dissociated alter identities, trance
states,
> > automatisms, catalepsy, stupor, or coma or coma-like states. These
> > dissociated mental states may appear in a spontaneous manner or
they may
> be
> > triggered by particular stimuli or cues or by the individual's
experience
> of
> > distress.
> >
> > Ritual abuse consists of traumatizing procedures that
are
> > conducted in a circumscribed or ceremonial manner. Such abuse may
include
> > the actual or simulated killing or mutilation of an animal, the
actual
or
> > simulated killing or mutilation of a person, forced ingestion of
real or
>
>
> > simulated human body fluids, excrement or flesh,
>
> The eucharist?
>
> forced sexual activity, as
> > well as acts involving severe physical pain
>
> self-flagellation?
>
> or humiliation. Frequently,
> > these abusive experiences employ real or staged features of deviant
occult
> > or religious practices, but this is not always the case. Some
reports
of
> > this phenomenon indicate that the abuse may occur outdoors, in a
> residence,
> > day care, laboratory or hospital setting as well as other
locations.
> Ritual
> > abuse may occur in a group setting, but occasionally it is
perpetrated
by
> an
> > individual.
> >
> >
> >
> > Associated Features and Disorders
> >
> >
> >
> > Associated descriptive features and mental disorders. Evidence of
> > psychological trauma is usually present and many individuals with
Cult
and
> > Ritual Trauma Disorder also exhibit some symptoms of Post-traumatic
Stress
> > Disorder, if not actually meeting the criteria for this diagnosis
as
well.
> > Intrusive and often fragmentary memories of abuse, alternating
terror
and
> > emotional numbing, nightmares, amnesia, anxiety, panic, flashbacks,
phobic
> > avoidance, and signs of increased arousal are often present. These
> > individuals typically report chronic depression, often with
cyclical
> > characteristics.
> >
> > Dissociation of identity is a feature of Cult and
Ritual
> Trauma
> > Disorder, and Dissociative Identity Disorder or Dissociative
Disorder
Not
> > Otherwise Specified, are frequently concurrently diagnosed.
> >
> > . Features of Borderline Personality Disorder are also
often
> > exhibited and occasionally individuals with Cult and Ritual Trauma
> Disorder
> > will also experience brief psychotic episodes, sometimes with
auditory
or
> > visual hallucinations. More commonly these individuals experience
or
act
> > out strong self-destructive urges including attempted or actual
suicide
> and
> > self-mutilation. Frequently there is a strong desire to injure the
self
> in
> > a manner that produces blood (e.g., "I have to see blood").
Sometimes
the
> > individual will report a desire to taste, touch, or smell their own
blood.
> > Chronic and unmodulated anger and sometimes rage alternate with
other
mood
> > states to create the impression that the individual is
unpredictable in
> mood
> > and unable to manage anger. Strong feelings of dependency
alternate
with
> > social aloofness. Narcissism and self-hatred are frequently
experienced
> > separately and together.
> >
> > In children (in addition to the above) motoric
hyperactivity,
> > impulsivity and problems in attention and concentration are seen at
a
rate
> > which exceeds the baseline for children without psychiatric
disorders.
> >
> >
> >
> > Associated laboratory findings. Individuals with Cult and Ritual
Trauma
> > Disorder typically show evidence of psychological trauma and
dissociation
> on
> > psychological testing.
> >
> > Associated physical examination findings and general medical
conditions.
> > There may be scars from self-inflicted injuries or physical abuse.
> Somatic
> > symptoms with or without objective medical findings typically
include
> > headaches, gastrointestinal, and genito-urinary complaints, but
other
> > reports of physical pain may be present. In some cases, physical
pain
> will
> > not reflect a current injury but will be a psychological component
of
> > implicit memories (e.g., "body memories") associated with previous
abuse.
> > These individuals also frequently show evidence of mild
neuropsychological
> > impairment that in some cases may result from a history of head
trauma.
> > Others have argued that psychological trauma in childhood may cause
mild
> > neuropsychological deficits in some individuals (e.g., van der
Kolk,
1987)
> > but further research is needed to clarify this question.
> >
> >
> >
> > Prevalence
> >
> >
> >
> > The prevalence of Cult and Ritual Trauma Disorder is unknown due to
a
lack
> > of reliable information. The alleged secrecy associated with
ritual
abuse
> > may make the accurate tabulation of such statistics difficult or
> impossible.
> >
> >
> >
> > Course
> >
> >
> >
> > The clinical course of these individuals is typically chronic with
> periodic
> > exacerbations and sometimes partial remission of symptoms. Some of
these
> > individuals report that they continue to participate in ritual
abuse
> either
> > as a victim, a perpetrator or both, typically while in a
dissociated
> state.
> >
> >
> >
> > Familial Pattern
> >
> >
> >
> > A history of sexual or ritual abuse is frequently reported among
family
> > members. In particular, transgenerational victimization is a
commonly
> > indicated pattern, consistent with the familial trends associated
with
> > non-ritual sexual abuse of children. However, the extent to which
ritual
> > abuse is a transgenerational phenomenon is presently unknown.
Features
of
> > dissociation are also frequently seen in family members.
> >
> >
> >
> > Differential Diagnosis
> >
> >
> >
> > Cult and Ritual Trauma Disorder must be distinguished from
Delusional
> > Disorder and other psychotic disorders where delusional beliefs are
better
> > able to account for the reports of abuse particularly when it can
be
> > demonstrated that the allegations of abuse are false. However,
there
are
> > also cases where these diagnoses can exist concurrently with Cult
and
> Ritual
> > Trauma Disorder, particularly when corroborating evidence of such
abuse
> > exists in an individual who is also exhibiting delusional or other
> psychotic
> > symptoms. Cult and Ritual Trauma Disorder must be distinguished
from
> > Malingering in situations where there may be forensic or financial
gain
> and
> > from Factitious Disorder where there may be a maladaptive pattern
of
> > help-seeking behavior. The possibility of suggestibility should
also be
> > evaluated and ruled out as a possible alternative explanation for
the
> > individual's reports of ritual abuse.
> >
> >
> >
> >
> >
> >
> >
> > ? Diagnostic criteria for 309.82 Cult and Ritual Trauma
Disorder
> >
> >
> >
> > A. The presence of clinically significant distress or
> > functional impairment with either
(1) or
> (2):
> >
> >
> >
> > (1) disturbing or intrusive recollections
of
> abuse.
> >
> > (2) involuntary dissociated mental states
> > consisting of at least one of the following:
> >
> > (a) dissociated alter
identities
> >
> > (b) involuntary trance states
> >
> > (c) automatisms
> >
> > (c) catalepsy
> >
> > (d) stupor, coma or coma-like
states
> >
> >
> >
> > B. The disturbance described in A is the result of
ritual
> > (circumscribed or ceremonial) abuse.
> >
> >
> >
> > C. The disturbance described in A cannot be better
accounted
> > for by Delusional
> >
> > Disorder or another psychotic disorder in which
> delusions
> > are present, Malingering
> >
> > or Factitious Disorder or as a consequence of
the
> patient
> > 's suggestibility.
> >
> >
> >
> >
> >
> > Many patients who report childhood ritual abuse
experiences
> also
> > allege lifelong revictimization. They frequently report being
crime
> > victims, particularly victims of rape and assault. It is sometimes
> unclear
> > whether their belief that they have been revictimized is a
consequence
of
> > intrusive recall, flashbacks, abreaction, or other phenomena, since
they
> may
> > not make a timely report to police or to submit to proper physical
> > examination in support of their claim.
> >
> > A patient claimed that she had been sexually assaulted
by
> > someone gaining access to her second floor bedroom via a window.
The
> > patient's house-mates denied the possibility that the patient could
have
> > been assaulted in such a manner and within the time-frame as she
reported
> it
> > since the house-mates were at home during the times the patient
reported
> the
> > attacks, and the bedroom was inaccessible from the outside. The
patient
> > held firm in her beliefs that she was being continually
revictimized
until
> > she came to recognize that she was actually experiencing vivid
recall of
> > what she believed to be past experiences.
> >
> > One of the most disturbing observations regarding the
language
> > of ritual abuse that has been developed thus far is that the
language
> > applied to such experiences has come almost exclusively from the
survivor
> > and backlash communities. The survivor community has provided such
> > terminology[2] as "ritual abuse," "programming," "triggering," and
> > "accessing." The backlash community has contributed such terms as
> > "recovered memory therapy," "false memory syndrome," and "parental
> > alienation syndrome," although these terms do not apply exclusively
to
the
> > area of ritual abuse. The treatment community has been dangerously
> reactive
> > and passive with respect to both their patient's claims and the
assault
on
> > their professions by backlash organizations. It has become
commonplace
> for
> > the media to report on unethical practices by "recovered memory
> therapists"
> > who routinely destroy families by implanting false memories of
horrific
> > experiences. The media, television, radio and print journalism,
serves
as
> > both arbiter and catalyst for the ongoing debate regarding the
veracity
of
> > ritual abuse allegations and claims of recalled accounts of
childhood
> abuse.
> > Unfortunately, the media appears to uncritically accept and
promulgate
the
> > version promoted by the most effective lobby, regardless of
evidence in
> its
> > support. Terms such as "recovered memory therapy," "false memory
> syndrome,"
> > and "parental alienation syndrome," permeate the scanty literature
on
> modern
> > day accounts of ritual abuse.
> >
> > Kenneth Lanning, an agent of the Federal Bureau of
> > Investigation, authored the monograph, Investigator's Guide to
Allegations
> > of "Ritual" Child Abuse, in which he wrote, "There is little or no
> evidence
> > for . . . organized satanic conspiracies," (1992, p.40.)
Individuals
and
> > organizations taking the position that ritual abuse allegations are
false
> > have subsequently adapted this claim. It is interesting to note
that
from
> > the time of its creation in 1908, the FBI was invested with the
> > investigation and prosecution of the elusive Mafia, to which a
large
> portion
> > of crimes ranging from extortion, to gambling, to bootlegging, to
murder
> > were attributed. Because of an extensive and effective lobby by a
> coalition
> > of Italian-American advocacy groups and other individuals and
> organizations,
> > the FBI was unable to substantiate the existence of the Mafia until
1989,
> > when a Mafia initiation ceremony was audio-taped by undercover
agents.
> > Previously, in order to facilitate prosecutions despite its
inability to
> > specifically identify a criminal entity called the Mafia, the FBI
> broadened
> > its focus by targeting "organized crime" as its primary agenda.
This
> raises
> > the question of why, when there are thousands of individuals
alleging
> ritual
> > abuse, some of which has resulted in arrests, confessions, criminal
> > convictions[3] and civil litigation, the FBI, or specifically Agent
> Lanning,
> > clings to the position that there is no evidence of widespread
satanic
> > ritual abuse. In truth, there may be no evidence of an "organized
satanic
> > conspiracy," but there is all manner of evidence in support of
crimes
> > against people and property that have occultic or ritualistic
elements[4].
> > If the FBI could alter its language in order to justify its
investigations
> > into the Mafia, it seems a small thing to reconsider the
terminology it
> > applies to investigations of crimes that contain ritualistic
elements.
> >
> > Considering the history of crimes against children and
the
> > traditional denial with which society has responded to such
allegations,
> it
> > is not surprising that reports of ritual abuse against children and
others
> > are frequently discounted. There appears to be a greater societal
> interest
> > in protecting the illusion that our children are safe, that
families are
> > inherently good and decent, and that danger comes infrequently and
only
> then
> > at the hands of demented strangers. In reality, most individuals
> reporting
> > histories of ritual abuse allege that the abuse occurred within the
> family.
> > And while there are periodic reminders that families do not always
protect
> > their own children and may, in fact, represent the greatest threat
to
> their
> > child's safety and life, it is evidently too painful for the public
to
> > accept the probability that some children are regularly and
deliberately
> > abused within their family unit. Nevertheless, this is a harsh
reality
we
> > must all be willing to face if we are ever to be able to fully
protect
> > children or to comprehend and address the sequelae of such abuses.
> >
> > Several years ago, I was contacted by a woman in
another
state
> > requesting advice regarding her four foster children, siblings who
had
> been
> > removed from their family of origin by the state due to chronic
abuse
and
> > neglect. These children, ranging in age from 18 months to five
years,
> > demonstrated extremely maladaptive behaviors. They had poor
vocabulary
> and
> > limited capacity to communicate. They had no apparent experience
with
> > modern plumbing. They could not identify or manipulate eating
utensils.
> > They were fearful of water, certain foods, and the night. The
children
> were
> > violent with each other and other people. They had uncontrollable
rages
> > without apparent cause. They were all sexually self-abusive. Upon
> physical
> > examination, all four children were diagnosed with genital herpes.
The
> boys
> > suffered from impacted bowels and scarring of their rectums. All
four
> > children had scars all over their bodies, most of which appeared to
have
> > been the result of deliberate injury. The three older children
talked
> about
> > being tortured by people in black robes.
> >
> > None of this information had been revealed by the
Department
> of
> > Social Services caseworkers responsible for transferring the
children's
> care
> > from the state to the foster family. The foster parents were
frightened,
> > anxious, concerned and confused. They wanted to help these
extremely
> needy
> > children, but were at a loss as to how to accomplish this. They
contacted
> > me in my capacity as executive director of the International
Council on
> > Cultism and Ritual Trauma to obtain information about ritual abuse
and
to
> > gain some insight into its effects. This telephone conversation
evolved
> > into several more between the foster family and myself and
eventually, I
> was
> > able to assist the family in obtaining consultation from my
co-author,
> > psychologist James Randall Noblitt, who has had extensive
experience in
> the
> > area of evaluating and treating individuals with ritually abusive
> > backgrounds. Dr. Noblitt and I visited the family, interviewed
everyone
> > involved including the foster family, DHS caseworkers and
administrators,
> > and ancillary helping professionals. Dr. Noblitt evaluated the
children
> and
> > reviewed the records of their previous therapists. I researched
the
> > children's histories, the manner in which they came to the
attention of
> DHS
> > caseworkers and the mechanisms by which their care was being funded
by
the
> > state. What our investigations revealed was evidence of a
conspiracy
> > designed to shield various county and state agencies from liability
for
> > negligence and fraud.
> >
> > A review of the family history revealed that the children's mother
had
> been
> > the subject of investigations by the DHS as a victim of child abuse
and
> > neglect perpetrated against her by her parents. This child was
evaluated
> by
> > a DHS staff psychologist who diagnosed her as marginally retarded
and
> > disoriented to person, place and time. His notes from his meeting
with
> her
> > reflect her report of hearing voices in her head that directed her
> behavior.
> > She was under DHS supervision when she became pregnant with her
first
> child
> > at age 15. Between the ages of 15 and 20, this young woman had
four
> > children from four different fathers, at least one of whom is
likely to
> have
> > been a close family member. Despite this young girl's age and
legal
> > status at the time of her first pregnancy, no intervention was made
on
her
> > behalf to educate her in either birth control or child care, or to
assist
> > her in improving her living situation. This young woman continued
to
> reside
> > in the home of her parents along with her children, exposing this
new
> > generation to the same neglectful and abusive environment in which
she
was
> > raised. DHS caseworkers did continue to observe the family and did
> > intervene on the children's behalf as they observed neglectful
conditions,
> > including lice infestation in all the children, malnourishment,
unhygienic
> > conditions, etc. The children were removed from the mother's
custody on
> two
> > occasions during which they were placed in foster care while an
effort
was
> > made to educate the mother in order to repatriate the children.
These
> > attempts failed and the mother's parental rights were finally
terminated,
> at
> > which time the children were placed with their third foster family,
who
> had
> > an interest in adoption.
> >
> > The children's bizarre behaviors led to psychiatric
hospitalizations and
> > placement with therapists in the community to pursue outpatient
> > psychotherapy. During the course of their therapy, the children
revealed
> > more and more details of abuse, including sexual abuse in their
second
> > foster home and in their family of origin. However, the three
therapists
> > engaged in these children's care never made a report to law
enforcement
as
> > mandated child abuse reporters. Furthermore, the therapists
appeared
> > unqualified to address the children's behaviors and emotional
distress
and
> > the children subsequently deteriorated under their care. When the
foster
> > parents repeatedly complained about the failure of these mental
health
> > professionals to address the children's reports, the therapists
were
asked
> > to resign from the case by a supervising psychologist contracted by
DHS
to
> > supervise distribution of services. The therapists subsequently
wrote a
> > letter of termination in which they blamed the children's symptoms
and
> > deterioration on the foster mother's overprotective position.
> >
> > The children required additional supervision by paraprofessionals
called
> > High Risk Interventionists (HRI). The HMO charged with the
administration
> > and dispersal of Medicaid funds funded the children's psychotherapy
and
> > high-risk interventionists. Our investigations revealed that this
HMO
> also
> > operated the HRI program and in effect, subcontracted the
children's
care
> to
> > their own agency resulting in hundreds of thousands of dollars paid
to
> > itself. In the meantime, few of the dollars allocated to the
foster
> family
> > and the children were actually delivered. Furthermore, the case
> supervisor
> > employed by the HMO was the same psychologist who years before had
worked
> > for DHS and had been the professional who evaluated the children's
> > biological mother.
> >
> > What we learned is that the professionals involved in
the
care
> > of the children were motivated more by self-interest than in
concern for
> the
> > well being of the children. In the meantime, the foster parents
engaged
> in
> > a concerted effort at recognizing and understanding their charges'
> > psychological, emotional, physical and educational concerns and
succeeded
> in
> > creating a highly effective integrated program to address these
concerns.
> > Now, several years have passed and the children have been adopted
by
their
> > foster family. But the effort to provide for these children's
therapy
and
> > safety needs continues to be a struggle between the adoptive
parents and
> the
> > county and state agencies controlling their funding. And for this,
we
> would
> > have to ask, "Why?"
> >
> > Why is there so much resistance to assisting these and
other
> > child victims? Why is there such a contentious environment when
victims,
> > children and adults abused as children, make an outcry? What
motivates
> > individuals to organize into lobbying groups with the intended
purpose
of
> > impeaching the testimony of abuse victims and vilifying their
advocates?
> > What are the politics behind such machinations? There are several
> possible
> > answers to explain this disturbing trend. One possibility is that
there
> is
> > truly a conspiracy of individuals and groups who perpetrate against
> children
> > and other vulnerable people using ritual abuse as a mechanism of
control
> and
> > containment. Some of these individuals are likely to have
infiltrated
> > various areas of society including child protection, the court
system,
law
> > enforcement, government, military, the media, etc., resulting in a
vast
> > cover-up. A second possibility could be that the reality that
children
> are
> > being systematically tortured and betrayed by their families and
trusted
> > others is so frightening and painful to the majority of people that
they
> are
> > in denial of this possibility. And in order to accommodate the
accounts
> > that allege that such things can and do happen, society has "killed
the
> > messenger" by blaming the epidemic of reports of child abuse on the
mental
> > health professionals and child advocates who attempt to intervene.
> >
> > The resulting attack on mental health professionals has
been
> > devastating to both the profession and to individuals desperately
in
need
> of
> > psychological services. Therapists under constant threat of
litigation
> have
> > been forced to amend their treatment style and even the manner in
which
> they
> > document patient claims. For example, in the interest of
protecting
> > patients from potential harm by recording claims that could be
> > self-incriminating if records were subpoenaed, therapists routinely
made
> > vague or sketchy notes, interpretable only by themselves. Now, to
protect
> > their own professional status, therapists are taking a more
> self-protective
> > stance. Fewer hospitals are providing inpatient programs that
address
the
> > special needs of this patient population, increasing the danger to
> patients
> > and society. In response to growing allegations against mental
health
> > professionals, licensing boards are altering and adjusting rules of
> > practice. As a consequence of civil suits brought against
therapists
for
> > "implanting false memories" of abuse, malpractice insurance
carriers are
> > increasingly limiting coverage for the treatment of certain types
of
> > psychological disorders. Consequently, fewer mental health
professionals
> > are willing to see patients alleging ritually abusive experiences
or
> > demonstrating symptoms of dissociative disorders.
> >
> > What is clear is that something is happening that results in
sometimes
> > disabling psychological illness that impacts on the individual, the
> family,
> > and society. How we respond to the resultant crisis is a measure
of our
> > collective character. Will we ignore the outcries of people in
pain in
> > order to embrace the comfort of denial? Or will we confront our
worst
> > nightmare, acknowledging the worst threat to children may be our
own
> > reluctance to admit that the dark secrets of our ancestors survive
today?
> >
> >
> >
> >
> >
> >
> >
> >
> >
> > Bibliography / References
> > Gardner, R.A. (1991). Sex abuse hysteria: Salem witch trials
revisited.
> >
> > Cresskill, NJ: Creative Therapeutics.
> >
> > Goldstein, E. (1992). Confabulations: Creating false memories,
> destroying
> >
> > families. Boca Raton, FL: SIRS Books.
> >
> > Kahaner, L. (1988). Cults that kill: Probing the underworld of
occult
> > crime. New
> >
> > York: Warner Books.
> >
> > Lanning, K.V. (1992). Investigator's guide to allegations of
"ritual"
> child
> > abuse.
> >
> > Quantico, VA: National Center for the Analysis of
Violent
> > Crime.
> >
> > Newton, M. (1993). Raising hell: An encyclopedia of devil worship
and
> > Satanic crime. New York: Avon Books.
> >
> > Noblitt, J.R. (1998). Accessing dissociated mental states.
> [Self-published
> >
> > monograph available through the Center for Counseling
and
> >
> > Psychological Services, P.C., PO Box 820729, Dallas, TX
> 75382].
> >
> > Noblitt, J.R., & Perskin, P.S. (1995). Cult and ritual abuse: Its
> history,
> >
> > anthropology and recent discovery in contemporary
America.
> > Westport,
> >
> > CT: Praeger Publishers.
> >
> > Noblitt, J.R., & Perskin, P.S. (2000). Cult and ritual abuse: Its
> history,
> >
> > anthropology and recent discovery in contemporary America, revised
> edition.
> > Westport, CT: Praeger Publishers.
> >
> > Ofshe, R., & Watters, E. (1994). Making monsters: False memories,
> >
> > psychotherapy and sexual hysteria. New York: Charles
> Scribner's
> > Sons.
> >
> > for the Study of Multiple Personality and Dissociation,
> Chicago.
> >
> > Raschke, C.A. (1990). Painted black. New York: HarperCollins.
> >
> > Terry, M. (1987). The ultimate evil. Garden City, NY: Doubleday.
> >
> > Wassil-Grimm, C. (1995). Diagnosis for disaster. Woodstock, New
York:
> The
> >
> > Overlook Press.
> >
> > Waterman, J., Kelly, R.J., Olivieri, M.K., McCord, J. (1993).
Beyond
the
> >
> > playground walls: Sexual abuse in preschools. New
York:
> > Guilford
> >
> > Yapko, M.D. (1994). Suggestions of abuse: True and false memories
of
> >
> > childhood sexual trauma. New York: Simon & Schuster.
> >
> >
> >
> >
> >
>
>
--------------------------------------------------------------------------
> --
> > ----
> >
> > [1] From Noblitt and Perskin (1995, 2000)
> >
> > [2] I have no objection to the terminology introduced by the
survivor
> > community. My concern is that the professional community has not
> generated
> > adequate language to meet the requirements of science and law.
> >
> > [3] Newton, M.
> >
> > [4] Terry (1987), Raschke (1990), Newton (1993), Kahaner (1988).
> >