Recovered Memory and How Not to Make It Worse

[clausewitz2]

Looking for some suggestions in how to approach a new patient of mine who has...many things going on, most of which I feel comfortable addressing, but one of which is relatively novel to me. Specifically, this middle-aged person feels that their life has been ruined by a grand guignol of systematic abuse by dozens of perpetrators as part of a trafficking ring for many years in their childhood. Thing is, they had literally no memory of this until they underwent hypnosis in 2015. That is when they began "remembering" this Hieronymous Bosch painting of a childhood. Their mother denied this had happened for many years but is getting to be frail and person has moved in to take care of her and allow her to remain at home. Perhaps not surprisingly now mom "agrees" with person that this abuse happened, though apparently is very hazy on details.


so much about the situation screams extremely sketchy previous provider (prescribing her narcotics, stimulants and benzos simultaneously, suddenly having to leave practice unexpectedly). I don't want to totally disregard her account but I also know the recovered memory literature and know it has essentially zero support as a non-iatrogenic phenomenon. I would like to convey my concerns about this to the patient but since they have built a lot of their identity around it I feel a need to tread lightly. Normally I don't really care about whether the details of my patient's trauma histories that they provide are or are not how someone else might have experienced the situation, but in this case where someone has been basically victimized by a predatory psychiatrist and had their life exploded by nonsense I feel a need to say something.

Anyone have experience with situations like this? Any literature on how one attempts to undo the damage? The controlled substance trainwreck I have no problem dealing with but this is fairly new to me.

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[Justanothergrad]

Oh man, that is such a wreck caused directly by a previous provider since the literature on that junk is so clear that its false memory. I'll defer to others who may have worked with this directly, but depending on functioning, I wonder if some assigned empirical readings may be worthwhile (e.g., E. Loftus) to help bridge a very difficult conversation. I'll be curious to see how to undo damage like this. Fingers crossed for you/them.

 

[cara susanna]

As a trauma/sexual assault person, I have heard of situations where the clinician doubts that the trauma actually happened so I wonder if it's similar. Basically, it would be that that it's not our job to verify if the trauma is real and, basically, you focus on functioning, symptoms, and the patient's goals.

 

[Justanothergrad]

As a trauma/sexual assault person, I have heard of situations where the clinician doubts that the trauma actually happened so I wonder if it's similar. Basically, it would be that that it's not our job to verify if the trauma is real and, basically, you focus on functioning, symptoms, and the patient's goals.

I'm not sure that I would advocate for that approach personally in the case of a hypnosis/false memory situation, as a trauma person as well. I think there comes into play an entirely different set of ethical responsibilities with treatment but that's my take.

 

[BuckeyeLove]

How is this stuff still happening. We have 40 plus years of solid data and case law showing what NOT to do as a clinician with this crap.

 

[WisNeuro]

How is this stuff still happening. We have 40 plus years of solid data and case law showing what NOT to do as a clinician with this crap.

Same reason I can get you a referral for several "brainspotting" providers in my area.

 

[bcliff]

On a similar thread to cara's point... I wonder if the functional neurologic disorder/conversion dx literature might be useful...?

 

[cara susanna]

I'm not sure that I would advocate for that approach personally in the case of a hypnosis/false memory situation, as a trauma person as well. I think there comes into play an entirely different set of ethical responsibilities with treatment but that's my take.

Yeah, I'm not sure either. It's really tricky (sorry, OP, I know that isn't helpful!)

 

[beginner2011]

I'm not sure that I would advocate for that approach personally in the case of a hypnosis/false memory situation, as a trauma person as well. I think there comes into play an entirely different set of ethical responsibilities with treatment but that's my take.

My initial thought would be to trial a more typical approach to treatment (e.g., PE or CPT), and if they don't respond or respond in an atypical fashion begin to explore the meaning behind the atypical or non-response. Moving in to Loftus et al. at that point (collaboratively) might be more well received.

 

[psych.meout]

Lilienfeld (RIP) also has some good articles about recovered memory pseudoscience.

 

[CheetahGirl]

Looking for some suggestions in how to approach a new patient of mine who has...many things going on, most of which I feel comfortable addressing, but one of which is relatively novel to me. Specifically, this middle-aged person feels that their life has been ruined by a grand guignol of systematic abuse by dozens of perpetrators as part of a trafficking ring for many years in their childhood. Thing is, they had literally no memory of this until they underwent hypnosis in 2015. That is when they began "remembering" this Hieronymous Bosch painting of a childhood. Their mother denied this had happened for many years but is getting to be frail and person has moved in to take care of her and allow her to remain at home. Perhaps not surprisingly now mom "agrees" with person that this abuse happened, though apparently is very hazy on details.


so much about the situation screams extremely sketchy previous provider (prescribing her narcotics, stimulants and benzos simultaneously, suddenly having to leave practice unexpectedly). I don't want to totally disregard her account but I also know the recovered memory literature and know it has essentially zero support as a non-iatrogenic phenomenon. I would like to convey my concerns about this to the patient but since they have built a lot of their identity around it I feel a need to tread lightly. Normally I don't really care about whether the details of my patient's trauma histories that they provide are or are not how someone else might have experienced the situation, but in this case where someone has been basically victimized by a predatory psychiatrist and had their life exploded by nonsense I feel a need to say something.

Anyone have experience with situations like this? Any literature on how one attempts to undo the damage? The controlled substance trainwreck I have no problem dealing with but this is fairly new to me.

Could it be like this?

Folie à Deux and its interaction with early life stress: a case report

Folie à deux is a very rare psychiatric syndrome in which a psychotic symptom is transmitted from one individual to another. We present a case of folie à deux occurring during childhood, which is not an usual presentation of this syndrome. ...

www.ncbi.nlm.nih.gov

Folie à deux and delusional disorder by proxy in a family

This report presents a 52-year-old woman who was admitted to nephrology ward with hypernatremia. She shared a persecutory delusion of poisoning with her 22-year-old daughter and did not feed her 8-year-old son due to her delusion.

www.ncbi.nlm.nih.gov

How much distress and dysfunction do the thoughts cause? I second the CBT, and perhaps CBT for psychosis may have good tools to mitigate the distress & dysfunction.

https://www.mirecc.va.gov/visn2/docs/CBTp_Manual_VA_Yulia_Landa_2017.pdf

 

[psych.meout]

Sounds less like folie a deux and more likely just acquiescence based on dependency (e.g., fear that if she disagrees she'll lose the assistance) or maybe even some age-related cognitive decline.

 

[CheetahGirl]

Sounds less like folie a deux and more likely just acquiescence based on dependency (e.g., fear that if she disagrees she'll lose the assistance) or maybe even some age-related cognitive decline.

Sure. folie a deux is very rare (edit: although, politically...the U.S. seems to be experiencing folie à plusieurs, delusions of many, at times IMO ), but reading about it plus the CBTp manual may help OP formulate a plan.

 

[Fan_of_Meehl]

Looking for some suggestions in how to approach a new patient of mine who has...many things going on, most of which I feel comfortable addressing, but one of which is relatively novel to me. Specifically, this middle-aged person feels that their life has been ruined by a grand guignol of systematic abuse by dozens of perpetrators as part of a trafficking ring for many years in their childhood. Thing is, they had literally no memory of this until they underwent hypnosis in 2015. That is when they began "remembering" this Hieronymous Bosch painting of a childhood. Their mother denied this had happened for many years but is getting to be frail and person has moved in to take care of her and allow her to remain at home. Perhaps not surprisingly now mom "agrees" with person that this abuse happened, though apparently is very hazy on details.


so much about the situation screams extremely sketchy previous provider (prescribing her narcotics, stimulants and benzos simultaneously, suddenly having to leave practice unexpectedly). I don't want to totally disregard her account but I also know the recovered memory literature and know it has essentially zero support as a non-iatrogenic phenomenon. I would like to convey my concerns about this to the patient but since they have built a lot of their identity around it I feel a need to tread lightly. Normally I don't really care about whether the details of my patient's trauma histories that they provide are or are not how someone else might have experienced the situation, but in this case where someone has been basically victimized by a predatory psychiatrist and had their life exploded by nonsense I feel a need to say something.

Anyone have experience with situations like this? Any literature on how one attempts to undo the damage? The controlled substance trainwreck I have no problem dealing with but this is fairly new to me.

You could consider a "Behavioral Activation for PTSD" approach as a non trauma focused technique with some growing empirical support for treating PTSD (obviously not as robust as CPT/PE, though...still, the efficacy of any approach a patient declines to participate in is effectively zero). BA for PTSD focuses on helping the patuent thoroughly examine their patterns of avoidance and collaborate with the clinician to engineer small changes in their routine to reduce their avoidance while pursuing meaningful life goals/changes. There's a decent workbook available on Amazon that I've used with veterans who refuse and/or can't do PE/CPT.

 

[psych.meout]

You're saying that recovered memories as a phenomena has no basis in reality and any time a person claims to have recovered one it is wholly due to the clinician somehow?

I was about to make about about the state of (acceptance/rejection) recovered memories in the western academic/scientific field of psychology because its obviously a.....well according to you/clausewitz2 its settled, but I have been reading the 8 volume APA Encyclopedia of Psychology and one of the first entries is abreaction. Its tone is that hidden/recovered memories are.........its like a description of lungs. We know they exist and have known for a while and its not a big deal and here is how they work. Theres not one suggestion that the phenomena is controversial in any way.

An encyclopedia entry is not a substitute for empirical, peer-reviewed research.

There is also Betrayal Trauma Theory and interestingly enough the originator, Dr. Jennifer Freyd, claimed that her father has abused her and she had recovered the memory (this was before she had published anything about BTT). He and his wife/her mom went on to found the False Memory Syndrome Foundation and from what I can tell, this group is responsible for the controversy/confusion over the validity of the phenomena.

No, recovered memory is controversial, because the research literature indicates that they're bunk. It's not how memory works.

And obviously he was guilty right? You don't have to be a psychologist to know that, if someone accuses this and then their parents start a group wholly motivated to to call the son/daughter a liar/delusional and spent so much time and energy on it that it became nationally recognized.........well we can at least say he did not care about her whatsoever. If he didn't do it and had one iota of affection for his daughter he would have wondered why something like this would have come to her mind instead of making the whole thing about himself and subjecting her to embarassment on a national level.

That's....quite the interpretation.

 

[MCParent]

I dunno how to say this.....by APA I meant American Psychological Association. The entry's citations are

Bibring, E. ( 1 954). Psychoanalysis and the dynamic psychotherapies. Journal oj the American Psychoanalytic Association, 2, 745-770.
Breuer. J., & Freud, S. ( 1955) Studies on hysteria. In J. Strachey (Ed. and Trans.), The standard edition oj the complete psychological works oj Sigmund Freud (Vol. 2). London: Hogarth Press. (Original works published 1 893-1 895)
Horowitz, M. ( 1997). Stress response syndromes (3rd ed.) Northvale, NJ: Aronson. Horowitz, M .. Marmar, C .. Weiss, D .. et al. ( 1984). Brief psychotherapy of bereavement reactions: The relationship of process to outcome. Archives oj General Psychiatry, 41, 438-448.

and it is also written by Mardi Horowitz who is a professor of psychiatry at UCSF.


I haven't read any of it but I do know that the sample sizes for psych studies are notoriously small and I'm gonna guess for something like recovered memories it is even smaller and I'm sure the people who ran the studies were smart enough to realize this but who is going to admit to abusing their child? You could focus on abuse victims whose abusers have been convicted in court but...they obviously remembered the abuse so....given these insurmountable barriers to the gathering of empirical evidence, it would seem hasty to pick a firm position.

And I say this because of a simple question which must have an answer. What happens when you become afraid of something you rely upon for survival?

I dunno. I think Freyd makes a compelling argument. And when I said published in reference to her I meant peer reviewed double blind p-value falsifiability stuff (actually I don't think her theories are falsifiable I just wanted to use those terms in a jokey way to show that I'm not a total noob even though it says I'm a non-student.)

Back to the original question, and considering the reaction I think I can safely assume that the psychodynamic/psychometric divide is ongoing.

I learned a word that warrents a trigger alert........also its possible that I didn't necessarily come here to ask questions but to argue (in an academic sense) because there is a massive amount of what I have coined as Western academic/scientific psychology (WAP. WASP is taken.) which is wholly illogical to me (not necessarily irrational)....ok the word is pseudoempiricism

If this is an inappropriate forum for me to do this in, does anyone know of one which allows the non-accredited to debate (only academic/scientific no personal) with the verifiably accredited? I have tried the unverified route and.....acreddited or not, you don't want those people to represent your positions.

You aren’t raging against an academic machine. You’re insufficiently informed on the topics you are trying to discuss. Since this is a professional forum, poorly informed opinions are going to be called out.
Google Dunning Krueger curve.
WAP is also taken.

 

[psych.meout]

I dunno how to say this.....by APA I meant American Psychological Association. The entry's citations are

Bibring, E. ( 1954). Psychoanalysis and the dynamic psychotherapies. Journal oj the American Psychoanalytic Association, 2, 745-770.
Breuer. J., & Freud, S. (1955) Studies on hysteria. In J. Strachey (Ed. and Trans.), The standard edition oj the complete psychological works oj Sigmund Freud (Vol. 2). London: Hogarth Press. (Original works published 1 893-1 895)
Horowitz, M. ( 1997). Stress response syndromes (3rd ed.) Northvale, NJ: Aronson. Horowitz, M .. Marmar, C .. Weiss, D .. et al. ( 1984). Brief psychotherapy of bereavement reactions: The relationship of process to outcome. Archives oj General Psychiatry, 41, 438-448.

and it is also written by Mardi Horowitz who is a professor of psychiatry at UCSF.

None of those seem germane to recovered memories (i.e., the topic of this thread) and most are decades old.

Moreover, it doesn't matter if the APA published it, it's still just an encyclopedia. It's not a substitute for peer-reviewed empirical research that isn't decades out of date.

I haven't read any of it but I do know that the sample sizes for psych studies are notoriously small and I'm gonna guess for something like recovered memories it is even smaller and I'm sure the people who ran the studies were smart enough to realize this but who is going to admit to abusing their child? You could focus on abuse victims whose abusers have been convicted in court but...they obviously remembered the abuse so....given these insurmountable barriers to the gathering of empirical evidence, it would seem hasty to pick a firm position.

No, that's not how science works. The responsibility is not on the skeptic to prove a negative, the onus is on the person making the positive claim to support said claims. That a particular form of research might be more difficult to conduct than others does not allow for proponents of a given theory to deflect responsibility.

Regardless, the skeptics have conducted extensive research on repressed and recovered memories, especially Scott Lilienfeld (RIP), and there is a wealth of cognitive literature on memory that doesn't comport with the claims of repressed and recovered memory theories.

Thus, it is in no way "hasty" to take the form position that repressed and recovered memories are pseudoscience.

And I say this because of a simple question which must have an answer. What happens when you become afraid of something you rely upon for survival?

Tragically, child abuse is very common and well-documented and researched. That these awful things occur is not, in and of itself, evidence for repressed and recovered memories. That this abuse occurs and people claim that repressed and recovered memories are caused by the former does not mean this is evidence for the latter.

This is just like dubious claims of proponents of Dissociative Identity Disorder as a legitimate syndrome despite the paucity of evidence and conflict with cognitive literature.

I dunno. I think Freyd makes a compelling argument. And when I said published in reference to her I meant peer reviewed double blind p-value falsifiability stuff (actually I don't think her theories are falsifiable I just wanted to use those terms in a jokey way to show that I'm not a total noob even though it says I'm a non-student.)

Back to the original question, and considering the reaction I think I can safely assume that the psychodynamic/psychometric divide is ongoing.

I learned a word that warrents a trigger alert........also its possible that I didn't necessarily come here to ask questions but to argue (in an academic sense) because there is a massive amount of what I have coined as Western academic/scientific psychology (WAP. WASP is taken.) which is wholly illogical to me (not necessarily irrational)....ok the word is pseudoempiricism

If this is an inappropriate forum for me to do this in, does anyone know of one which allows the non-accredited to debate (only academic/scientific no personal) with the verifiably accredited? I have tried the unverified route and.....acreddited or not, you don't want those people to represent your positions.

Huh?

 

[borne_before]

And obviously he was guilty right? You don't have to be a psychologist to know that, if someone accuses this and then their parents start a group wholly motivated to to call the son/daughter a liar/delusional and spent so much time and energy on it that it became nationally recognized.........well we can at least say he did not care about her whatsoever. If he didn't do it and had one iota of affection for his daughter he would have wondered why something like this would have come to her mind instead of making the whole thing about himself and subjecting her to embarassment on a national level.

Can someone more versed in logical fallacies/cognitive distortions tell me what the hell is going here?

Also, it's well established that you can make false memories. Most of these hypnotherapists are not "uncovering" anything, rather they are planting and creating false memories.

 

[Mad Jack]

WAP is also taken.

One of our times' great intellectuals wouldn't like her work being appropriated

I dunno how to say this.....by APA I meant American Psychological Association. The entry's citations are

Bibring, E. ( 1 954). Psychoanalysis and the dynamic psychotherapies. Journal oj the American Psychoanalytic Association, 2, 745-770.
Breuer. J., & Freud, S. ( 1955) Studies on hysteria. In J. Strachey (Ed. and Trans.), The standard edition oj the complete psychological works oj Sigmund Freud (Vol. 2). London: Hogarth Press. (Original works published 1 893-1 895)
Horowitz, M. ( 1997). Stress response syndromes (3rd ed.) Northvale, NJ: Aronson. Horowitz, M .. Marmar, C .. Weiss, D .. et al. ( 1984). Brief psychotherapy of bereavement reactions: The relationship of process to outcome. Archives oj General Psychiatry, 41, 438-448.

and it is also written by Mardi Horowitz who is a professor of psychiatry at UCSF.


I haven't read any of it but I do know that the sample sizes for psych studies are notoriously small and I'm gonna guess for something like recovered memories it is even smaller and I'm sure the people who ran the studies were smart enough to realize this but who is going to admit to abusing their child? You could focus on abuse victims whose abusers have been convicted in court but...they obviously remembered the abuse so....given these insurmountable barriers to the gathering of empirical evidence, it would seem hasty to pick a firm position.

And I say this because of a simple question which must have an answer. What happens when you become afraid of something you rely upon for survival?

I dunno. I think Freyd makes a compelling argument. And when I said published in reference to her I meant peer reviewed double blind p-value falsifiability stuff (actually I don't think her theories are falsifiable I just wanted to use those terms in a jokey way to show that I'm not a total noob even though it says I'm a non-student.)

Back to the original question, and considering the reaction I think I can safely assume that the psychodynamic/psychometric divide is ongoing.

I learned a word that warrents a trigger alert........also its possible that I didn't necessarily come here to ask questions but to argue (in an academic sense) because there is a massive amount of what I have coined as Western academic/scientific psychology (WAP. WASP is taken.) which is wholly illogical to me (not necessarily irrational)....ok the word is pseudoempiricism

If this is an inappropriate forum for me to do this in, does anyone know of one which allows the non-accredited to debate (only academic/scientific no personal) with the verifiably accredited? I have tried the unverified route and.....acreddited or not, you don't want those people to represent your positions.

The evidence in favor of the phenomenon is very poor and not at all in-line with our current understanding of memory as a neurologic process. False memories, on the other hand, have been extensively studied and are actually exceedingly easy to create. The problem with this and many other iatrogenic psychiatric diagnoses is that they often become so core to the identity of an individual that they cannot reconcile their current understanding of their life and mental state in the absence of said diagnosis. This makes it is difficult to have such diagnoses pulled out of manuals and diagnostic criteria once they are present unless you can say with complete certainty that there is a zero chance anyone suffers from them.

 

[borne_before]

The problem with this and many other iatrogenic psychiatric diagnoses is that they often become so core to the identity of an individual that they cannot reconcile their current understanding of their life and mental state in the absence of said diagnosis.

I love it when smarter people say things I'm thinking but better than I could have articulated.

So core to the individuals narrative about themselves that it becomes near delusional. It's also a perfect storm of victimhood and a perfect out. "My life isn't bad because of my decisions. It's bad because of things that happened outside of control." That's why it's insidious. Beyond calling parents sexual abusers, destroying families, false imprisonment, "recovered memories" shunt emotional and behavioral growth.

Can we get a running list of iatrogenic diagnoses?

 

[WisNeuro]

I love it when smarter people say things I'm thinking but better than I could have articulated.

So core to the individuals narrative about themselves that it becomes near delusional. It's also a perfect storm of victimhood and a perfect out. "My life isn't bad because of my decisions. It's bad because of things that happened outside of control." That's why it's insidious. Beyond calling parents sexual abusers, destroying families, false imprisonment, "recovered memories" shunt emotional and behavioral growth.

Can we get a running list of iatrogenic diagnoses?

Ones I see on a regular basis?

Chronic Lymes
Post-Concussion syndrome
Complex PTSD

 

[MCParent]

The problem with this and many other iatrogenic psychiatric diagnoses is that they often become so core to the identity of an individual that they cannot reconcile their current understanding of their life and mental state in the absence of said diagnosis. This makes it is difficult to have such diagnoses pulled out of manuals and diagnostic criteria once they are present unless you can say with complete certainty that there is a zero chance anyone suffers from them.

That, and I'll bet you $50 that "you can't take that one out, I bill for that one" has been said many times at the DSM meetings.

 

[Mad Jack]

Ones I see on a regular basis?

Chronic Lymes
Post-Concussion syndrome
Complex PTSD

Another one I'm always skeptical of is dissociative identity disorder

 

[WisNeuro]

Another one I'm always skeptical of is dissociative identity disorder

I've come across it a handful of times where another provider had "diagnosed" it. In every one of those instances there were clear primary and secondary gain issues involved with the behaviors in question. In a couple of the cases, the provider clearly did not have a grasp on the more common dissociative symptoms in trauma and just threw the label on for....reasons?

 

[Mad Jack]

I've come across it a handful of times where another provider had "diagnosed" it. In every one of those instances there were clear primary and secondary gain issues involved with the behaviors in question. In a couple of the cases, the provider clearly did not have a grasp on the more common dissociative symptoms in trauma and just threw the label on for....reasons?

Yeah, exactly this. Dissociation is a very real phenomenon, but full dissociation with distinct identities that persist for long periods of time completely separate from one another? In every case I've encountered, it has appeared to be nonsense, and either related to secondary gain or a misdiagnosis related to trauma. Unfortunately it is a "cool diagnosis" amongst people on TikTok right now with entire communities dedicated to people that supposedly show off their different personalities to large audiences, so get ready for an influx of it.

 

[psych.meout]

Yeah, exactly this. Dissociation is a very real phenomenon, but full dissociation with distinct identities that persist for long periods of time completely separate from one another? In every case I've encountered, it has appeared to be nonsense, and either related to secondary gain or a misdiagnosis related to trauma. Unfortunately it is a "cool diagnosis" amongst people on TikTok right now with entire communities dedicated to people that supposedly show off their different personalities to large audiences, so get ready for an influx of it.

Online support communities seem like a mixed bag, with some of them making things much worse. The CFS/ME community has harassed so many researchers out of the field just for studying any psychological or behavioral interventions, because this somehow implies that they're malingering, have conversion disorder, etc. You don't really see the same issue from, say, the chronic pain community.

 

[WisNeuro]

Online support communities seem like a mixed bag, with some of them making things much worse. The CFS/ME community has harassed so many researchers out of the field just for studying any psychological or behavioral interventions, because this somehow implies that they're malingering, have conversion disorder, etc. You don't really see the same issue from, say, the chronic pain community.

Fibromyalgia?

 

[MiniLop]

Unfortunately it is a "cool diagnosis" amongst people on TikTok right now with entire communities dedicated to people that supposedly show off their different personalities to large audiences, so get ready for an influx of it.

Oh, it's already happening.

 

[Mad Jack]

Oh, it's already happening.

Oh no

 

[PsyDr]

Online support communities seem like a mixed bag, with some of them making things much worse. The CFS/ME community has harassed so many researchers out of the field just for studying any psychological or behavioral interventions, because this somehow implies that they're malingering, have conversion disorder, etc. You don't really see the same issue from, say, the chronic pain community.

Uhhh, yeah you do. They spring to action, like Uncle Joe on his way to the Wonka factory. They've lobbied against restrictions to opioids to such groups as CMS, CDC, and DEA.

 

[futureapppsy2]

Oh, it's already happening.

Yeah, and you have people claiming "fictive alters," which means that 10 out of their 20 "alters" are cute anime boys and/or fictional murderers.

 

[borne_before]

Yeah, and you have people claiming "fictive alters," which means that 10 out of their 20 "alters" are cute anime boys and/or fictional murderers.

Y'all ever seen the tiktoker dude who tries all these different foods by "forcing" his alters to the front?

 

[AcronymAllergy]

Is it bad that I'm happy to never have used TikTok?

 

[WisNeuro]

Is it bad that I'm happy to never have used TikTok?

If that's wrong, I don't ever want to be right. TikTok can die in a fire.

 

[WisNeuro]

Does it bug you guys that CBT and DBT is basically Budhhism/Stocism and that was just a bunch of people sitting around thinking about stuff? No scientific method or statistical analysis or double blinds or peer-reviewed academic journals whatsoever? Just pure intuition.

Doesn't bother most of us at all as the protocols and methods have both been studied extensively in RCT trials and a myriad of other methods supporting their efficacy.

 

[borne_before]

Is it bad that I'm happy to never have used TikTok?

I really like TikTok. There's a wide range of content from silly to out right educational. The algo will figure out your interests pretty fast. One of my fav is this guy who rescues snakes and educates about them. I also follow a mining engineer who discusses various minerals and what not in my state.

 

[PsychPhDone]

Oh no

Oh no
Oh no no no

 

[WisNeuro]

Oh no
Oh no no no

 

[futureapppsy2]

Y'all ever seen the tiktoker dude who tries all these different foods by "forcing" his alters to the front?

The best part is that they all have the same "it's fine, I guess" reaction. Like, try to try...

 

[futureapppsy2]

Doesn't bother most of us at all as the protocols and methods have both been studied extensively in RCT trials and a myriad of other methods supporting their efficacy.

To be fair, though, it does bug me when hardcore ACT fans act like Hayes "discovered" mindfulness, self as context, etc., himself in the 70s, and no one had ever thought of it prior to that. I really like ACT, but the hardcore behaviorist ACT fans can get... weird.

 

[WisNeuro]

To be fair, though, it does bug me when hardcore ACT fans act like Hayes "discovered" mindfulness, self as context, etc., himself in the 70s, and no one had ever thought of it prior to that. I really like ACT, but the hardcore behaviorist ACT fans can get... weird.

Oh yeah, I like ACT principles a lot, but I'm no acolyte of the Hayes cult. It's definitely repackaged material, but it's repackaged in a useful way at least.

 

[MiniLop]

To be fair, though, it does bug me when hardcore ACT fans act like Hayes "discovered" mindfulness, self as context, etc., himself in the 70s, and no one had ever thought of it prior to that. I really like ACT, but the hardcore behaviorist ACT fans can get... weird.

This is my experience with everyone who seems overly committed to a particular modality or protocol. They can get real weird about it. It's particularly striking when all you get is super-rigid advice/supervision, in the name of treatment modalities that are intended to increase flexibility and reduce rigidity. Womp womp.

 

[AbnormalPsych]

All you guys did was check the work of people that lived 3000 years ago. And they didn't need science to figure it out. Physics though...that **** is difficult.

If they didn't attribute all that **** to someone they label as a scientist, it means their entire lives were a waste of time. If anyone can do it (which is what happened), then you don't need to spend your life getting a degree.

I looked up the Lilenfield guy

Nevertheless, no research has convincingly demonstrated memory suppression for autobiographical experiences in the laboratory (Otgaar et al., 2019), let alone for years or decades in everyday life. Furthermore, recent research suggests that memory suppression has been difficult to replicate (e.g., Bulevich et al., 2006). Adding to these doubts, Wessel et al. (2020) conducted a multiverse analysis3 on several memory-suppression experiments and failed to find evidence for consistent suppression effects. They concluded that their analysis “raises problems for inhibition theory and its implication that repression is a viable mechanism of forgetting” (p. 870).

Did they abuse a bunch of kids, wait a decade or two then see if they remembered it or not?

Bruh.

 

[MCParent]

All you guys did was check the work of people that lived 3000 years ago. And they didn't need science to figure it out. Physics though...that **** is difficult.

If they didn't attribute all that **** to someone they label as a scientist, it means their entire lives were a waste of time. If anyone can do it (which is what happened), then you don't need to spend your life getting a degree.

I looked up the Lilenfield guy

Nevertheless, no research has convincingly demonstrated memory suppression for autobiographical experiences in the laboratory (Otgaar et al., 2019), let alone for years or decades in everyday life. Furthermore, recent research suggests that memory suppression has been difficult to replicate (e.g., Bulevich et al., 2006). Adding to these doubts, Wessel et al. (2020) conducted a multiverse analysis3 on several memory-suppression experiments and failed to find evidence for consistent suppression effects. They concluded that their analysis “raises problems for inhibition theory and its implication that repression is a viable mechanism of forgetting” (p. 870).

Did they abuse a bunch of kids, wait a decade or two then see if they remembered it or not?

Here; I’ll do it for you then.

https://en.m.wikipedia.org/wiki/Dunning–Kruger_effect

 

[Mercury in Taurus]

Looking for some suggestions in how to approach a new patient of mine who has...many things going on, most of which I feel comfortable addressing, but one of which is relatively novel to me. Specifically, this middle-aged person feels that their life has been ruined by a grand guignol of systematic abuse by dozens of perpetrators as part of a trafficking ring for many years in their childhood. Thing is, they had literally no memory of this until they underwent hypnosis in 2015. That is when they began "remembering" this Hieronymous Bosch painting of a childhood. Their mother denied this had happened for many years but is getting to be frail and person has moved in to take care of her and allow her to remain at home. Perhaps not surprisingly now mom "agrees" with person that this abuse happened, though apparently is very hazy on details.


so much about the situation screams extremely sketchy previous provider (prescribing her narcotics, stimulants and benzos simultaneously, suddenly having to leave practice unexpectedly). I don't want to totally disregard her account but I also know the recovered memory literature and know it has essentially zero support as a non-iatrogenic phenomenon. I would like to convey my concerns about this to the patient but since they have built a lot of their identity around it I feel a need to tread lightly. Normally I don't really care about whether the details of my patient's trauma histories that they provide are or are not how someone else might have experienced the situation, but in this case where someone has been basically victimized by a predatory psychiatrist and had their life exploded by nonsense I feel a need to say something.

Anyone have experience with situations like this? Any literature on how one attempts to undo the damage? The controlled substance trainwreck I have no problem dealing with but this is fairly new to me.

There are multiple layers of dynamics in this case you described. In our responses, there is a belief that recovered memory could be repressed memory of traumatic event(s). There are strong empirical evidence support that false memory is induced and/or produced in recovering memory. cara susanna took the stand that treating the symptoms of trauma does not require us to investigate the legitimacy of trauma.

What does the patient need? We can dive into the ocean of knowledge and support a position with scientific data. Is it the best usage of our time, energy, and privileged access to knowledge? Does being right intersect with being helpful?

It makes me wonder if what we see here on this forum reflects what your patient experience in her life and how does that impact her. As a sensitive person, I wonder if it is beneficial or harmful for her mental health and well-being.

From a narrative perspective, we assess patients' current function by listening to their stories and pay attention to the role that they play. Individuals who position themselves as victims in their narratives might be stuck being a victim due to a pattern of anticipating being victimized. The same stories may be played out over and over again with different people and/or in different settings.

From a relational perspective, it is interesting what makes her be convinced that recounted events in her recovered memory were real events. In her effort of finding validation or confirmation, did any rupture occur in her relationship with her family? Now the mother is becoming dependent on her care and "agrees" with her. Did the mother's pseudo-validation strengthen their relationship, repair or further damage their relationship, improve or worsen your patient's symptoms?

Fan_of_Meehl has mentioned some options of evidence-based treatment for consideration. Any thoughts about any of these treatments, in regards to their effectiveness, suitability, accessibility...?

 

[clausewitz2]

Like, try to try...

Always brings this to mind:

 

[clausewitz2]

There are multiple layers of dynamics in this case you described. In our responses, there is a belief that recovered memory could be repressed memory of traumatic event(s). There are strong empirical evidence support that false memory is induced and/or produced in recovering memory. cara susanna took the stand that treating the symptoms of trauma does not require us to investigate the legitimacy of trauma.

What does the patient need? We can dive into the ocean of knowledge and support a position with scientific data. Is it the best usage of our time, energy, and privileged access to knowledge? Does being right intersect with being helpful?

It makes me wonder if what we see here on this forum reflects what your patient experience in her life and how does that impact her. As a sensitive person, I wonder if it is beneficial or harmful for her mental health and well-being.

From a narrative perspective, we assess patients' current function by listening to their stories and pay attention to the role that they play. Individuals who position themselves as victims in their narratives might be stuck being a victim due to a pattern of anticipating being victimized. The same stories may be played out over and over again with different people and/or in different settings.

From a relational perspective, it is interesting what makes her be convinced that recounted events in her recovered memory were real events. In her effort of finding validation or confirmation, did any rupture occur in her relationship with her family? Now the mother is becoming dependent on her care and "agrees" with her. Did the mother's pseudo-validation strengthen their relationship, repair or further damage their relationship, improve or worsen your patient's symptoms?

Fan_of_Meehl has mentioned some options of evidence-based treatment for consideration. Any thoughts about any of these treatments, in regards to their effectiveness, suitability, accessibility...?

These are all excellent questions and I very much appreciate the thoughtful feedback. I imagine it very much does reflect her experience in her life; from what I have gathered from her her marriage of 15 years ended in no small part because of her husband's unwillingness to accept these memories as 100% veridicial.

Unfortunately the patient in question seems to have vanished after I declined for the third time to prescribe narcotics and remained steadfast in insisting that we would be tapering her enormous benzo doses (excruciatingly slowly and gently, over many months) instead of increasing it more. There was also a mismatch between what she was reporting she was told by various emergency room physicians (catastrophic spinal damage) v. what was documented in notes I could see (nothing appreciably wrong). While a practical relief in terms of agita incurred for me, I do worry she is going to wind up with another, um, DEA-adherence-challenged provider.

 

[clausewitz2]

Oh yeah, I like ACT principles a lot, but I'm no acolyte of the Hayes cult. It's definitely repackaged material, but it's repackaged in a useful way at least.

I'm in a similar boat. I do end up using the principles a lot but they lost me at Relational Frame Theory as an adequate account of human linguistic behavior. My PhD is in linguistics so the failings of it are probably much more glaring to me than it would be for many people; in linguistics we have tried explaining the available data with theories like this before but don't seem to be able to get away from some notion of generativity involving underlying and not surface-perceivable structures that somehow still get learned by pretty much everyone in a linguistic community.

Good news, I have yet to see anything to convince me that you have to know a blessed thing about RFT to use ACT effectively. They insist it is super important to understanding but have not heard a coherent account of why, apart from a vague insistence that otherwise it is not based on science.

 

[psych.meout]

All you guys did was check the work of people that lived 3000 years ago. And they didn't need science to figure it out. Physics though...that **** is difficult.

If they didn't attribute all that **** to someone they label as a scientist, it means their entire lives were a waste of time. If anyone can do it (which is what happened), then you don't need to spend your life getting a degree.

I looked up the Lilenfield guy

Nevertheless, no research has convincingly demonstrated memory suppression for autobiographical experiences in the laboratory (Otgaar et al., 2019), let alone for years or decades in everyday life. Furthermore, recent research suggests that memory suppression has been difficult to replicate (e.g., Bulevich et al., 2006). Adding to these doubts, Wessel et al. (2020) conducted a multiverse analysis3 on several memory-suppression experiments and failed to find evidence for consistent suppression effects. They concluded that their analysis “raises problems for inhibition theory and its implication that repression is a viable mechanism of forgetting” (p. 870).

Did they abuse a bunch of kids, wait a decade or two then see if they remembered it or not?

 

[MiniLop]

I'm in a similar boat. I do end up using the principles a lot but they lost me at Relational Frame Theory as an adequate account of human linguistic behavior. My PhD is in linguistics so the failings of it are probably much more glaring to me than it would be for many people; in linguistics we have tried explaining the available data with theories like this before but don't seem to be able to get away from some notion of generativity involving underlying and not surface-perceivable structures that somehow still get learned by pretty much everyone in a linguistic community.

Good news, I have yet to see anything to convince me that you have to know a blessed thing about RFT to use ACT effectively. They insist it is super important to understanding but have not heard a coherent account of why, apart from a vague insistence that otherwise it is not based on science.

Maybe I'm a little slow, but I really had trouble following the RFT things during the ACT training I did. Would you mind briefly explaining RFT and why Hayes claims it's so essential to doing ACT well (even if those claims are incoherent)?