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therapies
A wave of nausea washed over Sheri J. Storm when she opened
the Milwaukee Journal Sentinel on a February morning a
decade ago and saw the headline: “Malpractice lawsuit:
Plaintiff tells horror of memories. Woman emotionally testifies that
psychiatrist planted false recollections.” The woman in the article
shared a lot with Storm— the same psychiatrist, the same memories, the
can have same diagnosis of multiple personality disorder. At that moment, Storm
suddenly realized that her own illness and 200-plus personalities,
long-lasting though painfully real to her, were nothing more than a figment of her
imagination— created by her trusted therapist, Kenneth Olson.
effects Storm initially sought treatment from Olson because of insomnia
on mental and anxiety associated with divorce proceedings and a new career in
radio advertising. She had hoped for an antidepressant prescription or
health a few relaxation techniques. But after enduring hypnosis sessions, psy-
NSTAINS
BRAIN By Kelly Lambert chotropic medications and mental-ward hospitalizations, Storm had
much more to worry about than stress. She had “remembered” being
and Scott O. Lilienfeld sexually abused by her father at the age of three and forced to engage in
bestiality and satanic ritual abuse that included the slaughtering and
consumption of human babies. According to her psychiatrist, these trau-
matic experiences had generated alternative personalities, or alters,
within Storm’s mind.
Storm is now convinced that her multiple personality disorder
was iatrogenic, the product of her “therapy.” But years after the psychi-
atric sessions have ceased, she is still tormented by vivid memories,
nightmares and physical reactions to cues from her fictitious past. Al-
though she was told that the false memories would fade over time, she
has had a difficult time purging these “brain stains” from the fabric of
her mind.
Storm’s case is similar to those of many other patients who underwent
recovered-memory therapy that revealed sordid histories of sexual abuse
and demonic ceremonies. Although the scientific literature suggests that
traumatic events are rarely, if ever, repressed or forgotten, this type of
therapy was widespread in the 1990s and is still practiced today. Only
after several high-profile lawsuits did the American Medical Association
issue warnings to patients about the unreliability of recovered memories.
Nadean Cool, the patient described in the newspaper story that turned
Storm’s life upside down, filed one such lawsuit. Cool received a $2.4-
SHERI J. STORM
In Storm’s case, a technique called abreactive bowel disturbances and severe insomnia. Olson
therapy helped to create these emotional associa- prescribed lithium, Prozac, Desyrel, Tegretol,
tions. Storm was told that abreactions were total- Xanax and several migraine medications to ad-
body “flashback” reactions that would enable dress these new symptoms. A decade later Storm
4 Research on patients
3 Chronic stress associated with post-traumatic stress
with traumatic memories disorder reveals diminished
compromises the prefrontal functioning of the anterior
cortex, reducing a patient’s cingulate cortex, a
ability to forget false structure that helps us
memories after ceasing choose between conflicting
therapy. In experiments on perceptions (for example,
rats, animals without a “My parents love me” versus
functioning prefrontal cortex “My parents harmed me”).
lose the ability to extinguish
fearful memories that are
no longer relevant.
2 Heightened anxiety
activates stress centers in
the brain’s regulatory center,
the hypothalamus, which in
turn primes the amygdala to 5 Chronic stress impairs
quickly consolidate fearful neurons in the hippocampus,
memories, regardless 1 Months of anxiety-provoking known for its role in learning
of their authenticity. therapy sessions may sensitize and emotion processing. This
the amygdala, known as the area of the brain is involved in
brain’s fear center, to relevant “contextual” learning and, if
information arriving from the weakened, may help explain
sensory processing thalamus why patients report losing
(blue) and the higher cognitive track of time and experiencing
center known as confusion in unfamiliar
the prefrontal cortex. surroundings.
In 2004 August Piper, a Seattle psychiatrist in MPD. This compelling movie, based on a 1973
private practice, and Harold Merskey, a professor book, won Sally Field an Emmy. Further confi r-
emeritus of psychiatry at the University of Western mation of the power of Field’s performance may
Ontario, examined the scientific literature and be found in the sharp increase in MPD diagnoses
concluded that there was no compelling evidence after the release of the book and movie. Before
that DID is caused by childhood trauma. They re- 1973 fewer than 50 cases of MPD associated
ported that the disorder is not reliably diagnosed,
that DID cases in children are practically never re-
(The Authors)
ported and that recurring evidence of blatant iat-
rogenesis is seen in the practices of some therapists KELLY LAMBERT is a professor of psychology, chair of the psychology de-
utilizing recovered-memory methods— for exam- partment and co-director of the Office of Undergraduate Research at Ran-
ple, calling out alters by name and referring to dolph-Macon College. Her research interests focus on animal models of
them as different people. Piper and Merskey con- experience-based neuroplasticity, specifically the neurobiological effects
cluded that DID is “best understood as a culture- of parental experience and the identification of coping strategies associ-
bound and often iatrogenic condition.” ated with enhanced resilience against the onset of mental illness.
In popular culture, books and films may have SCOTT O. LILIENFELD is a professor of psychology at Emory University and
THERESA SAKNO
played a role in turning MPD, and later DID, into a member of Scientific American Mind’s board of advisers. His research
a fad. The 1976 made-for-television movie Sybil interests include the causes and diagnosis of personality disorders and
portrayed the life of a shy graduate student, Shir- evidence-based practices in clinical psychology. The authors wish to thank
ley Ardell Mason, who was diagnosed with Sheri J. Storm for her contributions to this article.
S
heri J. Storm’s psychiatrist,
Kenneth Olson, videotaped length and branching of dendrites in the brain’s
some of her therapy ses- medial prefrontal cortex by about 20 percent.
sions after administering sodium This reduction is associated with an impaired
amytal (purportedly a truth serum). ability to shift attention while learning new tasks.
In this excerpt from a transcript of In contrast, neurons in the amygdala grow in re-
one such session, Olson tries to sponse to fear. The functions of the brain areas
Storm’s license plate summon alternative personalities. that are affected by fear and stress in animal stud-
ies are closely aligned with the symptoms exhib-
Sheri Storm: How does this operate with the brain? I mean, ited by recovered-memory patients. Compro-
is it like alcohol? mised functioning of the prefrontal cortex may be
Kenneth Olson: Yeah, I imagine. associated with a patient’s inability to distinguish
SS: So, does this mean I won’t remember this part? reality from fiction, whereas growth of neurons
KO: (inaudible) in the amygdala may lead to hypervigilance and
SS: It’s on tape, oh. suspiciousness. Animal research also suggests
KO: I think the first question that Sheri wanted to ask, and that once therapy sessions cease, compromised
probably the most important one, is did it really happen? prefrontal cortex functioning may diminish the
SS: (inaudible) ability to inhibit fearful memories.
KO: Did it really happen? And I’ll encourage you to talk to the Although investigations of brain responsive-
camera as if you were talking to Sheri. ness in MPD-DID patients are lacking, striking
SS: Did what really happen? similarities to brain areas known to be affected by
KO: She wants to know if she was really abused. She’s con- fear and stress in animals are found in neuroimag-
fused and thinks she’s making it up.… Is there anybody who’d ing studies of humans experiencing post-traumat-
like to come forward and answer that question? For Sheri? Hi. ic stress disorder (PTSD). PTSD is classified as an
Who’s here? anxiety disorder characterized by recurrent intru-
SS: I don’t know. sive memories of a past traumatic event; behav-
KO: I don’t know is here? ioral and cognitive avoidance; and psychophysio-
SS: Must be. logical arousal leading to mood disturbances and
sleep disturbances— all resulting in functional im-
pairment. Research on PTSD patients has shown
with child abuse had been reported, but by 1994 diminished responsiveness in the medial prefron-
the number had soared to more than 40,000. tal cortex and heightened activity in the amygdala
Mason herself may have been a victim of iat- proportional to the severity of PTSD symptoms.
rogenic practices. In 1997 Herbert Spiegel, a psy- Guided imagery and reenactments used in re-
chiatrist who worked with Mason for four years, covered-memory therapy may produce PTSD-like
told an interviewer that Mason’s behavior was symptoms. Harvard University psychologist Ste-
induced by the suggestive therapeutic techniques phen M. Kosslyn has found evidence that the
of her primary psychiatrist. That revelation has same areas of the brain activated when we see an
not stopped CBS from producing a remake of the object are activated when we close our eyes and
film starring Jessica Lange as Sybil’s psychiatrist, imagine seeing the object. From the brain’s per-
which has not yet been scheduled for broadcast. spective, guided imagery could be just as power-
ful as viewing home movies of abusive events.
Neural Restructuring The feelings of helplessness associated with re-
Decades of behavioral neuroscience experi- covered-memory therapy may increase the likeli-
ments using animal models have consistently sug- hood of negative effects. In animal research con-
gested that trauma and fear can change the archi- ducted in 1967 at the University of Pennsylvania,
tecture of the brain. For example, neuroscientist psychologists Martin Seligman and Steven Maier
Bruce McEwen’s group at the Rockefeller Univer- (Maier is now at the University of Colorado at
SHERI J. STORM
sity has shown that chronic stress alters neuronal Boulder) found that when dogs were allowed to
complexity in three key areas: the medial prefron- escape an aversive shock stimulus, they continued
tal cortex (involved in working memory and ex- to show motivation to escape in the future. But
ecutive function), the hippocampus (involved in when dogs were not given an opportunity to es-