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Section
4
Cognitive Dissonance in Sexually Abused Clients
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In the last section, we examined the various sides of
the controversy regarding repressed memories.
In this section, we will
discuss cognitive dissonance created in the therapist when predisposed ideas are
challenged and eight key characteristics that red-flag your co-dependent clients
to be predisposed to therapist implantation of ideas of sexual abuse.
♦ The Introduction of Cognitive Dissonance
When a person's core belief has
been challenged, as you know, a great internal conflict in the mind of
the client occurs, known as cognitive dissonance. How does cognitive dissonance
relate to repressed memories of sexual abuse? When two different opinions are
presented, the client must choose one. In the case of repressed memory, authority
figures, such as the child's parents or therapists, play a major role.
If one
opinion advocate, as Festinger states, is "seen as an expert or very knowledgeable
about such matters, the dissonance between knowledge of his contrary opinion and
one's own opinions will be greater." I am sure you probably have observed
this in your therapy sessions with your client. Festinger adds, "The person
will actively avoid situations and information which would likely increase the
dissonance."
In therapy, this may result in the client cutting him or herself
off from friends and family that express any doubts. By maintaining a very close-minded
approach, the client isolates themselves in a reality that might be false and
unhealthy for their growth.
♦ Therapist Predisposition
Let's
switch the focus for a moment, away from pseudo-memories or predisposition of
our clients, to therapist predisposition. How susceptible are therapists to pseudo-memories?
For example, how quick are therapists to assign diseases for which there is little
evidence? Let's look at an experiment by a Stanford psychology and law professor
D. L. Rosenhan. Rosenhan sent eight subjects to be admitted to 12 in-patient psychiatric
wards around the United States where, during admission, they complained of hearing
voices that said words such as "empty," "hollow," and "thud."
In reality, the subjects were students and other ordinary healthy volunteers from
the community. As soon as they were admitted, they totally ceased simulating any
symptoms of schizophrenia whatsoever. However, Rosenhan noted, "The pseudo-patient
spoke to patients and staff as he might ordinarily speak. However, because there
is commonly little to do on a psychiatric ward, he attempted to engage others
in conversation. When asked by staff how he was feeling, he indicated that he
was fine."
By the end of the experiment, none of the healthy people were
detected by psychiatrists. Eventually, each was released with a diagnosis of "schizophrenia
in remission." Some were kept in the hospital anywhere from a week to almost
two months.
The student and volunteer subjects wrote down
their observations of the therapists and patients. Amazingly, in each case it
was only the other patients in the hospital that detected the pseudo-patients
and not the staff. The other patients would make statements like, "You're
not crazy. You're a journalist or a professor. You're checking up on the hospital."
The real patients, just by normal, everyday observation, could see without any
pre-accepted theory that the subjects were perfectly healthy. However, those psychiatrists,
even though they kept close observation of subject's behavior, could not see that
they were devoid of mental defect.
Regarding sexually abused
clients, once the therapist is predisposed to the idea of sexual abuse, perhaps
by a wife seeking custody, the therapist may tend to pursue the line of thought
regarding sexual abuse, just as the therapists on the in-patient unit were predisposed
to see the healthy subject as being schizophrenic because of their admission criteria.
♦ Ethical Minute of Contemplation
Take a few minutes. In short, take a long ethical minute of contemplation and consider what
factors cause you to be predisposed or have a tendency to develop certain attitudes,
feelings, and perhaps diagnoses under the right circumstances.
--
Can you recall
a patient's or client's name where you received information from other family,
school records, or parents that predisposed you to be looking for sexual abuse?
--
Could
you have asked leading, probing questions in that interview that possibly could
have implanted false memories in your client?
--
What was your diagnosis?
--
And what
were the factors that contributed to that diagnosis?
--
Let's
go back now to the point of cognitive dissonance. As you know, many clients are
people-pleasers. Could you have created in your client a conflict between what
you are expecting them to say in the session, and what really happened?
--
Ask
yourself if your client may be unconsciously getting on the band wagon. Have they
mentioned watching Oprah, Jerry Springer, or Dr. Phil?
Sophia,
age 47, suggested to her therapist of three months that she believed she might
have been abused as a young girl and had repressed the memories. When asked how
she had come by this realization, she stated, "Well, I saw this episode of
Oprah where all these women had repressed the memory of their childhood abuse.
They described the symptoms they'd had before their discovery, and, oh my god,
it was exactly what I was going through!"
Her therapist was skeptical, because
the symptoms Sophia described were not the ones she had been exhibiting months
before. Before treating Sophia, her therapist had compiled an 8 point checklist
of examples of a client that is over-eager to find a cure for their behaviors
and therefore jump at any influence, for example, alleged child abuse.
♦ 8 Point Checklist
As
you read this checklist, you will find many of your clients have exhibited these
behaviors. However, if the overall context is a custody suit, or jail-time for
the abuser, you might use this checklist as merely food for thought. A client who may be predisposed to therapist
implantation of false memories might exhibit the following codependent type characteristics:
-- 1. Try
to please others instead of themselves,
-- 2. Abandon their routine to respond to
or do something for somebody else,
-- 3. Believe deep inside other people are somehow
responsible for them,
-- 4. Feel angry, victimized, unappreciated, or used,
-- 5. Finding
themselves saying yes when meaning no,
-- 6. Believe other people are making them
crazy
-- 7. Believe they don't deserve good things and happiness
-- 8. Wish other people,
including their therapist, would like and love them
Such descriptions
fit Sophia, and her therapist soon realized that any kind of diagnostic implication
from him would unduly influence Sophia into trying to fit into her symptoms to
the disorder. As a result, the therapist focused the sessions on Sophia with little
input from himself.
After several sessions of gently refusing to answer leading
questions, Sophia began to open up more about her life rathern than focus on treating
herself. The ethical thin grey line is not very clear here. Ask yourself, at what
point are you leading the client into false memories of sexual abuse? On the other
hand, at what point are you ignoring and invalidating their needs?
In
this section, we discussed predisposing the therapist and a codependent checklist.
In the next section, we will examine the influence of New Age Mentality on repressed
memories of possible sexual abuse as it relates to intuition, imagination, and
hearsay.
Reviewed 2023
Peer-Reviewed Journal Article References:
Levy, N., Harmon-Jones, C., & Harmon-Jones, E. (2018). Dissonance and discomfort: Does a simple cognitive inconsistency evoke a negative affective state? Motivation Science, 4(2), 95–108.
Murphy, J., Shevlin, M., Houston, J., & Adamson, G. (2012). Sexual abuse, paranoia, and psychosis: A population-based mediation analysis. Traumatology, 18(1), 37–44.
Nahleen, S., Nixon, R. D. V., & Takarangi, M. K. T. (2019). Memory consistency for sexual assault events. Psychology of Consciousness: Theory, Research, and Practice. Advance online publication.
Smith, R. D., Holmberg, J., & Cornish, J. E. (2019). Psychotherapy in the #MeToo era: Ethical issues. Psychotherapy, 56(4), 483–490.
Voisin, D., & Fointiat, V. (2013). Reduction in cognitive dissonance according to normative standards in the induced compliance paradigm. Social Psychology, 44(3), 191–195.
QUESTION
4
Does your client, who states he or she has been sexually abused, exhibit
a predisposition towards, perhaps, codependence? To select and enter your answer
go to .
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