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The Devil You Know

Originally posted on UK/US skeptical blog, The Heresy Club, this piece is an introduction both to the Internal Family System model of therapy, which is gaining ground in the US among psychologists and social workers alike, and to the ongoing events in St. Louis involving Mark Schwartz. Both of which might represent the last legitimate stronghold of DID in the US.  It’s also an introduction to me! Enjoy!

We’re often tempted to see memory as an ever-growing fabric of past actions, thoughts and moods. Sure, the edges might get frayed or a stitch undone every once in a while, but at the day’s end, there it is, an intricately woven tapestry of past events, free to return to and look over anytime we wish.

In actuality, memory is far from the perfect recollection we assume it to be. The edges fray constantly as only bits and pieces of a day’s life are ever meaningfully captured. The stitching warps and morphs not just as we record an event from our limited perspective, but every time we delve in to recall it. Most frighteningly, our perfectly laid out record can be subtly manipulated and altered without our awareness of it. At least, not until it’s too late.

In St. Louis, Missouri, a pristinely-located psychiatric facility called the Castlewood Treatment Center finds itself under attack by allegations of doctors creating false memories in the very patients they were sworn to treat and protect. Earlier this July, Brooke Taylor became the third person in less than a year to sue the clinic, often known as a haven for eating disorder sufferers, and accusing them of implanting memories of her being sexually abused by family members while she was under hypnosis and on psychtropic drugs. Taylor’s lawsuit comes on the heels of those filed by Leslie Thompson and Lisa Nasseff in February and last November respectively. In addition to the past, or even continuous, sexual abuse in which they were made to believe, the former two also contested they were convinced of being involved in gruesome satanic rituals as secretive cult members. One particular “memory” highlighted in Thompson’s petition included being witness to an infant’s sacrificial murder.

While Taylor’s suit neglects to mention the presence of Dr. Mark Schwartz , Sc. D and the Clinical Co-Director of Castlewood, the three lawsuits do share something else in common: they all accuse the center of willingly coercing the women into believing they were beset by multiple personalities, at least twenty in Nasseff’s case alone. It’s a similarity, as it turns out, that may not be in their heads at all. That might be exactly what the clinic is trying to do to its patients.

Even as Castlewood’s website touts its numerous approaches to treating eating disorders, with methods like cognitive-behavioral therapy, dance therapy and attachment-based psychotherapy, its crowning achievement, least judging by the repeated mentions it gets, has to be the Internal Family Systems model, developed by Richard Schwartz, PhD (no relation to Mark) sometime in the 1980s.

The Internal Family Systems model, or IFS for short, is based around the concept of the Self, an almost spiritual “curious, compassionate, and joyous” avatar, and of Parts,  distinctive, and apparently conscious, sub-personalities of a person’s psyche. These Parts relate to each other as pieces of a larger community of the person’s mind as well as to the independent Self, the idealization of the person’s personality and one capable of directing the Parts in unison, provided they’re all functionally healthy. But in the case of trauma, they take on different roles: Exiles, Managers and Firefighters. Exiles are parts that are considered actively vulnerable (for example: one that’s afraid of being beaten by their father), while Managers try to regulate or silence these Exiles in an attempt at protection. Firefighters spring into action via self-destructive behaviors like drinking or purging as a means of distraction when Exiles escape and take up space in the person’s consciousness by demanding attention. The Managers also actively berate and scold the Firefighters for being weak and disastrous, even as they use them as a means of control over their Exiles. Through the long, protracted sessions between a patient and IFS therapist, ultimately a patient strives to reconnect and heal the relationships between these Parts by way of communication. In other words, the patients are made to talk to their Parts individually, to reconcile and acknowledge these distinctive personalities to create a wholesome and confident Self. Complicated enough for you yet?

If all of that sounded like an infomercial for Relaxation Spas: Healthy Springs, Healthy Bodies! to you, then you’re not the only one. Even as Schwartz himself has admitted to leaning on Eastern philosophies while formulating his theory, there’s a very apparent taste of strangeness in reading through the various papers and case studies describing IFS in action. There’s nothing wrong with the idea of a person’s personality being comprised of different aspects: we often talk of angels and devils on our shoulders, Freud (and the many other, less publicized, psychologists in his wake) spoke of egos and ids and anyone who’s experienced friendships with drastically dissimilar groups from one another can attest to the power of a multifaceted mind. We show and experience different parts of ourselves to others and to ourselves, sure, but to hear Richard Schwartz describe it, is to realize he’s interested in taking that idea a bit further:

In a sense, we are all multiple personalities. The condition we call multiple personality disorder only represents an extremely disengaged and polarized version of the ordinary operation of our internal system.

With its focus on personalities, so-called Parts, each equipped with its own memories and quirks, it’s not inconceivable that through the actions of an overzealous – or even just suggestive – therapist eager to dig up more, a previously malnourished, highly suggestible patient could be convinced of memories and events that never happened to begin with. In the race to identify and graph all the different voices we apparently carry, it’s not a stretch of the imagination that someone could have been pushed to create ones out of thin air, especially in light of the documented link between hypnosis and false memory syndrome. Documented court cases where former patients of hypnosis stepped forward years later alleging and successfully suing their therapists over the formation of fake, incredibly traumatic memories that left innocent parents in jail and entire families destroyed. Does that mean Richard Schwartz’s IFS therapy, with its focus on confronting the different voices of a person’s mind, is purposefully creating multiple personalities, saddled with their very own artificial memories, in its patients?

Not according to Ann Akers, a Brooklyn-centered IFS certified therapist with 30 years of experience in psychotherapy. In a personally conducted phone interview, Akers disavowed the use of hypnosis as a tool in IFS sessions (brief conversations with other IFS-certified practitioners confirmed the lack of hypnosis in traditional IFS therapy), as well as the idea that IFS, used correctly, can cause the ‘fragmentation’ of a person’s mind. When it came to the question of whether the therapy could facilitate the creation of false memories, Akers carefully explained, “It’s never in the therapist’s agenda to introduce new things,” with the therapist’s role being one of mediator, not driver, according to her. That isn’t to say she didn’t acknowledge the possibility of improper use though, or of concerns in the community as to its legitimacy as a ‘real’ form of therapy. Despite all that, and aware of the ‘hokey’ reputation that some of her fellow psychologists have branded it with, Akers nevertheless had nothing but good things to say about Schwartz’s model, lauding it as a valuable asset in communicating and dealing with her patients’ psychological issues. In fact, many of those familiar with IFS seem to echo the good vibes of Akers, even if they don’t necessarily buy into the sweeping language of the model. The Center for Self Leadership, the flagship organization of IFS, boasts annual conferences and hundreds of certified therapists across the country, and the Castlewood Treatment Center even counts Richard Schwartz as one of its staff members. But it isn’t just the hokeyness that’s troublesome for IFS supporters, it’s the utter glaring lack of evidence behind its effectiveness.

Look through the scant literature of IFS and you’ll find a common theme: papers authored by Schwartz and others detailing the wonders of IFS in all its glory, case studies of patients being treated by IFS, and loosely related studies dealing with some of its concepts. What you won’t find is empirical data comparing IFS with other proved methods, or even any following up on the success rate of their patients. While testable evidence’s always been a bit of a thorn in the side of psychologists, with some in the lab worried about the disconnect behind the thousands of different therapies and the documented evidence to support those therapies, it’s especially jarring considering the nearly 30-year legacy of Schwartz’s model. It’s a disconnect which even both Richard and Mark Schwartz (alongside Castlewood’s other Clinical Co-Director and Mark Schwartz’s spouse Lori Galperin) admit in a recent paper of theirs, lamenting:

Unfortunately, at this time no well-constructed outcome studies testing the IFS model and methods have been completed;

They do however talk of several on-going studies examining various applications of IFS in areas as broad as dealing with rheumatoid arthritis sufferers to treating juvenile sex offenders. As of this writing, the only confirmation received as to the status of these studies came from Shelly Haddock, an Associate Professor of Human Development and Family Studies at Colorado State University, who is “in the process of getting the research written up  in manuscript form to submit,” though she couldn’t elaborate further. That isn’t to say that the other studies aren’t underway as we speak, of course. But the lack of usable data hasn’t stopped Schwartz and others from writing books, creating organizations and teaching new students while touting IFS as an universally beneficial treatment for patients of all traumatic issues.

So where does that leave us? Is IFS an inherently dangerous and clinically unsupported form of psychotherapy that heavily influences already deeply wounded patients into manifesting new problems in the guise of identifying their parts? Is it an misunderstood tool receiving a bad rap from former clients looking to cash in a lucrative settlement from a clinic eager to protect the reputation of an useful therapy? Or is there something else going on?

In an article profiling him in 2001, Mark Schwartz was asked about his views on the patients entering a former clinic of his:

In a June 1998 interview with St. Louis magazine, Schwartz said that more than 80 percent of the 3,000 patients he and Galperin had treated at the clinic since 1992 were victims of childhood sexual abuse. An additional 300 to 400 patients have been treated during each of the following two years, according to Schwartz, who says the percentage of patients who were abused as children remains at the same high rate.

Schwartz also authored a book in 1996 detailing the specific relationship between those with eating disorders and past sexual abuse. A book prominently displayed on Castlewood’s site as recommended reading. But most interesting of all, according to another piece in the St. Louis Post-Dispatch, former patient Meagan Mckay noted the large amount of women suffering from flashbacks of abuse and of Schwartz’s insistence that Lisa Nasseff’s exit from the clinic was prompted by a desire to return to her cult:

“I was there for about seven months altogether and saw an awful lot of people who were brainwashed,” she said. “I started saying things to people like, ‘I think the only cult anybody’s ever been in is the one we’re in right now.”

While the treatment center has steadfastly denied any of the three’s claims that they were being pumped for unlimited insurance money under the auspices of treatment for these created traumas, in the case of the former two, the center has decided to start settlement hearings sometime in September. According to CBS Local’s Kevin Killeen, the clinic has stood behind its director and its treatments regardless, releasing a public statement:

Castlewood has treated more than a thousand clients and is a leading treatment center for those suffering from anorexia, bulimia and compulsive over-eating. Castlewood is confident in the care that has gone on for over a decade.

For his part, Mark Schwartz has refused to comment so far on any of the three women’s claims. But with the lawyer for all three women’s complaints, Ken Vuylsteke, claiming that at least a dozen other women have voiced similar allegations of implanted memories and multiple personalities to his office, it’d be fair to ask just what sort of devils Mark Schwartz sees in the dark of his patients’ minds, and just how far he’d be willing to go to uncover them.

4 comments

  1. Plain Speaker

    That was wonderful, thank you!

    I am reminded of the utterly bogus concept of “co-consciousness”;
    “The phenomenon of more than one identity sharing an awareness of external life at the same time; usually refers to the Host maintaining an awareness of events which transpire when other identities take executive control of the body” – (taken from rcm-usa.org)

    The above definition at least substitutes the word “identity” for the word “self”, which was the way this nonsensical concept was originally described.
    There were some interesting experiments conducted with persons whose brains had been literally split – the connections between right hemisphere and left hemisphere totally severed – which COULD be interpreted as indicating a separate consciousness operating in each hemisphere at the same time. Excepting this very extreme circumstance, however, the concept of multiple distinct points of consciousness operating at the same time in one being is simply absurd. Going beyond this self-evidently impossible idea, and adding awareness of each other & communication between them, is nothing but laughably stupid. In my opinion.

  2. Plain Speaker

    I suppose I ought to say something about why the point of consciousness can only be a singularity, (even if it perceives itself to have multiple components), just in case that isn’t so self-evident to others.

    The simplest way to express this might be: the same neuron cannot fire more than once simultaneously. At least, not in this universe.

    The simplest, most easily understood description of the point of consciousness known to me, has two necessary components;
    - I am the person experiencing this and that
    - I am the person doing this and that

    Conscious awareness would not be possible if there were more than one “I” operating simultaneously. I-1, I-2, and I-3 are all experiencing this, would be a state of total confusion, and I-1, I-2, I-3 are all doing this would be incapable of ‘doing’ anything!

    As for the idea of I-1 and I-2 conversing with each other, one of the earliest insights about this idea remains just as valid today:
    “I had a long argument with my other Self, last night” says the patient.
    “Oh?” queries the doctor, “And what Self observed this conversation?”

  3. doug
    douglas

    ridiculous as co-consciousness is — and debunked though the idea of independent consciousnesses with no memory for one another is (http://news.harvard.edu/gazette/story/2012/08/a-story-that-doesnt-hold-up/?utm_medium=social&utm_source=twitter&utm_campaign=socialflow) — the idea of separate discrete personalities doesn’t even deserve neurological consideration, as “identity” is mostly a social construction. the idea that one would have personality states that are amnesiac for one another is one thing, but why in the world would these states have any need to rename themselves? why would, say, a ‘sally’ develop a ‘personality’ that saw fit to insist on understanding herself as ‘mary’, even as the people around her surely still refer to her as sally? it’s as ridiculous as if you were to ask a couple with a newborn, ‘what’s his/her name?’ and they were to reply, ‘we don’t know yet, he/she hasn’t told us’ — as though names are innate and divinely assigned, rather than arbitrary designations chosen by our parents.

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