Clinical Update on Cults
Michael D Langone Ph.D.
Psychiatric Times, July 1996. (Reprinted by permission)
that although a large majority of cult members eventually leave their
groups, many, perhaps most, experience high levels of psychological
distress after leaving and frequently seek mental health counseling.
A factor analytic
study of former cult members� experiences has led to the development
of a �Group Psychological Abuse Scale,� which in turn has found four
factors that characterize cultic environments of all types�compliance,
exploitation, mind control, and anxious dependency�which determine
whether and to what extent an individual may be harmed by the
Theories of Involvement
Why people join
cults, why they leave, why they often experience distress upon leaving,
and how they can be helped are questions that have not been extensively
researched, although three general models of cult conversion and
departure can be identified, with the answers to these questions varying
among the models.
First is the
psychodynamic model, which presumes that cultic groups fulfill
unconscious needs of their members. Second is the deliberative model (popular among theologians
and sociologists), which presumes that people join and leave cultic
groups because of their cognitive evaluations, however faulty, of the
group. Third is the thought
reform model, which presumes that cultic environments lure and hold on
to members through high levels of psychological manipulation.
An integrative model
proposes that the degree of deliberation in a group involvement is a
function of the psychological neediness of the individual and
manipulativeness of the environment.
When neediness and manipulativeness are low, deliberation will be
highest. When manipulation
is high, deliberation will be lower. Those harmed by a cultic
involvement are most likely to come from highly manipulative groups. About one-third appear to have had psychological disorders
before joining the cult, but most appear to have been relatively normal
Treatment of former
cult members should include a cult-sensitive assessment.
The clinician should appreciate the degree to which negative
emotional reactions can be a function of psychological trauma
experienced in the cult, and should not rush to a psychodynamic
interpretation that focuses on preexisting disorders.
However, even though the cult environment is potent, the
psychological, family, and social/vocational history of the individual
should be investigated thoroughly.
It is also important to assess the psychoeducational needs of
patients, that is, the degree to which they understand cultic
manipulations, as well as academic and vocational skills (cultic
isolation can put many ex-members years behind their peers in
educational and vocational development).
Elements of treatment
Treatment should also
include the following:
about psychological manipulation and an application of this
knowledge to the patient�s cult experience;
management of day-to-day crises, which are especially common in
recently exited persons;
reconnecting to the pre-cult past;
in the resolution of grief and guilt related to lost time, lost
friendships, and lost innocence;
and mobilization of the patient�s social support network; and
a cognitive integration of the positive and negative aspects of the
cult experience into the patient�s emerging postcult identity.
often help former cultists, especially those experiencing severe
depression, but psychiatrists should be more cautious in making the
decision to prescribe and more vigilant in follow-up when a cult
involvement is evident. Former
cult members� symptoms are often much more a function of psychological
trauma than of longstanding psychopathology.
Family members who
consult mental health professionals because of a loved one�s cult
involvement should not be dismissed as overprotective, enmeshed, or
otherwise dysfunctional. Most family members seeking help are relatively normal,
although many experience considerable anxiety and anguish in response to
the cult involvement. Family
members typically need information about cults, communication skills
training, and assistance in devising a strategy to help their loved one
make an informed reevaluation of the cult involvement.
Such persons should be referred to cult experts.
Treatment of youth
involved in Satanism, or ritual abuse survivors, though similar in some
ways to the treatment of cult victims, is different in others.
Satanically involved youth tend to be disturbed psychologically and
often are solitary in their satanic dabbling. These youth appear to gain
a compensatory, though illusory feeling of power through Satanism.
Treatment should locus on helping them build a more reality-based
treatment of ritualistic abuse survivors (children and adults) is
fraught with controversy, especially where recovered memories are
involved. Based on current
lack of research data, the recommendations of the American Psychiatric
Association�s Statement on Memories of Sexual Abuse appear to be the
most balanced approach to dealing with ritual abuse cases.
article is based on a presentation made at the 8th Annual U.S.
Psychiatric & Mental Health Congress in New York City, November 16-19,
1995. The author is Executive Director of AFF and Editor of AFF�s Cultic