Back in the 1980s, there was an explosion of "repressed memories" by children who had suffered satanic abuse in schools, day cares, and family homes. The only problem was that most of these memories were iatrogenic, which means they were "implanted" by their therapists. Before the truth came out (that the majority of these memories were implanted by a small percentage of therapists, a lot of innocent people had their lives literally destroyed.

So what happened to those children and the "false memories" that were implanted in them? This brief article from io9 takes a look at that topic.

Are Implanted False Memories Permanent?

Esther Inglis-Arkell
July 10, 2014

The 1980s saw psychologists discovering a lot of "repressed" memories in patients. As it turned out, they weren't so much memories as inventions. Are all those patients stuck with false memories of Satanic abuse and alternate personalities forever?

In 1973, the book Sybil took the world by storm. A pioneering psychiatrist took a very troubled young woman under her wing. After a lot of therapy and a lot of drugs, she discovered that the eponymous Sybil had many alternate personalities. What was the source of these alternate personalities? Extended therapy revealed that Sybil's mind created them to deal with the horrific abuse she experienced at her mother's hands. As therapy continued, the doctor learned more about the abuse by uncovering memories repressed by Sybil's conscious mind for decades.

The problem is, neither the personalities nor the abuse ever existed. Later records show that Sybil was dependent on the doctor for money and drugs, and tried several times to tell her that she was making everything up. That didn't make it into the book, and it didn't make it into the public discourse. What stayed with people was the idea that they could be unhappy because of deeply repressed memories. A kind of medical entertainment industry flourished as people "remembered" abuse by family, friends, and most famously, Satanic cults. These memories became criminal trials, books, and movies. Eventually, the claims became too fantastic, the defendants got the right lawyers and fact checkers, and many of the most famous "repressed memory" stories went down in a hail of justified lawsuits.

Sybil knew she did not have multiple personality disorder, and she knew most of her "memories" were false. She had come to her psychiatrist as an adult, and had known her motivation for making up false memories. Many of the kids who had remembered "repressed memories" had no such background or context. People began wondering whether medical professionals had forced "memories" of abuse into children's minds, and whether those children would ever be able to remember their real life again.

There is no ethical way of studying the memory of children who have been encouraged to form false memories of extreme abuse, but there have been studies done on children who formed more innocuous false memories. The most famous false memory test was done under the direction of Elizabeth Loftus. Her study showed that people, including children, could have detailed and vivid memories of an event that had been made up and implanted in their heads. Most of the false events were innocuous, like seeing Bugs Bunny at Disneyland, when as a Warner Brothers character, Bugs would never be at Disneyland. One memory was only slightly darker. Participants would remember being lost in a mall until an elderly stranger helped them find their parent. Children between three and six, studies found, were especially susceptible to imagining that a story told to them was their own story.

One study rounded up a group of 22 children who had participated in a Loftus study, two years after the study was over. The researches found that children remembered their true memories about 78 percent of the time, but they only remembered about 13 percent of false memories. This isn't as dramatic a drop as it sounds. The first time around, the children remembered about 22 percent of false memories.

An overall review of studies done on children with false memories is less hopeful. Sometimes children clung to made-up events. How the memory came about was the key factor in whether or not it stuck around. Children who had spontaneously come up with false memories tended to forget them rather easily. Children who were implanted with false memories, who were prompted and guided into specific memories, tended to remember them even more persistently than they remembered real events. The significance, and repetition, of these implanted memories overshadowed the real world. So even if kids are told that they had been coached into remembering a false event, it did nothing to dull the memory.

[Via Long-term Survival of Children's False Memories, Are False Memories Permanent, Misinformation Effects.]

Further Reading

What disease did Sybil, the world's most famous multiple-personality patient, actually have? 
Sybil, the book supposedly based on a real case study, made the concept of multiple personality… Read more



No matter how good your recall is, you still have false memories 

There is a condition known as Highly Superior Autobiographical Memory, in which people can remember … Read more

Cultural Contexts, Developmental Capacities, and the Meta-Narratives of Ritual Abuse Survivors

 

I have not seen any good and comprehensive work on this topic, so I want the throw out some ideas and see what sticks. You can view this as me thinking out loud - I have no investment in being "right," I simply seek a framework within which to conceptualize cases.

Few clients we see as therapists are as challenging in their insistence on the meta-narratives of their abuse as survivors of ritual abuse. We can always work with them "as if" their stories are true and accurate, but we then run the risk of validating harmful and often pre-rational beliefs (especially with satanic abuse narratives).

In my work as a sexual trauma counselor, and as one who specializes in clients manifesting dissociative and "psychotic" symptoms, I see more claims of ritual abuse than most therapists I know. I have read Colin Ross's controversial book, Satanic Ritual Abuse: Principles of Treatment, which keeps an open mind to the possibility of organized ritual abuse. Ross recommends that, in treatment, the therapist adopt "an attitude hovering between disbelief and credulous entrapment" (from the publisher's blurb).

I'm not interested in proving or disproving the existence of vast networks of satanic ritual abuse - in part, because I see other meta-narratives in the clients with whom I work, not just the satanic ritual aspect. There is also the issue of the client experiencing a rejection of the details of their narrative as a rejection of their experience, as well. That can only be destructive and does not serve the client.

What I am interested in understanding is the etiology of the various meta-narratives and why some clients present one type over another.

Meta-Narratives of Ritual Abuse

In the time I have been doing this work, I have seen three basic meta-narratives to the ritual abuse "memories."

• The first one is the one most people have heard of, satanic sexual abuse, and includes blood rituals, sacrifice of animals and infants, offerings of children as sexual objects to members of the "circle," and marriage of female children to satan or other demons.
• The second one is a little less common, but shows up as having a Nazi or racist theme and structure, including child pornography, child prostitution, and child "breeding."
• The third one involves a conspiracy by the United States government (MK-Ultra and its derivatives) to conduct secret mind control and manipulation experiments on American citizens (usually children), including induced dissociative identity disorder and the creation of super spies..  

Let's begin with the first and most common meta-narrative, satanic abuse.

The last eruption of this phenomenon into the larger society occurred in the 1980s and into the 1990s and focused on allegations of widespread satanic worship and ritual abuse of animals and children.

Many innocent people were charged with and convicted of crimes that had never happened. Many of the "recovered memories" the children presented were implanted into very suggestible minds by therapists who were ignorant of iatrogenic symptoms or had an emotional investment in "saving" these children from the hordes of satan.

According to Wikipedia's entry on Satanic Ritual Abuse, "Astrophysicist and astrobiologist Carl Sagan devoted an entire chapter of his last book, The Demon-Haunted World: Science as a Candle in the Dark (1996) to a critique of claims of recovered memories of UFO abductions and satanic ritual abuse and cited material from the newsletter of the False Memory Syndrome Foundation with approval.[62]"

The iatrogenic nature of the recovered memories used in court did more disservice to the subject of trauma memories than any other single event in the history of psychology. Survivors who, as children, naturally dissociated highly traumatic memories of abuse are now not believed when those memories return due to some form of trigger.

These recovered memories become problematic for the therapist, however, when they include satanic ritual abuse. [Please note, I have no doubt that ritual abuse exists, but the contexts in which it exists are open to discussion.] When these memories are recalled, some clients want to report to police, adding another layer of complexity to this issue.

Researchers have traditionally identified four forms of satanic ritual abuse:

1. Cult-based ritualism in which the abuse had a spiritual or social goal for the perpetrators
2. Pseudo-ritualism in which the goal was sexual gratification and the rituals were used to frighten or intimidate victims
3. Psychopathological ritualism in which the rituals were due to mental disorders
4. Crimes with ambiguous meaning (such as graffiti or vandalism) generally committed by teenagers but attributed to Satanic cults

The only ones of these I have any experience with (in my opinion) are numbers 2 and 4. Of these, number 2, "pseudo-ritualism," seems likely to be one of the more coherent explanations.

Satanic abuse is easily the oldest of the three major themes, with government and technology only becoming a theme following the Enlightenment (see A Visionary Madness for the history of the first "influencing machine" and its association with mental illness - likely PTSD with psychotic features). I would assume that racial meta-narrative is also quite old, but in the US it may not have been as prominent until the post-Reconstruction Era when the Ku Klux Klan emerged, and more likely until the Nazi holocaust against the Jews.

Embodiment of Evil

What all three of these meta-narratives have in common is the embodiment of "evil." Whether it's satan, Hitler, or the secret branches of government, each of these presents powerful evil as an explanatory factor for the sexual and physical abuse of children.

The Christian mythology of satan (the devil) is the easiest one to grasp because our society is based on Christian religious values. We might trace the fear of satanic cults back to the witch hunts in Europe during the Inquisition (witch trials began in the late 1400s).

[As an aside, there is also a tradition of Jewish cults centered around Kabbalah rituals that engage in child sexual abuse and sacrifice.]  

Despite the history, there has never been any real proof of witches or of organized satanic abuse (according to the FBI). This is from Wikipedia:

Kenneth Lanning, an FBI expert in the investigation of child sexual abuse,[150] has stated that pseudo-satanism may exist but there is "little or no evidence for ... large-scale baby breeding, human sacrifice, and organized satanic conspiracies".[46]

There are many possible alternative answers to the question of why victims are alleging things that don't seem to be true....I believe that there is a middle ground — a continuum of possible activity. Some of what the victims allege may be true and accurate, some may be misperceived or distorted, some may be screened or symbolic, and some may be "contaminated" or false. The problem and challenge, especially for law enforcement, is to determine which is which. This can only be done through active investigation. I believe that the majority of victims alleging "ritual" abuse are in fact victims of some form of abuse or trauma.[46]

Lanning produced a monograph in 1994 on SRA aimed at child protection authorities, which contained his opinion that despite hundreds of investigations no corroboration of SRA had been found. Following this report, several convictions based on SRA allegations were overturned and the defendants released.[54]

I suspect that even prior to the Christian era one tribe would fear another tribe and accuse them of molesting children (among other taboo violations). One of the dominant taboos in most, if not all, agricultural and post-agricultural societies is the one against adults having sex with children (incest and/or pedophilia). Granted, this taboo has never prevented such molestation.

With the rise of KKK influence in the 1920s, and then the Nazi racist agenda and the 1930s and 1940s, there was a "new" (racism and ethnocentrism are not new) embodiment of evil, a violent, racist, hate-based model of evil. An important aspect of this meta-narrative is racial purity, which plays out in some "recovered memories" of children being bred to produce more Aryans.

The history of technology/government conspiracy in mental illness goes back to shortly after the Enlightenment, as mentioned above (A Visionary Madness).

Following World War II, the Cold War and the rapid increase in psychopharmacology opened new doors of research and led to new efforts at bioengineering human beings. Beginning with Project Bluebird and Project Artichoke, MKUltra became the primary "special ops" program of the military and CIA.

Via Wikipedia:

Project MKUltra — sometimes referred to as the CIA's mind control program — is the code name of a U.S. government human research operation experimenting in the behavioral engineering of humans. Organized through the Scientific Intelligence Division of the Central Intelligence Agency (CIA), the project coordinated with the Special Operations Division of the U.S. Army's Chemical Corps.[1] The program began in the early 1950s, was officially sanctioned in 1953, was reduced in scope in 1964, further curtailed in 1967 and officially halted in 1973.[2] The program engaged in many illegal activities;[3][4][5] in particular it used unwitting U.S. and Canadian citizens as its test subjects, which led to controversy regarding its legitimacy.[3](p74)[6][7][8] MKUltra used numerous methodologies to manipulate people's mental states and alter brain functions, including the surreptitious administration of drugs (especially LSD) and other chemicals, hypnosis, sensory deprivation, isolation, verbal and sexual abuse, as well as various forms of torture.[9]

One challenge with this meta-narrative is that the government actually DID many of the things with which they have been charged and has either admitted to it or paid off accusers to keep them quiet. Moreover, their actions were supported by more than 80 institutions, including 44 colleges and universities, as well as hospitals, prisons and pharmaceutical companies.{Horrock, Nicholas M. (4 Aug 1977). 80 Institutions Used in C.I.A. Mind Studies: Admiral Turner Tells Senators of Behavior Control Research Bars Drug Testing Now. New York Times.}

Another issue is that the U.S. government was instrumental in the trials of Nazi doctors for their experimentation on human subjects, but then that same government experimented on its own citizens. Citizens in the U.S. have learned not to trust the government, and those prone to conspiracy thinking believe the government is still conducting experiments on human subjects, with theories ranging from "chemtrails" to HAARP (High Frequency Active Auroral Research Program) to water flouridation.

In those who subscribe to any of these meta-narratives, the identified groups, whether satanists, white supremacists, or the government, are all embodiments of evil.

Developmental Stages and Conceptions of Evil

Using the framework developed by Clare Graves and expanded by Beck and Cowan (1996), we might attribute each of the three meta-narratives to a specific worldview developmental stage.

The four stages of use are the magical/animistic (BO), the impulsive/egocentric (CP), the power/authoritarian (DQ), and the rational/strategic (ER).

[The first letter stands for the life conditions of a given stage, while the second letter stands for the biopsychosocial capacities developed to cope with those life conditions. When two stages are presented together, one is usually lower-case and one is upper-case. The stage that is dominant gets the upper-case listing. The combining of two stages indicates a transitional space between stages, and since stages are not concrete, there can be three stages listed. As an example, if you see BO/cp, the subject is transitioning from BO into cp, but more of the life conditions and/or coping skills remain in BO than have emerged as cp.]

Satanic ritual abuse

The superstition and magical beliefs of satanic abuse place its worldview in the magical/animistic stage, but there is some element of personal gain (egocentric drives) involved. In the Spiral Dynamics (SD) nomenclature, this would be defined as BO/cp - representing an early transitional period between magical and egocentric.

Nazi and Aryan themes

In addition to the egocentric and power-drive elements of the impulsive/egocentric stage, there is also a strong ethnocentric character to this stage. Within that ethnocentric drive is the belief that we (whoever is defined as "we") are God's people and anyone who is not like us is inferior and to be controlled, used, or slaughtered. In the SD nomenclature, this would be defined as CP/dq due to the underlying belief that race is a divinely given characteristic that defines one's value and role.

Technological and governmental conspiracies

Part of the worldview beneath this meta-narrative of sexual abuse is the belief in an all-powerful government that seeks control of its citizens through authoritarian power and technological manipulation. Again, this is a worldview that straddles two stages, the power/authoritarian (DQ) and the rational/strategic (ER), but the technology aspect is more prevalent, so the SD nomenclature would be dq/ER.

How this is useful

Being able to identify the subject's worldview allows us to better understand their ego development as well as, potentially, their cognitive, moral, and social development. Here is a graphic that makes correlations (not absolute in any way):

One of the things we notice here is that the magical stage correlates with symbolic thinking (preoperational) [Piaget] and with impulsive ego structures [Loevinger]. The egocentric stage correlates with conceptual cognitive skills (preoperational) and self-protective ego development. The power/authoritarian stage correlates with concrete operational cognitive skills and a conformist ego structure. Finally, the rational/strategic stage correlates with formal operational thinking, allowing for more complexity to their meta-narratives, and a self aware/conscientious ego stage, which is defined as demonstrating "an increase in self-awareness and the capacity to imagine multiple possibilities in situations" [Witherell, S., & Erickson, V.,(2001). "Teacher Education as Adult Development," Theory into Practice, 17(3), p.231].

While I hesitate to ever equate ontology with phylogeny, Jean Piaget favored a weaker version of the recapitulation theory, according to which ontogeny parallels phylogeny because the two are subject to similar external constraints, but they are not equivalent. Developmental psychology has been shown to fit within this framework - a child's cognitive development runs parallel to the cognitive development of the species through evolution [1].

Using this framework, it may be possible to use the meta-narrative of the abuse to help determine the age at which it was experienced. For example, early childhood abuse (prior to age 5) might be more likely to have a satanic theme because the child at this age still engages in magical and symbolic thinking and lacks the logic to "see through" efforts by the perpetrators to impose silence with demonic imagery and contexts.

Likewise, a child of 5-9 might be more likely to have a meta-narrative of Nazism or racism. These ages are defined by children forming peer-group cliques, often around interests or traits (segregation by race on many playgrounds).

A meta-narrative of MKUltra as the source of abuse is not likely to come from early childhood abuse - the ideas are too complicated and rational.

Conclusions

All of this is just me thinking out loud and trying to create a framework by which to better understand the narratives I hear from clients. It's always about understanding where the client is coming from and if this does not serve that purpose, then it is useless. That said, case conceptualization with survivors of ritual abuse is challenging at best, so any kind of framework that can help us make sense of their narratives is important.

I know there are many people who will reject the use of the Spiral Dynamics and integral frameworks in this conceptualization. So be it. I find the framework useful for this discussion. We need some kind of developmental system to help us make sense of clients' cognitive skills (Piaget, Commons), ego development (Loevinger, Cook-Greuter, Kegan), and values/worldviews (Graves/Beck and Cowan), among other lines of development. No other models are as inclusive as SD and integral theory.

I am very open to being wrong - so I welcome comments and criticisms.


NOTE

1. Foster, Mary LeCron (1994). "Symbolism: the foundation of culture". In Tim Ingold. Companion Encyclopedia of Anthropology. pp. p.387. Quotation:

While ontogeny does not generally recapitulate phylogeny in any direct sense (Gould 1977), both biological evolution and the stages in the child’s cognitive development follow much the same progression of evolutionary stages as that suggested in the archaeological record (Borchert and Zihlman 1990, Bates 1979, Wynn 1979) ... Thus, one child, having been shown the moon, applied the word ‘moon’ to a variety of objects with similar shapes as well as to the moon itself (Bowerman 1980). This spatial globality of reference is consistent with the archaeological appearance of graphic abstraction before graphic realism.

Mark Schwartz, Clinical Co-Director of Castlewood Treatment Center, Accused of Implanting False Memories of Satanic Abuse

I was sad to hear about this story - Mark Schwartz is not to be confused with Richard Schwartz (I mistakenly thought they were brothers), founder of the Internal Family System Therapy model of parts work. Mark is clinical co-director at Castlewood Treatment Center, where Richard Schwartz also works on occasion.

Mark has been accused of implanting false memories of satanic abuse in a former patient with the intent of collecting more money from insurance. If these allegations are true, it's a sad commentary on putting money above the well-being of the clients.

As many commentators on this story have suggested, the eating-disordered clients seen at Castlewood are particularly vulnerable to manipulation through hypnosis - getting them into a hypnotic state is easier due to the ease with which they already dissociate.

It's also important to know that only Schwartz is being accused here, although Castlewood is of course named in the lawsuit. Richard Schwartz and the IFS model are not implicated in the allegations.

Here is a version of the story from MSNBC (via the AP) - it has received a lot of attention, including several UK papers.

Woman: Psychologist implanted horrific memories

By JIM SALTER

updated 12/2/2011 7:54:41 PM ET

ST. LOUIS — The memories that came flooding back were so horrific that Lisa Nasseff says she tried to kill herself: She had been raped several times, had multiple personalities and took part in satanic rituals involving unthinkable acts. She says she only got better when she realized they weren't real.

Nasseff, 31, is suing a suburban St. Louis treatment center where she spent 15 months being treated for anorexia, claiming one of its psychologists implanted the false memories during hypnosis sessions in order to keep her there long-term and run up a bill that eventually reached $650,000. The claims seem unbelievable, but her lawyer, Kenneth Vuylsteke, says other patients have come forward to say they, too, were brainwashed and are considering suing.

"This is an incredible nightmare," Vuylsteke said.

Castlewood Treatment Center's director, Nancy Albus, and the psychologist, Mark Schwartz, deny the allegations. Albus pledged to vigorously fight the lawsuit, which was filed Nov. 21 in St. Louis County and seeks the repayment of medical expenses and punitive damages. As in repressed memory cases, which typically involve allegations of abuse that occurred during childhood, the outcome will likely hinge on the testimony of experts with starkly different views on how memory works.

Nasseff, who lives in St. Paul, Minn., stayed at Castlewood from July 2007 through March 2008 and returned for seven months in 2009. She was struggling with anorexia and as a resident of Minnesota, which requires insurers to cover long-term eating disorders, she could afford to stay at the center, which sits on a high bluff in the suburb of Ballwin overlooking a park and meandering river. Most states, including Missouri, don't require such coverage.

In her lawsuit, Nasseff claims Schwartz used hypnotic therapy on her while she was being treated with psychotropic drugs, and her lawyer says Schwartz gave her books about satanic worship to further reinforce the false memories. She says she was led to believe she was involved in a satanic cult whose rituals included eating babies, that she had been sexually abused and raped multiple times, and that she had exhibited 20 different personalities.

Vuylsteke said the trauma was too much to bear, and that Nasseff tried to get hold of drugs to kill herself during her stay.

"Can you imagine how you would feel if you thought you had participated in all these horrible things?" Vuylsteke asked.

Eventually, Nasseff learned from other women treated at Castlewood that they, too, had been convinced through therapy that they were involved in satanic cults, Vuylsteke said. And, he said, those women were also from Minnesota, allowing insurance to pay for their treatment.

"It seems like quite a coincidence that all of this cult activity was in Minnesota," he said.

Nasseff returned to Minnesota, where she works part-time in public relations and has her eating disorder in check, her lawyer said.

In her lawsuit, she claims Schwartz warned her in October 2010 to return to Missouri for additional treatment or she would die from her disorder. She says he left a phone message this October warning that if she sued, all of her memories of satanic rituals and abuse would be revealed.

Schwartz, reached by phone at the center, where he is its clinical co-director, denied any wrongdoing but declined to discuss the case further because he hadn't hired a lawyer yet. He previously told ABCNews.com that he never hypnotized Nasseff, that they had never discussed satanic cults and that she never told him she had committed criminal acts.

Albus didn't respond to requests for comment, but she told Courthouse News Service that Castlewood "strongly believes that all of these claims are without merit and we intend to defend these claims vigorously."

Some experts, including University of California, Irvine, professor Elizabeth Loftus, question the validity of repressed memory cases, which became more commonplace in the 1990s.

"Where is the proof you can be raped in satanic rituals and have absolutely no awareness of it, then reliably recover those memories later?" she asked.

However, neither Loftus nor Jim Hopper, a clinical instructor of psychology at Harvard Medical School, would speculate about whether Schwartz may have implanted false memories. Both agreed people can have memories of events that didn't really happen and that the power of suggestion can play a role in producing false memories.

Loftus cited several medical malpractice cases won over memories that proved to be false. Hopper said he believes memory is complex.

"Something that happened years ago can be encoded in the brain in various ways, and various combinations of those memory representations may be retrieved, or not, in various ways, for various reasons, at any particular time," he said.

Since this story originally aired, other women have come forward to support the original claims or add new ones to the situation now facing Schwartz and Castlewood.

From St. Louis Today:

Other women come forward in Castlewood center complaint

BY BLYTHE BERNHARD • bbernhard@post-dispatch.com > 314-340-8129 | Posted: Saturday, December 10, 2011 

In the lush hills overlooking Castlewood State Park, a secluded clinic attracts people from across the country who have tried and failed to overcome an eating disorder.

Pictures of Castlewood Treatment Center in west St. Louis County show a homelike sanctuary where residents practice yoga, sit around a fireplace and sleep under down comforters.

That idyllic image was shattered last month when a Minnesota woman filed suit against Castlewood and its director, psychologist Mark Schwartz, alleging she was brainwashed into believing she had multiple personalities and was implanted with false memories of sexual abuse and satanic cult activity while under hypnosis during her 15-month stay at the center for anorexia. Other women have since come forward to support the woman's claims and to report similar experiences.

"They definitely pushed the idea that I had been abused as a child on me," said Dara Vanek, 28, of Philadelphia, who stayed at Castlewood for several months in 2007 and 2008. "To all of a sudden have this huge amount of doubt about what happened in my childhood was incredibly damaging and shaming for me."

In her malpractice lawsuit against Castlewood, Lisa Nasseff, 31, also alleges that Schwartz wanted to keep her at the treatment center because she had insurance that would pay her medical bills that totaled $650,000.

The lawsuit against Castlewood came as a relief, Vanek and other women say.

"I feel like it validates that I'm not crazy, that it's something else that was going on," she said. "Satanic ritual abuse was talked about a lot in group therapy. It's kind of ironic (because) Castlewood itself almost seemed at times like a cult. It was implied that you could not recover unless you dedicated your life to Castlewood."

A LAST RESORT FOR SOME
Castlewood is a last resort for patients looking for healing after spending years of their lives in other medical facilities, according to a statement from executive director Nancy Albus.

Its treatment "is marked by compassion, respect and empowerment," according to Albus.

Albus said more than 1,000 clients have been treated at Castlewood since it opened more than 10 years ago. A second, castlelike facility opened recently nearby, and the two homes are licensed for 26 residents as well as outpatient services.

The sprawling Castlewood campus includes a swimming pool, hot tub, dance studio, art room and gym, according to state records. Residential stays cost $1,100 a day over an average of two to four months, and are sometimes covered by insurance, according to Castlewood's website. The facility doesn't accept Medicare or Medicaid patients, so it doesn't receive any government funding.

The private equity firm Trinity Hunt Partners of Dallas, funded by the Hunt family that owns the Kansas City Chiefs, bought majority control of Castlewood in 2008, expanded it in 2010 and announced plans to open similar facilities in other cities. The purchase was part of the firm's $25 million move into behavioral health care.

Former Castlewood patients said their days were spent making collages and writing in journals that they would share in individual and group therapy sessions. On the weekends, residents go on outings to movies, the Butterfly House and the zoo. Therapists supervise clients at meal times, and take them to restaurants and grocery stores to talk about healthy eating habits.

The Missouri Department of Mental Health licenses the facility and found only minor record-keeping deficiencies in its most recent inspection last summer. In their interviews with state inspectors, three Castlewood clients said they felt respected by staff, and another said the program saved her life.

Castlewood also meets the standards set by the Commission on the Accreditation of Rehabilitation Facilities, which conducts regular site visits and interviews with patients and staff.

A Florissant woman who asked only to be identified as Laura because she is still seeing a therapist from Castlewood said her inpatient experience in 2003 and 2004 was positive and that her therapy sessions never included discussions of cult activity or childhood sexual abuse.

"If I didn't go there I wouldn't be here," said Laura, 34. "Castlewood is a good place to go if you're very sick."

Schwartz declined an interview through his attorney. Albus said in her statement that Schwartz is internationally respected in the field of eating disorders.

Former patients of Schwartz, 60, said he is down-to-earth with a magnetic but mysterious personality. He looks like "an old hippie" with long hair, as one patient described him, and another said he has fertility statues and dead bugs behind glass hung in his office.

Schwartz is licensed as a psychologist in Missouri and has no discipline record with the state. He holds a doctorate in science degree from Johns Hopkins University and is an adjunct professor of psychiatry at St. Louis University, according to his résumé.

A spokeswoman for SLU said Schwartz gave a presentation at the medical school years ago but does not teach or supervise students.

THE TREATMENT
The main treatment strategy at Castlewood is called internal family systems. The technique is based on the theory that "the eating disorder actually protects (people) from re-experiencing or thinking about difficult things from their pasts," according to Castlewood's website.

Clients are encouraged to think of themselves as having many "parts" or emotions. Through therapy, they focus on improving the destructive parts of themselves, such as the perfectionist part, that can prevent them from fully enjoying life, as explained on the site.

Several local mental health practitioners said internal family systems therapy has not been rigorously studied for its effectiveness.

Therapists practicing the technique must take extra care with patients with eating disorders, who can be particularly vulnerable to having their memories and personalities twisted, in part because they are malnourished, experts said.

Some residents of Castlewood are so ill that they require feeding tubes, while others are so weak that they use wheelchairs, former patients said.

"People who are suggestible in certain ways can take a suggestion from a therapist and begin to split themselves into parts that they then name, and they will begin to think of themselves as having multiple personalities," said Dr. Lynne Moritz of the St. Louis Psychoanalytic Institute. "The issue is you don't want to encourage that in susceptible people."

Instead of encouraging a client to think about parts, "you want to integrate the whole person who has many different ways of thinking and feeling all at the same time," Moritz said.

Today, experts believe cases of multiple personality disorder are rare, if not nonexistent.
"I've never had a case of multiple personality in 40 years of practice," Moritz said.

REPRESSED MEMORIES
The mental health care field took a hit to its reputation in the 1990s after a rash of cases involving patients who reported memories of childhood sexual abuse that they had previously repressed. In many of the cases, the memories were found to be suggested by a therapist, and the concept of repressed memories grew more controversial.

Schwartz has written that the controversy over memory should not scare therapists away from asking about a client's past, especially because a history of sexual abuse is common in people with eating disorders. The psychologist was affiliated with Dr. William H. Masters and Virginia Johnson, famed local sex researchers of the 1960s and 1970s, and he operated a sex therapy clinic in their name before opening Castlewood.

"Certainly, eating disorders therapists have every reason to suspect the presence of sexual trauma in their patients," Schwartz wrote in the introduction to his 1996 book "Sexual Abuse and Eating Disorders."

"Individuals who actually believe that memories are created by therapists are, for their own reasons, motivated to not know and not see the extent to which abuse actually exists in our culture," Schwartz wrote. "If the statistics are accurate, then our friends and neighbors are having incestuous relationships with their daughters and sons, and by ignoring it, so are we."

Meagan McKay of Vermont said she was at Castlewood at the same time as Lisa Nasseff, the woman who is suing the center.

McKay recalled that when Nasseff left Castlewood, Schwartz told the other residents that she had returned to her cult.

That's when McKay realized something wasn't right.

She started questioning all the times she saw women shaking and screaming, saying they were having flashbacks of abuse. She wondered now about the woman who drew monkeys to represent her multiple personalities. And she thought back to all the times she heard someone say they would die if they left Castlewood.

"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."