Ashley Conway posts…
The recent position statement [see here] from the UK Royal College of Psychiatrists is brave, honest and extraordinary. This is a powerful lesson for both the British Psychological Society as the representative body for psychologists in the UK and “False Memory Syndrome” (FMS) advocates. The FMS line is typically that “Clients with no suspicion of having been abused enter treatment with a therapist who suggests their problems are likely to stem from repressed memories of child sexual abuse. The therapist encourages them to recover the memories using hypnosis, guided imagery or related techniques. The clients are persuaded by the therapist to treat the resulting material as fact, and typically go on to create ever more elaborate ‘memories’ based on suggestion or fantasy.” (Brewin and Andrews (2017). This supposition depends on three factors:
- There is no such thing as repressed memories or traumatic amnesia,
- False memories are triggered by therapists with an agenda,
- Laboratory studies with volunteer subjects (who may be rewarded in some way for taking part) tell us about “the science” of true and false memories of traumatic events.
What follows is my selective summary of the key points in the RCPsych document with verbatim quotations in italics for clarity. These often stand alone on their own merit but for some extracts I offer comments on their relevance for both the BPS and the FMS advocates.
Perhaps the most important single message from the RCPsych stament is the apology and significant acknowledgement that mental-health services themselves have sometimes caused additional harm to survivors of non-recent child sexual abuse (NRCSA). It states explicity that survivors have suffered “avoidable harm” when seeking mental-health care. It accepts that survivors may have been retraumatised when they finally disclosed abuse.
The College also acknowledges that disclosure can be extraordinarily difficult and that survivors may encounter disbelief, inappropriate questioning, poor responses and inadequate safeguarding. It therefore advocates making disclosure a process rather than a single event, and not expecting someone to produce a coherent account immediately.
It promises a new process for future projects so that survivor participation is more meaningful, safe and supportive
The RCPsych statement is co-produced with survivors and is highly survivor focussed. It states that “apologies from institutions must be genuine and sincere, never watered down or ambiguous”. It moves beyond saying that individual clinicians occasionally get things wrong. It acknowledges that the system’s ordinary practices can produce iatrogenic harm.
The FMS story has been used in ways which are clearly focussed on the defence of the accused and rarely attends to the traumatic effects of disclosure on survivors. To my knowledge, the BPS has never apologised for its complete failure to produce an equivalent to the RCPsych guideline document for psychologists, and indeed appears to have been generally sympathetic to the FMS line. It has frequently used FMS advocates as its advisors on memory and law issues of disclosure of NRCSA – e.g. Elizabeth Loftus (who was on the International Panel on advisory board of The Psychologist as well as the Advisory Board for the British Journal of Psychology) and the late Professor Martin Conway (who chaired BPS Memory and Law Group was on the Advisory Board of the British False Memory Society for many years, and The Psychologist has historically given a disproportionate amount of column inches to FMS advocates (The Brewin and Andrews paper cited above being one of the rare exceptions).
Iatrogenic harm
Psychiatrists have a duty to combat iatrogenic harm, and the organisations they work in have a duty to adequately support them in this work. Iatrogenic harm has been done to survivors within mental health settings and this has been one of the driving factors for the development of this position statement.
Disbelief, diminishment or turning away from the recognition of NRCSA, is likely to result in disclosure not occurring with subsequent failures in care. The statement acknowledges that survivors have suffered “avoidable harm” when seeking mental-health care. The harms described include retraumatisation during disclosure, misdiagnosis, inappropriate treatment and care planning, and inadequate access to help. The BPS has an urgent need to apply the same stance to psychologists, in both clinical and research settings (see previous posts on this site under False Memory Syndrome and Memory and the Law Group: for example here, here and here amongst many others).
Incidence of child abuse
…in England and Wales, 3.1 million adults aged 18–74 years experienced sexual abuse before the age of 16…. At least 500,000 children experience contact sexual abuse each year…
We know that child sexual abuse is vastly under-reported, “This is not just a national crisis, but a global one.”
The statement recognizes a very broad range of consequences, linking childhood sexual abuse with increased risks of depression, anxiety, PTSD and complex PTSD, psychosis, substance-use disorders, dissociative disorders, eating disorders and personality-disorder diagnoses. It also discusses effects on relationships, sexual functioning, self-esteem, education, employment and physical health.
Triggers to disclosure
Certain events may trigger disclosure and/or cause re-traumatisation, such as a national news story about child abuse, or a life event such as the death of the abuser or becoming a parent. This could also include certain physical procedures or investigations such as dental treatment, cervical smear tests, childbirth and so on. For example, birth trauma is more likely to occur in survivors of child sexual abuse. All professionals should be alert to such events and the possibility that they might present for disclosure. They should also be aware of the possibility that such events may increase the likelihood for disclosure by some survivors. When survivors or family members reach certain developmental milestones they can be a trigger for first disclosure, and require exceptionally sensitive and collaborative management. Such scenarios might include (a) the child of a survivor reaching the same age as the survivor was when they were abused … These should be covered in training for mental health professionals.
So, no mention here of dodgy therapists implanting false memories, as the FMS line would have us believe. Indeed the statement recognizes that fear of producing false memories from clinicians may become a barrier to disclosure. Likewise, fear of being labelled with a false memory may obstruct disclosure by a survivor.
The average time to disclosure for survivors is 16–24 years after the abuse and two-thirds of survivors don’t disclose during childhood. It’s also much more likely that people in the adult mental health system will be survivors of sexual abuse compared with the general population.
Justice
Safeguarding and criminal justice processes: these can be barriers to disclosure if a person with mental health conditions has been routinely failed by the criminal justice system; 76% of people going through criminal justice process say there has been an impact on their mental health. Presence of dissociation: this may mean that memories are fragmented and unclear.
In contrast to this measured consideration, dissociation is denied as a possibility by FMS theory.
Memory
Memory-processing during and after traumatic experiences … is unlike memory processing of non-traumatic experiences.
This is an extremely important statement. It means that the numerous laboratory studies in the closed, safe settings with volunteer subjects, which are used to provide “scientific” evidence for FMS are more or less irrelevant to real life traumatic situations in open life (See Conway and Pilgrim, in press). To make an assumption that these kind of studies inform us about traumatic memory is simply misleading and risk causing a serious miscarriage of justice for the survivor.
Dissociation during the event(s) may lead to partial or complete amnesia for the traumatic experience, which is linked to memory processing.
Another blow for the “if something bad happens to you, you always remember it” line of the FMS.
NRCSA and memory
Survivors commonly present with histories that are fragmented, inconsistent or confused. They may be unable to verbally recall the event(s) or only experience somatic sensations connected to the abuse. They may recover the memories of child sexual abuse as an adult in what is often a disturbing, discontinuous and fragmented experience, and this may occur while in treatment for physical and mental health conditions.
The reasons for this are many, and may include:
Grooming techniques that created confusion and uncertainty in the child’s mind:
Silence, shame and secrecy, which all perpetuated a sense of uncertainty and potential unreality in relation to the events
Early (preverbal) sexual abuse may mean the trauma is held as somatic experience within the body (procedural memory)… Dissociation during the event(s) may lead to partial or complete amnesia for the traumatic experience, which is linked to memory processing.
Dissociation:
Dissociation may be understood as the separation of realms of experience that would normally be connected. People may describe feeling ‘cut off’ from their thoughts, feelings, memories or even identity. It can be thought of as the ultimate survival defence, the escape when there is no escape. Dissociation is a psychic process that everyone experiences to some degree at some time, which may be transient or enduring. It can be used defensively, adaptively or as a form of protection.
Dissociation, as a defence against overwhelming and unbearable terror and helplessness, is part of the hypoarousal freeze-response. It is likely to occur in response to trauma, especially if a person has endured traumatic experience during childhood.
Examples of dissociation include:
depersonalisation and derealization, amnesic episodes, identity confusion, fugue states, freeze responses
“False Memory Syndrome” is not a real syndrome or diagnosis
There is no significant evidence base for so-called ‘false memory syndrome’ and it has never been ratified by any accredited psychological diagnostic systems as a formal medical diagnosis. Recovered memories of child sexual abuse have been found to be “more likely to correspond to genuine abuse events”. Despite the lack of evidence, the concept of false memory as a psychiatric syndrome has been used in legal proceedings to discredit survivors, [my emphasis] and in areas of social work underpinning decisions about a person’s care.
While there is no doubt that memory can be unreliable, and that there have been false accusations or retractions made following initial reporting, the evidence suggests that traumatic amnesia occurs in 19–38% of documented child sexual abuse cases with subsequent recovery of memories. False allegations are rare, and less than one quarter of respondents to the ONS crime survey who had been raped in childhood told someone at the time. Of those, only 8% told someone in an official position.
The Harm Caused by FMS promotion
The harm that the concept of false memory syndrome can inflict is perpetuated (and likely also underpinned) by the unfortunate culture of disbelief around sexual abuse of children. The mindset of not always believing people who have been sexually abused as children has likely contributed to the idea that false memory syndrome is a true phenomenon, despite the lack of evidence [my emphasis]. Society’s struggle to acknowledge the occurrence of something so terrible as the sexual abuse of children may be due to societal or cultural denial that something so nefarious is actually more commonplace than people can bear to consciously acknowledge.
Retraction
It should also be noted that a retraction does not mean that the initial allegation was incorrect; victims retract for many reasons, such as fear of the statutory process, Threats from abusers, pressure or fear of consequences from family, and lack of self-belief.
FMS theorists have often used the fact that survivors occasionally retract as evidence of “false memory”. It is not.
Research
The Medical Research Council should prioritise funding to standardise and strategically improve research into non-recent child sexual abuse, ensuring that all commissioned research has meaningful involvement of patients and survivors who are provided with comprehensive support to be actively engaged.
Survivor-led research identifies solutions to tackle key issues of disclosure, diagnosis and treatment. There remains considerable opportunity for improved research that is driven and led by survivors, with their voices truly at the forefront.
How does involvement in the criminal justice system impact survivors of sexual violence/abuse (for example, their emotional and psychological wellbeing), and what support do they need during and in the aftermath of criminal justice proceedings?
This is not something that appears to be considered by either FMS or BPS spokespeople.
Clinical Implications
The survivor’s voice and practicing shared decision-making should be at the heart of all treatment and care pathway design, production and implementation
It’s important that psychiatrists and other mental health professionals working with survivors are aware of the complexity of memory in relation to NRCSA, the concept of false memory and how a person seeking support can be impacted by this concept, either in their past interactions with services or by how it is sometimes portrayed in the media. It’s also vital that clinicians understand the importance of listening openly and respectfully to any disclosure of abuse.
Conclusions for the FMS
There is no wiggle room here. The emperor has no clothes. He never did have any. Their selective, unscientific reasoning, which favours abusers, should be dropped forever from serious discussion in psychology (except perhaps as a teaching example of harmful policy capture).
Conclusions for the BPS
The courage of the RCPsych is outstanding in the production of something that the BPS could (and, perhaps, should) have done. But it chose not to and was frequently complicit with the FMS line. The problem was not that the information was not out there – it was. Papers had been written of the dangers of the simplistic (and unscientific) FMS theory since the 1990’s (see, for example, Nash (1994), Freyd (1996 & 1998), Fish (1998) and Conway (1998)). None of these have been cited in the BPS’s FMS-leaning Memory and the Law guidelines and the evidence-base has continued to grow in the last 5 years (see, for example, Conway (2022 & 2023)). This failure of anything approaching balance demands a sincere public apology from the Society. Likely thousands of victims of abuse have been betrayed by BPS’s silence. The idea that controversy around accusations of false memory are matters of opinion or freedom of speech is misguided. That is not what the problem is. Look at the real data, the real science (Conway & Pilgrim, in press) and the real ethics of the situation. Make a sincere public apology. Demonstrate concern for survivors and clarify a strategy for change for psychologists.
References
Brewin, C. and Andrews, B. (2017). False memories of childhood abuse – are therapists to blame?The Psychologist, June 7th. https://www.bps.org.uk/psychologist/false-memories-childhood-abuse
Conway, A.V. (1998) Recovered Memories: Shooting the messenger. In: Sinason, V. (Ed.) Memory in Dispute. London: Karnac.
Conway, A.V. (2022) The abuse of science to silence the abused. In: Sinason, V. & Conway, A (Eds.) Trauma and Memory – The Science and the Silenced. London: Routledge.
Conway, A. (2023) Policy capture at the BPS (2): the memory and law controversy. In D. Pilgrim (Ed.) British Psychology in Crisis: A Case Study in Organisational Dysfunction. Bicester: Phoenix Books.
Conway, A. & Pilgrim, D. (in press) Witness for the prosecution – Resisting the False Memory Movement. Bicester: Phoenix Publishing.
Fish, V. (1998). The delayed memory controversy in an epidemiological framework. Child Maltreatment, 3(3), 204–223.
Freyd, J.J. (1996) The Science of Memory: Apply with Caution. Traumatic StressPoints, 10(4), 1-8.
Freyd, J.J (1998) Science in the Memory Debate. Ethics and Behaviour, 8, 101 –113.
Nash, M.R. (1994) Memory distortion and sexual trauma: the problem of false negatives and false positives. International Journal of Clinical and Experimental Hypnosis, 42(4):346-62.

