Memory Verdict Has Therapists Rethinking : Law: Psychiatric community reviews use of a drug, hypnosis after jury’s negligence decision in Irvine woman’s abuse case.

Many Orange County mental health professionals are reconsidering how they treat psychiatric cases following a jury’s decision that therapists had negligently “reinforced” an Irvine woman’s emerging memories that her father raped her as a child.

The UCI Medical Center is reviewing its use of hypnosis and a drug that was used by the defendant therapists to clarify repressed memories. The Community Psychiatric Centers facility in Santa Ana stopped those practices two years ago, when the father’s lawsuit, filed in 1991, began to attract publicity.

“I think there is clearly a need for our company and for other psychiatric hospitals to revisit strategies such as sodium Amytal interviews and hypnosis that are used . . . to assist in recovering memories,” said Dr. Martin Brenner, medical director of CPC in Santa Ana.

Dr. Barry Chaitin, medical director of the neuropsychiatric center at UCI Medical Center, said that, in addition to reviewing the use of hypnosis and Amytal, he expects that UCI therapists will “have to take a much more skeptical stance” in interviewing patients.

“This will have a great impact on our clinical practice in that we will have to be in a state of vigilance as to the potential impact therapy might have on other people in the patient’s life,” Chaitin said. “And that could severely interfere with the trust between the patient and the clinician.”

Neither the UCI Medical Center nor CPC were named in the litigation.

Mental health practitioners are divided whether the precedent-setting legal case involving Gary Ramona and his daughter, Holly, now 23, will make some therapists more cautious or unleash a wave of lawsuits that will hurt the therapist-patient relationship.

Gary Ramona in his suit alleged that while Holly was under sodium Amytal, therapists influenced her into falsely remembering that he had raped her when she was a child.

The therapists, however, said Holly had these memories while conscious and was put on sodium Amytal to determine if her story would remain the same under medication.

The plaintiff also contended that Holly was told that the medication, which lowers a patient’s inhibitions, was a truth serum, when in fact what a person remembers under its influence might not be factual.

Last Friday, a Napa Valley Superior Court jury found that Richard Rose, formerly chief of psychiatry at Western Medical Center Anaheim; Marche Isabella, a private therapist who practiced at Western; and the hospital were negligent in Holly’s treatment.

Thomas Dudum, the jury foreman, said the jury was uncertain whether Holly was molested by her father. He said, however, the jury found evidence that the therapists had reinforced memories that most likely were false.

Dudum said the jury determined that the therapists had failed to do their job. “She (Holly) went to the therapists for bulimia and depression and as the therapy went on the bulimia worsened,” he said. “There seemed more emphasis placed on these memories than what she went to the doctors for.”

The jury’s decision has had a pronounced effect on the medical community.

It’s been enthusiastically welcomed by some mental health professionals who contend that too many therapists have persuaded patients to remember sexual abuse in their childhood as the cause of their psychiatric problems.

But other mental health experts worry that the decision could affect the relationship between patients and their therapists, who might become paralyzed with worry that their patients’ spouses, parents and other third parties might sue them if they feel victimized by the therapy.

Several psychiatrists predicted that colleagues might reconsider the wisdom of using hypnosis and sodium Amytal, a medication that creates a state of hypnosis, in attempts to extract repressed memories and other information from patients.

“This recovered memory stuff has been a disgrace in the mental health field for a decade now,” said Don DeFrancisco, chief of the psychiatric division at Hoag Hospital. “I am very happy about this case and I hope it does change the mental health practice.”

DeFrancisco said too often he gets patients after previous therapists have convinced them that they were abused as children. “They say if you have problems with the opposite sex or you have depression, you must have been molested,” he said.

Dr. Lawrence Sporty, senior lecturer in psychiatry at UCI College of Medicine, said he also hopes the case will discourage therapists from “jumping to conclusions” that childhood sexual abuse is necessarily at the root of adult mental illnesses.

“I have dealt with many patients who have been abused. In many, many cases it is true,” Sporty said, “and it would be a major disservice to patients to deny the existence of abuse. But not every psychiatric illness comes from emotional abuse or from sexual abuse.”

The Ramona case, he said, “brings to the attention of everybody that simplistic formulations of patients’ problems are not the answer.”

The organized profession of psychiatry is still struggling with how to respond to the court decision, said Dan Willick, attorney for the California Psychiatric Assn.

“The problem is in determining whether repressed memories of sexual abuse are truthful or accurate,” he said. “While for purposes of therapy it may be necessary to treat the emotional hurt, whether the memory is accurate or not, the intrusion of the law into therapy creates difficult and complicated legal issues which may result in awards of substantial damages against therapists.”

Dr. Richard Rose, who has left the field of psychiatry and is operating a printing business in Maui, said he believes the jury faulted him for giving Holly reassurance to make her comfortable with telling her thoughts. “Reassurance is an appropriate part of the interaction between any professional and his client,” Rose said.

Western Medical Center, the hospital where Holly Ramona was questioned under sodium Amytal, probably will not recommend any changes to its psychiatric staff, said Ed Leonard, lawyer for the hospital.

Leonard said it is not a therapist’s role to investigate the veracity of what his or her client remembers.

“To comply with this muddled verdict, we would have to make fundamental changes in the way psychiatry is practiced for which there is no scientific support,” said Leonard.

But Richard Shearer, an attorney for Gary Ramona, said: “Hospitals clearly have oversight responsibility for what goes on within their walls. It was pretty clear that the Amytal interview for verifying memories was wrong and a hospital can’t just wink and say we are just providing the beds.”