Verdict Heats Up Memory Debate : Psychology: Experts on both sides of the issue say it will lead to more restrictions on therapists who work with patients’ suppressed recollections, as well as more lawsuits.

A Napa jury’s verdict against two therapists and a hospital in the recent “recovered memory” case has intensified a debate over whether such memories ought to be considered accurate reflections of the past.

The case, in which two therapists were found to have acted improperly in reinforcing the belief of a client that her father sexually abused her, is expected to have long-term legal and clinical ramifications for therapists.

It was the first time a non-client--in this case former winery executive Gary Ramona, the father of alleged victim Holly Ramona, now 23--ever won a recovered memory case. Ramona won a $500,000 award.

Some are predicting that the verdict will open the floodgates for similar suits as family members who believe they have been wrongly accused fight back through the courts. Others say the case will force legislatures--and perhaps therapists--to define and limit the scope of practice by mental health professionals.

Whatever the eventual repercussions, lawyers and others say the case has already had a profound impact on a profession deeply divided over the validity of recovered memories.

Even before the verdict, lawyers were issuing warnings to therapists: Explain the risks and controversial nature of recovered memory. Take good notes. Avoid leading questions. Use hypnosis or hypnotic drugs with extreme caution. Consult regularly with other professionals.

Predicting that the Napa verdict “will chill therapists’ work,” Sacramento attorney Ronald Kaldor, who represents physicians, hospitals and health maintenance organizations, said the case will force therapists “to be much more careful about what they do.”

“It will open up a lot of new lawsuits,” Kaldor said. “While it isn’t new law in the sense that other judges will be bound by it, clearly a new path has been cleared through the forest. Other lawyers will follow and widen that path.”

Mary Riemersma, executive director of the 23,000-member California Assn. of Marriage and Family Therapists, said therapists will feel pressure.

“Some will probably feel they are being placed in the role of being an investigator to determine whether what the patient presents is fact or fantasy. (But) that isn’t their role,” she said. “On the other hand, it will cause therapists to be much more cautious about the potential of implanting memories in the minds of patients, which I think could be one of the positive results of this case.”

It is impossible to say how many cases of repressed memory there are in the United States. With the development of the “recovery movement”--which includes memory recovery therapy, 12-step programs and self-help books--more and more people have been coming forward, revealing long repressed memories of abuse.

Brandt Caudill, a Costa Mesa attorney who defends mental health professionals in malpractice cases, said legal cases involving repressed memory were almost nonexistent two years ago. But over the last 18 months he has been averaging one new case a month.

He said most involve clients who once believed in the truth of their recovered memories, then changed their mind in the face of the intense pain it caused them and their families and sued their therapists for damages.

Therapists say repressed memory comes up most often in cases where there has been severe emotional or physical trauma. In the case of sexual abuse by family members, victims are said to be so traumatized that they erase the abuse from their conscious memory. But whether that is even possible will get a strong argument from many psychotherapists who believe such a willful act of memory erasure is impossible, particularly when the sexual abuse occurs over a period of years. Critics note that this kind of memory suppression has never been documented in a scientific study.

Psychotherapists use a variety of methods to uncover emerging memories, often beginning with a single image that is haunting a client, or a snippet of some long-ago event. Memory therapy involves numerous one-on-one sessions, and in some cases hypnosis or drugs. Holly Ramona’s therapists used the drug sodium amytal to help test the validity of her memories. Therapists say these sessions can last for months, if not years, and are painful to the analyst and patient as both relive childhood traumas.

Some mental health professionals say that although they question the procedures used by Ramona’s therapists, they strongly believe that many people bury childhood traumas so deeply that they do blot them out from their conscious memory.

Santa Monica therapist Ellen Ledley, who defends the practice of memory recovery, said good therapists are very careful about the way they draw out long-repressed memories from clients who have suffered from sexual and other kinds of abuse.

Even so, she said, the verdict will have a chilling effect.

“There is no way around feeling somewhat anxious,” Ledley said.

Therapists see the verdict as another sign of a growing backlash against the burgeoning recovery movement. Most often the critics zero in on what they say is the growing trend to explain away eating disorders, alcoholism and a variety of other complex conditions by simply attributing them to “abuse” as children and adults.

“Therapists will figure out a way to cope,” said psychologist Laura Brown of Seattle, an advocate of recovered memory therapy. “My concern is the effect this will have on (abuse victims). The message they are getting is that if they talk about what has happened to them that they will really put people at risk, that people will get hurt.”

Critics say that if therapists are alarmed and begin to practice more cautiously, then it’s about time. The critics, including some therapists, fault therapists for placing too much stock in recovered memories, which they say can be as much fantasy as fact.

The results often have dramatic and serious outcomes for the patients and their families. In some cases, allegations stemming from recovered memories have led to the filing of criminal charges and prison sentences.

Many critics within the profession do not mince their words. Dorothy Cantor, a New Jersey psychologist who is running for the presidency of the American Psychological Assn., said she hopes the verdict shows that the public “needs to be careful who they go to.”

“There are thousands and thousands of Gary Ramonas out there,” said memory expert Elizabeth Loftus, a psychologist and professor at the University of Washington who appeared as an expert witness for Ramona. The author of an upcoming book on what she calls the myth of memory repression, Loftus believes that therapists who uncritically embrace recovered memories as facts are not only wrong but are engaging in “dangerous” practices that can produce “horrible consequences” by leading to false accusations.

Therapists say the verdict will pressure them into a role of determining the truth of a client’s recollection of events, something they say they will resist.

“Therapists really aren’t trained to get at the truth of a client’s memories,” said Costa Mesa attorney Caudill. “They are trained to see the world as the patient sees it and work within that framework without regard to whether it’s true.”

But therein lies one of the problems because the patient’s view of events in recent years has led to criminal charges being filed against parents or civil lawsuits filed by children against family members for damages.

R. Christopher Barden, a psychologist and lawyer from Minneapolis, said the decision will force lawmakers and members of the mental health profession to act to set up legal parameters and ethical guidelines.

“What they cite as evidence is rumor, it’s innuendo, it’s hearsay, it’s clinical chitchat, but it’s not research,” Barden said.

But rape crisis counselors and therapists say people like Barden are ignoring the large numbers of women who approach them on their own, with no histories of counseling, and tell them of flashbacks and disturbing memories.

Leah Aldridge, of the Los Angeles Rape Hotline, said: “It is not uncommon for an adult woman to call us in crisis because she is experiencing flashbacks of some kind of sexual abuse and she doesn’t know what is going on. These memories often come without any intervention by a therapist, shaken loose by something that has happened, like the death of an uncle (followed by) a great sense of relief.”