Regression hypnotherapy

1. Introduction

Version followed: clinical hypnosis as taught by the American Society of Clinical Hypnosis (ASCH) to licensed health professionals. That means regression only to resource and mastery experiences, used for ego-strengthening and stabilisation inside a phase-oriented trauma frame, with Phillips and Frederick's (1995) SARI ego-state model as ASCH teaches it. It excludes memory-recovery regression and past-life regression, which are covered in the Harm account. Primary texts were thin: Hammond et al. (1995, ASCH memory guidelines) and Phillips and Frederick (1995) are not drawn on here. Where the guide goes beyond its sources, that is marked. [source: ASCH ego-strengthening workshop slides; ASCH EST/SARI course page; Kihlstrom, Hypnosis and memory] Sources for the Harm account also include the State v. Hurd (1981) safeguards, the APA working group's 1994 interim conclusions, the BPS 1995 working-party conclusions (as reported by Davies et al., 1998), key points of the BPS 2008 memory-and-law guidelines, Orne et al. (1996) on hypnosis and confidence, further Ramona trial details, later malpractice suits (Lief, 1999) and cautions about past-life regression (Stevenson, University of Virginia). Not drawn on [uncertain]: Hammond et al. (1995); the AMA's 1985 JAMA report; the Royal College of Psychiatrists' working-group report (Brandon et al., 1998); the People v. Shirley opinion; and the original papers by Laurence and Perry (1983), Lynn and colleagues, and Spanos and colleagues (1991).

"Regression hypnotherapy" is not one therapy. It is a family of hypnotic procedures that ask the client to re-experience, in imagination, an earlier time of life. In the legitimate clinical form, the point of going back is not to dig up hidden events. It is to reconnect the client with abilities, feelings of mastery and moments of safety that they already had. These are then carried into the present as self-suggestions, cues and self-hypnosis practice. The change model is ego-strengthening: improving the client's self-regard, self-efficacy and coping by direct or indirect suggestion and by re-living mastery. [source: ASCH ego-strengthening slides]

Research on hypnosis and memory sets the limits of this work. Experiments found no replicable evidence that age regression returns people to an earlier way of functioning. Hypnosis does not make recall more accurate. It increases false recognitions and raises confidence in memories regardless of accuracy. Kihlstrom concludes that clinicians and forensic investigators should not use hypnosis to enhance recollection. [source: Kihlstrom, Hypnosis and memory] So this guide treats everything a client "finds" in regression as imaginative experience to work with therapeutically. It is never evidence of what happened.

2. Framework

ASCH teaches ego-state therapy within the SARI model, a phase-oriented trauma model by Phillips and Frederick (1995). ASCH's course description says hypnotic techniques are matched to each SARI phase. [source: ASCH EST/SARI course page] The phase names and criteria from the primary text are not given here [uncertain]. The working sequence below follows a "safety and stabilisation first" rule and is [synthesis].

Phase A: Assessment, screening and consent (1–2 sessions). Goals: take a history; screen; correct myths about hypnosis and memory; agree goals framed as present-day coping, not finding out what happened. Move on when consent is documented, the client can describe what hypnosis can and cannot do for memory, and there are no exclusions (see the screening list in section 4). [synthesis; memory content from Kihlstrom]
Phase B: Stabilisation and resource building (typically several sessions; length depends on the client) [uncertain: no published session count]. Goals: safe-place or resource imagery for self-soothing and regulation [source: IJCEH trauma abstracts]; ego-strengthening by direct suggestion, metaphor and re-living mastery [source: ASCH ego-strengthening slides]; teaching self-hypnosis. Move on when the client can enter and leave hypnosis on their own, reliably lower their arousal with a cue, and use the resources between sessions.
Phase C: Resource regression and ego-state work (variable). Goals: revisit earlier experiences of competence, connection or pleasure to strengthen present coping; with ego-state-trained clinicians, communicate with self-states as ASCH's ego-state training describes [source: ASCH EST/SARI course page]. Traumatic memory is not targeted in this phase. Any processing of distressing memories should use an evidence-based trauma-processing method with its own readiness criteria [synthesis].
Phase D: Consolidation and future orientation (1–3 sessions) [synthesis]. Goals: rehearse coping in future situations. The IJCEH abstracts describe a future-focused paradigm as an alternative to age-regression uncovering [source: IJCEH trauma abstracts]. Also plan relapse prevention and continued self-hypnosis.

Format: individual sessions of 50–90 minutes. The hypnotic part is usually 15–30 minutes, with time before and after for preparation and debrief [synthesis]. Throughout, never go from resource regression into an unplanned search for earlier distressing events [synthesis, based on Kihlstrom and RCPsych 1997].

3. Guiding principles

Resources, not revelations. Go back to find strengths, not hidden events. Practical meaning: every regression has a named resource goal agreed before induction. [source: ASCH ego-strengthening slides; synthesis]
Hypnosis does not improve the accuracy of memory. Practical meaning: never offer, imply or accept hypnosis as a way to find out what happened. [source: Kihlstrom]
Hypnosis raises confidence without raising accuracy. Practical meaning: treat a vivid, certain image produced in trance as no more reliable than one produced awake. Tell clients this before the first session. [source: Kihlstrom]
Therapist suggestion shapes memory. Practical meaning: no leading questions, no interpreting symptoms as signs of hidden abuse, no suggestions that "more will come". [source: Loftus 1995; RCPsych guidelines as reported 1998]
Utilise what the client brings, including resistance. Practical meaning: build suggestions from the client's own interests, words and successes. [source: ASCH slides, on Erickson]
Give tools the client uses themselves. Practical meaning: every session ends with something the client can practise: a cue, a self-hypnosis routine, a token. [source: ASCH slides]
Permissive language and choice. Practical meaning: use phrasing like "you might notice…" and "I wonder…" so the client keeps control. [source: ASCH slides]
Daily repetition consolidates ego-strengthening. Practical meaning: assign brief daily self-suggestion or self-hypnosis. [source: ASCH slides, on Coué]
Adapt, do not read scripts. Practical meaning: use structured scripts as templates and personalise them. [source: ASCH slides, on Hartland]
Safety and stabilisation before any memory work. Practical meaning: no trauma processing until the client can regulate. [source: ASCH SARI course page]
Stay neutral about historical truth. Practical meaning: you neither confirm nor dispute what the client recalls. You work with its meaning and its effect on them now. [synthesis, based on Kihlstrom and RCPsych]
Forensic awareness. Practical meaning: before any hypnosis, ask whether the client is or may become a witness or litigant. Some jurisdictions restrict testimony refreshed by hypnosis. [source: Kihlstrom; Rock v. Arkansas]

4. Intervention inventory

Scope note: the ASCH material names the ego-strengthening techniques below but gives no step-by-step protocol for "age regression" as such. The steps are my operational synthesis around those named techniques, marked as such. Licensed clinicians should use them only within their competence and after hypnosis training. [source: ASCH ego-strengthening slides; synthesis]

4.1 Screening and contraindications

Purpose: Decide whether hypnosis, and regression in particular, is safe and suitable.
Steps: (1) Take a full psychiatric and trauma history. (2) Ask whether the client is seeking hypnosis to find out whether something happened. If yes, do not use regression. Offer the conversation in 4.2 and a non-hypnotic plan instead. (3) Ask about current or possible legal proceedings, police statements or civil claims. If any are likely, do not use hypnosis on related material, and tell the client why [source: Kihlstrom; Rock v. Arkansas]. (4) Screen for exclusions [synthesis unless noted]: active psychosis; severe dissociative disorder unless the clinician is specifically trained in phase-oriented dissociation work; untreated trauma with poor emotion regulation (no processing until stabilised); current crisis or acute suicidality; intoxication; strongly held belief that hypnosis reveals hidden truth or past lives (high risk of confabulation; based on Kihlstrom). (5) Record the decision.
Example language (illustrative): "Before we decide on hypnosis, I need to know whether you're hoping it will show you what happened. If so, I want to explain why it can't do that."
Watch for: A client mainly motivated by the hope of "getting memories back". Symptom lists the client brings as proof of hidden abuse. Pressure from a referrer to "uncover" something.

4.2 Informed consent and memory-myth correction

Purpose: Set accurate expectations and protect the client and any future legal process.
Steps: (1) Explain that hypnosis is focused attention and responsiveness to suggestion, and that the client stays in control. (2) Explain the memory findings in plain words: hypnosis does not improve accurate recall; it can increase false recollections and makes people more confident in whatever they recall [source: Kihlstrom]. (3) State the goal: regression here means revisiting strengths. (4) Explain the legal point: hypnosis may affect whether related testimony is allowed in some places [source: Kihlstrom; Rock v. Arkansas]. (5) Get written consent. ASCH publishes a sample consent form, which is not drawn on here [uncertain]. (6) Record the sessions or keep detailed notes [synthesis].
Example language (illustrative): "In hypnosis, imagination and memory blend easily. What feels vivid isn't necessarily accurate, so we'll use it to build on your strengths, not to establish facts."
Watch for: Nodding agreement but continued hope of uncovering. Ask the client to explain the limits back in their own words.

4.3 Induction, deepening and re-alerting (generic structure)

Purpose: Create the hypnotic context for the resource work.
Steps [synthesis]: (1) Preparation: settle on the goal and an agreed signal for "stop" (for example a raised hand). (2) Induction: use a permissive, eyes-closed or eyes-open focus-and-relaxation induction. The ASCH slides note Hartland's relaxation-based ego-strengthening was meant to be adapted, not read verbatim. (3) Deepening: a counting or descending-image deepener, kept brief. (4) Therapeutic work (4.4–4.11). (5) Re-alerting: count up, re-orient to the room and the present date, suggest feeling alert and comfortable. (6) Debrief (4.12).
Example language (illustrative): "You can let your attention settle on your breathing, going at your own pace, knowing you can open your eyes any time you choose."
Watch for: Rising distress, a stopped-breath or frozen look, spontaneous age-related shifts in voice or posture that weren't suggested. Respond with 4.13.

4.4 Safe place and resource imagery

Purpose: Build self-soothing and regulation, which clients with trauma often lack. It is the foundation for any regression. [source: IJCEH abstracts, "Revisiting the Safe Place"]
Steps: (1) Before trance, ask for a place, real or imagined, linked with calm and safety. Avoid places linked to people who may have harmed the client [synthesis]. (2) In trance, build it in several senses using the client's own details. (3) Suggest a feeling of safety and steadiness in the body. (4) Link it to a cue: a word, a touch of thumb and finger, a breath [synthesis]. (5) Rehearse moving in and out of the place. (6) Assign daily practice.
Example language (illustrative): "Notice what you see there… what you hear… and where in your body you feel that steadiness most."
Watch for: The safe place turning unsafe or intrusive images appearing. If so, switch to an imagined or neutral place and shorten the trance. It is working when the client can use the cue on their own and lower their own distress ratings.

4.5 Direct ego-strengthening

Purpose: Strengthen self-regard, self-efficacy and coping through affirming suggestions. [source: ASCH slides: "direct" type; Coué; Hartland]
Steps: (1) Gather the client's own strengths and values beforehand. (2) In trance, give short, positive, present-tense suggestions built from them. (3) Repeat key suggestions across sessions. (4) Turn them into a brief daily self-suggestion.
Example language (illustrative): "Each day you can notice a little more of the steadiness you already have."
Watch for: Suggestions that clash with the client's self-view and set off internal argument. Soften them into permissive or indirect forms (4.6).

4.6 Indirect ego-strengthening: metaphor and story

Purpose: Get around the internal argument that direct praise sets off. Draw on the client's own frame of reference. [source: ASCH slides: "indirect" type; Erickson's use of metaphor and story]
Steps: (1) Pick a metaphor from the client's interests (the slides give examples such as a child's dirt-biking hobby used as a source of confidence). (2) Tell a short story in which something grows, adapts or recovers. (3) Leave the link to the client open; do not explain it. (4) Ask afterwards what stood out.
Example language (illustrative): "I wonder what a rider learns about balance on rough ground… and how the body remembers it."
Watch for: Metaphors that unintentionally echo a trauma theme. Check ahead for themes to avoid.

4.7 Regression to past mastery (resource regression)

Purpose: Have the client re-live an earlier experience of competence, achievement or connection, then carry the feeling into a current challenge. This is the legitimate core use of age regression. [source: ASCH slides: "experience of mastery", "building on past successes", Erickson's recall of past mastery; operational steps are synthesis]
Steps [synthesis]: (1) Before trance, choose with the client a specific, known, positive memory of mastery. Choose it awake, not by "searching" in trance. (2) Agree that you will not explore other events. (3) After induction, invite the client to revisit that time, in the first or third person as they prefer. (4) Draw out the felt sense of capability: posture, breath, inner words. (5) Ask a mastery question (4.8). (6) Link the feeling to a cue or token (4.9). (7) Bring the client forward to the present, imagine using the resource in a current situation (4.11), then re-alert.
Example language (illustrative): "Go back to that afternoon you chose, when you finally got it right… notice what that capable feeling is like… and bring it with you as you come forward to today."
Watch for (risk flag): The client drifting to other, unchosen memories or reporting new "memories". Do not follow, probe or interpret them. Steer back to the chosen resource or move to containment (4.13). Do not suggest finding the first time or the cause of a problem; that turns resource work into memory recovery (see Harm account). It is working when the client spontaneously reports the resource feeling in daily life.

4.8 Mastery-focused questioning

Purpose: Turn a success into self-efficacy by having the client describe how they achieved it. [source: ASCH slides: "how did you do that?" case with a child, reported as 45% dry nights]
Steps: (1) Inside or outside trance, ask how the client did something well. (2) Help them spell out the steps in their own words. (3) Feed those words back as suggestions.
Example language (illustrative): "How did you manage that? What did you do first?"
Watch for: Shrugs and "luck" explanations. Ask for small concrete steps.

4.9 Bringing back a token or cue

Purpose: Give the resource a portable form. [source: ASCH slides: "bringing back a token/memento"]
Steps: (1) In trance, invite the client to notice an object, image, word or gesture that stands for the resource. (2) Suggest it will bring the feeling back when used. (3) Test it after re-alerting [synthesis].
Example language (illustrative): "Let something come to mind that can remind you of this, a small thing you could take with you."
Watch for: A token that later gets linked with a bad moment. Replace it.

4.10 Self-hypnosis and daily self-suggestion

Purpose: Hand the method over to the client. [source: ASCH slides: tools the patient uses themselves; Coué's daily practice]
Steps: (1) Teach a short self-induction: settle, breathe, use the cue. (2) Add the resource visit and one ego-strengthening phrase. (3) Re-alert. (4) Practise briefly every day and keep a log [synthesis]. Supply an audio recording if wanted, made by the clinician for this client [synthesis].
Example language (illustrative): "For a few minutes each day, sit somewhere quiet, use your cue, and spend a moment with that capable feeling."
Watch for: Distressing material during home practice. Tell the client to stop, ground (4.13) and bring it to the next session, not to explore it alone.

4.11 Future rehearsal (age progression)

Purpose: Apply the resources to coming situations. A future-focused approach is described as an alternative to regression aimed at uncovering. [source: IJCEH abstracts; steps synthesis]
Steps: (1) Pick a specific upcoming challenge. (2) In trance, have the client use the cue or token and imagine coping well, step by step. (3) Include a small setback and how they recover from it. (4) Suggest that the rehearsal stays available.
Example language (illustrative): "See yourself walking into that meeting next week, using your cue, steady enough to say what you need to say."
Watch for: Unrealistic, perfect outcomes. Rehearse "good enough" coping instead.

4.12 Debrief and reality orientation

Purpose: Consolidate the gains and separate imagination from fact. [synthesis, based on Kihlstrom]
Steps: (1) Check alertness and orientation: date, place, how the body feels. (2) Ask what was helpful. (3) If any new "memory" or image came up, say neutrally that images in hypnosis mix memory and imagination and are not taken as fact. Do not elaborate on them or rehearse them. (4) Note in the record what was suggested and what the client reported [synthesis]. (5) Agree home practice.
Example language (illustrative): "Some images come up in hypnosis that feel very real. We treat them as part of your inner experience, not as a record, and we don't need to work them out."
Watch for: The client leaving drowsy or upset. Lengthen re-alerting and grounding before they go.

4.13 Containment and grounding when distressing material emerges

Purpose: Respond safely to spontaneous distress, flashback-like experience or dissociation during trance. [synthesis]
Steps: (1) Stop the regression at once. Do not ask "what is happening?" in detail. (2) Use a calm, slower voice to orient the client to the present: their name, the room, today's date, feet on the floor. (3) Use the safe-place cue (4.4) or suggest putting the material into an imagined container for now. (4) Re-alert fully; use eyes-open grounding (naming objects, temperature, movement). (5) Debrief without exploring the content. Normalise the experience and say it is not evidence of anything. (6) Make a safety plan if distress continues, review your approach, and consider referral for an evidence-based trauma treatment.
Example language (illustrative): "Let's pause here. You're in my office, it's Tuesday, and you can feel the chair holding you. We can set that aside for now."
Watch for (risk flag): Trying to "complete" the scene, pushing for more detail, or calling the reaction proof of hidden trauma. All three are core features of harmful memory-recovery practice (see Harm account).

4.14 Ego-state communication within the SARI frame

Purpose: Work with conflicting self-states, for example to strengthen a protective or competent state, in trauma-focused hypnosis. [source: ASCH EST/SARI course page]
Steps: The ASCH material describes this only in outline. It says the mind is treated as a system of distinct, often unconscious self-states, reached with hypnosis, with techniques matched to SARI phases and ways of improving communication with states. The step-by-step methods are not given here [uncertain]. Use it only after specific ego-state training. In the stabilisation phase, keep the work to strengthening and connecting resource states [synthesis].
Example language (illustrative): "I'd like to speak with the part of you that knows how to keep you safe… what does that part want you to know?"
Watch for (risk flag): Encouraging the client to elaborate states as separate personalities, or using states to "find out" past events [synthesis based on Wikipedia RMT; Loftus 1995]. In the Rogers case described by Loftus, a self-diagnosis of multiple personality and ritual abuse came before family litigation.

4.15 Responding to requests for memory recovery or past-life regression

Purpose: Turn down an unsafe request without dismissing the client's distress. [synthesis, based on Kihlstrom; RCPsych guidelines as reported 1998]
Steps: (1) Ask what the client hopes knowing would change. (2) Explain that hypnosis cannot reliably tell them what happened, and can create convincing but inaccurate images and stronger certainty. (3) Offer goal-focused work on the current symptoms (4.4–4.11) or a referral to evidence-based therapy. (4) For past-life requests, explain that past-life regression is listed among memory techniques criticised for supporting false memories [source: Wikipedia RMT], and that it is not a clinical procedure. (5) Record the discussion.
Example language (illustrative): "I understand you want answers. Hypnosis can't give reliable ones and could make things more confusing, but we can work directly on the panic and the sleep problems."
Watch for: The client going elsewhere for regression. Give them neutral information on how to judge a practitioner (see Harm account, Recognising it today).

5. Handling problems

All guidance in this section is [synthesis] unless a source is named.

Client cannot experience the resource (stuck). Use smaller, more recent successes. Try third-person viewing or a borrowed image, such as a mentor or an admired figure. Use indirect metaphor (4.6) instead of direct praise. Bring in mastery questions (4.8) outside trance first.
Resistance or scepticism about hypnosis. Utilise it: let the client choose eyes open, say they can test it out, keep trance short [source: ASCH slides, on Erickson's use of resistance]. Make clear that the client is in control.
Overwhelm or dissociation in session. Stop and follow 4.13. Then slow down: go back to stabilisation, shorten trance, keep eyes open, and widen the time window between sessions. Reassess for a dissociative disorder and refer for specialist assessment if suspected.
Spontaneous "new memories" of abuse. Do not confirm, deny or explore them. Normalise, contain and record. Explain again that hypnosis-linked recollections are of uncertain accuracy [source: Kihlstrom]. Make no suggestion to confront family. If the client shares information about a child currently at risk, follow child-protection reporting duties [source: RCPsych guidelines as reported 1998; synthesis]. Consider whether to continue hypnosis at all.
Non-adherence to self-hypnosis practice. Shorten it to one or two minutes, attach it to an existing routine, give a personalised recording, and check the log at every session.
Rupture (client feels you refused to help them "find out"). Acknowledge the frustration. Explain your reasons again in terms of protecting them, and offer what you can do. Check whether they want a second opinion.
Pressure from a referrer or family to "uncover". Decline in writing, giving the evidence on hypnosis and memory [source: Kihlstrom; RCPsych 1997].
Legal involvement emerges mid-treatment. Pause hypnosis on related material. Document what was done and suggested. Advise the client to tell their lawyer that hypnosis has been used [source: Kihlstrom; Rock v. Arkansas].
Clinician drift. Signs: sessions start to aim at "the root cause" or the "first time". Use supervision and a written session plan with a named resource goal (4.7).
Client reports a past-life or abduction image during resource work. Treat it as imagery, and do not develop or interpret it. Return to the resource. Kihlstrom notes that memories recovered in hypnosis of abductions and prenatal events are rarely confirmed independently [source: Kihlstrom].

Harm account

Scope: "recovered-memory" practice of the 1980s–1990s that used hypnosis, age regression and related suggestive methods to "uncover" supposed repressed memories of childhood sexual abuse, satanic ritual abuse, past lives or alien abduction. No regression scripts are given; techniques are described qualitatively. Sources are named per claim. Items not drawn on are flagged [uncertain]. This account draws on court opinions and case briefs, professional-body documents and research papers; secondary reports are labelled as such.

What was actually done

The typical course below is put together from documented cases and investigations; the individual elements are sourced.

Symptom-based "diagnosis" of hidden abuse. Clients came with depression, eating disorders or vague distress. Therapists read their symptoms as signs of repressed abuse, often in the first session.
- In a 1993 CNN undercover investigation in Ohio, a pseudo-patient complaining of depression was labelled an "incest survivor" in the first session. When she said she had no memory of abuse, she was told she had repressed it. [source: Loftus 1995]
- In another 1993 undercover case, a therapist diagnosed sexual trauma at the first session, mainly from a recurring childhood dream about a bull. [source: Loftus 1995]
- In the Ramona case (therapy 1989–1990, Western Medical Center, Anaheim, California), counsellor Marche Isabella told Holly Ramona and her mother that bulimia was usually caused by incest. She said 60–70% of her eating-disorder patients had been sexually abused. [source: Wikipedia, Ramona case]
- The Canadian Psychological Association's 1996 guidelines later stated that no symptom pattern is diagnostic of child sexual abuse. [source: Wikipedia RMT]
Memory-recovery techniques. Documented techniques were hypnosis and age regression, guided visualisation or imagery, trance writing, dream work and interpretation, body work and "body memory" interpretation, inner-child exercises, journaling, free association, projective techniques, past-life regression and sodium amytal ("truth drug") interviews. [source: Loftus 1995; Wikipedia RMT, citing Canadian guidelines]
- In practice, the client was put in trance or deep relaxation and guided back to childhood with the stated aim of finding the event behind the symptoms. Images that came up were treated as memories. Sessions were repeated until detailed accounts emerged. [source: Wikipedia RMT; Loftus 1995; the sequence is my summary of these]
- Jennifer H. (Hoult v. Hoult, D. Mass., 1993) began therapy in 1984 with an unlicensed psychotherapist using Gestalt methods. Her "memories" came up during guided visualisation, and she later described thousands of rapes. She testified that she had paid the therapist $19,329.59. [source: Loftus 1995]
- Holly Ramona agreed to sodium amytal interviews by psychiatrist Richard Rose to recover memories. (This was drug-assisted interviewing, not hypnosis.) [source: Wikipedia, Ramona case] The amytal interview was not taped and the treating therapists kept no medical notes; some involved believed the drug guaranteed that what she said was true. [source: Greer, Boston Review 1998, reviewing Johnston's Spectral Evidence]
Reinforcement. Therapists disclosed their own abuse history, recommended self-help books (The Courage to Heal in the 1993 undercover case), and sent clients to survivor groups. [source: Loftus 1995] In R. v. Hawkes (Nova Scotia, 2017), the complainant rebuilt his memories after joining a men's group and hearing other "survivors'" accounts. [source: Wikipedia RMT]
Escalation of content. In Rogers (1992), two adult daughters who began therapy in 1987–1988 came to allege abuse, torture and ritual murder from infancy. The elder diagnosed herself with multiple personality and satanic ritual abuse, then involved her sister and niece. [source: Loftus 1995] Hypnosis was also used to "recover" memories of alien abduction and of prenatal events. [source: Kihlstrom] Lief's review of malpractice complaints lists the techniques patients alleged: insisting that emotional abreaction was necessary for cure, aggressive hypnosis including age regression, sodium amytal interviews, guided imagery, suggestive dream interpretation, survivor groups and books, psychodrama, channeling, NLP and primal-scream therapy; alleged outcomes included multiple alter personalities and beliefs in satanic ritual abuse. [source: Lief, Psychiatric Times 1999] Past-life regression was part of the same toolkit. [source: Wikipedia RMT] Stevenson, a reincarnation researcher, held that hypnotically evoked "previous personalities" are usually imaginary: their accurate historical details can usually be traced to what the subject had read or seen (Zolik 1962; Kampman and Hirvenoja 1978), and the hypnotist's suggestions shape the personality's features (Baker 1982; Spanos et al. 1991). [source: Stevenson, UVA Division of Perceptual Studies, citing these studies] The original Spanos and Baker papers, and any account of how past-life sessions were typically run, are not drawn on here [uncertain].
Confrontation and cutting contact. Clients were encouraged to confront the accused. In the 1993 undercover case the therapist called confronting a parent "empowering". A videotaped confrontation left the family "wrenched irreparably apart". [source: Loftus 1995] Holly Ramona confronted her father at Western Medical on 15 March 1990, with her mother present. [source: Wikipedia, Ramona case]
Lawsuits and prosecutions based on recovered memories followed, including criminal trials of Catholic priests. [source: Wikipedia RMT]

How widespread it was:

Poole and Lindsay (1994) estimated that up to a quarter of doctoral-level psychologists may hold the questionable beliefs and practices in question. [source: Loftus 1995]
In Yapko's 1994 survey of about 1,000 therapists, 19% knew of a case where therapy had suggested a false memory. [source: Wikipedia RMT]

How it caused harm

Mechanisms

Hypnosis does not improve accurate recall. It increases false recognitions and raises confidence in whatever is recalled, accurate or not. Hypnotised people may be more open to misinformation, and a suggestive setting interacts with the reconstructive nature of memory to create an illusion of remembering. Age regression showed no replicable return to earlier functioning; any accurate details are likely mixed with false ones. [source: Kihlstrom, citing Nash 1987 among others]
People can be led to believe in childhood events that never happened. Loftus's "lost in a shopping mall" studies led participants to believe they had been lost at age six. Critics argue that such events are not emotionally comparable to abuse. [source: Wikipedia RMT]
The Health Council of the Netherlands (2004) said memories can be confabulated or reinterpreted, and that the risk rises with suggestive techniques. [source: Wikipedia RMT]
Repetition, group endorsement, reading and therapist conviction reinforce the beliefs. [source: Loftus 1995; Hawkes case; synthesis on mechanism]
Hypnotic pseudomemory research. Laurence and Perry (1983) are cited for showing that fantasies suggested during hypnosis, unrelated to any real event, can later be remembered as true. Hypnosis also raises confidence in correct and incorrect memories alike (Sheehan 1988) and adds vivid invented detail that makes recall seem more credible (Dywan 1995). [source: Cultic Studies Journal 13(1), 1996, pp. 32–33, citing these] Orne, Whitehouse, Dinges and Orne (1996) found that hypnosis did not improve correct recall beyond the normal gain from repeated recall, that even low-hypnotisable subjects produced more confidently held errors under hypnosis than waking controls, and that confidence in hypnotically facilitated reports "is often escalated". They advise "great caution" in using hypnosis to reconstruct life events and say its products can be established only by independent corroboration. [source: Orne et al., IJCEH 1996] Lynn, Loftus, Lilienfeld and Lock (2003) on memory-recovery techniques is not drawn on here [uncertain].

Documented harms

Clients. A 1996 report by Washington State's Crime Victims Compensation Program found no benefit in the cases reviewed, and said patients' daily functioning was "significantly and possibly irrevocably impaired". Some patients later retracted their memories. [source: Wikipedia RMT]
Families. Gary Ramona lost his marriage and his job as a winery vice-president. [source: Wikipedia, Ramona case] The 1993 undercover case left a family irreparably broken. In Rogers, a woman in her seventies was sued by her daughters. [source: Loftus 1995]
Justice system. In the Netherlands, the LEBZ review body (formed 1999) reported for 2003–2007 that about 90% of the cases it reviewed were stopped for lack of reliable evidence. In R. v. Hawkes (2017), the accused was acquitted because the reconstructed memories could not be relied on. [source: Wikipedia RMT]
Court outcomes against practitioners.
- Ramona v. Isabella (Napa County Superior Court, 1994): the first suit against therapists over implanted memories and the first such malpractice suit by a non-patient. The jury voted 10–2 and awarded $500,000 for lost wages. [source: Wikipedia, Ramona case] Greer's review of Johnston's book on the trial says the award was a compromise among jurors, who were shocked that the amytal interview was untaped and undocumented; the amytal psychiatrist had faced five earlier malpractice claims and gave up practice. [source: Greer, Boston Review 1998] Sources differ on what the jury decided about the memories: Greer says it found them false, while the foreman reportedly said the jury did not accept that the therapists had implanted them [uncertain]. Lief cites a 1997 California appellate ruling allowing the third-party claim (citation incomplete in his article) [uncertain]. Bowman and Mertz (Harvard Law Review) criticised the third-party liability. [source: Wikipedia, Ramona case; Lief 1999]
- Minnesota psychiatrist Diane Bay Humenansky faced several large verdicts, including $2.6 million in August 1995, and a 1997 settlement. [source: Wikipedia RMT] The Burgus case (Patricia Burgus, her husband and two sons v. Bennett G. Braun, Rush-Presbyterian-St. Luke's Medical Center and Elva Poznanski) settled in 1997 for $10.6 million, described as the largest such settlement; the sons had been hospitalised for almost three years. Bartha v. Hicks Richard and Friends Hospital (Philadelphia, filed 1994; name as Lief prints it) alleged that hypnosis and medication produced multiple-personality symptoms, and settled for an undisclosed sum. Lief reviewed 62 False Memory Syndrome Foundation case files and cites an estimate of about 200 patient suits against therapists (Scheflin et al., 1998). Typical claims were breach of the standard of care, suggestive techniques producing false memories, and failure to tell patients that the techniques lacked reliable scientific support. [source: Lief, Psychiatric Times 1999; Lief writes as a critic of recovered-memory therapy]

Who was most at risk [synthesis from the cases above]: clients with eating disorders, depression or dissociative symptoms; highly hypnotisable or suggestible clients; clients already sure that something hidden explained their distress; those in long, intensive therapy, survivor groups or inpatient programmes; and accused relatives, who had no voice in the therapy. Low hypnotisability gave no protection: low-hypnotisable subjects also produced confident errors under hypnosis [source: Orne et al. 1996].

Professional and legal responses

Royal College of Psychiatrists (1997). Guidelines based on the Brandon working-group report became College policy. They were firmly against memory-recovery techniques, finding no evidence that they reveal real events, and warned that members who persisted could face loss of status and referral to the General Medical Council. [source: NZ Skeptics report, 1998] That report also says psychiatrists were told to resist adult patients' moves to report allegations, while reporting children's disclosures of current abuse is mandatory. This rests on a press summary only [uncertain]. The full report is not drawn on here.
British Psychological Society. Its 1995 working-party report Recovered Memories was written by three researchers and three clinicians who reached consensus: forgotten abuse can sometimes be remembered, but convincing pseudomemories can also be built; clinicians should avoid risky practices, and the report gave guidelines to reduce the risk. Mollon's guidance for patients "explicitly discouraged" memory-recovery techniques, "particularly hypnosis". [source: Davies, Morton, Mollon and Robertson, Psychology, Public Policy, and Law 1998] A draft revision by Frankland and Cohen followed in 1999. [source: The Psychologist, 1999] The BPS Research Board's 2008 Guidelines on Memory and the Law (working party chaired by Martin Conway) state that memories record people's experience of events, not the events themselves; that people can remember events they never experienced; and that vivid or highly specific details do not guarantee that a memory is accurate or that the event happened. [source: Neurophilosophy summary, 2008] Their sections on recovered memories and hypnosis are not drawn on here [uncertain].
ASCH. It published Clinical Hypnosis and Memory: Guidelines for Clinicians and for Forensic Hypnosis (Hammond et al., 1995). The text is not drawn on here [uncertain]. Hammond, Scheflin and Vermetten later wrote on informed consent and the standard of care in clinical hypnosis (American Journal of Clinical Hypnosis, 2001); only the citation record was seen [uncertain].
American Psychological Association. Its Working Group on Investigation of Memories of Childhood Abuse issued interim conclusions in 1994: most people sexually abused as children remember all or part of it; memories forgotten for a long time can be remembered later; convincing pseudomemories of events that never happened can also be constructed; and the mechanisms of both are poorly understood. [source: NCJRS abstract 153345] Its final report (Psychology, Public Policy, and Law, 1998) was set out as a debate between researchers and clinicians and reached limited consensus. [source: Davies et al. 1998; Kihlstrom 1997] The final report's text is not drawn on here [uncertain].
American Medical Association. The Council on Scientific Affairs' 1985 JAMA report on refreshing recollection by hypnosis is not drawn on here [uncertain]. A 1996 Cultic Studies Journal article reports that the AMA reaffirmed its position in 1994, calling for "a per se exclusion of testimony influenced by hypnosis"; this is a secondary report, not checked against the AMA text [uncertain].
Australian Hypnotherapists Association. It accepted that some recovered abuse memories are genuine but cautioned that some techniques can create illusory memories. [source: Wikipedia RMT]
Law. Most US jurisdictions give hypnotically refreshed memory no special credence, and some states bar testimony based on it. [source: Kihlstrom] Courts took three approaches: treat prior hypnosis as affecting credibility only; admit the testimony if procedural safeguards were followed; or exclude it outright. [source: Sendor, UNC Institute of Government memorandum, 1985] In State v. Hurd, 86 N.J. 525 (1981), the New Jersey Supreme Court upheld suppression of a stabbing victim's identification that emerged after an officer, during the session, asked whether the attacker was the defendant. It allowed such testimony only if the proponent proves by clear and convincing evidence that the session was run by a licensed psychiatrist or psychologist trained in hypnosis and independent of both sides, that any information given to the hypnotist was in writing, that a detailed account was taken before induction, that all contacts were recorded, and that only hypnotist and subject were present. Relying on Martin Orne, the court named heightened suggestibility, confabulation and equal conviction in false and true recall as the dangers. [source: Studicata case brief of State v. Hurd] People v. Shirley (Cal. 1982) applied the Frye general-acceptance test to exclude hypnotically aided witness testimony while exempting the defendant's own testimony; State v. Peoples (N.C. 1984) adopted outright exclusion, saying hypnosis "irrevocably masks" whether recall is true. [source: Sendor 1985; the Shirley opinion's exact scope is uncertain] In Rock v. Arkansas (1987), the US Supreme Court struck down Arkansas's blanket ban on a defendant's hypnotically refreshed testimony as arbitrary, without endorsing hypnosis as reliable. [source: Rock v. Arkansas case brief] In Borawick v. Shay (1995), childhood-abuse memories that first emerged during hypnosis were excluded, and the court declined to assume that therapeutic hypnosis carries less risk of suggestibility, confabulation and memory hardening than forensic hypnosis. [source: Cultic Studies Journal 13(1), 1996]

Recognising it today

The practice has not gone away. Patihis and Pendergrast's 2018 surveys found that about 8% of adults aged 50 and over had seen therapists who discussed repressed memories of abuse. [source: Wikipedia RMT] Recent journalism describes a "return of recovered memory" [uncertain].

Features and phrases to watch for [synthesis, drawn from the documented practices above]:

Regression offered to find the "root cause", the "original event" or the "first time" behind a symptom. This includes "inner child" regression aimed at uncovering, and "regression to cause" in hypnotherapy marketing.
Symptom checklists or single symptoms (an eating disorder, a dream, a body sensation) presented as proof of hidden abuse. Absence of memory treated as evidence ("you've repressed it").
"Your body remembers" or body-memory readings; dreams interpreted as records of events.
Past-life regression offered for phobias, relationship problems or pain; alien-contact "regressions".
Pushing the client to confront, accuse or cut off family; telling them to keep therapy secret from relatives.
Encouraging survivor groups, books or online communities where memories are compared and built up; the therapist sharing their own abuse history to model it.
Repeated sessions until "more comes"; vivid detail or strong emotion taken as confirmation.
Drug-assisted interviews to "get at the truth" (as in Ramona).
Escalating content (ritual abuse, multiple personalities, many perpetrators) [source: Loftus 1995 for the Rogers pattern].

Red flags in a colleague's or a service's practice [synthesis]:

Session notes recording "recovered" memories as fact, or no record at all of memory-focused or drug-assisted sessions (the Ramona jurors were shocked that the amytal interview was neither taped nor documented [source: Greer, Boston Review 1998]).
An abuse "diagnosis" in the first session.
No informed consent about hypnosis and memory.
Hypnosis used with clients who are, or may become, witnesses.
A therapist who calls themselves a "regression specialist" or sells memory retrieval.
Advertising for past-life or "cause" regression, especially promises of a real past life or fees for finding one. Stevenson disapproved of such hypnotists and warned that a regressed "previous personality" sometimes did not leave on instruction, leaving the subject altered for days or longer. [source: Stevenson, UVA Division of Perceptual Studies]

How legitimate practice differs [source: section 4; Kihlstrom]: the goal is agreed in advance and is a resource or a coping skill. The target memory is chosen while the client is awake and is already known. Nothing new is searched for. Spontaneous images are contained, not explored. The clinician stays neutral about historical truth and gives the client accurate information about memory before starting.

What to do instead and how to help those harmed

Safer alternatives [synthesis unless noted]

For trauma symptoms: phase-oriented care with stabilisation first. Then use an established trauma-focused therapy that has its own readiness and dosing rules, such as trauma-focused CBT, cognitive processing therapy, prolonged exposure or EMDR, delivered by trained clinicians. These are named from general practice knowledge; their guidelines are not drawn on here [uncertain].
For ego-strengthening within hypnosis: the resource-only procedures in section 4. [source: ASCH slides]
For a client wondering whether abuse happened: non-suggestive, open-ended exploration of present concerns. Accept that certainty may not be possible. Focus treatment on current functioning.

Assessing and treating people who hold memories recovered this way [synthesis]

Stay neutral. Do not confirm or debunk. Explore what the memories mean to the client, how they came about (techniques, setting, groups, reading) and how they affect daily life and relationships now.
Check for depression, suicidality, dissociation, eating disorders and isolation. Treat these directly.
Give accurate information about memory gently, as a resource [source: Kihlstrom], and let the client draw their own conclusions.
Do not use hypnosis or regression with this client.

Supporting retractors [synthesis]: expect grief, shame, anger at the former therapist, loss of identity and damaged family ties. Offer validation, and family work if both sides want it. Lawyers or complaints bodies may be relevant; some retractors have taken legal action [source: Wikipedia RMT].

Supporting accused or estranged relatives [synthesis]: treat their grief and trauma reactions without asking them to prove innocence. Help them set realistic expectations about contact.

Ethical, reporting and legal duties

Follow mandatory child-protection reporting when a child may currently be at risk [source: RCPsych guidelines as reported 1998].
Before any hypnosis, record consent that covers memory risks; failure to tell patients that memory-recovery techniques lacked reliable scientific support was a standard malpractice claim [source: Lief 1999]. Do not hypnotise current or likely witnesses about related events [source: Kihlstrom; Rock v. Arkansas]. If hypnosis may touch events that could reach court, document the client's recollection in detail beforehand and record the session: courts that admit such testimony limit it to pre-hypnosis recollections, best supported by objective pre-hypnosis records [source: Orne et al. 1996; State v. Hurd safeguards].
Report harmful practice by a colleague to the relevant licensing body or professional association. Practitioners face disciplinary exposure (RCPsych 1997; state licensing investigations among the cases Lief reviewed) and civil liability (Ramona 1994; Humenansky 1995; Burgus settlement 1997) [source: NZ Skeptics; Wikipedia; Lief 1999].
Keep detailed records of what was suggested, in case of later legal scrutiny [synthesis].

Sources

Sources:

Further reading (not drawn on) [uncertain]:

Hammond, D.C. et al. (1995). Clinical Hypnosis and Memory: Guidelines for Clinicians and for Forensic Hypnosis. ASCH Press.
Phillips, M., & Frederick, C. (1995). Healing the Divided Self (source of the SARI model). Norton.
Nash, M.R. (1987). What, if anything, is regressed about hypnotic age regression? Psychological Bulletin.
Brandon, S. et al. (1998). Recovered memories of childhood sexual abuse: implications for clinical practice. British Journal of Psychiatry.
Johnston, M. (1997). Spectral Evidence: The Ramona Case. Houghton Mifflin.
American Medical Association, Council on Scientific Affairs (1985). Scientific status of refreshing recollection by the use of hypnosis. JAMA (journal page blocked).
Laurence, J.-R., & Perry, C. (1983). Hypnotically created memory among highly hypnotizable subjects. Science.
Spanos, N.P., et al. (1991), on hypnotic past-life regression; Baker (1982) (both cited by Stevenson).
Lynn, S.J., Loftus, E.F., Lilienfeld, S.O., & Lock, T. (2003). The remembrance of things past. Skeptical Inquirer.
People v. Shirley (California Supreme Court, 1982), opinion.
APA Working Group on Investigation of Memories of Childhood Abuse (1998). Final report. Psychology, Public Policy, and Law, 4, 579–726.
British Psychological Society (1995). Recovered Memories: report of the working party; and BPS Research Board (2008). Guidelines on Memory and the Law (full texts).

← Previous · VI-109Directed waking dream (Desoille)Next · VI-111 →NLP (neuro-linguistic programming)