Psychic driving (Cameron, MKUltra)

This entry is listed for history and safety. Psychic driving and the "depatterning" programme it belonged to caused serious, lasting harm to patients who had not consented. The guide describes what patients went through, never how to carry it out. The guide covers the psychotherapist's own work: historical literacy, recognition, assessment, safeguarding, referral, advocacy and work with survivors and their families.

1. Introduction

Version followed: the historical record of D. Ewen Cameron's "psychic driving" and "depatterning" at the Allan Memorial Institute, Montreal (roughly 1948 to 1964), as given in the 1977 US Senate hearing record, the Canadian Encyclopedia, Torbay's 2023 history in History of Psychiatry, and Canadian news reporting (CBC, Canadian Press). The clinical sections draw on NICE guideline NG116 (PTSD) and the Nuremberg Code.

What it was. Psychic driving was an experimental psychiatric method developed by Donald Ewen Cameron, the first director of the Allan Memorial Institute, a McGill-affiliated psychiatric teaching hospital in Montreal [source: Canadian Encyclopedia, Noakes 2021]. Cameron presented it in a 1956 American Journal of Psychiatry paper titled "Psychic driving". He described replaying recorded verbal messages to patients to bring repressed material into awareness, and framed it as a possible treatment for mental disorders, including schizophrenia [source: Torbay 2023; the 1956 paper itself is cited through Torbay]. It was used with "depatterning", which aimed to erase existing memories and patterns of behaviour and return patients to a childlike state from which a new personality would supposedly be built [source: Canadian Encyclopedia].

Its claimed mechanism of change. As historians summarise Cameron's view, talking therapies were slow, ineffective and expensive. Repeated recorded messages, delivered after a patient's existing patterns had been broken down, could in his account erase abnormal memories, beliefs and behaviours and rebuild the person as sociable and well adjusted [source: Saunders 2016, QMUL History of Emotions blog; Torbay 2023]. Patients did not give informed consent, and the method caused lasting memory loss, disability and family harm (see Harm account) [source: Canadian Encyclopedia; CBC 2017].

Why it matters to a psychotherapist now. From 1957 the work was secretly part-funded by the CIA's MKUltra programme (as Subproject 68, through a front body, the Society for the Investigation of Human Ecology), and also by the Canadian government [source: Torbay 2023; Canadian Encyclopedia; CBC 2017]. Survivors' compensation claims and a Quebec class action, authorised in July 2025, are still active [source: Canadian Press via CFJC Today, 31 July 2025]. Clinicians may meet surviving former patients, their children and grandchildren, people whose distrust of psychiatry draws on this history, and people drawn to "mind control" or "reprogramming" ideas.

2. Framework

The phases below are [synthesis], anchored where stated to NICE NG116. Session number and length follow the client's needs and the setting [synthesis]. NG116 says trauma-focused treatment for people with complex needs may need more sessions or a longer course to build trust (1.7.3) [source: NICE NG116].

Historical phases of the practice (outline only)

Development (c. 1948 to 1957). Cameron builds a programme of intensive physical treatments at the Allan Memorial. Sources put the start of the experimental work at 1957, or as early as 1948 [source: Canadian Encyclopedia; Canadian Press 2025]. The Canadian government gave him about half a million dollars between 1950 and about 1965 [source: Canadian Encyclopedia].
CIA-funded phase (1957 to 1964). The CIA funds the work through the Society for the Investigation of Human Ecology. Totals are given as about US$69,000 [source: Torbay 2023] and as US$75,000 [source: Saunders 2016] [uncertain: secondary, unverified; sources differ]. MKUltra itself ran from 1953 to 1964 as an "umbrella project" of drug and behaviour-modification subprojects [source: US Senate 1977 hearing].
Concealment and disclosure (1964 to 1980s). Most MKUltra files were destroyed in 1973. Surviving finance records were found in 1977 and presented to a joint Senate hearing on 3 August 1977 [source: US Senate 1977 hearing]. The Church Committee investigated CIA abuses in 1975, and CBC's The Fifth Estate brought the Montreal experiments to Canadian public attention in 1980 [source: Canadian Encyclopedia].
Redress (1986 to now). A 1986 report found that federal officials had not known the full extent of Cameron's work [source: CBC 2017]. In 1992 Canada paid compassionate payments of $100,000 to more than 70 former patients (77 in one account) without admitting liability, and turned down more than 250 claimants [source: CBC 2017; Canadian Encyclopedia]. A Quebec Superior Court class action against the Royal Victoria Hospital, McGill University and the Government of Canada was authorised in 2025 [source: Canadian Press 2025].

Phases of the psychotherapist's work [synthesis]

Recognition and engagement. Notice the connection (a client's own treatment, a relative's, or the history as a source of fear) and build enough trust to continue. Goal: the client stays in contact and feels believed. Move on when the client agrees to an assessment and has some sense of control over pace and content.
Assessment and safety. Carry out a full assessment of trauma symptoms, memory, risk, social needs and the family picture, following NG116 1.1 to 1.2 [source: NICE NG116]. Goal: a shared formulation and a safety plan where risk is present (NG116 1.6.3). Move on when risk is managed and the client has chosen what to work on.
Stabilisation and meaning-making. Psychoeducation about what is documented, support with records and legal processes, and work on distrust, shame and grief. Goal: the client can hold the history without being flooded by it. Move on when the client can tolerate trauma-focused work, if they want it.
Trauma-focused treatment and repair. Where PTSD or complex PTSD is present, offer the treatments NG116 recommends, adapted for complex needs [source: NICE NG116 1.6.16 to 1.6.20, 1.7.3]. Family and intergenerational work runs alongside. Goal: symptoms reduce and life rebuilds.
Advocacy, commemoration and follow-up. Support the client's chosen public or legal role, plan support after therapy ends (NG116 1.7.3), and plan for relapse when anniversaries, court dates or media coverage come round.

3. Guiding principles

Never provide, supervise or refer to the practice or anything resembling it. In practice, no "reprogramming", looped-message or memory-erasing method has a place in care, and you decline any request to take part.
Consent is the centre of the work. "The voluntary consent of the human subject is absolutely essential" (Nuremberg Code, principle 1) [source: Nuremberg Code]. In practice, every step of your work is explained and agreed, and consent is checked again as you go [synthesis].
The right to stop. The Code says the subject "should be at liberty to bring the experiment to an end" (principle 9) [source: Nuremberg Code]. In practice, the client can pause or end any session, topic or exercise at any time, without penalty [synthesis].
Distrust is a reasonable response, not a symptom. NG116 asks clinicians to recognise that people may feel ashamed, anxious or distrustful, to follow up missed appointments and to be flexible (1.6.2) [source: NICE NG116]. In practice, you do not interpret wariness of psychiatry as paranoia without assessment.
Accuracy over drama. In practice, you tell clients what courts, inquiries and historians have documented, say where sources differ, and do not add unverified detail [synthesis].
Do not reconstruct memories by suggestion. In practice, memory gaps are worked with as losses. You never use techniques meant to recover memories, and you rely on records and collateral accounts for facts [synthesis; see the separate guide on recovered-memory therapy].
Avoid re-traumatising settings. NG116 advises avoiding triggers such as noisy or restrictive environments, including restraint (1.4.2) [source: NICE NG116]. In practice, offer a calm room, an open door if wanted, no recording and no clinical paraphernalia the client links to past treatment [synthesis].
Do not delay treatment for legal processes. NG116 says treatment should not be delayed because of court cases or compensation claims, and the effect of timing on the person's decisions should be discussed (1.3.2) [source: NICE NG116]. In practice, therapy and litigation run side by side, and you keep the roles separate.
Families are affected too. NG116 asks clinicians to support and assess family members and carers (1.4.3 to 1.4.5) [source: NICE NG116]. Family accounts describe relatives who came home changed [source: CBC 2017; Canadian Encyclopedia]. In practice, you offer descendants their own space and do not treat their pain as second-hand.
Keep roles clear. In practice, you do not act as a client's treating therapist and also as their expert witness or advocate in the same proceedings. Consider Standard 3.05 (Multiple Relationships) of the APA Ethics Code [source: APA Ethics Code].
Respect the client's choice of meaning. In practice, some survivors and families want justice, some want privacy and some want both at different times. You follow their lead [synthesis].
No moralising, no glamorising. In practice, you speak plainly about documented harm and avoid sensational language, and also avoid excusing it [synthesis].
Safe messaging on suicide. In practice, you assess risk directly, never discuss methods, and give crisis resources: 988 (US) and Samaritans 116 123 (UK and Ireland) [synthesis].

4. Intervention inventory

The interventions below are the psychotherapist's own work; steps not drawn from a cited source are marked [synthesis]. None of them is a step of psychic driving or depatterning. All example language is illustrative.

4.1 Building your own historical literacy

Purpose / when: Before working with a survivor, a descendant or a client preoccupied with this history, so you can speak accurately and calmly [synthesis].
Steps: (1) Read the core record: the 1977 Senate hearing, the Canadian Encyclopedia entry, Torbay 2023 and the CBC and Canadian Press reports (see Sources). (2) Note the points where sources disagree: start dates (1948 or 1957), CIA funding totals (about US$69,000 or US$75,000), and the 1988 US settlement (nine survivors in one account, one in another) [source: Canadian Encyclopedia; CBC 2017; Torbay 2023]. (3) Keep a one-page summary with citations for your own reference. (4) Leave technical detail of the treatments out of your notes and your conversations. You need to know that harm was done, not how.
Example language (illustrative): "What I know comes from the Senate hearing record, Canadian court reporting and historians. If something you've read isn't in those, I'll say I don't know."
Watch for: Being drawn into online material that mixes documented fact with speculation. It is working if you can answer a client's factual question with its source, or say plainly that a point is not established.

4.2 Recognising a connection in history-taking

Purpose / when: At intake or during assessment, where a client or relative mentions psychiatric treatment in Montreal between about 1948 and 1964, the Allan Memorial or the Royal Victoria Hospital, unexplained gaps in a parent's memory, or a family story of someone who "came back different" [source: Canadian Encyclopedia; CBC 2017; Canadian Press 2025 for the institutions and dates].
Steps: (1) Ask open questions about family psychiatric history without suggesting answers. (2) If the client raises Montreal or Cameron, ask what they already know and where it comes from. (3) Record what the client says as their account, not as established fact, until records or other sources confirm it. (4) Ask whether they want to explore it now, later or not at all.
Example language (illustrative): "You mentioned your grandmother was treated in Montreal in the late fifties. What has the family said about that time?"
Watch for: Over-eager linking of every family difficulty to the experiments, or the opposite, dismissing the link. It is working if the client feels able to bring the topic back when they choose.

4.3 Trauma-informed assessment

Purpose / when: For any client affected directly or through family, following NG116's recognition and assessment recommendations (1.1.1 to 1.1.5, 1.2.2) [source: NICE NG116].
Steps: (1) Explain the purpose, content and the client's right to pause before you begin. (2) Ask about PTSD symptoms and functioning with specific questions (NG116 1.1.3), including for events long ago (1.1.1 to 1.1.4). (3) Assess memory complaints, concentration, startle and irritability; family accounts describe these after treatment [source: CBC 2017; Canadian Encyclopedia]. (4) Cover physical, psychological and social needs and risk (1.2.2). (5) Where cognitive problems are significant, route the client through their physician for medical and neuropsychological assessment [synthesis]. (6) Share a written summary if the client wants one.
Example language (illustrative): "I'll ask some questions about sleep, memory and how you react to reminders. You can skip any question, and we can stop whenever you like."
Watch for: An assessment that feels like interrogation. Use short blocks, check in often and keep it collaborative. It is working if the client gives an account in their own words and agrees the formulation fits.

4.4 Engaging a client who distrusts psychiatry

Purpose / when: When a survivor, a descendant or a member of the public cites this history as a reason to avoid mental health care. NG116 asks clinicians to recognise distrust, follow up missed appointments and allow flexibility (1.6.2) [source: NICE NG116].
Steps: (1) Acknowledge the documented basis for distrust plainly: patients did not consent and records were withheld [source: Canadian Encyclopedia]. (2) Explain what has changed in consent and oversight without claiming abuses cannot happen now. (3) Give the client control over pace, topic, room arrangements and contact. (4) Follow up a missed appointment with a brief, non-pressuring message. (5) Offer a choice of therapist, including gender (NG116 1.3.1) [source: NICE NG116].
Example language (illustrative): "Given what was done in Montreal, being wary of psychiatry makes sense. You decide what we talk about, and you can question anything I suggest."
Watch for: Defending the profession, which closes the conversation down. It is working if the client keeps attending and starts to disagree with you openly.

4.5 Explicit, ongoing consent as repair

Purpose / when: In every contact with someone harmed by non-consensual treatment, as a corrective experience shaped by Nuremberg Code principles 1 and 9 [source: Nuremberg Code; application is synthesis].
Steps: (1) Explain any proposed approach, its aims, likely benefits, discomforts and alternatives before starting. (2) Ask for agreement and record it. (3) Agree a stop signal and honour it at once. (4) Check consent again when the work changes in intensity. (5) Never record sessions without explicit, informed, revocable consent. Some survivors may react strongly to recorded voices given the history; offer no recording as the default [synthesis].
Example language (illustrative): "Before we try anything, I'll tell you what it involves and why. If you want to stop at any point, say so or raise your hand, and we stop. No reason needed."
Watch for: Consent that is passive ("I suppose so"). Slow down and offer real alternatives. It is working if the client uses the stop signal at least once and finds it respected.

4.6 Psychoeducation on the documented history

Purpose / when: When the client wants accurate information, or is distressed by rumour.
Steps: (1) Ask what they want to know and how much. (2) Give the facts with their sources, in outline: who (Cameron, Allan Memorial), when (about 1948 or 1957 to 1964), funding (CIA via the Society for the Investigation of Human Ecology; the Canadian government), what is documented about consent and harm, and what redress followed [source: Canadian Encyclopedia; Torbay 2023; CBC 2017]. (3) Say where sources disagree. (4) Leave out technical detail of the treatments. (5) Check how the information landed.
Example language (illustrative): "The record shows patients weren't told what was being done, and many lost memories and skills. What's less clear is exactly when the experimental work began. Sources differ."
Watch for: Flooding. Information about a relative's suffering can trigger intense grief. It is working if the client feels more oriented and less at the mercy of rumours.

4.7 Working with memory loss and a fragmented life story

Purpose / when: With a survivor who has retrograde amnesia or lost skills, or with a family trying to piece together a relative's life. Retrograde amnesia and forgetting of children and work skills are documented [source: Canadian Encyclopedia].
Steps: (1) Name the memory loss as a documented injury, not a personal failing. (2) Work with records, letters, photographs and relatives' accounts to build an external narrative. (3) Grieve what is lost rather than trying to retrieve it. (4) Never use hypnosis, guided imagery or other memory-recovery techniques; they risk suggestion and false memory [synthesis; see the guide on recovered-memory therapy]. (5) Support practical compensations (diaries, routines) and route cognitive concerns medically.
Example language (illustrative): "We won't try to dig memories out. We'll put together what the records and your family can tell us, and make room for what's gone."
Watch for: Pressure from the client or family to "find out what really happened" through therapy. Redirect to records. It is working if the client can tell a coherent story that includes the gaps.

4.8 Supporting access to records

Purpose / when: When a survivor or descendant wants medical records. Records were withheld in the past, and in 1992 claimants without records were often refused [source: Canadian Encyclopedia].
Steps: (1) Explore what the client hopes the records will show and how they might react. (2) Point them to the institution's formal access-to-records route and to a lawyer or advocate for legal questions. (3) Plan support for the day they read the records: a session soon after, someone with them. (4) Process the contents together if they want.
Example language (illustrative): "Reading those files may stir a lot up. Would it help to plan when you'll open them and who'll be with you?"
Watch for: Records that are missing or contradict family memory, which can feel like being erased again. It is working if the client experiences the search as their own choice and the result, whatever it is, as bearable.

4.9 Supporting clients through compensation and litigation

Purpose / when: When a client is a claimant or potential class member in the 2025 Quebec class action, which covers former patients and their immediate family, successors and dependants [source: Canadian Press 2025], or is weighing a claim. NG116 says not to delay treatment because of court cases or compensation claims (1.3.2) [source: NICE NG116].
Steps: (1) Do not give legal advice; encourage the client to see a lawyer. (2) Discuss how the timing of therapy and proceedings might affect their decisions (NG116 1.3.2). (3) Prepare for the stress of testimony, cross-examination and delays. (4) Keep clinical notes factual, since they may be requested. (5) Discuss any confidentiality or non-disclosure terms only as they affect wellbeing; legal meaning is for the lawyer. Advocates have said such terms silence survivors [source: Canadian Encyclopedia].
Example language (illustrative): "I can't advise you on the case, but I can help you get through it. What part feels hardest right now?"
Watch for: A refused or partial award experienced as a fresh rejection. Families describe the process as reliving the trauma [source: CBC 2017]. It is working if the client keeps perspective on their worth apart from the legal outcome.

4.10 Family and intergenerational work

Purpose / when: With children and grandchildren of former patients. Families described relatives as more unstable after treatment, and families of patients who died before 1992 were excluded from that year's payments [source: Canadian Encyclopedia; CBC 2017]. NG116 asks clinicians to support and assess family members (1.4.3 to 1.4.5) [source: NICE NG116].
Steps: (1) Map how the parent's changed state shaped the family: caregiving, role reversal, fear, secrecy. (2) Explore inherited beliefs about doctors, illness and being controlled. (3) Offer joint sessions or family psychoeducation if wanted. (4) Make room for ambivalence towards a parent who was harmed and who may also have been hard to live with.
Example language (illustrative): "Growing up with a mother who came home changed would shape anyone. What did you have to take on as a child?"
Watch for: Guilt about anger towards an injured parent. It is working if the client can hold both compassion and their own losses.

4.11 Offering trauma-focused treatment where PTSD is present

Purpose / when: When assessment shows PTSD. NG116 recommends trauma-focused CBT (for example cognitive processing therapy, cognitive therapy for PTSD, narrative exposure therapy or prolonged exposure) and, for non-combat trauma after three months, EMDR (1.6.16 to 1.6.20) [source: NICE NG116].
Steps: (1) Explain the options and likely benefits and let the client choose (1.3.1). (2) Deliver only what you are trained and supervised in, using a validated manual (1.6.17); otherwise refer to an appropriately trained clinician. (3) Adapt for medical trauma: plan exposure-based work around reminders of hospitals and treatment with explicit consent, a clear rationale, a stop signal and pacing. (4) Plan for ending and booster sessions (1.6.17).
Example language (illustrative): "There are a few well-tested approaches. I'll go through what each involves and you can tell me which feels right, or whether you want to wait."
Watch for: Exposure work that feels like a repetition of being done to. Pace slowly, and keep agency with the client. It is working if distress on reminders falls and the client feels in charge of the process.

4.12 Adapting for complex needs

Purpose / when: For survivors and descendants with complex PTSD, dissociation, substance misuse, emotional dysregulation or unstable circumstances. NG116 advises more sessions or longer treatment to build trust, attention to housing and other circumstances, help with these barriers before or during trauma-focused work, and planned ongoing support (1.7.3) [source: NICE NG116].
Steps: (1) Agree a longer timeframe at the outset. (2) Work on stabilisation skills and practical stability first. (3) Do not exclude people only for substance misuse (1.7.2). (4) Plan support after therapy ends (1.7.3).
Example language (illustrative): "We don't need to rush to the hardest material. First we make sure things are steady enough for you."
Watch for: Stabilisation that never ends. Review the plan with the client. It is working if the client's daily life is steadier and they feel ready to choose next steps.

4.13 Reducing re-traumatising features of the setting

Purpose / when: Throughout care. NG116 advises avoiding triggers such as noisy or restrictive environments, including restraint (1.4.2) [source: NICE NG116].
Steps: (1) Ask what in clinical settings feels threatening: waiting rooms, beds, white coats, locked doors, recorded voices, headphones. (2) Adjust what you can: seating, door, lighting, no recording, telehealth if preferred. (3) Avoid audio-delivered homework (recorded relaxation or affirmation tracks) unless the client has chosen it knowing the alternatives [synthesis]. (4) Where hospital care is needed, help the client prepare and, with consent, tell the treating team about relevant sensitivities.
Example language (illustrative): "Some people find recorded voices or headphones unsettling. Would you rather we did any practice live, here, instead?"
Watch for: Hidden triggers that appear only as sudden withdrawal. It is working if the client reports feeling physically safer in the room.

4.14 Risk assessment and safety planning

Purpose / when: At assessment and whenever distress rises (court dates, anniversaries, media coverage). NG116 asks for a risk management and safety plan where there is significant risk to self or others (1.6.3) [source: NICE NG116].
Steps: (1) Ask directly about suicidal thoughts, intent and plans, using current standard practice. Do not discuss methods. (2) Develop a written safety plan with warning signs, coping steps, supportive people and crisis contacts. (3) Give crisis resources: 988 (US) and Samaritans 116 123 (UK and Ireland). In Canada, give local emergency and crisis services [synthesis]. (4) Where risk is acute, follow your service's emergency procedure. (5) Coordinate with the client's physician with consent.
Example language (illustrative): "When people carry this much, thoughts of not wanting to be alive can come up. Has that happened for you?"
Watch for: Hopelessness linked to failed claims or a relative's death before redress. It is working if the client can name their plan and would use it.

4.15 Working with a client preoccupied by "mind control" material

Purpose / when: When a client, survivor or not, is absorbed in MKUltra or "mind control" content, or believes they are being controlled now [synthesis].
Steps: (1) Acknowledge that MKUltra and its Montreal funding are documented [source: US Senate 1977 hearing; Torbay 2023]. (2) Explore what draws them to it: fear, a search for explanation, family history. (3) Help sort documented facts (with sources) from unverified claims, without ridicule. (4) Assess for psychotic symptoms with care, and do not treat belief in the documented history as a symptom. (5) Where psychosis is suspected, refer for psychiatric assessment and explain why.
Example language (illustrative): "Some of what you've read is on the public record, and some isn't. Shall we look at which is which, and what it means for you now?"
Watch for: Collusion on one side or dismissal on the other. It is working if the client's distress falls and they can tolerate uncertainty.

4.16 Working with a client drawn to "reprogramming" methods

Purpose / when: When a client seeks a method to "wipe" painful memories or "reprogram" themselves by repetition. The appeal of a quick fix is part of how historians explain psychic driving [source: Saunders 2016] [uncertain: secondary, unverified] [synthesis for the application].
Steps: (1) Explore the wish behind the request: relief, control, speed. (2) Explain, without lecturing, that the historical attempt to erase and rebuild a person caused lasting harm [source: Canadian Encyclopedia]. (3) Offer supported options for the underlying problem (for PTSD, see 4.11). (4) Decline to provide or endorse unproven memory-erasing products or programmes, and explain your reasons.
Example language (illustrative): "Wanting it all wiped away makes sense. The history of trying to erase people's memories is a painful one, though. Can we look at what would actually help with what hurts?"
Watch for: The client hearing refusal as rejection. It is working if they engage with a supported alternative.

4.17 Keeping roles clear in legal and public work

Purpose / when: When you are asked to write a report, give evidence or speak publicly for a client in proceedings or campaigns. Consider APA Ethics Code Standard 3.05 (Multiple Relationships) [source: APA Ethics Code]; other ethics points are [synthesis].
Steps: (1) Distinguish treating-clinician letters (facts of care, with consent) from independent expert evidence, which should normally come from someone else. (2) Discuss with the client what disclosure involves. (3) Get written consent for any release. (4) Seek ethics consultation when unsure.
Example language (illustrative): "I can confirm I'm seeing you and describe your treatment, with your consent. For an expert opinion on the case, it's better to have someone independent, so I can stay your therapist."
Watch for: Pressure to take on advocacy that changes the therapy. It is working if the therapeutic frame stays intact.

4.18 Duties when a colleague or institution uses coercive or unconsented methods

Purpose / when: If you learn that a colleague or service is using experimental, coercive or non-consensual methods, or anything aimed at erasing or reprogramming a person [synthesis].
Steps: (1) Do not take part, supervise or refer. (2) Make sure clients are safe, and use safeguarding procedures for children or adults at risk. (3) Raise the concern through your service's clinical governance or research ethics route; where research is involved, the ethics committee or institutional review board. (4) Report to the relevant professional regulator or licensing board as its published procedures require. (5) Keep a factual, dated record. (6) Get advice from your professional body's ethics service.
Example language (illustrative), to a manager: "I'm concerned this procedure is being used without informed consent. I can't take part, and I'm raising it formally through governance today."
Watch for: Being told the method is "research" and therefore acceptable. The Nuremberg Code requires voluntary consent and freedom to withdraw in research too [source: Nuremberg Code]. It is working if the practice stops and affected clients are offered support.

4.19 Research ethics in your own practice

Purpose / when: When you take part in research, audit or service evaluation, and when a survivor asks whether research is safe [source: Nuremberg Code; application is synthesis].
Steps: (1) Make sure any study has ethics approval and fully informed, voluntary consent. (2) Make clear that declining has no effect on care. (3) Do not invite survivors into studies without their explicit interest. (4) Disclose all funding sources to participants. Concealed sponsorship is central to the Montreal history [source: US Senate 1977 hearing; Torbay 2023].
Example language (illustrative): "There's a study running here. Whether you take part or not makes no difference to your care, and you can withdraw at any time."
Watch for: Subtle pressure through the therapeutic relationship. It is working if the client's decision is clearly free.

4.20 Advocacy, commemoration and planned follow-up

Purpose / when: When a client wants to testify, speak to media, join others affected, or mark a relative's history. Also at the end of therapy, since NG116 asks for planned ongoing support (1.7.3) [source: NICE NG116].
Steps: (1) Explore the hoped-for and feared effects of going public, including on family members who prefer privacy. (2) Help plan support around interviews or hearings. (3) Signpost survivor and family groups only as they present themselves, and check they are independent of any party to the litigation [synthesis]. (4) Agree a follow-up and relapse plan for anniversaries, rulings and media coverage.
Example language (illustrative): "Telling your family's story publicly could matter a lot to you. Let's think through what support you'll want before, during and after."
Watch for: Exhaustion or exposure after media contact. It is working if the client's public role feels chosen and sustainable.

5. Handling problems

The problems below are the psychotherapist's own synthesis [synthesis], except where NICE NG116 is cited.

Stuck: the client circles the history without moving. Name the pattern gently. Ask what going over the facts again does for them: protection, loyalty to a relative, unfinished grief. Shift from "what happened" to "what it did to us" (4.10), or to present-day goals. [synthesis]
Resistance rooted in distrust of the profession. Treat it as information (4.4). Invite criticism of you and of psychiatry. Offer more control (pace, topic, room, contact). NG116 asks for flexibility and follow-up of missed appointments (1.6.2) [source: NICE NG116].
Overwhelm when reading records, news or court documents. Stop the material and use grounding. Return to stabilisation (4.12), and agree a plan for how and when to look at such material again. Never push the client to read or hear details. [synthesis]
Non-adherence to between-session tasks. Check whether the task (especially anything audio-based or repetitive) echoes the history (4.13). Make tasks optional and co-designed. [synthesis]
Ruptures. These are likely when the client feels "done to": a change of plan without discussion, an unexplained referral, being recorded or discussed with others. Acknowledge it at once, take responsibility for your part, and restore choice (4.5). A repaired rupture can be part of the repair work itself. [synthesis]
The client asks you to confirm a family story that the records cannot settle. Say what is documented and what is not. Help them live with uncertainty, and do not supply certainty you do not have (4.6, 4.7). [synthesis]
Pressure to recover memories. Explain why you will not use memory-recovery techniques (risk of suggestion), and redirect to records and collateral accounts (4.7). [synthesis]
An older survivor with cognitive impairment. Assess capacity for each decision. Involve trusted family with consent, use simple and repeated explanations, and coordinate with the physician. Never proceed on assumed consent. [synthesis]
Family conflict over going public, suing or staying silent. Hold space for each member's position. Separate individual and family sessions if needed. Do not take sides on legal strategy. [synthesis]
Confidentiality or settlement terms that leave the client feeling silenced. Explore the emotional impact. Send legal questions to their lawyer. Help the client find what they can say and where (4.9). [source: Canadian Encyclopedia for advocates' concerns about such terms; responses are synthesis]
A rejected claim, or a relative who died before redress. Expect grief, anger and renewed hopelessness. Reassess risk (4.14) and give crisis resources: 988 (US), Samaritans 116 123 (UK and Ireland). [synthesis]
The client wants you to join their case or campaign. Keep the therapeutic role (4.17). Offer a factual treating-clinician letter with consent, and point them to independent experts. [source: APA Ethics Code Standard 3.05; rest synthesis]
Media coverage, anniversaries or court rulings trigger relapse. Plan ahead (4.20). Offer extra contact around known dates, and reassess need for further support when symptoms return (NG116 1.3.1) [source: NICE NG116].
Your own reactions as a member of the profession. Shame, defensiveness or an urge to rescue can distort the work. Use supervision. Acknowledge the profession's history without making the client look after your feelings. [synthesis]
Vicarious trauma. Limit your own exposure to graphic material, use supervision, and keep a balanced caseload. [synthesis]

Harm account

What was actually done

At the Allan Memorial Institute in Montreal, a McGill-affiliated psychiatric teaching hospital, its director D. Ewen Cameron ran an experimental programme from 1957 to 1964, possibly beginning as early as 1948 [source: Canadian Encyclopedia; Canadian Press 2025]. Patients were often admitted for conditions such as depression and anxiety. One family account describes a woman admitted in 1957 for postpartum depression [source: CBC 2017]. The programme combined "depatterning", which aimed to erase existing memories and patterns of behaviour, with "psychic driving", the prolonged replaying of recorded messages to sedated patients. The Canadian Encyclopedia, CBC and the 2025 class action also describe drug-induced sleep or coma, a hallucinogenic drug, intensive electroshock, sleep deprivation and sensory deprivation [source: Canadian Encyclopedia; CBC 2017; Canadian Press 2025]. Patients did not consent, families were not told key information and medical records were withheld [source: Canadian Encyclopedia]. From 1957 the CIA secretly part-funded the work as MKUltra Subproject 68, through the Society for the Investigation of Human Ecology. The Canadian government also funded Cameron [source: Torbay 2023; Canadian Encyclopedia; CBC 2017]. Historians debate whether Cameron knew the CIA was the source of the money. Torbay argues it is plausible he did not, and that his work was already heading this way before the funding [source: Torbay 2023]. At the 1977 Senate hearing the CIA Director called using people as "guinea pigs" "totally abhorrent" [source: US Senate 1977 hearing].

What it looked like to patients and families. Patients were kept in drug-induced sleep or coma, sometimes far longer than planned and in one reported case for weeks on end; they were heavily sedated and immobilised [source: Canadian Encyclopedia]. In psychic driving, recorded messages were played to them on a loop for many hours a day and repeated an enormous number of times, some aimed at a supposed flaw in their personality and others meant to be positive [source: Canadian Encyclopedia]. Some were given electroshock far more intensely and more often than was normal practice, some were given LSD and other psychotropic drugs, and some were placed in surroundings designed to dull sight, hearing and smell, with food and water sometimes restricted [source: Canadian Encyclopedia]. Patients came out unable to stand or walk, some incontinent, many with retrograde amnesia; one woman could not recall up to two years of her life, and families were not told that the treatment was experimental [source: Canadian Encyclopedia]. Warning signs in a family history: a relative admitted to the Allan Memorial in the 1950s or early 1960s for depression, anxiety or postpartum illness who came home with large gaps in memory, unable to manage everyday skills, and with records that the family could not obtain [synthesis].

How it caused harm

The Canadian Encyclopedia reports that patients were often left helpless, some unable to stand or walk and some incontinent. Many had retrograde amnesia, losing memories and skills from before treatment; some forgot their children or how to run their businesses. Families often found their relatives more emotionally unstable than before [source: Canadian Encyclopedia]. A CBC family account describes a woman who came home unable to concentrate on reading or writing, jumpy and angry [source: CBC 2017]. The Canadian Encyclopedia describes the experiments as a breach of the Nuremberg Code, whose first principle requires voluntary consent [source: Canadian Encyclopedia; Nuremberg Code]. Harm continued through the redress process. In 1992 more than 250 claimants were refused because they could not produce records, filed late, or were judged not to have been sufficiently "de-patterned", and families of patients who died before 1992 were excluded [source: Canadian Encyclopedia; CBC 2017]. Some later settlements reportedly carried confidentiality terms that advocates say silence survivors [source: Canadian Encyclopedia]. According to the Canadian Encyclopedia, neither the CIA nor the Canadian government has apologised to the patients [source: Canadian Encyclopedia]. That source also reports a 1984 US apology to Canada as a state, so the two statements refer to different things [uncertain: current position not verified].

Recognising it today

Direct survivors. Former patients of the Allan Memorial between about 1948 and 1964 are now elderly or deceased [synthesis]. Signs include lifelong memory gaps, lost skills, fear of hospitals and doctors, and reactions to recorded voices or treatment settings [synthesis, drawing on Canadian Encyclopedia and CBC 2017].
Descendants. Children and grandchildren describe a parent who "came back different", family secrecy, caregiving in childhood, and anger at institutions. Many are involved in, or weighing, the 2025 class action [source: CBC 2017; Canadian Press 2025].
Echoes in present-day practice [synthesis]. Warning signs in any service are: treatment without fully informed, voluntary consent; concealed funding or sponsors; claims to "erase" and "rebuild" personality or memory; methods based on repetition and that call themselves therapy, without evidence; withholding records from patients; and institutions that dismiss complaints by defending the founder's reputation, as Allan Memorial directors did in the mid-1980s [source for the last point: Canadian Encyclopedia].

What to do instead and how to help those harmed

Supported care. For PTSD and complex PTSD, use the treatments NICE NG116 recommends: trauma-focused CBT and EMDR, with extra time and stabilisation for complex needs, choice, family support and safety planning [source: NICE NG116]. For the underlying conditions patients were admitted with (depression, anxiety, postpartum illness, psychosis), refer to evidence-based, consented care through the client's physician or a mental health service [synthesis]. Never advise starting, stopping or changing a medicine.
Survivor and family support. Use the interventions in section 4: trauma-informed assessment, consent-centred work, records support, family and intergenerational work, and planned follow-up [synthesis].
Legal routes. A Quebec Superior Court class action against the Royal Victoria Hospital, McGill University and the Government of Canada was authorised on 31 July 2025. It covers patients who underwent the experiments and their immediate family, successors and dependants [source: Canadian Press 2025]. Its current status may have changed [uncertain]. Clients should get independent legal advice. In the US, compensation was paid in 1988 after a lawsuit; accounts differ on whether this covered nine survivors or one [source: Canadian Encyclopedia; CBC 2017] [uncertain: sources differ].
Reporting duties. If a current service uses non-consensual or experimental methods, follow 4.18: governance, research ethics committee, regulator and safeguarding [synthesis].
Survivor organisations. No dedicated survivor organisation is known [uncertain]. Check that any group a client approaches presents itself openly and is independent of parties to the litigation [synthesis].
Crisis resources. 988 (US); Samaritans 116 123 (UK and Ireland); local emergency services elsewhere, including Canada.

Sources

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