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and the Treatment of Personality Change
in Victims of Captivity and Cults

Part 1 of 3

From Dissociation: Clinical and Theoretical Perspectives. Lynn, SJ and Rhue JW, eds. ©1994 The Guilford Press. Reprinted with permission.
Louis Jolyon West
Paul R. Martin

Dissociative phenomena are not necessarily symptomatic of illness, and probably represent a continuum beginning with normal psycho-biological modulation of information -- incoming, stored, and outgoing -- by the brain (West, 1967). In recent years there has been a sharp increase of interest in dissociative phenomena accompanying psychiatric disorders, especially multiple personality and related disorders of identity, including states of possession (Bliss, 1986; Kluft, 1991; Suryani & Jensen, 1993). Dissociative symptoms also are important in many other types of psychopathology, and commonly accompany a range of psychiatric disorder from schizophrenic illnesses to severe stress reactions. Still, the distortion or alteration of a person's identity and the appearance of a new and different persona remains one of the most interesting manifestations of dissociation.

Prolonged environmental stress, or life situations profoundly different from the usual, can disrupt the normally integrative functions of personality. Individuals subjected to such forces may adapt through dissociation by generating an altered persona, or pseudo-identity (West, 1994). Such a pseudo-identity enables the subject better to cope with the extraordinary situation in which he finds himself, regardless of how he got there.1 Parents and others close to individuals who have become members of totalist cults are often astonished at such changes, saying "He has become a different person." This article is based on observations of such changelings from a clinical point of view.

Conditions of brutal captivity, such as those experienced by prisoners of war (POWs) or civilian victims of hostage taking, in which the captor seeks to force a false confession or induce compliant behavior, can generate a type of post-traumatic stress disorder (PTSD) in which dissociative features are prominent. During the Korean war, the relative success of the Chinese communists in eliciting false confessions of war crimes (e.g., germ warfare), self-denunciations, and participation in propaganda activities was in large measure achieved because of the captors' absolute control over the environment of the prisoners. To achieve this control, the communists contrived a variety of stressors, which produced in their captives a state of debility, dependency, and chronic apprehension or dread (Farber, Harlow, & West, 1957; West, 1964).

Civilian prisoners were also subjected to prolonged manipulation by their Chinese communist captors to produce altered political convictions, as described in Lifton's discussion of thought reform (Lifton, 1961). As with the Korean War POWs, these civilian victims were subjected to prolonged stress in situations from which, at least for a time, there was no escape. Necessarily, they became dependent upon their captors for various physical and psychological needs. In response to these conditions their personalities begin to change in many cases. O'Neil and Demos (1977) have likened the first step in the thought reform process to the creation of an identity crisis. In our view, it is during such a crisis that a new pseudo-identity may begin to emerge. Once formed, it is likely to endure, and gradually grow stronger and better defined, as long as the demand characteristics of the situation require it.

Long before the term "Stockholm syndrome" was coined (see below), difficult-to-explain feelings of sympathy and even identification with one's captors were recounted by former prisoners. One of these was Hungary's late Cardinal Mindszenty, who was arrested, tried, and imprisoned from 1948 until the 1956 uprising in Budapest. In his memoirs (1974), Mindszenty wrote that within 2 weeks of his arrest, under constant coercive interrogation he found himself thinking along different lines from before and seeing things from his captors' point of view. His judgment, reasoning, and sense of self became distorted. He wrote: "Without knowing what had happened to me, I had become a different person" (p. 114).

Patricia Hearst was violently abducted by members of the Symbionese Liberation Army in February of 1974, brutalized, raped, tortured, and forced to participate in illegal acts beginning with the bank robbery for which she was later (in our view wrongly) convicted. The traumatic kidnapping and subsequent 2 months of torture produced in her a state of emotional regression and fearful compliance with the demands and expectations of her captors. This was quickly followed by the coerced transformation of Patty into Tania and subsequently (less well known to the public) into Pearl, after additional trauma over a period of many months (Hearst & Moscow, 1988; The Trial of Patty Hearst, 1976). Tania was merely a role coerced on pain of death; it was Pearl who later represented the pseudo-identity which was found on psychiatric examination by one of us (West) shortly after Hearst's arrest by the FBI. Chronic symptoms of PTSD were also prominent in this case.

The term "Stockholm syndrome" was coined to describe a certain psychological phenomenon in hostages following a 1974 bank holdup in Sweden. Four employees were held captive by two robbers for 5-1/2 days. During the ordeal, some hostages became sympathetic toward the robbers. In fact, one female hostage swiftly and unaccountably fell in love with one of her captors and then publicly berated the Swedish prime minister for his failure to understand the criminal's point of view. For a limited period of time after her release, the former hostage continued to express affection for her captor(Ochberg, 1978).

Other hostages have also developed sympathy for or identified with their captors. For example, in 1975, during the 13-day seizure of a Dutch train by South Moluccan gunmen demanding freedom for their islands in the Malay archipelago, despite the executions of 2 hostages, some of the surviving captives rapidly developed feelings of affection or sympathy for their murderous captors, along with attitudes of distrust toward the legitimate Dutch authorities. A psychiatrist might better define this phenomenon using the more psychodynamically descriptive phrase: "identification with the aggressor" (coined for a different purpose during World War II by Anna Freud). If this process is sufficiently profound and prolonged, in our view the accompanying personality change may best be understood in terms of pseudo-identity as explicated below.

Identification with the aggressor has been analyzed in relation to a variety of psychiatrically important situations, ranging from imprisonment in Nazi concentration camps, where doomed prisoners sometimes sought out discarded insignias and other shreds of SS uniforms with which to adorn their rags, to the battered children who grow up to become child-battering parents. However, some cases do not involve prisoners or captives. For example, Solomon Perel, the subject of a recent film (Europa, Europa [Holland, Menegoz, & Brauner, 1911), was a German Jewish boy who assumed a non-Jewish identity in order to cope with the life-threatening conditions of the time. He transformed himself into Joseph ("Jupp") under extremely stressful circumstances.

Knowing that Jews would be killed, he got rid of all documents identifying him as a Jew and, in the chaos of war, said, "I am a patriotic German." He even served in the German army. Gradually, however, the teenager's role became a new identity because of the demand characteristics of his situation. For years after the war, following his emigration to Israel, Perel experienced moments when he had to ascertain whether it was Sol or Jupp who was answering a question (Williams, 1992). Like the incomprehensibly compliant Jozsef Cardinal Mindszenty and the abnormally passive Patricia/Tania/Pearl/Hearst, under stress, Solomon Perel's identity had changed. The new pseudo-identity, initially formed as a role played in response to stressful circumstances, was a different personality of sorts. This personality was superimposed upon the original which, while not completely forgotten, was enveloped within the shell of the pseudo-identity.

Through the exercise of psychosocial forces more subtle than those described above, people can be deliberately manipulated, influenced, and controlled to a considerable degree, and induced to express beliefs and exhibit behaviors far different from what their lives up to then would have logically or reasonably predicted. While the thought reform program of the Chinese communists to convert people to "right thinking" was hardly subtle, the indoctrination techniques applied to new recruits by contemporary totalist cults can be very subtle indeed (West, 1989, 1993). Subjects are forced to communicate verbally and continuously, in a strictly controlled fashion. Most of these cults rely also on the effects of structured group dynamics, environmental manipulation and control, the relationship of dominant leaders to dependent members, the relative initial isolation of recruits from previous ideas or relationships, and the evolution of a new identity with constant group pressures to bring errant individuals into line.

A totalist cult is defined as follows: "Cult (totalist type): a group or movement exhibiting a great or excessive devotion or dedication to some person, idea, or thing, and employing unethical, manipulative or coercive techniques of persuasion and control (e.g., isolation from former friends and family, debilitation, use of special methods to heighten suggestibility and subservience, powerful group pressure, information management, promotion of total dependency on the group and fear of leaving it, suspension of individuality and critical judgment, and so on, designed to advance the goals of the group's leaders, to the possible or actual detriment of members, their families, or the community." The basis for this definition, and a general discussion of the cult problem, is given elsewhere (West, 1983). Among various totalist cults, there may be some differences as to how intense the persuasive activities are, and in the degree to which recruits can be separated from their previous social networks. Even though he may have been attracted to the cult by elaborate and deceptive recruiting techniques, the neophyte cultist enters it "voluntarily." With rare exceptions, nobody puts a gun to his head. Yet, successful indoctrination of a cult member often includes many elements similar to the political indoctrination by such groups as the Chinese communists, which Schein (1961) described as coercive persuasion. In cults, as in the Chinese "brainwashing," "thought reform," or "coercive persuasion," people are often encouraged to criticize themselves in small-group confessionals as a means of strengthening their dependence on the group. As the process continues, members are systematically trained to relinquish independent action and thought, since only obedient behaviors and passive attitudes are rewarded, while resistance or self-assertion is punished.

Even groups that have derived from respectable religious sects (such as the Lundgren cult, a splinter or a sect of the LDS, see below) or that have evolved from therapeutic communities such as Synanon, can evolve into totalist cults if the autonomy of the members is progressively diminished, while the concentration of power in the leadership grows more and more absolute. Under these conditions usually the emphasis shifts from the members' well-being to their manipulation and exploitation. In this way, it is easy to understand how the followers of Jim Jones (People's Temple), L. Ron Hubbard (Church of Scientology), Sun Myung Moon (Unification Church), Moses David (Children of God), Elizabeth Clare Prophet (Church Universal and Triumphant), Rajneesh, and others are successfully influenced to become "different people."

Lifton (1961) describes how certain Chinese citizens and Westerners, having undergone the stressful process of" thought reform" and apparently changed their political beliefs, upon liberation continued to parrot the programmed Maoist cliches for a time until, in the new and free environment, those beliefs and the attendant formulae began to crumble away, leaving each bewildered survivor with an acute identity problem. Lifton characterizes this process as resembling death and rebirth. Former members of religious cults, or veterans of mass-marketed group therapies and self-help techniques, have called abrupt forms of such transformation "snapping" (Conway & Siegelman, 1978). This corresponds to the observations of many former cult victims, who have undergone "deprogramming" and, as a result, abruptly reverted from their cult-induced pseudo-identity to something resembling their previous or original personality. Indeed, "snapping" seems like an appropriate term when the victim, having been coerced or manipulated into his strange pseudo-identity, eventually "snaps out of it." He is again his old self, but with some serious new problems as a result of the cult-related experience and the trauma involved in relation to it. Furthermore, years may have passed since the original identity was functioning normally; meanwhile the world has become a different place.

The term pseudo-identity has only been used twice previously in the scientific literature. In 1974, Glatzel used it to describe a delusional alteration of self in cases of major depression involving cyclothymic illness (Glatzel, 1974). To the best of our knowledge this usage has not since been repeated. More recently, Girodo (1985) employed the term when describing problems experienced by certain undercover narcotics agents who, after prolonged role playing, found it difficult to discontinue assumed behaviors when an operation was finished. Employed only once or twice in Girodo's article, the term was used casually to convey the sense of a long assumed role, not a dissociative disorder, and was limited to the highly specialized circumstances of undercover work. In fact, Girodo minimized the possibility of dissociative reactions in the subjects he studied. However, careful review of his clinical material suggests that some cases of pseudo-identity in our sense may indeed have occurred in certain cases, studied by Girodo, of law-enforcement officers who were required to play the part of criminals for months or even years. In our view some of these officers showed symptoms of PTSD as well.

Through hypnotic suggestion, it may be possible to create temporary distortions of values, viewpoints, or perceptions of reality, which are sufficient to induce in some subjects behaviors that would be otherwise unacceptable to them. Certain hypnotists (e.g., the late Harold Rosen and Milton Erickson) specialize in hypnotic induction that does not involve trance induction or the exercise of traditional techniques such as eye closure. Clinical literature is also replete with examples of increased suggestibility or controllability of individuals during altered states of consciousness, such as those induced by psychotropic substances, environmental manipulation, sensory isolation, powerful emotions elicited by group dynamics (especially in large groups), religious ceremonies, and other special circumstances. Latah is a special case in that hyper-suggestibility usually occurs as the consequence of the subject being taken by surprise through a harmless maneuver (e.g., an abrupt noise, tickling, etc.) (Suryani & Jensen, 1993).

Pseudo-identity is more than a temporary role assumed by a subject in a laboratory exercise or during a transient period of intoxication. It is more like an "alter" in a case of multiple personality disorder (MPD). However, pseudo-identity differs from the alter of MPD in the following important respects:

1. Pathogenesis. MPD is most likely a consequence of early childhood trauma, with symptoms appearing later in life as a result of inner conflicts interacting with experiential circumstances. A pseudo-identity is usually generated by external stress originating in the environment of a person who may have been previously quite free of any signs or symptoms of personality malfunction, and for whom the new persona represents a transformation required to meet the demand characteristics of a life situation markedly different from the person's previous one.

2. Psychopathology. The MPD patient may have more than one alter; in the case of pseudo-identity, the personality change, whether swift or gradual, usually involves the generation of a single different personality. In pseudo-identity, under certain conditions there may be abrupt switching back and forth between behaviors characteristic of the two separate personalities (a phenomenon sometimes referred to as "floating"), but without MPD's typical boundaries between the two personalities, and without the MPD patient's sense that one self is separate from the other one. In MPD, the different alters or personalities primarily reflect facets of the original character. In pseudo-identity, the new personality primarily reflects the new situational forces and requirements. In MPD, the original identity is usually unconscious of the existence of the alters as they emerge and submerge. In pseudo-identity, the original persona remains but is overlaid or enveloped by the new identity.

3. Prognosis. MPD is notoriously difficult to treat (Braun, 1986; Kluft, 1984b). The outlook is generally better for the patient with pseudo-identity, although the syndrome may become chronic like any dissociative disorder or (in the old terminology) monosymptomatic major hysteria. Sometimes merely returning the patient to his original life situation (or even a neutral environment where information is freely and honestly exchanged and nonexploitive people are available for support) will, in a few weeks, result in the abrupt ("snapping") or gradual disappearance of the pseudo-identity. However, the patient then faces resuming many long-neglected functions of his former personhood, and working through the complex emotional aftermath of having -- for whatever period of time and to whatever degree -- become a different person.

4. Treatment. Therapy of both syndromes requires appreciation of the mental mechanisms involved, the reality of traumata or stress -- however subtle -- in pathogenesis, and the technical maneuvers known to be useful in management of dissociative disorders. While in the psychotherapy of MPD the usual goal is primarily the reconciliation and integration of the alters into a new and healthier whole, the goal in therapy of the patient with pseudo-identity is restoration of the original identity. However, the patient then usually requires treatment for the residual PTSD which is the legacy of the stress that produced and maintained the pseudo-identity syndrome. Cases of pseudo-identity observed among cult victims are often very clear-cut, classic examples of transformation through deliberately contrived situational forces of a normal individual's personality into that of "a different person." (Others are colored by certain prominent additional symptoms into types that have been described as "floaters," "contemplators," and "survivors," see below.) The following brief case description illustrates a more or less classical case of pseudo-identity in a small totalist cult.

Danny Kraft grew up in a small town in the midwest. Testimony from over 60 family members, friends, and former teachers indicated that Danny was a fairly normal young man. He appeared to be well adjusted, sociable, performed well in school, had many friends, and showed no signs of anti-social behavior. There was no evidence that Danny suffered from any mental or personality disorder. His parents were divorced, and he sometimes appeared to experience conflicted loyalties between his father and mother, but not inappropriately so.

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