Mental-Health Issues in Cult-Related Interventions
ICSA Today, Volume 6, Number 2, 2015, pages 2-7
Mental-Health Issues in Cult-Related Interventions
We present in this issue selected conference papers that articulate key topics participants discussed during an important one-day ICSA conference on the subject of mental-health issues in cult-related interventions. Every talk at this conference was significant and exciting for speakers and audience alike.1 Some participants submitted written papers. We have selected those papers that adhere to ICSA Today space requirements and most clearly reflect the issues discussed at the conference. We thank all the participants for their important contributions. —Editors
By J. Paul Lennon
On October 13, 2013, ICSA brought together cult-intervention specialists and mental-health professionals for a landmark event at the Sheraton Philadelphia [PA] University City Hotel. The purpose was to discuss the roles of these individuals in helping members and former members of cultic groups and their families.
As the event chair, ICSA President Steve Eichel, noted, this was the first time that intervention specialists (sometimes called exit counselors) and mental-health professionals had sat down together and discussed their different approaches to helping cultic-group members and their families.
The questions for the conference were
What assessment criteria should be considered to determine the appropriateness and feasibility of cult-related interventions?
What criteria should be considered to determine the appropriateness of mental-health consultation and/or treatment?
Attendees at the event were former members of high-control groups or relationships, families concerned about an affected loved one, and helping professionals whose assistance families and former members sometimes seek. Speakers included some of the leading intervention specialists, mental-health professionals, and authors in this field: David Clark; Steve K. D. Eichel, PhD, ABPP; Lorna Goldberg, MSW, LCSW, PsyA; William Goldberg, MSW, LCSW, PsyA; Steven Hassan, MEd, LMHC, NCC; Joseph Kelly; Arnold Markowitz, LCSW; Patrick Ryan; Daniel Shaw, LCSW; and Joseph Szimhart. You will find biographical sketches of all these presenters on ICSA’s people-profiles page (www.icsahome.com/elibrary/peopleprofiles).
The mental-health professionals spoke first, followed by brief discussion with the audience; then the intervention specialists spoke, followed by another audience discussion. Each group discovered some consensus, explaining where they saw the extension and limits of their work, and how they frequently referred clients to those who had more expertise at the other end of the spectrum of clients’ needs.
In the third part of the program, both sets of professionals formed a roundtable and a general discussion ensued, revealing and fleshing out the complementariness between interventionists and therapists. The fourth stage of the program offered the audience an array of experts available to answer questions. Final remarks summarized the historic nature of this meeting and the satisfaction both sets of professionals felt. As the program drew to a close, members of the audience sought out their favorite expert for one-on-one help, more specific information, and that often-vital networking.
We publish here the presentations by intervention specialist Joseph Szimhart and mental-health professionals William Goldberg and Daniel Shaw.
The Intervention Specialist’s Approach
By Joseph Szimhart
This presentation is about an intervention case with someone who was not a member of a cultic group, but whose experience and issues illustrate those that former members and their families face. The case is a useful example of why a cult interventionist should have not only a solid grasp and definition of harmful cult behavior, but also an adequate grasp of mental disorders and how to recognize and treat them.
My flexible model of a harmful cult has four basic elements:
Transpersonal attraction. Attractive devotional systems are easy to get into but may be hard to leave. New recruits tend to say things like I was filled with the Holy Spirit for days; I knew then that I found the truth; I feel these are the most spiritual people I ever met; I felt like I was transported to another world; or it just felt right and I wanted to know more. A transpersonal attraction is simply something that draws you to grow beyond your limits, to become transcendent.
Exclusive leadership. After the ecstasy or deep insight, a new recruit invariably turns to the environment in which the experience happened for support, explanation, and direction. Followers point to the leader as the ultimate guide, but a subleader, personal spiritual friend, or “discipler” might be the immediate teacher. A special relationship develops. No one outside the group is good enough or as reliable. Elitism filters into the recruit’s attitude, which includes rejection of any challenges to the leader or the devotional system.
Circular tension. An orbit of devotion sets in. The recruit feels momentum at first, as if making progress, but soon finds limits. Progress levels out. The recruit falls in line. Challenges to leadership or questions about the group cause tension, and to avoid tension, the recruit stays in place, orbiting the foundation myth and following the leader’s suggestions by sustaining daily rituals and continuing to sustain self-control in behavioral, intellectual, emotional, financial, and physical ways.
Exit perils. Anything outside the elite group milieu is tainted, contaminated, ignorant, dangerous, or evil. Any member who defects will encounter “exit costs,” which could be loss of personal salvation or the best chance to serve humanity. A defector risks becoming one of the lost and might be shunned. The transcendent protection from disease, insanity, corruption, failure, or evil will cease. Material investments and community support may be lost, but the worst peril lies in facing the anxious struggle to rediscover identity.
This 1991 case involved a 22-year-old woman whom I will call Connie. She flew home in a psychotic state to Nebraska from a Native American festival in Arizona. A concerned festival attendee alerted Connie’s mother that he and others had put Connie on a plane. A flight attendant sat with Connie the entire way. By the time Connie got home, she withdrew into her bedroom and remained there for 2 weeks, saying and eating little, not seeming to care.
Her mother teased out that Connie believed she was inhabited by someone called Lily, and that this entity or spirit was the same spirit introduced by the popular New Age author, Ruth Montgomery, especially in her 1986 memoir, Herald of the New Age. Connie’s mother was deeply concerned because Connie had no history of a mental breakdown before the festival. The mother listed many books in Connie’s room that revealed her deep interest in New Age pursuits, especially books by Carlos Castaneda, Ruth Montgomery, Edgar Cayce, Paramahansa Yogananda, José Arguélles, Alice A. Bailey, and the psychic healer Barbara Brennan—with all of which I was familiar.
Days before contacting me, Connie’s mother, an evangelical Christian, wondered whether a demon had taken over her daughter. Her local minister interviewed Connie. He concluded it was probably a cult or mental disturbance and suggested psychological evaluation and therapy. Connie adamantly refused to see a mental-health professional, insisting, “I am not crazy.” She did not meet criteria for involuntary commitment.
Connie’s mother was referred to me through a local cult-awareness worker. I agreed to meet with Connie, knowing that we had no evidence that this was a typical cult case: There was no identified group or leader, no devotional behavior, no hard exit costs, and only a personal obsession with some New Age authors. My intervention goals would be to help evaluate her mental status, diffuse her dependence on delusional New Age ideas, and encourage her to seek treatment.
Connie had one younger brother, age 20, who would be of some help introducing me. Connie’s father was an alcoholic who had never sought treatment. The mother would be my main support throughout the intervention. I met with the father in the living area before I met Connie, and before he started drinking that day. He was a pleasant man but clearly insecure. He readily agreed that his presence would be counterproductive.
When I first met Connie in the family kitchen, she appeared visibly depressed with a flat affect—her eye contact was poor and she appeared distracted. She showed some emotion when I told her I had a degree in fine arts and that I was a practicing artist. One of the things I did during the first few hours with her, at her request, was to quickly sketch her image in pencil. She liked it and probably has it to this day. She also began trusting my familiarity with the spiritual books she read. I was not critical of anything at this initial stage.
Connie told me that she had attended the powwow as a way to transformation after she had read a book by Carlos Castaneda. Soon after arrival, she fell in with a friendly group that invited her to a drumming and chanting circle. During a climactic bonfire event on the third day, she danced with others around the fire. When she told some of them she felt she could be one with the flames, they grew concerned. One man had to physically stop her from jumping into the flames, she recalled. She began talking excitedly, making little sense, and alarming the friends she met there, the same ones who urged her to go home and get help.
I met with Connie and her mother for 6 hours that first day. We took things slowly because Connie was clearly struggling to stay focused. She retired to her bedroom early in the evening. I discussed her situation with her mother and brother.
The second day, Connie said she slept well. She was more attentive, and the flat affect had diminished. At her mother’s request, I gave a brief rundown of what a cult is. Connie was curious. We watched two short videos on the topic.
Connie remained protective of her New Age authors and what they taught. I needed something to challenge her, and she gave me an opening. When we discussed her alter personality that she described as a “walk-in” named Lily, Connie kept referring to Lily as a female. Connie said it was the same guide who Ruth Montgomery (1912–2001) used. Montgomery was an established political columnist and journalist in Washington before she turned to her incredibly successful psychic career. Many considered her the “First Lady of the Psychic World.”
I came prepared with two of Montgomery's books. Herald of the New Age, an autobiographical book by Ruth Montgomery (1986), mentions the author’s encounter with the Lily spirit. Following the advice of psychic Arthur Ford in 1955, Montgomery had experimented with automatic writing, a form of free association with marks and words on paper until coherent messages appear during a trance.2,3 Lily, another guide called Art, and a third called The Group first appeared to Ruth during her experiments with automatic writing. With Connie’s permission, I read on page 104 (Fawcett edition, 1986):
The following morning the pencil began, haltingly at first and then with vigor, to write messages from Ruth’s father. Next came funny little drawings of children that were signed with a flourish by a long-dead aunt, and finally the introduction of an entity calling himself “Lily,” who announced that he would now take over the regular sessions as her spirit mentor. (bold added)
“Lily,” I pointed out, “is male.”
Connie looked confused, so I pressed my point forcefully. I stood up, showed her the passage, and raised my voice. “Connie, do you realize that what you so strongly believed in is not true? How could you mistake a male for a female?”
Connie got the message that after all these years either her Lily was lying to her or there was no Lily. The realization disturbed her enough to wonder if she had been deceiving herself. What about the rest of what she believed? Now she was open to expand the discussion.
I pulled out Aliens Among Us, another one of Montgomery’s books from 1986. In that book, Montgomery writes an entire chapter heartily endorsing Frederick Von Meiers, a former male model and social climber from Brooklyn, as a legitimate New Age guru and a true “walk-in.” I showed Connie a tape of a television talk show that featured Von Meiers and members of his cult Eternal Values. Von Meiers, who was HIV positive and promiscuous, had infected many male and female students with the virus. He also charged enormous amounts of money for magically powered gemstones in rings that he sold to wealthy but naïve members. This video discredited Von Meiers and therefore Montgomery totally in Connie’s eyes. She listened more intently as I methodically discredited most of the authors she had so ardently believed. By the end of that day, her Lily identity had left her completely.
Connie was still not agreeable to see a psychiatrist, and we suspected she might not need one, although she yet seemed fragile. She opted to go to Wellspring in Ohio, a retreat and rehabilitation center that had recently expanded its services to non-Christian cult victims. The three or four other clients there at the time were former members of Bible-based cults. Connie liked the place and people at first, but she had a dramatic relapse when a number of former members and perhaps an evangelical staff member got permission from Connie to pray over her in a group to remove demonic influences. This magical Christian behavior sent her over the edge into a near psychotic break again. When she got home, she called me and agreed with me and her mother to see a psychiatrist.
Connie was diagnosed with bipolar disorder and placed on lithium. She responded well.
I heard from Connie again a year later. She sounded wonderful, like a new person. She had completed her courses for a master’s degree to be a speech therapist. She remained on medication, indicating that her struggle with bipolar disorder was not over.
How the Psychotherapist Approach Differs From Intervention
By William Goldberg
The major difference between my approach to the cult issue and that of intervention specialists, or exit counselors, is the type of help we each offer. Exit counselors’ expertise is in helping the cult members recognize the techniques that were used to get them to join and maintain membership in the cult. My expertise is more likely to come into play after cult members have left the cult, when they’re struggling with understanding how they were manipulated, or how to resolve the issues that they may have been struggling with before they joined the cult.
In working with families, exit counselors will be able to articulate the worldview of the cult to the family and to explain changes the family has observed through that lens. I am more likely to highlight other factors such as stage-of-life issues, dependency issues, the individual’s struggle for autonomy, and so on.
I probably take a more thorough history from the family than exit counselors do. Indeed, the family does most of the talking for the first hour when I’m with them. I ask the family how the cult member has responded to losses in the past, whether he has been able to acknowledge when he is wrong, who in the family and outside the family he is more likely to respect and confide in. I ask about the cult member’s relationship with every family member as a means of assessing who may be helpful either in trying to get the cult member to speak to an exit counselor or during an exit counseling.
I ask about the quality of the cult member’s friendships, drug and alcohol use, and whether he was sexually active. Not all the symptoms displayed by a cult member spring from membership in the cult or from cult membership alone. The reason I take a history of precult behavior is so that I can distinguish between cult-related symptoms and psychopathology.
I am more likely to focus on the dynamics of the family, how they approach problem solving, and how they can be mobilized to help their family member reconsider the situation that he is in. For example, who in the family does the most talking? Do some members defer to others? What happens when they disagree about the answer to something I’ve asked? How does the family resolve these issues? These factors help me to advise them about their strategy in dealing with the situation.
I am more likely to emphasize issues that may not be foremost in the minds of exit counselors, such as reminding parents that they must not neglect the emotional needs of their other children. Also, I’m better able to speak about mental-health care and other issue after the individual has left the cult.
I see my main role as helping the family determine what their next step is. I may focus on helping them to mobilize themselves if they seem depressed and frightened, or I may suggest that they more thoroughly assess the situation if they’ve reached a conclusion about what they should do without having explored all the options.
I tell them what their alternatives are—for example, watchful waiting, setting a date for further evaluation, consulting an exit counselor, speaking to the cult member himself, or asking a trusted nonfamily member to do so. I discuss the pros and cons of each approach based on this particular family’s situation.
If there is a difference of opinion between parents regarding how they should deal with the situation, I try to help them to clarify their reasoning, and I try to suggest compromises that take into account both parents’ positions. Medical/psychiatric consultation is warranted if there is a history of severe psychopathology, drug abuse, suicidal ideation, or suicidal gestures or attempts in the past.
If the family is anxious about what the next step may be after the individual has left the cult, I discuss alternatives. Sometimes parents are not aware of the residential aftercare programs that are available to former cult members. I may suggest that therapy for the former cult member is an alternative to consider, but that they should first focus on getting him out of the cult, then see how he is progressing. It’s not the parents’ responsibility to lay out the rest of his life.
I have worked with families in a conflict-resolution mode, in which I mediated between the family and the cult member. My goal in these meetings has been to help the family members and the cult member to articulate their concerns to each other and to help each hear what the other is saying without prejudgments. I attempt in these meetings to facilitate communication so that there is a clearer understanding of what the participants’ concerns are and how they see the issues. I encourage the family to articulate the warning signs or unacceptable changes they see in the cult member so that these concerns are brought to the consciousness of the cult member. I ask the family to articulate behavior that would allay their concerns (e.g., continuing the cult member’s education). I ask the cult member to tell the family what circumstances or revelations could theoretically lead him to reconsider his membership in the group. I always end with a recommendation that the family members continue their dialogue, even if they disagree, and I invite the participants to call me for individual, confidential consultations if they would like to do so.
Results of these meetings for the cult members have usually been positive. They appreciate the fact that I am not ostensibly judging their decisions, and they see me as someone who wants to help them to find a way for their family to accept their present lifestyle choices. Remember that I am seeing a population of cult members who still care what their family thinks about them and their membership in the group; otherwise, they would not agree to meet with me.
From the point of view of the family, these meetings are rarely successful. Despite the fact that I tell the family not to expect that the meeting will result in the cult member’s leaving the cult, they always hope and expect that it will do so. The family’s anger toward the cult member (and, perhaps, toward me) is re-ignited. I am still exploring how best to prepare the family for this outcome.
A Psychoanalytic Perspective
By Daniel Shaw
I am a psychoanalytically trained psychotherapist, and I am also a former cult member. The beginning of my training as a psychotherapist coincided, 20 years ago now, with my final break with the cult in which I had been a full-time staff member for more than a decade. The paper I wrote for the completion of my Master’s in Social Work (MSW) degree was entitled Traumatic Abuse in Cults, a paper I later amended, and to which I added the subtitle A Psychoanalytic Perspective. This paper was eventually published in the Cultic Studies Journal. But before this official publication, I had put the paper online, and that is how I became both a psychoanalytic psychotherapist, my original intention, and also a counselor of former members of cults, and of family and friends of cult-involved loved ones.
What assessment criteria should be considered to determine the appropriateness and feasibility of cult-related interventions?
I greatly admire the work of the cult-intervention specialists here today, and I am aware of how many people have benefited immeasurably from intervention. Nevertheless, when I am consulted by terrified and anxious parents or relatives, suggesting a cult intervention is not typically my first response. My basic approach is as follows:
Hear the whole story. I want to know all about how the son or husband or brother (or the female counterpart) got involved; what was going on before; what has happened since the involvement; what other professionals or written materials have they consulted before they decided to see me.
Assess the family. I want to know about this family, how it functions, what its strengths and weaknesses are; and I ask direct questions about these things. I want to learn what plans or ideas, if any, the family members have been contemplating; and I want to hear what any other professional they have consulted has advised. I want to get a sense of how psychologically aware, or not, they might be—and what they think may have contributed to their loved one’s recruitment. I want to see whether this family would be capable on their own to strengthen their relationship to the cultist: Do they need to backpedal, and even apologize, for attacking the choice the cultist has made? Do they need to respect the cultist’s wishes, and be willing to have a relationship on the cultist’s terms? What might be possible in terms of an approach that focuses on strengthening family ties, and working slowly and patiently toward gaining and keeping the trust of the cultist?
Suggest intervention if appropriate. At any point in this kind of work with family, but especially when the members seem desperate, I remind them that intervention with a specialist is also an option they can consider. In many cases, I have suggested that they speak to an interventionist and educate themselves about the process. If they choose to work with the interventionist, I support their decision. Sometimes they do make that choice—and when they don’t, it’s usually because they don’t want to risk being totally cut off by their loved one.
In one case, I was consulted by multiple members of a large family about one of the siblings. As we reviewed all the options, it became clear that there was urgency for various reasons: Their brothers’ wife and children would be abandoned, and their brother might be suffering from a psychotic disorder. I identified the strongest member of the group, the one with the best chance of reaching the brother, and I worked with her to assemble a team from within her family. I then coached that small team through various scenarios, and then they went to where their brother was and succeeded in bringing him home. All the coaching I did was via conference calls—I never met the family in person.
If I do an intervention, I do not practice or advise any kind of deception or coercion.
Assess whether the member is in danger. When the member is in danger of physical harm—sexual abuse, beatings, coerced felonies—or when the safety of children is involved, I will advise consultation with an interventionist and suggest that the family consider legal or police action or both. I consider these issues beyond the scope of my practice.
Assess whether the member is seriously ill, physically or mentally. If I suspect psychosis, and not simply ideological fervor, I speak openly about this to the family. If I feel that I would not be capable of leading the family in an intervention they themselves could stage, I refer them to an interventionist and suggest they work with that person to try to get the cultist to a psychiatric evaluation, or to cult rehab. If they succeed, on condition that the member complies with psychiatric recommendations, and the family is supportive, I may agree, if I am asked, to see this person for psychotherapy in my practice after she has completed cult rehab or has been appropriately medicated.
If the member is physically ill, I will work with the family member to advise the cult leader of the situation and appeal to the leader to remand the cultist to the care of her family. In my experience, cult leaders for the most part do not want to have sick people in the ranks, especially if there might be a threat of the cultist harming herself or others, or dying while in the group.
What criteria should be considered to determine the appropriateness of mental-health consultation and/or treatment?
In considering when it might be appropriate for an interventionist to refer to a mental-health professional, I would advise the following: In my personal opinion, anyone who exits a cult would benefit from psychotherapy; in many cases, the family members might benefit as well from their own therapy. Cult participation is traumatic to one degree or another. Psychotherapy explores the nature of trauma and allows the emotional release and narrative coherence that is a path to healing. I would like to see all interventionists routinely recommend psychotherapy to the families of cultists and to the cultists themselves.
 Unfortunately, a videotape of the conference is not available.
 Ford endorses Montgomery 1955 as a medium, encourages her to automatic write
 Ford endorses Moon 1965 during séance through spirit “Fletcher”
About the Authors
J. Paul Lennon, STL, MA, LPC, Board member, Regain Network (Religious Groups Awareness International Network). Mr. Lennon was a Legionary of Christ brother from 1961 to 1969 and an LC priest from 1969 to 1984. He served as a Diocesan priest from 1985 to 1989 and received an MA in Counseling from the Catholic University of America in 1989. For the past 10 years he has worked as a Child and Family Therapist in Arlington, Virginia. In 2008 he published a memoir, Our Father who art in bed, A Naive and Sentimental Dubliner in the Legion of Christ.
Joseph Szimhart began research into cultic influence in 1980, after ending his 2-year devotion to a New Age sect called Church Universal and Triumphant. He began to work professionally as an intervention specialist and exit counselor in 1986.
Since 1998 he has worked in the crisis department of a psychiatric emergency hospital in Pennsylvania. He continues to assist families with interventions and former members in recovery, including consultations via phone and Internet. As an artist he maintains a studio at Goggleworks Art Center in Reading, Pennsylvania. email: email@example.com
William Goldberg, MSW, LCSW, a therapist in private practice, has co-led a support group for former members with his wife, Lorna, for more than thirty years. He retired in 2008 from his position as Program Supervisor for Rehabilitative Services for the Rockland County (NY) Department of Mental Health. He is presently an Adjunct Instructor in the Social Work Department of Dominican College.
Daniel Shaw, LCSW, is a psychoanalyst in private practice in New York City and Nyack, New York; Faculty and Clinical Supervisor, The National Institute for the Psychotherapies (NIP), New York, New York; and former cochair, Continuing Education Committee, The International Association for Relational Psychoanalysis and Psychotherapy. Shaw spent 13 years as a staff member in Siddha Yoga (SYDA Foundation). There he wore many hats, including manager of the residential Manhattan facility, educator, spokesperson, public-relations coordinator, community organizer, and writer/director of public programs. Shaw exited Siddha Yoga in 1994, published an Open Letter about Siddha Yoga on the Internet in 1995, and helped create the Leaving Siddha Yoga website, one of the first Internet websites for former cult members. Shaw is the author of “Traumatic Abuse in Cults: A Psychoanalytic Perspective,” published in the Cultic Studies Journal, and of numerous psychoanalytic papers. Mr. Shaw leads the monthly New York-area ICSA group with Chris Carlson. This group offers support, education, and interaction for all those who have been harmed by, or want to learn about high-demand groups.