Ritual of Separation  An Integrative Guideline for Helping Clients from High-Intensity Faith Groups

Cultic Studies Review, Volume 8, Number 1, 2009, pages 16-42

Ritual of Separation:  An Integrative Guideline for Helping Clients from High-Intensity Faith Groups

Martin John Faulkner

Abstract

Do high-intensity faith groups attract persons prone to anxiety, stress, and depression as the result of presently unknown factors, and does the resulting thought reform and stress of membership exacerbate pre-existing conditions? Or do religious totalism and the nature of thought reform itself represent contributory factors to mental ill health in otherwise healthy persons who become attached to such groups? Either way, therapists who are working with clients from high-intensity faith groups must understand the insidious nature of thought reform and the phenomenon of religiosity as they facilitate change within the framework of: understanding coercion and cohesion in recruitment and maintenance; using an established diagnostic criteria for disorders of severe stress; engaging therapeutically with clients; creating conditions for change; cultivating mindfulness and right understanding; nurturing stabilization; processing and grieving; reconnecting and reintegrating.

Key Words: mental health, thought reform, thought control, group-think, high-intensity faith groups, anxiety, stress, depression, post traumatic stress disorder (PTSD), Buddhist psychology

“We read the world wrong and say that it deceives us”—Rabindranath Tagore, Stray Birds

This paper is the result of helping clients from high-intensity faith groups who were experiencing anxiety, stress, and depression; its title reflects the journey they undertook. It does not purport to be a manual for therapy, but rather a guideline for understanding concepts such as how therapists should consider religion as a means of social coercion, how to engage therapeutically with clients who are exhibiting PTSD, and how to create conditions for change. Although I address clients from high-intensity faith groups generally, I focus on the eschatological religion, Jehovah’s Witnesses, concerning which there are some valuable social studies (Botting, 1984; Penton, 1985).

There have been several studies concerning the psychological health of Jehovah’s Witnesses: Rylander (1946), Pescor (1949), Hoekema (1963), Janner (1963), Spencer (1975), and Montague (1977, 1992 - writing as Bergman). However, these studies have been criticized (Beckford, 1975; Penton, 1985; Religion-Staat-Gesellschaft, 2000). Spencer’s study claimed that Jehovah’s Witnesses were “over-represented” in admissions to mental-health services in Western Australia. Of the 7,546 admissions, 50 were active Jehovah’s Witnesses. Whereas, the percentage of those admitted compared to the annual rate per 1,000 of the general population was 2.54, amongst Jehovah’s Witnesses it was 4.17. Spencer’s conclusion was that the incidence of schizophrenia was about three times higher in the Jehovah’s Witnesses group as compared to the general population. Criticisms concerning the study’s limited provenance remain valid, although it is still used as a benchmark by those antagonistic to the Watchtower Society (e.g., the Christian Apologetics and Research Ministry, www.carm.org).

During a two-year period, I helped five ex-members from high-intensity faith groups; four of the ex-members were first generation, one was second generation, and all exhibited symptoms of PTSD. This work led me to ask the following questions:

1. Do high-intensity faith groups attract persons prone to anxiety, stress, and depression as the result of presently unknown factors?

2. Do thought reform and the stress of membership exacerbate pre-existing conditions?

3. Or, do religious totalism and thought reform itself represent contributory factors to mental ill health in otherwise healthy persons who become attached to such groups?

My interest comes from my own involvement with the Watchtower Society. I was recruited at age 13 in 1969; I left in 1983, and in 2000 I was hospitalized following a suspected heart attack, later diagnosed as prolonged duress stress disorder, a sub-branch of PTSD caused by prolonged pressures of coercion and chronic anxiety in an unforgiving milieu.

Qualifying Emphasis—Focus and Taxonomies

Therapists and researchers must understand the insidious nature of thought reform as they engage with clients from high-intensity faith groups. At the same time, they must note the notorious belligerency in published literature and on the Internet, which may be construed as having an evangelical agenda (e.g. Martin, 1982; Campbell, 1991; Bergman, 1992; Blue, 1993).

Therapists should also be aware of the value-laden words and terminologies such clients often articulate—words and terms that consist as they do of inclusive Orwellian language in the form of new-speak and double-think, with adjective and noun wielded into a single compound noun reminiscent of Soviet/Maoist group-language (Botting, 1984; Elliott, 1993). The legitimacy of the word cult is also problematical, although several studies have identified the psychological tactics associated with thought reform, or what Singer called a “coercive influence continuum” (Singer, 1995; see also Langone, 2005; Lalich and Tobias, 2006). These tactics include:

• Appeals to emotions

• Consistent compliance tactics to promote authority

• Control and destructive isolation from social support

• Denigration of individual self and critical thought

• Dissociative behavior to suppress doubt

• Use of threat and love

• Control-oriented guilt

• Confessions

• Promotion of dependency

• Totalitarian and elitist

Hassan (1988), following Singer’s and Lifton’s analyses, has also provided four main elements of thought reform known as the BITE model:

• Behavior control

• Information control

• Thought control

• Emotional control

DESNOS Diagnostic Criteria for Disorders of Traumatic Stress

Using DESNOS criteria[1] for diagnosing complex post-traumatic stress disorder (PTSD) also provides a sound foundation for good practice for therapists who work with persons damaged by previous religious affiliation. These criteria are especially helpful in the context of symptoms that may seem bizarre in terms of alterations in perception and consciousness and of psychosomatic factors resulting from eschatological religiosity with its agenda of psychological coercion. Alongside this scenario, the combination of Person-Centered Therapy (PCT)[2] and Pre-Therapy Contact Work’s (PTCW)[3] emphasis on entering the phenomenological world of the client guides therapists away from pathologizing clients.  This approach promotes instead human engagement with persons who may be locked in a process of grieving that often brings with it unknown factors regarding trauma and the management of intense emotions.

The DESNOS criteria for traumatic stress disorders include the following primary and secondary components:

I. Alteration in Regulation of Affect and Impulses

(A and one from B–F required):

A. Affect Regulation

B. Modulation of Anger

C. Self-Destructive

D. Suicidal Preoccupation

E. Difficulty Modulating Sexual Involvement

F. Excessive Risk-Taking

II. Alterations in Attention or Consciousness

(A or B required):

A. Amnesia

B. Transient Dissociative Episodes and Depersonalization

III. Alterations in Self-Perception

(Two of A–F required):

A. Ineffectiveness

B. Permanent Damage

C. Guilt and Responsibility

D. Shame

E. Nobody Can Understand

F. Minimizing

IV. Alterations in Relations with Others

(One of A–C required):

A. Inability to Trust

B. Revictimization

C. Victimizing Others

V. Somatization

(Two of A–E required):

A. Digestive System Symptoms

B. Chronic Pain

C. Cardiopulmonary Symptoms

D. Conversion Symptoms

E. Sexual Symptoms

VI. Alterations in Systems of Meaning

(A or B required):

A. Despair and Hopelessness

B. Loss of Previously Sustaining Beliefs (Luxenberg et al., 2001)

My five clients exhibited a high number of symptoms categorized in the DESNOS criteria. The degree of signature fit is interesting. I am aware that many clients experience PTSD, and not only those from high-intensity faith groups. But what interests me is how, because of the effect of Singer’s “coercive continuum,” my clients displayed a very high degree of the symptoms cited in all DESNOS criteria.

Philosophical, Theoretical, and Therapeutic Engagement

My engagement with clients is integrative: I practice PCT and PTCW as a psychotherapist and existentialist Buddhist philosophy as a practicing Buddhist. It may be argued that Buddhism is just another theistic religion, but many Buddhists would deny this because belief in a personal god is unnecessary (Watts, 1995; Harris, 2006). Existentialism has had a marked influence, first on PCT and later on PTCW. And although existentialism’s origins in the West are only comparatively recent, with Kierkegaard and Nietzsche, it shares strong features with millennia-old Buddhist psychology and its sophisticated descriptive phenomenology. In the Buddhist view, humankind is understood as having full responsibility for ethical behavior and the creation of meaning in a life that is impermanent.  Our imperative is change and renewal in defining the nature of our own existence (Batchelor, 1983, 1997; Appignanesi & Oscar, 2006). Often, PCTs theoretical concepts for psychological contact (e.g., the core conditions) link with basic Buddhist philosophical concepts:

• Compassion (karuṇā)

• Loving kindness (mettā)

• Altruistic joy in others or oneself (mudita)

• Equanimity to all (upekkhā)

There is also a similarity between the Cognitive Behavioral approach and the Buddhist conception of right-understanding (samādhi), or reality testing, originating in the Noble Eightfold Path concerning ethical conduct, reflective insight, and wisdom. 

Figure 1. Theory and Practice Linkage

PCT sees humans as striving for growth and actualization. The premise of PCT is that therapy should be nondirective, although this is problematical because the goal for the client is that of becoming a fully functioning person; and surely any goal has a directive meaning implied (Brazier, 1995). Gestalt therapy similarly holds that if we are psychologically healthy we pass through cycles of needs and actions with the object of satisfaction—a completed ‘gestalt’, similar to the Buddhist approach of our reacting to change, whether positively or negatively. Very often these cycles become blocked, which causes anxiety. Dis-ease (‘dukkha’—stressful states of mind in Buddhist thought), according to Gestalt, is seen as a growth disorder (PCT’s conception of a blocked actualizing tendency) that causes one to become ‘stuck’ in perceptive awareness, with behaviors such as incorporation of negative constructs, anger projection, implosion or internalized repression, and subsumation or conflict avoidance (Perls, 1973; Subhuti, 1985; Brazier, 2003) (see “Processing and Grieving” below).

Figure 2. The Noble Eightfold Path

Using PCT as a core model, I have found its philosophical principles receptive to Buddhist psychology and facilitative in working with clients from high-intensity faith groups. What has impressed me in my work is how Buddhist psychology’s tried and tested approach has enabled me to engage more fully with clients, especially concerning the concept of mindfulness, which has only recently been introduced into mindfulness-based cognitive therapy as well as schema-based therapy (Segal et al., 2002; Corrie, 2002). In Buddhist therapeutic practice, this mindfulness focus may involve the meditation practice of Metta Bhavana—the cultivation of loving kindness, which invokes unconditional loving kindness by bringing harmony to conflict. I have utilized Metta Bhavana especially with clients with chronic stress disorders (Ratnapani, 1992).

However, the key principle of PCT’s ‘core self,’ in its theory of personality as being inborn, innate, consistent, and irreducible, although fluid and changeable, is at the same time a specific entity (Rogers, 1959). In Buddhist psychology, "core self" does not exist. In Buddhism, there is no specific self (atta) or fixed personality; we are instead an ever-changing collection of skandhas, or mental constructs we form as we try to understand our relationship with the world (Rawson, 1991). However, what Buddhist psychology does share with PCT is that, whatever the nature of personality, it is acquired, learned, and modifiable. PCT would see this as the self-concept, an aggregate of experiential living that forms our conceptions, whereas Buddhism would view this aspect as the impermanent human organism’s holistic reaction to external events (Harvey, 1995).

We all possess patterns of behavior we employ to cope with stress. If negative, these patterns of behavior can themselves become dukkha, or a source of suffering. In this sense, mindfulness and right understanding are inextricably linked.  In my experience, working with clients in the midst of intense emotions—caught between desire and aversion, experiencing dukkha or existential pain and a wish to be healed yet also having a feeling of injustice—the employment of these principles has been appropriate.

I am impressed by two factors in the PCT approach:

• With emotional conditions being indicative of organismic valuing processes, these emotions thus effect motives for the actualizing tendency to function (Rogers, 1963).

• With optimum health being the absence of obstruction along with a functioning of every facet of experience, employment of the six core conditions is sufficient for therapy to take place and change to occur (Rogers, 1967).

PCT has evolved considerably with the development of process-directive and experiential methodologies, such as focus orientation, and PTCW’s accomplished work with contact-impaired, or deficient reality testing, clients has reversed the assumption that PCT was ineffective. (Prouty, 1994; Prouty et al., 2002; Clarke, 2005). With its origins in PCT and strong influences from phenomenology and existentialism, PTCW also inherits the ideal from PCT of equal psychological contact between therapist and client. This equal contact is problematical because there is always an inherent power-base divergence. Clients often see therapists as experts or professionals, and a therapist may involuntarily project such attitudes, something PTCW particularly addresses (Clarke, 2005).

Reality contact in PTCW with a client includes:

• Promoting understanding of existential awareness of events and of being within the world

• Promoting effective emotional contact and being in touch with emotions

• Promoting contact functioning through understandable language, which ensures effective psychological contact (Clarke, 2005)

Low-functioning clients include those with clinical depression, psychosis, autism, severe learning difficulties, and pre-expressive behaviors such as delusions, bizarre behavior, and emotional regression. I also would include persons who have undergone thought reform and thus are impaired in their reality testing, which in my experience has included symptoms of hallucinations, perceived demonic activity (chronic psychosomatic anxiety attacks), profound alienation, and severe inability to express emotions and function socially.

I am impressed by PTCW’s emphasis on the therapist entering the relational-phenomenological world of the client, no matter how bizarre, a world that otherwise might be interpreted as psychotic behavior. In my experience of clients who have undergone thought reform and are thus contact impaired, and who often also have undergone punitive alienation, I have observed their authentic growth and re-engagement with the world through PTCW experiential work. The process is a painful journey for clients undergoing therapy and experiencing reconnection from their disaffection. The key to understanding the importance of PTCW with such clients is not that they are psychotic, but that their symptoms reflect the results produced by such an all-consuming religiosity and the resulting PTSD—experiences that have caused them to read the world differently and thus become contact impaired.

In my own experience of what I previously perceived as demonic activity while I was a Jehovah’s Witness, I now know the events were actually incredibly violent anxiety attacks, during  which my limbs would convulse and I would display symptoms akin to epilepsy. This is also a common feature of delirium often seen in psychotic phenomena. When I sought therapy twenty years later, my therapist (I realize now) engaged in a dialogical rather than the classic PCT non-directive approach; in doing this, he was able to relate to my worldview although, at first, he could neither understand nor empathize with my prior experience (see Cooper, 2007).

In PTCW, the therapist:

• takes full responsibility in contacting clients

• validates clients’ experiences and values the importance of their apparent psychotic expressions

• regards hallucinations and delusions as meaningful and as tools for therapy

• acknowledges clients’ self-autonomy process toward meaningful experience

• compassionately contributes to clients’ healing process

• is accepting, nonjudgmental, and nondirective

• is interested, receptive, and respectful (Prouty et al., 2002)

Cultivating Mindfulness and Right Understanding

In Buddhist psychology there is another approach I undertake with clients which has been successful: the practice of mindfulness and right understanding. Mindfulness is a means by which an individual becomes aware of his or her thoughts in any given moment. It is the seventh aspect of the Noble Eightfold Path, which the Buddha said would lead to an understanding of ‘dukkha’, or suffering (Ratnapani et al., 1992; Keown, 2003). I use this approach in various forms, whether by guided visual work or, quite often, with the Buddhist practice of Metta Bhavana meditation, the practice of loving kindness. Central to Buddhist psychology is the idea that we cannot feel good about anyone or anything unless we begin to feel good about and aware of ourselves, of how and why we think and react as we do. The aim of the Metta Bhavana is to feel aware and, through applied effort, to gradually become integrated and less disposed to internal discord and more able to cultivate positive feelings (Ratnapani et al., 1992).

There is another aspect to the Noble Eightfold Path that I believe is equally good therapeutic practice with clients who have PTSD: the first aspect, or right understanding (Rewata Dhamma, 1997). Therapists can successfully incorporate this into therapy as a means to enable clients to begin to appreciate themselves and their experience, and to see that unique experience within a larger framework of being—that of re-engagement with the world, finding new relations with it, and letting go of painful experiences. Buddhist psychology essentially is concerned with our emotions, sensations, and cognitions and how these are the cause of suffering (Watson, 2001), in conjunction with our being attentive to how we respond to the inevitable suffering of life with compulsive patterns of behavior. These compulsive patterns take the form of an attachment to ego, which in Buddhist thought does not actually exist—only the illusion of it; ego attachment in turn results in aversion-dissonance, or the unsatisfactory nature of living (Prebish, 1993).

Understanding Coercion and Cohesion in Totalist Recruitment

Singer (1995) identified that on a coercive-influence continuum, high-intensity faith groups manipulate compliance by irrational characteristics that are demanding, perfectionist, over-generalizing, and conditional.

My clients who formerly were Jehovah’s Witnesses, whether they had left voluntarily (disassociated) or had been excommunicated (disfellowshipped) as ‘spiritually diseased’ (Holden, 2002), conveyed little in the sense of being empowered. Lalich (2004) introduced the concept of “bounded choice” to help us understand how persons in high-intensity faith groups make irrational choices that formerly seemed rational and consistent when those persons were in a meaningful relationship with their former faith group. The bounded choice concept is valuable for understanding these persons as previously having existed in a hermetic bubble.

Thus, communication between client and therapist may be complex. I stress this because the Watchtower Society uses exclusive group-language to separate itself from the world and to internally monitor potential dissent. We do not absorb knowledge per se, but we take it in through packages known as conceptual perceptions (De Bono, 1990), which thought-reform employs. And it is these perceptions that thought-reform unfreezes, changes, and refreezes (Hassan, 2000).

In Buddhist psychology, this coercive-influence continuum for self-relation is called rupa, or how we relate to the world through a distorted perception (Brazier, 2003). Thus, consonance is maintained however tortuously by theological gymnastics. In working with such clients with PTSD, therapists must be aware of the following elements of coercion, which will be writ large in the clients’ psychology of ego-attachment.

Appeals to Emotions

Appeals to the emotions are often negative, based upon the anxieties of the faith group which allow for an effective consensus in behavior. The Watchtower Society during recruitment emphasizes the "evils" of the world; indeed, the imagery in its publications is often violent, with promises of eternal life after Armageddon, which only Jehovah’s Witnesses will survive. This appeal to Weltschmerz, or world-weariness, is fostered even amongst children, who grow up with an imagination immersed in a rich imagery of destruction and informed that, if even they stumble, they will also die (Harrison, 1978).

Compliance to Promote Cohesion

This compliance promotes the authority of what is taught. What is taught is usually the Bible and the teachings, in primers, of the group’s founder.

Control and Isolation from Social Support

A proselyte’s point of gravity moves toward the faith group and is insidiously isolated from previous significant others as he or she adopts the "new personality" in group-speech and thought patterns. Until recently, Witness husbands and wives were forbidden to even speak to their disfellowshipped spouses except in extreme circumstances (The Watchtower, Sept. 15, 1981).

Denigration of Individual Self and Critical Thought

In adopting the new personality, individuals are subsumed under the coercive authority of the faith group. Individual thought is seen as harmful, exposing one to error and extermination at Armageddon. Independence may lead to punishment by marking within the group (isolation) or excommunication (demonization).

Dissociative Behavior to Suppress Doubt

In Orwell’s 1984, Winston, guilty of sex-crime with his lover Julia, is subjected to thought-reform and abreacts to Julia with violent dissociation. This response is also a signature with PTSD, in one’s being unable, as a consequence, to express independent thought other than that of the faith group; or, as with Winston, that of the Party of Big Brother. The act of disempowerment in effect operates in the form of fear inhibitors, such as the following, to psychologically coerce and dissociate the individual:

• thinking the unthinkable

• exposure

• punishment

• expulsion

Resistance to these inhibitors may cause clients to behave dissociatively by removing themselves from situations in which they might be compromised. In this agenda of anxiety and displacement of blame, individuals become aggressive toward others in seeking a scapegoat, similar to Freudian projection as a defense mechanism (Segal, 1990). Botting (1984) writes from his own experience as an ex-Jehovah’s Witness that their “cauldron of transformation and liberation” becomes “the crucible of repression from which they in turn must seek, through reflection and reaction, yet another truth.” This is a key point with clients who exhibit PTSD, for such a crucible of repression becomes a Freudian pleasure-principle similar to The Party in Orwell’s 1984.

Contingencies of coercion can be numbingly negative in terms of behavior reinforcement. Reinforcers tend to be evolutionary in origin, but in a hermetic faith group they are Pavlovian guiding principles for maintaining acceptable behavior with the aim of habit formation. Oppressive conditions of worth produce a self-idea only in accord with the expectations of the group (Lietar, 1984).

Uses of Threat and Love

The faith group uses threat and love punitively as an authority figure; and, according to De Beauvoir, like a father figure, threats and love become the sole transcendent means to communicate with the world (Owen, 1983). Love is abundant in compliancy, but threats are woven into the fabric of the love object. Rebelling against the group is apostasy, a feasting “on the table of demons” for “the new personality is gone” (The Watchtower, Jul. 1, 1994). Outside “you will have no protection,” and “there will be no place to go” (The Watchtower, Sept. 15, 1993).

Control through Reward and Threat

Control is maintained through threat (e.g., excommunication for disloyalty) and love (rewarded upon compliance to the faith-group’s strictures).

Confessions to Promote Homeostasis

Such confessions can be in the classical sense of one standing before a congregation and proclaiming one’s own sins. The guilt culture is cultivated and used to maintain the group’s social cohesiveness; in DESNOS terms, a guilt culture is a prime contributor to PTSD.

Promotion of Dependency

Dependency is achieved in conjunction with denying personal judgment and making oneself dependent upon the wisdom of the faith group.

Physical, Spiritual, and Emotional Purity

The faith community in promoting consensual validation effectively isolates it membership from contact with the outside world or ex-members by the promotion of ‘purity’. In this process miscreants are regarded as impure and deviant and any repressed anxieties caused by them are relieved upon their expulsion from the community.

Creating Conditions for Change

DESNOS criteria recommend that the recovery process be implemented in three phases:

• Stabilization

• Processing and grieving of traumatic memories

• Reconnection/reintegration with the world

Stabilization

Stabilization involves understanding four psycho-social characteristics (compare DESNOS criteria) that clients emerging from cognitive manipulation often present:

• emotional-psychological (anxiety, stress, depression, behavior disorders)

• physical (eating disorders, addictions)

• social (isolation, alienation, disaffection)

• spiritual (malaise, cynicism, increased religiosity)

Figure 3. The Cycle of Awareness (CSCT Professional Training, 1993)

These characteristics are often self-perpetuating—similar to a blocked gestalt. A healthy gestalt re-establishes equilibrium. Whereas, when it is blocked or destabilized, it isolates a person within what is often a self-perpetuating pilgrimage of pain that creates a tortuous logic of its own via conditional, debilitating mental formations (Brazier, 2003).

Breaking a Blocked Cycle of Awareness

In Buddhist terms breaking a blocked cycle of awareness is called the Skandha Cycle, wherein we react negatively to the world and our experience of it, and Buddhist thought proposes breaking from such a cycle by:

• Samudaya—Reacting positively to escape the cycle

• Nirodha—Harnessing energy to change

• Marga—Adopting the spiritual path of the Eightfold Noble Path

Figure 4. The Skandha Cycle (Brazier, 2003)

To understand life, we must encounter it in the here and now for what it is. The keys to begin this process in Buddhist psychology are:

• understanding the nature of mind

• understanding phenomenology

• understanding clarity and contamination

• understanding learned behavior and conditioning

This process is similar to the DESNOS process of “stabilization”; clients from high-intensity faith groups may often be swept along by a cycle of self-negating despair and become dependent upon their conditioned persona as the only form of “realness.” In Buddhist psychology, this is seen as “craving” for constructs that are illusory (Subhuti, 1985).

Emotional-Psychological

PTSD trauma can lead to a depressive shutdown as a defense strategy in an otherwise fight-flight situation. In my observation of this client group, suicide ideation is low because of religious taboo, although death ideation is not uncommon as individuals appraise life’s meaning. One major emotional difficulty will be an inability to trust, for the clients will have invested a great deal of their emotional being in the former faith group.

Cognitive difficulties may most likely be a denial that anything is wrong by over-diligence to maintain a rigid form of thinking through the adoption of “dysfunctional strategies” (Brazier, 2001). It will be difficult for clients to make any important decisions that may have a knock-on effect that exacerbates other symptoms—e.g., emotional shutdown, high-risk behaviors, and flashbacks (Ehlers and Clark, 1999; Rothschild, 2003). Night visions may also occur and be perceived as demonic activity; this is because in an REM hypnogogic theta brainwave state one awakes while the body is frozen, wherein dreams-nightmares-reality are melded; this state is similar to states in those who claim experiences of alien abduction.

Repetitive conditioned behavior may also present itself as clients seek something solid upon which to grasp as a point-focus, for they will now be living in the painful, existential present, not projected toward a future now denied. This condition is similar to the Buddhist rupa (see “Understanding Coercion and Cohesion in Totalist Recruitment” above), or how we distortedly relate to the world and thus give our ego-attachment a false impression of reality (Brazier, 2003).

Social

The period following expulsion may often be accompanied by withdrawal and communication difficulties, whereas previously a client’s personhood will have been expressed as the member of the faith group rather than as a person in his or her own right. Psychotherapy becomes a rite of passage from “possessionhood” to “personhood” and in itself a spiritual experience, which may also cause problems if psychotherapy becomes the new love-object.

When she was considering leaving the Watchtower Society, Harrison (1978) commented on her own experience, in which inaction seemed intolerable while action seemed impossible. In the former there was no honor; in the latter, only drowning in contradictions. Thus, it was safer to remain within what one despised than to leave and face spiritual and social extinction. Leaving and seeking therapy could also bring a reign of fire, for there are professional considerations regarding confidentiality for therapists. The Watchtower Society sees itself as transcending notions of professional relationships between physicians, patients, and administrative staff; each Jehovah’s Witness is required to report any suspected miscreant for disciplinary action (The Watchtower, Sept. 1, 1987; “A Time to Speak—When?” Aug. 15, 1997; “Pay Attention to Yourselves and to All the Flock,” 1991).

Spiritual

Leaving the former group may cause stress, depression, and other emotional-behavior problems. Another pitfall may be the lure of certainty in adopting another belief system too quickly for the client’s psychological well-being (see “Avoidance” below). However, clients' previously learned behavior will be challenged by alienation from the group as they come to live outside the orbit of the group’s strictures. Residual beliefs may also impede any form of therapy because the Watchtower Society sees psychotherapy as a tool of evil manipulation, and it uses the Bible to condemn psychotherapy as demonic (I Timothy 1:4).’

Physical

Psychological distress will naturally have an effect upon the physical being of a client. An eating disorder, for example, may take the form of binge eating to feel good, and then expulsion or vomiting in disgust or expiation. In this case, expiation is a religious office of release, or deliberately starving oneself ascetically is to punish or mortify—again, having fetishistic implications.

Processing and Grieving

Processing and grieving encompasses various possible behaviors, including incorporation, projection, implosion, and avoidance.

Incorporation

Clients from high-intensity faith groups can adopt a powerful mask in dealing with a disagreeable world, a mask that displays love but behind which is contempt (Reich, 1972). They may reapply this mask toward the former faith group upon their leaving, but it may also fall malevolently back upon them because they will have become so psychologically connected to that group through thought reform that they instead develop contempt for themselves.

Projection

If clients have been expelled from the group for a specified crime, this action may create dissonance and spiritual, emotional, and psychological confusion within them. With excommunication, they may project their anger toward former brethren, and even toward the therapist as a newly perceived authority figure. With both incorporation and projection, therefore, their grieving process may be traduced and subsumed by a self-negating cycle of internalized and externalized anger.

Implosion

Clients may develop internalized anger, repression, and self-harm; they may even never fully recover from expulsion and may remain angry (similar to a Freudian emasculated anger), with potential spiritual and emotional damage.

Avoidance

Clients may feel they have fully recovered, while in fact they are avoiding conflict, merging with the environment, shutting down, or suppressing anger. This false security may be hidden under a newly found certainty and attachment to another adopted belief system. The therapist also needs to consider how to support clients in their internal worlds as they reconsider their former beliefs. I cannot emphasize enough how important it is for a therapist to accept that a client’s avoidances, hallucinations, and delusions are meaningful experiences. It is equally important for the therapist to engage in these because they will be real experiences for the client, although they often might be disconcerting for the therapist; PTCW here is especially helpful.

Reconnection and Reintegration

From my experience working holistically with clients, I have found there will come a time when they will address their beliefs and begin to reappraise their life. This process can also take time because clients will be at pains to explain why they believed, in order to give validation to why they came to reject their beliefs. In Buddhist psychology, this reassessment of values (compare Ellis’ Rational Emotive-Behavior Therapy) is called “Breaking the Ant Hill,“ wherein one reconsiders positive and negative desires/aversions, and begins to reformulate a rationale by which it is comfortable to divest negative views.

In my work I have been able to discern the following areas of productive work with clients:

Exploring Choices

• What are the main areas of concern?

• Can former beliefs and attitudes be reappraised?

• What beliefs are good or not good for the client?

Attending to Unfinished Business

• What risks are there in leaving, and how may they be minimized?

• What are the benefits in leaving, and what may they be in the long term?

Challenging Confrontation from the Former Faith Group

• How will the client deal with pressure from the former faith group?

• How will the client deal with potential opposition from family/friends?

Networking for Support

• How can a support network be established?

• Is that network within the client’s personal, social, and economic means?

Using DESNOS Criteria and Combined PCT and PTCW Approaches

DESNOS criteria provide clear guidelines for identifying and delineating the characteristics of complex trauma as represented in PTSD; these criteria also give clear guidelines for a structured yet creative environment that requires stabilization, process, and reconnection. Such an environment encompasses the following aspects:

Clients

• Reduction in delirium and anxiety.

• Grounding and increased ability to engage in human relationships again other than those with the former faith group.

• Engagement in reality testing, and allowance for cognitive growth through reflexive, post-thought-reform thinking that is stimulating and empowering.

• Trust in the therapist as a respectful and empathic responder.

• Restoration of clients back to themselves to engage further.

• Clients being able to realize they have choices to fully function.

Psychotherapists

• Understanding the problems that clients who are exhibiting PTSD from high-intensity faith groups experience.

• Increased knowledge and skills base for dealing with delirium, hallucinations, anxiety, stress, and depression

• Ability to facilitate clients to make self-informed choices and engage in "personhood" rather than "possessionhood."

Conclusion

Therapists with no experience of clients from high-intensity faith groups may experience for the first time a truly challenging and ingenious system of defensiveness and irrationality in such clients. PCT and PTCW’s key concepts are invaluable in facilitating therapeutic practice, as is Buddhist psychology with its practical contribution regarding meditative mindfulness. DESNOS criteria and PCTW in particular provide an effective awareness model for facilitating clients who often bring along unknown factors related to trauma and management of intense experiences such as hallucinations, delusions, frozen terror, emotional regression, bizarre physical behavior, fragmented or jumbled verbalizations, isolation, and withdrawn behavior. Therapists should also be wary of pathologizing clients, wanting to ‘fix’ problems, and being rigorously attached to theoretical dogmatism. Rather, they should  fully engage in psychological-dialogical contact by attempting to understand each client’s perception of the therapist, which should be central to good therapeutic practice. As therapists, we ought to challenge ourselves and bring ourselves back into the corporeal world of our own inhabitance. Doing this is especially important in facilitating clients who are spiritually bereaved and find themselves thrust into a world that is alien and frightening.

Some ex-members might say, like Thackeray in his novel Vanity Fair (1848), "the play is played out."  This perception however is nonsense, for it is clear that those leaving cultic groups are far from finished with psychological self-examination.  Indeed, departure from a cult provides them with an opportunity to begin substantial self-examination that originates within themselves and not in some external, imposed ideological structure.

References

Appignanesi, R., and Oscar, Z. (2006). Introducing Existentialism. Cambridge, England: Icon Books Ltd.

Batchelor, S. (1983). Alone with others: An existential approach to Buddhism. New York: Grove Press.

Batchelor, S. (1997). Buddhism without beliefs: A contemporary guide to awakening. New York: Riverhead Books.

Beckford, J. (1975). Organization, ideology and recruitment, Sociological Review, 23, 897.

Beckford, J. (1976). The trumpet of prophecy: A sociological study of Jehovah’s Witnesses. Oxford: Basil Blackwell.

Bergman, J. (1976). The evaluation of an experimental program designed to reduce recidivism among second felony offenders. Unpublished doctoral dissertation, Wayne State University, Detroit, MI.

Bergman, J. (1992). Jehovah’s Witnesses and the problem of mental illness. Clayton, CA: Witness Inc.

Blue, K. (1993). Healing spiritual abuse. Downers Grove, Illinois: Intervarsity Press.

Botting, G. (1984). The Orwellian world of Jehovah’s Witnesses. Canada: University of Toronto Press.

Brazier, D. (1995). Zen therapy: A Buddhist approach to psychotherapy. London: Constable and Robinson.

Brazier, D. (2001). The feeling Buddha: An introduction to Buddhism. London: Constable and Robinson.

Brazier, C. (2003). Buddhist psychology: Liberate your mind, embrace life. London: Constable and Robinson.

Campbell, J. (1991). Manual for counselling Jehovah’s Witnesses. England: J. Ritchie Ltd.

Clarke, C. (2005). Prouty's ‘Contact Work.’ Mental Health Practice, 9(24), 24–27.

Clarke, C. (2005). Pre-Therapy: Theory and practice of psychological contact. Accessed 15 Oct. 2008 online at www.psychological-wellbeing.co.uk

Cooper, M. (2007). Person-Centred Therapy: The growing edge. Therapy Today, 18(6), pp. 33-36.

Corrie, S. (2002). The role of the therapeutic relationship in promoting psychological change: A cognitive-behavioural perspective. Counselling Psychology Review, (19)1, 23–31.

CSCT Professional Training (1993). Student Course Guide 0901 (Rev.) London.

De Bono, E. (1990). I am right, you are wrong. London: Viking.

Ehlers, A., & Clark, D. (2001). A cognitive model of posttraumatic stress disorder. Behaviour Research and Therapy, Vol. 39, Issue 4, April 2001, pp. 373-393

Elliott, J. Language and identity at the Kingdom Hall: The discursive strategies of the Watchtower Society. Accessed 14 Nov. 2008 online at http://www.unc.edu/~elliott/langid.html

Harrison, B. (1978). Visions of glory: A history and memory of Jehovah’s Witnesses. New York: Simon and Shuster.

Harvey, P. (1995). The selfless mind. London: Curzon Press.

Harris, S. Killing the Buddha. In Shambhala sun: Buddhism, culture, meditation life. Halifax, Nova Scotia, Canada.

Hassan, S. (1988) Combatting cult mind control. Rochester, Vermont: Park Street Press.

Hassan, S. (2000). Releasing the bonds: Empowering people to think for themselves. Somerville, Massachusetts: Freedom of Mind Press.

Hoekema, A. (1963), The four major cults. Grand Rapids: Paternoster Eerdmans.

Holden, A. (2002), Jehovah’s Witnesses: Portrait of a contemporary religious movement. London: Routledge.

Holden, A. (2002). Cavorting with the devil: Jehovah’s Witnesses who abandon their faith. Department of Religious Studies, University of Lancaster, England, accessed Jan. 4, 2008 online at  http://www.watchtowerinformationservice,org/index

Janner, J. (1963). “Die Forensisch-Psychiatrishe Und Sanitatsdiensatilche Beurteilung bon Diestrweigern,” Schweitz Med. Wschr. Vol. 92, pp. 89–826.

Keown, D. (2003) Dictionary of Buddhism. Maryland: Scarecrow Press.

Lalich, J. (2004). Bounded choice: True believers and charismatic cults. Berkeley, California: University of California Press.

Lalich, J., & Tobias, M. (2006). Take back your life: Recovering from cults and abusive relationships. Berkeley, California: Bay Tree Publishing. This study uses guidelines originally formulated by M. Langone, available online at http://www.icsahome.com/infoserv_articles/langone_michael_checklis.htm

Langone, M. (1995) Recovery from cults: Help for victims of psychological and spiritual abuse. New York: Norton. Also “Questionnaire Study: Preliminary Report,” 1991. International Cultic Studies Association.

Langone, M. Cult awareness groups and NRM scholars: Toward depolarization of key issues. Cultic Studies Review, 4(2), 2005, 146–168.

Lietar, G. (1984). Unconditional positive regard: A controversial basic attitude in client-centered therapy. In R. F. Levant, J. M. Schlien (Eds.), Client Centred Therapy and the person centred approach. New York: Praeger Publishers

Lifton, R. (1967). Thought reform and the psychology of totalism. New York: Norton.

Luxenberg, T., Spinazzola, J., Bessel, A., & Van der Kolk, B. (2001). Complex trauma and disorders of extreme stress (DESNOS) diagnosis, part one: Assessment. Directions in Psychiatry,  21, 373–414.

Martin, W. (1982). The kingdom of the cults. Minneapolis, MN: Bethany House.

Montague, H. (1977). The pessimistic sect’s influence on the mental health of its members: The case of Jehovah's Witnesses. Social Compass, 24, 135–147.

Owen, U. (1983). Fathers: Reflections by daughters. London: Virago Press.

Paritta. The Book of protection. (Transcribed from the print edition in 1999 by Dana Murty and Dr. Gabriel Jivasattha Bittar. Copyright, 1999, Buddhist Publication Society.) Available online at http://www.accesstoinsight.org/lib/authors/piyadassi /protection.html

Penton, M. (1985). Apocalypse delayed. Toronto: University of Toronto Press.

Perls, F. (1973). The Gestalt approach and eyewitness to therapy. Palo Alto, California: Science and Behavior Books.

Pescor, M. J. (1949). A study of selective service law violators. American Journal of Psychiatry, 105, 652–691.

Prebish, C. (1993). The historical dictionary of Buddhism. Oxford University Press.

Prouty, G. F. (1994). Theoretical evolutions. In Person-centred/experiential therapy: Applications to schizophrenic and retarded psychoses. Westport, Connecticut: Praeger-Greenwood.

Prouty, G. F., Van Werde, D., and Pörtner, M. (2002). Pre-therapy: Reaching contact-impaired clients. Ross-on-Wye, England: PCCS Books.

Ratnapani, Abhaya; Vidyasri, Dhammadinna; Pauling, Nagabodhi; & Lokamitra. (1992). Metta: The practice of loving kindness. Birmingham, England: Windhorse Publications.

Rawson, P. Sacred Tibet. London: Thames and Hudson.

Reich, W. (1972). Character analysis (3rd ed., first pub. 1945). New York: Simon and Schuster/Touchtone Book.

Religion-Staat-Gesellschaft (Religion, state, society), Vol. 1 (2000), No. 1, 41–59. Universität Leipzig, Religionswissenschaftliches Institut, Germany.

Rewata Dhamma. (1997). The first discourse of the Buddha. Somerville, Massachusetts: Wisdom Publications.

Rogers, C. (1959). A theory of therapy, personality and interpersonal relationships as developed in the client-centered framework. In S. Koch (Ed.), Psychology: A study of a science, Vol. 3:Formations of the person and the social context. New York: McGraw Hill.

Rogers, C. (1961). On becoming a person. Boston: Houghton Mifflin.

Rogers, C. (1963). The actualizing tendency in relation to “motives” and to consciousness. In M. R. Jones (Ed.), Nebraska symposium on motivation, 11 (pp. 1–24). Nebraska: University of Nebraska Press.

Rogers, C. (1966). The necessary and sufficient conditions of therapeutic change. In Bard (Ed.), Counseling and psychotherapy: Classic theories on issues (pp. 126–141). Palo Alto, California: Science and Behavior Books.

Rothschild, B. (2003). Out of flashback, into the here and now: Somatic trauma therapy, cognitive behavioral therapy. In The body remembers: The psychophysiology of trauma and trauma treatments. New York and London: Norton.

Rylander, G. (1946). Jehovah’s Vittnam-En Psykologisk-Sociologisk Studie (Jehovah’s Witnesses: A psychological-sociological study). Nordisk Medicin, 29, 523–533.

Segal, Z., Williams, J., & Teasdale, J. (2002). Mindfulness-based cognitive therapy for depression. New York: Guilford Press.

Singer, M. (1995). Cults In our midst. San Francisco: Jossey-Bass Publishers.

Smail, D. (2001). The nature of unhappiness. London: Robinson.

Spencer, J. (1975). Mental health and Jehovah’s Witnesses. British Journal of Psychiatry, 126, 556-559. 

Subhuti, Dharmachari. (1985). The Buddhist vision: An introduction to the theory and practice. London: Rider.

Tagore, R. (1916). Stray birds. New York: McMillan Company.

Thackeray, W. M. (1848). Vanity fair – A novel without a hero. Heron Books, London (undated).

The Watchtower, Sept. 15, 1981.

The Watchtower, Sept. 1, 1987.

The Watchtower, Sept. 15, 1993.

The Watchtower, Jul. 1, 1994.

The Watchtower, Aug. 15, 1997.

The Watchtower Bible and Tract Society. (1991). Pay Attention to Yourselves and to All the Flock. New York.

Watson, G. Buddhism meets Western science. Dharmanet International, accessed online 8 May 2007 at http://www.dharmanet.org/lcscience.htm

Watts, A. (1995, posthumous). Buddhism: The Religion of No Religion. Boston, Massachusetts: Tuttle Pub.

Wyatt, G., & Sanders, P. (2002). Contact and Perception, Vol. 4. Manchester, England: PCCS Books.

About the Author

Martin Faulkner is a counselor, trainer, and lecturer. He graduated with a BA Hons in Theology and Religious Studies from the University of Manchester, England,  in 1993, majoring in Christian Ethics and New Testament Studies. He gained his post-graduate teaching qualifications from the University of Bolton and is completing an MSc in Counselling Studies at the University of Salford researching mental health concerns in recruitment by high-intensity faith groups.  (Martin.Faulkner@hopwood.ac.uk)

Cultic Studies Review, Vol. 8, No. 1, 2009, Page

[1] DESNOS criteria—complex trauma or “disorders of extreme stress not otherwise specified” (Luxenberg et al., 2001)

[2] Person-Centered Therapy (PCT) emphasizes a nondirective approach as well as engagement with clients in the ‘here and now’ using six core conditions for effective therapy to take place (Rogers, 1961)

[3]Pre-Therapy Contact Work (PTCW) emphasizes the importance of therapists entering the phenomenological world of the client. This model is aimed mostly at clients who have learning difficulties or pre-psychotic behaviorisms wherein existential conceptions and language usage are problematical between client and therapist (Prouty, 1994; Prouty et al., 2002)